Determine whether any HIS in the rollout regions can benefit from sharing data with iHRIS. If so, establish a method and agreements for sharing data.
Health Information Exchanges: Concepts
It is likely that the health worker data managed in iHRIS is just a segment of the available data on health workers in the country. In many cases, multiple systems collect and manage data on the same health workers. It is also very common for iHRIS to be deployed by the Ministry of Health across multiple areas that wish to aggregate data to a national installation of iHRIS. For these reasons, iHRIS has built-in functionality to exchange data with other iHRIS applications and other HIS.
Several open source HIS may be in use other than iHRIS. The most frequently used systems are:
- DHIS2, a health information system that tracks service delivery and disease statistics.
- OpenMRS, a medical records system that stores and maintains patient data on clinical encounters.
- RapidSMS, a mobile clinical support system for community health workers.
All of these systems require information on health care providers and can benefit from sharing data. Because these systems were developed with standard open source formats, their data formats are compatible and can easily be shared.
Now may be a good time to link to these systems in order to share common data, such as facility lists and geographic data, and reduce duplication of effort. This is an important step for countries to compare data such as service delivery demand (from DHIS2) with health worker skills supply (from iHRIS), for example. The quickly emerging and most ideal model for a data exchange is to set up a health information exchange (HIE) where all HIS adopt the same standard for data exchange. The HIE model uses technologies to aggregate health worker, facility, or patient data across various systems into a single registry.
To facilitate sharing data among different open source systems in Rwanda, CapacityPlus developed a Health Worker Registry (HWR) based on the iHRIS platform. The HWR pulls data from regional health worker management systems (such as iHRIS Manage, FBOs, and private-sector systems) and regulatory bodies like nursing councils to provide a national picture of a country’s health workforce into a centralized database. The HWR contains a minimum dataset on all providers of healthcare services that can be shared to all systems that need them.
The HWR is part of the Open Health Information Exchange (OpenHIE), which gives health workers access to patient’s health records across the country. OpenHIE can also provide access to a central Patient Registry and a Facility Registry to systems that need the data.
The OpenHIE technologies are based on the Care Services Discovery (CSD) international standard. iHRIS is compliant with the CSD standard, and developers will find the code base very similar to iHRIS. With adequate Internet connectivity, multiple iHRIS installations or other systems that are CSD-compliant can use the OpenHIE Health Worker Registry to share data.