Browsing by Author "Okemwa, Joshua"

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A Fuzzy Ontological Model for Semantic Interoperability in Distributed Healthcare Information Systems
(International Journal of Research and Innovation in Applied Science, 2025-01-17) Okemwa, Joshua; Owoche, Patrick Oduor; Mbuguah, Samuel Mungai
The exchange of patient or care data across heterogeneous health systems is crucial in the modern healthcare ecosystem yet remains daunting. Integration and interoperability in siloed health applications require robust health information exchange (HIE) and a pragmatic ontological model to be successful. This paper details a prototype development endeavor and systematic review of literature that has pioneered the development of a robust, practical, and tested fuzzy ontological model to enhance semantic interoperability in siloed, distributed health systems. Leveraging the tenets, standards, LOINC codes, and developed model from this study will enable robust and flexible data mapping and sharing health data in an environment marred with ambiguities and uncertainties but requiring the sophistry of interoperability
Assessing the role of electronic health records standards in advancing semantic interoperability in distributed health systems in Kenya
(Global Journal of Engineering and Technology Advances, 2025-06-07) Okemwa, Joshua; Owoche, Patrick Oduor; Mbuguah, Samuel Mungai
Achieving semantic interoperability in distributed healthcare systems is a global challenge, especially in low-resource settings such as Kenya. Inconsistent implementation of electronic health record (EHR) standards hinders semantic interoperability by limiting the ability of distributed healthcare systems to exchange and interpret data with shared, unambiguous meaning. This study evaluates the influence of EHR standards on semantic interoperability in distributed health systems in Kenya. A mixed-method approach using descriptive and correlational research design was adopted, targeting four Level 5 public hospitals with 301 sampled respondents including system developers, health practitioners, and administrators. Statistical analyses confirmed a very weak but statistically significant correlation between EHR standards and semantic interoperability (Spearman’s ρ = 0.007, p = 0.04, N = 268). Additionally, the Kruskal-Walli’s test revealed significant differences in semantic interoperability across low, medium, and high EHR adoption groups (HStatistic = 6.52, p = 0.038), with high adopters demonstrating the highest mean rank (148.92). However, mediation analysis indicated that system usability does not significantly mediate the relationship between EHR standards and semantic interoperability (Indirect effect = -0.0004, 95% CI [-0.0125, 0.0097]). Findings highlight that EHR standards alone have limited impact, and greater interoperability gains depend on integrated approaches combining standards with usability, governance, and technical alignment.
Evaluating the impact of security techniques on semantic interoperability in Kenya’s Distributed Health Information Systems
(World Journal of Advanced Engineering Technology and Sciences, 2025-05-29) Okemwa, Joshua; Owoche, Patrick Oduor; Mungai, Samuel Mbuguah
The rise of distributed health information systems in Kenya has brought significant opportunities for enhancing clinical efficiency and patient outcomes through electronic data exchange. However, semantic interoperability, the ability of systems to exchange data with shared, unambiguous meaning, remains severely constrained by inconsistent adoption of security techniques such as access control and encryption. Weak security measures not only compromise data integrity and confidentiality but also hinder healthcare professionals' trust and willingness to engage in interoperable data exchange. This study aimed to evaluate the impact of security techniques on semantic interoperability in Kenya’s distributed healthcare systems. The central research question guiding this inquiry was: What is the impact of security techniques on semantic interoperability in healthcare data exchange? The target population consisted of healthcare professionals, system administrators, developers, and records officers in four Level 5 hospitals across Kenya: Kisii, Nyeri, Nakuru, and Coast General Teaching and Referral Hospital. A sample of 301 respondents was determined using Yamane’s formula, with participants selected through purposive and stratified random sampling techniques. Data collection employed structured questionnaires, complemented by interviews and focus group discussions for triangulation. Descriptive statistics (frequencies, percentages, means) were used to summarize respondent characteristics and perceptions. Inferential analysis included Spearman’s correlation, Mann-Whitney U test, and bootstrapped mediation analysis, conducted using SPSS to explore the relationship between security techniques and semantic interoperability, as well as the mediating role of system usability. Ethical approval was obtained from the National Commission for Science, Technology and Innovation (NACOSTI) and respective hospital boards. Informed consent was secured from all participants, and data confidentiality was strictly maintained. Findings revealed a significant but weak positive correlation between security techniques and semantic interoperability (ρ = .053, p = .002). Descriptively, institutions that reported higher levels of access control and encryption practices showed increased semantic data exchange effectiveness. The Mann-Whitney U test confirmed statistically significant differences in semantic interoperability scores between institutions with robust and weak security practices (U = 7425, p = .005). Moreover, system usability was found to significantly mediate the relationship between security techniques and semantic interoperability (β = .400, p < .001), underscoring the importance of user-centered design in leveraging security for interoperability gains. The study concludes that while security techniques positively influence semantic interoperability, their impact is contingent upon the usability of health information systems. It recommends the national enforcement of security protocols such as role-based access control (RBAC) and encryption standards, alongside targeted training programs to enhance system usability among healthcare staff. Strengthening both technical safeguards and human-centered design will be critical in advancing trustworthy and interoperable healthcare data exchange in Kenya’s distributed environments.
ICT4D and E-government
(International Journal of Scientific Research in Science, Engineering and Technology, 2020-08-28) Okemwa, Joshua; Wechuli, Alice Nambiro
The advancements surrounding information and communication technologies have become ubiquitous so much so that governments are now compelled to use them to reduce cost and increase their efficiency. E-government entails the application of information and communication technologies to deliver government services, increase interaction between the government and citizens, and improve the efficiency of the government. This paper details the various aspects of e-government implementation, ICT4D policies, and case studies from the United States and Kenya. Kenya is fast catching up with the rest of the world, having benchmarked the local e-government system with systems in Malaysia, Singapore, the UK, and South Africa among other nations. Limitations that the local implementation faces are detailed with the future of e-government being pitted as fruitful despite myriad infrastructural and training deficiencies.