Improving health for the underserved OpenHIE Improving health for the underserved

What We’ll Cover What is OpenHIE? What does OpenHIE do? How does OpenHIE work? How can OpenHIE help me? How do I get started?

What is a HIE? Health Information Exchange: Curates the storage and access to health-related information typically stored by multiple organizations. Some examples: Health workers Health facilities Patients Maintains the context and integrity of the information being exchanged

What is OpenHIE? OpenHIE is an architecture and approach to Health Information Exchanges. The Architecture contains workflows, standards and profiles to guide best practices in implementing HIE’s at scale. OpenHIE has reference technologies to support the component architectures. OpenHIE is a community made up of countries, organizations, individuals and donors driven to help underserved environments better leverage their electronic health information through standardization

What does OpenHIE do? Looks to address storing longitudinal patient centric data linked to providers, facilities and codified against medical terminologies Provides architecture and design to support information sharing at scale Provides a pattern that connects data silos holding health information Gives providers a method to communicate with each other

OpenHIE Components

OpenHIE Components The external applications and tools that communicate with the HIE: mHealth apps electronic medical records, mobile messaging services Laboratory management systems

OpenHIE Components Interoperability layer: manages communications from the external systems and orchestrates how the rest of the HIE will do its work to satisfy them.

Terminology Service: Provides answer to the question: What vocabulary do we agree on? Allows the different databases to map to each other, even when they use different terms. How does OpenHIE work?

OpenHIE Components Client Registry: Lets HIE know who received the health services. Creates and curates a unique identity for every patient.

OpenHIE Components Shared Health Record: What is the client’s health history?

Health Management Information System: Holds information on the population’s health history. Supports big data analytics, public health planning, decision making OpenHIE Components

Facility Registry: Answers question: What location provides health services? Manages the master facility list. OpenHIE Components

Health Worker Registry: Answers Question: Who provides health services? OpenHIE Components

Debunking some common “myths” around OpenHIE! OpenHIE: Mythbusters! Debunking some common “myths” around OpenHIE!

OpenHIE.exe? Q: Is OpenHIE a downloadable and single click install software package? A: No. OpenHIE is firstly an architecture and an approach. There are reference tools and technologies that are able to prove the architecture but these are not packaged as a “downloadable and installable” solution

Open Source Only Q: Does OpenHIE only work with Open Source software? Can I use commercial or non open software with OpenHIE? A: OpenHIE supports an open architectural approach; meaning non open applications are welcome to engage and leverage the architecture as well as play the role of the key components. OpenHIE provides open source reference technologies to support the architecture but welcomes commercial solutions too.

All or Nothing! Q: Do you have to use all of OpenHIE at once? Can I use bits and pieces? Will you still like me if I don’t use it all? A: OpenHIE promotes an evolutionary architecture; use what is needed but be lead by architectural design. By thinking broader we are able to meet our current needs and create space for future expansions. In short: use what is needed, don’t need to use it all at once.

Our way or the highway! Q: Do I have to use your profiles exactly? What if there isn’t a workflow for what I want to do? What about new standards? A: OpenHIE encourages implementations to challenge and bring new use-cases to the communities. Each implementation has unique needs and they may drive different decisions when it comes to standards. OpenHIE provides a base to “step off” from and customize your implementation design.

Let’s use an example to unpack this… How does OpenHIE Work? Let’s use an example to unpack this…

Meet Mosa She is 19 years old and lives in a small village in Rwanda She is pregnant And, like many in her village, she is HIV Positive

Meet Mosa Mosa registered at a local clinic providing MOH-sponsored antenatal care (ANC)

Using National ID for Info The clinic uses a local instance of an electronic medical record (EMR) and synchs with the SHR The clinic’s local EMR uses Mosa’s national ID to synch with the National HIE

Logging Protocols The local EMR notes to the National SHR, through the IOL, that Mosa requires hospital delivery using PMTCT (prevention of mother-to-child transmission) protocols.

CHW Grace Weeks into her pregnancy, Mosa experiences minor bleeding. Mosa’s community health worker (CHW) Grace logs this information on a basic mHealth application.

At the Clinic Grace advises Mosa to go to the clinic for a checkup At the clinic, Mosa is found to be anemic and referred to the hospital. The referral is flagged ‘urgent’ and updated to Mosa’s SHR.

Three Days Later Mosa has not checked into the hospital A mobile alert is sent to Grace Grace finds Mosa at home with a fever

At the Hospital Grace arranges for Mosa’s transport to the hospital Health workers retrieve Mosa’s medical history from her SHR.

Appropriate Care With the information from Mosa’s SHR, health workers are able to provide appropriate care for Mosa and her baby

OpenHIE Vocabulary Architecture: Fundamental structure of a technical solution. Data Element: An individual unit of data or information, such as name or birth date, within an information system. Data Governance:  The set of policies and procedures which define the sharing of health worker information with the public and between systems within the Health Information System Health Information System:  The collection of software systems operating within a country (or region) which manage, store and use information on the health system.   Minimum Data Set:  The set of data elements that a system will provide and which source data systems are required to report on.  Also known as its acronym, MDS. Reference Implementation: A piece of software that has been created and implemented to fulfill the technical requirements of a business case, but is not quite ready for full release. 

OpenHIE Vocabulary Standards: Describe how the various components of information systems interact with each other.  Standards typically represent a common data model that will be used to represent the data being shared. Use Case: A list of steps, typically defining interactions between an actor and an information system, to achieve a goal. The actor can be a human or another information system.

Architecture Framework Sharing Data to Improve Health Outcomes

http://ohie.org