2018 DHIS2 Symposium

Schedule

https://dhis2symposium2018.sched.com/

Day 1 (Thursday, March 22) 

Plenary presentations

From Container to Content: DHIS 2 as Canal to Foster Convergence, Completeness, Commensurability and Quality

Knut Staring

• More guidance on how to actually implement → essentially talking about the DHIS 2 Community of Practice (CoP)
• UiO department of informatics WHO collaborating centre: Innovation and implementation research for health information systems strengthening
• UiO/HISP/WHO → developing better standardized guidance on dashboards based on WHO recommendations
• Health data collaborative
• WHO/UiO/USAID MEval, PEPFAR, UNICEF + GFATM & Gavi

Packages 

• Guidance, packages, essentially an implementer’s guide
• Have chosen 6 countries for initial testing: Malawi, Myanmar, Pakistan, Tanzania, Uganda, Zimbabwe
• Packages - Working at WHO HQ Geneva and UiO to come up with the outputs, the minimums that all countries should pay attention to. Trends = immunization, an important indicator is coverage.
• Curriculum - system agnostic, can be used with any system.
• Exercises - use with the DHIS2 demo database, building a new environment
• A package to “get started” with dashboards and all basic indicators/information a country may need
• Packages are designed to be generic. Can fit with existing data. Can download just the outputs (dashboards) and link to your own existing legacy data, or you can download the data elements, categories, etc., to fully guide an implementation. Use generic periods, org units, etc.

Thinking is changing at UiO - they now want to provide guidance for streamlining and standardizing the collection and use of data using DHIS2

International Medical Corps asked a question about logistics systems specifically 

Knut on LMIS - a very specialized topic and there are excellent systems out there. Generally we’re talking about integration. The strength that DHIS2 has is that it’s present at the health facility level. For the last mile of data collection, sometimes DHIS2 could potentially serve as an intelligence point that feeds back data on usage. Then, could have more sophisticated backbone systems that manage the actual supply chain. Could have more than one system at the last mile, but needs to appear as one system. 

Follow up question from IMC: Do you recommend any sort of open source software that can be adopted into pharmacies and link consumption with patient information. OpenMRS?

Knut says that he didn’t emphasize the word community enough (!)

DHIS 2 Interoperability in the Rwanda Health Data Warehouse

Randy Wilson  

Rwanda Health Systems Strengthening Project, Team Lead

MSH

• Data is fed into the DHIS 2 instance at the central level, which is used as a data warehouse. Reports and indicators are then generated based on data from a variety of sources. Data comes from the Rwanda HMIS (DHIS 2) instance, the DHS, and others, and visualized in the data warehouse instance.
• Made a replica of the first instance of RHMIS (DHIS 2), developed a set of sync tools for the metadata.

Structure

• Org units
• Data elements
• Data values
• Created indicators
• Created analytical objects and dashboards

Metadata mapping scenarios

• One to one
• Many to one
• Created data element groups and IDs
• Problem to maintain, but he says it works

Challenges

• Org. unit sync → moving between upgrades, sync breaks
• Metadata mapping
• Linking data elements between instances without a visual interface is tedious and error prone
• Current sync script doesn’t update changed/deleted records

Future plans

• Update sync scripts to handle updates and deletions in addition to just copying new records each month
• Link to WO’s National health Observatory
• Build a GUI for mapping metadata from other DHIS 2 instances

Link with eLMIS

• 80 tracer drugs are pulled from the Rwanda eLMIS instance
• Collected by data managers and collected monthly, but now they use an API to pull that data directly from the eLMIS instance

Questions

• Attempting to build a data warehouse community in Uganda
• What did you need to say to people to convince them that this is a good idea?
  • Marketing wasn’t difficult, people knew it could be useful.
  • The issue comes afterward in its use - we’ll give you data but don’t let this person see it.
  • Open global data index - Rwanda scores high. MOH scores low.  

Breakout Sessions

Streamlining Data Use between Programs and Systems

Tamara Goldschmidt - Bluesquare

• Building a dashboard in Benin - mentioned the words “Global Good”
• Integrating different sources in DHIS2, including private sector service provision data, health facility assessments, quality of care, etc.
• Then enriching that data with population and demographic data - big data sources.
• Using DHIS2 as a facility registry
• Humanitarian data exchange (HDX) - a way to house data if you’re afraid that you’re going to lose it because a project will no longer be funded, etc.

Tracker 2.0 Roadmap

Mike Frost UiO

• Talked about last mile logistics - the “holy grail” of health data, being able to match your logistics and health data to see both who is being immunized (example) and how much product has been used/available/etc.
• Jira.dhis2.org
• Relatively new to use Jira to track DHIS2 development. Keep track of the roadmap for tracker.
• Able to expand/comment/give feedback on things that DHIS2 is working on. Clear view of what’s coming in next releases.
• Useful to capture data at the lowest level (SDP) and feed that into an LMIS
• Same with EMR - integrate with OpenSRP
• Could add to a patient record that they track over time
• Aiming specifically at the CHW/SDP level. Modular basis, focus on MCH, then could add in a vx or pediatric component, etc. Could eventually approximate an EMR. Many settings aren’t ready for a full fledged EMR/LMIS/etc. UiO’s position is that Tracker positions itself to gather the data that they’re ready to capture.
• Main message: DHIS2 is not trying to take the place of other purpose-built systems (EMR, LMIS), but Tracker can be used to approximate or provide some of that functionality as an interim solution as supply chains mature. 

Questions

Richard Stanley - Intrahealth

• Where do you see interoperability in a year from now? Where does this stand in terms of standards? FHIR? As a project implementer we have interoperability obligations
  • DHIS 2 is actively looking at FHIR - responsible to look at standards
  • Has been on some working groups (which ones? → follow up with Mike)
  • IHE group - profiles http://www.ihe.net/
  • Clinical health data community

IMC

• Connectivity/power connection/challenges to SDP level data collection. Offline capable? Sync?
  • Offline capability approach is through Android. There are existing Android apps for DHIS2. Existing instance in Bangladesh. Decides which data to sync (doesn’t have to be all data, can be configured). Can store locally on the device.

HISP SA

• Cost of SMS can be prohibitive. Exploring other ways to message? Whatsapp?
  • In-app notifications.

The future of the health Network Quality Improvement System (HNQIS)

PSI

Daniel Messer | CIO

Wycliffe Waweru | Evidence Team

Rodolfo Melia | PSI Information Architect

Day 2 (Friday, March 23)

DHIS2 New Generation Mobile App

Rodolfo Melia

DHIS2 Android today

• Data Capture
• Event Capture
• Tracker Capture
• One app per data model
• Available since 2015.
• 100s of deployments live, with 1000s of users
• Supported for last 3 versions of DHIS 2
• New documentation on the website

How did they decide what to do/build next?

• Took a public survey
• 35% responses came from MOH
• 35% came from iNGOs
• 15% academic institutions

Results

• 100% of respondents are using DHIS2 for health
• Most users are using Tracker Capture 69%
• 22% have custom apps
• Types of tracked entities were primarily people 85%
• Others were lab samples, processes, water points, etc.
• Interesting that no one mentioned products ie. LMIS

Future state

• A single capture app
• Highly visual
• No distinction with DHIS2 data model

Android SDK

• Responsible to provide offline services
• Sychronized metatdata and data with a dhis2 instance
• Security

Performance

• New API endpoints on the DHIS side
• Stress testing - what kind of memory is needed
• Using apache kafka instead of having to download all data every time, you will only need to download the single, or few, changes that were made to the metadata
• Long term: microservices
• Re-architect the backend of DHIS toward microservices.