District OPD does not pause for a spinner. Flowrisehms is built so registration, vitals, and the encounter note write locally first.
What stays up
Reception still issues identifiers. Nurses still capture a pulse and a temperature. The clinician still signs an order. None of that waits on a national fibre cut.
What waits
Sync, NHIS batch upload, and cloud backups resume when the radio or fibre returns. The clerk does not re-key the morning.
This is not a slide about "offline-ready." It is the default path for Northern Ghana.