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• Laboratory Services: Hematology, biochemistry, microbiology, and pathology.
• Radiology Services: X-ray, Ultrasound.
• Pharmacy Services: Dispensing medications for inpatients and outpatients.
• Emergency Services: 24/7 emergency and casualty department.
• Community Health Programs: Outreach programs focused on vaccinations, family planning, and chronic disease management.

Number of Customers Served: Kisumu Community Hospital serves approximately 5,000 unique outpatients per month and manages an average of 300 inpatient admissions per month. This translates to roughly 60,000 outpatient visits and 3,600 inpatient admissions annually. Our catchment area covers a significant portion of Kisumu and surrounding sub-counties.

Issues and Needs for Upgrading HCIS

Kisumu Community Hospital currently operates on a fragmented and largely paper-based information system with some disparate digital components (e.g., a basic billing software, separate lab system, and manual patient registration). This creates numerous inefficiencies and poses significant risks.

Key Issues and Needs:

1. Fragmented Patient Information: Patient records are scattered across different departments (OPD, wards, lab, pharmacy), leading to incomplete patient histories, delays in retrieving critical information, and difficulty in care coordination.
2. Medication Errors: Manual prescription writing and dispensing increase the risk of transcription errors, drug-drug interactions, and incorrect dosages due to poor legibility or lack of immediate alerts.
3. Inefficient Workflows: Manual processes for patient registration, scheduling, lab order entry, and billing consume significant staff time, reduce throughput, and increase waiting times for patients.
4. Poor Data for Decision-Making: Lack of centralized, digitized data hinders the ability to analyze patient outcomes, track disease patterns, manage inventory effectively, and make informed administrative or clinical decisions.
5. Billing and Revenue Cycle Management Challenges: Manual billing leads to claims denials, revenue leakage, and delays in payment, impacting the hospital’s financial sustainability.
6. Limited Patient Engagement: Patients have no easy way to access their health information, schedule appointments online, or communicate securely with providers.
7. Suboptimal Resource Utilization: Difficulty in tracking bed occupancy, equipment usage, and staff allocation due to a lack of real-time data.
8. Compliance and Audit Risks: Relying on paper records makes audits difficult and poses challenges for demonstrating compliance with evolving healthcare standards and regulations.

Proposed HCIS Type: Integrated Electronic Health Record (EHR) System with Key Modules

Given the identified needs, the primary HCIS upgrade required is a comprehensive, integrated Electronic Health Record (EHR) system. This core system will encompass several key modules and functionalities:

• Electronic Health Record (EHR) Core: For complete patient medical history (demographics, medical history, diagnoses, treatment plans, progress notes).
• Computerized Provider Order Entry (CPOE): For electronic ordering of medications, labs, imaging, and procedures.
• Electronic Medication Administration Record (eMAR): For nurses to document medication administration, often integrated with barcode scanning.
• Clinical Decision Support System (CDSS) (Integrated): Embedded within the CPOE and EHR to provide alerts for drug interactions, allergies, best practice guidelines, and preventive care reminders.
• Laboratory Information System (LIS) Integration: Seamlessly connect with the existing or upgraded lab system for electronic ordering and receipt of results.
• Radiology Information System (RIS) Integration: For electronic ordering of imaging studies and viewing reports/images.
• Patient Registration and Admissions/Discharge/Transfer (ADT): For managing patient flow within the hospital.
• Scheduling Module: For outpatient appointments and inpatient procedures.
• Billing and Revenue Cycle Management (RCM): To automate claims processing, manage patient accounts, and track payments.
• Patient Portal (Limited Scope Initially): To allow patients basic access to appointments, lab results, and secure messaging.
• Basic Inventory Management (Pharmacy & Supplies): To track drug and medical supply stock.

While other technologies like AI, cloud computing, or telehealth are important, the immediate and most foundational need for Kisumu Community Hospital is a robust, integrated EHR system. Cloud computing would likely be the deployment model for this EHR to reduce local IT infrastructure burden, and telehealth could be an future module.

Essential Activities in the Systems Development Life Cycle (SDLC) for Proposed HCIS

The implementation of an integrated EHR system is a major undertaking that requires a structured approach. The following outlines the essential activities within the Systems Development Life Cycle (SDLC) specific to Kisumu Community Hospital’s proposed HCIS:

1. Planning Phase: * Activity: Feasibility Study & Needs Assessment (Detailed): * Form a multidisciplinary project team (clinical, IT, administrative, financial). * Conduct a thorough analysis of current workflows, pain points, and desired future state across all departments. * Define clear system requirements (functional and non-functional). * Assess technical, operational, economic, and schedule feasibility. * Conduct a vendor market scan and initial shortlisting. * Activity: Project Charter Development & Budgeting: * Define project scope, goals, objectives, deliverables, timelines, and key performance indicators (KPIs). * Secure executive sponsorship and allocate initial budget. * Establish governance structure and communication plan.

2. Analysis Phase: * Activity: Detailed Requirements Gathering & Documentation: * Conduct interviews, workshops, and observation sessions with end-users (nurses, doctors, lab technicians, pharmacists, administrators) to capture granular requirements for each module (EHR, CPOE, eMAR, LIS integration, RCM, etc.). * Document current workflows and map out desired future state workflows with the new system. * Develop detailed use cases and user stories. * Activity: Vendor Selection (RFP/RFI Process): * Develop a comprehensive Request for Proposal (RFP) based on the detailed requirements. * Evaluate vendor proposals, conduct demonstrations, site visits (if possible), and reference checks. * Negotiate contracts with the chosen vendor.

3. Design Phase: * Activity: System Configuration & Customization: * Work closely with the selected EHR vendor to configure the system to KCH’s specific needs, workflows, forms, and templates (e.g., specific admission forms, medication order sets, lab panels relevant to Kenya’s healthcare context). * Design interfaces for integration with existing systems (e.g., financial software, if not replaced). * Develop data migration strategy and plan. * Activity: Security & Privacy Design: * Design robust access controls, user roles, audit trails, and encryption protocols. * Develop policies for data backup, disaster recovery, and breach response, considering local regulations and international best practices.

4. Development Phase (Predominantly Vendor-Led for COTS EHR, but KCH involvement is critical): * Activity: System Build & Integration: * The vendor builds/configures the system environment. * Develop and test interfaces between the EHR and other systems (LIS, RIS, billing). * Develop custom reports and dashboards. * Activity: Data Migration: