The Ministry of Health has clarified the transition from the Social Health Authority (SHA) Provider Portal to the Health Management Information System (HMIS), saying the changes are intended to create a more integrated digital health environment and reduce administrative burdens on healthcare providers.
The Ministry said there has been “some miscommunication and confusion” regarding the transition, prompting it to explain what has been in place since the establishment of SHA, what is changing and how the new system is expected to improve healthcare delivery.
Since the establishment of SHA, the Digital Health Agency (DHA) has provided healthcare providers with a portal to support the submission and transmission of claims to SHA, particularly during the transition period.
However, hospitals have continued to operate two separate systems.
The first is their own Health Management Information System, which supports day-to-day hospital operations, while the second is the SHA Provider Portal, which is used for claims and related transactions.
According to the Ministry, operating the two systems has created additional administrative work for healthcare facilities and, in some instances, contributed to longer processing and waiting times for patients.
The transition to HMIS is therefore intended to address this duplication by allowing hospitals to use an integrated system capable of communicating with SHA and other relevant health-sector systems.
The Ministry said the change is “not a new system” but part of the ongoing rollout of the digital superhighway and an already paid-for suite of SHA systems.
“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 Ministry said.
It added that the broader objective is to ensure that hospitals 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,” the Ministry said.
Reduced duplication
The Ministry outlined several expected benefits of the transition, beginning with patients.
An integrated workflow is expected to reduce duplication of data entry and administrative processes, allowing healthcare workers to spend more time attending to patients.
The system is also expected to improve the patient experience by allowing information to be captured and accessed through an integrated workflow, rather than requiring staff to repeatedly enter the same information into different systems.
Properly integrated health records could also improve continuity of care by enabling authorised healthcare professionals to access relevant patient information when needed.
The Ministry said faster processing of admissions, consultations, procedures, billing and claims could contribute to a more efficient patient journey.
Digital records are also expected to provide greater transparency by creating a clearer trail of services provided and claims submitted.
For hospitals and healthcare workers, HMIS is expected to provide one integrated workflow, reducing the need to operate separate systems for different functions.
The Ministry said information captured at one point of care could potentially flow to relevant systems without repeated manual entry.
It also expects improved data quality, noting that capturing information once and using it across connected systems can reduce inconsistencies and errors caused by repeated data entry.
The integrated system is further expected to support better management of hospital operations, including patients, staff, facilities, supplies, medicines, equipment and financial processes.
Hospital managers could also have more timely and reliable information to support resource planning and service improvements.
Impact on SHA claims
The transition is also expected to affect the way claims are processed by SHA and other health insurers or payers.
The Ministry said claims could be generated from information captured during the delivery of care, making them more accurate and timely.
Integration could also reduce manual processing by limiting the need for providers to repeatedly enter or transfer information between systems.
The Ministry said claims could be more closely linked to patient encounters and services actually provided, supporting better verification.
Integrated digital records could also strengthen fraud and error controls by making it easier to identify inconsistencies, duplicate claims and unusual transactions.
The system is expected to support faster processing and payment through better-quality electronic transmission of information.
The Ministry stressed that the transition should not simply be viewed as replacing one portal with another.
“The objective is not simply to replace one portal with another,” the Ministry said. “The bigger objective is to connect the different components of the healthcare ecosystem.”
Ideally, it said, a hospital should have one HMIS capable of securely communicating with SHA and other relevant health systems.
The Ministry said this would support a more efficient, transparent and patient-centred healthcare system.
The transition is therefore being presented as part of a broader effort to integrate Kenya’s digital health infrastructure, reduce duplication and improve the flow of information between hospitals, patients, SHA and other health-sector systems.