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• CHWs are often linked to working out of a centralized physical brick and mortar location where their management sits. This could be a district hospital, primary health facility, or other
• We often need to sync information with a facility based EMR to provide medical record continuity between the CHIS and facility based care

Assumptions

• Every system needs to have a full representation of a person or patient locally within their system.
• There's business logic that needs to be executed on both sides of an integration for each system. Each system is responsible for receiving the content, parsing it and storing it appropriately within the system.

Notes on Architecture:

• We need to consider the process of patient de-duplication in both systems.
  • We probably assume that the receiving system will handle this. In a point to point integration, we would need to return a response in the case there's a high likelihood that they are the same patient.
  • How much data do I want to store in my system about the patient's state in another system? ← This is a big question.
• Considerations:
  • Only sync what you know you need to sync.
    • You could send a bundle, which would be great for the sending system.
    • Being able to create a bundle is hugely important for the sending system. The receiving system will need to break down that bundle, loop through each item and then
• General points:
  • Sending side support
    • Needs to package a bundle
  • Receiving side support
    • Break down a bundle
    • Return a response of failed in the event there's a parsing error in the bundle
  • Most of our integration requests are for sending DHIS2 aggregate information
  • We need to determine if we want to send a standardized document or just particular transaction
    • We send the limited things that we know will be used by the receiving end.
• Big problems to solve:
  • What does the sending system care about in the case of duplicates in the receiving system?
  • What information do you want to store in the sending system to make it easier in the receiving system?
  • From a project perspective, who takes on the responsibility of implementing the requirements in the receiving system?
    • For OpenMRS there's a multiple stage process
    • For DHIS2 there's a two stage process

Point to Point FHIR Interoperability

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