Use Case Bazaar: The Unified Interoperability Adapter (iAdapter)

Use Case Bazaar:- UDSM DHIS2 Lab 16:30 - 19:00, 12 June 2023

The Unified Interoperability Adapter (iAdapter): A game-changer for health data interoperability between Electronic Medical Records (EMR) and DHIS2 systems

HIS integration is one of the challenges facing most developing countries. Many studies show that most strategies to address these challenges are more theoretical than practical-oriented. Despite several EMRs in Tanzania, many have not been linked with DHIS2. Consequently, health workers face double reporting work in EMR and HMIS reporting tools to produce DHIS2-based summary forms, particularly in primary health facilities (HFs), which account for over 80% of all HFs. A lack of effective integration has increased the financial burden due to costs incurred in paper-based tools printing for use in parallel to EMRs. This challenge prompted UDSM DHIS2 Lab experts to utilize their experience from working with different EMRs to develop an interoperability adapter (iAdapter) that can be used to integrate any vendor-based EMRs with DHIS2.


  • In 2019 UDSM DHIS2 Lab encountered challenges in integrating EMR developed on top of Bahmni with DHIS2 e.g Mappings difficulties, missing data collection tools/elements e.t.c
  • Two years later, we faced challenges in integrating Tertiary hospitals (eIDSR, OPD and IPD data) with HMIS - DHIS2 Warehouse i.e coupled design on EMR, cost, local developers not acquainted with vendor based EMRs.

Methodological Approach

  • Development of the iCareConnect+ on top of OpenMRS (without using the Bahmni layer) to take advantage of the OpenMRS community support.
  • iAdapter was developed to make it easy to retrieve and push data to HMIS DHIS2.
  • Mapping, querying databases, connecting to multiple instances, and so on were created to provide users with simple steps to complete the setup without requiring knowledge of DHIS2 technical details.
  • A medical doctor from UDSM HC mapped ICD 10/11 diagnoses into HMIS diagnoses to standardize diagnoses recorded in EMRs with those reported in HMIS.
  • Data sharing between iCareConnec+ and DHIS2 training instances was accomplished smoothly using iAdapter to test the integration


  • Multiple database technologies
  • Easy to set up (Docker)
  • Data extraction queries can easily be tested on the fly


  • Integration of OPD, IPD, and Malaria Lab test at UDSM Hospital and DHIS2 training instance
  • iAdapter has been demonstrated at different platforms such as BetterHealth and DHIS2 interoperability academy in Rwanda.

NB: The source system can also be DHIS2, making the iAdapter featured to accommodate DHIS2 to DHIS2 integration.