Notice D

Notice D for promoting investments in digital health global goods

Towards an Integrated HIE Approach to Patient-Level Indicator Reporting

Two-sentence overview: 

To support with an integrated approach to patient level monitoring, we propose the use of a health information exchange that supports onboarding of multiple digital health systems through HL7 FHIR-based interfaces, providing a common way to connect and register data to a longitudinal client record, on which indicator calculations are performed.  

This work will be achieved through a consortium of partners working together on a shared vision and architecture, leveraging each partner’s individual strengths while limiting overlap, and optimising investment through an integrated, extensible approach, enhancing existing global goods towards a solution that supports multiple Point of Service applications and Health Information Exchange components able to support patient-level indicator reporting.

Executive summary: 

The Digital Square investment will be used to bring together a consortium of partners to collaborate on solution to patient-level monitoring that is appropriate and scalable for low and middle income countries (LMICs). We propose the use of a standards-based architectural framework and integrated solutions to patient-level monitoring. Our vision of an integrated approach adopts the use of international architectural patterns (OpenHIE) to provide a mature solution that is both instantiable and reusable, through the use of an extensible framework able to support a multitude of Point of Service (PoS) applications in an integrated patient level monitoring system.

The consortium aims to use the Digital Square investment to support FHIR profiling activities to specify the data model, resource mappings, terminologies and indicator definitions relevant to the priority use case, supporting the development of HL7 FHIR interfaces in the selected PoS applications and IOL, and demonstrating the end-to-end feasibility of the paired and integrated approaches to extracting indicator data from a Minimum Data Set Message or a shared longitudinal data store.

Consortium Team: 

Jembi Health Systems will lead and oversee a consortium that also includes OpenMRS Inc., BlueSquare, Open Concept Lab (OCL), and IntelliSOFT. In this role, Jembi will set up a central Health Information Exchange (HIE) sandbox for testing, and ensure the platform provides FHIR-based end points for Point of Service applications to submit demographic and clinical data, and enable extraction of indicators from a longitudinal FHIR server. OpenMRS Inc. will work to ensure OpenMRS supports integrated patient-level monitoring architecture, and similarly, BlueSquare will focus on openIMIS, Open Concept Lab on the OCL suite of tools, and IntelliSOFT on Bahmni.

Jembi is an African non-profit company specialising in digital health and open source software development and implementation. Jembi has a successful track record developing and implementing open source software in the health sector, including in a number of African countries. It has contributed to many open-source software development projects and communities of practice, including OpenMRS, Bahmni, OpenHIM, HEARTH and OpenHIE. Jembi is registered and headquartered in South Africa with country offices in Mozambique, Rwanda and Zambia. 

OpenMRS Inc. provides oversight on the open source EMR, OpenMRS, and its associated community, which seeks to engage and motivate contributors and supporting organizations who actively engage in all aspects of the software development and implementation process. 

Bluesquare is a Belgian data company founded in 2012, focused on digital health in emerging economies around the globe. Bluesquare, thanks to its proven experience in designing and leading IT products in use in UHC sector, will reinforce the development team and ensure that the high level architecture is translated without distortion into concrete software components. Thanks to its involvement in the openIMIS re-architecture, which includes the provision of a native HL7 FHIR interface, Bluesquare will also facilitate a good integration with the coming openIMIS platform.

Open Concept Lab (OCL) provides an open-source suite of tools to support terminology and metadata management, including the OCL Terminology Service, OCL Metadata Browser, and OCL for OpenMRS Authoring Interface. OCL is recognized as a digital global good and works in close partnership with the OpenHIE and OpenMRS communities. OCL is actively supporting PEPFAR’s demonstration project for TX_PVLS to evaluate indicators directly from patient-level data.

IntelliSOFT Consulting Limited is a wholly owned Kenyan company with more than 8 years of experience. As a technology company, IntelliSOFT has deliberately focused on designing, developing, implementing, supporting and maintaining digital health solutions, particularly for Low to Medium-Income Countries. They have extensive experience in implementing appropriate digital health solutions running either on OpenMRS or Bahmni in resource constrained environments. IntellISOFT’s past and current projects are spread across Africa covering Kenya, Uganda, Tanzania, Zambia, Sierra Leone, Rwanda, Ethiopia, Mozambique & Zimbabwe.

Geographic Reach: 

OpenHIM: Rwanda, Tanzania, South Africa, Mozambique, Lesotho, Liberia, as well as PEPFAR recipient countries and DATIM reporting countries.

OpenMRS: Albania, Argentina, Armenia, Australia, Bangladesh, Belarus, Bhutan, Bolivia, Botswana, Brazil, Burundi, Cambodia, Cameroon, Chile, Colombia, D.R.C., Ecuador, Ethiopia, Gambia, Georgia, Ghana, Haiti, Honduras, Hungary, India, Indonesia, Israel, Japan, Jordan, Kazakhstan, Kenya, Kiribati, Kyrgyzstan, Laos, Lesotho, Liberia, Libya, Madagascar, Malawi, Malaysia, Mali, Mexico, Mozambique, Myanmar, Nepal, Nicaragua, Nigeria, Pakistan, Peru, Philippines, Rwanda, Senegal, Sierra Leone, South Africa, Spain, Sri Lanka, Svalbard, Tajikistan, Tanzania, Uganda, Ukraine, United States

openIMIS: Nepal, Tanzania

OCL: Ethiopia, PEPFAR global implementation, CIEL interface terminology publication

Bahmni: Nepal, India, Lesotho, Bangladesh, Sierra Leone, Uganda, Pakistan, South Africa, Zambia, Cambodia, Haiti, Kenya, Mozambique

WHO Classification: 
Data interchange interoperability and accessibility
Application Status: 
Pending Review & Investment
Application Tags: 
interoperability layer
shared health record
point of service