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Brandon Bowersox-Johnson, Elias Muluneh and Craig Appl (Unlicensed) attended the OpenHIE Community Meeting and Connect-a-thon in Arusha Tanzania 31 July - 4 Aug 2018. This page documents the activities and outcomes of the meeting.

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Day 2: Country-Driven Success

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Day 3: Innovations breaking new ground in information exchange

  • Brandon went on a site visit to Usa River Health Center, primarily to see the TImR Android app used for EPI (vaccination) patient records and stock management. TImR is part of the BID initiative and submits monthly orders to VIMS (a version of OpenLMIS). For other programs besides EPI, paper records are used at the pharmacy and store room, but an accountant enters quarterly reports into eLMIS (on the one desktop computer there). Brandon has extensive notes and a few photos. Key issues: (1) There is heavy data burden because a paper immunization register is used in parallel with TImR (paper registry has been eliminated only at 55 sites so far); (2) The paper systems require about 4 paper register entries for each child immunized (because of a tally sheet, a monthly EPI report, and another monthly report, and a child card given to the mother) so there is lots of manual data entry and significant paper and Excel data that still go to the district for data entry by a HMIS focal person; (3) There is no electronic system for transactional stock management anywhere besides EPI; (4) There is no electronic health record or EMR for any other programs besides EPI (although the GoTHoMIS "unified solution" promises to offer a local patient health record); (5) Significant work remains to strengthen the culture of data use by facility staff.
  • On Day 4, Brandon went on a site visit to Shree Hindu Union Charitable Hospital, a private hospital that provides free immunizations and uses TImR Android app (which submits orders to VIMS). Similar issues emerged as in the site visit from the Day 3 visit above. Brandon has extensive notes and some photos.
  • "Unconference" Open Session - Indicator Reporting and Analysis - Elias and Craig attended
  • "Unconference" Open Session - Global Open Facility Registry (GOFR) - Elias attended
  • Interoperability and Standards: OpenHIE on FHIR - Craig and Brandon attended; Carl has helpful slides and promises to put together more training materials on FHIR
  • "Unconference" Open Session - How to assess and continuously improve maturity of health information systems for achieving better health outcomes - Brandon attended

Connect-A-Thon Day 4 and 5

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  • Connect-A-Thon Notes (generic notes for all attendees/topics)
  • Documentation of the OpenLMIS-OpenHIE interoperability:
  • Discussed key areas of alignment:
    • Facility Master List - we have a working prototype, draft specs, and a pattern
    • Product Master List / Product Registry - we have a possible design for how OpenLMIS data could be aggregated and flow into DHIS2, using a FHIR Indicator Service and CQL for aggregation (developed with Carl Leitner) 

      • We discussed specific challenges: 
    • An understanding of FHIR Measure and Measure Report FHIR Indicators (and HEARTH already has the resource available)
    • Path forward on defining alternative location hierarchies within the same health system using FHIR (Luke Duncan is going to publish a paper with ITI)
    • Better understanding of the Tanzania Health Information Exchange with a demo environment of OpenInfoMan, OpenHIM and Global Open Facility Registry Tool on Elias Muluneh machine
    • Elias Muluneh has a prototype of running HEARTH within OpenLMIS as a microservice so we can capitalize on the FHIR structure that is available with the tool. This is connected to OpenLMIS using a lightweight node.js app that he wrote to translate each location into a FHIR resource. This potentially unlocks a number of new features that will ease the burden of integration with an HIE in the future.

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