The government has explained how it intends to utilise Artificial Intelligence (AI) to ensure optimal efficiency of the proposed Social Healthcare Insurance Fund (SHIF)
Speaking during an Interview, Dr. Elizabeth Wangia, the Head of Health Financing at the State Department for Medical Services stated that the government will incorporate AI in the systems to detect any anomalies.
Wangia elaborated that the systems will monitor facilities and the number of services offered in registered institutions in real time to curb corruption.
The move is expected to provide SHIF with daily data on these activities to avoid late detection of loopholes that were previously exploited by unscrupulous individuals to commit fraud.
Dr. Timothy Olweny, Chairperson Social Healthcare Insurance Fund (SHIF)
In her explanation, she provided an example of the kind of anomalies the system would detect “You find small facilities being paid more or conducting more surgeries than Kenyatta National Hospital or a county hospital in a remote area seeing more patients in Kiambu,” Wangia stated.
Wangia also explained how the AI system would be integrated with the Kenya Medical Practitioners and Dentists Council (KMPDC) data to link a service offered with a registered medical practitioner.
“Even for the providers, we’ll be linking each service within the medical council to a provider, if it is a clinician or a doctor”, elaborated Wangia
The move is expected to provide information about the providers who offer any services and to curb any corruption activity that a medical practitioner may engage in.
In a previous statement, Social Health Authority (SHA) chairperson, Timothy Olweny had also confirmed that the government would also use a Means Testing Instrument (MTI) to identify persons who deserve free care.
Olweny stated that individuals who were unable to pay the Ksh300 would qualify for free healthcare. He however noted that they would be subjected to scrutiny, a statement which Elizabeth Wangia corroborated.
Additionally, the health committee chairperson in parliament, Robert Pukose had also stated that the current National Health Insurance Fund (NHIF) would be valid until the end of the year 2024 before the country fully transitions to SHIF.
The government also confirmed that Kenyans would engage in a self-registration process during SHIF’s initial implementation stages.
Health CS Susan Nakhumicha (left) meets President William Ruto at State House, Nairobi on August 1, 2023.