In the article Evaluating the impact of a digital hospital information management system on the operational and financial performance of health facilities in Kenya, Christabel Apholong Ngwashi et al., seek to address the distinct gap in evidence around the impact of digital Health Information Systems (HIS) on health systems in Sub-Saharan Africa.

Looking at longitudinal data collected at 21 health facilities in Kenya using Elephant's outpatient and/or billing modules for at least 9 months, the study compared trends of operational and financial performance with pre-adoption baseline values.

Here are some highlights of results from the study: 

18% decrease in patient waiting times:

"The EHIMS had positive impact on operational performance evidenced by statistically significant reduction, between baseline and 9 months after adoption, in monthly waiting (43.55 vs 35.79 minutes).

110% increase in monthly recorded revenue:

"Positive impact was also observed on financial performance as shown by an increase in recorded monthly revenue (100000 vs 210000 KES) and improved tracking of unpaid revenue (0.57 vs 1.19). The above changes were associated with and not directly caused by the EHIMS."

A statistically significant increase in total monthly revenue (TMR):

"The majority of individual facilities using the billing module experienced statistically significant increase in total monthly revenue (TMR). Similar to other indicators, many factors contribute to the revenue collected by a health facility. EHIMS may have contributed to this increased TMR in two ways; by improving willingness to pay because of patient satisfaction and by better tracking of invoices/unpaid revenue."

The study concluded that :

"The EHIMS was found to have a positive impact on the performance of health facilities at the time points analysed in this study. To demonstrate the full impact of digital HIMS and for clearer attribution, further research should be done to analyse the confounding factors that affecthealth facility performance."