SHIF’s Hidden Costs: Research Fees and Privacy Risks Explored
The rollout of the new Social Health Insurance Fund (SHIF) has revealed an additional layer of fees impacting medical research and patient care in Kenya. Under the proposed Digital Health Information Management Regulations 2024, the government aims to monetise health data, with access limited to entities paying prescribed fees.
Central to the new system is the Enterprise Service Bus (ESB), which facilitates data exchange among health providers and integrates two key repositories: the National Health Data Bank and County Health Data Banks. Accredited health facilities must store all patient data collected during diagnosis and follow-ups in these banks. However, access comes at a price.
Fee Structures and Licensing Costs Entities seeking to use the ESB must pay onboarding fees ranging from Ksh2,000 to Ksh100,000, based on the service level. Annual licenses are charged separately, with Level 6 facilities paying up to Ksh25,000. Independent researchers must part with Ksh30,000, while postgraduate and undergraduate medical students are charged Ksh20,000, Ksh5,000, and Ksh500, respectively. Research institutions face even steeper costs, set at one per cent of their annual research budgets.
Private Sector Access and Controversies Private entities, including health insurance firms, can access anonymised data for claims management, paying a flat fee of Ksh25 per insured life annually. Critics warn this could pave the way for commercial exploitation, raising questions about how these costs will impact insured Kenyans.
Privacy and Security Concerns While the regulations mandate data aggregation and anonymisation, stakeholders express concerns about potential breaches. Violations attract hefty penalties under the Digital Health Act 2023. The regulations also allow for the suspension of health data controllers from the ESB for breaches, misuse, or non-compliance, a move designed to enforce accountability.
Streamlining Healthcare vs. Patient Costs The centralised system, through the ESB and registries, promises efficiency in healthcare operations, potentially reducing wait times and enhancing patient identification through a unified client registry. Better data sharing among healthcare providers could lead to improved treatment decisions and care coordination.
However, the cost implications for patients remain contentious. Fees for accessing the ESB and shared resources may ultimately burden patients if healthcare providers pass on these charges. Additionally, the extensive data collection raises privacy concerns, leaving Kenyans wary of how their health information will be used.
Future Implications Health Cabinet Secretary Deborah Barasa defends the proposals as necessary for a streamlined, efficient healthcare system. Critics, however, question whether the financial and privacy costs outweigh the benefits, as the government positions itself to profit from the health data of its citizens.
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SHIF’s Hidden Costs: Research Fees and Privacy Risks Explored
