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Implementation of Kenya Electronic Medical Records (KenyaEMR): Costs and Efficiencies

Background: Electronic medical record (EMR) rollout is a key element of health systems strengthening activities. To facilitate national rollout and country ownership of KenyaEMR, we assessed costs associated with development and point-of-care implementation of KenyaEMR supported by the International Training and Education Center for Health (I-TECH) between April 2012 and September 2013. Methods: We reviewed and collated I-TECH costing records and considered KenyaEMR implementation costs through two lenses: (1) overall direct I-TECH project costs to characterize costs across resource category, activity and location; and (2) health facility-specific costs to estimate cost per facility and explore variation in costs across facilities. Results: KenyaEMR development and implementation during this period cost I-TECH US$3,803,810. Human resources represented the majority of costs (51%), followed by travel (25%), and equipment (10%). Deployment (34%), project management (33%), and training and capacity building (22%) made up the largest proportion of I-TECH KenyaEMR costs; software (9%) and curriculum (2%) development costs were lowest. In-country expenses made up 65.9% of costs; this proportion increased over time. I-TECH was able to initiate implementation in 204 facilities and complete an equivalent of 128 implementations. Implementation in a facility, from sensitization through installation and back data entry, cost an average of US$9,879. The cost per patient of KenyaEMR implementation decreased as the number of patients in a facility increased. Cost per patient was uniformly less than US$20 per patient in facilities with more than 700 patients. Conclusions: Human resources, rather than equipment and infrastructure, drove costs of KenyaEMR implementation. Implementation quickly transitioned to be country-led. We observed substantial economies of scale in implementation of KenyaEMR. Resource limited countries should prioritize of implementation of point-of-care EMRs facilities in larger health facilities. Additional research is needed to determine whether point-of-care EMRs improve efficiency or cost-effectiveness of HIV care and treatment in resource-limited settings.

Electronic Medical Record, Cost, HIV, Resource Limited Settings, Health Systems, Kenya

Sebastian Kevany, Starley Shade, Chloe Waters, Nancy Puttkammer. (2023). Implementation of Kenya Electronic Medical Records (KenyaEMR): Costs and Efficiencies. Science Journal of Public Health, 11(5), 143-153.

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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