Notice E1 Client Registries

Notice E for promoting investments in digital health global goods

Patient Registration and Identity Management Services for Health Information Exchanges

Two-sentence overview: 

IntraHealth’s new Open Client Registry (OpenCR) represents a foundational global good supporting identity management needs in developing countries using leading technologies, including the powerful ElasticSearch engine and the reference standards-based HAPI FHIR server. Building on its successful real-world pilot, IntraHealth and partners Regenstrief, Ona, and IntelliSOFT seek to expand OpenCR into a robust, high-value global good and field test it with select ministries of health through a consortium that includes unparalleled international design and deployment expertise in client registry and identity management as well as leadership within the OpenHIE architecture and client registry communities.

Executive summary: 

IntraHealth recently completed development of an open source, standards-based prototypical client registry, OpenCR, which was built to safely and uniquely identify patients who have demographic information stored in multiple health information systems. Leveraging IntelliSOFT’s relationships with ministries, Ona’s understanding of the evolving security landscape, and Regenstrief’s expertise developing client registries in high- and low-resource settings, the consortium proposes to rapidly expand the functionalities of OpenCR to meet the global community’s unmet needs for a standards-based, advanced, yet accessible open source client registry to support longitudinal management of patient data across the health sector.

The initial use case driving development for OpenCR was developed to match and link records together under a single unique ID. With funding from Digital Square, the consortium team plans to complete the expansion of the OpenCR prototype into a broadly applicable global good across a wide variety of low-resource settings and use cases to enable countries to track patient records across health information systems. 

Consortium Team: 

IntraHealth International is a global health NGO with a 40-year history in developing successful data tools and digital health applications for health workers and managers. We develop solutions that are open source, data-driven, sustainable, and collaborative. As a pioneer in the field of health workforce informatics, we’re committed to using technology, information, and analytical approaches to support the people at the center of our health systems. IntraHealth will lead the overall solution development process. IntraHealth’s consortium includes partners Ona, IntelliSOFT, and Regenstrief.

  • Regenstrief is the creator of OpenMRS, an open source electronic medical record system and leaders in the OpenHIE Client Registry community. Regenstrief will support Work Package One with high-level solution design and will bring forth feedback from the OpenHIE community.
  • Ona is a social enterprise based in the United States and Kenya that was founded in 2013 to build data infrastructure to drive change. Ona will contribute to Work Package One and deliver Work Package Three.
  • IntelliSOFT Consulting ltd. is a Kenyan-based company that has been implementing health information systems in East Africa since 2009. IntelliSOFT will use its national client registry and unique patient identifier experience in Tanzania and Kenya to undertake Work Package Two.
Geographic Reach: 

OpenCR has been deployed on servers at the Country Public Health Laboratory of Uganda.

WHO Classification: 
Shared Health Record and health information repositories
Application Status: 
Pending Review & Investment
Application Tags: 
packaging and deployment
client registry
shared health record


Since the Digital Square website says "Use comments to state your interest in joining a team", I now express my interest.

I have been familiar with the topic of client registries for several years now, and I have received many requests from various countries regarding the existence of "ready-made" beneficiary registries for health and social protection.

Additionally, I have been involved in other Open Source Client Registry projects for the health sector, which turned out to be challenging for large scale implementations. Sharing and learning from this experience might be useful for you.

Please see my profile on Linkedin and feel free to contact me for further collaborations

Hi Emily

Thanks for the cnocept note, a quick thought is around QA, could you touch on the QA aspects of the work that you are expecting to understake too as well as what level of auditing will be in the system, i.e. both message audit and system changes/use audit?

Hi Carl, thanks for the comment. Currently the system saves audit messages when resources are submitted with the matching details saved (and when matches are broken or unbroken). We plan to expand this to cover all of the UI functionality as well as track details on startup and shutdown when possible. Actions done outside the software will be beyond the scope of this project (like manually editing files) but we’ll be able to track the change during startup, just not who made the change. We’re also planning on making most of these options configurable with the software so those changes would be tracked.

Thanks, great concept note. Some thoughts: 

  • What are the proposed areas of work in relation to the OpenHIE CR specifications?
  • What are the current matching algorithms/features that exist and what need to be developed? 
  • What are some of the risks?