@mksd this was used in Haiti before my team joined that project. We’re pulling OpenMRS out of the role of the SHR because you’re exactly right - it didn’t scale well and didn’t serve the full purpose. If you want, you can talk with @ccwhite23 about the experience with OpenMRS as the SHR in that project. We’re now implementing HAPI FHIR with a nodejs business logic on top for the SHR - and using the IPS profile for exchange with OpenMRS through the FHIR2 module. @pmanko can say more about that if you want the details. We’re using OpenCR as the CR in our case. Hope that’s helpful.