Establishing standard coding for medicine in Kenya
The ICT and Data exchange sub committee had an engagement with Prof. Francis Ndemo of University of Nairobi (UoN) and Pharmacy and Poisons Board (PPB), on 4th April 2019, at Kenya Healthcare Federation (KHF) offices, to discuss and understand the development of standard codes for medicines. In his opening remarks, Prof. Ndemo informed the meeting that the Ministry of Health is interested in monitoring usage of drugs in the country through a track and trace solution from point of entry to patient.
In addition, Prof. Ndemo indicated that Medication Therapy Management (MTM) is a needed process in optimizing benefits of medicines. MTM ensures that drugs prescribed are the most appropriate, most effective, are safe and that the patient is compliant. “This can only be done when one has the proper documentation. The good thing is that there is a collaborative effort between the physicians and the pharmacist and this has improved clinical and economic outcomes” he added. Prof Ndemo emphasized that the uniform coding is key. “We should try and learn from the American coding system which has proven to reduce errors.” Prof Ndemo. The data exchange committee shall continuously engage Prof. Ndemo and other players inorder to come up with a standard medical classification position.
The ICT and Mobile health committee takes lead in establishing healthcare coding systems
The ICT Committee held it’s first quarterly meeting at Kenya Healthcare Federation offices (KHF) on 24th January 2019 to outline the focus areas for 2019. The meeting was chaired by Dr. Torooti Mwirigi (Carepay Limited). The focus areas outlined included: data exchange, data regulation and governance, active participation in the Health Act 2017 technical working groups (TWGs) and Universal Health Coverage (UHC) committees at the Ministry of Health (MOH), and, partnerships. Mr. Joel Lehman (Infospective) updated the group that at the last Ministerial Stakeholder Forum (MSF) it was agreed that standardization of coding of persons, facilities, practitioners, procedures and diagnoses was a priority in the health sector. The Pharmacy and Poisons Board (PPB), with the help of consultant Prof. Francis Ndemo of the University of Nairobi and chair of PPB Practice Committee will take a lead in introducing standard codes for pharmaceuticals. The recommendation of Pharmaeutical Society of Kenya (PSK) and KHF, is to use the globally used ATC codes with a suffix unique to the specific brand registered in Kenya. The Kenya Medical Practitioners and Dentists Board (KMPDB) will take the lead in adoption of standard codes for procedures and diagnoses.
The data – exchange sub-committee was mandated to structure a framework for a data exchange. The sub-committee agreed that key considerations for this framework include standard codes e.g. ICD10, ACT, CPT, RADLEX etc., health information exchange standards e.g. HL7, clinical pathways and formularies. To achieve this, stakeholder mapping is necessary to pick up on best practice. Establishment of a good relationship between the subcommittee and the Nursing Council of Kenya, the Kenya Medical Laboratory and Technician Board and, the Kenya Medical Practitioners and Dentist Board is also necessary to give an opportunity for supporting these boards on the best coding systems considering global best practices.
After the framework is created it will be floated to KHF member for endorsement, a milestone to be achieved by mid-2019. Similarly, ICT and mobile health committee will make policy proposals on data governance and regulation and present to KHF membership for endorsement. KHF will advocate the adoption of these policy proposals by government.
Kenya Healthcare Federation(KHF) contrives on enhancing the eHealth Policy
The ICT and mobile health committee held it’s quarterly meeting on 9th October 2018 at KHF Board Room to discuss the ministry of health(MoH) eHealth policy document being discussed as the key agenda.On eHealth policy, document that is being reviewed by the committee. From the document, the issues of data exchange is addressed mainly under “health infrastructure” and not under “health information,” the Policy does not specify or make a proposition about which of the 10 different ‘orientations’ of the eHealth policy is most relevant to the private sector, and where the industry is expected/invited to be involved and provide support, Kenya Health Architecture; It is not quite clear who the target users of the document are, with regards to the private sector, a challenge in the private sector is the issue that emerging technology often remains unregulated (e.g. MyDawa experience).
The Health Information Interagency Committee (ICC) is the highest committee in charge of coordinating health information related issues at the Ministry of Health and involving partners. For private sector players (health service providers, medical insurance providers, IT providers and others), more specific and strict regulation “with teeth” may be required. The policy documents presented appear relatively vague and high-level, and as such do not provide clear guidance or binding rules for the private sector, The engagement of the government with the private sector (with regards to health information and data exchange) should be more systematic; communication with individual companies – who do not have a mandate to share information with others – or with the top-level leadership of KHF alone may not lead to the desired outcome of a broad-level dissemination of messages and a two-way communication with broad representation from the various private health sub-sectors.
There is an interest of private sector players to participate/provide input in the development of indicators in the national health information systems, so that issues that affect the private sector more can also be captured and reported. The current practice appears to be that indicators for the national health information system are discussed by the government and international partners without involvement of private sector.
The committee is also reviewing two documents namely: Standards and guidelines for mHEALTH, the WHO classification of digital health systems (2018) and the standards and guidelines for Electronic Medical Record Systems in Kenya (2010).The committee has also formed a PPP subcommittee who held their first meeting on 6th September 2018 at HUAWEI Technologies to outline PPP issues within ICT health sector. This subcommittee has also met Mr. Anthony Okoth, Chair of KHF’s main PPP committee to align the KHF’s PPP agenda for onward presentation to Ministerial Stakeholder Forum and Presidential Round Table.