Replacing the HIS after the end of SAP IS-H and i.s.h.med: what hospitals must decide now

What is ending, and when?

IS-H is SAP’s industry solution for patient management and patient billing in hospitals, built on SAP ERP (ECC). According to DSAG, the association of SAP customers in German-speaking countries, SAP stopped its own development of a new patient billing solution on S/4HANA in October 2022; there is no successor from SAP. In future, patient administration and billing are to be covered by the HIS (hospital information system, German: KIS) of other vendors.

For the core applications of SAP Business Suite 7, SAP has committed to regular maintenance until the end of 2027, followed by an optional, paid extension (extended maintenance) until the end of 2030. After that, only customer-specific maintenance remains.

i.s.h.med is a clinical system from Oracle (formerly Cerner) that builds on IS-H and covers medical documentation. According to DSAG, Oracle is also discontinuing support, but offers an extension until 2035 under certain conditions (as of July 2023). Check the conditions in your contract.

	Regular maintenance	Extension
SAP IS-H (Business Suite 7)	until the end of 2027	paid, until the end of 2030
i.s.h.med (Oracle)	also being phased out, according to DSAG	until 2035 under conditions

As of October 2026. The dates apply equally in Germany, Austria and Switzerland.

How much time is left for the switch?

Less than the dates suggest. DSAG expects selection and rollout of a new system to take up to three years and advises starting selection and tendering early. Many hospitals will therefore need the paid extension until 2030.

Public contracting authorities, such as municipal hospitals and university hospitals, must put a new HIS out to tender; at this scale usually EU-wide. According to Krankenhaus-IT Journal, ten vendors had presented solutions for the IS-H succession by autumn 2025, and the first pilot projects are under way. On procurement law: Procurement law for AI in Germany, and for Austria and Switzerland the guides on the BVergG and the IVöB.

Which decisions are due?

1. Scope: Replace only patient management and billing and keep the clinical system? Or the whole HIS in one project? If i.s.h.med is in use, the clinical side is tied in.
2. Architecture: A HIS from a single vendor, or individual modules with open interfaces. DSAG warns of new dependencies, for example if a HIS does not connect billing solutions from other vendors.
3. Interfaces and data: Which ISiK modules are confirmed (under § 373 SGB V)? Which data does the HIS provide via FHIR to other systems, and on what terms? How is legacy data migrated?
4. Operation: In your own data centre or in the vendor’s cloud. In the cloud, the proof under § 393 SGB V applies to health data.
5. AI: Which AI does the HIS bring, where does it run, and what should run outside the HIS?

What does a switch look like in practice?

One example: after an EU-wide tender, Klinikum Stuttgart chose the HIS from Avelios Medical (press release of 5 August 2026). The project fully replaces the existing landscape of SAP IS-H and i.s.h.med, with a rollout in the cloud for all clinical and administrative core processes. Avelios describes its HIS as AI-native, with conversation documentation, drafts for the discharge letter and coding suggestions; the hospital’s board names structured data as the basis for using AI.

Other hospitals choose an established HIS and initially replace only billing. Both are possible; what matters is the schedule, the budget and how much change the departments can absorb while operations continue.

How do you plan for AI in a HIS replacement?

Keep two questions apart:

• AI in the HIS: Conversation documentation, doctor’s letters from case data, coding suggestions in the screens of the HIS. This comes with the vendor and belongs in the tender: what is available today, what is announced? Where does the AI model run? Is a feature a medical device? An overview is given in the guide AI in the HIS: what ORBIS, CGM, NEXUS and iMedOne can do.
• AI for the whole hospital: Guidelines and SOPs, contracts, emails, purchasing, HR, quality management. These tasks do not need the HIS and do not have to wait for the switch. More on this: Horizontal AI platform or AI in the specialist system.

For the tender, one point that is often missing is worth adding: the new HIS should make data readable for other systems through a documented interface, for example FHIR according to ISiK, with the permissions of the respective person. Then any AI can be connected later, without having to come from the HIS vendor.

How does this work with basebox?

basebox does not replace a HIS and works alongside any HIS. Most of the 146 use cases for hospitals run without the HIS, with documents, guidelines and emails, and therefore also during the switch.

We connect a HIS as soon as the vendor provides the access, for example through the FHIR interface according to ISiK, a data platform in your hospital or an interface your hospital already uses; in agreement with you and the vendor. The design is free of charge, followed by a fixed price: €13,800 for complex systems such as a HIS, or €6,900 if the connector may go into our library (list prices, excluding VAT). If the HIS changes, the same route applies to the new system: the vendor provides the access, then we build the connector.