The use of Health Information Exchanges (HIE) is growing in low resource settings as Ministries and Departments of Health move towards
connected health systems that provide better care to beneficiaries. The improvements in health provider access to complete clinical data, patient
linking across disparate systems and standardised terminology and registries enable not only better patient care but also more efficient
operational reporting and cost reduction. One of the key challenges to data exchange is the complexity of the technology required to set up and
manage data storage. HEARTH[i] is a standards-based health data store that brings together the functionality of multiple HIE registries,
simplifying the architecture of a data exchange solution. The design and development of this software was driven by implementation needs to
be able to rapidly store demographic and clinical patient level data from multiple existing systems, while ensuring that this data is linked to the
correctly identified patient. Within the context of an HIE architecture such as the Open Health Information Exchange (OpenHIE)[ii] HEARTH
serves the purpose both of a Client Registry (CR) and a Shared Health Record (SHR) component. It supports Fast Healthcare Interoperability
Resources (FHIR), which is a draft, modern, developer-friendly base standard developed by Health Level Seven (HL7). The goals of this
project are to (i) further develop HEARTH as a core component of the OpenHIE and a more user friendly alternative to existing Client Registry
and Shared Health Record components; (ii) productionise it to make it more accessible to the growing number of implementers in Africa and
other low resource countries, and; (iii) grow the community of practice to sure that HEARTH effectively addresses real world challenges and is
more sustainable in the long term.