OpenHIE Blog

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:

• Carl Leitner of IntraHealth led an introduction to OpenHIE
• Alvin Marcelo of AeHIN discussed the history, lessons learned and next steps in the Asia eHealth Network.
• Niamh Darcy of RTI International hosted a talk on expanding knowledge of OpenHIE in sub-Saharan African and expressively collaborating with the group Health Informatics in Africa (HELINA).
• Brian Taliesin of PATH spearheaded a conversation on harmonizing OpenHIE registries with other registries used by the supply chain profession.

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.

Here are a few highlights of the 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