Christabel Apholung Ngwashi1, Vera Oliveira2, Carine Asnong1, Bruno Holthof1
1Centre for Tropical Medicine and Global health, Nuffield Department of Medicine, University of Oxford, Oxford, UK 2Elephant Healthcare Ltd London, UK
Corresponding Author: Christabel Apholung Ngwashi
Background: In Sub-Saharan Africa, hospital information management systems (HIMS) are
predominantly paper based. Countries like Kenya are adopting digital HIMS. However, there is
limited evidence about their impact. This study aimed to evaluate the impact of a digital HIMS on the
operational and financial performance of Kenyan health facilities.
Methods: A retrospective analysis was done using longitudinal data collected at 21 health facilities in
Kenya that had actively used the outpatient and/or billing modules of the Elephant HIMS (EHIMS)
for at least 9 months. Trends of operational and financial performance indicators across months 3,6,9
after EHIMS adoption were compared to pre-adoption baseline values. The Wilcoxon test was
performed to determine the statistical significance of the difference between baseline and 9 months
Results: The EHIMS had positive impact on operational performance evidenced by statistically
significant reduction, between baseline and 9 months after adoption, in monthly waiting (43.55 vs
35.79 minutes) and journey times (59.90 vs 60.34 minutes). Positive impact was also observed on
financial performance as shown by an increase in recorded monthly revenue (100000 vs 210000 KES)
and improved tracking of unpaid revenue (0.57 vs 1.19). The above changes were associated with and
not directly caused by the EHIMS.
Conclusion: The EHIMS was found to have a positive impact on the performance of health facilities
at the time points analysed in this study. To demonstrate the full impact of digital HIMS and for
clearer attribution, further research should be done to analyse the confounding factors that affect
health facility performance.
Read the full article: DOI: https://doi.org/10.52403/ijhsr.20230309