Systems Approach to Digital Transformation
Lessons from implementing Electronic Health Record System in Somalia
True digital transformation requires more than just technology—it demands a holistic approach that considers governance, human capacity, and local context. The HADDA initiative’s work on Somalia’s RAAD Electronic Health Record (EHR) system illustrates how this systems’ thinking translates into practice. For organizations pursuing similar transformations, the key takeaway is this: the hardest parts of digital change are rarely technical. Lasting impact comes from addressing the interconnected web of policies, people, and processes that determine whether technology delivers on its promise.
Strengthening the Broader Health System
At its core, the initiative recognized that introducing a digital health solution like RAAD needed to go hand-in-hand with strengthening the broader health system. Rather than simply deploying software, the project focused on building government leadership, ensuring the system aligned with national health priorities, and fostering collaboration among diverse stakeholders. This meant working closely with Somalia’s Ministry of Health to embed technical expertise within their structures while also creating coordination platforms that brought together international partners and local implementers
Balancing Standardization With Flexibility
A key lesson emerged around balancing standardization with flexibility. While RAAD was built on an established global digital health platform (Bahmni), its implementation required continuous adaptation—from customizing features based on health worker feedback to integrating with Somalia’s existing health information systems. The human element proved equally critical: investments in training and support helped bridge the gap between technical potential and real-world usage, particularly in challenging environments with limited digital literacy.
Systemic Challenges Require Systemic Solutions
The initiative also demonstrated how systemic challenges require systemic solutions. When procurement bottlenecks threatened progress, the team redesigned the approach to leverage local partners while maintaining compliance—turning a constraint into an opportunity for more sustainable implementation. Similarly, the phased rollout acknowledged that successful digital transformation isn’t about immediate scale, but about creating the right conditions for gradual, lasting adoption.