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Interoperability · Standards · Africa

Healthcare only works when its systems speak the same language.

We help public health institutions and health information system implementers institutionalise and operationalise the foundations that allow health systems to work together, through globally recognised, community-supported approaches to data exchange, shared meaning, and governance.

Diagram showing two organisations, each running EMR, lab, and imaging systems on their own proprietary standard, exchanging POST and GET requests through an interoperability layer with a FHIR server. Data exchange Organisation A and Organisation B each run EMR, lab, and imaging systems on their own proprietary standard. Both send POST requests through an interoperability layer to a FHIR server, and GET data back.
Organisation A
Organisation B
EMR
Lab
Imaging
EMR
Lab
Imaging
Interoperability layer
Client Registry
Mapping
Terminology Service
Shared Health Record
POST
GET
POST
GET
MPI CLINICAL DATA
GET
PII
MPI
TRANSLATE
MAPPED CODE
LEGACY
EXPECTED
How interoperability works

Four levels. Four different goals.

Each level solves a different problem. Skipping one doesn’t make the work simpler, it leaves a gap that has to be addressed somewhere else. Getting all four right is what separates an integration that is genuinely robust from one that merely appears complete.

The four levels of interoperability, building on one another Foundational connectivity leads to structural agreement on format, then semantic agreement on meaning, then organisational agreement to actually exchange data — each level building on the one before it. L1 connect systems L2 agree on message format L3 establish shared meaning L4 commit to making it work
Level 1

Foundational

The basic ability to send and receive data between two systems, regardless of what that data means.

GoalEstablish basic connectivity between two systems.

Level 2

Structural

Data is packaged into a shared, well-defined structure, such as HL7® FHIR®, an industry-recognised standard that defines how information is structured and exchanged between systems.

GoalAgree on a shared format for exchanging data.

Level 3

Semantic

Industry-recognised clinical terminologies such as SNOMED CT® and LOINC® help ensure that systems interpret exchanged data consistently.

GoalEnsure systems interpret exchanged data consistently.

Level 4

Organisational

The governance, policy, and trust frameworks that let independent institutions actually agree to exchange data at all.

GoalSecure institutional agreement to exchange data.

Mapping

The format a system already uses rarely matches the format it needs to exchange. Mapping bridges the two, translating the existing structure into the shared one while preserving the meaning of the information.

GoalTranslate between structures without losing meaning.

What we do

Framework-level work, not point fixes.

Interoperability isn’t solved by connecting systems one interface at a time. It requires the technical, policy, and governance foundations to work together. That’s where we focus.

Framework

Interoperability framework design

Designing and institutionalising standards-based interoperability frameworks that hold up across all four levels, not just the technical layer.

Standards

Content & vocabulary standards

Establishing and implementing industry-recognised content standards and clinical terminologies, with FHIR® as the foundational standard, to enable systems to exchange data with consistent meaning, not just consistent structure.

Mapping

Legacy-to-standard data mapping

Translating proprietary and legacy data formats into standards-based structures and terminology, allowing existing systems to participate in shared information exchange without requiring costly replacement or redevelopment.

Policy

Policy & governance frameworks

Working with implementers to develop and operationalise the policies and governance structures needed to build trust, establish accountability, and sustain information exchange across independent health institutions.

Continuity

Continuity of care architecture

Architecting how patient information moves across levels of the health system, so care stays coordinated as patients move between providers.

How an engagement runs

Four phases, in order, every time.

01

Assess

Audit the current landscape - systems, data flows, standards, and existing policy, against what standards-based interoperability requires.

02

Architect

Design the interoperability framework across all four levels, from technical mappings and content standards to the policies and governance structures that connect them.

03

Implement

Support the staged implementation and validation of the exchange, testing conformance at each level before institutions depend on it.

04

Sustain

Document the framework, support and train the teams responsible for maintaining it, and establish the governance processes needed to sustain interoperability beyond the initial implementation.

Toolkit

Standards and frameworks we work in.

For the implementers reading this: yes, these are specific on purpose.

Four levels of interoperability HL7® FHIR® FHIR® Implementation Guides Content & vocabulary standards Data exchange OpenHIE architecture Data policy & governance
About

Grounded in practice, informed by research.

InteroHEALTH is a health informatics consultancy focused on standards-based interoperability for continuity of care. We work with health institutions and implementers to turn interoperability from a technical ambition into something that can be implemented, governed, and sustained — using internationally recognised standards, with FHIR® at the core.

Our team has built a strong footprint across Africa in technical training on interoperability and standards — covering not just what FHIR® is, but how to build with it, how to implement it, and how to sustain it in real health systems.

  • Certified HL7® Educator
  • Certified HL7® FHIR® Proficient

Already implementing interoperability? Let’s make it work better.