Framework for the implementation of a patient electronic referral system: case study of Nairobi province.

The aim of the research was to develop a framework for the implementation of a patient e-referral system. An initial observation showed that hospitals are run as single entities with no information to linkamong them resulting to discontinuity in care delivery thereby leading to very inefficient patient care because of lack of care continuity and high costs in care delivery. Literature in strategic role of  ICTs in health care citing the current and emerging technologies in electronic health care delivery is reviewed. It shows that the challenges of cost and quality care can be overcome if the services were delivered electronically. The key challenges to electronic health care delivery include standards, privacy, trust, security, costs and lack of ICT skills. Data was collected using questionnaires. A response rate of63% with a total of 228 out of 360 respondents in health facilities in Nairobi province was a considerable response rate to substantiate the findings of the survey. Various models were also reviewed and compared. Key findings to do with data collected showed that majority of public health institutions have not embraced use of ICT tools for handling patient health data. Application programs found  to be used in Kenyan health facilities include the following; Ms-access, Ms-Excel, Ms-word, FTP, GIS, health CIS, Care2000-  ERP, and e-  Hospital. However most of the software reported were available only in private health institutions where the software are used mainly for financial and administrative activities but not for improving health care delivery. To address these challenges, the researcher has proposed a patient e-Referral framework to improve the integration of primary care and specialty care through a common interface. The proposed framework provides a starting point for further work in solving the problem  of inefficient referral system.