Overview
This guide provides a starting point for learning about the Botswana Health Information Exchange (HIE). The project is based on the OpenHIE architecture and uses the Instant OpenHIE V2 tooling to for packaging, deployment, and horizontal scalability. Currently, the HIE consists of core components of the HIE architecture customized to the Botswana context, as well as components supporting two target workflows: Patient Identity Management and Laboratory Order and Result Management. As this project levereges a number of open standards and global goods (OpenHIE, FHIR, HIE IGs, etc.), this documentation contains a number of references to useful external resources.
Architecture
The Botswana HIE is based on the OpenHIE architecture. The following diagram shows the core components of the HIE architecture, and highlights the components currently in scope for implementation as part of the Botswana HIE project.
HIE Components Index
Interoperability Layer
The Interoperability Layer (IOL) is the core component of the OpenHIE architecture responsible for securely routing messages between the various other components of the HIE, and providing the entrypoint interface for external point-of-service clients. This layer is implemented using OpenHIM.
Client Registry (Master Patient Index)
The Client Registry (CR) is responsible for linking and managing the identities of patients across the health system. This component is iplemented using OpenCR.
Shared Health Record
The Shared Health Record (SHR) service stores the longitudal health record for each patient from across the health system. This component supports workflows that require access to a shared central repository of patient data, such and laboratory order and result workflows. This component is implemented using SHR.
Terminology Service
The Terminology Service (TS) is responsible for managing terminology collections from across the health system and their mappings to standard terminologies. This component is implemented using Open Concept Lab.
Other OpenHIM Mediators
The CR and SHR run as OpenHIM mediators. In addition, the following mediators are used to support the HIE workflows:
FHIR Converter: This mediator is responsible for converting FHIR messages to HL7 messages and vice versa. This mediator is implemented here: https://github.com/I-TECH-UW/openhim-mediator-fhir-converter
Omang, BDRS, and Immigration API: This mediator provides and interface for the Omang, BDRS, and Immigration databases. This mediator is implemented here (private repository): https://github.com/I-TECH-UW/OmangSVC
Common OpenHIE Instant V2 Components
These components are used across HIE implementations and packaged using Instant OpenHIE V2. A number were based on or inspired by the Jembi platform project: https://github.com/jembi/platform
Reverse Proxies
Kafka: https://github.com/I-TECH-UW/hie-botswana/tree/main/message-bus-kafka
HAPI FHIR Store: https://github.com/I-TECH-UW/hie-botswana/blob/main/fhir-datastore-hapi-fhir/README.md
Monitoring for Kafka and Docker: https://github.com/I-TECH-UW/hie-botswana/tree/main/monitoring
Externally Managed Services
These integrations include both point-of-service systems like EMRs and LIMs, as well as HIE components like the Facility Registry.
Facility Registry (Master Facility List): OpenHIE Documentation* The Facility Registry (FR) or Master Facility List (MFL) is responsible for managing the list of facilities and their health services across the health system. This system is being built and maintained by BITRI.
PIMS: This is a custom-built EMR used in Botswana.
Botswana EMR: This is an OpenMRS-based EMR used in Botswana, and developed by BITRI.
IPMS: This is a EMR and LIS system used in major facilities in Botswana developed by Meditech.