Etherpad Link: https://notes.ohie.org/2018-08-01_Unconference_Faru_1230

• What do we hope to get out of this meeting?

• Understanding the different approaches

• Some people only really seen the patient care side

• Some only seen the governmental health side

• What tools can we use to make this happen and be more valuable?

• What do we mean by value-based HIE?

• Improve patient care

• Allergies for example, can be very real-time sensitive

• BID project example, for immunization

• Practitioners needs full (relevant) patient information to provide proper care

• Improve management and administration (this often conflicts with patient care priorities)

• Outbreaks or programme management (HIV etc.)

• Needs a much more limited set of data

• Facilitates resource management

• Facility registry and healthcare provider registry

• Portability of service

• Continuity of care

• Reduces duplicate data capture

• Facilitates referrals (community linkage)

• Reduce false loss-to-follow-up numbers

• How are value-based priorities identified and ranked?

• Insurance priorities

• Requires some specialist knowledge/experience

• Patient benefits

• Ethical/greater good

• Economic benefits

• Administrators want to make money or reduce costs

• Rollout priorities

• Very complex system

• Hard to motivate to organisations, clinicians and patients

• Tanzania is being rolled out top-down

• Different organizations will have different views on the priorities

• Healthcare provider priorities

• Statistics

• Bed occupancy

• Death rates

• Are the systems mature enough to interop properly?

• May need to be earmarked for improvements before the specific use cases can be implemented

• Value-based HIE

• Tanzania Examples

• BID Project - immunization management

• Point to point integration

• Looking at the demands, projections would quickly get unmanageable, so this was a priority to get resolved

• Bed Occupancy

• Death by Disease Case

• Revenue

• Services received

• Notes

• Many of these were mandated by the minister of health as priorities

• These are multi-component systems

• Integration decisions were not based on maturity of the system, they were based on indicators required

• After decisions, some systems were found to not be very mature

• Recommendations were then made to improve the systems to move them towards better integration maturity

• For example, some didn't have any export functionality at all

• Validation was sometimes very poor

• All of the above slowed down the process

• Kenya

• Some manual processes

• Provides basic data to make management decisions

• Does very little to improve patient care