A hospital management system built for Ethiopian hospitals
Wards, theatre, the emergency department, lab, imaging, pharmacy and the running bill on one record — so what is done is charged, and what is charted is safe. For primary, general and specialized hospitals — private hospitals and the private wings of public ones.
The problems we hear from hospitals
Medication errors on the ward
A paper drug chart cannot tell a nurse what is due now, what was held and why, or who witnessed the controlled drug.
Charges that never reach the bill
Bed nights, theatre time, tests and consumables are recorded in five departments and billed from one — and what falls between them is lost.
A surgical checklist that is filled in, not followed
A paper WHO checklist can be ticked after the case. Sign-out — counts, specimen labels — is the step most often skipped.
A crowded emergency department
Without a board, the sickest patient is not always seen first, and nobody can say how long anyone has waited for a doctor.
Lab and imaging results that arrive late, on paper
A result walked to the ward is a result that waits. A critical value phoned to nobody is worse.
An EMR that was tried before and abandoned
Many Ethiopian hospitals have watched a system arrive and fade. Use depends on training, manuals and support — not on installation.
What you get on day one
One running bill
Bed nights, procedures, tests, imaging and ambulance trips land on one inpatient bill, with deposits and refunds against the patient’s account.
A MAR that shows what is due
Dose slots, holds and witnessed controlled drugs — and prescriptions checked for interactions, dose and allergies before they reach the ward.
A checklist the system enforces
Consent and sign-in before the operation, time-out before the incision, sign-out before the patient leaves — the case cannot move on without them.
Every department on the same patient
The ED, the ward, the theatre, the lab, imaging, the blood bank and the pharmacy all record against one patient and one visit.
Wards and nursing: bed census, MAR and observations
The ward board shows every bed, every patient waiting for one, and the rounds list sickest first. Nurses record observations and progress notes on the stay, keep the charts the facility designs — fluid balance, neuro and more — and accept readings from bedside monitors rather than copying them.
- Ward board with bed census and patients waiting for a bed
- Medication administration record with dose slots, holds and witnessed controlled drugs
- Nursing observations, progress notes and a rounds list, sickest first
- Ward charts the facility can edit: fluid balance, neuro and others
- Bedside-monitor readings waiting for a nurse to accept
- A vacated bed released only when housekeeping has cleaned it
Theatre and the emergency department
Theatre sessions and case bookings check for clashes; the WHO surgical safety checklist is enforced step by step, and the theatre register records its four times. In the emergency department, the tracking board runs by zone and bay, sickest first, with door-to-doctor time and dispositions that admit, refer or discharge in one step.
- Theatre sessions, case booking and the WHO surgical safety checklist
- Theatre register and recovery board
- ED tracking board by zone and bay, built on triage (ETAT+ or five-level)
- Blood bank: compatibility enforced on every issue
Rehabilitation and palliative care
Physiotherapy runs as episodes with outcome measures — Barthel, FIM and muscle testing — and billed sessions, assistive products and prosthetics. Palliative teams record enrolment, home visits with symptom scoring, opioids on the WHO ladder, advance care planning and bereavement follow-up.
- Rehabilitation episodes with Barthel, FIM and muscle-testing assessments
- Billed therapy sessions, assistive products and prosthetics
- Palliative home visits with symptom scoring
- Opioids on the WHO ladder, with the pharmacy’s controlled-drug register
The modules hospitals use
Every facility gets the core. Add-ons are switched on only where you need them.
Inpatient Wards
Wards, beds and the stay itself — from the admission waiting list to the discharge clearance.
- Ward board with bed census and patients waiting for a bed
- Admissions, transfers and discharges, with the bed charged per night
- Medication administration record (MAR) with dose slots, holds and witnessed controlled drugs
- Nursing observations, progress notes and rounds list, sickest first
Operating Theatre
Sessions, case booking and a WHO safety checklist the system actually enforces.
- Procedure catalogue tied to priced services
- Theatre sessions and case booking with clash checks
- WHO surgical safety checklist: consent and sign-in, time-out, sign-out
- Theatre register with its four times, and a recovery board
Emergency Department
A tracking board for the ED, with dispositions that admit, refer or discharge in one step.
- ED tracking board by zone and bay, sickest first
- Attending clinician and door-to-doctor time
- Dispositions that admit to a ward, refer out, or discharge
- Built on triage, so acuity carries through
Laboratory
Ordering from the room, a worksheet for the bench, and results that keep their corrections.
- Lab test catalogue with order sets and STAT / urgent / routine priority
- Lab worksheet — technicians see their day's work in one list
- Barcoded specimen labels and scan-to-receive
- Results straight from analysers (ASTM and HL7)
Radiology & Imaging
A modality worklist that runs scan, report and verify, and lands the impression in the chart.
- Imaging study catalogue tied to priced services
- Accession numbers and a modality worklist
- Pre-procedure checklist
- Scan → report → verify, with the signed impression returned to the chart
Blood Bank
From donor to transfusion, with compatibility checked by the system rather than by memory.
- Donor register with computed eligibility
- Collections held in quarantine until screening is complete and non-reactive
- Stock board by blood group and component
- ABO/Rh compatibility enforced on every issue
Pharmacy
A dispensing window that knows the prescription, the stock and whether the visit is paid.
- Prescription queue by patient visit
- Dispensing with stock deduction, pricing, and the earliest-expiring batch picked first
- Partial supply, substitution, cancellation
- Over-the-counter sales at the drug window
Billing & Payments
One balance per visit, however many counters and bills it passed through.
- Invoicing and payment recording
- One consolidated balance per visit, even when several bills are raised
- Separate pharmacy and clinical cash counters, each seeing only its own money
- Point-of-sale register with barcode scan, product grid, and running ticket
Insurance & Claims
The payer and patient share split on the bill, and claims batched per payer.
- Payers, plans and patient coverage
- Line-by-line split between what the payer and the patient owe
- Claims batched per payer, with remittances posted as payments
Support Services
The kitchen, the cleaners, the mortuary and the ambulance — each with its own list.
- Dietary: clinical diets and the kitchen tray list, with food allergies and nil-by-mouth
- Housekeeping: a vacated bed is released only when its clean is done
- Mortuary register with chain of custody and recorded release
- Ambulance fleet, dispatch and call log with response times
HMIS & Surveillance
The national returns a facility is legally required to file, produced from the work already recorded.
- Monthly, quarterly and annual HMIS service return on the official reporting calendar
- OPD and IPD disease returns by sex and age band
- DHIS2 export keyed by FMOH indicator code
- Notifiable-disease alerts and the weekly IDSR return
What hospitals ask us
Which modules does a primary, general or specialized hospital need?
Every hospital gets the core — patients, appointments, charting, billing, staff and reports. Most add Inpatient, Laboratory, Pharmacy and Inventory; general and specialized hospitals typically add Operating Theatre, Emergency, Imaging and Blood Bank. Each is switched on per facility.
Does it have a medication administration record?
Yes. Dose slots for every order, holds, and a witness for controlled drugs.
Is the WHO surgical safety checklist built in?
Yes. Consent and sign-in, time-out and sign-out are enforced, with a theatre register and recovery board.
Can patients pay a deposit and run a bill?
Yes. Patient deposits, refunds and a running bill for inpatients, with bed nights charged automatically.
Does it produce the HMIS return?
Yes — the monthly, quarterly and annual HMIS service return, the OPD and IPD disease returns, and a DHIS2 export keyed by FMOH indicator code. It produces the export; it does not submit to DHIS2 for you.
We are on a national EMR. Can Bloom work alongside it?
Bloom does not integrate with SmartCare, Bahmni or PulseCare. It offers FHIR R4 read access and CDA documents for exchange. It fits best where there is no national EMR — private hospitals, private wings, or where billing, stock and departments need one system.
Does it work offline?
Recording work needs a connection. The staff mobile app keeps records readable offline, but new entries wait for the connection.
The research behind this page
EMR in Ethiopia: adoption is not the hard part, use is
Roughly half the Ethiopian health workers who have an EMR in front of them use it. The evidence points squarely at training, manuals and management — not at software features — and the paper baseline being replaced is worse than most comparisons assume.
Reporting on time and reporting correctly are different problems
Ethiopia runs one of the world's largest DHIS2 deployments — 30,000+ facilities, 95% reporting rates. The national maturity assessment scores data quality and infrastructure far lower. Submitting a report and submitting a correct one are not the same achievement.
Who pays: out-of-pocket, insurance, and why billing accuracy is a supply problem
The most-quoted figure for Ethiopian out-of-pocket spending is 31%. The WHO-sourced series puts it at 46.3% for 2023. Both are cited here, because the gap between them is the whole point about dated statistics.
The workforce math: more graduates, unfilled posts, and an $800m gap
Ethiopia's health labour market analysis projects steadily rising supply of nurses, midwives and doctors through 2030 — and a financing gap large enough that graduates go unemployed while services stay understaffed. When clinician time is the scarcest input, admin minutes are clinical minutes.
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Walk one admission through it
Bring a real inpatient stay — admission, ward round, theatre, discharge, bill. We will run it through the system with your matron and finance head on the call.