harvesting architecture from active ehealth projects paul biondich, md ms shaun grannis md ms …and...
TRANSCRIPT
Harvesting Architecture From Active eHealth Projects
Paul Biondich, MD MS
Shaun Grannis MD MS
…and the entire OpenHIE community
What We’ll Cover
• Examples of information sharing• Models of architectural development• How architecture promotes reuse• OpenHIE: a community of practice• Discussion / questions
Overheard during WAHO meeting…
• Surveillance models are “front of mind” for most WAHO countries
• Concerns that surveillance might starve traditional health service delivery
• Are there ways to service surveillance & other aspects of health delivery simultaneously?
• How can we become informed consumers / directors of health IT implementation?
INTEROPERABILITY?
ARCHITECTURE?
Surveillance System A
Surveillance System B
Surveillance System C
?
Surveillance System A
Surveillance System B
Surveillance System C
Registry of Health
Facilities
NationalHMIS
230493 Ejisu Clinic
3544765-544908-2
Ejisu Clinic
3544765-5927852
Juaben Hospital
4357245-2
• Supports a consistent list of unique locations and care organizations that deliver health services within a country.
• Allows for rich descriptions of each of these places
• It answers the question “Where was care delivered?”
Surveillance System A
Surveillance System B
Surveillance System C
Registry of Health
Facilities
NationalHMIS
Registry of Health Terms
45Q72 # confirmed w/EVD
276-695425
# confirmed w/EVD
276-6IND#452
# confirmed w/EVD
276-6
• Uniquely identifies the clinical ideas that occur within an enterprise
• Defines codes for each idea, as well as how those ideas relate to each other
• Answers the question, “What health concepts do we need to communicate?”
Surveillance System A
Surveillance System B
Surveillance System C
Registry of Health
Facilities
Inherently Reusable / Useful…
• Facility Finder: Person finds facility via name, phone number, etc.
• Facility Planner: Plan for future facilities by identifying geographic or
other attributed gaps
• Facility-Based Performance Financing: track key metrics or
financials for a given facility
• Whatever user-centric need emerges!
Building incrementally towards an architecture…
MNCH Use Case
Dispensary / Antenatal
Clinic
• Place where antenatal care services are typically delivered
• Record system in place to manage information for each pregnant mother
• Often distinct electronic record system within each clinic
Dispensary / Antenatal
Clinic
Dispensary / Antenatal
Clinic
Community HealthWorker
Community HealthWorker
• Attends to mothers in between visits
• Identifies pregnancy, looks for risk during pregnancy
• CHWs often communicate this information via SMS message to a central server
Dispensary / Antenatal
Clinic
District / Referral Hospital
Community HealthWorker
• Supports high risk problems during pregnancy
• Supports high risk deliveries
• Each hospital often has a distinct hospital information system that support clinical and administrative services
District / Referral Hospital
Building towards an architecture?
Community HealthWorker
Dispensary / Antenatal
Clinic
District / Referral Hospital
230493 Ejisu Clinic
3544765-544908-2
Ejisu Clinic
3544765-5927852
Juaben Hospital
4357245-2
• Supports a consistent list of unique locations and care organizations that deliver health services within a country.
• Allows for rich descriptions of each of these places
• It answers the question “Where was care delivered?”
Registry of Health
Facilities
NationalHMIS
Registry of Health Terms
Community HealthWorker
Dispensary / Antenatal
Clinic
District / Referral Hospital
528465Hemoglobin, Total
718-742798
Hgb Lvl
718-7924356
Hemog Level
718-7
• Uniquely identifies the clinical ideas that occur within an enterprise
• Defines codes for each idea, as well as how those ideas relate to each other
• Answers the question, “What health concepts do we need to communicate?”
Registry of Health
Facilities
NationalHMIS
Registry of Health Terms
Community HealthWorker
Dispensary / Antenatal
Clinic
District / Referral Hospital
Registry of Health
Facilities
Registry of Clients
NationalHMIS
Registry of Health Terms
002867-5 Dansua, Samia
463782770301
Dansua, Samea
4637821289495
Dansue, Samia
463782
• Maintains a unique and consistent identity for all clients receiving health care services.
• Answers the question, “For whom was care delivered?”
Community HealthWorker
Dispensary / Antenatal
Clinic
District / Referral Hospital
Registry of Health
Facilities
Registry of Clients
NationalHMIS
Registry of Health Terms
393719Frances Marley
12563-3429465-1
Nurse Idris Elba
14267-9828364
Dr. Kwame Anyidoho
11935-4
• Maintains consistent and unique identities for health workers within an enterprise.
• Allows for rich description of each health worker
• Answers the question, “by whom was care delivered?”
Registry of Health
Workers
Community HealthWorker
Dispensary / Antenatal
Clinic
District / Referral Hospital
Registry of Health
Facilities
Registry of Clients
NationalHMIS
Registry of Health Terms
• Maintains a normalized collection of clients’ health data that is validated and standardized using each of the registries.
• Supports storing and querying patient centric data across the entire enterprise.
Registry of Health
Workers
Shared Health Records
Repository
Community HealthWorker
Dispensary / Antenatal
Clinic
District / Referral Hospital
Registry of Health
Facilities
Registry of Clients
NationalHMIS
Registry of Health Terms
• Provides the infrastructure to process information coming from various point of care health applications
• Also processes queries coming from these same point of care systems
• Manages access to and security of the contents of the exchange
Registry of Health
Workers
Shared Health Records
Repository
Interoperability Layer
Other real-world implementations
• Tanzania: BID (better immunization delivery)
• South Africa: momConnect• Liberia: mHero• Bangladesh: BHIE• Philippines: PHIE• Nigeria’s ICT Framework• …many more being conceived
“Our mission is to improve the health of the underserved through the open,
collaborative development and support of country driven, large scale health information sharing architectures.”
http://ohie.org
Interoperability Layer
Mobile Applications
Clinical Record
Systems
Hospital Information
Systems
Registry of Health
Facilities
Registry of Clients
Health Management
IS (HMIS)
Shared Health Records
Repository
Registry of Health Terms
Registry of Health
Workers
Laboratory Information
Systems
M&E Applications
Kenya’s FR
The difficult stuff…
• Technology is the “easy part”• Responsible technologies support:
– Governance choices of the country/region– Requirements from the broadest set of
stakeholders– Local development, evolution, and
sustainability
• Who serves as “authority” within country for a given architectural component?
Country Leadership & eHealth Capacities
eHealth Strategy and Policy Framework
eHealth Stakeholder Leadership
ICT Infrastructure
Health Information Technologists
eHealth Literacy for Health Workers
Global, Regional & National eHealth Partnering
http://ohie.org
Questions?
Want a copy of the slides? Scan ->
..or go to: http://pgb.me/waho