1. DHIS2 Interoperability
August 16, 2014
Jørn Braa
Bob Jolliffe
Carl Leitner

2. HMN architecture - National data warehouse: Enterprise architecture for management

3. Getting data in - Data warehousing
Web Portal
Data capture from paper
forms
-Data mart
-Meta data
-Visualising
tools
Dashboard
Data from
Mobile devises
Data
warehouse
DHIS 2
Extract
Transform
Load
LMIS
Graphs
EMR HR
Maps
Mobile
Getting data in - Data warehousing
Getting data out - Decision support systems – ‘Business intelligence (BI)

4. Integration and interoperability
DHIS : Data warehouse
Statistical
data
Data transfer
from iHRIS to
DHIS, e.g.:
#midwifes
@health centre X
for month of May
Data transfer
from OpenMRS
To DHIS, e.g.:
#deliveries
@health centre X
for month of May
DHIS is calculating
the indicator:
Deliveries per midwife
Per facility per month
Interoperability
Interoperability
iHRIS: Human Resource records
OpenMRS :
Medical records
Integration

5. In many countries there’s a lack of health workforce data:
**on training status
**on the registration of workers in certification or licensure programs
**on the distribution and deployment of workers especially in rural areas
**on management to meet emerging or changing needs
**finally, on planning to develop policies and programs to place the right person with right skills in the right place at the right time
All of these features and factors inform sound decisions as to the skills and availability of the workforce

6. In many countries there’s a lack of health workforce data:
**on training status
**on the registration of workers in certification or licensure programs
**on the distribution and deployment of workers especially in rural areas
**on management to meet emerging or changing needs
**finally, on planning to develop policies and programs to place the right person with right skills in the right place at the right time
All of these features and factors inform sound decisions as to the skills and availability of the workforce

8. What is Interoperability? Main Use Case: iHRIS & DHIS2 Data Exchange
There are 2 Nurses in Plebo Clinic this month
Thank you very much!
iHRIS
DHIS2
Collects detailed information on health workers
Wants to share number of health workers by facilities and cadre
In many countries there’s a lack of health workforce data:
**on training status
**on the registration of workers in certification or licensure programs
**on the distribution and deployment of workers especially in rural areas
**on management to meet emerging or changing needs
**finally, on planning to develop policies and programs to place the right person with right skills in the right place at the right time
All of these features and factors inform sound decisions as to the skills and availability of the workforce
Wants to know number of health workers by facility and cadre

9. iHRIS & DHIS2 Data Exchange: The Problem of Standardized Lists
There are 2 Nurses in Plebo Clinic this month
There are 2 Nurses in Plebo Clinic this month
Do you mean “Plebo HC”?
What’s a Nurse?
iHRIS
DHIS2
In many countries there’s a lack of health workforce data:
**on training status
**on the registration of workers in certification or licensure programs
**on the distribution and deployment of workers especially in rural areas
**on management to meet emerging or changing needs
**finally, on planning to develop policies and programs to place the right person with right skills in the right place at the right time
All of these features and factors inform sound decisions as to the skills and availability of the workforce
Computers are stupid!
We need to tell them that “Plebo Clinic” and “Plebo HC” are the same
iHRIS needs to tell DHIS2 about the cadres it manages

10. Governance of Standardized Lists
All lists should be coded
“Plebo Clinic” and “Plebo HC” all share the same code “24”
This code is available to all systems
What is in this list?
What is a health facility? A point of clinical care? What about pharmacies? Labs? The MoH headquarters?
What is a health worker?
WHO: All people engaged in the promotion, protection or improvement of the health of the population
Who owns each of the standard data lists?
What is the authoritative body?
Ownership = Responsibility to maintain and share this list

11. iHRIS & DHIS2 Meta-Data Exchange: Sharing Meta-Data / Standardized Lists
Was ist Ihre Liste von Gesundheits-einrichtunge?
Вот мой список клиник
What is your list of clinics?
Here is my list of clinics
Here is my list of cadres?
What is your list of cadres?
iHRIS
DHIS2
Wants to know list of facilities
Wants to share list of HW cadres
In many countries there’s a lack of health workforce data:
**on training status
**on the registration of workers in certification or licensure programs
**on the distribution and deployment of workers especially in rural areas
**on management to meet emerging or changing needs
**finally, on planning to develop policies and programs to place the right person with right skills in the right place at the right time
All of these features and factors inform sound decisions as to the skills and availability of the workforce
Wants to share list of facilities
Wants to know list of HW cadres
iHRIS and DHIS2 need a common language to talk with each other! (SVS = Sharing Value Sets)

12. iHRIS & DHIS2 Data Exchange: Main Use Case – Revisited
Es sind 2 der Cadre #4 in der Einrichtung #24 diesen Monat
что?
There are 24
of Cadre #4 at Facility #24 on
Thank you very much
iHRIS
DHIS2
In many countries there’s a lack of health workforce data:
**on training status
**on the registration of workers in certification or licensure programs
**on the distribution and deployment of workers especially in rural areas
**on management to meet emerging or changing needs
**finally, on planning to develop policies and programs to place the right person with right skills in the right place at the right time
All of these features and factors inform sound decisions as to the skills and availability of the workforce
Shared Standardized Lists Are Not Enough
Need language to communicate the numerical data (DXF):
The value we are reporting (Cadre #4)
The place the data comes from (Facility #24)
The reporting period ( )

13. iHRIS & DHIS2 Data Exchange: System Complexity
I CAN HAZ INTEROPERABILITY?
mHealth
Medical Records
Supply Chain
mHealth
mHealth
Yes!
Doctor Council
iHRIS
DHIS2
Crisis Alerts
Nursing Council
In many countries there’s a lack of health workforce data:
**on training status
**on the registration of workers in certification or licensure programs
**on the distribution and deployment of workers especially in rural areas
**on management to meet emerging or changing needs
**finally, on planning to develop policies and programs to place the right person with right skills in the right place at the right time
All of these features and factors inform sound decisions as to the skills and availability of the workforce
Labs
Share cadre lists
Share facility lists
Share number of health workers
Share facility list
Share stock lists
Share current stock levels
In-Service Training

14. iHRIS + DHIS2 Interoperability
Variations of the above implemented in:
What if there is more than one iHRIS system?
What if you don’t have iHRIS?

15. Health Information System Health Information Exchange
Interlinked Health Services
Health Worker Registry
Facility Registry
Terminology Service
Client Registry
Health Management Information System
Shared Health Record
DHIS2 OrgUnits
DHIS2 Aggregate Data Warehouse
Interoperability Layer
Messaging / Alerts
DHIS2 Tracker
Citizen Access
Training Information Systems
Point Of Care Applications
mHealth Apps

16. Care Services Discovery
Care Services Discovery (CSD)
International Standard from IHE (Integrating the Health Enterprise)
Federated XML data model
Extensible API for Health Service Discovery
OpenInfoMan (Reference Implementation)
XQuery Implementation using BaseX
Adapters (e.g. FHIR, OpenSearch)
Interlinked Health Services
Health Worker Registry
Facility Registry
Interlinked Health Services
Health Workers
Organizations
Facilities
Services

17. Care Services Discovery - Actors
Services Finder
Services Directory
Brokers queries on health services
Services Finder
Services Directory
Services Finder
Info Manager
Services Directory
Services Finder
Services Directory
Services Finder
Services Directory
Wants to know about health services
Knows about health services

18. Organizational Affiliation
Service Delivery Organizations
National (MOH, FBO)
Regional, District Collections (e.g. Org Units at level < 4)
Professional Councils and Organizations
Insurance Funds
What service delivery organization employees a health worker?
What service delivery organization manages a facility?
Health Workers
Organizations
Facilities
Services

19. Facility Affiliation What is the physical location of a health worker?
What services are available at a facility from a health service delivery organization?
What services does a health worker provide at a facility?
Health Workers
Organizations
Facilities
Services

20. Provider Affiliation Who is the contact health worker for a facility?
Who is the contact health worker for an organization?
Health Workers
Organizations
Facilities
Services

21. Federated Facility Information
Faith Based Organization
Faith Based Organization
Ministry of Health
Private Sector
Private Sector
Facility Registry
Organizations
Facilities

22. Federated Health Worker Information
HR Management System
iHRIS Manage
HR Management System
iHRIS Manage
License + Registration iHRIS Qualify
HR Management System
iHRIS Manage
License + Registration iHRIS Qualify
License + Registration iHRIS Qualify
In-Service Training iHRIS Train
In-Service Training iHRIS Train
In-Service Training iHRIS Train
Health Worker Registry
Health Workers
Organizations
Pre-Service Training iHRIS Grad Tracker

23. Data Governance Of Federated Directories

24. Current Health Worker Registry Implementations

25. HWR & DHIS2 Data Exchange: Main Use Case – Revisited (Again)
There are 24
of Cadre #4 at Facility #24 on
Thank you very much
Interlinked Health Services
Health Management Information System
Health Worker Registry
Facility Registry
DHIS2 can act as Source Directory for FR
DHIS2 as HMIS can synchronize the list of facilities from FR
HWR pulls list of facilities from FR
HWR publishes list of health cadres on a Terminology Service (TS)
DHIS2 as HMIS pulls list of health cadres from TS and creates data set
DHIS2 as HMIS pulls aggregate HW data from HWR

26. Facility Registry Scenarios
Native Support
DHIS2 (direct support for CSD in core)
Facility Registry
Facade
DHIS2 (metadata export)
OpenInfoMan (Services Directory)
Facility Registry
DHIS2 (pulls org unit data)
External Synchronization
Rwanda, Kenya*, Tanzania

27. Terminology Service Scenarios
Native Support
iHRIS 4.2
Terminology Service
Facade
DHIS2 (metadata export)
OpenInfoMan (SVS Repository)
Terminology Service
DHIS2
External Synchronization
SVS, CTS2, FHIR, etc.

28. Getting Connected OpenHIE http://ohie.net
Health Worker Registry Community
Facility Registry Community
BaseX
OpenInfoMan DHIS Adapter
HWR Implementation Guide
OpenInfoMan
IHE ITI Committee
HMIS Community
Care Services Discovery