Africa Implementations – Kilimanjaro Christian Medical Centre
Kilimanjaro Christian Medical Centre (KCMC) is a 600-bed tertiary referral hospital located in Moshi, Tanzania serving over 15 million people. Founded in 1971, the hospital complex encompasses the following clinics and training programs:
Kilimanjaro Christian Medical University College
Regional Dermatology Training Centre
Training Centre for Orthopedic Technologists
Child Centred Family Care Clinic
Kilimanjaro Clinical Research Institute
KCMC has tried twice to implement electronic health records (EHRs). Initially this was done by purchasing a pre-built system through a vendor which failed implementation. A second attempt was made by hiring a service to build a custom EHR system. This second implementation was discontinued when it was realized that it would take years to develop a hospital-wide EHR. This is not a unique scenario; hospitals in the developing world have struggled to automate their medical records with few viable EHR options. KCMC contacted eHealth Records International (EHRI) in the Fall of 2015 to investigate the viability of implementing HarmoniMD as the hospital’s electronic health record system. This project would encompass the creation of a facility-wide records system including Laboratory, Imaging, Pharmacy, Inpatient, Clinic and Research Departments.
In February of 2016, Ann Dannelly, VP of International Operations, left for KCMC with 200 pounds of hardware including a pre-loaded server, wireless access points, 30 tablets, scanners, card and label printers. These were purchased in the United States to save the hospital money due to inflated pricing of IT equipment in Tanzania.
Ann worked closely with the hospital staff and within a few weeks, they had begun registration and clinical documentation in the Ear Nose and Throat (ENT) clinic. Once involved in the process, the ENT doctors were very surprised when they learned that they would no longer have to write out lab orders, and that the orders would appear instantaneously in the Laboratory Department.
KCMC is one of the few hospitals that we visited that maintained extensive clinical information regarding the many patients seen. The hospital was keeping diagnosis information on 3 by 5 cards with ICD10 coding. The hospital had a relatively well-organized paper charting system but the sheer volume of paperwork has been crippling. Because KCMC is spread across an extensive campus, the recovery and reporting of information added yet another burden as every paper chart had to be read in order to build a report of any kind.
It would be easy to underestimate the magnitude of change that the implementation of an electronic medical record system will provide in a hospital like KCMC. The process of full adoption will likely take most of a year as each department comes online and workflows are adjusted to work in conjunction with the new technologies and benefit from the efficient and improved workflow.