Notice D

Notice D for promoting investments in digital health global goods

mADX on FHIR on Android

Two-sentence overview: 

Most mobile health reporting is generated server side or in a HMIS. Our goal is to provide a standardized way for health apps to make real-time reports accessible to health workers offline for better decision making. We will create a set of open source libraries, expanding HAPI FHIR and CQL tools, to enable Android based apps to quickly generate health reports offline using a standards based approach defined in the mADX Profile.

Executive summary: 

The digital health ecosystem is rapidly maturing with mobile solutions that support the capture of health services delivered by frontline health workers. While data collection in these apps is quite mature, in-app reporting is still very limited with most solutions limited to pushing reports into a Health Management Information System (HMIS) from the central system.

There are two major problems that we aim to address. First, the majority of mobile frontline health systems push report generation to a central system that requires internet connectivity instead of providing the capability to generate reports at the point of service. This results in frontline health workers not having access to up-to-date reports offline for decision making. Second, developing performant reporting on low powered mobile is technically challenging and, to date, a standards based approach to address this has not emerged.

Our goal is to develop an open source FHIR standards based reporting stack for offline generation of health reports on Android devices. We will use OpenSRP to implement a reference app using this approach. To achieve this we will adapt a reporting architecture we developed for OpenSRP in-app reporting.

Consortium Team: 

Ona is a technical social enterprise focused on global health, based in the United States & Nairobi, Kenya. Ona was founded in 2013 and has been in operation for close to 6 years. The company has a 25-person development team which includes software developers, software architects, and machine learning experts. Ona has extensive experience designing, developing and implementing health information systems that are used at national scale and integrate with existing government health information systems and open standards. Ona has developed numerous open source standard tools and libraries in the space that are used by mobile teams to add functionality to their existing technologies. Ona serves as the technical lead for OpenSRP, having co-created the platform with the World Health Organization.

As an organization we have extensive experience developing digital health applications for mobile. We are the technical leads and main developers of OpenSRP - a digital health global good that provides service delivery support for frontline health workers. With OpenSRP we currently are supporting large implementations of OpenSRP in Tanzania with Jhpiego, with UNICEF in 5 countries in West Africa and with GAVI and Mastercard in Mauritania. Previously, we supported PATH to use OpenSRP to develop a national electronic immunization registry (EIR) in Zambia. For this we developed extensive in-app reporting, that was used to tally over 100 indicators which were then reported to DHIS2. This work forms the technical foundation for this proposal.

With Akros, Vital Wave and CHAI we are developing Reveal ( a next generation task based service delivery tool developed on top of OpenSRP. Reveal relies heavily on FHIR including supporting FHIR task, planDefinition and location resources. As part of the Reveal work, Ona is developing with Novel-T the geo-widget - an Android SDK that makes it possible to view locations and structures on map and link services to it by clicking on it. The Geo Widget is a global good currently being adopted by DHIS2, CommCare and other popular digital health applications.

Lastly, for the past year we supported Village Reach to help develop a reporting stack using an open source enterprise analytics suite we developed called Canopy. In doing this we got hands on experience using the appropriate R4 FHIR reporting resources that are cited in this application including generating measures, measureReports and libraries. This work also included building organizational capacity in running HAPI FHIR as part of the Canopy stack.

Digital Health Atlas: 

OpenSRP has been cited in two DHA projects:

We have also requested that OpenSRP be registerd a a part of the taxonomy (see email attachment)

Geographic Reach: 

Indonesia, Pakistan, Bangladesh, India, Zambia, Tanzania, Kenya, Mauritania

WHO Classification: 
Community-based information system
Final Technical Application: 
Application Status: 
Pending Review & Investment
Application Tags: 
universal health coveage
Mobile tools
data collection


Ranga's team at ITINordic is working on some Android+FHIR libraries that you may be able to leverage.


Thanks Carl, we'll check it out.

Yes, thanks Carl. We are working on integrating DHIS2 with Programs with a HAPI FHIR. Data is captured on Android devices. We are developing an Android library for HAPI FHIR integration.