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Healthcare

Kenyan health providers are being asked to become digital organisations on a fixed timetable. SHA moved Level 4 facility claims onto the Taifa Care HMIS in June 2026 and gave providers ninety days to integrate with the national system or lose contracting. That is a clinical systems deadline with a very large finance problem attached to it.

The situation

What we usually find

For hospitals, clinics and health groups whose clinical systems are moving faster than their finance function can follow.

The Digital Health Act 2023 created the Digital Health Agency and set interoperability standards for health data. What followed has been rapid: claims processing consolidated onto a national platform, real-time patient verification, electronic claim submission, and providers who do not meet the requirements becoming ineligible for contracting in the FY 2026/28 cycle. For most facilities, meeting that deadline has consumed all available attention.

What has not moved at the same pace is everything behind it. Revenue that used to be recognised on invoice is now recognised on adjudication, so the receivable is a claims position rather than a debtor ledger. Procurement of consumables and pharmaceuticals still runs on reorder habits. The cost of a bed-day, a theatre hour or a department is estimated rather than measured.

The result is a facility that can submit claims correctly and still cannot say which of its services make money. That is a solvable problem, and it is a finance and reporting problem rather than a clinical one.

How the work flows

Where the pressure points are

Every business in this sector runs a version of this cycle. These are the points where it strains when the systems behind it do not join up — and where the value of joining them up shows first.

The Patient to payment cycle, and where it strains without joined-up systems. Register: Patient and payer details captured clinically, then re-entered for billing. Treat: Consumables issued against a patient but not against a cost centre. Claim: Submissions tracked in the clinical system while the ledger still shows an invoice. Reconcile: Rejections and part-payments aged by hand, with no view of the real claims position. Account: Departmental cost and margin estimated, so service-line decisions are made on instinct.

Where we'd start

The first move

We would take one month of submitted claims and follow them into the accounts — how many were rejected, on what grounds, how long the rest took to settle, and whether the ledger and the clinical system agree on the total. Most facilities have never had that number produced in one place.

Where we are not the answer

We do not publish a hospital management system, an EMR or a clinical platform, and we do not compete with the accredited HMIS vendors SHA requires you to integrate with. That choice is yours and it is a clinical decision. We work on the finance, procurement and reporting layer around it — and on making that layer agree with whatever clinical system you have chosen.

Is this how your operation runs?

Tell us where it strains, and we will tell you plainly which of this is relevant to you and which of it is not — before you commit to anything.

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