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The OpenHIE initiative grew out As a part of the RHEA project, where a Health Information Exchange has been a health information exchange (HIE) was designed and developed to support maternal health in Rwanda. More information about this project and the HIE implementation is available here . The Shared Health Record  was designed and developed for this project and has been implemented and is currently operational in one district of Rwanda.    This included a Shared Health Record (SHR) component, based on OpenMRS (http://openmrs.org/).  This is currently implemented and operational within a single district of Rwanda. You can find more information about this project here. 

As a part of the OpenHIE initiative that grew out of the RHEA project, our SHR Following the roll-out of the RHIE in Rwanda, our community was tasked with reviewing the existing SHR tool and evaluating the question: "what makes a good shared health record, including a review of the current tool, and to determine what technologies best suit an SHR for our purposesSHR that will meet the future aims of the OpenHIE initiative?".  The objective  was of the review was to provide a recommendation of whether we should use /or modify an existing technology or build something ourselves , with the ultimate aim of providing a generic SHR that is appropriate for use in low-resource settingsi.e. taking the  “adopt, adapt, develop” approach.  


The

evaluation 

evaluation process

The process and methodology we used to evaluate options for an interoperability layer the Shared Health Record were:

  1. Document use cases and requirements for a Interoperability LayerShared Health Record

    1. Initial discussions 

    2. SHR - Use Cases and Requirements

  2. Performance test the current OpenHIM OpenMRS SHR used in RHEA in order to ensure the OpenHIM is scalable to national levelthe RHIE 

    1. Performance evaluation of OpenMRSInteroperability Layer Performance Analysis
    2. Estimated load figure for a Rwandan national deployment

  3. Create a tool to evaluate how well the Interoperability Layer software meets evaluate Shared Health Record software that is closely linked to the requirements

    1. SHR

      Shared Health Record Evaluation Tool

  4. Compile a list of software that could be used as an interoperability layera Shared Health Record

    1.  Shared Health Record

      SHR

      - Tools for review

  5. Evaluate list software options using the evaluation tool

    1. SHR

      Shared Health Record Evaluation Tool

  6. Write up results of the evaluation and come to consensus on a recommended way forward i.e. whether to use or (ie. Use/modify an existing tool or build from scratch.  

    SHR

    )

    1. Shared Health Record options and recommendation   

The

final recommendation

recommendation

Following the evaluation, the OpenHIE SHR community decided that the best option for OpenHIE to move forward with would be to utilise the existing SHR using OpenMRS, with the addition of certain enhanced features. This was due to the fact that  OpenMRS is a widely adopted and supported EMR which has successfully been implemented in low-resource settings across the world. It was designed to be an edge node EMR but the clear separation of the data model and the interfaces, the powerful API and the usage of a modular approach to build extended functionality enable OpenMRS to function as a central shared health record repository.


 

 

 

 

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