valantic viewpoint
Hospital Information Systems
Hospitals in Europe are replacing outdated core hospital IT systems, prioritizing interoperability, clinical depth, and phased migrations.
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€50bn
modernization need for infrastructure and clinical software in Europe
300
core HIS migrations in DACH as SAP IS-H / i.s.h.med support ends (2027–2030)
~11%
CAGR for Hospital Information Systems market until 2030
Our perspective on Hospital Information Systems
Executive Summary
European hospitals face their largest IT replacement wave in decades, driven by SAP sunsets and regulatory interoperability standards.
European hospitals have to replace their old legacy systems amid the sunset of SAP IS-H and i.s.h.med between 2027 and 2030, combined with mandatory interoperability standards, accelerates a multi-billion-euro migration wave. Hospitals demand API-first, modular platforms that bridge legacy systems and enable phased, low-risk migrations. For investors, this market offers attractive recurring revenues, service pull-through, and consolidation opportunities.
Vendors that combined clinical credibility with modular flexibility and strong integration capabilities benefited most. The resulting market showed concentrated incumbency in Germany, strong regional suite leaders elsewhere in Europe, and specialized clinical point solutions competing for share-of-wallet around imaging, lab, perioperative, and medication safety. For investors, this created a multi-year, multi-billion migration wave with attractive recurring revenue, service pull-through, and platform roll-up angles.
Key Findings
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1
SAP support deadlines compress refresh cycles, intensifying tenders
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2
Buyers demand FHIR/API-first stacks and unified data layers
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3
Phased migration strategies outperform big-bang replacements
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Khalid Ouaamar
valantic Managing Director
”Europe’s HIS market is entering a €50 bn modernization wave, driven by SAP sunsets and new interoperability standards. The winners will be those that unite clinical credibility with modular flexibility and seamless data integration.“
Market Trends: from compliance push to clinical productivity
European HIS buyers moved from grant-funded projects to core replacements as SAP IS-H and i.s.h.med sunsets (2027–2030) converged with interoperability mandates and national e-record rollouts. Hospitals prioritized FHIR-first platforms with unified data layers to integrate real-time clinical and administrative data. Aging populations and multimorbidity reinforced demand for care orchestration and medication safety, driving a ≈ €50 bn replacement wave with hundreds of DACH migrations.
Key Takeaways:
- Compliance and SAP sunsets synchronized refresh cycles
- ≈ 50 bn EUR modernization demand across HIS/CIS stack
- 2027–2030 support end dates shape tender calendars
Market Drivers: cost, workforce, and interoperability
Workforce shortages drove demand for automation, standardized workflows, and revenue-cycle optimization. Interoperability mandates enforced FHIR/API-first designs, enabling data exchange across networks. Rising patient volumes and complexity reinforced the need for decision support and closed-loop medication. Budgets moved from grant-funded projects to core HIS replacements and cloud-ready platforms that cut costs and speed upgrades.
Key Takeaways:
- Staff shortages pushed automation and standardization
- API-first, FHIR compliance required for networked car
- AI prioritized in medical coding, clinical decision support, and forecasting patient demand
Competitive Landscape: fragmented by geography and product breadth
The European HIS market is fragmented. In Germany, Mesalvo and CompuGroup Medical dominate with large installed bases, making them key challengers in the SAP migration wave. Across Europe, Dedalus has the broadest footprint but must improve modules and interoperability to compete in Germany. In the Netherlands, ChipSoft offers modern full-suites and uses SaaS rollouts to enter neighboring markets. Specialists like Philips, Dräger, Sectra, Oracle Health for i.s.h.med and SAP legacy systems remain strong in niches but lack full-suite breadth.
Key Takeaways:
- Incumbents dominate with full-suite solutions in Germany
- Germany: SAP sunsets trigger big market shifts
- Specialists capture modules but lack full-suite scale
Business Model & Value Chain: software-led, services-amplified
Most HIS/CIS vendors earn mainly from software, using primarily a mix of SaaS and managed services, like implementation, training, and support. The highest value lies in high-acuity modules such as perioperative, ICU, oncology, radiology – integrated via a unified data layer. While ADT, billing, and financials remain core, differentiation comes from clinical depth and interoperability. Cloud-ready designs and standardized rollouts further improve scalability, margins, and time-to-value.
Key Takeaways:
- Growing SaaS share drives predictable revenues
- Increasing service revenues from implementation and managed ops
- Differentiation in high-acuity clinical modules
Growth Levers: Winning migrations, expanding modules, scaling delivery
The strongest short-term lever is capturing SAP IS-H and i.s.h.med migrations in Germany, using proven migration playbooks and reliable partner capacity. Mid-term, vendors grow wallet share by adding high-acuity clinical modules, embedding AI into decision support and revenue cycle, and rolling out API-first architectures across networks. Operating models increasingly shift to SaaS and managed services, supported by standardized rollout templates and alliances with hyperscalers or major ERPs. Select bolt-on acquisitions help close module gaps and accelerate reach. Collectively, these moves prepare vendors for consolidation into global platforms or expansion into adjacent European markets.
Key Takeaways:
- SAP migrations (2027–2030) dominate near-term tenders
- Land with core software suite, expand into clinical depth
- SaaS and managed services drive scalability and margins
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Christoph Nichau
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Khalid Ouaamar
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