Approaches and Implications of Transitioning National Level Health Information Systems: Case Example of Mozambique.

Transitions in national level health information systems (HIS) require careful assessment of technical, organizational, and policy implications, particularly in low- and middle-income countries. Mozambique is currently transitioning from a long-standing OpenMRS-based HIV electronic medical record (EMR) to a new national python-based EMR. This paper proposes a conceptual framework to guide such transitions, synthesizing digital health standards, enterprise architecture principles, and implementation science. The framework outlines five analytic domains: technical architecture; data governance and migration; interoperability and standards alignment; institutional and human capacity; and financial sustainability. Applying the framework to the Mozambican case demonstrates how structured evaluation can inform decision-making, mitigate migration-related risks, and ensure institutional continuity. Insights highlight the importance of phased implementation, adherence to global interoperability standards, and strengthened governance. The proposed framework provides a practical tool for countries undertaking nationally embedded HIS transitions.