So we have national-level and enterprise-level interoperability layer instances. Can you kindly point me to resources that talk of such a thing? This is like a federated interoperability layer (with the possibility of different interoperability layer implementation technologies).
Also, how is this entertained in OpenHIE architecture?
Haftamu – this is a very interesting use case, and may be similar to what we have in Canada. Please can you elaborate on the health data governance for your architecture? Is there an expectation that the different ILs will communicate with each other as peers or that there will be an over-arching IL on top of the other ones?
The eHealth Architecture is the adoption of OpenHIE Architecture and the health data governance can be assumed to be in alignment with it. I am more focused on the architectural solution in this case.
The national-level IL is where the point of systems interact with the shared service instances.
On the other hand, at the enterprise level, we have larger health service providers(hospitals and national, regional projects) with their own dedicated ICT team. So they don’t want to rely on the national IL instance. Rather they will have their own, it could even be a different IL implementation technology. But since those point of service systems are interacting with the national shared health services, we need an insight into the IL transactions and preferably with a single access entry.
The need to have federated IL instances can be backed with many benefits, especially in resource-limited settings. But since I first thought of this with a practical issue we faced, I just wanted to sort of crawl over the idea and resources for such a thing.
But this definitely is something we need to have a grasp on OpenHIE architecture. We probably have already!
@dritz Are my points clear? You could re-phrase it and I would confirm 
@haftamu.k – yes, these points are very clear. To confirm – the national IL will have data holdings (e.g. national CR, HWR and FR, for example) that are to be shared across all participants in the care delivery network. Some of these participants will, themselves, be connected by ILs that are not national in scope. A key architectural decision is: will data holdings of these “local” HIEs be replicated to the national one (or vice versa), or will there be a pass-through to the national assets, and will the national IL point to these federated data holdings (as a sort of lookup index in front of a pass-through message processor) as the source of truth? Of course… it could be a mix of these two scenarios.
We have a mix in Ontario, Canada where I live. We have a number of separate ILs… and we have an overarching set of jurisdictional data holdings (e.g. CR and HWR) that are leveraged by all of the local HIEs. Some data holdings, however, are federated – such as Diagnostic Imaging repositories and some other personal health records (SHR) assets.
What are your plans for Ethiopia? (and this is why I asked about governance… your plans will need to be consistent with the legal basis and authority of each level of data custodian).