From SHA portal to HMIS: What you need to know of the Duale big ‘switch’

The Health Ministry on Thursday announced that all hospitals in the country have until October 30 to move from the Social Health Authority (SHA) provider portal to the Health Management Information System (HMIS).

Ministry data shows that all 6,427 level 2 and level 4 facilities have made the move to HMIS, a fully digital system. However, only about four public level 5 facilities have moved from the SHA provider portal. The remaining 23 are still a work in progress. Of the 518 faith-based facilities contracted by the government, only 38 have transitioned to the new system.

"We are digitising the health space, and Kenya is now one of the best systems in the world in terms of digitisation. Our citizens don't need to carry any document to hospital. Our whole healthcare system is paperless. Your SHA card is your thumb," said Health Cabinet Secretary (CS) Aden Duale.

The move to HMIS does not do away with SHA or the Social Health Insurance Fund (SHIF).

To understand the move, we asked Duale to explain the HMIS transition.

Why are hospitals moving to HMIS?

When the government rolled out SHA, the Digital Health Agency (DHA) provided a portal to help healthcare providers submit and transmit claims to SHA, particularly during the transition period.

In practice, however, hospitals have had to work with two separate systems. One is their own HMIS, which supports day-to-day hospital operations. The other is the SHA portal, which is used for claims and related transactions. This has created extra administrative work for facilities and, in some cases, contributed to longer processing and waiting times for patients.

What is changing?

The transition is meant to create a more integrated digital health environment, where the hospital's HMIS becomes the main system for managing healthcare services and related information.

This is not a new system. It is part of the ongoing rollout of the digital super highway and the already paid-for suite of SHA systems.

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Instead of hospital staff having to enter or transfer the same information into different systems, the HMIS is designed to integrate and communicate with SHA and other relevant health sector systems. The broader objective is simple: one hospital system that can securely communicate with the different systems supporting healthcare delivery.

This is consistent with the principle that a patient should not have to navigate multiple disconnected systems simply to receive healthcare services.

What are the benefits of HMIS to Kenyan citizens?

Kenyans will have less duplication of data entry. Administrative processes can allow healthcare workers to spend more time attending to patients. This means less waiting time at the facilities.

A patient's information can be captured and accessed through an integrated workflow, rather than being entered repeatedly into different systems. There will also be well-structured, integrated health records, which will help authorised healthcare professionals access relevant patient information when needed.

This will improve service efficiency in admissions, consultations, procedures, billing and claims. Overall, the digital records will give Kenyans a clearer trail of the services provided and the claims submitted.

What changes will happen to hospitals and healthcare workers?

There will be an integrated workflow, and hospitals can reduce the need to operate separate systems for different functions. Once information is captured at the point of care, it will be used without repeated manual entry.

The HMIS can support the management of patients, staff, facilities, supplies, medicines, equipment and financial processes. Once information is available, it can be used across connected systems. This reduces the inconsistencies and errors caused by repeated data entry.

Hospital managers can also have more timely and reliable information to plan resources and improve services. Digital records provide better visibility of the services delivered, the resources used and the claims submitted.

Will this benefit SHA and other health insurance providers?

Yes, because it will have accurate and timely claims. All claims can be generated from information captured during the actual delivery of care. Integration will also reduce the need for providers to repeatedly enter or transfer information between systems.

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Claims can be linked more closely to patient encounters and the services actually provided. There will be improved fraud and error control, as the digital records will flag any inconsistencies.

Facilities will have faster processing and payment, which will be done electronically. Aggregated data will also provide useful information on service utilisation, resource needs and healthcare trends.

Why do we need this now?

We are not just replacing one portal with another. The bigger objective is to connect the different components of the healthcare ecosystem.

This means moving away from fragmented systems that require healthcare workers to repeatedly enter the same information, and towards an interoperable digital health ecosystem.

The ultimate beneficiary should be the patient. That means less paperwork, fewer repetitive processes, reduced waiting time, better continuity of care and a more efficient healthcare experience.

The transition will naturally require adjustments, technical integration and support for healthcare workers and facilities. The focus should therefore be on ensuring that implementation is smooth and that hospitals receive the necessary support. The system should ultimately deliver better services for patients while improving efficiency and accountability across the health sector.

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