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- Requesting System: Any system that wants a community based health worker to find and follow-up with a patient. The requesting system will often be an EMR like OpenMRS
- CHIS: A Community Health Information System is an information system that supports the routine and emergency health care of a patient population within community contexts in defined geographic areas.
- CHW: Community Health Workers are the central users of CHIS. CHWs conduct household visits and are responsible for the health of their community.
- SHR: Shared Health Record is a centralized data repository for storing patient’s shared health record.
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Flows
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Workflow Overview
From a very high level perspective, the workflow is designed around having the Requesting System determine which patients need to be followed-up with and a CHW trying to find the patient and recording the outcome of their attempt(s).
- Requesting System → Determine patients needing follow-up
- Requesting System → Send list of patients
- CHIS → Notify
- CHW→ Find patient and record outcome
- CHW→ Sync results
- CHIS→ Update with outcome of follow-up
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Data Flow
The flow is centered around the use of the FHIR "ServiceRequest" resource . to initiate follow-ups in the community.
- Requesting system determines which patients need follow-up
- Requesting system creates a ServiceRequest for each patient and sends the ServiceRequest to HIE
- CHIS queries the HIE to determine if there are any patients to follow-up with
- Requesting system returns results of CHIS' query
- CHIS determines where or not to claim the service request
- CHIS "claims" the ServiceRequest to confirm that they will be following up with the patient
- CHIS tasks the appropriate CHW with finding and advising the patient
- CHIS records the results of the CHW's efforts
- CHIS updates the ServiceRequest
- Requesting system receives update
- Requesting system updates itself accordingly
Draft Indicators
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- Count of ServiceRequests Created
- Count of ServiceRequests ClaimedCount of ServiceRequests Completed
- Count of ServiceRequests Completed with Outcome of X
- Count of ServiceRequests Completed with Outcome of Y
- Average Time from Created to Claimed
- Average Time from Claimed to Completed
- Average Time from Created to Completed
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The proof of concept uses the Instant OpenHIE architecture interacting with multiple CHIS (CommCare, OpenSRP, and CHT).
The current setup includes the following components.
- OpenHIM Admin Console
- OpenHIM
- HAPI FHIR
- CHIS
Detailed technical information about this infrastructure, including servers set up on which utilizes a HAPI FHIR Server as a Shared Health Record component and OpenHIM for the Interoperability Layer. Detailed technical information and instructions for the CoPs shared infrastructure, can be found here.
Data Flow Diagram (CHIS Processing Only)
The diagram below illustrates the dataflow between the SHR / FHIR Server and CHISs.
