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How does this project fit with the strategy?

This project contributes to an integrated approach that supports patient-level indicator reporting using a standards-based HIE architectural framework.

See proposed Archtecture 

This work is closely aligned to the OpenMRS Analytics Vision, FHIR in OpenMRS vision, and related discussions about analytics on FHIR. It complements the solutions currently under development by the Analytics Engine Squad, FHIR Squad, and the Intellisoft Bahmni PLIR Team.


Who's working on this?

Project Points of Contact:
Steven Wanyee Jennifer Antilla

Squad:

Kaweesi Joseph Moses Mutesasira Ian Bacher

CLIFF GITA  Ayeshmantha Perera

Bahmni (Intellisoft)

Esther Kanyangonda Ken Omondi Susan Gathu

For more information about the specific people working on this project, please see the PLIR Squad contact page.

Issues Tracking

Status

ACTIVE 




Why are we doing this?

Problem statement

Doing modern analytics on OpenMRS data is challenging - even more so when national and global reporting requirements change frequently. Over the years, OpenMRS implementers have developed a variety of reporting solutions in response to customer demands for aggregate data, often housed in separate, aggregate data systems. They often rely on writing custom scripts in order to meet deadlines, meaning that every change to reporting indicators will require a manual fix. This limits the ability to re-use and sustainably scale these solutions among OpenMRS implementers. Additionally, calculating indicators within OpenMRS often leads to performance issues. 

One solution is to use an OpenMRS Analytics Engine that goes beyond extracting data from OpenMRS and calculates reporting indicators. This solution is currently in development by the Analytics Engine Squad.

A related solution is to extract and send the disaggregated data to a mediator, such as OpenHIM, that will in turn forward the data to a FHIR server and CQL engine, where the indicator calculations will be done.

Impact of this solution

More and more countries are seeking robust, interoperable solutions that will fit into an increasingly sophisticated health information exchange architecture based on recognized standards. By developing a proof of concept that demonstrates how OpenMRS patient data can be extracted and sent to a mediator and is standards-based, countries and implementers will have access to a proven solution that works and can be extended for use within their country's HIE architecture.

Goals

What are we doing?

  • Develop a proof of concept which supports the calculation of the TX_PVLS indicator.
  • Build a proof of concept that supports exporting the necessary data for the measure calculation to a standard format e.g., a CSV or a FHIR bundle
  • Build the capability for reading a FHIR Measure resource for the TX_PVLS indicator

Logins   (To be completed)


  • OpenMRS   (POC EMR)
    • .password:             username:
    • URL   
  • OpenHIM   (Middle ware component) 
    • .password:             username:
    • URL 
  • OpenCR     (Client Registry)
    • password:               username:
    • URL
  • Happi Fhir Server (SHR )     
    • password:               username:
    • URL

Validation

What do we already know?


What do we need to answer?



Concepts for  Calculation of  TX_PVLS


  • The TX_PVLS indicator 
    • .This indicator represents the percentage of ART patients with a suppressed viral load (VL) result (<1000 copies/ml) documented in the medical or laboratory records/laboratory information systems (LIS) within the past 12 months 
  • Numerator  
    • .Number of adult and pediatric patients on ART with suppressed viral load results (<1,000 copies/ml) documented in the medical records and /or supporting laboratory results within the past 12 months    . 
      We will consider patients with result from  CIEL:856 with a threshold of < 1000 copies / mL as the standard for viral load suppression  and in case the patient does not have a CIEL:856 result, we will consider results  CIEL:1306 where the value is (BEYOND DETECTABLE LIMIT) 
  • Denominator
    • Number of adult and pediatric ART patients with a viral load result documented in the patient medical record and/or laboratory records in the past 12 month
      We will consider patients with a relevant CIEL:1305 result but only if the patient does not have a CIEL:856 result
  • Concepts to consider     
    • CIEL:856  for quantitative values   (Same as SNOMED CT   315124004)
    • CIEL:1305  for qualitative values , in case the patient doesnt have a quantitative value.   (Same as SNOMED MVP 13051000105000)


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