Case study 01
National HL7 FHIR platform
Interoperability infrastructure so health data can move between national systems without being re-interpreted at every boundary.
Problem
Health data in Nepal was produced by systems that had no common language. Facility records, registries, laboratory results, and programme reporting each carried their own structures and code sets, so every new connection meant a new bespoke integration — and every integration became something someone had to maintain.
The cost of that is not mainly technical. It is that a question like “how many patients does this actually represent?” cannot be answered reliably across systems, which means national decisions get made on partial evidence.
Approach
I developed the national FHIR-based health data exchange capability, together with the implementation guidance that makes it usable by teams who were not in the room when it was designed.
- Designed the FHIR resource and profile set representing Nepal's health data, so the standard constrains real local practice rather than describing it loosely.
- Wrote the national implementation guidelines — the artefact that determines whether an interoperability platform gets adopted or quietly bypassed.
- Deployed Open Concept Lab for terminology management, giving code systems a governed home instead of leaving them embedded in application code.
- Aligned the design to OpenHIE architecture so component responsibilities and boundaries were named up front, and components could be replaced independently.
- Contributed the resulting design into Nepal's HIS interoperability roadmap.
Technology
- HL7 FHIR
- Open Concept Lab
- OpenHIE
- SNOMED CT
- ICD-11
- DHIS2
- REST APIs
- Terminology services
Impact
The platform gives Nepal standards-based, secure, interoperable health data exchange — and, just as importantly, published guidance and governed terminology so the capability outlives any single implementation team.
- Standardized, secure health data exchange across national systems.
- Implementation guidelines that let other teams build conformant systems independently.
- Terminology services under governance rather than scattered across applications.
- A direct contribution to the national HIS interoperability roadmap.