Community Health Worker Community of Practice

Background

Health systems, as they are designed and set up today, exclude people from care. Half of the world’s population still cannot obtain basic health services. These gaps in health systems are bridged by millions of Community Health Workers (CHWs) worldwide, who provide basic doorstep care to communities as the trusted, first points of care, while also linking people to facilities. 

In the last two decades, digital health has emerged as an important opportunity to empower and support CHWs in their work across over 500 distinct deployments globally. Still, the absence of coordinated approaches to digital health has led to a highly fragmented landscape, without universally agreed upon digital health standards, principles and practices to guide the wider community in how to build interventions for scalability, sustainability and interoperability. Data and interoperability standards that do exist are used infrequently, and as a result, information sharing between tools and geographic locations or domains is difficult. There is also limited capacity to connect these tools for frontline health workers to digital systems supporting different levels of a health system, such as facility-based electronic medical records, and health management information systems. These and other challenges have collectively resulted in fragmentation and duplication of the digital health landscape. Together, we hope to seek solutions to these challenges.

Goals

Together, we hope to create robust, community-driven consensus on key digital standards and interoperability frameworks for Community Health Information Systems (CHISs).

We propose to begin the COP’s work by conducting a Delphi study to solicit insights and build consensus among a systematically selected pool of global experts. The Delphi method has been widely used in information systems and health research as a means of obtaining the most reliable possible consensus from a group of experts., A number of studies have shown that for questions requiring expert judgment, the average of individual responses is inferior to the averages produced by group decision processes such as the Delphi method.

Our consortium will then transition to an analysis of open standards that can be leveraged to deliver the workflows outlined in the profile. We will analyze HL7 FHIR as a baseline interoperability standard, IHE profiles such as the International Patient Summary (IPS) for standardized information exchange, terminology services such as ICD-11, OpenConceptLab and LOINC, Clinical Quality Language for logic execution, and best practices identified by the OpenHIE community and the World Health Organization Computable Guidelines working groups. This analysis will be added to the profile and set recommendations that can be balloted by the appropriate standards body.

Finally, we will develop a reference architecture for interoperability that accounts for the variability of CHISs deployed across the globe. This technical document will present an architecture that supports the content of the profile. Additionally, it will identify existing CHISs that support the identified workflows in the profile.