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A page to capture trip notes and photos from the Global Digital Health Forum 2017. December 4-6, 2017, JW Marriot, Washington D.C. 

VillageReach attendance:

Table of Contents


Conference website: 
http://www.globaldigitalhealthforum.org/washington/2017

Conference program: http://exhibitionfloor.himss.org/gdhf17/Public/Sessions.aspx


Day 1: Monday, December 4

Digital Health's Early Pioneers and Champions: Look Back and Forward

An interesting comment by Olasupo Oyedepo, Health Strategy and Delivery Foundation Nigeria

"We need to help the health sector think of tech differently - they should think of it as a tool, the same way a surgeon uses a scalpel. They need to think of tech as a means to achieve health improvements, and we need to help the health sector better communicate their needs to the tech sector." 

Focus on East Africa


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HMIS/LMIS Integration: A Tanzania Case Study in Integration, Interoperability, Analysis and Governance
by Alfred Mchau, VillageReach with Alpha Nsaghurwe and Ssanyu Nyinondi, JSI

Alfred, Alpha and the presenters explained the Tanzania current state and future state, including integration between eLMIS and DHIS2 and the LLIN dashboard in DHIS2. They explained the Tanzania OpenHIE framework and work on an eHealth strategy.

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Alfred Mchau it would be great to get the slides uploaded to this page.

Implementation of a Dashboard for Pharmaceutical Information in Namibia 

by Bayobuya Phulu: MSH/SIAPS (part of the session Digital Technologies Supporting Data for Decision-Making in Africa)

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Innovating Across the Continuum of Care: Digital Health in the Maternal & Child Survival Program

by representatives from JSI, Jhpiego, and Erick Mwale, Save The Children

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(in Android app store see Hello Nurse and ME4Health)

Blockchain

The website isn't updated with speaker information

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David Nguyen (united solutions) - think about this as a foundation piece of the system. Can reduce the auditing effort/costs. Share data across a complex value chain. Remove the intermediaries. 
  • I didn’t hear his pitch/speech
Hugh McDonough: Abt Associates
  • Exciting to work with something during the hype (retrofit something done into our area)
  • Pilot in papua New Guinea, FinTech
    • Distributed secure applications were needed (not specifically block-chain)
    • Pilot 1: IDBox using fingerprinting to connect people to census services 
    • Pilot 2: Asset registry app for insurance and loans
    • Pilot 3: Vital registries
  • Abt is trying to connect the new Tech folks with the field to build their platforms in a way the bottom 2 billion can use their platforms
Maria Vachino: John Hopkins Applied Physics Lab
  • Researching block chain for 2 years (capabilities, challenges, etc.)
  • Identify management and data privacy for border protection
  • Funding research into:
    • interoperability
    • Distributed key management
  • Supply chain management may actually lead to something beneficial because it is permanent and distributed
    • Good for supply chain and sensors (IOT sensors)
  • Danger around Personal Identifiable Information (anything encrypted will essentially be broken)
  • If it needs to be encrypted long-term (quantum computing) - for instance public key encryption will be broken
  • Homeland security workshop on benefits and nascent aspects of block chain
  • No standard way to read/write to block chain
Paul Nelson
USAID global development lab (focus on finTech)
  • I will share more questions I ask start-ups to understand the applicability of this application in USAID
  • How does the given distributed ledger “better" than the status quo alternative
    • What is the metric is it better by?
  • How does it align with the digital development principles?
  • How does it account for low resource setting or challenges faced in this sector/field?
Questions
Maria - using block chain for IOT sensors to discover if it has been tampered with 
Maersk to IBM (newark to rotterdamn) case studies
Maria - you cannot trust that the ‘right/accurate’ data is first recorded. It only affirms that the data isn’t tampered with after it is written.
Maria - so many of these applications could easily use an encrypted DB on AWS
#you’d be an idiot to put health records on block chain - Maria
What are the characteristics of a problem/challenges where block chain is a good solution?
  • Is there a deficit of trust with you are interacting with? Fraud is the biggest reason.
    • If you need a legally binding law of transactions.
    • If two entities cannot agree on who has legal management over the data.
  • Is there a need for the information to be stored in a database?
  • More than one person read/writing to the DB
  • No viable trusted centralized alternative.
"Testing feasibility and functionality isn’t testing necessity"
Last words
  • Hugh: Don’t take block chain in the mind and start thinking what can we do it? Think of a problem and work the possibilities.
  • David: Imagine a future where your phone and computer had a distributed ledger. Create a frictionless way for devices to work together. To execute transactions on our behalf. It isn’t block chain alone. The notion of absolute privacy is no such thing. What are willing to give up to derive the benefit.
  • Maria: I’d arge that’s an encrypted data store not a ledge. I’d argh not putting sensitive information on distributed ledgers on public encrypted keys. Refugees are more sensitive or vulnerable (which we aren’t aware or are privileged enough to not notice).
  • IBM guy: define networks with 3rd parties (not sensitive) and determine what the problems are before saying it has to block chain
  • Paul: It is an early stage technology. Unfair to really know clearly where it work and where it doesn’t. Would be valuable if the innovators were being more constructive with implementers.
  • Krista from DAI


Open Source: What does it mean, Whom does it serve? A panel to demystify the meaning, use and value of open source software in the digital age.

http://exhibitionfloor.himss.org/gdhf17/Public/SessionDetails.aspx?FromPage=Sessions.aspx&SessionID=2656&SessionDateID=26

  • Carolyn Florey DIAL: ICT4D at the Rice Research Institute
  • Dykki
  • Sharon: Medic Mobile
  • Marc: D-Tree


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Dykki: open source definition on wikipedia. Make it as open and freely available as possible (some rights reserved)
  • Free redistribution
  • Include source code
  • Must allow derivative works
  • No discrimination
  • Technology neutral 
Why is it good for international development? Arguably it is about building capacity and building ownership in country. Adaptable. Not being locked in. Neat alignment between the efforts.
Carolyn: principles came from a series of workshops (open innovation, source, standards, etc.) DIAL started reviewing what has been done.
  • Follows the product life-cycle
    • Analyze plan
    • Design develop
    • Deploy 
    • M&E
  • How doe you feel about removing the ‘mandate’ of creating open source? Being more context specific… may not always make sense.
Sharon: 
  • Just because our code isn’t there doesn’t mean it is accessible
  • Open source design methodologies
  • Financials are open 
Marc: Widely available, cheaper, better?
  • Sharon: see it as a way to achieve scale and reach. Lowers barriers to adoption of our toolkit. Hopefully spur innovation. However, doesn’t really materialize without a lot of effort of those who created the original code. We have contributed code back to ODK and ENKATO. End goal is a government to own and manage the tool long-term.
  • Dykke: Total Cost of Ownership is not cheaper than commercial counterparts. Money is either going back to license/developers versus into your own country building the capacity of your own team. Community is a ‘wonderful’ by-product.
  • Carolyn: the new standards is ‘softer’ on getting government buy-in.
  • Dykke: Oracle was an aggressive push to get in the door. No way governments could sustain the on-going support support and customization. PeopleSoft
  • Dykke: I came up around redhat, brought them to IntraHealth iRIS. Felt strongly about the uptake of open-source. Previously donors would push stuff and countries would take ‘anything’.  Maybe not single software but more modular so you could plug and play with different open source and commercial software.
IntraHealth/Dave Potenziani: usually has dreadful UI, developer has an itch and creates software. Why should our users have a less than delightful experience when they don’t have cash to pay for it.
Anne from Jembi: open standards. How to maintain it? What about a maturity model for open-source?
Scott Fitzpatrick DHIS 2: liability of the core developers? What about usage at your risk? Are d-tree or Oslo protected?
  • D-Tree; no liability if taken and deployed without support of Medic Mobile.
  • Dykke: reputation of vulnerable software, people will exit. Culpable enforcement depends on jurisdiction and bodies. Trying to address at the policy level.
Transparency is what is important. True costs of implementations. ‘Don’t have the knowledge to get into the details’. 
Dykke:  as you mature as a business (country) you decide what is ‘my’ core business. Is it IT or outsourcing?
Nils Kaiser (USAID Guinea) : coming up with sustainable solutions can be challenging for ministries when they don’t understand their own capacities. Budgeting is challenging too. Most of our devices are ‘closed’. Telecommunications is another component of ‘closed’. We need budgeting and financing aspects.


Day 2: Tuesday, December 5

Interoperability in the Health Information System: Managing data using enterprise-level architecture

Presenters included Amanda BenDor, PATH; Marcos Mzeru, ICT Officer MOHCDGEC, Tanzania, and Mary Rocheleau, Engineering Manager, Vecna Cares Charitable Trust

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Introduction: 

Michael Downey, Director of Community, Open Source Center, Digital Impact Alliance at United Nations Foundation

- open source is a "hedge" against maintainer burn-out; to survive organizational strategic shifts over time; single points of failure; to catalyze contribution

- http://osc.dial.community/


Carl Leitner on Financing Mechanisms:

- Deputy Director - Global Goods, Digital Square / PATH

- "let a thousand flowers bloom" -> problem for Uganda in 2014 leading to the moratorium

- "software monocultures" is also a problem -- open source tools that are used in many many places at scale

- OpenHIE solves both -- a blueprint for a way of talking and sharing

- Digital Square includes: 

 -- governance and advocacy

 -- aligned funding

 -- global good commons? (WHAT IS THAT?)

 -- community coordination

 -- GGMM = Global Good Maturity Model

    -- was developed with input from HDC Health Data Collaborative team

    -- 3-axis maturity model

    -- example google spreadsheet for self-assessment: http://bit.ly/2AvjV1z (self-assessment in Google sheets)

  --> NEXT STEP: we should test and give feedback on their self-assessment tool

 -- "Notice B" for 6 awards totaling $600,000 to help global goods proceed along the GGMM "for sustained development"

 -- How do we prioritize limited funding? Demographic data (impact/scale); GGMM; Digital Health Atlas; TCO of GGs


Tenly Snow on OpenLMIS:

Tenly Snow (Deactivated) do you want to add your script and slides?


Dave Potenziani about IntraHealth's new iHRIS Foundation

David Potenziani, Senior Informatics Advisor, IntraHealth International

- "we cannot do it alone and we should not try"

- context: global health worker crisis -- shortage of millions of health workers

- "if somebody gives you a kitten, it's great, BUT it is the gift that eats"


Q & A:

- Documentation: Dave/iHRIS: WE want to write the documentation first, then write the code after we have thought through it.

- Balance building new features versus investing in improving/evolving/sustaining existing platforms?

 -- Dave: code bounties and projects are often skewed towards the "new and shiny". BUT you have to realize one of the things that requires care and feeding are the people you have already won over. Taking care of those people is not the glamorous, shiny work. 

- Language Barriers? How to overcome? Tenly example of holding events in Senegal to bring in perspectives.

- Dreams for the Holidays: more creative ways to do collaborative funding; start to fund innovation even it might fail; more summer of code type programs; want a stronger workforce in countries to manage these tools.


Day 3: Wednesday, December 6

DHIS2 & OpenLMIS & OpenSRP: HMIS/LMIS Integration Demonstration

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