The CHS platform · Care delivery
Care delivery and connected records
This is the clinical part of the CHS platform: one health identity, one longitudinal record and the authorised workflows that contribute to it.
It supports the CHS concept by keeping care information connected. Coverage may inform payment at the point of care, but it does not direct clinical decisions.
The record travels with the patient
A health identity that resolves to the same person across facilities, and a longitudinal record carrying conditions, allergies, medicines, encounters, results, referrals and admissions. Released by role, and logged on every open.
The physical card is the offline fallback. It identifies a person; it proves no entitlement. That distinction is deliberate: a card that proved entitlement would become a document people lend each other.
The modules, and the order they are built
Order is set by dependency and by what can be shown. Nothing is built before the record it writes to exists, and within that constraint the earliest modules are the ones that make the platform legible to somebody opening it for the first time.
Patient identity, duplicates and the health card
Establishing who somebody is, so that proving it twice does not create two people. Every record written afterwards hangs off the identity created here.
Longitudinal record
The spine of the platform. Every clinical module built after this one writes into the record built here.
Consultation and encounter
The clinical core. From here the platform is genuinely usable for care, and every later module hangs off the encounter.
Nursing, vitals and triage
The other half of the clinical front line, with a different rhythm: short, frequent entries rather than one long encounter.
Laboratory
The first hand-off between services, and the first proof that a shared record removes duplicate work rather than merely storing it.
Pharmacy
The second hand-off, and the one where the shared record most directly prevents harm.
Referrals
Care that crosses facilities, where a shared record earns its keep most visibly, and the first workflow that spans two organisations.
Admissions, beds and discharge
Care that stays overnight. This is the end of the standalone care product: everything a facility needs to run clinically, with no financing at all.
Vaccination
The public-health programme with the clearest value from a shared record: a child's schedule that follows them between facilities instead of living on a card that gets lost.
Maternal and child health
The longest continuous journey in the platform, and the one that most tests whether the record really is longitudinal: antenatal through delivery to a newborn with an identity of their own.
Operations and facility analytics
The view above the individual patient, for the people running a facility rather than treating in one.
Interoperability gateway
The doors through which other systems connect. Documented, versioned, and open to anyone the owner authorises.
The clinical record is mutable; the financial record is not
A clinical mistake is corrected. A financial figure is never corrected in place.
This is the sharpest difference between the two pillars, and it drives the data model on both sides. A clinical record is corrected when it is wrong, under clinical governance, with the correction visible in the record's history. A financial figure is never corrected in place: the original stands and an adjustment is recorded against it.
Building both under one convention would either make clinical correction impossible or make financial history editable. Neither is acceptable.
Who sees what
A role is defined by the permissions it holds, never by a title in a dropdown. Every screen is built permission-first: the query is scoped before it is written, not filtered after.
| Role | What they do | What they must not see or do |
|---|---|---|
| Registration clerk | Identifies the patient, creates the health identity, issues the card, records the household. | Any clinical content. |
| Nurse | Records vitals and triage, follows admitted patients, reads the shared record. | Prescribing, claim decisions. |
| Doctor | Examines, diagnoses, prescribes, orders, refers, admits, discharges. | Claims, contribution history, settlement. |
| Laboratory scientist | Receives orders, registers samples, validates results. | Unrelated clinical history. |
| Pharmacist | Reviews prescriptions against allergies, dispenses, manages stock. | History beyond safety context. |
| Facility administrator | Manages accounts, permissions, activity and the access log. | Clinical content of any encounter. |
What the care pillar owes the coverage pillar
- Billable service events. Every completed act of care emits an immutable event the financing pillar can price. Clinicians record healthcare; they never construct claims.
- Enough clinical context to justify a decision, behind its own permission. An adjudicator reviewing an unusual claim may need justification, but that access is separate and audited.
- Nothing else. The care pillar does not know tariffs, does not calculate contributions, and does not change behaviour according to a patient's coverage. Care is decided clinically.
An honest limit of that separation
We say it here rather than leave it to be found: a data-protection reviewer will find it, and finding it first is better.
Built for the conditions
Intermittent power, thin connectivity, shared devices, and staff who have never used a clinical system. That is the design centre, not the edge case.
Offline by design
Offline capture is not a degraded mode. Every entity carries a client-generated identifier and a version, so an encounter captured offline reconciles rather than duplicates.
Shared devices
Devices are shared. Sessions are short, switching user is quick, and the access log says who opened what, not which workstation.
The ward's vocabulary
The vocabulary is the ward's, not the software's. A system that needs training before it can be used will not be used.
Follow the build
Talking about the care pillar
If you run a facility or a network and want to go through this pillar in detail, get in touch.