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  • 2009 Implementers Group Meeting Program OpenMRS, DHIS, and iHIRS
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<html><head><title></title></head><body>= Interoperability between openmrs and XYZ =

Systems to be integrated

    • DHIS
    • iHRIS
    • CRIS
    • TracNET
    • BAOBOB
    • Pentaho

Facilitator

Andy Kanter

Note Taker

Justin Miranda

Notes

  • andy Notion: we have several projects using same applications that run on same stack
    • could talk about sharing data across applications
    • all of these share the same infrastructure
    • we could discuss specific use cases for aggregating data for operational / reporting needs
  • andy we could discuss use cases to build integration instead of interoperability
    • categorizing site list
    • for a given institution, series of functions that they needs to do
      • list of providers (HR functions)
      • set of household related data
      • EMRs
      • facility
      • report to MoH
    • andy not thinking about the big national picture, but rather at an institutional level manage daily operational tasks
    • openmrs as platform allows
    • darius community health worker
      • not storing a proper list of CHWs to allow management to d
      • daily/weekly report -> preaggregated (how many visits, was generator working?)
      • how do we store that? openmrs should not handle that, we should store that in DHIS
    • andy data in EMR
      • (to manage users is not well developed)
        • CHW -> iHRIS
      • household information is not well developed
        • Household -> ?
      • aggregated data (patient or site aggregated data) we don't ask a question
        • Aggregated data -> DHIS
      • metadata around facilities (number of nurses, number of beds)
        • Facility -> ?
      • census data -> DHIS, CRIS
      • resource management (human, supply chain)
    • dhis we should focus the conversation on use cases
    • roger sharing a backend
    • darius what are we proposing? libraries to make integration with DHIS possible.
    • sunni eHealth architecture state health society
      • integrated view of all the above
      • demo/mockup (http://lewispages.net/)
      • MHIS -> DHIS
      • Infrastructure -> # beds
      • Drug Mgt -> stock management system (reporting, ERP)
      • Patient -> OpenMRS
      • Financial Management -> ?
      • Human Resource Management -> iHRIS
      • License Systems -> ? (licensing for surgery centers?)
    • used centrally at the
      • services:
        • single sign on (one login to
        • tabs to go between systems
        • unified UI conventions (prevent users from having to think between systems, where do i find help)?
        • systems share things between systems (i.e. location)
    • andy problem with data integrity
    • need to figure out shared "tables" (locations)
    • security issues around these metadata tables
    • concepts need to be shared
    • how do we move from EMR data element to Indicator data element
    • two levels of standardization:
      • concept dictionary (mapped between sites)
      • rolling up concepts into indicators
        • rules should be allowed to be used in paper reports as well (standardizing the rules for indictors)
        • rules need to be more rich to tell the system how to calculate a
        • use reference standards to define indicators so a system can calculate
    • start with easiest integration (start with common ground)
      • openmrs best concept dictionary (well-defined)
        • how does that repository get moved/mapped between systems
      • Example: EHR (Snomed)
        • be attentive of different initiatives
        • we need to be able to reuse archetype architecture
    • human resources piece
      • what's the use case?
        • list of health workers, doctors, data officers
        • why do you need that?
        • use for resource management -> (e.g. moving doctors to the location of a tsunami)
        • workflow indicators
    • bill lober HR maintenance -> interesting use cases
      • how to contact staff (SMS messaging)
      • credentials/authentication
      • what's the use case?
        • manage list of resources
        • directly communicate with providers
        • authenticate people against central registry
    • justin
      • ues case: send SMS to CHW to find patients lost to followup
      • implemented as an LDAP system
      • iHRIS
        • health workers
        • position descriptions
        • facitlities
        • certifications (renewal)
        • high level functional (no leave balance, no )
    • andy quality of care indicators
      • certain providers are seeing a lot of patients, do we need to add providers
      • map between households and CHWs
    • richard HR system in Rwanda (where are the doctors, nurses, empty positions)
      • age range, who is about to retire
      • nurse/doctor recruitment
      • health care facilities are public (government contract)
      • government maintains list of all HR at all sites
    • chris 2 plug: concept collaborative discussion this afternoon
    • andy what's the workflow for things like drug management
    • sunni DHIS handles it decently well, not as fine grained (drug of this quantity will expire on this date)
    • andy maturity module
      • plug in different modules as you become able to support them
      • transition from simple systems (DHIS) to more complex systems
      • figure out minimal requirements to do things simply and extend
      • stay agile
    • darius bolt the applications together through web services
      • practically speaking that won't be the way
    • andy use phased approach (use "bolted together" approach)
      • original scope of discussion: how does this work within one system? not national level?
    • roger doesn't agree with low-hanging fruit
      • start with a system that is well-designed (we shouldn't have to reinvent the wheel)
      • predictive ordering might not be the first thing you think of, but you should get people together to solve it
    • andy let's not waste energy trying to get "experts" together
      • we should still
      • start smaller
      • remember that there are standards, but don't let those constrain development
      • don't wait 3 - 5 years to build the ideal solution
    • ? sharing information should be done through APIs (at a first level)
      • have a single source of data
      • sync would be a first
    • andy next steps?
    • bob three levels of thinking (elaborate)
      • shared information entities (staff list, facility hierarcy, site list, report definitions, etc).
      • map system - who owns these entities (gatekeeper)
      • operational exchange - how do you access/exchange/reject that data
    • andy governance process
      • use certain systems as source "gold standard" of information entities
    • andy haven't talked about financial system
      • should be able to report an encounter to a
    • andy worfklow
      • rapidsms
      • how do you know when something happens
      • e.g. mothers are supposed to have immunization before they deliver
        • based on decision support
        • business process management (firing events -> actions)
    • richard add drug list to info entities
    • information entities
      • concepts
      • staff
      • users
      • facilities hierarchy
      • indicators / report elements
    • ? continuation of this discussion through
      • lewispages.net
      • tghin.org
    • isaac going to add more use cases to wiki

Next steps

  • Ola: Further discussions on this topic could be facilitated using the The Global Health Information Network forums. There is already a forum being used for this discussion here. The forum has email notification. Or we could set up an open mailing list (with archives) at googlegroups or similar.

Want to try these applications?

OpenMRS, DHIS, IHRIS (and later also other related applications in this domain) will shortly be made easily available through the Public Health Information Toolkit. The Public Health Information Toolkit (PHIT) is meant to be a self-contained USB pendrive that makes public health tools and frameworks available “out of the boxâ€Â, including content developed by international organizations and networked communities of practice. The starter suite of tools brings together OpenMRS, iHRIS, DHIS2 and OHE. Follow the webpage above for updates on this project.

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