If data is the new oil, medical data is premium fuel, in high demand from tech companies and predictive Artificial Intelligence technologies Aga Khan University Hospital, Nairobi (AKUH,N) CEO Rashid Khalani speaks to Maudhui House about the project to digitize all patient records, the potential risk and reverence  for the novel office of the data commissioner.

As a hospital you must have so much data on us?

Data and information has always been there, right? And when we talk about the healthcare setting, it has a lot of confidential information about patients' health and their family and the next of kin. So we are the custodians of a lot of confidential data, very sensitive data, but that data has always been there. But the point is that it was always paper-based system with the Aga Khan University Hospital.

What we have done in the past six, seven months is that we have now, migrated to an electronic health record system.

What sort of data does this set contain?

As the name suggests, an Electronic Health Record system is whereby the entire patient file, all the records are electronic. The patient, the clinical protocols are embedded within the system. The pharmacy orders, the lab orders, the radiology or the orders, the even the scans for everything is now electronically within the system.

Medical data has become a big thing with wearables that track our heart rates and phones that monitor our vitals, is this where you are going with this digitization?

If you look at other industries, there is a marked shift in the different industries. Look at hotel industries, the biggest hotel chain doesn't own a hotel. Airbnb, the biggest taxi company, doesn't own a single hot taxi, Uber and Bolt and so many others, I think. So there are shifts in industries.

We are seeing the shift in healthcare as well, where artificial intelligence can predict data looking at the scans, looking at the reports more accurately than humans. But that can only happen when the records are electronically available.

AI is all about computing power, right? But once you have that data, then you can use the computing power to do research and to use artificial intelligence for your interventions so that this journey of electronic health records will help us in shaping the health industry across Kenya as well.

What are some of the direct benefits you will draw from the database?

It ensures efficient care, timely care, because let's say if you are in a center in Buruburu and, you are transferred to the main hospital, you do not have to carry your paper file, the same data, which is on the server within the main hospital can be accessed anywhere within the AKDN network.

All that data will allow us to do research, right? Because of the millions of patients who are seen across AKDN and health every year, that information will be available. So if you want to do research on cancer, let's say on breast cancer with a different population, we can do that research. And this hospital, as you know, is not just a hospital, it's a university hospital. So we have trainee doctors and nurses. So that data is very available for their research, and it'll be available for the training purposes of the doctors as well.

From the patient perspectives I know the medical world is shifting to value based healthcare that prioritizes preventive care and promoting healthier lifestyles?

From the patient perspective, if you, let's say if you are diabetic, diabetic patients require to do sugar tests every month. Now, it's very difficult to keep those paper-based records with you all the time. Right now, with the electronic health system, we have a patient portal, which you can download on your phone now, if you want to track your history of your sugar levels, that history is available with a click of a button. So you can see how your diabetes and your results are moving up and down. Right. And then if it's going up, and for God forbid, then you can do the timely intervention. You can go speak to your doctor that this medication is not working right. So it can help you self-diagnose as well, because the, records, the medical records are available electronically within the network, within the system.

How much has it cost to put together the system?

This initiative of electronic health records is going to cost tens of millions of dollars across A K D N. But for just this hospital, it has cost us, $12 million, call it, Kes1.5 billion shillings just for this hospital. And its outreach centers.

https://www.youtube.com/watch?v=p0gHL6FhZCs

Recently the data commissioner has slapped institutions with huge fines on abuse of customer data, how are you tackling these concerns?

All the data that we have within this hospital is not outside of Kenya. Those are within the servers within Nairobi, within Kenya. The second part is that we have been seeking advice from the office of data protection. We are working hand in hand. We are seeking advice from the regulator, are we doing anything wrong? Are we doing something which is outside of law? So we are walking the journey.

This phenomenon is new, it's new for everyone, right? So, nobody can claim that they know it all.

Can you predict whether I can have a heart attack?

Absolutely. So there is a lot of research that is going on across the world that looks at different diagnoses, looking at your eyes, computers can predict if you're gonna have any heart diseases, so that research is still happening around the world. We want to bring that research here.

What are my chances once you make that prediction I know Aga Khan has been certified as a centre of excellence for the management of heart attacks by the Joint Commission International (JCI)?

We are the only hospital in Kenya and second in Africa to become the center of excellence for heart attacks. So first we picked heart attacks as a clinical program from whatever your entry point is from clinics from accident and emergency, if you have a chest pain, if you're having a heart attack, what are the clinical protocols that are followed, what are the standards that are supposed to be followed, right?

We got the certification, which is called CCPC, Clinical Care Program Certification from the Joint Commission, which looks at the standardization of care and standardization leads to better clinical outcomes.

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