CIEL and OCL Reach a Major Milestone: CIEL Is Now Managed Entirely in OCL

After years of collaboration, we've reached a milestone we've been building toward for a long time: as of the July 2026 release, the CIEL terminology is managed entirely within Open Concept Lab (OCL), not just distributed through it. On June 24, 2026, CIEL officially completed the switch, with a small content release to confirm everything worked end to end.

This matters beyond CIEL. It shows that a full-scale terminology, not just a smaller collection of concepts, can do the heavy lifting of source management in OCL's cloud environment. Previously, CIEL was authored in OpenMRS (to stay compatible with it) and distributed through both OCL and Dropbox. Now the whole lifecycle lives in one place.

Special thanks go to Dr. Filipe Lopes of Orango I/O, who did the substantial programming work that made the transition possible.

What's new for CIEL users?

Managing CIEL in OCL unlocks things that weren't possible before:

• See what changed between releases. You can now review the differences from one CIEL release to the next, along with all the metadata associated with each concept — no more treating a release as an opaque drop.
• Download OpenMRS-compatible SQL dumps directly from OCL. If you previously pulled SQL dump files from Dropbox, you'll now find them on OCL. Click on Actions → External Exports next to the published CIEL version you want to download.

Individual SQL dumps for each OpenMRS platform version are available to download. If you use this method to overwrite the concept tables in your OpenMRS instance, be sure to read the ReadMe file first.

We'll continue to support the legacy versions in the interim. Depending on actual usage, we're likely to retire older releases over time. If you're on an older version, this is a good moment to plan your move.

How do I access CIEL?

Access requires a free OCL account, and there will continue to be no charge for the open-source CIEL content.

OpenMRS users can continue to get CIEL content through OCL using the OCL module, or via export.

Why clinical interface terminology matters

Clinical interface terminology like CIEL is a critical bridge between the complex clinical concepts clinicians actually use — often captured as local codes inside health information systems — and standard reference terminologies such as SNOMED CT, ICD, RxNorm, and LOINC.

CIEL does two jobs at once. It makes sure clinical intent is captured at the right level of specificity in the health information system, and it guarantees that standard interoperability mechanisms can reach for the right standard codes, even when a concept needs more than one (post-coordination). CIEL also ships multiple standard maps, so if one use case needs SNOMED CT and another needs LOINC, you have both on hand.

Since improving the integration of CIEL into OCL, we have substantially improved our quality assurance processes as well. Mappings to retired codes are being updated, and we have added other improvements such as checking mapping relationships to differentiate SAME-AS maps to reference codes from non-SAME-AS ones. In addition, to improve CIEL's usefulness on the front end, new translations have been created for Spanish (>98% coverage), French (>99% coverage) and Russian (>98% coverage), and we are currently expanding Portuguese coverage (~80%, including Portugal and Brazil). This will also increase the value of the Mapper tool for non-English mapping. As part of our ongoing effort to increase LMIC data in analytics and AI applications, CIEL was recently refreshed inside of the OHDSI/OMOP vocabulary using OCL as the source. This simplifies normalization to the OMOP CDM and ensures accurate LMIC data can be used for OHDSI federated research.

A recent evaluation of how CIEL can support mapping to major code systems like ICD-11, using the new OCL Mapper tool, will be presented at the 2026 OHDSI Symposium and 2026 Global Digital Health Forum in Bangkok. Without giving away the results, I can tell you CIEL provided a major benefit, and more to come once those are public.

A partnership grounded in the commons

CIEL and OCL are both Digital Public Goods, recognized by the Digital Public Goods Alliance and by Digital Square. We've worked together for many years to bring expert-curated, standardized medical terminology to implementers, especially those in resource-constrained settings.

The partnership has been genuinely mutual, and it keeps growing. Alongside our long-standing work with OpenMRS and Madiro, we're seeing new collaborations with the OHDSI community, Thesaurus Health, and others to extend the reach of both CIEL and the OCL platform.

How do I get started?

• New to OCL? Create a free OCL account.
• Check out the latest CIEL release: CIEL August 2026
• Upgrading an OpenMRS instance from a CIEL SQL dump? Download the External Export from OCL and read the ReadMe file in the download.
• Questions or feedback? We'd love to hear from you! Reach out on OCL Chat or the #ocl channel on the OpenMRS Slack.