- Created by Jamie Thomas, last modified on Aug 21, 2018
Session Name: Implementers’ Experiences: OpenHIE in Action - Highlight how OpenHIE was used for BID Project in Tanzania
OHIE18 Event Page - ohie.org/OHIE18
Time / Room: 11:30 - 12:15 Marquee
Attendees: all/plenary
Notes:
Objectives:
- increase data use at all levels
- improve the performance
- increase capacity for leaders at a district level
Challenges:
- lack of unique idenitifcation for individuals
- poor data visibility
- tools did not support data decisions
Interventions
- immunization registry
- automated report generation
- Barcodes to identify the child
- Targeted supportives supervision for health workers
How OHIE architecture was used
- Story of Mosa, 19 pregnant with HIV
- Her national ID is in the two systems
- When Mosa has not checked into the hospita, a mobile alert is sent to the community health worker
BID Architecture
- Health facility registry - all the health facilities in TZ
- Client registry, Medic CR
- RapidPro - creates complex SMS workflows
- Tanzania Immunization registry (TImR)
- VIMS - Vaccine immunization management system (VIMS is an implementation of OpenLMIS)
- VIMS tracks aggregate vaccine data (usage, stock levels, reorder levels) and syncs data with TImR; see screenshots at https://openlmis.atlassian.net/wiki/spaces/OP/pages/112468948/Program+Data+Example+VIMS+IVD+Form
How does BID actually work
- Baby Ally is registered (Name, DOB, mom name) Text from community worker -> From Rapid pro -> OpenHIM - -> TImR
- If a mother misses the appointment for her child, the RapidPro system integrated with TImR sends an SMS to remind the mother
- TImR and VIMS interoperate so the stock levels flow from TImR to VIMS, and when stock is low the user is prompted to re-order; later when a shipment is coming that info may be sent from VIMS to TImR
Demo
- Can see how many children who are expected for each vaccine so that the clinic can plan for the vaccines they need for a month (able to view from a calendar)
- Can select the lot numbers that are going to be used on a particular day so that the batch and lot can be tracked
- registration module
- There SMS reminders if a child misses a vaccine
- There is a summary / history of the vaccines
- There is a schedule of what is needed in the future
- facility where the vaccine occurred and health worker who gave the vaccine are captured
- Have reports of coverage, list of vaccionation reports and many more
- Stock management
- Can request stock and receive stock from teh district level
- This happens through the interoperability layer
- stock overview - shows which doses are expiring soon (yellow in color)
- System works in both offline and online mode
- There is the ability to see when data was synchronized with the district level
- See also demo videos of TImR: http://bidinitiative.org/photos-videos/timr-demo-overview-2/ (overview) and http://bidinitiative.org/photos-videos/timr-demo-full/ (full 19 minutes)
Questions
Q - Michale S - About OpenHIM - Did you engage resources from OHIE to help?
- A - Oswald - it was a collabration with Mohawk and IntraHealth
Q - How do you link the barcodes to the children?
- A - Oswald - There is a serial number designated for each child
Q - How have you delt with loss of child health cards?
- A - Oswald - The new card will be issued with the new barcode which will replace the existing barcode in the system.
Q - Any plan to link with eMR
- A - Oswald - yes there is a plan and they have started organizing that.
Q - What type of identification are you using
- A - National IDs are not given until you are around 18, but there is the ability to capture that once the national ID is provided.
Implementing in three regions
Q - How does the registration process work?
- A - Ally - the registration happes at the community level
- SMS of birth is sent and the child is registered
- A - Oswald - can also register at the facility
- A - community registration is done quickly at the community level - taking a very limited data set - data is used to notify the clinic that the vaccines are needed
Q - Ryan C - what standards were used in the project?
- A - Ally
- FHIR
- CSD for facility registry
- GS1 for stock
Q - ID system
- A - children are assigned to facilities, and each facility has a vaccination schedule in the system
Q - Stock management--are there existing stock management systems, like a LMIS system?
- A - we have VIMS (see above) used at the District level. The stock management at the facility level receives their vaccines, makes adjustments, records wastage.
- A - we also have eLMIS for other programs, not vaccines. There are several systems, and we want to see the best way to make these systems interoperate.
- A - VIMS is built on the eLMIS/OpenLMIS platform. It is all the same platform. It's an LMIS that is specifically designed to capture immunization program supply chain needs.
Q - what terminology did you use for defining or coding the drugs/immunzations?
- A - the codes are generated from TImR, also SNOMED (?)
Q - What do you wish was available in the OHIE communiity that wasn't
- A - Ally - I wish we could have more reference software
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