Reference Architecture: Blueprint for Scalable and Interoperable Health Systems
In national healthcare transformation, reference architecture plays a vital role in aligning technology, policy, and healthcare delivery. It serves as a strategic blueprint, guiding the design, integration, and governance of digital health ecosystems across ministries, providers, insurers, and citizens.
E-Salamat delivers reference architecture design services rooted in global standards and adapted to regional contexts. We support countries and large health systems in building architectures that are modular, federated, standards-based, and future-proof.
What is a Digital Health Reference Architecture?
A digital health reference architecture defines the key components, standards, integration patterns, and governance models that shape a national or institutional digital health ecosystem. It provides:
A common language for stakeholders (technical and policy)
Guidelines for implementing interoperable systems
Guardrails for investment and procurement
A foundation for compliance, privacy, and innovation
Enterprise Architecture Layer
Policy, governance, services
Information Architecture Layer
Data flows, standards, models
Application Layer
EMR, eRx, registries, analytics
Technology Infrastructure Layer
Networks, cloud, ID, cybersecurity
Global Foundations and Frameworks
Global Health Standards
- WHO/ITU National eHealth Strategy Toolkit
- OpenHIE Architecture
- World Bank Digital Health Toolkit
- HL7 FHIR & OpenEHR
Regional Frameworks
- GCC eHealth Strategy
- Regional Data Protection Laws
- Cross-border Health Data Exchange
- National Digital Health Policies
Security Standards
- ISO 27001/27799
- HIPAA Security Rule
- GDPR Requirements
- Zero Trust Architecture
Implementation Guidelines
- IHE Integration Profiles
- SNOMED CT Implementation
- DICOM Standards
- Healthcare API Security
E-Salamat's Reference Architecture Approach
Phase 1: Assessment and Scoping
- Baseline review of existing systems and policies
- Stakeholder mapping and alignment
- Digital maturity assessment (WB Toolkit)
Phase 2: Conceptual Design
- Define guiding principles
- Develop core architecture principles
- Identify priority use cases
Phase 3: Logical and Physical Architecture
- Define enterprise, application, and data architectures
- Create diagrams for data exchange
- Align to privacy-by-design principles
Phase 4: Standards and Interoperability
- Define data models and exchange standards
- Develop terminologies guidelines
- Integrate with health IDs and registries
Phase 5: Governance and Implementation
- Define roles and ownership
- Create phased roadmap
- Embed architecture governance
Core Components of the Reference Architecture
National Digital Health Registries
Shared Services Layer
Point-of-Care Applications
Health Information Exchange
Analytics & Intelligence
Design Principles
Interoperability by Design
All systems must communicate
Federation and Modularity
Minimize lock-in, maximize reuse
Privacy and Cybersecurity
Architecture-level enforcement
Resilience and Offline Capability
Design for fragile contexts
Human-Centered
Align with frontline clinical workflows
Open Standards, Open APIs
Avoid proprietary silos
Deliverables and Artifacts
Enterprise Architecture Maps
TOGAF-style architecture documentation
Data Flow Diagrams
System interaction and data exchange patterns
Technical Specifications
Detailed implementation guidelines
Let's Build the Backbone of Digital Health Together
If your ministry or institution is embarking on a digital health transformation, let's start with the right foundation. Our reference architecture services ensure alignment, resilience, and long-term success.