These are the paths that will lead us beyond lofty goals and onto practical action.
We know that interoperability is key to improving the effectiveness and resilience of health information systems.
As we’ve said before, it’s crucial to overcoming the fragmented and proprietary global health information systems we have today, and can allow governments and their stakeholders to make the most of their data, including extending, upgrading, and preserving it.
Yet how do we move from that lofty goal to practical action? For us at IntraHealth International, there are three clear pathways to greater health systems interoperability: standards, tools, and advocacy.
Health information systems need clear standards to communicate with each other and with the wider health ecosystem. So we’re developing those standards.
For instance, through the OpenHIE effort, IntraHealth is a core contributor to the Care Services Discovery (CSD) profile, which supports queries across related directories that contain data about organizations, facilities, services, and providers.
We also contribute to the Mobile Case Services Discovery (mCSD) profile. This is based on HL7’s Fast Healthcare Interoperability Resources (FHIR) standard and supports transactions and actors similar to CSD, including pulling data on organizations, locations, health care services, and practitioners from multiple data sources and responding to queries on those resources.
Standards are important, but without the software tools to make them useful, users won’t adopt them.
So we developed OpenInfoMan, an implementation of the CSD profile to find matching services and query for updated services transactions as part of OpenHIE. OpenInfoMan is the engine behind the CSD-compliant Health Worker Registry.
And now we’re working on an implementation of the mCSD profile to add FHIR support to the Health Worker Registry. This tool is extended from Jembi Health System’s Hearth FHIR server and gives implementers an extended set of operations beyond what is required by mCSD.
We are also developing Global Open Facility Registry (GOFR) tools, in partnership with DATIM and Digital Square, to support ministries of health as they develop and maintain master facility lists and link them with existing public sources of health facility data.
Standards and tools need one last component to help communities adopt them: constant advocacy to engage decision-makers and shift from ideas to reality.
We are tireless advocates of interoperability in the US and around the world. At the Integrating the Health Enterprise (IHE) Connectathon—the health care industry’s largest, most rigorous interoperability testing event—we connected our tools with those of other vendors to ensure that just by following the mCSD profile, any two systems can exchange data, despite being built entirely separately.
And within the Global Digital Health Network (GDHN), we promote interoperability across the international development industry. You can RSVP now to join us at the June GDHN meeting, where we will focus on interoperability across the health systems ecosystem.
Later this summer, we’re looking forward to joining many of our digital health colleagues at the OpenHIE Community Meeting in Arusha, Tanzania, to support country-owned, country-driven, large-scale health information-sharing architectures. We are particularly excited to give policy-makers an opportunity to better understand interoperability and systems thinking.
After all, learning more about the problems they face in sharing and using data drives our investment in standards.
Source:: Intrahealth Blog
|Wayne and Desire upgrading the Health Center Implementation|
On Wednesday this week, the team took on the challenge of attempting to setup and configure the Rwamagana Health Center Server on site with a new version of OpenMRS as well as installing the updated RHIE modules and connecting the Health Center OpenMRS implementation to the Rwandan Health Information Exchange (RHIE); all this in a single day. Challenging indeed but not impossible.
|Dentist chairs make for great motivators when
sitting in a chilly server room as
|Hard-Long-Day but smiles all round!
Florentin (MoH Administrator), Wayne (Project Manager),
Desire (JHS-Rw Developer), Daniel (Senior Developer)
I’m sitting here writing this to the sound of drums beating and imagining the dance classes happening down the road from the Jembi office in Rwanda. Symbolic too, as the team are working to a steady fast beat!
Today (Monday) our team had a big push, we took on the task of getting 2 new sites installed. I must make the distinction between ‘installed‘ and ‘implemented‘. We have defined them as follows:
|Wayne (Left) and Hannes (Right) after getting our test
environment setup pre go-live.
With that said we are excited to do a quick update from the field: Our Implementation Training team have successfully completed the first day of training at Karenge (the first new site to get installed last week) and are looking forward to the next few days of training and getting the users at Karenge up and running with the new system.
|Desire (left) working with Gishari’s IT manager,
training on system use and administration
As for our Installation and Technical Implementation team I am excited to announce that we now have 2 more sites ready for our team to train users on! Gishari and Avega are now technically installed, tested and validated as being able to send and receive data from the Rwanda HIE!
|Wayne setting up
We look forward to our team recouping tomorrow and reviewing the lessons learned from this hard day and using these to sharpen our edge of installation and implementation. Credit goes out to the Jembi Rwanda office for ensuring that things are running smoothly!
Looking forward to another great day in Africa tomorrow!
– Carl | Jembi Health Systems NPC (South Africa)
|Daniel reviewing the Rwamagana servers ahead of Wednesdays
|Desire, Wayne and Daniel: All smiles after a LONG day and having
Gishari and Avega installed!
|Wayne and Daniel | Jembi South Africa Team|
|Getting the system setup and local IT managers familiar with new fields.|
Well dusting off the blog and firing it up again to get things moving on the updates front. We are still here and working hard! Since our last post the RHEA team have been hard at work and quite a few exciting things have happened.
Some of them include the launching of a new global initiative drawing a lot of its core from the work in Rwanda, the OpenHIE (www.ohie.org) an open source community focused around tool and technologies that strengthen national health information systems through facilitating data exchange.
We have been working at our live sites and monitoring and refining the features and functionality we have implemented. We have been refining our search mechanisms to make it easier for our users to find patients and reduce duplicate registrations, we have been gathering data on reports that are needed and we have been spending time ensuring that our tools and the OpenMRS components are all upgraded to 1.9.x (we have been working very closely with the MoH and their technical team to achieve this).
We have been hardening and updating the in country Rwanda HIE implementation and investigating new channels in the OpenHIM (www.openhim.org) and user/implementation driven needs and requirements for new connections and features in the hosted HIE. We have also moved into a more sustainable model for the HIE with the applications being hosted on MoH supplied server space in the National Data Centre in Kigali.
Wow so much! Watch this space as we now enter into another implementation phase!
International delegates and representatives from partnering organisations and various entities, excitedly made their way to Kigali – Rwanda, for the much anticipated Rwanda Health Information Exchange (HIE) workshop. The four-day workshop, 24th – 27th September 2012, hosted by the Rwanda Ministry of Health (MoH) and Jembi Health Systems focused on the outstanding RHEA work done-to-date, getting a preview of the Live Demo walk-through, and lastly to workshop and map the road ahead – towards achieving the ultimate “dream” – Better Health care for Rwanda through technology!
RHEA HIE workshop in a “nutshell” – daily highlights and pics!!!
Day 1 – An atmosphere of anticipation and expectation filtered through the main conference meeting room at Hotel Chez Lando, as delegates started to arrive and register at the main table for the four-day workshop. One could sense an eerie mix-feeling of excitement as the various delegates greeted and interacted with each other, before being seated awaiting the start of the four day-RHEA HIE workshop.
|“All smiles – we are finally Live and Connected”
Dr Chris Seebregts (Jembi) & Dr Richard Gakuba (MoH)
|M&E plan focus group|
|Dr Richard Gakuba and Mr Nyamurinda Pascal leads “NID” focus group discussion|
|Track 1 and 2 breakout focus group|
|Track 3 breakout group|
|Michael Gehron – HIS Coordinator – PEPFAR|
|Group photo taken on final day!|
|Representatives from Tanzania MoH|
|Lorrine Banister (Regenstrief), Jonnea Smith (Jembi) Ophelia McMuarray (Cardno), Wendy Schultz (InSTEDD)
“Improving Global Health by developing partnerships”
|Dr Dennis Israelski (InSTEDD) and Dr Chris Seebregts (Jembi)
takes time out to visit kLABS in Kigali
|First Health Centre connected!|
|The Rwanda HIE Architecture, the components that
allow the HIE to “tick” so to say.
Congratulations to the teams for so much hard work and hours of after hours work and discussions to get us to this stage. We look forward to the RHEA meeting next week where we will be discussing this more and showing the use of the system in a demo on Monday morning!
Well it’s all in the title, well most of it, and sums up the teams work for yesterday. Let me unpack. Our goal for yesterday were:
|“IT LIVES – PoC Lives”|
|Our 2 first sites including the addition of Rwamagana.|
Yesterday has been quite a day for the JHS-RW and RHEA team as we mustered our forces and had a full charge at our implementations; 2 vehicles loaded with teams went out to 3 sites (Ruhunda, Musha and Rwamagana). We sent out the technical team in one car; dropping Hannes Venter (
|Implementation Kit and
Barcode Scanners &
|Jembi and MoH working at Musha to ensure all is loaded
and functioning as expected.
|Musha Health Centre (Part of it – it is a few separate
There was an eerie sense of silence in the Jembi camp last nigh…well it didin’t last too long and was followed with quite some laughing and possible hugging (we are still awaiting photographic evidence of the latter). Why you may ask, why this change or reaction.
|First Health Centre to start using the PoC functionality|
Today marks the day that the RHEA Point of Care module will be actively used in the Clinic for the first time! 8 days ago we went out to begin our implementation process of installing software and testing at Ruhunda and today marks the mentored and supported use of the PoC system at the clinic on the ANC clinic day. It has been a long uphill run to get the system to this point, note: we are not connecting to HIE as of yet as there are a few more tests to run but that isn’t stopping us collecting clinical data;
Today the team has divided; one to move onto Musha to replicate the implementation done at Ruhunda and the other back out to Ruhunda to support Liz and Dawn and the clinical staff as they start to use the system at a clinic and medical level.
|Tired but back into the car for the next day.|
We are running into some heavy challenges with internet at the various sites, Ruhunda being fixed and moving forward well – Musha giving the team a headache but we are confident that this will be resolved in the not to distant future.
We are all excitedly anticipating the call/sms from Wayne saying that X clinic is now connected to the Rwandan HIE and is sending live data to the SHR! These are, as always, exciting times and will keep us all updated!