How we led the architecture of a national health information system, and built its health ID, birth declaration, equipment management and citizen platforms, alongside EY within a UNOPS program

Tunisian Ministry of Health: Building the Foundations of a National Digital Health System

Tunisian Ministry of Health

The Tunisian Ministry of Health is modernizing its health information system through a national program financed by the World Bank and implemented by UNOPS, with EY Tunisia as program lead.

Highlights

Lead technical architecture of a national health information system
National Health ID registry with 3.3 million entries
5 platforms, from the maternity to the citizen app
With EY Tunisia, within a UNOPS program financed by the World Bank

Services

Digital Transformation Advisory
Industry-Specific Consulting
End-to-End Project Delivery
Systems & Product Integration
Data Architecture & Infrastructure
Data Security & Compliance

Industry

Government

3.3M

entries in the National Health ID registry

national platforms designed, built or aligned by Satoripop

health professionals trained on the birth declaration and enrolment platforms

Satoripop experts mobilized on the program

About the program

A national program to modernize the health information system of Tunisia, financed by the World Bank and implemented by UNOPS.

The Ministry of HealthOwner of the program, with its IT centre hosting and operating every platform.

EY TunisiaProgram lead, steering the workstreams: urbanization, health ID, school health and equipment.

SatoripopSenior technical architect of the whole program, and builder of five of its platforms.

The Challenge

Many health applications, no shared identity of the patient

Fragmented systems

Hospital systems, vaccination, school health, equipment and HR were each built separately, by different vendors, with their own data and their own logins.

No national patient identifier

Without a unique health identifier, the same citizen exists several times across facilities, and records cannot follow them from birth to adulthood.

Many stakeholders

The ministry, its IT centre, the national registry, international funders, a Big Four program lead and several software vendors all had to move in the same direction.

Sovereign and secure by design

Health data must stay in Tunisia, hosted by the ministry, with high availability, security testing and transfer of skills to the ministry's own teams.

Our approach:
one identity, one architecture, many services

Urbanize first: a target architecture every vendor aligns with
Put a national health ID at the centre, shared through secured APIs
One single sign-on for citizens and health professionals
Transfer the skills, so the ministry runs its own platforms

One National Health Identity

Five platforms built around the same identifier

Lead architecture

Urbanization of the health IS

The target architecture every platform of the ministry now aligns with.

Architecture committees with the ministry and every vendor
Architecture documents validated by the ministry
FHIR R4 and IHE interoperability strategy
Training of the ministry's technical teams

In production

National Health ID & SSO

A unique health identifier for every citizen, and one login for citizens and health professionals.

ID generation aligned with the national registry
Health ID registry, with 3.3 million entries
Secured APIs for hospitals and health apps
Single sign-on, enrolment and registry dashboard

Maternities

PNDN: national birth declaration

Health professionals declare every newborn from the maternity, who receives a health ID from birth.

Declaration with parents' data pre-filled
Printable summary and multilingual interface
80 health professionals trained on the platform

In production

EMS: equipment management

Medical equipment and its maintenance, managed across health facilities.

Inventories, work requests, losses and retirement
Maintenance contracts, preventive and corrective maintenance
Data migrated for the pilot facilities

Mobile app in acceptance testing

Sahetna: the citizen app

The citizen showcase of the national health ID, on the web and as a mobile app.

Sign-in with the national digital identity
Children, vaccination, school and university health
Declared medical record, health near me, complaints

Connected

Hospitals & national services

The platforms plug into the systems that already exist.

Hospital information systems, patient indexes unified on the health ID
National vaccination system and school health
National registry and digital identity provider

A health ID from the very first day

The National Health ID is generated in line with the national registry and stored in a central registry. Every health application, from the maternity to the hospital, queries it through secured APIs.

Generation algorithms validated by the ministry
Registry with deduplication, validation and archiving
Access partitioned by facility with relationship-based access control
Single sign-on for citizens and health professionals, in production

A health ID from the very first day

The National Health ID is generated in line with the national registry and stored in a central registry. Every health application, from the maternity to the hospital, queries it through secured APIs.

Generation algorithms validated by the ministry
Registry with deduplication, validation and archiving
Access partitioned by facility with relationship-based access control
Single sign-on for citizens and health professionals, in production

Every medical device, followed

EMS gives health facilities one tool to manage their equipment and its maintenance, from inventory to retirement.

Inventories and work requests by facility
Maintenance contracts, preventive and corrective maintenance
Interfacing studied with hospital systems and the cold chain

Every medical device, followed

EMS gives health facilities one tool to manage their equipment and its maintenance, from inventory to retirement.

Inventories and work requests by facility
Maintenance contracts, preventive and corrective maintenance
Interfacing studied with hospital systems and the cold chain

Sahetna, the citizen showcase

Sahetna brings the national health ID to every citizen: one account for the whole family, connected to the national services. The mobile app, built in React Native for iOS and Android, is in acceptance testing.

Sign-in with the national digital identity e-Houwiya, through Mobile ID
Children attached to the parent account
Vaccination records and school and university health
Declared medical record, health near me and complaints

Sahetna, the citizen showcase

Sign-in with the national digital identity e-Houwiya, through Mobile ID
Children attached to the parent account
Vaccination records and school and university health
Declared medical record, health near me and complaints

Architecture & Interoperability

The foundations that let the ministry add services without starting over

Interoperability built on standards

We proposed an interoperability strategy based on international health standards, so that existing and future systems can exchange data without one-off integrations.

FHIR R4 as the pivot format
IHE profiles for patient identity, documents and audit
SMART on FHIR on top of the existing single sign-on
International terminologies: LOINC, ICD-10, ATC, UCUM

Interoperability built on standards

We proposed an interoperability strategy based on international health standards, so that existing and future systems can exchange data without one-off integrations.

FHIR R4 as the pivot format
IHE profiles for patient identity, documents and audit
SMART on FHIR on top of the existing single sign-on
International terminologies: LOINC, ICD-10, ATC, UCUM

Key architecture decisions

The principles agreed with the ministry and applied to every platform.

Every platform is hosted in the ministry's own data centre, on a container platform operated with the ministry's teams.

Databases run in high-availability clusters with automatic failover, behind load balancers and the ministry's web application firewall.

A single sign-on platform serves citizens and health professionals in separate spaces, and connects to the national digital identity.

Applications follow OWASP guidelines and go through independent security audits, with findings tracked and fixed before go-live.

Architecture documents, procedure manuals and training sessions on the architecture and the technology stack let the ministry's IT centre run and extend the platforms.

« Au-delà de vos compétences techniques, qui sont remarquables, vous avez fait honneur à l'image de Satoripop et de l'ESN tunisienne capable de relever le défi. »

« Votre image auprès du ministère, la Banque mondiale et l'UNOPS est très valorisée. Fier de vous avoir comme partenaire privilégié. »
Beyond your technical skills, which are remarkable, you have done credit to Satoripop and to the Tunisian IT services industry, which proved it can rise to the challenge. Your reputation with the ministry, the World Bank and UNOPS is highly valued. Proud to have you as a preferred partner.

Partner, EY Consulting Tunisia

The Impact

The building blocks of a national digital health system are in place

A shared architecture

Every platform of the ministry now aligns with one target architecture, validated by the ministry and its IT centre.

One identity for each citizen

A national health ID, generated from birth and shared through secured APIs, with single sign-on in production.

A ministry that owns its systems

Health professionals and the ministry's technical teams trained to use, run and extend the platforms.

Modernizing a public information system?

Tell us about your institutions, your systems and your partners. We will help you design the architecture and build the platforms on top of it. Talk to our team

Tunisian Ministry of Health: Building the Foundations of a National Digital Health System