commvita™

Connected care platform

Caribbean

Built for a ministry, not scaled down from a hospital

Three Caribbean jurisdictions are configured in commvita today. This sets out what the platform supports, which standards are shipped and which are not, and the four architectural properties that decide what a ministry is committed to in ten years' time — with the gaps stated alongside the strengths.

Live vs demonstrated: Live — real, API-backed platform logic (wired end-to-end today) Demonstrated — representative control surface with seeded data / illustrative UI mock-up

1Three Caribbean ministries are already configured

Not as a roadmap item or a slide. Jamaica, Antigua & Barbuda and Montserrat each exist in the platform today as a configured jurisdiction, with their own ministry identity, currency and identifier scheme.

Currencies verified in the platform: JMD for Jamaica, XCD (East Caribbean Dollar) for Antigua & Barbuda and Montserrat. Jamaica additionally carries a ministry dashboard covering the regional health authorities, national health fund benefits and the patient register, keyed on the NIS Number format.

The design rule that makes this cheap. Nothing about a country is compiled into the software. Identifier format and check rule, regulator and inspection framework, professional registers, coding systems, statutory clocks and currency are read from a versioned, source-cited, effective-dated profile — and where a country has not configured a value, the dependent behaviour fails safe to nothing rather than borrowing a neighbour's. A ministry is never quietly running on another country's rules because nobody got round to changing them.

2What a small island health system actually has to solve

The constraints are not the ones a large national system is designed around, and that is usually where a procurement goes wrong.

None of these is exotic. They are simply the wrong shape for software priced and built for a system of sixty million people.

Priced per instance, not per clinician

The Community Edition is £1 per instance, with optional paid support. A ministry is not charged for the number of nurses it employs, and the cost of adding a clinic is not a licence conversation. The paid editions add governance and the clinical platform; the base is not metered by headcount.

Community EditionLive

Capture that does not need a signal

The community nursing portal and the care-worker portal queue what a visiting professional records and sync when connectivity returns, with the pending state visible so nobody is unsure whether their work was saved. The mobile learning app works the same way.

/community-nursing/care-portal/mobile-learnLive

Care that leaves the island, treated as a pathway

Referral off-island is not an exception to be handled by email. Eligibility, approval, travel episode, fitness to fly, escort authorisation, accommodation and patient reimbursement are all part of one tracked pathway, because for a small jurisdiction this is tertiary care.

/patient-transportDemonstrated

Public-health delivery, not just a hospital record

Immunisation with a national schedule, screening programmes, maternity, sexual health, community nursing and telehealth are modules of the same platform rather than separate purchases — which matters most where the ministry is the health system.

/immunisation/screening-programmes/maternity-epr/telehealthDemonstrated

3Standards — what is shipped, and what is not

Stated per standard with a status, because a comparison table of ticks is the easiest document in the world to write and the least useful one to buy from. Delivery is tracked item by item in the platform's own interoperability register; nothing below is called shipped until the work naming its evidence is done.

Standard	What it is for	Position today	Status
FHIR R4	The exchange format for records, documents and queries	Used throughout — record exchange, bulk export, consent, audit events	Shipped
HL7 v2	Admission, discharge, transfer and laboratory messaging	Message engine, ADT feed, ORU laboratory ingest	Shipped
SNOMED CT	The clinical vocabulary	International Edition selectable as a jurisdiction binding, with the licensing stated at the point of choice — an affiliate licence is the gate, and it is free at point of use in Member and low-income countries	Shipped
CVX / vaccine coding	Coding an immunisation so it can be counted	Vaccine code system is a per-country binding; an unconfigured country gets none rather than a US or UK default	Shipped
ICD-10	Morbidity and mortality classification	Configurable per country and per purpose	Shipped
OMOP CDM v5.4	Research and population analysis on a common model	Real extract-transform-load from the live record, with data-quality reporting	Shipped
IHE profiles	Cross-enterprise patient discovery and document exchange	XCPD and XCA implemented; conformance is proven at a Connectathon, not self-declared	Partial
ATC	Drug classification for stewardship and reporting	Anatomical main groups present, declared as a subset — not the full classification. Expanding it needs a licensed release from the WHO Collaborating Centre, which is a licensing decision rather than an engineering one	Partial
ICD-11	The successor classification many ministries are moving to	Adapter built and the OAuth request shape verified against the live WHO endpoint. Outstanding is the WHO licence and its credentials — not engineering. No successful response has yet been parsed, and the API says so itself rather than only this page	Pending licensing
LOINC	Laboratory and clinical observation codes	Plumbing in place and a code column already carried. Outstanding is the Regenstrief licence and reachable source access; nothing is seeded from memory, because a wrong code on a pathology result is worse than an admitted gap	Pending licensing
OpenHIE 2.0	The reference architecture for a national health information exchange	Roughly seventy per cent of the components exist and are unclaimed — client registry, facility registry, health worker registry, shared record, terminology. What is missing is a conformance surface and a mediator	Not built
DHIS2	National aggregate reporting and surveillance	Built. Indicators are computed from the record, mapped to data elements and org units, and exported as dataValueSets. An unmeasurable indicator is omitted and named, never sent as a zero. NOT yet exercised against a running DHIS2 server, and the status endpoint states that	Partial
PAHO/WHO Digital Health Strategy 2026–2031	The regional strategy a ministry is measured against	No mapped self-assessment yet. It is the next-cheapest strategic item on the register and is named there as such	Not built

Two of those rows say “not built”. They are in the table because a supplier that only shows you the green rows is telling you about its marketing, not its software. Both are on a published register with an order and an effort estimate against each, and the register is written to be read by the customer rather than by the sales team.

“Pending licensing” is a different thing from “not built”, and it matters commercially. For ICD-11 and LOINC the adapter, the plumbing and the per-country binding all exist; what is outstanding is a licence from the body that publishes the codes, and the credentials that come with it. Terminology licensing is not uniform across the world — terms and fees differ by publisher, by country and by the type of organisation licensing them, and in several schemes a country's membership status or income classification changes what it pays, if anything. SNOMED CT is the clearest example: it is licensed through a national affiliate arrangement and is free at the point of use in Member countries and in low-income countries, which is why commvita treats the SNOMED edition as a per-jurisdiction binding rather than shipping one and assuming it fits.

Ceiling on this paragraph: the specific current terms for each publisher were not retrieved — the publishers' sites are unreachable from the environment these documents are built in. Treat the shape as correct and confirm the numbers with the publisher, or with us, before they go into a business case.

4Why this is a better thing to replace a national system with

Not a comparison of feature lists. Four properties of the architecture that decide what a ministry is committed to in ten years' time.

Leaving is a property, not a project

Live

The record is held against open models and exported through open standards. A ministry can take its data to a common research model, to bulk FHIR, or to another supplier, without asking permission and without an extraction fee. The strongest guarantee of good behaviour from a supplier is a customer who could leave.

Configuration where others need a release

Live

Identifier rules, terminology bindings, regulators, statutory clocks, currency and organisational structure are governed data with an effective date. A new country, a renamed ministry or a redrawn health region is an entry, not a version.

One platform, not an integration programme

Live

Clinical record, community and public-health delivery, governance and board assurance are the same product on the same record. A ministry with a small technical team is not also buying the job of keeping six systems in step.

The ceiling is stated in the product

Live

Where something is seeded rather than measured, the page says so. Where an integration is not provisioned, the interface says demonstration rather than claiming a transmission. That is a deliberate engineering rule, and it is the property that matters most when the buyer cannot easily audit the supplier.

What is deliberately not argued here. This document names no incumbent and makes no claim about any other supplier's product. A ministry evaluating a replacement should ask every candidate the same four questions above and compare the answers — including ours, and including the rows in the table above that say “not built”.

5Who is behind it

Relevant because a ministry is choosing a relationship, not only a product.

commvita's founder holds both British and Jamaican citizenship. The platform's Caribbean jurisdictions were not added because a tender appeared; they were configured early, alongside the United Kingdom ones, which is why three of them already exist in the product rather than in a proposal. The engineering standard that runs through this document — state the ceiling, never claim what has not been measured — is the same one applied to every other market the platform serves.

6The honest edges

No deployment in the region today. The three Caribbean jurisdictions are configured and demonstrable on the running platform with seeded data. That is a materially different thing from a live national deployment, and this document does not blur them.

No aggregate-reporting connector. Until one is built, national returns to a regional or aggregate reporting platform mean somebody keys them. It is on the register with an estimate.

Terminology needs a licence, not just a switch. Adopting the SNOMED CT International Edition requires an affiliate licence in the ministry's own name. commvita points at a terminology server; it does not host or sublicense the content.

Non-SaMD. The platform is decision-support and record-keeping. It is not a certified medical device, and no clinical decision in it is made without a clinician.

7Where every claim in this document lives

Capability	Route	Basis	Status
Jamaica ministry overview, regional authorities, benefits, register Jamaica Health Dashboard	/jamaica-health	seeded ministry dashboard	Demonstrated
Per-country identity, currency, regulator, terminology Jurisdiction Profile & Wizard	/jurisdiction-profile · /jurisdiction-wizard	sourced, effective-dated, fail-safe entries	Live
Regulator and registers resolved per country Regulatory & Commissioner Engine	/regulatory-engine	configurable; never borrows a neighbour	Live
One person across systems and identifier schemes EMPI Hub	/empi	multi-identifier resolution	Live
Offline capture in the community Community Nursing · Care Worker Portal	/community-nursing · /care-portal	queue and sync on reconnect	Live
Off-island referral, travel, escort, reimbursement Patient Transport	/patient-transport	eligibility → travel → claim	Demonstrated
National immunisation schedule and coverage Immunisation Management	/immunisation	vaccine coding is a country binding	Live
Screening programmes and call-recall Screening Programmes	/screening-programmes	programme register	Demonstrated
Maternity and sexual health records Maternity EPR · Sexual Health EPR	/maternity-epr · /sexual-health-epr	full clinical modules	Demonstrated
Research and population model export Clinical Studies · OMOP	/clinical-studies · /omop-cdm	real ETL with data-quality reporting	Live
Standards delivery, item by item Interoperability register	—	docs/INTEROP-STANDARDS-ROADMAP.md	Live

FHIR R4 · HL7 v2 · SNOMED CT · OMOP CDM v5.4 · IHEJamaica · Antigua & Barbuda · Montserrat configuredStandards delivery tracked per item, not claimed as a setNon-SaMD record-keeping and decision-supportCommunity Edition — £1 per instance (optional support)