Missed opportunities for digital health data use in healthcare decision-making: A cross-sectional digital health landscape assessment in Homa Bay county, Kenya

Area of Science:

• Digital Health
• Health Informatics
• Healthcare Systems Research

Background:

• Sub-Saharan Africa faces challenges in healthcare access and decision-making, driving digital health system adoption.
• Digitization efforts are hampered by fragmented implementation, lack of universal patient identifiers, poor system linkages, and limited data sharing.

Purpose of the Study:

• To describe the digital health landscape in Homa Bay County.
• To highlight strengths and limitations of digital health data use for healthcare decision-making.

Main Methods:

• Mixed-methods study combining a cross-sectional survey of 112 healthcare facilities and 33 in-depth interviews with stakeholders.
• Survey conducted June 2022–October 2023 to assess digital health system adoption and utilization.

Main Results:

• Ten digital health systems identified, nine in active use, with the Kenya Electronic Medical Record system for HIV management being most prevalent (91% of facilities).
• Key challenges include lack of interoperability, unreliable internet, system downtime, power outages, staff turnover, and absence of universal patient identifiers.
• Network instability is the primary barrier to effective digital data utilization, compounded by data quality and identifier issues.

Conclusions:

• Recommendations include establishing data governance, implementing unique patient identifiers, harmonizing data quality, promoting interoperability, and evaluating data suitability for research and decision-making.
• Addressing systemic challenges is crucial for leveraging digital health data to improve patient-centric care and healthcare outcomes.