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      Hospital information systems (HIS) are at the heart of a fundamental shift in Swiss healthcare. What began as a documentation system is now evolving into the strategic operating system for hospitals.

      Today, HIS connect clinical, nursing and administrative processes and provide the foundation for seamless care delivery. This makes them a central tool for managing the organization and a critical lever for hospitals’ future ability to act.

      At the same time, pressure to transform is increasing significantly across the market. Many hospitals face the challenge of advancing their existing systems while meeting growing demands for digitalization, efficiency and connectivity.

      „The choice of HIS shapes not only the IT landscape, but also a hospital’s future strategic ability to act.“
      Florian Vinzenz Schmid

      Director, Sector Head Public

      KPMG Switzerland

      Florian Vinzenz Schmid

      Director, Sector Head Public

      KPMG Switzerland

      Christoph Marschner

      Director, Digital Transformation

      KPMG Switzerland

      Why now is the right time to act

      Our latest study on hospital information systems (HIS) (in German) highlights the current state of Swiss healthcare:

      High dissatisfaction with existing HIS

      The hospitals surveyed report low overall satisfaction with their current hospital information systems, with Swiss hospitals rating their systems even more critically than hospitals in Germany. Future readiness is viewed particularly critically. Many systems are considered stable, but neither innovative nor scalable.

      Cloud, automation and artificial intelligence (AI)

      Although digital innovation in healthcare, automation and AI are still used only to a limited extent, the hospitals surveyed consider their potential to be very high. A substantial gap remains between strategic ambition and operational reality.

      Strategic reasons for replacing an HIS

      The Swiss hospitals surveyed are pursuing the following objectives by replacing their HIS: 

      • Reduce the burden on staff
      • Standardize processes
      • Integrate new technologies, AI and automation
      • Improve interoperability and data availability

      In this context, cost reduction and patient safety receive comparatively lower ratings.

      These findings show that HIS transformation extends far beyond technology.

      At the same time, several structural developments are reshaping the role of HIS:

      1. Economic pressure and efficiency requirements

      • Increasing cost pressure
      • Growing need for efficient care delivery processes

      2. Regulatory requirements

      • Increasing importance of interoperability
      • Requirements for data flows and connectivity

      3. Technological momentum

      • Cloud and platform architectures
      • Advances in data processing and AI

      4. Clinical and operational changes

      • Growing expectations for patient-centered care
      • Integration of outpatient and inpatient services

      These developments are significantly increasing the pressure to act and compelling hospitals to realign their HIS strategy. Replacing an HIS is often no longer simply a technology decision. It is part of a broader organizational transformation.

      Beyond documentation: the new role of HIS

      While traditional systems primarily served documentation purposes, modern HIS support not only clinical documentation but also appointment scheduling, medication management and numerous administrative processes.

      They orchestrate processes, connect care partners and lay the foundation for data-driven decisions

      Key development areas:

      • Workflow automation
      • Integration of different care delivery systems
      • Provision of structured data
      • Clinical decision support
      • Connectivity across organizational boundaries

      New technologies are accelerating this development:

      • Automated data capture, for example through voice input and sensors
      • Integration of external data sources
      • Increasing use of data-driven applications

      Why the alignment of IT architecture is a core strategic consideration

      The chosen architecture determines how flexible, integrable and future-ready an HIS will be over the long term.

      Hospitals are currently choosing among:

      • Monolithic systems – stable, but not very flexible
      • Modular systems – flexible, but still vendor-dependent
      • Microservices-based systems – agile, but complex

      The choice of architecture is not merely an IT decision. It is a strategic organizational decision.

      Greater flexibility also creates additional requirements:

      • Integration capabilities, for example APIs and FHIR
      • Mature operating and monitoring structures
      • Clear governance and release processes
      • The ability to manage multiple vendors

      This means:

      • Not every organization benefits from maximum flexibility
      • Modularity is often the most practical intermediate step

      For hospitals, this means that the most modern architecture is not automatically the right one. The right architecture is the one that fits the organization’s strategic objectives, resources and capabilities.

      Interoperability makes the difference

      Without standardized interfaces, clinical, administrative and external systems can be connected only to a limited extent.

      Core requirements:

      • Standardized interfaces, for example FHIR
      • Integration of clinical and administrative systems
      • Connectivity with external partners
      • Support for data platforms

      This raises a central strategic question: Should the HIS primarily orchestrate processes, or should it also serve as the foundation for an organization-wide data platform?

      „Interoperability is becoming a strategic imperative.“
      Christoph Marschner

      Director, Digital Transformation

      KPMG Switzerland

      Alongside technological considerations, regulatory requirements are also becoming increasingly important:

      • Future hospital information systems will increasingly provide medically relevant functionality, making compliance with Switzerland’s Medical Devices Ordinance more important.
      • HIS vendors are therefore increasingly moving toward modular system designs to better address the complex requirements of the Medical Devices Ordinance.

      The challenge is therefore not simply to connect systems, but to create a data foundation that enables cross-functional processes and informed decision-making.

      Why some HIS transformations succeed while others fail

      „Adopt before adapt.“


      Implementing a new HIS is not a conventional IT project. It is a comprehensive transformation.

      Successful transformations do not begin with software selection. They begin with strategic objectives, implemented through a clear target architecture and standardized processes, and with an organization that actively supports the change.

      Key success factors:

      • A clear target architecture and strategic vision
      • Early involvement of all specialist functions
      • Consistent standardization
      • Integrated preparation across technology and the organization

      Particularly important:


      During an HIS transformation, standardization should be treated as a strategic priority to improve efficiency and ensure future readiness.

      This is not purely a technical issue. It is a holistic challenge that can support the organization-wide use of artificial intelligence (AI).

      • Not every existing process should be carried over
      • Focus on standard processes rather than customized solutions

      Typical risks:

      • Excessive customization
      • Underestimating data migration
      • Lack of acceptance among specialist functions
      • Unclear governance
      • Insufficient change management

      The success of an HIS transformation therefore depends less on software selection than on the consistent alignment of the organization, processes and governance.

      „Technical implementation is only the beginning of the transformation. Sustainable value emerges only through successful adoption and integration into day-to-day operations.“
      Christoph Marschner

      Director, Digital Transformation

      KPMG Schweiz

      Collaboration as a response to growing complexity

      Before embarking on an HIS transformation, hospitals should answer the following questions in particular.

      Objectives of collaborative approaches:

      • Reduce complexity
      • Harmonize processes
      • Achieve economies of scale
      • Use resources more efficiently

      Practical effects:

      • Less duplication
      • Better use of capacity
      • Faster processes
      • Greater focus on core clinical services

         


      Collaboration reduces complexity, creates economies of scale and improves the quality of care at the same time.

      Questions hospitals should ask now

      Before embarking on an HIS transformation, hospitals should answer the following questions in particular:

      • What role should the HIS play in the future?
      • Which architecture fits the organization?
      • How will interoperability be ensured?
      • Which processes should be standardized?
      • Where can collaboration create added value?
      priority_high

      Note

      These questions should be answered at an early stage, because architecture, processes and the organization can be changed only to a limited extent after implementation.

      HIS shape hospitals’ future readiness

      Hospital information systems are now far more than clinical information systems. They provide the digital foundation for management, collaboration and care delivery within the hospital.

      Their value does not come from individual functions, but from the interaction of:

      • Strategy and target architecture
      • Architecture decisions
      • Interoperability and data capabilities
      • Organization and governance

      Today, hospital information systems shape not only the quality of the IT landscape, but increasingly a hospital’s ability to deliver, manage operations and remain future-ready.

      Organizations that view HIS transformation solely as a technology project will not realize its full potential. Successful transformations bring strategy, architecture, processes and the organization together in an integrated target state, creating the foundation for high-performing and future-ready healthcare deliver.

      Shaping change together – with foresight and impact

      Digital transformation in healthcare requires a holistic approach.

      Our expert teams support organizations in developing and implementing sustainable digital strategies for hospitals – from current-state assessments, governance and transformation considerations to the practical implementation of connected healthcare solutions.

      Meet our experts

      Florian Vinzenz Schmid

      Director, Sector Head Public

      KPMG Switzerland

      Christoph Marschner

      Director, Digital Transformation

      KPMG Switzerland

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