Health information systems often have incompatible, incomplete, and non-authoritative representations of the same geographies, which makes integrating data across systems by location difficult. Most systems can only model a single location hierarchy and no single hierarchy type (e.g., administrative, MoH geographic, MoH operational) is suitable for all needs. Additionally, these systems cannot track changes to locations and hierarchies as they change over time. Just as a terminology service helps to facilitate interoperability by common classifications and semantic standards that are curated by authoritative organizations, geographic locations and hierarchies are likewise semantic structures that enable interoperability, but they are curated at local levels. FHIR provides syntactic interoperability but does not ensure semantic interoperability, as the values across HIE components need to be consistent. TerraFrame strengthens HIEs by using semantic technologies to integrate data by common geographies and to provide accurate geographic data to different components of an HIE architecture, starting with health facility management.
GeoPrism Registry® is an open-source Common Geo-Registry (CGR) implementation that utilizes spatial knowledge graphs to provide a single source of truth for managing geographic data over time across multiple organizations and information systems. It is used to host, manage, regularly update and share lists, associated hierarchies, and geospatial data through time for geographic objects core to spatial data infrastructure, sustainable development, and public health (e.g., administrative divisions, settlements, health facilities, schools, and other relevant physical and non-physical geographic features).
A Ministry of Health should not be responsible for maintaining the administrative hierarchy in its health information systems. Rather, such location data dependencies should be automatically maintained by a common geo-registry across all MoH systems as they change over time. Data from a client registry, facility registry, and the health worker registry should be interoperable by location using machine-to-machine readable interfaces and for the correct periods of time to facilitate trend analysis.
TerraFrame has been actively involved in the OpenHIE Facility Registry working group and plans to get more involved in the Architecture and Standards group to raise awareness of the importance of a common geo-registry for facilitating interoperability.
GeoPrism Registry is a recognized global good. It is being used as a facility registry by the MoH of the Lao People’s Democratic Republic, as a common geo-registry by the National Geospatial Agency of Mozambique and the U.S. Department of Interior. It integrates natively with DHIS2 and the Global Open Facility Registry (GOFR) using FHIR.