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HIMSS 2013 Demo A short user story illustrating a compelling OpenHIE –supported m/eHealth interaction for demo at the HIMSS Showcase in March, 2013.

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Presentation on theme: "HIMSS 2013 Demo A short user story illustrating a compelling OpenHIE –supported m/eHealth interaction for demo at the HIMSS Showcase in March, 2013."— Presentation transcript:

1 HIMSS 2013 Demo A short user story illustrating a compelling OpenHIE –supported m/eHealth interaction for demo at the HIMSS Showcase in March, 2013.

2 Overview A short user story that illustrates a compelling maternal care / HIV workflow Mapping the story to RHEA PoC interactions The RHEA technology stack and where modifications are recommended to support IHE The IHE profiles and interactions corresponding to our user story 2

3 The story Mosa is pregnant; she goes to the local clinic where she registers into the ANC programme. She already has a pre-existing record at the clinic and in the Client Registry. Mosas rapid HIV test (at the clinic) indicates she is HIV positive. As such, she is flagged as deliver at hospital so that PMTCT protocols can be followed. Mosa has had some minor bleeding or spotting. During a routine visit with a CHW she shares this and the CHW reports it. The CHW tells Mosa she must go for a check up at the clinic ASAP. At Mosas 2nd ANC visit, she is found to be anemic. She is referred to the hospital for follow-up (urgent). After 3 days, Mosa has not yet attended the hospital for her follow-up. An alert SMS message is sent to her CHW in the village. The CHW finds Mosa in her home in a fever. The CHW arranges for Mosa to go to the Hospital where she receives appropriate care. The hospital has full access to all of Mosa's history. 3

4 A simple play in 5 Acts… Act 1 – Clinic 1.1 Mosa registers at clinic, she already has a pre-existing record; resolve her NID 1.2 Mosas history is taken; rapid HIV test administered indicating that she is HIV+ve Act 2 – Mosa's home 2.1 Observation of bleeding; CHW sends RISK message to RapidSMS (and on into the SHR) 2.2 CHW tells Mosa to go the clinic as soon as she can Act 3 – Clinic 3.1 Mosa attends ANC visit; resolve her NID 3.2 It is seen that Mosa is pregnant, that her HIV test came back +ve and that she now has anemia 3.2 She is referred to the district hospital with an urgent flag Act 4 – RapidSMS-supported follow-up of care 4.1 Mosa has missed her referral; CHW gets an SMS reminder to follow-up with Mosa 4.2 CHW visits Mosa at her home and arranges for her to go to the Hospital Act 5 – Hospital 5.1 Resolve Mosas NID 5.2 Retrieve and display Mosas shared health information: pregnant, HIV+, fever 5.3 Provide appropriate, informed care! 4

5 RHEA Technology 5 REST SMS REST PIX XDS CHW CHW Manager Ambulance IHE Interfaces Referral aging logic Workflow (openMRS) 1a JSON

6 The Black Box Approach 6 Entire RHEA Infrastructure except CR and SHR PIX XDS EMPI XDS Repository OpenXDS OpenEMPI

7 Why this strategy? We minimize the number of changes needed to our existing RHEA infrastructure; this reduces risk We are able to leverage our client applications unmodified; this preserves our user story, including the mHealth portion which is very compelling The only infrastructure piece we unseat is the SHR Our CR is already IHE compliant and can participate with us. (NOTE: at the Connectathon, we must show we can interoperate with any PIX provider) We will need to modify the openHIM to be able to save to and query from an IHE-compliant XDS repository instead of our existing OpenMRS-based SHR. 7

8 Necessary modifications The openHIM would need to be able to issue a PIX query and process the returned result from an IHE-compliant EMPI The openHIM would need to be able to save our existing HL7v2 messages to an IHE-compliant XDS repository The openHIM would need to be able to query an IHE- compliant XDS repository for one or more of our HL7v2 messages and process the returned result set IHE foundational audit (ATNA) and consistent time (CT) profiles would need to be supported HL7v2 messages sent to the XDS repository would need to be echoed to OpenMRS to trigger the referral aging logic currently in that implementation of the SHR 8

9 IHE Interactions 1.1, 2.1, 3.1, 5.1 Retrieve EMPI record PIX lookup using Rwanda NID 1.2, 2.1, 3.2 Save: patient history; diagnosis of pregnancy; diagnosis of HIV+; PMTCT order; observation (temperature); referral to hospital XDS – save HL7v2 ORU message(s) 3.2, 5.2 Retrieve: patient information XDS – query for HL7v2 ORU message(s) 9

10 January 2013 Connectathon Our Black Box will need to participate in the Connectathon in Chicago in January and successfully achieve 3 interoperability certifications: 1.Patient Identity Cross-reference (PIX) Consumer 2.XDS Document Source 3.XDS Document Consumer IMPORTANT NOTE: at the Connectathon, we dont get to choose who we interoperate with 10

11 March 2013 HIMSS Showcase At the Showcase, we will provide the entire RHEA stack including OpenEMPI and OpenXDS in their IHE-compliant roles We will demonstrate our workflow, including the RapidSMS-based mHealth interactions We will need a configured RapidSMS Server We will require a basic mobile phone (old Nokia) To run multiple successive demos, we will need a one-click mechanism to reset the system to our initial, pre-demo, state 11


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