iHRIS Blog: Dispatches from the Global Team

Countries Save $177 Million with iHRIS

We know that iHRIS helps save lives by allowing countries to place health workers where and when they are most needed. But it also saves money. A lot of money.

Annually iHRIS gives the 19 nations that use its open source software the opportunity to save $177 million. Without iHRIS, that money would be spent on licensing fees alone.

That’s money that iHRIS nations can reinvest in their people, systems, and infrastructure to improve the health and lives of their citizens.

iHRIS Country Map

The Real Value of iHRIS

That $177 million figure, impressive as it is, is not the whole story. The real-dollar value of iHRIS extends beyond licensing fees.

Consider the other benefits that accrue to nations that implement iHRIS systems:

  • Free customization, support, and ongoing updates of the software
  • Optional modules and systems to expand iHRIS functionality
  • A global community of developers constantly working to improve and expand the software

 

All these benefits spell additional savings. The updates and support volunteered by the iHRIS community would cost nations more than US $30 million or more each year if they were using proprietary software.

Now consider the benefits that are hard to put a price tag on, but that have clear value in human terms:

  • Local empowerment: countries take control of the development and direction of their health information management.
  • Global partnership: a community of developers, implementers, and users support one another to make iHRIS better.
  • Development of local skills: iHRIS implementers encourage local solutions to national needs.

 

These additional benefits put the real value of iHRIS far beyond the $177 million figure. Ultimately, the value of iHRIS does not rest on the fact that iHRIS is free of charge, but on the fact that iHRIS results in a better product with plenty of support. To do what iHRIS can do “right out of the box,” proprietary systems often need costly customizations. iHRIS’s adaptability to local needs alongside its zero-dollar price tag is why more and more nations are coming on board.

Every Voice Adds Value

Because iHRIS is built on the principles of sharing and learning from one another, everyone in the community is valued, and everyone adds value. While saving money is a great reason to choose iHRIS, open source offers much more than dollar value.

Ricardo Lopez, iHRIS technical advisor, spoke to us recently about what iHRIS means to him and to his nation of Guatemala. Here is an excerpt from that interview:

What is the value of iHRIS and its open source software to you and to your country?

Guatemala doesn’t have that much money to buy expensive proprietary software. So iHRIS is a big opportunity to have a great product without having to pay an outside group expensive licenses.

What does it mean to you to do this kind of work?

Every day in the news I see that people don’t have good health because the area where they live doesn’t have medicine. They don’t have a doctor. They don’t have a nurse. They have big problems with nutrition. I want my country to have a good health service, to know where we need doctors, nurses, and other health-related resources. For me personally, it’s very important to help, to improve how information is managed. The rural areas especially need help to manage their data.

What is it about working with open source and the iHRIS community that you especially value?

Working in an open source community gives me the chance to work with people who make incredible contributions in programming. I do this kind of work because of the open source ideology. Everybody can use the code. The community can share all the knowledge.

With proprietary systems, it’s very difficult to access information, to access new developments. Everything costs a lot of money — the courses, the licenses, the tools. Everything has a cost. With open source, you obtain a good software at no cost. I prefer open source software because I think it’s the fairest approach.

Versatility Equals Ever-Expanding Value

To put the final decimal point in place, factor in the versatility of iHRIS. iHRIS open source software can easily be adapted to broaden its functionality, and its value, in response to a need.

Take Tanzania as an example. iHRIS implementer Juma Lungo is adapting iHRIS to track all the assets of his Computer Science Department at the University of Dar es Salaam, assets such as furniture, computers and supplies.

iHRIS implementer Bakari Bakari, also in Tanzania, is customizing iHRIS to track all public employees, extending use of the system beyond health workers. This expansion of iHRIS in Tanzania increases the value of iHRIS from $177 million to more than $200 million annually.

As iHRIS Community Manager Michael Drane puts it: “This is why iHRIS is such an asset for the nations that implement it. It’s always inherently of greater value, because at any given moment it can be adapted to suit additional needs.”

iHRIS isn’t just software that saves nations money. iHRIS helps train a workforce of empowered and creative individuals working together to improve lives, resulting in an end product tailored to each nation’s different needs.

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VSO, THET and Ministry of Health Push iHRIS Forward in Malawi

If you’re not convinced that open source is right for global health and development then talk with Herman Fung. Herman,  a VSO volunteer who spent nearly two years in Malawi working at the Ministry of Health on a health systems strengthening project funded by Tropical Health and Education Trust (THET) is a strong proponent of iHRIS and open source software. At the request of the Ministry of Health, Herman and five other volunteers implemented iHRIS Manage because it was free and open source. Herman was an active community member, taking advantage of the community’s collaboration tools to implement the software at a fraction of the cost proprietary systems require. We are particularly proud of the team in Malawi. Herman and his team demonstrate that it does not require direct financial or project management support by CapacityPlus to implement and use iHRIS for managing a country’s health workforce. The iHRIS Community and it’s free online resources are sufficient support to implement and maintain the software.

Herman describes the scope and success of iHRIS in Malawi in his blog post  A to Z: I is for iHRIS.  This is a must read for anyone who wants to understand the power of open source and the cascading impact it can have in global health. Thank you Herman and the iHRIS MoH Malawi team!

Below is just one example of  iHRIS in Malawi empowers its users to turn data into information.

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International Standards Adopted in Zimbabwe for National Health Worker Registry

These programmers see the light, embrace international standards for the Zimbabwe Ministry of Health and Child Care’s new national health worker registry.

HiTracZimbabwe

The registry is a database that will pull together a basic set of data on health workers from various information systems in the country.

Once the data are available, health leaders can use them to make all kinds of decisions that can improve the health of Zimbabweans—from influencing health workforce policy to improving the delivery of clinical services.

But first, the computer programmers in this photo had to figure out how to make the different systems “talk” to the registry, or share agreed-upon information.

That’s why IntraHealth joined Zimbabwe’s Health Informatics Training and Research Advancement Center (HITRAC) and Jembi Health Systems to hold a one-week “OpenHIE coding academy.” All three organizations are members of OpenHIE, an open source community that helps countries strengthen their health information and developed the model registry on which Zimbabwe’s is based.

Most of the programmers work for HITRAC, which is leading the work that’s funded by the Health Information Public-Private Partnership.

During the week, the programmers created a plan for integrating information from the ministry’s health workforce information system and other information systems in the country, like those managed by the health professional councils, TrainSMART (which tracks in-service training for health workers), and DHIS2 (which tracks service delivery info and disease statistics).

The plan ensures that the registry is compatible with the international Care Services Discovery standard, a defined way to exchange data that makes it easier to access and merge health workforce data from various sources, and that data-sharing is secure.

IntraHealth’s Carl Leitner co-authored the Care Services Discovery standard and facilitated the academy (he’s sixth from the right in the photo above). He explains why all this matters:

“If countries follow international standards, they open themselves up to innovative health workforce information tools developed by other countries that follow the same standard,” Leitner says. “What is really exciting is we have opened up the possibilities for the ‘appification’ of health workforce and health services data. In other words, we are creating a market opportunity for country and regional software developers to make use of health service data in their own apps.

The model health worker registry is based on IntraHealth’s iHRIS and OpenInfoMan software platforms developed under the IntraHealth-led and USAID-funded CapacityPlus project. Other current implementations include Nigeria and Rwanda.

By Carol Bales and Dr. Carl Leitner

Read more about the coding academy.

Read more about why data standards are important.

Photo courtesy of Carl Leitner.

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OpenHIE- Bridging information systems and mobile applications with common standards

What is OpenHIE (Health Information Exchange)? And what does it mean to the iHRIS community?

OpenHIE is a framework that allows for sharing information across different health information systems. For iHRIS users, it’s an opportunity to contribute to and access a much bigger picture of their nation’s eHealth landscape.  One of the major components of OpenHIE is a national health workforce registry. A Health Worker Registry (HWR) serves as the central authority for maintaining the unique identities of health workers within a country. The registry not only provides a big-picture view of the country’s health workforce, but also enables numerous uses cases for analysis, validation, and interoperability within the larger health information system, eHealth architecture, or health information exchange. It harmonizes data gathered from various sources that categorize and store information differently from one another, resulting in higher-quality data. This improved data quality supports more refined analysis of the health system for quality measurement, reporting, and research, with the aim of improving health outcomes.

OpenHIE and the HWR represent a natural progression along  the continuum that iHRIS has followed since its inception. Ten years ago, iHRIS began helping countries move from paper to electronic record keeping. Now that the data are captured electronically, the iHRIS community has been focusing on learning how to use that data most effectively. Part of that process entailed classifying and categorizing the data, essentially creating electronic  lists to help analyze the information.

“We’ve created a set of technical tools for iHRIS users,” said Carl Leitner. “Now we need to build a culture of using those tools. Typically we’ve been working within one organization. But now the question is, ‘How do we work across multiple organizations?’”

Complex questions about governance and policies arise when you work across organizations, as well as fears about ownership of data. “How can we best mitigate some of the issues and fears that people have about sharing data?” said Leitner. “How do we open up people’s perception so that they see it’s beneficial to share this data? What solutions have people found to overcome some of these innate fears that people have?”

Nigeria provides a good precedent for how a nation can go about this. Nigeria spent two years developing a minimum data set of health worker information, agreed upon by the federal Ministry of Health, as well as by the other national stakeholders and states. “Everybody got together and developed this minimum data set. One we had that, all we had to do was adapt the health worker registry to make sure that those minimum data set fields were captured.” According to Leitner, the technical aspects of it are relatively small. The trick is getting the consensus; for example, getting everyone to agree on the definition of the term “facility.”

“OpenHIE is the meeting point for different health information system components to agree on standards so that all those systems can talk together.” It can substantially reduce the complexity of data exchange. By taking part in it, iHRIS stands to further realize its mission of national ownership of information. A great place of iHRIS community members to take part is by joining the OpenHIE HWR Community.

“I think we’ve gotten to the point where all of this work we’ve done — getting health worker data from paper into electronic form, cleaning it up, thinking about what  the data standardized lists are — we’re getting to a point where it’s going to start to have some really large impacts on the health system.”

As Nigeria continues its work with OpenHIE, other nations are coming online as well. Zimbabwe, Kenya,  Botswana, and Rwanda are preparing deployments, and other nations will likely come on board soon.

The sky is the limit when it comes to the opportunities that are presented to countries when common standards connect information systems together.

 

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Special Event Showcases the iHRIS Software for Strengthening the Health Workforce

On May 6, CapacityPlus hosted its third knowledge-sharing and dissemination event, Better Data, Stronger Health Workforce: The Open Source iHRIS Approach. Held at the National Press Club in Washington, DC, the event showcased iHRIS, the leading open source software for tracking and managing data on the health workforce.

Through a combination of presentations by USAID and CapacityPlus, interactive roundtable discussions, software demonstrations, and a moderated question-and-answer session, participants experienced each of the five iHRIS applications (ManageTrainQualifyPlanRetain), learned about success stories resulting from countries using iHRIS, and discussed the power of open source approaches for maximizing local ownership, capacity-building, innovation, and partnership. The event featured interactive knowledge café discussions to provide participants with a deeper understanding of iHRIS. Participants also had the opportunity to visit different tables to delve even deeper into features and advantages of each iHRIS software application.

Watch videos and access presentations from the event:

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New Technical Brief on Using Data Standards in Health Workforce Information Systems

CapacityPlus has published a new technical brief, Establishing and Using Data Standards in Health Workforce Information Systems, co-authored by iHRIS team members Dykki Settle, Michael Webba Lwetabe, Amanda Puckett, and Carl Leitner.

Human resources information systems are successful when they support policy and management decisions and when those decisions lead to better health care. However, success depends on the quality of the human resources for health data going into the system. The aim of this technical brief is to convey why data standards matter. The authors review organizational, national, and international data standards that can help ensure data quality, provide country examples, and discuss the key role of multisectoral stakeholder leadership groups in formulating and reaching consensus on standards.

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Serious Fun: Health Workforce Planning and Management in Botswana

Health workforce management and planning is serious business, but it can be fun too! Health decisions-makers at the Botswana Ministry of Health recently cut loose during their annual Back-to-School Day. CapacityPlus’s Twaha Kabocho [from the iHRIS team] was in the country and captured the photo below. 

Botswana Ministry of Health employees dressed as students for Back-to-School Day

Twaha visited the Ministry for several weeks to teach HR managers and data clerks how to use the open source iHRIS software. The Ministry is using iHRIS ManageiHRIS Qualify, and iHRIS Train to track in-service and preservice training of health workers who provide HIV care and services, as well as to inform overall health workforce policy and planning.

He also built capacity for the Ministry’s IT staff to support and update the software. Here are three IT technicians that now keep iHRIS humming.

IT technicians from the IT department at the MoH

This story was originally posted on the CapacityPlus blog.

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Christian Health Association of Ghana Chooses iHRIS

The Christian Health Association of Ghana (CHAG) has begun using the iHRIS software to improve management and support of over 13,500 health workers posted in its health facilities across the country.

With 184 facilities primarily located in hard-to-reach locations—where half the population of Ghana lives—CHAG is a significant provider of health care in the country. According to Samuel Nugblega, CHAG’s technical adviser on leadership, governance, and human resources, CHAG provides 20% of all out-patient and 35% of all in-patient care. Nugblega and his colleagues believe that using health workforce data from iHRIS will improve CHAG’s human resources planning and facility management, as well as boost the quality of service delivery.

Read more about CHAG’s adoption of the iHRIS software on the CapacityPlus blog. Reverend Stephen Kwaku Fokuoh, a CHAG facility director, participated in one of the iHRIS workshops in Ghana and describes his experience in the latest video in the CapacityPlus series, “I’m a Health Worker.”

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Event: Better Data, Stronger Health Workforce: The Open Source iHRIS Approach

To ensure that the right health workers are in the right places with the right skills to deliver high-quality family planning, HIV/AIDS, and other essential health services, countries require current, accurate data on human resources for health. Join CapacityPlus and USAID for a knowledge-sharing and dissemination event on iHRIS—the leading open source software for national health workforce information systems. Participants will experience the iHRIS applications (ManageTrainQualifyPlan,Retain), learn about country success stories, and consider the power of open source approaches for maximizing local ownership, capacity-building, innovation, and partnership.

CapacityPlus is hosting this knowledge-sharing and dissemination event on Tuesday, May 6, 2014, from 12:00–4:30 p.m. at the National Press Club, Holeman Lounge, 529 14th Street NW, 13th Floor, Washington, DC. Lunch is included. RSVP.

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First eLearning Course for iHRIS Users Now Available

iHRIS User – Level 1 eLearning Course is now available via the eLearning program hosted by CapacityPlus’s HRH Global Resource Center. The course is free and requires only that you register with the Global Resource Center.

The iHRIS User – Level 1 eLearning Course provides instructions on how to set up and manage human resources data in the iHRIS Manage database. Information on managing employee and job applicant data, as well as training data, is included. Each module is designed to be used separately, as an online help guide, to teach HR staff and hiring managers how to use the software. Specific modules of this course can be targeted to different staff depending on what they want to do with iHRIS. The modules use audio as well as visual teaching aids to reduce any potential barriers to learning to use iHRIS. Currently, the course is available only in an English-language version.

The User eLearning course was developed as preparation for the deployment of iHRIS Manage in Botswana at the district and facility level.  As new HR staff and other users of iHRIS come into a facility, the eLearning course provides an easy way to offer training without having to sending a trainer out to the facility.  It is also been designed to be a reference guide so that users have an easy way to remind themselves on how to perform a certain process.

The course is largely based on the standard iHRIS Manage user’s manual. It was developed using the open source learning platform Moodle so that it can be easily exported and modified for use in different countries. For example, a module teaching specific customizations for that country can easily be created and added to the full course.

Visit the GRC eLearning page to sign up for the iHRIS Users course!

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