Ghana's Digital Health Ambition Needs an Interoperability Framework

As Ghana expands digital health and Free Primary Health Care, we need to think not only about digitising healthcare, but about whether our health systems can actually talk to each other.

Ghana's digital health space is growing fast. Electronic medical record systems, health applications, diagnostic platforms, telemedicine services, wearables and AI-based tools are increasingly part of healthcare delivery. That's progress. But there's a question we need to ask more seriously: are we building digital health systems that can actually communicate with each other?

Ghana already has a Policy and Strategy on Digital Health 2023–2027, and interoperability is part of that ambition. The challenge is moving from saying our systems should be interoperable to defining exactly how they become interoperable.

Building an app is not the same as building a health system

A software team can identify a healthcare problem, build an app, and deploy it — and it may work perfectly. But healthcare doesn't happen within one application. A patient might have their blood pressure checked at a CHPS compound, visit a health centre months later, run lab tests at a private laboratory, get medication from a pharmacy, and eventually be referred to a hospital. Each stop generates health information. Can that information move meaningfully between systems?

If every developer invents their own way of representing patients, lab results, diagnoses and medications, connecting these systems later becomes difficult. One app may record a lab test as "Blood Sugar," another as "Glucose," another as "BG." A clinician knows these mean the same thing. Computers don't — not unless we tell them to. Multiply that across thousands of data elements and hundreds of systems, and the scale of the problem becomes clear.

The gap isn't policy- it's execution

A 2026 scoping review of Ghana's digital health system integration found that the country's continuing struggles aren't primarily about missing strategies or technology. The researchers described a governance execution gap — authority for digital health is scattered across many institutions, interoperability is treated as a strategic aspiration rather than a mandatory requirement, and there's little enforcement tying system deployment to shared standards.

That distinction matters. We can have a national strategy that says interoperability is important — but the developer building a laboratory application still needs concrete answers: How should a patient be identified? What coding system should a lab result use? What does the API look like? How is consent handled? These are implementation questions, not policy statements, and this is where Ghana has a real opportunity.

What Ghana needs: a framework, not just a policy

Ghana should work towards a comprehensive National Health Information Interoperability Framework, paired with a Ghana HL7 FHIR Implementation Guide. The framework would set the broader rules — governance, patient and facility identification, terminology, privacy, consent, security, and institutional responsibilities. FHIR (Fast Healthcare Interoperability Resources), developed by HL7 International, gives standardized building blocks — Patient, Observation, Encounter, DiagnosticReport, MedicationRequest — for representing clinical information. WHO has been working with HL7 to support exactly this kind of adoption globally.

Adopting FHIR alone doesn't solve interoperability. Countries still have to decide how it applies in their own context — which is what an implementation guide is for. A Ghana-specific guide could define required fields, terminology systems, identifiers and APIs, giving developers something concrete to build against instead of guessing.

Free Primary Health Care makes this urgent

Ghana's Free Primary Health Care initiative, launched in April 2026 across 150 underserved districts as the first phase of a national rollout, is about to push far more people through primary healthcare facilities — generating far more blood pressure readings, lab results, immunisation records, referrals and follow-ups.

If this information is digitised but trapped in systems that can't talk to each other, we risk solving one problem while creating another. A patient screened for hypertension at a CHPS compound, later seen at a health centre, and eventually referred to a hospital shouldn't become a new digital patient at every stop. Their information should be able to follow them — with appropriate privacy, consent and security safeguards. Free Primary Health Care should not only become digital. It should become interoperable.

The opportunity ahead
Ghana isn't starting from zero — it has policy, infrastructure and institutional momentum. What's missing is one clear, health-specific implementation framework that hospitals, developers, laboratories and health-tech vendors can consistently build against. Without it, two developers can both claim their systems are "interoperable" while building them in incompatible ways — and someone will eventually have to reconcile that mess. It's far easier to design for interoperability now than to retrofit it after hundreds of systems are already deployed.

Policy tells us where we want to go. An interoperability framework tells our health systems how to get there together. Ghana shouldn't only be building more health apps — it should be building a health system that can talk to itself.