1. GHANA HEALTH SERVICE HEALTH INFORMATION EXCHANGE
IMPLEMENTED BY THE CENTRE FOR HEALTH INFORMATION MANAGEMENT-POLICY PLANING MONITORING AND EVALUATION DIVISION
DOMINIC K ATWEAM HEALTH INFORMATION SYSTEMS ANALYST GHANA HEALTH SERVICE POLICY PLANING MONITORING AND EVALUATION DIVISION

2. OUTLINE -
Overview of the Ghana Health Service Health Information Exchange
The nationwide District Health Information Management Systems – DHIMS2 (DEMO)
EPI data sets and reports
EPI group sets of indicators in DHIMS2
DVD-MT like dasboard on DHIMS2 based on agreed minimum outputs
EPI agreed minimum outputs agreed on with WHO-Afro,WHO HQ , GHS, MOH , WHO -GH
New EPI Vaccine districts regional and national ONLY Store report ( not facilities)
Revised monthly EPI faclity report
DVD-MT and RIM like excel template from DHIMS2 to allow data exchange from DHIMS2 to DVD MT and RIM
Performance Feedback to Regions and Districts
Capacity Building
Kintampo Case Study
Over view of the GHS eTRACKER for matarnal and child health services (DEMO)

3. GHANA HEALTH SERVICE HEALTH INFORMATION EXCHANGE –GHS/HIE
Overview GHS HIE
The Ghana HIE is composed of existing functional components
The HIE reflects current concrete reality (from the ground up) of data flows and systems delivering current use value
It is also forward looking
There is scope for it to be further elaborated

4. (Hams, iHost, OpenMRS etc.)
HEALTH SECTOR
REPORTING PORTAL
DISTRICT HEALTH
INFORMATION SYSTEM.
DATA WAREHOUSE
DHIMS2
INDIVIDUAL CLIENT
RECORDS
MCH, TB, HIV/AIDS
IDENTITY
MONITORING
MANAGEMENT
BACKUP OF
DHIMS2
AND INDIVIDUAL
DATA WAREHOUSE
TRAINING
INSTANCE OF DHIMS2 DATA
WAREHOUSE
FACILITY REGISTRY/
DATA DICTIONARY
INTEROPERABILITY LAYER
Orchestrate Data flows
Alerting
Gateway security
Co-ordinate backups
LOGISTICS
MANAGEMENT
(open LMIS)
HEALTH WORKER
REGISTRY
(iHRIS)
PATIENT LEVEL SYSTEMS
(Hams, iHost, OpenMRS etc.)
LAB SYSTEM
(BLIS)
MOBILE
GATEWAY
(USSID, SMS,
short codes

5. Facility Registry Expansion Development (FRED)
The Ghana HIE is composed of existing
functional components.
The HIE reflects current concrete reality
(from the ground up) of data flows and systems delivering current use value.
It is also forward looking. There is scope for it to be further elaborated.
Routing and TLS encryption
(nginx reverse proxy)
Orchestration of data flows
Implemented through a set
of PHP scripts controlled by a
central configuration file
Individual Data Warehouse E-Tracker and Line Listing data Live
Identity Management Single sign-on/user management on across applications Monitoring System and application level monitoring Planned
DHIMS The national aggregate routine reporting system Live
Training Temporary system for user training Live
Back Up Archiving for disaster recovery Live
Facility Registry Public facing master facility service Live
Data Dictionary Structural metadata and vocabulary service Pending
Data in Individual data
warehouse is aggregated and posted as routine report into DHIMS.
DHIMS database is replicated to Training Database.
Backups are scheduled,
moved off-site and tested.
DHIMS is then moved to backup in data warehouse.
DHIMS to facility registry.
DHIMS is facility data source.
Facility registry is driven by changes in DHIMSAlerting intercept to monitor/log
changes being made at district level.
DHIMS to data dictionary.
Data element, disaggregation and
dataset definitions Published annually.
Individual data compiled and transported to backup.
Hospital data (HAMS) is aggregated
and posted to DHIMS. Potentially
other EMR systems eg. OpenMRS,
iHOST)
Routine data posted from Lab
System (BLIS)
Health worker system (iHRIS)
Aggregate reports of HR data
CSD integration with infoman?
OpenLMIS
Mobile gateways
GHS HIE STANDARD
Facility Registry Expansion Development (FRED)
The GHS HIE aligns to established standards such as DICOM and HL7 which support our specific system needs
API specifications v1.0 for the FRED facility registry service.
This provides information for analysts, architects and systems integrators to understand the behavioral and structural characteristics of compliant FRED facilities registries and consumers. It describes the FRED interfaces at a wire level, covering both the host and client services. This is based on the March 22, 2013 version of the API developed
collaboratively by the facility registry community.
Facility registry public API . IHE.net Care Service Discovery (CSD)
OpenHIE FRED api
Data Dictionary public API - DHIS2 native api to data dictionary components

6. Overview of the Ghana Health Service Health Information Exchange
The Nationwide District Health Information Management Systems –DHIMS2 (DEMO)
EPI data sets and reports
EPI group sets of indicators in DHIMS2
DVD-MT like dasboard on DHIMS2 based on agreed minimum outputs
New EPI Vaccine districts regional and national ONLY Store report ( not facilities)
Revised monthly EPI faclity report
EPI agreed minimum out puts agreed on with WHO-Afro,WHO HQ , GHS, MOH , WHO -GH
DVD-MT and RIM like excel template from DHIMS2 to allow data exchange from DHIMS2 to DVD MT and RIM
Capacity Building
Kintampo Case Study
Performance Feedback to Regions and Districts
Over view of the GHS eTRACKER for matarnal and child health services (DEMO)

7. AGREED EPI MINIMUM OUTPUTS

8. NEW EPI VACCINE DISTRICTS REGIONAL AND NATIONAL ONLY STORE REPORT ( NOT FACILITIES)

9. REVISED MONTHLY VACCINATION REPORT

10. STATUS & UTILISATION OF VACCINE STOCKS AND OTHER COMMODITIES –FACILITY LEVEL

13. CAPACITY BUILDING –KINTAMPO CASE STUDY

14. Overview of the Ghana Health Service Health Information Exchange
The nationwide District Health Information Management Systems –DHIMS2 (DEMO)
EPI data sets and reports
EPI group sets of indicators in DHIMS2
DVD-MT like dasboard on DHIMS2 based on agreed minimum outputs
New EPI Vaccine districts regional and national ONLY Store report ( not facilities)
Revised monthly EPI faclity report
EPI agreed minimum out puts agreed on with WHO-Afro,WHO HQ , GHS, MOH , WHO -GH
DVD-MT and RIM like excel template from DHIMS2 to allow data exchange from DHIMS2 to DVD MT and RIM
Capacity Building
Kintampo Case Study-
Performance Feedback to Regions and Districts
Over view of the GHS eTRACKER for matarnal and child health services (DEMO)

15. WHAT eTRACKER MEANS FOR DATA ENTRY IN DHIMS2
eTRACKER WILL POPULATE DHIMS2 DATA SETS WITHOUT ANY DATA ENTRY BY FACILITIES
FAMILY HEALTH FORMS(RCH )
Midwives returns (form A)
Family Planning
PMTCT
Child Health Returns(from C)
Nutrition
EPI
TB & HIV/AIDS FORMS

16. IMPACT ON CHOs WORK AT THE FACILITY
BEFORE eTRACKER
AFTER eTRACKER DEPLOYMENT
Reports
Every month, trained staff in all health facilities manually tally and summarize Child and Maternal Health registries (ANC, Deliveries , PNC ,FP & Child Health ) into the monthly reporting forms
Form A (midwife returns )
EPI
Form C ( child health returns )
Nutrition
All facility Child and Maternal Health service reports automatically populate DHIMS2 in their respective data sets reports.
Copies can be generated
Number of days used to tally
Averagely 3-5 days
Number of days used to tally
None

17. IMPACT ON CHOs WORK AT THE FACILITY
BEFORE eTRACKER
AFTER eTRACKER DEPLOYMENT
Period of reporting
5th for entry into dhims2 at facility level or submit to district for entry to be done for facility
15th For all data to be validated and signed of by DDHS for the previous month data
Period of reporting
Service data is aggregated by system and populates respective datasets in eTracker instance
eTracker datasets is automatically pushed into dhims2 on the 15th of a month for the previous month .
Services
All clients details need to be recorded in a register every year.
Client from other facilities have to be registered again
Hard to trace defaulter and reschedule
Registration is done once .
Clients from other facilities have to be relocated and services continued
Filter reports by defaulters and can re schedule etc

18. Mobile Hand Device (MHD) POLICY GUIDE LINES
TYPICAL TRAINING SESSION
Mobile Hand Device (MHD) POLICY GUIDE LINES
DEMONSTRATION OF THE e-TRACKER
HANDS ON TRAINING
REGISTERING MOTHERS & CHILDREN AND THEIR SERVICES
WORK PLAN ….
MCH eTracker System Business Requirement
MCH work flow
eTracker agreed requirement for child health records
National rollout plan
cPBF work plan
MOST OF THE WORK IS BUILT AROUND WHAT WE AS A COUNTRY HAVE LEARNT FROM THE BID JOINT LEARNING NETWORK …

19. THANK YOU