Interoperability assumes paramount importance in the ever-evolving and ever-expanding digital health ecosystem; users adopt systems tailored to their specific needs. For example, data collected in a resource-limited setting may resemble data collected in a well-resourced environment, yet the employed systems can differ substantially. Therefore, there exists no one-size-fits-all approach capable of accommodating the vastly different requirements across systems, contexts, and cultures.
The Community Health Toolkit (CHT) has achieved Fast Healthcare Interoperability Resources (FHIR) compliance to facilitate seamless data exchange with other systems through a middleware, serving as the health information exchange layer. This interoperability layer empowers the CHT to transmit data in a standardized format and receive standardized data in return.
Projects with specific needs can utilize this capability to route data from the CHT to other external systems within a systems integration setup involving one or multiple systems.
The reference application proves invaluable in scenarios where updating patient/client registries, data aggregation systems like DHIS 2, or patient-centric records such as the Shared Health Record (SHR) are required.
Ministry of Health Kenya has successfully utilized a portion of this work related to the reference application to facilitate data exchange between eCHIS and a shared health record. All data now flows through Open Health Information Mediator (OpenHIM), effectively realizing the desired impact at a national level as a new electronic community health information system (eCHIS) is rolled out across all 47 counties. Moreover, the entire workflow has been utilized in pilot health facilities where MoH Kenya deployed their electronic medical records system AfyaKE.
Earlier this year, we published a three-part blog series emphasizing the significance of interoperability within the digital health ecosystem. We detailed Medic’s journey to establish an interoperability layer in the CHT, leveraging OpenHIM, Open Health Information Exchange (OpenHIE), and FHIR. We delved deeper into the framework we utilized, and the final blog post discussed our proof of concept: a Loss to Follow-up Workflow (LTFU), which constitutes a vital component of the complete referral workflow.
- Revolutionizing Healthcare Coordination: Unlocking the Power of Interoperability
- Interoperability in Digital Healthcare
- Developing Interoperable, Scalable, and Sustainable Health Information Systems with OpenHIE and FHIR
There remains a necessity to enact a standards-based approach for scalable solutions at a lower cost. As Njuguna Ndung’u eloquently articulated, “…By enabling different health systems and applications to communicate with each other, interoperability can enhance care coordination, reduce medical errors, and enhance the efficiency of healthcare delivery.”
This underpins our work related to the reference application. Our overarching objective is to maximize impact and enhance scalability, a shared goal within the Technical Working Group, including Community Health Impact Coalition (CHIC), Dimagi, Ona, ADP, and Medic.
To this effect, Medic has partnered with other players in the digital health ecosystem seeking impact of our work. Earlier this year, Medic participated in the OpenHIE conference in Malawi, where we showcased the LTFU proof of concept.
During Q1 and early Q2 of 2023, Medic engaged in various hackathon initiatives in Machakos, Kenya, in collaboration with Ministry of Health Kenya and other technical partners. The primary aim was to establish an interoperability layer for eCHIS Kenya, powered by the CHT.
Plans are underway to expand the scope of interoperability to encompass electronic medical records at the facility level, including OpenMRS, and to incorporate additional FHIR resources into the reference application. This expansion will make it easier for community health workers to share data with facility-based systems and other data aggregation systems, thereby enhancing their efficiency.