DEVELOPMENT OF A STANDARDIZED HEMODIALYSIS PATIENT FILE IN KENYA: JULY 2024 – MAY 2025

Although hemodialysis treatments are offered in a number of public, private, and faith-based facilities across Kenya, documentation methods remain variable and ineffective. This results in fragmented, segregated data, a lack of clinical care continuity, and challenges in tracking patient outcomes. The Ministry of Health developed a standardized digitized hemodialysis patient file in consultation with allied stakeholders to standardize data collection and enhance data integrity with the aim of improving patient outcomes. 

From July 2024 to May 2025, a multiphase consultative approach was used to develop the standard hemodialysis patient file. In the first phase, a literature review and stakeholder consultations were held, and the need for a data collection tool was established. A situational analysis of paper-based hemodialysis documentation tools was planned, and sample patient files were obtained from six tertiary hospitals: two each from suitable public, private, and faith-based facilities.

Nephrologists, nurses, nutritionists, mental health professionals, health records officers, digital health practitioners, and patient advocates were among the stakeholders with whom a consultative series of interactions was conducted in the second phase. To determine whether the common data elements in each file matched the pertinent data elements required for the hemodialysis registry and reporting system—the Kenya Health Information System (KHIS) — a situational analysis was conducted. Identifier information, baseline evaluation, dialysis prescriptions, dialysis session data, comorbidities, complications, and follow-up were the main sections of the first drafts of the patient file that emerged from this exercise.

The third phase concentrated on piloting and refining the draft file through iterative pretesting and validation workshops, where thirty (30) hemodialysis-unit healthcare workers were interviewed using a semi-structured questionnaire. Using a Likert Scale, their perceptions of the new tool and its ease of use were recorded and analyzed. Further, digitization and linkage to the Shared Health Record (SHR) — a secure, interoperable, and uniquely identifiable patient record was initiated. Twelve (12) digital health practitioners involved in this phase were interviewed using a semi-structured questionnaire regarding their perceptions of the feasibility of converting the paper-based tool to a digital format.

These processes produced a standard hemodialysis patient file with twelve sections, aligned with the World Health Organization (WHO), the International Society of Nephrology (ISN), the Kidney Disease Improving Global Outcomes (KDIGO), and Kenyan policy and legal frameworks. Final pilot testing results showed that 25 (83%) of the healthcare practitioners interviewed reported that the tool was easy to use and comprehensively captured patient information. A preferred digital format for the same was proposed by twenty-three respondents (73.3%), who believed it would perform well at scale. Interviews with the digital health practitioners found that 9 (75%) considered the conversion to a digital format feasible and scalable. 

A crucial first step toward standardized renal data systems and enhanced hemodialysis service quality in Kenya is the creation of a standard, shareable, digitized hemodialysis patient file. To support evidence-based renal policy and care optimization, future phases will focus on improving the prototype tool, user training, national rollout, and enhanced interoperability. These measures will enhance secure patient-level data sharing between users, improve patient outcomes, and strengthen data for decision-making.