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Purpose of the Diagram

The following diagram is a high-level conceptual diagram or logical overview of the OpenHIE architecture that is intended to be notional.  This diagram represents the consensus of the OpenHIE Architecture Review Board as determined through the Architecture Governance and Principles.   It is expected that implementations based upon OpenHIE may have more precise lower-level conceptual diagrams and /or physical diagrams.  

High Level Overview

A Health Information Exchange (HIE) makes the sharing of health data across information systems possible. Like a universal translator, an HIE normalizes data and secures the transmission of health information throughout databases, between facilities, and across regions or countries.

OpenHIE’s architecture is made up of six open-source software components, all interacting/interoperating to ensure that health information from various external systems is gathered into a unified person-centric medical record.  To accomplish this, the exchange normalizes the context in which health information is created across four dimensions: 1) who received health services, 2) who provided those services, 3) where did they receive the services, 4) and what specific care did they receive.  By focusing on the “For Whom”,”By Whom”, “Where”, and “What” of a patient's health visit we help to bring relevant information directly to the point of care. This supports enhanced decision-making, improves the quality, safety and continuity of care, and facilitates the appropriate use of information to improve population health.

Note: Registries maintain authoritative reference  information required to support health information exchange. They provide query and resolution services so that participating systems can validate or obtain the formal and normalized observations, identifiers, names and codes to reference an entity (such as a health worker, client, facility, etc.)


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  1. Terminology Service serves as a central authority to uniquely identify the clinical activities that occur within the care delivery process by maintaining a terminology set mapped to international standards such as ICO10, LOINC, SNOMED, and others – “What?” See also:What constitutes an OpenHIE Terminology Service?

  2. An enterprise master patient index (EMPI), or Client Registry manages the unique identity of citizens receiving health services with the country – “For whom".  See also: What constitutes an OpenHIE CR?

  3. Shared Health Record (SHR) is a repository containing the normalized version of content created within the community, after being validated against each of the previous registries.  It is a collection of person-centric records for patients with information in the exchange. See also: What constitutes an OpenHIE SHR?

  4. Health Management Information System (HMIS) stores routinely-collected aggregate health care data, and facilitates their analysis with the goal of improving the quality of health services. See also: What constitutes an OpenHIE HMIS?

  5. Health Facility Registry serves as a central authority to uniquely identify all places where health services are administered within the country – “Where?” See also: What constitutes an OpenHIE Facility Registry?

  6. Health Worker Registry is the central authority for maintaining the unique identities of health providers within the country – “By whom." See also:  What constitutes a HWR?

  7.  A Health Interoperability Layer receives all communications from external services within a health geography, and orchestrates message processing among the external systems and the OpenHIE component layer. See also: What constitutes an OpenHIE IOL?


  8. External systems, such as the OpenMRS electronic medical records (EMR) system and the RapidSMS mHealth application, are used by clinicians and by community health workers to access and update a patient’s person-centric shared health information and to record healthcare transactions.