Integration, Interoperability & Standardisation - Example: WHO / HMN project to develop Free and Open Source Public Health Toolkit
Uneven infrastructure in countries - how to achieve “uniform” and scalable RHIS approach? Architecture?
Addressing interoperability and standardisation at different levels: syntactic /technical; semantic & “political”
Mobile telephones; two conflicting trends: Empowering the people - Or Western companies?
Networked ICT: More and different capacity needed
Objective: To work with partners in a collaborative effort to deliver a suite of free interoperable information tools for public health Approach: Leveraging existing products/efforts and providing a standard-based extensible platform for technology and data integration Data Warehouse
Other Data Sources
Demographic & Health surveys
Electronic patient record systems etc.
Clinical systems Eg. OpenMRS Health Management DHIS, CRIS ... Interoperability Standards Additional Databases HR management eg.. iHRIS e.g. SDMX-HD (WHO project) OpenHealth Platform Indicator & Metadata Registry (IMR) Public Health Starter Toolkit Suite of interoperable tools for public health for countries Field data collection tools SAM etc Data Exchange and Integration Platform
Patient management/tracking Surveys Outbreaks Investigations Surveillance Logistics & Supplies HR managemt Financial management Monitoring & evaluation District health Management Public health data architecture Laboratory systems Drug monitoring … Public health applications framework – examples - Approaching a RHIS architecture
Open MRS CSpro Episurveyor .. EpiInfo … iHRIS … CRIS DHIS OpenHealth – Platform/Architecture … … Patient management Epi surveillance Health info mgt Surveys Logistics & supplies Financial mgt Outbreaks invest. HR management Monit. & eval. L Laboratories Drug monitoring . . . Leveraging existing tools and systems For starter integrated toolkit …
Criteria/operating principles For the Public Health toolkit
be freely available
support data standards and open communication protocols
allow for local customisation, peer user support and adaptation over time.
be capable of being deployed by appropriate personnel
adopt industry best practices and standards for scalability, modularity, and expandability
Example: DHIS-OpenHealthMapper in Sierra Leone Indicators by Chiefdom displayed using colours
The Adapted HMN Data warehouse approach (for aggregate data) An integrative “umbrella” across programs, sub-systems & infrastructures (paper, computers, Internet, mobile telephones Data warehouse Reports, GIS, Pivot, graphs, etc, (for aggregate data) Import Electronic data Data capture from paper reports Electronic Patient records Paper patient records Electronic e.g. HR records Export electronic summary data Monthly summary reports Replicated at each Administrative Level: National State/Province District Municipality Data from / to Mobile telephones
From paper records to electronic patient records (and other records, e.g. HR)
Increasing differences between views 3 Levels of (achieving) Interoperability/ Standardisation: -- Organisational/ Political /pragmatic -- Semantic -- Syntactic /technical Compared to telephone conversations: -Interested in talking? -Shared language and Shared understanding? -compatible telephones & networks? Interoperability and integration require standards Standardisation & interoperability may be seen as going on at 3 levels of increasing complexity Standardisation process: cycling through the levels. For each level, “solutions” based/running on solutions at level below, and rely on agreement at level above SDMX-HD, etc . Shared / agreed indicators & meta data Programs / donors /agencies Agree to standardisation Unique id.
“ Country in Africa”: Network provider & Western software company provide /sell services to health program,
funded by donor
“ We provide infrastructure, incentives to data collectors (airtime), security, data management & reports”
Data sent to company server - cloud computing
Increased fragmentation &
“ Solving “ Africa’s capacity problem by outsourcing complicated technology to Western companies!
Same technology – two different outcomes
Humans, not the technology, is the determinant!
HR & Capacity development; How may Developing countries NOT get disempowered in the age of Networked ICT – some concerns Mastering & “controlling” ICT in the context of Internet, Servers, WEB & Mobile telephones Different & new skills & capacity At the same time: ICT services are being globalised – “cloud computing” How can countries cope? (Apart from traditional training) RHIS interventions should always be based on local participation, ownership and control – ALSO in the area of ICT!