The healthcare sector is embracing a new era where data sharing is the linchpin in reshaping the very essence of healthcare delivery. 2023 heralded a watershed moment with the introduction of the Digital Health Act, illuminating the path toward an interconnected, data-driven healthcare ecosystem. This pivotal legislation signals a profound shift in how healthcare is administered and underscores the transformative power of data in shaping the future of medicine.
Data sharing in the healthcare sector in Kenya faces quite a few challenges and barriers. Some of these include a fragmented healthcare system with public and private healthcare providers operating independently; lack of interoperability with facilities often using different electronic health record (EHR) systems and data formats, data privacy and security concerns, a limited healthcare IT infrastructure, regulatory and legal challenges to data quality and standardisation.
Estonia, tiny yet mighty, is not just known for its digital inspiration, but also for its advanced approach to digital economy and infrastructure. A delegation that consisted of some of the top e-health companies such as Asper Biogene, SpeakTX, Cognuse, DocuMental, Nortal, Triumf Research, and Better Medicine are at the forefront of tackling healthcare challenges, from mental health to cancer care.
Meanwhile, in Kenya, the digital health landscape is evolving rapidly, driven by factors such as the ease of doing business and the accelerated adoption of digital health technologies during the pandemic. The country has made significant strides in digitising healthcare records, apps, and telemedicine services. The government’s commitment to digitisation, coupled with public-private partnerships, is helping bridge the healthcare gap.
Kassim Were, Head of Trade KNCC&I said that the private sector and government needed a dual bridge building to enhance digital healthcare. “We are doing quite well in terms of e-health services. You can now have drugs delivered to your doorstep. Our challenge is the availability of drugs. I we can work on simplifying access, we can hope for an integrated health system,” he said, adding that when it comes to Estonia, we can “Take some of their tech lessons seriously.”
The Digital Health Act addresses critical provisions to increase accessibility and privacy within the healthcare system. It establishes a health committee responsible for policymaking in the government sector. This act recognizes the essential role of both the private sector and government in building a dual bridge towards a more integrated health system. The Act paves way for the adoption of advanced technologies such as artificial intelligence (AI) and machine learning (ML) to streamline manual processes in healthcare, ensuring efficiency and quality in healthcare delivery.
To ensure the successful implementation of digital health initiatives, education and innovation are crucial. Kenya has integrated ICT education into its curricula, ensuring a high availability of digital health talent. Moreover, healthcare associations and institutions have created innovation-friendly environments where technology-driven solutions can thrive.
Privacy and data protection are paramount in the digital health landscape. The Digital Health Act emphasizes privacy and quality as pillars of digital healthcare. Companies like MyDawa have set guidelines for e-pharmacies and worked closely with the government to ensure compliance and combat issues like counterfeit medications. Patients have more rights over their data, which has shifted the data ownership balance in favour of patients.
The act also addresses the standardisation of data, an essential element in the interoperability of healthcare systems. It encourages collaboration among various healthcare players, recognising that no single entity can provide all-encompassing solutions. This collaborative approach fosters an ecosystem where different stakeholders can coexist and contribute to the growth of digital healthcare.
Harrison Muiru, Smart Applications Group, Group Managing Director lauded Estonia for their 99 per cent digital health penetration while admitting Kenya did not have that far to go. “124 per cent of Kenyans have access to mobile phones. It means we have more phones than people, providing a platform from which digital healthcare can be accessed.” With 47.6 million internet connections comes a high penetration of internet connectivity and the opportunity for actors to capitalise on it.
With the president signing off on the Digital Health Act on 19 October, the government has recognised the role of digital health actors as significant players. On 19 Oct Ruto signed the digital health care bill into an act, recognising the role of digital health care as playing a big role. This, said Muiru, “Is the kind of conversation that is on the backbone of the superhighway, establishing guidelines for digital health players who want to deliver services and move forward collaboratively” especially where both national and county healthcare ecosystems are at stake.
As the Director of Africa Afya Health Care, Ken Njeru pointed out while working with the government may be challenging, “And there is a lot of scepticism in the private sector when it comes to working with them,” they, an investment company doing M&As of hospitals and added IT solutions in the healthcare centre also acknowledged “It’s all about not leaving anyone behind in the theme of digital strategy. Many healthcare facilities are fully digitised or partly digitised to some commendable level. Take the example of Daktari Smart Telemedicine by Gertrude’s Children’s Hospital.”
The experts all agreed that not only does Kenya need a lot more penetration of telehealth, but we are also merely on the cusp and the Act will be a guiding light. Patients tend to prefer face-to-face consultations. With this mindset, digital trust will need to be redefined and designed. Take the example of Kenyatta National Hospital where patients wield their medical files as they move from doctor to doctor, something that can be eliminated with the digitisation and sharing of data. This would eliminate time wastage and improve efficiency.
Working with the government has its advantages as well. Maeve Rafferty, Project Manager, MyDawa gives the government its accolades as well, stating “We were the first and only e-pharmacy for years and together with the government, we set up guidelines for e-pharmacies to operate in the Kenya space. The government also leads in the regulation space that allows technology to work. We found them accommodating but tough. I think it is because they desire to see the right application of the technologies. There is always a reason behind the difficulty. It’ll take time, but at the end of the day, there is a reason why we are taking this much time.” While the law is critical, it is also important to look at data in the right contexts and with nuance.
As it is, the private sector could also easily provide the government with much-needed data and help answer the question ‘Where is our data going and how do we protect the citizens’ information?’ Furthermore, the Act converges with the provided infrastructure, all serving to facilitate collaboration in a way that was not possible before the emergence of the Act. It governs data in a multifaceted way while simultaneously installing mechanisms to safeguard sensitive personal information.
It is worth noting that the legal framework allowing the exchange of information may not have been comprehensively crafted before the Act, but that does not mean information sharing was not happening in the past. It did, between hospitals and insurance for instance. Of course, the legislation could stand a little more refinement by drawing inspiration from other countries on how to protect individual rights, facilitating data-driven research and working at fostering trust in the healthcare system. Forward-looking legislation is, in that regard, as inevitable as a framework that benefits the health industry.