An architecture and reference implementation of an open health information mediator: enabling interoperability in the Rwandan health information exchange

Abstract

Rwanda, one of the smallest and most densely populated countries in Africa, has made rapid and substantial progress towards designing and deploying a national health information system. One of the more challenging aspects of the system is the design of an architecture to support: interoperability between existing health information systems already in use in the country; incremental extension into a fully integrated national health information system without substantial reengineering; and scaling, from a single district in the initial phase, to national level without requiring a fundamental change in technology or design paradigm. This paper describes the key requirements and the design of the current architecture using the ISO/IEC/IEEE 42010 standard architecture descriptions. The architecture takes an Enterprise Service Bus approach. A partial implementation and preliminary analysis of the architecture is given. Since these challenges are experienced by other developing African countries, the next steps involves creating a generic architecture that can be reused for health information exchange in other developing African countries.