Health IT - the African Approach

Transcription

1 Health IT - the African Approach Chris Seebregts, PhD Executive Director, Jembi Health Systems SOUTH AFRICA HIMSS Asia-Pacific, Sep 2012

2 Outline Challenges and opportunities associated with low resource environments Approaches to Interoperability in low resource settings Implementation experiences from Rwanda

3 Preventable Deaths

4 Income / GDP

5 Current Implementation Blog Carl Fourie, Jembi Health Systems, 18 September 2012,

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7 Open Community-Driven Technologies Open Architecture Open Standards Open Source Software Ubuntu Southern African philosophy that we are who/where we are because of the community.

8 Public Private Academic Innovation Models Public Private Academic More Academic

9 Funding for RHEA

10 Health Enterprise Architecture Framework for National Health Information Systems Integration -> Capacity Building -> Methodology -> Methodological Tools -> Repository of Assets -> Registry Application -> Reference Models

11 Slide courtesy of Bron Kisler, Elizabeth Keller, Don Newsham, Joint Initiative Council Key Requirements (3) STANDARDS OF INTEREST (first list of 33) (1-18) Note: Need to further rationalize the 50 standards needed into 4-5 buckets / business requirements using enterprise view (the house picture) (use SKMT) Deployment of a Clinical Data Warehouse TS Provider Identification TS Health Indicators for Conceptual Framework IS Health Informatics -Service Architecture -Enterprise Viewpoint IS Health Informatics -Service Architecture -Information Viewpoint IS Health Informatics -Service Architecture -Computational Viewpoint IS Identification of Subjects of Health Care TS EHR Definition, Scope and Context TR Good Principles and practices for a clinical data warehouse TR Health Indicators for Conceptual Framework TS Harmonized Data Types for Information Interchange (name change 2007) IS Guidelines for terminology development organizations TR Common Glossary for ISO/TC 215 TS Directory services for security, communications and identification of professionals TS and patients Secure Archiving of electronic health records Part1 Principles and RequirementsTS Privilege Mgmt and AC-1 Overview & Policy Mgmt TS HC Info Privilege Mgmt & Access Control P-2 Priv Mgmt TS HC Info Privilege Mgmt & Access Control P-3 AC Mgmt TS

12 Key Requirements (3) STANDARDS OF INTEREST (first list of 33) (19-33) Functional and Structural Roles TS Pseudonymisation TS Information Security Mgmt in Health using ISO/IEC (name change 2007 Montreal IS and Brisba Capacity-based ehealth architecture roadmap -Part 1 - International Initiatives on TR ehealth System Capacity-based ehealth architecture roadmap - Part 2: Business Requirements TR Personal Health Records: Definition, Scope and Context TR Knowledge Management of Health Information Standards TR Requirements for an electronic health record architecture TS EHR System functional model ISO/HL Business Requirements for Health Summary Records - Part 1: Requirements TR Business Requirements for Health Summary Records - Part 2: Environmental Scan TR WHO ICD-10 Logical Observation Identifiers Names and Codes (LOINC) SNOMED-CT (for LIC) SDMX-HD Slide courtesy of Bron Kisler, Elizabeth Keller, Don Newsham, Joint Initiative Council

13 SDMX-HD The Statistical Data and Metadata Exchange Health Domain (SDMX-HD), a data exchange format for the Monitoring and Evaluation community. See

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15 Atlas of known OpenMRS Implementations

16 Architecture and Solutions slide courtesy of David Lubinski, PATH 16

17 slide courtesy of Derek Ritz, ecgroup Improving Interoperability for Maternal and Child Health in Rwanda 17

18 Rwanda

19 VISION - Rwanda ehealth Strategy (Dr Richard Gakuba, National ehealth Coordinator, Ministry of Health, Rwanda)

20 GENERALIZING THE VISION - ISO > Vision and goals -> Domains -> Governance -> Infostructure -> Infrastructure -> Standards 20

21 Goals Increase the number of pregnant women accessing ante-natal care services Increase the number of HIV-positive pregnant women accessing PMTCT services Improve progress in implementing MDGs 4, 5 and 6 (lower incidences of maternal and child mortality and HIV/AIDS) 21

22 Business Architecture MODELED (ArchiMate) Slide courtesy of Mead Walker, Northrup Gruman

23 Rwanda Health Enterprise Architecture Framework

24 Canada Health InfoWay EHR Architecture

25 Health Information Exchange Training in Canada

26 Technology components CR PR HL7 SHR LRS TS HIAL HL7 VCT Clinic Core Architectural Services: Client Registry and Patient Identification (CR) Provider and Facility Registry (PR) Terminology Standards and Service (TS) Shared Health Record (SHR) Logical Record Service (LRS Health Information Access Layer) SMS Mosa s Village Community Clinic 26

27 Connectathon at Medinfo 2010

28 Architecture of the Rwandan Open Health Information Exchange 1. Crichton R, Moodley D, Pillay A, Gakuba R, Seebregts CJ. An Interoperability Architecture for the Health Information Exchange in Rwanda. In: International Symposium on Foundations of Health Information Engineering and Systems

29 OpenHIM Interoperability Layer Design (developed by Ryan Crichton, Jembi Health Systems)

30 OpenHIM Mediation and Orchestration Design (developed by Ryan Crichton, Jembi Health Systems)

31 OpenHIM Component Scalability Design (developed by Ryan Crichton, Jembi Health Systems)

32 Implementation of the Rwanda Open Health Information Exchange

33 HL7 IP available free-of-charge

34 Rwanda Terminology Service developed by Hannes Venter, Jembi Health Systems -

35 Maternal Concept Lab Developed by Jon Payne, Partners in Health -

36 Health Architecture Registry and Repository developed by Open Health Tools (

37 Applying the Framework in Mozambique

38 Modeling ehealth Regulations

39 Summary Low resource settings provide opportunities for advanced health information systems development and implementation Constraints on capacity and other resources promote the development of good practices Open technologies will play an increasingly important role in low resource environments

40 Partners and Funders PARTNERS Ministry of Health of Rwanda Jembi Health Systems Regenstrief Institute InSTEDD Sysnet Intrahealth Apelon Partners in Health OpenMRS Foundation RapidSMS (UNICEF) University of KwaZulu-Natal Pivot Access FUNDERS Canadian International Development Research Centre (IDRC) Rockefeller Foundation (RockFound) United States President s Emergency Plan for AIDS Relief (PEPFAR) United States Centres for Disease Control and Prevention (CDC)

41 Thank you Mozambique Avenida Julius Nyerere no 3326 Condominio Diplomatic Village Casa numero um Maputo South Africa Rwanda Kacyiru Road Plot Number 1760 Kigali