In the last two decades, digital health has emerged as an important opportunity to empower and support Community Health Workers (CHWs) in their work across over 500 distinct deployments globally. Still, the absence of coordinated approaches to digital health has led to a highly fragmented landscape, without universally agreed upon digital health standards, principles and practices to guide the wider community in how to build interventions for scalability, sustainability and interoperability. Data and interoperability standards that do exist are infrequently used, and as a result, information sharing between tools and geographic locations or domains is difficult. There is also limited capacity to connect these tools for frontline health workers to digital systems supporting different levels of a health system, such as facility-based electronic medical records, and health management information systems. These and other challenges have collectively resulted in fragmentation and duplication of the digital health landscape. Together, we hope to seek solutions to these challenges.
We hope to create robust, community-driven consensus on key digital standards and interoperability frameworks for Community Health Information Systems (CHISs). We propose to begin the COP’s work by conducting a Delphi study to solicit insights and build consensus among a systematically selected pool of global experts. Our consortium will then transition to an analysis of open standards that can be leveraged to deliver the workflows outlined in the profile. We will analyze HL7 FHIR as a baseline interoperability standard, IHE profiles such as the International Patient Summary (IPS) for standardized information exchange, terminology services such as ICD-11, OpenConceptLab and LOINC, Clinical Quality Language for logic execution, and best practices identified by the OpenHIE community and the World Health Organization Computable Guidelines working groups. This analysis will be added to the profile and set recommendations that can be balloted by the appropriate standards body. Finally, we will develop a reference architecture for interoperability that accounts for the variability of CHISs deployed across the globe.