Back in March 2016, the OpenHIE community of practice officially endorsed The Principles for Digital Development, an initiative to take lessons learned in the use of information and communication technologies (ICTs) in development projects and put them into practice. As a values-driven community, it was natural to align with this initiative, given how closely our community aligned with the concepts inherent in the Digital Principles.
As we reflect on our community’s activities for 2016, we are pleased to have many examples of how we advocate and encourage this values-based model, working with countries as they plan, and begin to implement large scale health data sharing architectures.
Design with the User: Many countries are currently in the process, or have completed the publication of a national architecture for health data sharing. We are proud that many of these countries ministries, such as Kenya, Nigeria, Ethiopia, Tanzania, and the Philippines are being supported by members of our community. In each case, these architectures are being conceptualized against real world health issues, and the priorities of health leadership. For example, in Nigeria’s recent National Health ICT Strategic Framework, the architecture has been conceptualized against the country’s vision of universal health coverage, and the early operational activities have been prioritized against a collection of real world health data sharing challenges. In Tanzania, members of our community participated in a Gates-funded activity called the Better Immunization Data Initiative. This early work around encouraging better immunization compliance through technology and data sharing was an important precursor that supported their national eHealth architecture plan. In all of these circumstances, countries are designing architectures against real, not perceived needs.
Use Open Standards, Open Data, Open Source, and Open Innovation: Throughout the OpenHIE community, we strive to be a potent example of the power of open standards and open content. We are strong ambassadors of open standards, through our partnership with Integrating the Healthcare Enterprise (IHE), a standards-specification organization which helps to operationalize the use of base syntactic and semantic standards such as HL7, FHIR, ICD, and SNOMED. Many of the country experiences within our community have both validated these standards as viable within resource-constrained environments and encouraged fundamental revisions to them. In some cases, we have even been lead developers of new standards; our work on ADX, and CSD are two prominent examples. We also spend significant energy in developing reference technologies to demonstrate the viability of these standards, and in most cases, these demonstration technologies are made available via liberal open source licenses. But in the spirit of true openness, we also encourage the participation of commercial or proprietary equivalents for these technologies within our larger ecosystem to maximize the potential choices for consumers. Most importantly, we go out of our way to do all of the work of our community out in the open. That has become an obsession for us! New members of our community can learn about most of the previous conversations by reviewing our wiki, our mailing lists (which are archived and available to the public), and through recordings and collaboratively developed minutes to our meetings.
Address Privacy & Security: One of the more challenging aspects of working with countries on data sharing strategies is the need for a highly tailored set of policies and procedures for how to ensure the privacy and security of health data. Each country has unique socio-political dynamics that obligate a deliberate discernment of details around topics such as data ownership, stakeholders, and individual rights. In other words, there is no common boilerplate or approach to addressing privacy and security around health data sharing. This has been a fundamental challenge that has hindered our ability to adequately support countries. In response to this, in 2016, we worked with domain experts within the US and around the world to develop a framework for starting a dialogue with countries, and discerning the aspects of privacy and security that are priority areas of emphasis. “A Global Framework for Health Information Exchange” is a report laying out the framing questions and the concepts which will assist decision-makers in documenting the relevant policies that ensure adequate safeguards for privacy and security. That being said, we are very interested in learning how others have broached these kinds of issues and would benefit greatly from the involvement of others as we work through this challenging topic.
We are proud to be an endorsing organization of the Digital Principles, and look forward to the peer learning opportunities that will come with further active engagement with this initiative in 2017.
OpenHIE is very proud to be a contributor to the 2017 HIMSS Book of the Year: “Health Information Exchange: Navigating and Managing a Network of Health Information Systems” published by Elsevier. We all felt it was important to contribute to this book due to our focus on implementation and interoperability. This book provides a great way for key members of our community to share our implementation guides and place them within the overall conceptual framework of HIE. We were also looking forward to having a physical book available, so this information can be more readily accessible by all.
This book is a significant accomplishment and a huge thank you goes to Brian E. Dixon, PhD from Regenstrief Institute for providing OpenHIE the opportunity to share our knowledge when it comes to addressing the myriad challenges of data exchange.
If you would like to learn more about implementing an HIE, please reach out to the OpenHIE Implementers Network. Anyone can view content posted by this group and anyone can join in the conversation by subscribing here.
You can get your copy of the “Health Information Exchange: Navigating and Managing a Network of Health Information Systems” book here.
The OpenHIE Meet-Up on Wednesday, December 14 at the Global Digital Health Forum had two simple goals:
One, to gather those working in different components and areas of OpenHIE’s architecture – or at least those working in health information systems – to explain some of the technical challenges they are facing.
Secondly, to find areas of collaboration with other participants to help solve these challenges.
We knew no challenges would be solved at the short breakfast meeting. But simply connecting the more than 20 participants from a variety of implementing groups provided an opportunity to strengthen the community built around OpenHIE.
IntraHealth International organized the meeting as an un-conference, which put the responsibility on the attendees to provide topics and lead discussions in a collaborative and open fashion. A number of people proposed discussion topics, and in the end, four participants initiated separate discussions:
Paul Biondich of Regenstrief Institute opened the meeting with a short welcome. Afterwards, attendees were invited to join the table of their choosing. In un-conference fashion, attendees were reminded they could participate as much as they liked, but the higher amount of participation would increase the quality of discussions.
Intro to OpenHIE: A wide ranging discussion, filled with OpenHIE novices and experts, covered the main components of OpenHIE and the fundamentals of its community. Members from teams working in two South American countries were in attendance, signaling interest in a region without much OpenHIE activity.
Expanding knowledge of OpenHIE in Sub-Saharan Africa: Anecdotal evidence shows that many eHealth practitioners working in Africa lack comfortability of talking about OpenHIE with their peers. The table discussed a few methods to increase knowledge and confidence, including study tours (where informatics professionals in one country travel to another country to discuss OpenHIE planning, performance and lessons learned) and creating a regional task force to increase training and dialog around OpenHIE. Increasing the amount of OpenHIE toolkit documentation was also discussed. A push to speak about OpenHIE use cases at the upcoming HELINA conference on April 23 to 26, 2017 in Burundi.
AeHIN history, processes used, next steps: Alvin Marcelo provided an overview of AeHIN and some lessons learned as the network has expanded. He overviewed the process AeHIN uses for assisting governments in South and Southeast Asia in the development of their health information systems and described both what is needed to continue to provide this support and AeHIN’s vision for the future.
OpenHIE Registries and Supply Chain Management: The conversation centered on aligning registries used by the health system and health care delivery with those used by supply chain practitioners. The link between young children and vaccine transactions is one example: Once a baby is born, she will appear in a health care delivery registry (like DHIS2) and a vaccine registry. Could the young child’s clinic record be leveraged for supply chain databases? Discussions also took place about attempting to align locations (of health centers) within a facility database with those used by supply chain registries.
After nearly one hour of conversation, each table reported out their findings and next steps. Business cards and contact information were exchanged along with promises to keep in touch and move the discussion to the next level. The participants then went off to join the final day of the Global Digital Health Forum.
Post by: John Liebhardt
On January 25-29 over 1000 health IT professionals gathered in Cleveland, Ohio to participate in the health information technology (HIT) industry’s largest collaboration, testing and education event the IHE North America Connectathon. This week long event provides developers a forum to advance interoperability for health information systems.
Why does interoperability matter when it comes to the sharing of health information? Interoperability enables interactions between disparate information systems without having to directly connect them through a hard-coded interfaces. This decoupled approach reduces dependencies and provides the ability to more easily exchange data with other healthcare systems. To provide interoperability, both semantic and syntactic interoperability need to be addressed. As we have seen in other industries, standards can be used to help address interoperability.
IHE standards address syntactic interoperability and provide some support for semantic interoperability. The focus of IHE testing is to ensure message standards are complete and that applications that implement the standards can interoperate. OpenHIE participation in connectathon allows testers and independent monitors to verify that the disparate OpenHIE reference systems can exchange information with other systems via the defined protocols.
OpenHIE community members came from around the globe to participate in this year’s North American Connectathon event to test standards that support OpenHIE workflows. OpenHIE focused on testing protocols related to:
For more information on IHE testing and conformance statements for previous connectathon testing, visit the OpenHIE Integration Statements page on our wiki.
During this weeks MedInfo conference members of the OpenHIE community will be presenting a workshop on “Promoting Effective Health Information Exchange in Developing Environments: An Overview, Tips, and Tactics for Engaging with the OpenHIE Community”. MedInfo is the premier international health and biomedical informatics event. This years theme “eHealth-enabled Health”, will bring world leaders in this field together in São Paulo, Brazil to share knowledge and analyze how eHealth and biomedical informatics are contributing to address some of the most challenging problems in health care, public health, consumer health and biomedical research.
Workshops at MedInfo are informative or interactive sessions that address a specific theme or topic in biomedical and health informatics. During the OpenHIE workshop, we will share three key elements of OpenHIE, including: the OpenHIE technical framework, the OpenHIE community process, and examples of implementations that leverage the OpenHIE initiative. We will further enable workshop participants to explore those elements through small group dialogue facilitated by OpenHIE community members. During the closing session participants will be brought together to help synthesize discussions and provide feedback to the OpenHIE community.
To learn more about OpenHIE’s workshop download our submission paper here.
We are pleased to announce the release of OpenHIE version 1.0 today, 05/15/15!
OpenHIE 1.0 includes exemplar open-source software that supports a collection of tested health information exchange (HIE) integration workflows that support common health care patterns. OpenHIE workflows specify interactions between Point-of-Service (PoS) applications and the HIE, as well as interactions between components that make up OpenHIE’s software architecture. OpenHIE 1.0 is not just software – it also includes a variety of informational artifacts and documentation. For details on how you can download, install and upgrade from your previous installations, please see our Release Notes Page.
Shaun (OpenHIE Chief Architect)
This week I was in Washington DC for the inaugural FHIR terminology services connectathon. This was the first of its kind: a connectathon focused on the terminology services portion of the FHIR specification.
The following organizations were represented:
The focus of the connectathon was on the two simplest operations in the terminology services API:
The OpenHIE community would like to congratulate Dr. Richard Gakuba, of the Rwanda HIE initiative, for receiving the mHealth Alliance’s Holly Ladd mHealth Pioneer Award. On Monday December 9th, at the 5th annual mHealth Summit, Dr. Gakuba was named the recipient of this year’s award. The Holly Ladd mHealth Pioneer Award recognizes an individual who advances sustainable solutions for personal and community health empowerment through the use of mobile technology.
This award recognizes Dr.Gakuba’s as Rwanda’s National eHealth Coordinator for the Ministry of Health, a role he has held since 2005. His vision has helped to create and implement Rwanda’s national e-Health strategy goal of improving the effectiveness of health care delivery and making services scalable and affordable to Rwanda.
“FHI 360 is honored to support the Holly Ladd mHealth Pioneer Award this year,” said Albert J. Siemens, Ph.D., Chief Executive Officer of FHI 360. “The award acknowledges Holly’s vision of how communication technology can transform the lives of millions of people around the globe. It celebrates her outstanding leadership and passion that have been an inspiration for so many.” (Quote from www.prweb.com)
One of the more recent eHealth initiatives led by Dr. Gakuba and partners include the Rwanda Health Information Exchange (RHIE) which is the first known electronic, health information exchange in Africa. RHIE is the first implementation of the OpenHIE architecture providing the ability for health centers and hospitals to connect and communicate by sharing patient information through a secure network. RHIE is currently implemented in 11 of 14 health centers in Rwamagana District, specifically focusing on antenatal care. As the final health centers in Rwamagana District and the district hospital are connected, RHIE will expand to include different care services including maternity, HIV, TB, etc.
OpenHIE has dubbed 2013 as “the year of engineering”. This year is of particular significance because it is an opportunity for our OpenHIE subcommunities to collectively focus on the tasks of strengthening our community network of peer support, fostering our approach of open innovation, sustainability, and capacity development, and developing our technological tools such that they are more robust, useful, and better able to scale to a broader variety of countries and situations.
Our community is not simply a collection of technical specifications, but also a strong network of stakeholders who work together to solve problems around health information interoperability. In the “year of engineering”, we want to work towards best positioning ourselves to be effectively leveraged by current and future deployments of OpenHIE. Some of our aims are to define the communication processes and structure of our group, and ensure that our culture is strongly user-centric. A subset of community members will also gather together this year in order to create short, medium, and long term strategies for the OpenHIE community as we continue to grow.
OpenHIE subcommunities will also use “the year of engineering” as a time to enhance their software tools. For some groups, this activity will involve improving the existing software tools selected for or currently in use. Efforts will go towards building out those systems, eliminating their identified limitations, engineering new requirements if necessary, and making sure that the linkages to other OpenHIE efforts are well designed and built. These groups may also invest time to inform and support a standards-based approach for sharing data, which helps consumption of the tools in different contexts.
Other OpenHIE subcommunities have not yet selected a tool for use. For these groups, the “year of engineering” will involve exploration and planning so as to reach consensus on a software, the features it needs, how best to build it, and completing the development of that particular technology. This task may entail leveraging an existing tool and modifying it to meet user needs, or designing and developing a new tool from scratch. By the end of 2013, these subcommunities aim to have a solid base platform which may be extended and iterated on in coming years.
Our vision is for all health systems to be able to leverage a robust, highly-aligned health interoperability ecosystem which forms as a result of the collective activity within the OpenHIE community. Our community of practice, which has been self organized to interactively develop, refine and harden a collection of approaches and freely available standards based technologies, is central to achieving this vision. In 2013, we are collectively focusing on engineering our community to be stronger, more robust and user-centric, and best prepared to be leveraged by implementations for use in current, future, and more demanding environments.
|A common question we get is: “What is the OpenHIE initiative about?” The short answer would be that OpenHIE is about helping resource-constrained environments leverage their electronic health information by standardizing it. But it’s more involved than that…|
So what’s our approach? OpenHIE is a community of communities. We have organized various projects involved in standardizing health information into a common, scalable approach that has immediate pragmatic value for a whole host of real world health use cases. We’ve underpinned this technical approach with a series of experienced implementers of large scale interoperability projects, so that as countries come to our community with expressed needs, we can personalize an engagement strategy that simultaneously meets their immediate needs and further refines the technology and standards support for subsequent members of the community.
Want to learn more? Do you think we can support your country or project? Fill out our get involved page, we welcome you to to join our community!