Submission ID 130354
| Issue/Objective | Healthcare systems in low- and middle-income countries are undergoing rapid digital transformation; however, inefficiencies in financial processes continue to undermine service delivery and patient experience. In Kenya, despite widespread adoption of mobile money, many healthcare facilities still rely on fragmented payment systems that involve manual processes, delayed transaction confirmations, and complex reconciliation procedures. These challenges contribute to long patient waiting times, billing inaccuracies, increased administrative burden, and reduced operational efficiency. At a private healthcare facility in Kenya, traditional payment methods-including mobile money till numbers, card payments, and cash-were associated with significant inefficiencies such as prolonged transaction times, reconciliation discrepancies, and limited traceability of payments. These gaps highlighted the need for a more streamlined, accurate, and patient-centered payment solution. This study aimed to evaluate the implementation of a QR code-based payment system and its impact on financial and operational performance. The specific objectives were to assess changes in transaction processing time, billing accuracy, staff workload, and patient satisfaction, as well as to determine the system's financial viability through a cost-benefit analysis. This study aligns strongly with Sub-theme 3: From evidence to impact, as it demonstrates how a practical digital health innovation can be translated into measurable improvements in real-world settings. By generating robust quantitative and qualitative evidence, the study contributes to bridging the gap between innovation and implementation. It provides a scalable model for leveraging digital financial technologies to strengthen health systems, enhance accountability, and improve patient-centered care in resource-constrained environments. |
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| Methodology/Approach | The study was conducted at a private healthcare facility in Kenya providing outpatient and inpatient services within a regional healthcare network. The facility operates in a resource-constrained setting with high patient volumes and widespread use of mobile money payments. A mixed-methods quasi-experimental (pre-post) design was used to evaluate the implementation of a QR code-based payment system. Quantitative data assessed transaction processing time, billing accuracy, reconciliation efficiency, and patient satisfaction, while qualitative data were collected through questionnaires, key informant interviews, and workflow observations to explore user experiences and implementation challenges. The implementation involved integrating the QR code payment system into existing billing platforms, supported by staff training and patient sensitization. The study included 20 finance and IT staff, 5 departmental heads, and 100 outpatients selected through purposive and systematic sampling. Data were collected over a three-month pilot period, comparing pre- and post-implementation outcomes. |
| Results | The implementation of a QR code-based payment system led to significant improvements in efficiency, accuracy, and patient experience. Transaction processing time decreased from 7.5 minutes to 2.8 minutes (62.7% reduction; p < .001), while billing accuracy improved from 88% to 97%, with reduced reconciliation discrepancies. Patient satisfaction was high, with 80% of respondents reporting positive experiences due to improved convenience and speed. Staff efficiency also increased, with reconciliation time reduced from 3.5 to 1.5 hours per day and administrative workload declining. Daily transaction capacity increased by 50%, reflecting improved operational throughput. The system demonstrated a positive net annual financial benefit of KES 200,000, driven by time savings, reduced errors, and lower administrative costs. Key lessons included the importance of staff training, system integration, and leadership support, while challenges such as digital literacy gaps and network instability highlighted areas for ongoing improvement. |
| Discussion/Conclusion | The findings demonstrate that digital financial innovations, such as QR code-based payment systems, can significantly strengthen healthcare operations by improving efficiency, accuracy, and patient experience. This has important implications for healthcare facilities in resource-constrained settings, where administrative inefficiencies often limit service delivery. By reducing transaction times, minimizing errors, and improving reconciliation processes, such systems can enhance accountability and optimize resource utilization. From a policy perspective, the study highlights the need for supportive regulatory and institutional frameworks that promote the adoption of interoperable digital payment solutions within healthcare systems. Policymakers and healthcare leaders should prioritize investments in digital infrastructure, data protection, and capacity building to enable sustainable integration of financial technologies into health systems. In terms of scalability, the intervention demonstrates strong potential for replication across similar healthcare facilities in Kenya and other low- and middle-income countries, particularly where mobile money ecosystems are well established. A phased implementation approach, combined with continuous staff training and patient education, will be critical to successful scale-up. Aligned with Sub-theme 3: From evidence to impact, this study provides practical, evidence-based insights on how digital innovations can be translated into measurable system improvements, contributing to more efficient, accountable, and patient-centered healthcare delivery. |
| Presenters and Affiliations | Damaris Were Avenue hospital Asad Mian Head of Healthcare Transformation, Learning Programs & Systems Evercare Group |
