October Meeting Recap: Health Information Systems Interoperability

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Dear Global Digital Health Network Members Health Information System HIS Interoperability is a very popular topic among Network members and Digital Health Implementers At the recent WAHO September Joint Annual HIS and IDSR Managers and Partners Meeting in Cape Verde it was reported that DHIS 2 will be rolled out in over 20 West and Central Africa countries by 2019 The topic of interoperability of DHIS 2 with other HIS featured in many discussions including the need to address data sharing comprehensive data reporting and other HIS efforts Admittedly there is still a lot for implementers to learn thus our October Global Digital Health Network meeting featured four experts to share their experiences in HIS Interoperability Over 70 people joined the discussion in Washington DC and online last Friday as our presenters delved into the subject Here is a brief recap of the presentations and the discussions All of the presentations are available on the Global Digital Health Network website here add hyperlink Apollo Temu PATH Deputy Director of the Better Immunization Data BID Initiative in Tanzania provided an overview of the work done in Arusha to improve data availability and quality to support immunization and vaccination programs The pilot work done in Tanzania focuses on immunization challenges in rural areas around Arusha including urban peri urban rural and pastoral populations including those bordering Kenya Apollo emphasized that BID builds to improve data quality and data use at all levels of the health system in Tanzania starting with Arusha Region In Arusha BID Initiative interventions have already been implemented in Arusha City Meru and Karatu District Councils The next planned districts are Longido Monduli Ngorongoro and Arusha District Council After implementation in the Arusha region the interventions will be scaled up to other parts of Tanzania The BID Initiative is designed around the framework of OpenHIE a quintessential example of how adaptation is being used in HIS development The vision is to develop a robust national immunization registry that synchronizes immunization data with client registries links to the HMIS such as DHIS 2 and provides a more holistic view for informed decision making to save lives BID Tanzania also harnesses mobile SMS to incorporate data collection Data captured in the BID clients birth notification is captured by the RapidPro SMS application and the child immunization record is created and updated at facility treatment sites Birth notification data is stored in the OpenHIE client registry the child immunization record is ultimately stored in the OpenHIE Shared Health Record The BID solution as part of the Electronic Immunization System EIS has a component Tanzania Immunization Registry TImR is designed such that systems can be built on what exists and can interconnect via standards of interoperability and this is being fully supported by the Ministry of Health in ensuring harnessing data from various systems is attained Apollo shared a great story about how SMS is enabled for village elders to alert the system used by the health care workers at the facility of village births thus highlighting the need of a child s immunization needs in the village As much as technology is part of the BID approach connecting with people and communities is equally as important to ensuring a successful program Apollo also highlighted the BID Learning Network and how various partners are sharing and learning together how interoperability enhances HIS The BID Tanzania Program is even sharing their experiences with the new BID Zambia program sharing insight as the Zambia team prepares for their initial pilot Steven Wanyee an African Regional Health Informatics Consultant compared his experiences in working with governments on HIS interoperability in Kenya and Sierra Leone Four years after devolution Kenya is picking up steam to address its eHealth Architecture and the MOH is committed to launching a new eHealth Strategy soon There is a major demand and push towards implementation of the strategy including ensuring HIS interoperability Steven acknowledged significant knowledge in country about OpenHIE and showed in this slides the different technology stacks and architecture frameworks that have been designed by the national government Some of the key data sources in the Kenya Health Enterprise Architecture include KEMSA Kenya Medical Supply Agency DHIS MFL Master Facility List and iHRIS Several new awards from USAID and other donors are bolstering the vibrant multi stakeholder community to take support the MOH to take forward its vision The MOH is also committed to its vision and ensuring HIS interoperability through annual workplans and commitments through the Health Data Collaborative In contrast Sierra Leone is in quite a nascent stage of developing its HIS strategies including HIS interoperability Strong interest has recently been acknowledged including commitments through the Bintumani Declaration indicating leadership at the national level to prioritize HIS as part of its rebuilding efforts post Ebola There is still a lot to be done to build capacity in country little is known about OpenHIE and no work has formally begun on an eHealth Strategy However there are some positive signs as the MOHS has prioritized development of a MFL indicating it s commitment to ensuring HIS interoperability is part of their vision for the future There was quite a lively discussion after Steven presented the experiences in Kenya and Sierra Leone including enterprise architecture information stacks and particularly the Data Services Layer DSL that is set to be implemented in Kenya The DSL as a platform for collaboration and sharing information is an integration and aggregation of health information data sources with great potential to impact health outcomes Primary data sources include the Kenya Medical Supplies Agency KEMSA Integrated Financial Management Information System iFMIS National Health Insurance Fund NHIF among others The DSL is revolutionary and has capability to analyse predict anticipate diverging and converging factors of health for evidence decision making The high level of technical insight and commentary demonstrated the complexity and sophistication of HIS interoperability especially in the design of a country s eHealth architecture Experience has taught Kenya the importance of coordinated collaboration and interoperability COIN are 3 sides of the same coin Highlighting the recent work undertaken by RTI in Guinea Eileen Reynolds shared the activities under way to establish DHIS 2 in the country Many challenges in the country s health systems including a lack of standardization of data management parallel data collection systems and a breakdown in follow up key for successful surveillance all very much exacerbated during the 2014 2015 Ebola outbreak prompted government to call for the installation of a national DHIS 2 Part of the work RTI is facilitating is the integration of the surveillance data directly into the national DHIS 2 Eileen s team s approach is to focus on the long term use open source technology tools build capacity at the MOH and ensure they are following the Principles of Digital Development The team s current next steps include configuring surveillance data elements in DHIS 2 hosting a stakeholder workshop to discuss surveillance system requirements now and in the future and to validate the surveillance sub system in DHIS 2 and to train end users at District labs and hospital level in the use of the surveillance sub system in DHIS 2 to include weekly aggregate surveillance data reports and case based surveillance including laboratory results Though the MOH in Guinea is not yet ready to take on HIS interoperability they are building their systems with this view in mind An exciting update was shared that the MOH has rallied support for iHRIS data collection nationally To date only some of the health worker data has been collected to update the iHRIS system This along with their work to implement DHIS 2 signals national leadership to improve HIS The final presentation was from Mike Edwards who spoke about the recent September 20 29 RHINO Forum on Interoperability Linking Routine HIS RHIS with other Data Sources The Forum discussed several themes including 1 Resolving fragmentation of the HIS 2 MFL and other health information registries 3 Focus on interoperability 4 Enterprise Architecture and 5 Scaling up Interoperability Thirty three countries were represented in the Forum Discussions included a deeper dive into linking HIS such as linking various EMR systems linking EMRs to aggregate systems linking RHIS subsystems and linking RHIS with population census and data from demographic health surveys Mike discussed metadata data about data and how metadata is essential for understanding information stored in data warehouses Like in the previous presentations the themes of MFL eHeath architectures and enterprise architecture were explored during the RHINO Forum One final salient discussion explored Decision Support Systems DSS which are computerized applications that allow health managers to visualize RHIS health indicators and data elements These help help to compare data points spatially over time and between indicators DSS bring the data together and are valuable tools for informed decision making We encourage you to review the very informative slides from Mike s presentation We thank everyone who attended the October meeting and very much appreciate all of the discussion Please feel free to respond to these minutes to continue the discussion online HIS Interoperability and many other relevant topics will be further explored at the Global Digital Health Forum If you have not yet registered please do so by clicking on this link here Next month we will not be having our regular Global Digital Health Network monthly meeting but instead will host a tweet chat Stay tuned for more information including the upcoming launch of the new Global Digital Health Network Twitter Account Best wishes Heidi Amanda
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Monthly Meeting Minutes, Monthly Meeting Minutes, October, Interoperabilty
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