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This use case allows other systems to make requests to a CHIS to follow-up for any reason. A common implementation might be for Lost to Follow-Up whereby a clinic generates a list of patients that have missed appointments and wants community based systems to help find the patient and encourage them to attend their appointment or to understand why they cannot or will not. This might be achieved either by having a health worker physically go find the patient or by other communication protocols (SMS, for example).
See here for a list of interoperability workflows that add value to community health organizations. See here for a list of real world use cases that many of the CHIS' have already implemented.
Definitions
- 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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| Description | Structure Definition | Samples |
|---|---|---|
| Patient | Patient.StructureDefinition.json | patient_cht.fhir.json |
| ServiceRequest | ServiceRequest.StructureDefinition.json | service_request.fhir.json |
| Encounter | Encounter.StructureDefinition.json | encounter_cht.fhir.json |
The Technical Working Group has also put together a high level list of FHIR resources that are important for interoperability. That list is being maintained here.
Reference Architecture
The proof of concept uses the Instant OpenHIE architecture interacting with multiple CHIS (CommCare, OpenSRP, and CHT).
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Detailed technical information about this infrastructure, including servers set up on the CoPs shared infrastructure, can be found here. A review of some higher level architecture considerations can be found here. A review of technical interoperability modifications to existing CHIS can be found here.
Known Limitations
This proof of concept use case was explored to learn about a number of things: OpenHIE tooling, what modifications might be required to CHIS', gain experience with FHIR, gain experience with Instant OpenHIE, etc... with that in mind, there are known limitations.
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