Scenario (current or future) - value, people, what's painful, life different (ie. Mosa)
Use Cases or Data Exchanges - aggregate reporting from EMR to HMIS, case reporting from EMR to SHR, facility source to HMIS
Workflow - transactions/internactions
Mosa (HIV/PMTCT)
Mosa is a 19-year-old woman living in a small village in Rwanda. Mosa is pregnant, and like many in her village, she is HIV positive. She is registered at a local clinic providing Ministry of Health sponsored antenatal care (ANC). The clinic uses a local instance of an electronic medical record (EMR), referencing her national ID and syncing with her country-wide shared electronic health record (EHR) maintained in the Ministry’s database. The clinic’s EMR notes that she requires a hospital delivery using PMTCT (prevention of mother-to-child transmission) protocols. This information is updated to the national shared EHR.
Weeks into her pregnancy Mosa experiences minor bleeding or spotting. During a routine home visit, Mosa’s community health care worker (CHW), Grace, logs this information. Grace uses a basic mHealth application on her mobile phone to update Mosa’s EHR. Grace advises Mosa to go to the local clinic for a checkup. At the clinic Mosa is found to be anemic and referred to hospital for follow-up. The referral is flagged as urgent, and is updated to Mosa’s shared EHR.
Three days later when Mosa has not checked into the hospital, a mobile alert is sent to Grace to follow up with Mosa. Grace finds her at home with a severe fever. Grace arranges for Mosa’s transport to the hospital where they retrieve her medical history from the shared EHR. With this important information, they are able to provide appropriate care to Mosa and her unborn baby.
Case-Based Reporting
https://drive.google.com/open?id=1GQHBuKgZD6GRM6OzOzAq7fR7Lvj9WPVd
Immunization 1
The characters in the child immunization scenario are:
a village elder who uses an mHealth application (mHealth app) to record basic information about the birth of a new baby in the village the mum, who has just delivered a new baby during an at-home birth in her village the baby who will be issued an immunization card with a barcode ID sticker on it an immunization nurse who works at a rural clinic that tracks vaccinations using an “engineered” paper form that is preprinted with optical mark recognition (OMR) data capture areas an immunization nurse at an urban immunization clinic that is able to use the web-based online immunization registry application (GIIS) to track immunization events a District Immunization & Vaccination Officer, DIVO, who leverages a form scanning application (Form Scanner) and an online immunization registry application (GIIS) to track immunization events, vaccine inventory, and the supply chain transactions needed to ensure vaccine stocks are maintained at all the clinics in the district an MOH data analyst who uses a national health management information system (DHIS2) to track immunization programme metrics and indicators.
The immunization story progresses in 5 acts;
Part 1, a pregnant mum gives birth to her baby boy during an at-home delivery in her village. The next day, a designated elder (a village “officer”) in the woman’s village uses his mobile phone to send an SMS message to an MOH-supported application. The message records that a male child has been born in his village the previous night. The elder receives an ID code as an SMS reply and he writes down and gives this code to the child’s mum with a reminder that she needs to take the baby for its immunizations.
Part 2 of the story, the mum brings her 6-week old baby to the local rural immunization clinic. At the clinic, the mum is given the child’s immunization card. Specific demographic details (including the SMS code from the elder, if the mum has it) are captured for the mum and the child, and these are hand-written on a paper form. A barcode sticker is placed at the top of the immunization card indicating the child’s unique ID#. An identical sticker is placed on the paper form beside the baby’s demographic information. The child is weighed and given his 6-week vaccinations. These details are recorded on the paper form beside his barcode sticker and onto his immunization card, which his mum keeps.
Part 3 of the story takes place at the DIVO’s office. It is month-end, and the nurse from the rural clinic has brought the hand-entered forms and the filled-in scannable forms to the DIVO for data entry into the online immunization registry (GIIS). For each newborn baby, the information is hand-entered into GIIS. For babies who are already in the database, their immunization transactions are scanned from the filled-in “OMR” forms. [NOTE: Transactions entered into the immunization registry (GIIS) are batch-updated to the HIE (see endnote).] After the data entry and scanning is completed, the DIVO prints a new set of scannable forms for the nurse to take back to
Immunization 2
Interoperability; antenatal care, child immunization case-based malaria care
https://drive.google.com/file/d/1yx-4AokEBTTOkS6wvcMhKr9oyZ3fP6Iv/view?usp=sharing