Connecting RBF data systems

Why a single standard taxonomy of health results is important

Bringing value to RBF, HMIS and OpenData efforts

Antoine Legrand and Knut Staring

Strong IT development in the health sector

RBF IT systems : OpenRBF in action : Senegal, Zambia, Nigeria, Cameroun, Bénin, Chad, DRC, Burundi, Haiti, Burkina, Laos…

HMIS migration to new technologies : DHIS2.org being used at various levels in 40 countries

Making RBF attractive for the GFATM Enhancing accountability of the GFATM

Value for the Global Fund Live and verified results instead of static results. Click on the results and zoom on it

DHIS 2 as an online national HIS - integrated repository for all health statistics

Health Metrics Network Framework

Export and Import

CSV, Excel, XML, JSON

Web API to link

Routine data

Cultivate an open infrastructure

• Evolve towards shared, open infrastructure (backbone)

• Stakeholder alignment

• Openness and sharing data and knowledge

National HIS

Logistics

MIS Human

Resource

Other

systems

Program

Tracking

Medical

Records

Systems

Population Health

Health Interventions

Operationalizes

Yield

Person-centric transactional data

Population-level health metrics

eHealth Infrastructure

Generate

Inform

OpenHIE

10

WHO-ITU Toolkit, Part I page 8 OpenHIE’s “Scope”

What for? Example : Regional integration of HMIS data

REGIONAL DASHBOARD Regionaldatawarehouse

This is a project that has recently started and is supported by HISP/DHIS2

WAHO HIS - A regional database for WAHO under development

• 15 member states • One unified list of indicators

• Unified list of districts

• Most countries will be able to

report DHIS to DHIS

• All countries have signed common policy

Live results. Zoom from aggregated data to each of the health facility on the frontlines (geolocalized, and with a picture)

Example of Regional RBF data integration

National RBF

Link RBF data systems to the African Union website. • Highlight governments efforts

towards RBF and OpenData. • Make all RBF results available.

From regional dashboards you can zoom to geo-localized and verified results of each provider (ex. Adjob in Chad)

.

National HMIS

National HMIS

National HMIS

National RBF

National RBF

Example of national HMIS web database : https://hiskenya.org/ Ghana : ghsdhims.org AfDB 2013 Award Winner on eHealth

Example of national RBF OpenData database : www.fbpsanteburundi.bi/ www.fbrbenin.org

Single taxonomy

RBF as a multi-donor health system strengthening funding platform.

Taxonomy problem

• Limited interoperability

• System fragmentation

• Data islands

• Complex system integration

Normal assisted delivery

Births attended by skilled health personnel

Births by caesarean section

Césarienne

Accouchement eutocique

Accouchement encadré

Major surgery

Acte chirurgical majeur

Partos assistidos por pessoal de saúde qualificado

Eutócico entrega

Distócicos entrega

Cesariana

Cirurgia major

Example: Maternal Health

Accouchement assisté

Example of the current situation: Multiple and not standardized definitions of health indicators. Extreme complexity to link systems

Example

Births attended by skilled health personnel in Banikoara Hospital (Benin) in June 2013 - RBF

268 BJ HR23 201306 MHD01 02 V GF

West Africa

Benin

Banikouara Hospital

June 2013 Delivery Assisted by skilled staff

Verified data

Financed by the GFATM

Proposal

Proposal:

Set up a standard taxonomy for health system outputs and results.

Make the standard taxonomy available on the web (WHO, OpenRBF, DHIS2, OpenHIE) and governmental websites

Implement this taxonomy in Result Based Financing projects in Benin, Cameroun, Senegal, Nigeria, RDC, CAR, Lesotho.

In practice :

Database with standard codes and definitions of health outputs that indicates the date, location, type of output/result in a health system. This code enables connections across systems.

The taxonomy will link with existing efforts

This taxonomy should reinforce current harmonization processes • OpenHIE • ICPC (WHO) • IATI standard. International aid transparency standard • ICD10 (WHO) : International Classification of Diseases • Service Delivery Indicators (SDI)

A collaborative project

• A joint BlueSquare.org (OpenRBF) – Oslo University (DHIS2) initiative

• Possible support from Norway, ADB, Gates, the WB

• Project managed by BlueSquare (OpenRBF) and HISP (DHIS2) • In collaboration with WHO

• In collaboration with the SDI team

• Single taxonomy available on OpenRBF, DHIS2, ADB, WHO websites

• Implementation proposed in all the DHIS2 – OpenRBF databases on the African continent

• Regional workshops

Building Communities of Practice

• Web

• App Store

• Mobiles

• Open Source

• Translations

• Users and profiles

• Academy

• User doc

• Mailing lists

• Googlable archives

• WAHO, EAC, AeHIN

DHIS 2 Interpretations - fostering communities of data use

• Charts, reports, maps can be shared with other users

• Discussion forum open to all users to comment on the data

Murakoze! Tusen takk!

Internal messaging

GENERALIZING THE VISION - ISO 14639

• -> Vision and goals

• -> Domains

• -> Governance

• -> Infostructure

• -> Infrastructure

• -> Standards

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DHIS2

• Web API • Exposes the data model

• Integration engine

• Portals

• Plugins for direct embedding in external web pages

• Event interactive analysis

• CSV data value import-export

1.Avoid duplication

2.Accurate reporting

• Monitor facility services

• Perform Disease Surveillance

1.Monitor Trainings

2.Monitor Leaves

• Monitor Postings

• Emergency services

1.Beneficiary payments

2.Insurance tracking

1.Lab Tests

2.Diagnosis

• Treatment

5

eHealth Architecture

1.External Agencies

2.Sterilization

• Drug Stores

• Labs

1.Electronic health records

2.Service tracking

in the community

• Decision support

to work force

Tracker

Interoperability (ANSI)

• The ability of systems, units or forces to provide services to and accept services from other systems, units, or forces and to use the services so exchanged to enable them to operate effectively together

• OpenRBF – DHIS2 integration • Within countries

• Regionally