Dira Health

Most Kenyan hospitals run on a patchwork: one system for billing, another for the lab, paper on the wards and spreadsheets for MOH returns. Dira (Swahili for "compass") is a single hospital management information system that each hospital can run under its own brand.

What it covers

• Patient flow. Registration with a master patient index and duplicate detection, appointments, queues, triage with an early-warning score, outpatient encounters and emergency.
• Clinical services. Lab, radiology, pharmacy and stock, admissions and bed board, nursing and eMAR, theatre, ICU, maternity, NICU, dialysis and oncology.
• Revenue cycle. Billing, cashier, refunds, payers, pre-authorisations, claims and remittances, feeding a finance ledger.
• Back office. HR and rostering, inventory and procurement, assets, fleet and mortuary.
• Reporting and governance. MOH 705, 710 and 717 returns, public-health surveillance, research, a patient portal, and audit and privacy controls.

Under the hood

Dira is a SvelteKit and TypeScript application on MongoDB, with Typesense search and OIDC sign-in. A hospital can run on dedicated infrastructure or share a multi-tenant deployment with its own database, managed from a control plane. Clinical data moves as FHIR Kenya Core bundles, reports map to DHIS2/KHIS, and sensitive actions use four-eyes approvals, break-glass access and an audit ledger. It ships as a hardened Docker image, and 33 roles drive a generated access matrix.

Built to be trusted

Every significant design choice is written down: 184 architecture decision records so far. Playwright tests run on phone, tablet, laptop and desktop, alongside accessibility, FHIR-conformance, contract and load tests. A downtime mode with paper registers and reserved identifier blocks keeps a hospital running when the network doesn't.

Where it stands

Dira runs end to end against synthetic hospitals and patient data, and is ready for a first pilot site.