Notice F2: Shelf readiness with a focus on building local capacity and new teams.

Shelf-ready interoperability by reconciling common geographies, hierarchies, and GIS between Instant OpenHIE components and external systems using FHIR

Two-sentence Overview: 

TerraFrame has developed an open-source Common Geo-Registry with support for FHIR that provides a single source of truth for managing geographic data over time to enable interoperability across multiple information systems. Our goal is to provide local teams with self-ready interoperability between Instant OpenHIE components and to facilitate trend analysis by creating semantic standards for locations and hierarchies with common geographies.

Executive Summary: 

GeoPrism® Registry (GeoPrism) is a Common Geo-Registry[1] (CGR) implementation that has recently added support for FHIR with the goal of creating semantic standards for common geographies and hierarchies for Instant OpenHIE. Just as a terminology service can standardize vocabularies for interoperability, a CGR standardizes location identity, classification, geometries, and how locations are used in multiple and interrelated hierarchies. By using common geographies, OpenHIE components will be able to integrate data by location and for the correct periods of time. This enables the possibility to perform trend analysis. Additionally, these components will not need to conform to the hierarchy structure of a single system, such as an instance of DHIS2. Rather, GeoPrism can track different hierarchies used by multiple systems and how they relate to each other. For example, the facility registry can have different levels in its hierarchy than an instance of DHIS2, and yet GeoPirsm can facilitate synchronization of health facilities between the two systems for the correct operational and administrative boundaries. This goes beyond the capabilities of the Global Open Facility Registry (GOFR) Facility Match tool developed by IntraHealth, which focuses on reconciling facility lists maintained by multiple sources and does not model the time component.

Investment from this grant will provide a reference implementation for how Instant OpenHIE components can integrate data by common geographies starting with the GOFR, but eventually any component that has support for the FHIR mobile care service delivery (mCSD) standard. Although GeoPrism can facilitate interoperability by normalizing geographies across existing systems, less integration effort is needed when OpenHIE components use common geographies from a CGR when they are initially implemented. Even if a country initially deploys only one component, integrating additional components later will be easier, as these systems start off by using a semantic standard for geographies. Since GeoPrism is feature complete, funds will be used to make GeoPrism and its integration with the OpenHIE Architecture to support GOFR with common geographies shelf ready to minimize implementation effort needed by local teams. To that end, we will integrate GeoPrism with the Open Health Information Mediator (OpenHIM) and adapt the containerization deployment according to the OpenHIE DevOps guidelines. Additionally, effort will be spent on developer documentation so that this reference approach can be duplicated by local teams with other components that support an integration with FHIR/mCSD for location data. This will be facilitated by creating a testing framework with test cases, an automated test suite, and extensive test data. We also suggest funds be used to create an integration with OpenStreetMap (OSM) so that the administrative hierarchy and boundaries defined there could easily be utilized for any country as a convenient starting point. Although in a production environment it is best it to obtain such data from an authoritative source, using OSM would be a convenient way to provide data for demonstration, development, and testing purposes.

Consortium team: 

TerraFrame worked as a supporting organization to IntraHealth on the recent Facility Registry (#2020-046) grant to develop an integration between GeoPrism and GOFR using FHIR/mCSD, with GeoPrism providing GOFR with reconciled hierarchies and GOFR mastering health facility location, name, and (optionally) relationships between facilities and their parents. At the time of this writing, TerraFrame and IntraHealth have not officially formalized a commitment on working together for this shelf-readiness grant, but the discussion is ongoing. TerraFrame would be happy to work as the prime or as a supporting organization with any entity that has developed an OpenHIE component with support for FHIR/mCSD to develop a shelf-ready integration for interoperability using common geographies.  TerraFrame has been developing open-source geospatial data integration and analysis solutions to support disease intervention efforts for over 10 years and currently is developing applications for the US Federal Government on[1], which is mandated by the Geospatial Data Act of 2018 to facilitate the sharing of publicly available geospatial data. TerraFrame is also open to working with a local team who can participate in the development, provide guidance, and verify shelf-readiness.

TerraFrame has a working relationship with an organization that expects to receive funding to work on projects in multiple countries in Africa that would involve GeoPrism and one or more components from the OpenHIE architecture. Since the contract has not yet been finalized, TerraFrame cannot divulge any details. However, it is our understanding that the contract will be finalized in early 2022. Should that happen, this organization would be an excellent in-country resource for helping to validate the requirements and provide additional quality assurance and testing as a part of that grant.


[1] - TerraFrame developed the Imagery Data Manager application that manages, processes, and shares outputs from unmanned aerial vehicles.

Project Description: 

i. Background or problem statement

Information systems used to make decisions often have different pictures of the geographies (i.e., people, places, and infrastructures) they respectively cover. Within a single area, different programs collect and store different geographic data in siloed systems at different times, leading to discrepancies and duplication of effort. This also results in decisions based on incomplete and out-of-date geographic data (e.g., spatial distribution of population and resources), ineffective resource allocation, and in the worst cases, affected populations being missed completely during times of crisis. For example, DHIS2 is limited to a single hierarchy that is configured primarily for reporting purposes. It is not necessarily the same hierarchy that is best suited for a health worker, client, or facility registry. Additionally, the same identifiers are not being used for the same locations referenced across these systems. A Common Geo-Registry (CGR) is an IT solution that provides a single source of truth for managing geographic data over time across multiple information systems and data sources. It is used to publish, access, and manage changes over time to master lists, associated hierarchies, and geospatial data for geographic objects such as administrative divisions, villages, infrastructure, and other relevant physical features. GeoPrism’s hierarchy management and normalization capabilities have been deployed in several countries in southeast Asia, Africa, India, and the US Federal Government. The current gap is that GeoPrism does not meet the shelf-readiness requirements of Instant OpenHIE.

ii. Objectives and activities

We will use agile development methodologies and industry-standard best practices to create a series of working iterations that will ideally be evaluated and tested with a local team or with in-country staff from partner organizations working on implementation projects funded by other grants. The existing FHIR integration between GeoPrism and GOFR will need to be implemented with the OpenHIE Interoperability layer and the DevOps guidelines and containerization will need to meet the requirements of Instant OpenHIE. An important focus of our effort will be to create enough documentation, test cases, and test data so that the integration with GOFR can be deployed and configured in-country with minimal to no support from TerraFrame. Additionally, third parties would have a reference for replicating the approach to create a semantic standard of common geographies, hierarchies, and GIS with other OpenHIE components.


iii. Deliverables and schedule



Project Kickoff

July, 2022

OpenHIM Mediator

August, 2022

OpenStreetMap integration

September, 2022

Quality assurance and testing framework, test suite and test data

November, 2022

Documentation & Containerization

December, 2022


iv. Risk mitigation

Receiving contributions, guidance, and validation throughout the project from local teams will be important to ensure shelf-readiness is achieved. If a local team cannot be identified, then there are a few organizations TerraFrame has a working history with that have local software talent in Africa as full-time employees.

Application Status: 
Pending Review & Investment


This will add a new dimension to Instant OpenHIE and makes it a perfect candidate for an Infrastructure package. Is GeoPrism a digital public good at this point?

We need to register with Digital Health Atlas, but will do that soon.