ABA Editorial · Nov 17, 2025 · 13 min read
Hospital information systems and electronic medical records are the data infrastructure that modern healthcare depends on, but African hospitals have historically operated on paper records that fragment patient care. Helium Health has become the most visible African operator in the category, with successful expansion into Saudi Arabia since 2021. This report maps the hospital information systems landscape.
Hospital information systems (HIS) and electronic medical records (EMRs) are the data infrastructure that modern healthcare depends on. A hospital that operates without digital records cannot coordinate care across departments efficiently, cannot track patient outcomes systematically, cannot generate the quality metrics that regulators and payers require, and cannot integrate with the broader health information ecosystem that includes laboratories, pharmacies, insurers, and public health authorities. African hospitals have historically operated largely on paper-based records, with patient files physically moving between departments and often getting lost, duplicated, or rendered illegible over time. The transition to digital records is one of the most fundamental infrastructure shifts that African health systems need to make, and several operators have built businesses addressing specific portions of this transition. Helium Health has become the most visible African operator in the category, with operations across multiple African countries and successful expansion into Saudi Arabia since 2021. This report maps the hospital information systems landscape.
Helium Health, headquartered in Nigeria, built its business around an integrated hospital information and electronic medical record platform designed for African hospital conditions. The platform handles patient registration, clinical documentation, laboratory orders, pharmacy management, billing, and reporting within a single system. The design emphasizes usability in African contexts including intermittent connectivity, varying workforce digital literacy, and the specific clinical workflows that African hospitals operate. Helium Health raised substantial funding through its growth phase and has deployed its system to hundreds of hospitals across multiple African countries.
In 2021, Helium Health expanded to Saudi Arabia, entering the Gulf healthcare market where the commercial opportunity for hospital software is substantially larger and less price-constrained than in most African markets. The Saudi Arabian expansion has been described as a significant growth driver for the company and represents one of the more successful examples of an African healthtech operator competing in adjacent international markets. The broader pattern (African operators finding their most attractive growth opportunities in Gulf or European markets rather than in Sub-Saharan African markets) also applies to Helium Health, though the company has maintained substantial African operations alongside its international expansion.
An important component of the African EMR ecosystem is OpenMRS, an open-source electronic medical record platform developed specifically for resource-constrained environments. OpenMRS is used by thousands of health facilities across Africa and globally, often through deployments managed by non-governmental organizations, ministries of health, or academic partnerships. The open-source model provides flexibility and avoids the licensing costs of commercial platforms, but it requires local technical capacity to implement, customize, and maintain.
The tradeoff between commercial platforms like Helium Health and open-source alternatives like OpenMRS is a recurring question in African health information system planning. Commercial platforms offer vendor support, regular updates, and consistency across deployments, but at licensing costs that public and non-governmental health systems sometimes cannot afford. Open-source platforms avoid licensing costs but require local capability that not every operating environment has. The practical result is that different African health systems use different solutions based on their specific resource constraints and technical capacity.
One of the most persistent problems in African hospital information systems is the lack of interoperability between different platforms. A patient receiving care at multiple facilities may have their records distributed across incompatible systems that cannot exchange information, which undermines care coordination and forces clinicians to work with incomplete histories. Donor-financed projects, national health insurance schemes, and public health reporting all depend on interoperability that current systems often cannot provide.
International standards (HL7 FHIR, ICD coding, SNOMED CT) exist for health data interoperability, and African health systems are gradually adopting them. Progress has been uneven, and full interoperability across the ecosystem remains a multi-year project even for countries that have committed to the effort. The interoperability gap is a constraint on the value that any individual information system can deliver, because a system that cannot exchange data with its counterparts serves only the internal needs of a single facility rather than supporting continuous patient care across the health system.
DHIS2 (District Health Information System 2) is an open-source health information management platform widely deployed across African public health systems for aggregate reporting of disease surveillance, program coverage, and facility performance data. DHIS2 does not replace patient-level EMRs; it operates at the aggregate level, collecting summary data from facilities and supporting public health decision-making at district, regional, and national scales. Most African countries use DHIS2 in some form for their national health information reporting, and the platform has become one of the most ubiquitous pieces of health technology on the continent.
The success of any hospital information system depends on the clinical and administrative workforce using it effectively. African hospital workforces have varying levels of digital literacy and experience with electronic health records, and transitioning from paper-based to digital workflows requires substantial training investment alongside the software deployment itself. Operators like Helium Health have emphasized workforce training as part of their deployment approach, but the training component is expensive and time-consuming, and its effectiveness depends on workforce stability (high turnover undermines training investments) and ongoing support.
Three indicators will shape African hospital information systems. First, whether Helium Health's continued expansion demonstrates scalable commercial viability for African-built health technology in international markets, validating a pathway that other operators could follow. Second, whether interoperability standards adoption accelerates across African health systems, enabling the data exchange that current fragmented deployments cannot support. Third, whether public-sector investment in digital health infrastructure keeps pace with private-sector deployments, because public health systems serve the majority of African patients and their digitization is more important for population-level outcomes than private hospital digitization alone. Hospital information systems are unglamorous but essential infrastructure, and their progress will shape how much other healthcare investments can actually achieve.