From Disconnected to Integrated: How Eswatini's Healthcare Systems Now Share Patient Information Safely

Healthcare facilities across Eswatini now share patient data securely.

Jembi, in partnership with DataFI, has strengthened Eswatini's health data interoperability by implementing a practical digital health solution that connects previously disconnected healthcare systems. The project demonstrates how targeted investments in health technology improve patient care outcomes through more accurate patient identification, secure FHIR-based information sharing, and enhanced clinical decision-making.

The Challenge: Connecting Healthcare Systems

Healthcare providers in Eswatini operate with separate, disconnected systems that limit effective patient care coordination—a challenge common across many low- and middle-income countries. Accurate patient identification across facilities and secure sharing of clinical information are essential foundations for better care delivery.

Building a Better Healthcare System

Working alongside Eswatini's health IT teams, Jembi implemented a secure, standards-based interoperability platform using Fast Healthcare Interoperability Resources (FHIR) and the OpenHIM Platform. This foundation enables healthcare facilities to share and access patient information safely while maintaining data privacy and security.

Making It Happen: Step by Step

The implementation followed two complementary phases, each building local technical capacity to ensure long-term sustainability:

Phase 1: Getting Patient Records Right

The first phase addressed a crucial foundation: ensuring each patient has one unique, accurate health record across all facilities. The implementation included:

• Deployment of a Master Patient Index (MPI) with both deterministic and probabilistic matching algorithms

• Machine learning enhancements to improve matching accuracy

• Integration of Eswatini's Population Registry to strengthen patient identification

• Enhanced search capabilities, including fuzzy matching for handling name variations

• Training for local health IT teams on system maintenance and troubleshooting

This system now provides healthcare providers with more complete patient information at the point of care.

Phase 2: Sharing Information Safely

The second phase focused on enabling secure data exchange across the health system:

• Integration of the MPI into the OpenHIM Platform for centralized patient identity management

• Configuration of FHIR-based health information exchange architecture

• Development of specialized mediators to process demographic and clinical data separately

• End-to-end testing using real-world workflow simulations

• Additional hands-on training for local teams to support ongoing operations

Healthcare facilities can now share both demographic and clinical information securely and in near real-time.

Real Results That Matter

The implementation has delivered measurable improvements:

• More accurate patient identification and reduced duplicate records through advanced matching algorithms

• Secure, standards-based data exchange using FHIR between healthcare facilities

• Strengthened local capacity among health IT teams who now maintain, test, and enhance the system independently

• Better clinical decision-making through improved access to comprehensive patient data at the point of care

The Road Ahead

This foundation enables continued health system strengthening in Eswatini. Next steps include:

• Refining data-matching algorithms to further increase accuracy

• Scaling the FHIR-based interoperability model to additional health facilities

• Ongoing collaboration with local health authorities to support long-term adoption

• Regular monitoring of system performance and user adoption to inform continuous improvement