Notice C

Promoting the collaborative development of proposals for investments in digital health global goods

Digital Square supports investments in digital health global goods, which are tools that are adaptable to different countries and contexts. Mature digital health global good software is software that is (usually) Free and Open Source (FOSS), is supported by a strong community, has a clear governance structure, is funded by multiple sources, has been deployed at significant scale, is used across multiple countries, has demonstrated effectiveness, is designed to be interoperable, and is an emergent standard application.

We are using an open proposal process. Your concept notes and proposals will be publicly posted, giving you and other submitters the opportunity to find collaborators and provide and receive feedback from your peers.

Concept-Notes (48 total)

Displaying 6 - 10

CERHIS: connect small hospitals and health centers to OpenIMIS

Submitted by Jean-Pierre d'Altilia on Fri, 07/20/2018 - 16:27 Last revised by Digital Square on Mon, 04/15/2019 - 05:58.
Notice C Opportunity: 
Announcement C1: Modular transformation of openIMIS

Executive Summary

CERHIS has been developed to address the issue of non-existing suitable IT solution to facilitate information management in small hospitals and health centers confronted to difficult environmental conditions (poor power supply , poor internet connection, low computer skills, distant IT competences, low financial resources) in low and middle income countries. CERHIS is a facility health information system using Android tablets in replacement of the paper registers. The tablets are synchronized using a Wi-Fi local area network. It is an integrated solution, with software and hardware components, including a specifically designed protection and charging cabinet with alimentation by solar panels and/or grid electricity and/or generators, when available. It produces a simplified EMR, information for the facility management, and aggregated information for the National HMIS (through interoperability with DHIS2).

Connecting CERHIS with OpenIMIS will thus allow to consolidate the OpenIMIS coverage in reaching healthcare users who would otherwise be excluded because they are attending facilities that cannot use more demanding hospital information systems like OpenMRS or Bahmni.

For that purpose some work is still needed to fully comply with open source requirements, to adhere to interoperable standards and to connect the CERHIS billing module (under development) to the OpenIMIS platform.

The project consists in providing additional resources mainly in terms of labor costs to:

  • Support the transition of CERHIS towards an open source system, with an ultimate goal of reaching a global good status;
  • Implement adherence to the HL7 FHIR standards and OpenHIE framework, particularly concerning FHIR standards for claims & reimbursement;
  • Adapt the billing module to integrate health insurance management functionalities, working in interoperability with OpenIMIS.

Consortium Team

Consortium includes the following organizations:

AEDES - the European Agency for Development and Health, is a private consulting company specialized in public health in low and middle-income countries. AEDES is very much involved in supporting Health information system with a focus on challenging operating environment. AEDES has started supporting the development of CERHIS in 2014 in collaboration with students of the computer and engineering departments of the Université libre de Bruxelles who help design CERHIS full solution package including the cabinet to store tablets, power supply, server and router. AEDES also works with the cooperation agency of the university (ULB-Coopération) that is active in DRC where the first pilot took place.

Since then, AEDES has hired developers to continue the development of the solution, and AEDES as a health organization provides health professionals to advise the developers. The combination of these two competences (IT and health) guarantees the relevance of the developed solution.

The pilot has been extended with the support of the Global Fund in Kinshasa in close collaboration with the HIS department of the Ministry of Health, an installation took place in Burundi with the Belgian Technical Cooperation agency (Enabel), a new installation is starting in partnership with ULB-Coopération and the Provincial Hospital of North Kivu (HPNK) funded by the European cooperation. Other installations are planned among others with NGOs such as MEMISA.

AEDES is responsible for technical project management, software development, training of local trainers, helping local implementers, contact with partners, coordinating volunteer effort, and public relations.

In countries AEDES builds partnerships with local organizations that AEDES trains so that they have the capacity to provide close technical support to implementers. The local ULB-Coopération bureau in Goma, DRC, and the North Kivu Provincial Hospital (Hôpital Provincial du Nord-Kivu) will participate in the testing process.

Project Description

In low and middle income countries, well established digital solutions exist to help manage health information at National level (DHIS2), at the level of rather large health facilities (OpenMRS, Bahmni...) as well as for frontline health workers (OpenSRP). But at the level of small health facilities in difficult environmental conditions (poor (or no) power supply, poor (or no) internet connection, scarcity of IT competences...) where OpenMRS or Bahmni could not operate there was no solution answering all the needs of the health facility Information management. The patients of such facilities would therefore be excluded from an Insurance scheme managed with a system like OpenIMIS.

CERHIS has been developed to address this issue. CERHIS is a facility health information system using Android tablets in replacement of the paper registers. The tablets are synchronized using a Wi-Fi local area network. It produces a simplified EMR, information for the facility management (without requiring Internet connection) and aggregated information for the National HMIS (interoperable with DHIS2 via only intermittent internet connection if available or via any other means including USB drive). CERHIS is highly configurable and adaptable, and is meant to address, amongst others, the needs of the National Health Information Systems.

 A billing module has been designed and is in its pilot phase but it doesn’t integrate yet health insurance management functionalities.

CERHIS is an integrated solution, with software and hardware components, including a specifically designed protection and charging cabinet with alimentation by solar panels and/or grid electricity and/or generators, when available. The software is free to use but the code is not yet published as open source, and it will require some refactoring, improvement and commenting before being ready to efficiently accept input from independent developers and to be easily reviewed by third parties, as part of a wider open source community. Some documentation is available on a private wiki, but it needs to be to be further elaborated and opened to the public to allow the community to independently install and configure the system.

Facilitating the process for CERHIS to conform to open source requirements, facilitating meeting the interoperability standards, and providing support to finalizing the billing module with a connector to OpenIMIS will allow OpenIMIS to consolidate its coverage in conformity with its priorities and roadmap: open source, scalability, interoperability and modularity, adherence to standards, build on existing software, handling IMIS facility-level functionalities (registration and pre-authorization, claiming), approach on micro-services and standardization).

The project consists in:

  • Supporting the transition of CERHIS towards an open source system, with an ultimate goal of reaching a global good status;
  • Implementing adherence to the HL7 FHIR standards and OpenHIE framework, particularly concerning FHIR standards for claims & reimbursement;
  • Adapting the billing module to integrate health insurance management functionalities, working in interoperability with OpenIMIS.

The technical approach follows steps as described below:

  • Analysis of i) the existing code and data model, ii) relevant FHIR standards (particularly the Claim & Reimbursement and Accounting and Billing standards) and iii) the OpenIMIS API;
  • Adaptation of the design of CERHIS to adhere to those standards (this is already done with dxf2 for DHIS2, and ready for ADX), to optimize the data model, and to improve implementation of the microservices architecture;
  • Review of some elements by an independent eHealth security specialist, including existing encryption, authentication and role-based access control;
  • Further development of the billing module that includes functionalities required by insurance management and a connector to OpenIMIS (a medical doctor and a health economist from AEDES, who are both specialized in health facility management will be associated in the process to better conform to real needs);
  • Iterative development in order to insure both quality improvement and compliance with open source standards and communication standards (FHIR, OpenHIE): code review, refactoring, unit testing creation, and documentation;
  • Migration of the code of this new version of CERHIS from the current private GitLab repository to a public GitHub repository;
  • Testing in an existing implementation site in the DRC, with iterative development, adaptation and maintenance.

At this point, a production-ready, open source new version of CERHIS will be available to the wider community. Since CERHIS is already highly configurable, it is expected that independent implementations of the core system will then be possible without requiring modification of the code, thanks to the provided software in a ready state and the sufficient documentation. The project will also be in a state making it possible to start forming an open source community for interested contributors.

Development of a new billing / insurance management module will take place on a public branch of CERHIS 2.0, using agile methodology, with testing on the same site in DRC and progressive adaptation under the supervision of a local team of hospital personnel comprising a medical doctor, the administrative agent, and a technician who will participate to the deployment and ensure that remarks, requests and bug reporting is facilitated between field testers and the development team.

Anticipated timeline: the process is expected to be finalized within a 12 month periods including iterative testing and adaptations.

 

 

Deliverables:

  • Open source code of CERHIS core available online;
  • Open source code of the billing and insurance management module available online;
  • Documentation for CERHIS implementation and use available in a public wiki;
  • Beta-testing reports shared with the community.

 

Internal monitoring will be facilitated by the use of the JIRA project management system. A steering committee will also gather periodically to review progress and validate results. Reports presenting progresses and results will be produced. The QA procedures includes as well public bug tracking; public issue tracking, code published on a public GitHub repository; public wiki with documentation for use and installation.

The main risk is to miss the deadlines, but the use of JIRA project management tool and close follow up by the steering committee must mitigate that risk.

 

For this proposal, the following team composition is proposed:

Within AEDES, in Belgium:

  • The current CERHIS project manager (part time)
  • The current CERHIS developer (part time)
  • A new developer funded through this Digital Square request for application (full time)
  • A medical doctor (part time, specific activities)
  • A health economist (part time, specific activities)

Independent:

  •  eHealth security specialist (consultancy)

To pilot the tests, in the Democratic Republic of Congo (Goma):

  • A local medical doctor from ULB-Coopération (part time)
  • A local computer technician from the hospital (part time)
  • A contact person from the hospital staff (part time)

Roles and responsibilities of the actors are as follows:

 

 

Tagging

  • Facility management information system
  • Health finance and insurance information system
  • Electronic medical record
  • Low-resource settings
  • Interoperability
  • Open source
  • OpenIMIS
  • FHIR
  • OpenHIE
  • DHIS2
Application Status: 
In Scope

Connected Diagnostics Platform and DHIS2

Submitted by Jack Regnart on Thu, 07/19/2018 - 15:05 Last revised by Digital Square on Mon, 04/15/2019 - 05:58.
Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

Executive Summary

Blue Frontier, owners of the Connected Diagnostics Platform (CDP) would like to request funding to explore and develop interoperability features and open source components that will bring the output of CDP into DHIS2 and other distributed systems enabling the open source community to benefit from Blue Frontier’s wealth of experience in the world of connected diagnostics in both LIMCs and the developed world.

CDP was originally architected at the Foundation for Innovative New Diagnostics (FIND) to allow the collection and aggregation of data from diagnostic platforms, not just those that are digital in nature e.g. GeneXpert, but also traditionally unconnected diagnostic methods. CDP was developed to allow diagnostic results to be linked to patients and disease cases whilst providing an efficient digital process throughout the diagnostic pathway.

Since 2017, Blue Frontier has taken ownership of the platform with the goal to ensure data can be quickly and easily integrated with existing healthcare applications and other specialised systems (e.g. EQA schemes or disease surveillance) and to optimise the system for use by MOH’s, national disease programmes, research and study programmes: in fact anyone looking to make positive health impacts on the lives of people in poverty.

With CDP, Blue Frontier are bringing the world of diagnostics, tests, and test results into the open source world of DHIS2, enabling everyone to manage the emerging plethora of clinical mHealth applications as an interoperability layer which all rely in some way on interconnected datasets, in order to function.

Consortium

Blue Frontier IT Ltd

Blue Frontier is an ISO 13485:2016 accredited development and IT agency, putting us in the unique position to have the quality management system in place to work on development projects. Quality is integral to the success of healthcare solutions, and our engineers and QA teams develop and test to ensure the quality and credibility of the end product. We are also ISO 9001, and 27001 accredited and continue to develop and support a number of world leading connected health platforms. All the projects we undertake are run according to agile best practices and by providing consultancy, development, technical IT, and support services. We are a fully end-to-end provider with a rare blend of specialist knowledge and capability.

Blue Frontier has been involved in global health for more than 6 years and have the knowledge of implementing connectivity solutions that are being used in countries across the world. We’ve supported governments, charities, NGOs and health organisations to develop connectivity solutions that help to save lives.

Partners

Mo Tobin - acting as an advisor will be supporting us in our implementation of CDP and the wider connected diagnostic space and who brings with him a wealth of experience which uniquely spans both the domains of mobile technology and connected health service provision. Mo has experience with donor led healthcare programmes and has worked on numerous projects aimed at tackling infectious diseases in high burden developing countries, both in the office and in the field.

eSHIFT - a Swiss not-for-profit association established to help great ideas scale into the national health systems of developing countries so that populations achieve better health outcomes.  At the core of eSHIFT is our network of commercial and non-commercial members with many years of expertise, providing strategic advice on, and implementation of, information management and digital health solutions to both national level and global-health bilateral actors. eSHIFT also hosts the Swiss node of HISP (HISP Geneva), the network of global partners supporting DHIS2 and improvement of health information systems in low and middle income countries.

Project Description

Background

The world of diagnostics is growing exponentially, with ever more instruments, devices and laboratory systems appearing inside the health systems of LMICs. All too often, the complexity of attempting to integrate these devices digitally into clinical care pathways results in a kind of connectivity spaghetti, with different systems in different locations being connected via one-off bespoke efforts where funding is available.

CDP was born out of recognition of this issue and was built to solve these issues of complexity within device  connectivity, by abstracting diagnostics behind an interoperability layer.

CDP has a well documented, open, and accessible API. It allows its users to accept data from any source through its Manifest System. It also, allows its users to forward data using its Integration Engine. DHIS2 is used on a national scale in over 50 countries as a health management information system (HMIS). It is used by hundreds of organisations to manage and report on their health data. It is an established technology with well defined and documented APIs.

Technical approach

Blue Frontier would like to prove the interoperability features in CDP by examining and enhancing their Integration Engine and Manifest System to provide a documented useable integration with DHIS2.

This would bring with it the ability for DHIS2 and by extension the open source health community to interface with hundreds of compatible connected devices wherever there is an implementation of CDP, or a CDP compatible bridge platform.

 

Fig 1. Example of a DHIS2 - CDP Interopability System Design

There are two proposed phases within the project;

Phase 1 - Develop a DHIS2 - CDP connector

The CDP Device endpoint allows you to send a ‘Message’ into CDP that can be interpreted by the CDP Manifest and the data within the Device Message can be mapped to any of the fields within CDP, or associated with an existing entity if the field is not appropriate. This endpoint supports JSON, XML, HL7, POCT1A, and ASTM in both uni-directional and bi-directional transmissions where possible. There should be no barrier for CDP to collect transmissions from DHIS2. However, in the context of an interoperability layer it would be the device support that CDP offers.

Pushing data into DHIS2 will require the support of the Integration Engine. Currently, this feature only forwards data in the context of an existing patient. This should be expanded to allow new patients to be forwarded over to DHIS2 without the need to set them up individually once they have been created.

User-friendly documentation for this integration will also be produced as part of our 13485 Quality System and made publicly available.

Phase 2 - Open Source Connector

CDP supports oAuth2 authentication over its API. This allows users to authenticate with CDP itself and then access the different API endpoints using the provided token. The CDP Devices endpoint is a standalone application aside from CDP that uses this authentication mechanism in order to interact with the core of CDP’s EMR, and Test Order functionality.

In order to encourage development in the open source community, we intend to develop the codebase that powers the CDP Devices application into an open-source library available to all. This will allow integration partners to quickly get up and running with CDP and take advantage of its capabilities in diagnostic connectivity scenarios.

The proposed technologies are;

  • Ruby gem for use in Ruby scripts and Ruby on Rails applications
  • Cloud-hosted/CDN’d javascript library for use in browsers
  • Node.js NPM library
  • PHP library

The source-code for these will be released under a yet undecided open source licence (as defined on https://opensource.org) and will be hosted on the Connected Diagnostic Platform’s Github account and published to the appropriate repositories for public use.

Timeline

Each sprint referenced is two weeks.

Phase 1

  • 1 Sprint requirements gathering
  • 3 Sprints engineering time to develop the integration with DHIS2
  • 1 Sprint testing and feedback

Phase 2

  • 1 Sprint to build requirements and identify the most effective technologies to build each proposed library
  • 2 Sprints for each proposed technology solution

Total

The total estimated timeframe in for these activities is 8 Sprints of two weeks. A total of 16 weeks.

Quality Statement

At Blue Frontier, we are focused on the delivery of quality solutions that meet the needs of our customers and exceed expectations wherever possible. Our quality management system (QMS) ) is ISO 13485:2016 (medical devices) accredited and is at the core of our commitment, ensuring we plan effectively, control our internal and external-facing activities and assess our performance in all areas of the business; to set targets and objectives and promote the continual improvement of our business operations and the products and services that we provide.

Tagging

  • Interoperability
  • DHIS2
  • Data interchange
  • Connected Diagnostics
  • Patient centric
  • Health Management System (HMIS)
  • Electronic Medical Record (EMR)
  • Identification Registries and Directories
  • Client Communication System
  • Data Warehouse
Application Status: 
Incomplete

cStock DHIS2: Community Health Supply Chain Solution

Submitted by Sarah Andersson on Tue, 07/17/2018 - 09:22 Last revised by Digital Square on Mon, 04/15/2019 - 05:58.
Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

Executive Summary

Community-based health workers are critical to achieving universal health coverage by reaching underserved communities with important health services. Visible, responsive and effective supply chains will be essential to the success of community based health programs. In Malawi, JSI and the Ministry of Health introduced a simple mobile solution with web-based dashboards and data review teams called cStock. This supply chain solution proved successful in improving stock reliability by supporting demand-based resupply procedures, connecting Community Health Volunteers (CHVs) with their resupply facility and promoting data use.  

Over the past two years JSI and the University of Oslo have been working together to incorporate the cStock workflows into the DHIS2 system so that all countries can capitalize on this investment. As DHIS2 is used in over 60 countries and by a growing number of community health programs this will offe countries a simple option for improving supply chain visibility within their current information system. The cStock workflows have now been developed in DHIS2 and are currently being piloted in Kenya. This proposal seeks funding to learn from the Kenya experience and make refinements to the system to benefit other community based health programs using DHIS2 and struggling with supply chain management. 

Overall goal of this proposal is to learn from current implementations and improve the structure and design of cStock in DHIS2 to provide a supply chain tool to benefit other countries and community health programs.

Consortium Team

John Snow, Inc. JSI is a health care consulting and research organization dedicated to improving the health of underserved individuals and communities. JSI has many years of experience strengthening supply chain systems and implementing health and logistics management information systems. JSI implemented the Supply Chains for Community Case Management Project (2009 to 2014) that developed and supported the design and scale of the cStock approach in Malawi. JSI continues to support cStock, under a current Saving Lives at Birth grant, where it has been adapted for Kenya in DHIS2 and early results show promise for improving the community health supply chain.

University of Oslo. University of Oslo (UiO) hosts the core DHIS2 software development team, contributes to in-country capacity building and implementation support and promotes DHIS2 as a global public good. UiO brings the technical know-how of DHIS2 as well as the steering direction of enhancements of DHIS2 to better serve the needs of DHIS2 implementers and users. See http://www.dhis2.org for further information.

inSupply Health, Kenya. Affiliated with JSI inSupply based in Kenya aims to improve the performance and efficiency of supply chains in East Africa by offering regional supply chain expertise. cStock in Kenya has been implemented by inSupply.

Needed Implementing Partners. JSI is seeking any countries using DHIS2 who are interested and have resources to implement a supply chain tool for community health workers. We would like to find opportunities to expand the cStock approach and learn from implementation experiences in other countries.

Problem Statement

Community-based health workers are critical to achieving universal health coverage, playing a critical role in reaching underserved communities with preventive, promotive and curative services related to reproductive, maternal, newborn and child health, infectious diseases, and non-communicable diseases. Visible, responsive and effective supply chains that ensure critical health products reach community health workers will be essential to the success of community based health programs.

The Supply Chains for Community Case Management Project (2009 to 2014), implemented by JSI Research & Training Institute, Inc. aimed to find supply chain best practices for community based health programs by testing different approaches in three countries. The cStock approach implemented in Malawi proved to be a best practice from this project. This approach uses simple mobile tools and web-based dashboards to support demand-based resupply procedures, better connect CHVs with their resupply facility and promote data use to improve availability of health products (figure 1). In Malawi this system was scaled nationally and continues to be an integral component of the community health program. However, as the technology was custom built for Malawi other countries have not benefited from Malawi’s success.

To address this issue, JSI sought an appropriate open source health information system that cStock workflows could be integrated into and to create a tool that other countries can implement without large upfront costs.  DHIS2 was selected as the right solution as it is used in over 60 countries and many community health programs are opting to use DHIS2 for collecting other community health data.

JSI and the University of Oslo have been developing enhanced cStock workflows within DHIS2 using Kenya as the pilot country. Since April 2018 over 580 CHVs in Kenya are using the first version of the system. cStock has been well accepted by the users as demonstrated by quotes below; however, over the course of development the project has identified a number of changes to the system that could benefit Kenya and the broader community.

cStock could not have come at any other time better than now, with the challenges that had crippled the system where commodities tracking and documentation seemed to be the challenge” Community Health Assistant, Kenya

“The App is easy to use and it will help me account for the commodities I have been issued with” CHV, Kenya

This proposal will build on the Kenya experience and make refinements to the system to benefit other community based health programs using DHIS2 and struggling with supply chain management. 

Goal and Objectives of this Project

The overall goals of this proposal are to create an easily replicable model for community based health program implementers globally by learning from Kenya and to improve the structure and design of cStock in DHIS2.

To achieve these goals JSI will focus on three key objectives:

1.1 Based on user feedback from Kenya, identify possible enhancements to the system

Using a human centered design approach, the team will gather inputs from current users in Kenya to understand how to improve the usability of the system. This will include interviewing users and then conducting a participatory workshop to dig deep into possible design enhancements. JSI and the University of Oslo have already identified a number of enhancements, such as moving some functionality to DHIS2 tracker for transactional supply chain data and enhancing the use of predictive analytics for forecasting demand, and will use this workshop to validate these.

JSI will be conducting an endline evaluation of the current pilot in Kenya in September 2018. This endline evaluation will measure the feasibility, acceptability and effectiveness of the cStock system in the pilot county.  JSI will use the results of the pilot evaluation to identify the questions and areas of focus for the human centered design activity. 

1.2 Validate DHIS2 community supply chain workflows with other countries

JSI and University of Oslo will validate the refined DHIS2 cStock workflows with other countries who have expressed interest in implementing a similar system. The purpose will be to gather information on the structure of other community health programs and assess the applicability of the cStock system in different contexts. The team will share current workflows and proposed enhancements to identify any alternative ways of structuring the system to increase applicability across countries and contexts. 

The project will find opportunities to interact with other partners and countries through existing forums and conferences, such as the DHIS2 Community Health Information Systems community, the Child Health Taskforce (formerly the CCM Taskforce), and DHIS2 symposiums. The project team will attend relevant meetings but also reach out to individuals within these groups to gather inputs through phone calls, interviews and possible site visits. The team will also use this opportunity to connect staff form other country programs and implementing partners working in community health to share experiences in addressing supply chain challenges.

1.3 Enhance current Kenya instance of cStock/DHIS2 to create a robust model for other countries

After gathering information from Kenya and other country programs the team will develop and prioritize a list of enhancements for the system. System enhancements will be developed within the Kenyan instance and then tested with community health volunteers in Kenya. Results will be monitored, documented and shared with the broader community on an ongoing basis.

The project will continue to actively and routinely engage stakeholders who provided initial input and have an interest in community health supply chains. The project team will hold webinars, send out updates by email and participate in relevant conferences and meetings to share the learnings of this project with both community health practitioners and DHIS2 implementers across all 60 plus countries using DHIS2. If and as other practitioners take up this tool beyond our initial project we seek to connect new adopters to form a network of users who can share experiences and answer questions.

Proposed Outcomes of Project

The purpose of this project is to provide a cost effective supply chain solution for community health programs. As such the outcomes of the project will be:

  • A well-developed use-case and model for a community health supply chain solution using DHIS2.
  • Software available for easy implementation by other country community health programs.
  • Dissemination materials, meta-data, webinars and discussions groups to share the use case and model widely with DHIS2 implementers and community health programs. 
  • Networked community of practitioners are available to answer questions from new adopters from other countries

Tags - Supply Chain Management, DHIS2, community health - Applies to the following Digital health Interventions: 3.2.1, 3.2.2, 2.3.1, 2.7.2, 2.2.4, 4.1.2, and 4.1.3

Application Status: 
Incomplete

Develop a claim submission, enrollment and enrollment verification module with a clinical point of service application using the relevant HL7 FHIR standards, openIMIS and OpenMRS

Submitted by Jakub Sławiński on Tue, 07/17/2018 - 04:53 Last revised by Digital Square on Mon, 04/15/2019 - 05:59.
Notice C Opportunity: 
Announcement C1: Modular transformation of openIMIS

Executive summary

The Insurance Management Information System (IMIS) was designed by the Swiss Tropical and Public Health Institute (Swiss TPH) in the context of the Swiss Agency for Development and Cooperation (SDC)’s Health Promotion and Systems Strengthening Project in Tanzania.

 

IMIS was first implemented in 2012, as the IT backbone for the Government of Tanzania’s Community Health Fund (CHF). Over the last years IMIS has developed into a flexible health insurance solution that is ready for deployment and should be able to accommodate most immediate needs of many potential users. However, IMIS also has some limitations regarding parametrization, modularity and interoperability.

 

The technical roadmap points towards a step-wise integration of modularity, interoperability and open source components. During the technical workshop in February 2018, these elements were discussed and agreed upon by a wider team of stakeholders.

 

All the parties agreed on the following approach for moving forward:

  1. Keep the current IMIS code maintained as a core module for the time being, without any significant investment.

  2. All major functional updates will be made based on the open source technology or existing HL7 standards or modules, whenever possible.

  3. Elements of the openHIE architecture will be used and integrated with whenever possible.

 

As an outcome of this project, we will build the working integration between openIMIS and OpenMRS - the world's largest open source project to develop health information technology for resource-constrained environments. We will develop claim submission, enrollment and enrollment verification module with a clinical point of service application using the relevant HL7 FHIR standards. This will help healthcare facilities gain easier and better access to the insurance information of their patients, enroll them faster in the system and allow them to provide their medical services without any bureaucratic set-backs.

Consortium team

Consortium includes the following organizations:

 

SolDevelo

  • Responsible for:

    • technical project management, software development

  • Point of contact:

    • Jakub Sławiński - SolDevelo CTO

  • Organization’s relevant qualifications

    • SolDevelo is a dynamic IT company focused on delivering high-quality software and innovative solutions. It has a deep expertise in the IT projects management and development, gathering experience in various projects during the last decade, for such institutions as:

      • VillageReach

      • Terre des hommes

      • Grameen Foundation

      • Pathfinder International

      • Benetech

      • FrontlineSMS

      • And many, many others

    • SolDevelo will be able to gather exact requirements, prepare project timeline, manage development according to SCRUM principles and deliver the final results back to the community.

  • Relevant experience and examples of related work

    • SolDevelo has been involved in many opportunities that required skill sets relevant to this particular project, especially OpenMRS (core contributors), HL7 FHIR (OpenMRS Sync 2.0 module), nation wide micro-service based implementations (OpenLMIS), nation wide OpenHIE architecture based implementations (National Health Infrastructure project with such components like OpenELIS, DHIS2, OpenMRS and many other HIE compatible applications, health standards-based workflows for the Client Registry, Facility Registry, Health Management Information System, Shared Health Record, and Interoperability Layer).

  • Qualifications of key members of the proposed project team

    • Paweł

      • Senior Java Developer/Team Leader/Project Manager

      • Working in international teams for various projects/clients:

        • Mifos

        • MOTECH

        • NDT

        • Ananya Care reporting

        • VillageReach

        • International Rescue Committee

        • Terre des homes

      • Preparing high-level designs

      • Creating solutions architecture

      • Performing code review

      • Leading several frontend and backend development teams

      • Taking care of all arrangements and delegation of tasks

    • Kamil

      • Java Developer/Team Leader

      • Working in international teams for various projects/clients, like:

        • MOTECH

        • Terre des homes

  • Number of years in operation

    • SolDevelo was established in 2009 and started contributing to OpenMRS in 2013 and is consistently supporting this fantastic community since then.

 

Swiss TPH

  • Responsible for:

    • Know-how of openIMIS, inputs for Concept development, openIMIS system/architecture design, drafting of technical specifications for development to be undertaken on openIMIS  

  • Point of contact:

    • Dragos Dobre - IT Systems Architect

  • Organization’s relevant qualifications

    • The Swiss Tropical and Public Health Institute (Swiss TPH) is a world-leading institute in global health, with a particular focus on low- and middle-income countries. By uniquely combining research, services, and education and training, Swiss TPH aims to improve the health and well being of populations through a better understanding of disease and health systems and by acting on this knowledge.

  • Relevant experience and examples of related work

    • Swiss TPH is currently active in 300 projects in over 100 countries, working across a variety of topics from infectious and non-communicable diseases, environment, society and health as well as health systems and innovative interventions. It has more than 800 employees and students from over 70 nations currently work at Swiss TPH. About 600 are based in Basel, while another 200 are based abroad in 40 different countries.

    • Swiss TPH currently hosts the WHO Collaborating Centre for Health Technology Management and eHealth. The Swiss Centre for International Health (SCIH) provides consultancy and project implementation services. As a department of the Swiss TPH, SCIH draws on in-house expertise and synergies between the research and education departments to design and innovate solutions including information systems. The in-house know-how is state-of-the-art knowledge in a broad range of topics including primary healthcare, health economics and financing, health technologies, sexual and reproductive health and health promotion.

    • The Health Economics and Financing and the Health Technology and Telemedicine Unit jointly has been involved in the design and implementation of the Insurance Management Information System (which is the genesis of the openIMIS initiative) since its inception in Tanzania and has supported its implementation in a number of countries. Having worked on grounded solutions with local software vendors and generalizing it for operations by different insurance models it now supports the direction of the software to becoming more modularized and adhering to global standards to ensure better interoperability in its IT environment.

    • Swiss TPH is currently implementing two projects at scale for deployment of insurance schemes through openIMIS, in Tanzania and Cameroun, and two openIMIS pilots in Chad and Democratic Republic of Congo. In addition, Swiss TPH is actively involved in the development of openIMIS as part of the IT & product team of the openIMIS initiative.

    • In parallel of these health insurance-related projects, Swiss TPH is also implementing projects focused on systems’ interoperability such as a Clinical Decision Support System (CDSS) in Nigeria where data collected through CommCare is automatically integrated in DHIS2, or more globally, a civil registration system collecting and evaluating birth and death events through ODK and integrating them as tracked entities in DHIS2.

  • Qualifications of key members of the proposed project team

    • Dragos

      • IT System Architect at Swiss Tropical and Public Health Institute

      • OMG-Certified Systems Modeling Professional™

      • Over 4 years of IT teaching experience at University Level

      • Management of software life cycle (from specification to development to deployment)

      • Development of open source applications

      • Maintenance of open source software source code

      • Speaking at international conferences

      • Publication of scientific articles

  • Number of years in operation

    • Swiss TPH founded in 1943 is based in Basel, Switzerland and is an associated institute of the University of Basel.

Project Description

Technical approach

The development effort can be split into two parts: the openIMIS side and the OpenMRS side.

 

On the OpenMRS side, we will implement a module that will be responsible for checking patient enrollment status and submitting claims. This module will be responsible for checking patient insurance enrollment on registration and managing patient billing. We will also implement an app module that will extend the user interface in OpenMRS using extension points (fragments) in other modules, such as the Registration App Module, responsible for the patient registration interface. The interface responsible for recording patient visits (form entry) will also need to be extended to support billing details. The module will also provide its own interface that will give a billing/claim overview.    

 

This module will depend on the existing OpenMRS FHIR module - it will leverage it to act as a FHIR client that will communicate with openIMIS. Any extension that will be required to the FHIR module will be contributed to the FHIR module codebase. The new module will allow configuring connection details through an admin interface.

 

On the openIMIS side we will implement a module acting as a FHIR server. We will use an open source implementation of FHIR STU3 for .NET - https://github.com/ewoutkramer/fhir-net-api. The module will be responsible for exposing the relevant FHIR resources and mapping them to domain objects.

 

During the development process, we will host publicly accessible test instances. The test infrastructure for openIMIS and OpenMRS demo servers will be hosted in the cloud (Amazon Web Services). These servers will be continuously updated with the latest versions of modules being developed. This server will be used QA for testing of new features as well as it will be shared with the community and anyone interested in the development as a single point of reference for the current state of the systems and their integration.

Use of Digital Health Technologies

FHIR STU3 will be the main standard of communication between openIMIS and OpenMRS. The financial module of FHIR will be used to represent the claim/enrollment data being exchanged between OpenMRS and openIMIS. Exact mapping of business domains to FHIR resources will be worked out with the involvement of openIMIS and OpenMRS communities to achieve the best possible result.

 

Since FHIR will be used as the standard of data exchange it will be possible both for OpenMRS and openIMIS to integrate with different systems that implement the standard - the integration will not be specific to these two systems.

Workplan and schedule

Current plan:

Below are the man day estimations for the tasks identified in the project.

Task

Estimation (man-days)

Set up of code bases, development environment, automated tests and code quality tools - Openmrs

5

Set up of code bases, development environment, automated tests and code quality tools - openIMIS

5

Set up of CI/CD process - OpenMRS

5

Set up of CI/CD process - openIMIS

5

Creation of a module that can extend the current functionality of openIMIS

10

Implementation of a FHIR server module for openIMIS

20

Connecting the openIMIS FHIR server with business logic

20

Extend the OpenMRS FHIR module

5

Creation of a basic OpenMRS claims module

5

Implementation of billing management in OpenMRS

25

Connecting the OpenMRS module with openIMIS through FHIR

10

Claim submission user interface

15

Extension of the patient registration screen with enrollment verification

10

Form entry user interface extension

10

Module admin screen in OpenMRS

5

Documentation

5

Testing & bug fixing

15

OVERALL

175

Team composition

For this proposal, following team composition is proposed:

  • SolDevelo

    • 2 FTE developers

    • 0.5-1 FTE Tester/QA

    • 0.25 FTE Project Manager

  • Swiss TPH

    • 0.25 FTE Consultant



This team composition is assumed in the RACI Matrix below, and the Gantt chart timeline.

RACI Matrix

The RACI Matrix includes the roles on the project team, as well as the role of the OpenMRS/openIMIS Communities, which will be regularly consulted and updated during the development process.

 

Task\Role

Project Manager

SolDevelo Developers

SolDevelo QA

Swiss TPH

OpenMRS Community

OpenIMIS Community

Design of OpenMRS features

Accountable

Responsible

Informed

Consulted

Consulted

 

Design of openIMIS features

Informed

Consulted

Informed

Responsible/Accountable

 

Consulted

Development of OpenMRS modules

Accountable

Responsible

Informed

Informed

Consulted

 

Development of openIMIS modules

Accountable

Responsible

Informed

Consulted

 

Consulted

Review of code submissions for OpenMRS

Informed

Responsible/Accountable

  

Consulted

 

Review of code submissions for openIMIS

Informed

Responsible/Accountable

 

Consulted

 

Consulted

Test Infrastructure management

Accountable

Responsible

Consulted

Consulted

Informed

Informed

Testing in the test environment  

Accountable

Consulted

Responsible

Consulted

Informed

Informed

Documentation and user guide

Accountable

Consulted

Responsible

Consulted

Informed

Informed

 

The timeline assumes the already mentioned team composition. Notes:

  • Start & end dates are exemplary and can be shifted. (start assumed at 07.01.2019)

 

Gantt Chart in the attachment.

Digital Health Atlas

Registered

Project Deliverables

  • openIMIS FHIR module integrated acting as a FHIR server

  • OpenMRS claims module, able to communicate with openIMIS by FHIR

  • OpenMRS claims app that extend patient registration and form interface with insurance billing

  • Extensions to the OpenMRS FHIR module

  • Comprehensive documentation for the OpenMRS module

  • Comprehensive documentation for the openIMIS module

  • Recorded bi-weekly demonstrations of development progress

  • Testing reports & a list of test cases and scenarios

 

2-sentence overview

 

a) A description of your global good for a non-technical audience.

Connecting two open-source health projects to save time and resources of the healthcare providers in the developing countries. Making access to affordable healthcare easier and faster.

b) What this investment from Digital Square will specifically go towards

Investment from Digital Square will go towards team of experienced developers, who will make sure that whole project will be created in time and great quality. Their experience with work on social impact software and open-source projects will guarantee involvement of the OpenMRS and openIMIS community and their collaboration.

Community Feedback

 

SolDevelo is very involved in OpenMRS community, thanks to being one of the core contributors to this project. OpenMRS forum -  “Talk” had in 2017:

  • 29,986 total visits

  • 2,816 topics created

  • 20,323 posts written

 

Thanks to this engagement, 209 developers from around the globe made 4,250 commits to 112 code repositories in 2017 alone. OpenMRS is a one of the endorsers of the Principles for Digital Development, which means every project with in it has to be collaborative.

 

We want to use the creative power of this enormous community. Creating topics on Talk, doing daily stand-ups, that are public and open to everyone who is interested to this project and also doing showcases will help us achieve this task. Working with community everyday of the project will allow us to incorporate their feedback, comments and suggestions as quick as it is possible.

 

Swiss TPH has been involved in the design and development of openIMIS in all its implementation sites so far, and as such, will be able to source feedback from users on new developed features and their practicality in the field. Also, Swiss TPH is currently mandated  as the IT & Product team within the openIMIS initiative which will allow direct feedback of the developments to the community via it's dedicated communication and contribution platforms (JIRA, Wiki, GitHub).

 

Use Cases, User Stories

The following use case will be covered by the developments for this proposal:

 

 

  1. A person gets enrolled by the Insurer and receives the insurance card with an unique insuree number.

  2. Once the person gets sick they would go to a health facility that uses openMRS. The patient might or might not be already registered in openMRS with a unique ID number. Once registered in openMRS the patients insurance ID number would be entered in the openMRS record of the patient.

  3. The insurance ID number would be queried to get details from openIMIS on the patient’s eligibility. Details needed to establish the clients identity and the benefits covered by the insurance will be provided from openIMIS to openMRS.

  4. The treatment of the patient will be undertaken by the health facility and the information recording and processing of payments/billing will be (as per details shared by openIMIS) managed in openMRS.

  5. Once the patient treatment is completed, the relevant details from openMRS are sent to openIMIS as part of submission of a claim in order to get reimbursed. The claim is then processed in openIMIS as per its internal claim scrutinization process and final results of the scrutinization concluding with the amount to be paid to the health facility against the claim is sent back to openMRS.

Self-Assessment on the Global Goods Maturity Model

Two attachments:

  • OMRS evaluation

  • openIMIS evaluation

Tagging

  • OpenMRS

  • Interoperability

  • HL7 FHIR

  • Claim submission

  • Enrollment

  • Enrollment verification

List of attachments

  • Budget

  • Budget narrative

  • CVs

    • Paweł

    • Kamil

    • Dragos

  • Global Goods Maturity Model

    • OpenMRS

    • openIMIS

  • Gantt Chart

Application Status: 
Pending Review & Investment

DHIS 2 Utility Suite

Submitted by Peter Galletta on Fri, 07/20/2018 - 11:28 Last revised by Digital Square on Mon, 04/15/2019 - 06:00.
Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

Executive Summary

BAO Systems is pleased to present its proposal to develop a DHIS 2 Utility Suite in response to the Digital Square Notice C - Open call for Global Goods.

DHIS 2 is a flexible, open source health information system that allows users to collect, manage, and visualize data. Originally created to support the management of aggregate health data in low-resource settings, the use of DHIS 2 has expanded into other sectors and additional use cases due to its highly flexible and configurable nature, robust database structure, and ability to scale and interoperate. Through first hand experience with clients and feedback from other organizations, we identified a demand for: more efficient administration and configuration, integration with other data collection platforms, and the ability to perform more advanced analytics through connectivity with more advanced business intelligence (BI) tools. While DHIS 2 natively supports some of this functionality, it is limited in its capabilities.

To address these needs, BAO Systems proposes to fortify DHIS 2 with a suite of tools and utilities that will increase efficiency and simplify process for users concerned with DHIS 2 configuration and data analytics. This suite of tools and utilities will target individuals responsible for system configuration and for those interested in data interpretation. The solutions would not only conserve precious organization resources, but help increase the insights derived from their data and better inform decision making as it relates to their programs and goals. BAO Systems will deliver these tools and utilities in a timely manner and provide the software, documentation, and promotion of the solutions to the community.

 

Consortium Team

BAO Systems

BAO Systems is a leading technology firm that provides health information system (HIS) design, support, and development  through managed, cloud-hosted solutions that enable governments and organizations in low-resource settings to sustainably monitor and manage data to improve outcomes. Founded in 2012, BAO Systems has become the largest US-based DHIS 2 consulting and hosting firm in North America. We work at a global scale and use open source software solutions to tackle the tough challenges faced by organizations across a variety of sectors including health, education, sanitation, refugee assistance, and nutrition. Our organization is part of the Open Health Information Exchange (OHIE) community and is committed to data accessibility beyond platform silos. 

Our team has extensive experience working with and for governments, non-governmental organizations, and in the private sector around the world. BAO's team consists of software developers, data scientists, system administrators, as well as HIS and program monitoring and evaluation specialists with experience working in LIC/LMICs across South/Latin America, Africa, Asia, and the Middle East. We are well versed in governance, compliance, and data and information security and have deep technical expertise in application development, hosting, and technical assistance. With this diverse expertise, we are uniquely positioned to understand the unique challenges our clients face and implement lasting, effective solutions that meets client needs.

University of Oslo

The University of Oslo (UiO) is home to the Health Information Systems Program (HISP). HISP at UiO is one of the leading organizations in HIS strengthening and conducts in-country capacity building and implementation support, research, a PhD program, and hosting the core DHIS2 software development team. HISP coordinates DHIS2 development, an open process with developers in Norway, India, Vietnam, Tanzania, Ireland, and the United States. The core development team at UiO, focuses primarily on developing and maintaining a robust API and backend, setting the development roadmap, developing and maintaining core, generic applications, fixing bugs, and performing system stabilization.

BAO Systems, Population Services International (PSI), and the UiO are a current holder of a Digital Square Notice B award, focusing on the development of a Power BI to DHIS 2 connector.

Key Personnel

Peter Galletta, ProductsDirector (BAO Systems). Mr. Galletta has over 20 years experience in the design, development and management of feature rich web-based applications. Mr. Galletta will have overall technical responsibility for product development, including conducting user research, documenting product requirements, determining specifications, and ensuring that production timetables are met in a timely and high quality manner. Tasks will include leading user research and requirements gathering, developing and assigning product development tasks, ensuring that product development tasks are completed in a timely manner with high quality, and oversee user testing. 

Katherine Lew, Products Liaison Senior Manager (BAO Systems). Ms. Lew brings over 13 years of public health experience with emphasis in health information systems, data management, and data analytics, visualization and use. Before joining BAO Systems, she supported NGO country programs and headquarters with customization and implementation of data analytics platforms to improve data use for program adaptive management and improvement. Having worked in multiple countries across Asia and Africa, she has keen insight into the business requirements of our clients. Katherine holds a BS in Molecular Biology and a Masters of Public Health, specializing in international health. Ms. Lew will support monitoring project plans, schedules, work hours, budgets, and expenditures, and ensuring that project deadlines are met in a timely manner. Tasks include organizing and participating in stakeholder meetings, maintaining open communication between project staff and Digital Square, and follow up with project staff to ensure that project deliverables are met. 

Dan Cocos, Senior System Administrator (BAO Systems). Mr. Cocos leads the systems team and is responsible for BAO Services’ hosting services, keeping our clients’ DHIS 2 servers secure and reliable. With over five years of DHIS 2 experience he also works closely with clients and the DHIS 2 Development team to ensure smooth upgrade paths and development of future features. Having extensive experience in both the public and private sectors, he has been exposed to a variety of clients such as The Census Bureau,The National Education Association, and Orbitz. He holds a BBA in Systems Analysis from the University of Wisconsin. Mr. Cocos will serve as the lead System Administrator for this project, though may task his team members with day-to-day responsibilities. The System Administrator will ensure that DHIS 2 production instances are well maintained and operate reliably. Tasks will include performing regular systems and security monitoring, handling backup procedures and helping set up, maintain and delete user accounts as required.  

Jennifer Jones Arnesen, Senior Software Engineer (BAO Systems). Ms. Arnesen is a senior frontend web developer, based in Oslo, Norway with 20 years experience in software development, in industries such as environmental consulting, education, and media streaming. At BAO Systems, she focuses on building analytics apps for the core DHIS 2 platform. She holds a BA in biochemistry from the University of Colorado. Ms. Arnesen will serve as the lead Software Engineer, though may task specific technical deliverables to a pool of software engineers. The appointed software engineers will work together with the Product Manager and User Experience Designer to design and develop the product(s), and iterate upon it in accordance with user-testing. Tasks will include participation in user research and requirements gathering and test development in an agile environment.  

TBD, User Experience Designer (BAO Systems), will be responsible for the design the overall functionality of the product(s), and in order to ensure a great user experience, iterate upon it in accordance with user-testing. Tasks will include participation in user research and requirements gathering and translating them into sitemaps, user flows, customer journey maps, wireframes, mockups and prototypes.

Pool, Community Liaison (UiO), will support identification of specific use cases and community feedback in the proposed utilities/tools. The UiO maintains a community newsletter, communication with the various Health Information System Programme offices, and has worldwide presence. 


Project Description

Background

DHIS 2 is a flexible, open source health information system that allows users to collect, manage, and visualize data. Originally created to support the management of aggregate health data in low-resource settings, the use of DHIS 2 has expanded into other sectors and additional use cases due to its highly flexible and configurable nature, robust database structure, and ability to scale and interoperate. As a result, DHIS 2 has been widely adopted by numerous Ministries of Health, development partners, and non-governmental organizations in over 60 countries, with thousands of instances and tens of thousands of individual users comprising data entry clerks, data scientists, M&E specialists, and program managers. With its quickly growing and diverse user base, the number of demands for enhanced functionality has grown. Core DHIS 2 developers continue to have a robust roadmap, however are not able to all of the community's demands. 

With its unique position in supporting a wide range of NGOs in configuring and hosting DHIS 2 instances, BAO Systems has identified a number of community demands which it would like to address:

  • More efficient administration and configuration: During the setup and configuration of a new DHIS 2 instance, the creation of metadata objects can be time consuming and tedious depending on an organizations' structure and management. 
  • Integration with other data collection platforms: Many organizations use Open Data Kit v.2 (ODK) based tools, such as KoboToolbox and Ona for mobile data collection. While these tools are easy to use and offer the necessary user interface for data collection, users struggle with finding equally easy solutions for analyzing the often complex datasets collected.
  • The ability to perform more advanced analytics through connectivity with more advanced business intelligence (BI) tools: Though DHIS 2 offers a robust and often times sufficient analytics application, a number of organizations have expressed the need to connect their DHIS 2 datasets with more advanced business intelligence tools such as Tableau. Not only would this extend the analytic features available, but it would also enable organizations to mashup their data with data sources collected and managed in other software. 

While DHIS 2 natively supports some of this functionality, it is limited in its capabilities. However, due to the extensive REST-based Web API, DHIS 2 functionality is highly extensible and more advanced solutions are possible to implement and integrate with the platform.

  

Technical Approach and Digital Health Technologies Integration

BAO Systems proposes a suite of tools and utilities to address the challenges faced by many DHIS 2 users, which will target individuals responsible for system configuration and data analysis, interpretation, and use. The solutions outlined below will be interwoven with DHIS 2, an existing Digital Health Technology. 

BAO Systems is currently developing proof of concept solutions to address multiple challenges and would like to further extend the functionality; fortify the development, user experience, documentation and release; and promote these solutions to the public health community.  Since NGOs, international agencies, and governments have already made sizable investments in existing technology (software, infrastructure and training), BAO Systems believes our suite of tools can assist with integration and interoperability between DHIS 2 and existing commonly used technologies without adding additional technology burden.

For each utility/tool developed, the BAO team will follow a phased approach, as described below.  Development of the three utilities/tools will occur concurrently, and phases may overlap.

Phase 1: User research and requirements gathering. BAO Systems will compile research and user requirements through interviews with key stakeholders and target users to fully understand and document their specific needs with respect to each proposed utility/tool.  Information that will be distilled out during this phase will include: user goals, system components, main capabilities and the reason for needing them, target users and capabilities, a plan for system maintenance and support, system architecture, and assumptions and dependencies.  

Phase 2: Product development and testing. The bulk of the implementation timeline will be used to implement an agile product development methodology, whereby the team will iteratively implement a cycle of development→development→testing→delivery→feedback.  During this time, we will identify concrete use cases in which the products will be tested to ensure that the final products meets the requirements identified during Phase 1, as well as ensures that any system bugs are addressed prior to release.  BAO Systems will obtain feedback on the user interface, user experience, and functionality of the the utilities/tools.  Feedback will be incorporated into any further development prior to product release.

Phase 3: Documentation. Throughout the research and development process, BAO Systems will ensure that proper documentation is maintained, including user requirements, development processes, and testing conducted.  

At the end of the anticipated 6-month timeline, BAO will be prepared for product release and promotion.  A number of dissemination and promotion channels have been identified, and include, but is not limited to:

  • Posting documentation on BAO’s website, the DHIS 2 App Store and other DHIS 2 community channels
  • Leverage existing relationships with NGOs 
  • Share/present at industry events such as:
    • The annual DHIS 2 Symposium, hosted by the UiO and BAO Systems in Washington, D.C. The DHIS 2 Symposium has been hosted since 2014, and gathers NGOs implementing health and nutrition programming globally. 
    • The annual  DHIS 2 Experts Academy, hosted by the UiO in Oslo, Norway. The 2018 Experts Academy brought together over 200 participants from 85 organizations, including governments, implementing partners, and the WHO, UNICEF, and PEPFAR. 
    • The annual MERLTech conference held in Washington, D.C.

Configuration Utility

To increase efficiency of the DHIS 2 setup process, we propose a one-stop, user-friendly configuration tool, meant for the bulk creation of metadata objects in DHIS 2. The utility is intended to be the singular tool needed for the ‘out of the box’ configuration of a DHIS 2 system. The metadata import is ‘user-friendly’ because it masks the complicated and often times messy API interactions. 

The configuration will help mitigate the following admin issues:

  • Speed: The graphic user interface, whilst user-friendly, does not allow for a quick configuration process of the large number of objects required to build a functioning database. For e.g., one org unit would take 30-60 seconds to create. Most organisations have a hierarchy consisting of ~1000 org units. That is ~16.5 peron hours just to create one of nearly 20 metadata considerations for a small sized aggregate DHIS2 configuration.
  • Interdepence: Difficulty keeping track of interdependent objects built one-by-one in the system
  • Versioning: Metadata during configuration, testing and rollout goes through rounds of natural iteration that are nearly impossible to manage through the front-end
  • Quality-control: Incremental database changes through the front-end would require coordinating multiple resource inputs, making it difficult to maintain an overall quality control.
  • Editing: When configuring manually in the system, every dependence is impacted, meaning it is essential to plan to the end before doing anything in the system to make a database as clean as possible. Minor manual edits introduce mess within the back-end of the database.
  • Updating: Having once made an object, updating it requires a lengthy process of remembering what it was called, the type of object, it’s details, navigating to it and making the required change.

The metadata configuration utility will be developed as a native app within the DHIS 2 environment, installed via the existing App Management workflow within DHIS 2. Once installed, the end user simply needs to create a standard format CSV file to be uploaded through the app to import the values.

The utility will support the following modules:

  • Organization Loader - This module is used to upload a flattened organisation layout CSV file, to create and update organisation units.
  • Category Power Loader - This module is used to upload categories, category options and combos CSV file, to create and update them in the DHIS 2.  
  • Indicator Loader - This module uploads the Indicators CSV file, it creates, updates and assigns them to specified datasets.
  • Power Group Loader - This module uploads different kinds of groups as specified in the CSV file, it links existing child records.
  • Translations - This module uploads a CSV file to add, update and delete translations.
  • Sharing - This module uploads CSV file that allows objects to be shared within DHIS 2. It creates and updates the external access, public access, and specific user groups with which you will like to share an object.   
  • Style Loader - It uploads a new CSS stylesheet.
  • UID Generator - UIDs are important in the configuration of metadata in the DHIS 2, to help keep track of objects to enable use in other modules, one is advised to include UIDs during configuration. This module enables you to generate between one and 100 UIDs at a time.

ODK Connector

Many organizations who use Open Data Kit (ODK) based tools, such as KoboToolbox and Ona for mobile data collection would like to use the data analytics tools freely available within DHIS 2. We are proposing a utility to allow the user to pull data from ODK based tools, like KoBoToolbox into DHIS 2 with minimal user interaction. KoBo collected data can then be analyzed with the analytic tools from DHIS 2.

This will ultimately enable the user to freely interact with and analyze the dataset within DHIS 2. The connector will use a packaged native app within DHIS 2 to use the API to create metadata according to a standard defined during development, then push data values as Events for the newly created DHIS 2 Programs without registration. The connector will integrate natively with the ODK tool by having the user authenticate for the first use. Next the user would select the appropriate ODK forms they wish to import, and finally select the data elements they wish to import to DHIS 2. An initial import would either create the data elements in DHIS 2 or allow the user to map to existing data elements. Once a sync is setup, a scheduler can be run the imports at set intervals.  

 

Tableau Connector

We are proposing a "connector" utility to allow users to connect the data in their DHIS 2 instance to Tableau in order to create data mashups and perform more advanced analytics. In collaboration with the Tableau Foundation, BAO Systems has developed a working prototype of a Tableau Connector that was fully self-funded by BAO Systems. Our team has solicited feedback from audiences at the DHIS 2 Symposium in 2018, the recent DHIS 2 Experts Academy, and our existing client base. Based on that feedback, we identified the need to continue development to fortify the code base, improve the user experience, and complete documentation before making it more widely available to the community.

Some of the core operations a user should be able to accomplish:

  • Quickly connect to a subset of their data and ask iterative questions
  • Create indicators and expressions on the fly
  • Perform cross database joins or data blends to other sources of data (e.g., financials stored outside DHIS2)
  • Build interconnected, dynamic dashboards to allow drill-down
  • Allow rapid reporting on this data to program staff and external partners

The technical approach of the Tableau connector will utilize the web data connector within Tableau to connect to the data of an organizations desired DHIS2 instance. BAO Systems will develop an easy to use interface to allow a user an intuitive way to authenticate, then select which data elements they want to pull into Tableau to analyze and interrupt.


Workplan and Schedule

The proposed implementation timeline of this project is about six months.

Configuration Utility

  • Phase 1: User research and requirements gathering will commence at project start and last 4 weeks.  At the end of Phase 1, BAO Systems will have completed stakeholder interviews and user requirements documentation.

  • Phase 2: Product development and testing will consume the majority of the implementation timeline, lasting about 10 weeks and occurring concurrently with Phases 1 and 3..  During this phase, the development team will iterate through multiple cycles of design, development, testing, and quality assurance to ensure that development is appropriately meeting user needs.

  • Phase 3: Documentation will take approximately 5 - 6 weeks to complete, and will overlap with Phase 2.

ODK Connector

  • Phase 1: User research and requirements gathering will commence at project start and last 4 weeks.  At the end of Phase 1, BAO Systems will have completed stakeholder interviews and user requirements documentation.

  • Phase 2: Product development and testing will consume the majority of the implementation timeline, lasting about 12 weeks and occurring concurrently with Phases 1 and 3..  During this phase, the development team will iterate through multiple cycles of design, development, testing, and quality assurance to ensure that development is appropriately meeting user needs.

  • Phase 3: Documentation will take approximately 6 - 8 weeks to complete, and will overlap with Phase 2.

Tableau Connector

  • Phase 1: User research and requirements gathering will commence at project start and last 3 weeks.  At the end of Phase 1, BAO Systems will have completed stakeholder interviews and user requirements documentation.

  • Phase 2: Product development and testing will consume the majority of the implementation timeline, lasting about 12 - 14 weeks and occurring concurrently with Phases 1 and 3..  During this phase, the development team will iterate through multiple cycles of design, development, testing, and quality assurance to ensure that development is appropriately meeting user needs.

  • Phase 3: Documentation will take approximately 6 - 8 weeks to complete, and will overlap with Phase 2.

 

Project Deliverables

This project will produce the following deliverables, listed below by utility/tool:

Configuration Utility

Deliverable

Timeframe

User research conducted and documented

End of Month 1

Product developed and released 

Month 2 - 5 

Documentation completed and made available

Month 4 - 5

ODK Connector

Deliverable

Timeframe

User research conducted and documented

End of Month 1

Product developed and released

Month 2 - 4 

Documentation completed and made available

Month 4 - 5

Tableau Connector

Deliverable

Timeframe

User research conducted and documented

End of Month 1

Product developed and released

Month 2 - 6 

Documentation completed and made available

Month 5 - 6

 

2-sentence Overview

BAO Systems' proposed project will further extend DHIS 2 functionality, fortify the development, user experience, documentation and release, and promote these solutions to the public health community through the development of three utilities: Configuration Utility, ODK Connector, and a Tableau Connector.  


Community Feedback

As part of Phases 1 and 2, the team will conduct user research, testing, and feedback on the overall architecture, design and use case alignment of the three utilities developed.  Furthermore, BAO Systems will continue to seek feedback on the products after release at the various industry events mentioned above as well as through our regular contact with clients.  BAO Systems is committed to ensuring that these product continue to meet user needs as they evolve.

 

Use Cases

Configuration Utility

The concept for the configuration utility is intended to be a one-stop metadata configuration app for the bulk import of DHIS2 metadata via csv (comma separated variable) templates. This means that from empty to configured database a user interacts with the configuration utility to:

  • Bulk import: Import large numbers of objects into DHIS2 at a single click to avoid lengthy configuration time
  • Arrange work and dependencies:Use of the csv templates enables creation of objects in an arranged fashion prior to importation into the system. The templates also enable a visual layout of what is going into the system to easily standardise object naming and properties.
  • Easily update and edit: Imported objects can be assigned UIDs that mean a simple edit in the template followed by re-import enables large-scale editing.
  • Build intuitively: Each successive object created through the configuration utility may draw upon previously created objects. Having the details in templates quickly references those objects.

The proof of concept contains modules capable of creating a complete aggregate configuration: from category options through to data set sections, indicators, translations and sharing. The configuration utility is also capable of creating the majority of both Event and Tracker programs: from data elements to program stage sections. Additionally, the configuration utiltiy is exceptionally powerful for integration projects as it enables to importation of mapped values against object-specific attributes for the creation of integration routes for data transfer.

To be a comprehensive one-stop shop for metadata configuration, we envisage the configuration tool being improved with:

  • New modules for the creation of the remaining “program” related items: Option sets and Tracked entity attributes
  • Addition of features into pre-existing modules to bring them in line with new features in latest releases: attributes for all object types, colours and icons for android apps, data sharing levels for data capture and more
  • Incorporation of user group and user creation modules for the bulk creation of users (an often long and drawn out process for large organisations.)
  • Standardisation of import and output formats, dry run functionality, error logs and help texts
  • Accompanying template ‘books’ that provide pre-existing templates for all objects on an ‘as-needed’ basis.

ODK Connector

The ODK Connector allows organizations a simplified method to integrate ODK collected data with the current analytics of DHIS 2 and use the analytics tooling of DHIS 2 for analysis, thus alleviating the lack of data analysis functionality in ODK. It enables analysis of surveys and other data collection methods designed with ODK.

Because the ODK API is quite different from DHIS2 API (e.g. one thing is the "select many options in a question" which is just not possible with DHIS2), we had to define a strict scheme on how data will be imported (e.g. all metadata must be affixed with `KB-` etc.). This means it is not very flexible on how it's imported.

Tableau Connector

Tableau is an industry leader in visualization and analytics. Many organizations desire to do more than what can be done native in DHIS 2 and want an easy and reliable way to get DHIS 2 data into Tableau desktop. Additionally, with a majority of data and DHIS 2 expertise residing with the country teams, other stakeholders (i.e. HQ) often struggle to gain access or have the proper training to use the built-in data analytics tooling of DHIS 2. The Tableau connector allows for access and interpretation with little to no experience with the core DHIS 2 instance where the data resides.

Once connected, the connector allows for the user to gather and model data together, that come from different sources (DHIS 2 being one source) within more powerful graphing and visualization toolset.

 

Self-Assessment on the Global Goods Maturity Model

Attached as PDF

Tagging

#DHIS2, #dataanalytics, #interoperability, #configuration, #businessintelligence, #Tableau, #KoBoToolbox, #ODK, #ona

Application Status: 
Pending Review & Investment

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