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Department of Global Health
Our Work
Digital Transformation at Scale—
With the Ecosystem to Sustain It
We combine open source health technologies with the workforce development, governance, and evaluation needed to make digital transformation last. Our solutions are deployed across 26+ countries, supporting over 18 million patients worldwide.
DIGI’s portfolio comprises three core areas of applied research in informatics and digital health innovation:
Health Information Technologies & Architecture
We design, develop, and implement standards-based health information systems—from electronic medical records and laboratory information systems to health information exchanges. Our work spans the full lifecycle: requirements analysis, architecture design, software development, deployment, and ongoing support for systems serving millions of patients.
Workforce Development, Governance & Policy
Technology alone doesn’t transform health systems—people and policies do. We build local informatics capacity through training programs, strengthen HIT governance structures, and support the policy frameworks that enable sustainable digital health ecosystems. This enabling environment work is what makes digital transformation stick.
Evaluation & Continuous Quality Improvement
We apply rigorous evaluation methods to assess system performance, program effectiveness, and health impact. Our ISHO Assessment framework has been used in 20+ countries to benchmark informatics maturity and guide strategic investment. This evidence-driven approach ensures that digital health investments deliver measurable improvements in care.
Featured Projects
Electronic Medical Records
National EMR Systems
DIGI supports national EMR implementations across multiple countries, building on OpenMRS to create sustainable, country-owned health information systems that scale from community clinics to national networks.
DIGI and OpenMRS
The DIGI team includes the OpenMRS Community Engineering Lead and the OpenMRS Chair of the Board of Directors.
At DIGI, we provide expertise to governments and organizations on every aspect of OpenMRS:
✓ Landscape analysis and requirements
✓ Design, development, QA, migration, deployment
✓ Interoperability and architecture
✓ SMART guidelines implementation
✓ Training for users, developers, supporters
✓ Data warehousing and research data models
Built on OpenMRS, an open source medical record platform used in 80+ countries for millions of patients worldwide.
Did You Know?
DIGI is a Top-Tier OpenMRS Partner
Country Implementations
🇰🇪 Kenya
KenyaEMR – National EMR system supporting HIV care and treatment across Kenya
🇭🇹 Haiti
iSante+ – Haiti’s national health information system
🇨🇮 Côte d’Ivoire
SIGDEP3 – National EMR with OpenCR-based client registry integration
🇨🇩 DRC
Supporting national EMR development in the Democratic Republic of Congo
🇿🇼 Zimbabwe
National EMR implementation for Zimbabwe’s healthcare system
CDC Technical Assistance Platform (TAP)
As TAP partners, DIGI and OpenMRS are collaborating to realize the Triple S aim for the OpenMRS 3.x product — stable, secure, and scalable. This initiative ensures that OpenMRS-based systems meet the highest standards for national-scale deployment.
Computable Guidelines
WHO SMART Guidelines for HIV
DIGI is working with WHO to implement SMART (Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable) guidelines for HIV care. These computable guidelines translate clinical recommendations into machine-executable logic that can be integrated directly into electronic health systems.
By encoding WHO clinical guidelines as FHIR-based decision support, we enable consistent, evidence-based care across diverse health systems—reducing clinician burden while improving patient outcomes.
Key Features
Standards-Based — Built on HL7 FHIR and CDS Hooks specifications
Machine-Readable — Clinical logic encoded in CQL (Clinical Quality Language)
Adaptive — Configurable to local contexts and workflows
Testable — Includes test cases for validation and conformance
Partner
Surgical Care
Patient Reported Outcomes for Post-Surgical Follow-up
OpenMRS serves as the backbone for this surgical care system, where surgery patients are registered. Patients can later share photos of their surgery site incisions so surgeons can monitor progress and advise on follow-up.
This innovative approach to post-operative care reduces the need for in-person follow-up visits while enabling timely intervention when complications are detected—improving outcomes and reducing healthcare system burden.
Partner
Interoperability
Health Information Exchange
Healthcare systems worldwide face the challenge of providing high-quality patient care with seamless access to accurate and timely health information. Fragmented digital health systems and lack of interoperability hinder this goal. Providing access to the right information at the right time in the right place is the key goal of a Health Information Exchange (HIE).
Our Approach
DIGI specializes in developing national-level HIE platforms using open-source technologies and global standards. We collaborate with Ministries of Health and stakeholders to create scalable, secure, and modular HIE solutions that ensure data integrity and enhance patient care.
We provide informatics and technical engineering expertise to advise and facilitate stakeholder consensus building for national HIE architecture. With collaboration, we define priority workflows, select and configure HIE components, build standards-based integrations, and conduct quality and conformance testing to ensure patient information is accurate, timely, and complete.
Technology Stack
We establish foundational national standards-based HIE using the OpenHIE architecture, FHIR standards, and global goods including: OpenMRS EMR, HAPI FHIR as the centralized Shared Health Record (SHR), OpenCR Client Registry, OpenHIM interoperability layer, and Instant OpenHIE v2 packaging for production-ready deployment.
Our architectures conform to OpenHIE specifications, ensuring interoperability with the global digital health ecosystem.
HIE Components
• OpenHIM — Interoperability Layer
• HAPI FHIR — Shared Health Record
• OpenCR — Client Registry
• GOFR — Facility Registry
• Instant OpenHIE v2 — Deployment
Country Implementations
🇧🇼 Botswana
Focused on automated exchange of laboratory test orders and results between EMR and LIS systems. Designed a technical solution using OpenHIE architecture with Kafka-based task runners that enable flexibility, easier contextualization, and rapid expansion across the public and private health sector.
🇭🇹 Haiti
SEDISH (Système d’Échange de Données d’Information en Santé d’Haïti) – Haiti’s national health information exchange platform connecting EMR and laboratory systems.
✓ Improved turnaround times by ~1 week
Workforce Development
Digital Health Training for Field Epidemiologists
Public health emergencies know no boundaries. Epidemiologists on the ground are our first line of defense against the spread of infectious diseases. When field epidemiologists are able to use the right digital health solution for the job, they can rapidly detect, diagnose, and respond to public health outbreaks. DIGI collaboratively designed and developed two opportunities for local epidemiologists to come up to speed with advances in digital health.
FETP Informatics Course
A one-week introductory course for the Field Epidemiology Training Program (FETP) designed using an open, iterative, and collaborative curriculum development process. The result is training that can be adapted to reflect local digital health systems and responds to real, on-the-ground surveillance and outbreaks as experienced by field epidemiologists.
✓ Locally owned ✓ Sustainably implemented ✓ Reality-based scenarios
AES-PHI Fellowship
A two-year fellowship for local epidemiologists interested in deepening their digital health skills through the Applied Epidemiology Solutions – Public Health Informatics (AES-PHI) program. This advanced program builds informatics leadership capacity for sustainable public health systems.
✓ Advanced informatics training ✓ Leadership development ✓ Applied projects
Partner
Open Source Products We Steward
We’re committed to the long-term sustainability of these global goods, providing technical leadership, community governance, and continuous improvement.
OpenELIS Global
Laboratory Information System
OpenELIS Global is a robust, enterprise-level laboratory information management system (LIMS) serving over 600 labs across 14+ countries. Built to meet international standards, it supports the full spectrum of laboratory workflows from sample collection to results reporting.
TB Diagnostics
Clinical Chemistry
FHIR Integration
OpenCR
Open Client Registry
OpenCR is an open source patient identity management solution that enables patient matching and de-duplication across health information systems. It serves as a foundational component for Health Information Exchanges, ensuring unique patient identification across disparate systems.
Key capabilities include probabilistic and deterministic matching algorithms, FHIR-native API, configurable matching rules, and integration with OpenHIE architectures.
GOFR
Global Open Facility Registry
GOFR is an open source facility registry that enables the management and reconciliation of health facility data across multiple sources. It provides a central reference for facility information, supporting health system planning, service delivery, and interoperability.
Features include facility matching and de-duplication, hierarchical organization support, FHIR Location resources, and configurable data import from multiple sources.
Resources
Assessment Toolkit
ISHO Assessment
Informatics-Savvy Health Organizations (ISHO) Assessment: Strengthening health systems and public health informatics
The ISHO Assessment helps public health systems achieve their informatics vision by offering a comprehensive framework to assess readiness for transformation, identify critical gaps, and build stakeholder consensus. Used in 20+ countries, this collaborative process develops roadmaps to enhance informatics capabilities at national and sub-national levels.
Three Core Capabilities
Vision, Policy & Governance
Clear strategy and governance for managing information and technology as critical resources.
Skilled Workforce
Adequate staff skilled in using information and technology tools effectively.
Effective Information Systems
Systems thoughtfully designed to support staff work effectively and efficiently.
Stages of Maturity
Six stages: Absent → Initial → Managed → Defined → Measured → Optimized
Partner
“We were able to conduct the above-site rapid assessment efficiently. The results are now helping shape the situation analysis and identify key areas for inclusion in the digital health strategy.”
Sam Wambugu, Project Director, Center of Digital and Data Excellence at PATH
Knowledge Base
HIE Knowledge Hub
Our comprehensive wiki provides documentation, architecture patterns, implementation guides, and best practices for health information exchange. Whether you’re building your first HIE or optimizing an existing platform, you’ll find practical resources from real-world implementations.
Topics Include
• OpenHIE Architecture
• FHIR Implementation Guides
• Client Registry Patterns
• Lab-EMR Integration
• Instant OpenHIE Deployment
Ready to Build Something Together?
Whether you’re a ministry of health, implementing partner, or funder—we’d love to explore how we can support your digital health goals.