Duale unveils real-time health data system to fight hospital billing fraud
By Kiprono Keileb, August 4, 2025Kenya has rolled out a fully operational Health Information Exchange (HIE), placing itself among the first African countries to digitise public healthcare systems with a focus on transparency, security, and real-time service delivery.
Health Cabinet Secretary Aden Duale, speaking at a press conference on Monday, August 4, 2025, said the move marks a significant milestone in the government’s fight against theft, cost manipulation, and ghost billing in hospitals
“We are not just automating processes. We are building a system that protects patients and safeguards public funds,” said Duale.
The system, now operational across all Social Health Authority (SHA)-contracted facilities, including public, private, and faith-based hospitals, enables secure, real-time data sharing among hospitals, county governments, and the national health system
“No more paper records. No more fake claims. No more double billing. Every shilling contributed by Kenyans must work for Kenyans,” Duale declared.
As part of the reforms, SHA will only reimburse health facilities for drugs that are dispensed to patients. Facilities that fail to stock medicines and let prescriptions go unfilled will not receive any compensation.
“From today, claims will only be paid for what was given to the patient. If it was not dispensed, it will not be reimbursed,” he said.
To safeguard the system’s integrity, all pharmaceutical companies are required to upload certified product data to the National Product Catalogue within 30 days; failure to comply will result in deregistration from the SHA ecosystem.
“This catalogue ensures that only safe, authorised, and approved pharmaceutical products reach the hands of Kenyans. We are locking out counterfeits and substandard drugs for good,” he stated.
The digital infrastructure is also designed to eliminate duplicate testing, fraudulent claims, and billing fraud. Hospitals no longer need to submit physical documents to file claims, a loophole that has been widely exploited in the past.
“Kenyans who are charged multiple times for services like MRIs or X-rays should report such cases to SHA through the call centre 147. We will not hesitate to suspend any facility involved in fraud,” Duale warned.
Currently, 24 counties are actively transitioning to the Health Management System (HMS), with all public facilities expected to go fully digital by November 2025. This shift to a paperless system aims to enhance efficiency, curb corruption, and safeguard patient records
“Patient safety and public trust are non-negotiable going forward. Any violation of this trust will attract very decisive action,” said Duale.
The ministry has linked the reform to the broader Universal Health Coverage (UHC) agenda, noting that digital security is now central to healthcare delivery and accountability.
“This is not just a technical upgrade. It’s a moral duty to protect our people from exploitation and ensure every Kenyan receives value for their contribution,” he concluded.
With a nationwide digital health firewall in place, the government says the system will now track every prescription, every test, and every shilling in real time.