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Purpose of this document This document provides guidance for EMR system developers and implementers, as well as health facilities in Kenya that are contemplating or currently using EMR systems to manage patient data. These guidelines are based on various local and international reference documents, including: · WHO and Kenyan HIV treatment guidelines · The Kenya HIS strategic plan and policy · International and Kenyan health informatics standards, including those from the International Organization for Standardization (ISO) · Experience from MOH and partners using EMRs in Kenya · Experience from groups using EMRs in other countries · Published medical and public health literature Audience This document is intended for the following audiences: · Developers of EMR systems for the Kenyan market · Health facilities or health systems currently using EMR systems · Health facilities or health systems considering procuring, adapting, or installing an EMR system, including public, private, mission, and NGO-supported facilities · Health policy makers at all levels · Donors providing resources to support the Kenyan health system Structure of the Standards and Guidelines Document This Standards and Guidelines for Electronic Medical Record Systems in Kenya document is divided into 3 sections that provide requirements and offer guidance to discrete target audiences throughout the process of EMR systems development, deployment and implementation. The content in each volume is tailored to the understanding and implementation roles of the identified target audiences. Section 1: Building an Electronic Medical Record System – This section outlines the prerequisite processes of EMR system development and identifies basic functional requirements for Standards and Guidelines for Electronic Medical Records Systems in Kenya 9
EMR systems in Kenya, as well as the EMR software attributes needed to ensure quality patient data and secure systems. This section is mainly targeted at EMR developers. Section 2: EMR System Interoperability – This section describes how EMR systems interact with other systems within the HIS eHealth architecture. The section provides profiles for interoperability and draws on cases studies to demonstrate potential applications. Section 3: Implementing an EMR System – This section outlines the conditions that must be met in order to create an environment for successful EMR system implementation. The section primarily targets program managers in EMR implementing agencies and provides guidance throughout the implementation process. Throughout the 3 sections, this document defines requirements to describe both the functions and the information interactions and exchanges of EMR systems and offers implementations guidance as to how those requirements can be met. Specific guidance draws on standards, best practices, and previous experience, as relevant. Scope and Evolution Both the EMR requirements and EMR recommendations should be viewed as evolving guidelines. In some cases, these guidelines may become more specific as to the necessity and feasibility of a particular set of practices demonstrated over time and across the country. In other cases, the guidelines may change due to rapidly evolving technologies and capabilities. In either case, the process to identify and agree upon the EMR requirements and recommendations presented in this document is more important than the guidelines contained in this initial version. The Government of Kenya, with the support and technical assistance of the international community, should reevaluate, refine, and extend this guidance as the healthcare system, the maturity of information systems, and available technology within the country evolve over time. Policies and International Standards The implementation of electronic health systems in the entire health setting is a complex process. The widespread adoption of these systems across the health sector (clinical, pharmaceutical, laboratory) has highlighted the need to develop standards governing system functions and the promotion of information sharing between systems. Standards and Guidelines for Electronic Medical Records Systems in Kenya 10
Page 1 and 2: Ministry of Medical Services Minist
Page 4 and 5: Acknowledgements This initial publi
Page 6 and 7: Change Management Process .........
Page 8 and 9: Architecture Enterprise Architectur
Page 10 and 11: and without the ability to share pa
Page 14 and 15: Globally, several organizations hav
Page 16 and 17: will be reviewed by the technical w
Page 18 and 19: Section Introduction The section de
Page 20 and 21: The above listed documentation requ
Page 22 and 23: Clinical Decision Support This refe
Page 24 and 25: H = Requirements. These items tare
Page 26 and 27: 4.3. System has the capability to r
Page 28 and 29: 10.2. System has the capability of
Page 30 and 31: 16. Children’s Health 16.1. Syste
Page 32 and 33: The recommendations in this section
Page 34 and 35: Backup Backup is the procedure for
Page 36 and 37: Case Example: Building an EMR syste
Page 38 and 39: o Date medically eligible to start
Page 40 and 41: o Height o Blood pressure o BMI Whe
Page 42 and 43: · Form 711 - Cross-sectional quart
Page 44 and 45: Section Introduction Within the hea
Page 46 and 47: Data Transmission Protocols There a
Page 48 and 49: i. EMR systems ii. Patient Identifi
Page 50 and 51: Summary Primary Actor Secondary Act
Page 52 and 53: Use Case Title Summary Primary Acto
Page 54 and 55: Business Rules Pre-condition(s) Cor
Page 56 and 57: Section Introduction The implementa
Page 58 and 59: Requirements 1. Servers and worksta
Page 60 and 61: informatics skills in order to effe
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competencies will be of greater use
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esponsible for utilizing the inform
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expertise, this cadre is also likel
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Data Quality and Confidentiality Id
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Demonstrate use of mouse functions
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Health facility management plays a
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A locally stored backup log should
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· User related issues could also b
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Upgrade Scheduling The EMR system n
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Monitoring is an ongoing, continuou
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down these alerts on a notification
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Hardware requirements Other infrast
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System Costs, Ownership and Sustain
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their health records upon request o
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A. Sample EMR Implementation Plan E
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deployment of the EMR (i.e. change
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C. EMR Readiness Assessment Checkli
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Is there a computer at each point o
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D. Security Policy Template Documen
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1.9 Employees shall not access, sto
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E. Information Asset Inventory Name
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G. Sample Service Level Agreement T
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• Determine appropriate incident
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H. Sample EMR Monitoring and Evalua
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Strongly agree Agree Disagree Stron
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Functional areas Attributes Compone
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Functional areas Attributes Compone
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