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The OpenHIE initiative grew out of the RHEA project, where a Health Information Exchange has been developed to support maternal health in Rwanda. More information about this project and the HIE implementation is available here . The OpenHIM ( tool was designed and developed as the interoperability layer for the Rwandan project and has been implemented and is operational in one district of Rwanda.   

As a part of the OpenHIE project this community was tasked with reviewing and evaluating what makes a good interoperability layer going into the future and to determine what technologies best suit an interoperability layer for our purposes. The objective  was to provide a recommendation of whether we should use/modify an existing technology or built something ourselves, with the ultimate aim of providing a generic IOL tool that is appropriate for use in low-resource settings. 


The process and methodology we used to evaluate options for an interoperability layer were:

  1. Document use cases and requirements for a Interoperability Layer

    1. Interoperability Layer - Use Cases and Requirements

  2. Performance test the current OpenHIM used in RHEA in order to ensure the OpenHIM is scalable to national level

    1. Interoperability Layer Performance Analysis

    2. Estimated load figure for a Rwandan national deployment

  3. Create a tool to evaluate how well the Interoperability Layer software meets the requirements

    1. Interoperability Layer Evaluation Tool   
  4. Compile a list of software that could be used as an interoperability layer

    1. Interoperability Layer - Tools for review
  5. Evaluate list software options using the evaluation tool

    1. Interoperability Layer Evaluation Tool
  6. Write up results of the evaluation and come to consensus on a recommended way forward i.e. whether to use or modify an existing tool or build from scratch. 

    1. Interoperability Layer options and recommendation

  7. Create design specifications

    1. Status: COMPLETED

    2. Working Document(s):Deadline(s): 

      1. OpenHIE Interoperability Layer design document
      2. Additional Notes:
        1. Design Session HIM
        2. Open HIM Scalability Discussion
        3. No ESB Diagram
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