Platform Directory
Software that implements parts of a digital health architecture. Categorised by the architectural role it fills, because that is how the selection question is actually asked: "we need a shared health record — what are the options?"
Last verified: 2026-08-24. Project activity and versions change. Verify the repository's recent commit history and release cadence before committing to a platform, and treat the "status" column as a prompt to check rather than an assurance.
A platform is not an architecture. Choosing OpenMRS does not give you a health information exchange, and choosing OpenHIM does not give you interoperability — see interoperability for what else is required.
EMR / EHR
| Project | Description | Licence | Language | Standards | Status |
|---|---|---|---|---|---|
| OpenMRS | Modular EMR platform designed for low-resource settings; concept dictionary model | MPL 2.0 / HL7 | Java, JavaScript | FHIR (module), HL7 v2, CIEL/SNOMED/LOINC dictionaries | Active, large community |
| OpenEMR | Ambulatory EMR and practice management, long-established | GPL | PHP | FHIR, HL7 v2, CCDA | Active |
| Bahmni | Hospital system assembling OpenMRS, OpenELIS and Odoo | AGPL | Java, JavaScript | Inherits OpenMRS | Active |
| GNU Health | Hospital and health information system, includes lab and social medicine modules | GPL | Python | HL7 FHIR, ICD | Active |
| EHRbase | openEHR clinical data repository | Apache 2.0 | Java | openEHR, AQL | Active |
HMIS and routine reporting
| Project | Description | Licence | Language | Standards | Status |
|---|---|---|---|---|---|
| DHIS2 | Aggregate reporting, tracker programmes and analytics; the de facto national HMIS in many countries | BSD | Java, React | ADX, FHIR (partial), its own metadata API | Active, very large deployment base |
Interoperability layer and integration
| Project | Description | Licence | Language | Standards | Status |
|---|---|---|---|---|---|
| OpenHIM | The OpenHIE reference interoperability layer: routing, mediators, transaction log | MPL 2.0 | Node.js | FHIR, HL7 v2, arbitrary via mediators | Active |
| Mirth / NextGen Connect | Mature health integration engine; strong HL7 v2 tooling | MPL (open core) | Java | HL7 v2, FHIR, X12, DICOM | Active, commercial editions |
| Apache Camel | General integration framework with health components | Apache 2.0 | Java | FHIR, HL7 v2 via components | Active |
| Apache NiFi | Flow-based data routing, better suited to bulk pipelines | Apache 2.0 | Java | Generic | Active |
| OpenFn | Workflow automation and integration used in global health | LGPL | Elixir, JavaScript | FHIR, DHIS2, CommCare adaptors | Active |
See integration engines for the selection criteria.
FHIR servers
| Project | Description | Licence | Language | Notes |
|---|---|---|---|---|
| HAPI FHIR | The Java reference implementation: client, server, validation, terminology | Apache 2.0 | Java | The most common self-hosted choice |
| Firely Server / .NET SDK | .NET implementation; SDK open source, server commercial | Varies | C# | Strong validation tooling |
| Aidbox | Commercial FHIR platform with a free tier | Commercial | Clojure | Configurable storage model |
| Google Cloud Healthcare API | Managed FHIR, HL7 v2 and DICOM | Commercial | — | See GCP |
| Azure Health Data Services | Managed FHIR and DICOM | Commercial | — | See Azure |
| AWS HealthLake | Managed FHIR data store with analytics | Commercial | — | See AWS |
| Medplum | Open-source FHIR-native application platform | Apache 2.0 | TypeScript | Includes app framework and auth |
Fuller comparison in FHIR servers.
Terminology
| Project | Description | Licence | Notes |
|---|---|---|---|
| Snowstorm | SNOMED International's terminology server | Apache 2.0 | The standard choice for SNOMED CT hosting |
| Ontoserver | CSIRO terminology server | Commercial, free in some jurisdictions | Widely used nationally |
| Open Concept Lab (OCL) | Terminology and dictionary management, used with OpenMRS | MPL | Curation-oriented |
| HAPI FHIR terminology | Terminology operations within HAPI | Apache 2.0 | Sufficient for many deployments |
See terminology services.
Registries
| Project | Registry | Licence | Notes |
|---|---|---|---|
| OpenCR | Client registry | Apache 2.0 | OpenHIE community; FHIR-based matching |
| SanteMPI / SanteDB | Client registry / health data platform | Apache 2.0 | IHE and FHIR interfaces |
| iHRIS | Health worker | GPL | Human resources for health |
| GOFR | Facility reconciliation | Apache 2.0 | Facility list matching across sources |
See registries.
Identity and access
| Project | Role | Licence | Notes |
|---|---|---|---|
| Keycloak | Identity and access management | Apache 2.0 | OIDC, SAML, federation, token exchange; the common choice |
| Ory Hydra / Kratos | OAuth server / identity | Apache 2.0 | API-first, composable |
| Open Policy Agent | Policy decision engine | Apache 2.0 | Externalised authorisation |
| Vault / OpenBao | Secrets and key management | MPL / MPL | See security architecture |
Laboratory, imaging, supply chain, financing
| Project | Domain | Licence | Notes |
|---|---|---|---|
| OpenELIS Global | Laboratory | MPL | Used in several national deployments |
| SENAITE | Laboratory (LIMS) | GPL | Plone-based, research and public health labs |
| Orthanc | Imaging (DICOM server) | GPL | Lightweight, strong REST/DICOMweb API |
| dcm4che / dcm4chee-arc | Imaging archive | MPL/GPL | Production-scale archive |
| OHIF Viewer | Imaging viewer | MIT | Zero-footprint web viewer |
| OpenLMIS | Supply chain | AGPL | Logistics management |
| openIMIS | Health financing / insurance | AGPL | Claims and beneficiary management |
Community health and data collection
| Project | Role | Licence | Notes |
|---|---|---|---|
| Community Health Toolkit (CHT) | CHW application framework | AGPL | Offline-first, SMS-capable |
| CommCare | Mobile data collection and case management | Open core | Widely deployed |
| ODK / ODK-X | Mobile data collection | Apache 2.0 | Survey and structured capture |
| KoboToolbox | Data collection | AGPL | Humanitarian and health surveys |
| DHIS2 Android Capture | Offline capture for DHIS2 | BSD | Tracker and aggregate |
See community health and offline-first.
Workflow and decision support
| Project | Role | Licence | Notes |
|---|---|---|---|
| Camunda | BPMN workflow engine | Apache 2.0 (community) | Executes the BPMN from a DAK |
| Temporal | Durable workflow orchestration | MIT | Long-running, failure-tolerant processes |
| n8n | Low-code automation | Sustainable use licence | Useful for glue, not for clinical workflow |
| CQF Ruler / cqf-tooling | CQL evaluation on FHIR | Apache 2.0 | Executes SMART Guidelines decision logic |
| OpenCDS | Clinical decision support | Apache 2.0 | Verify current activity |
Data platforms
| Technology | Role in health | Notes |
|---|---|---|
| PostgreSQL | The default operational database for most of the above | PostGIS for spatial |
| MySQL / MariaDB | Used by several platforms | |
| MongoDB | Document storage, used by some FHIR servers | Licence is SSPL — check policy fit |
| Elasticsearch / OpenSearch | Search, log analytics | Licence differs between the two |
| ClickHouse / DuckDB | Analytical query engines | Increasingly used for indicator computation |
| Kafka / RabbitMQ / NATS | Event and message transport | See integration |
Choosing
Six questions, in this order:
- Which architectural role does it fill? If two candidates fill different roles, you are not comparing them.
- Which standards does it actually implement, at which version, and is there conformance evidence?
- Can your team operate it? Operational complexity is the most commonly underestimated cost, and the one that determines whether the deployment survives.
- What is the community's health? Commit frequency, release cadence, number of independent contributors, and whether there is more than one organisation depending on it.
- What is the exit? Is the data extractable in a standard format, and what would migration cost?
- What is the total cost over ten years, including hosting, support, upgrades and the staff to run it?
Question 3 disqualifies more candidates in practice than question 2.
References
Project sites are linked from each platform's page. Community directories worth consulting: the Digital Public Goods Registry (https://digitalpublicgoods.net/registry/), Digital Square Global Goods (https://globalgoodsguidebook.org/), and the OpenHIE community (https://ohie.org/).