Implementers’ Experiences - Highlights from Ministry of Health in Ethiopia

• Fekadu Wannaw, JSI

• Paul Biondich

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

• There are two pillars in the information revolution

• cultural transformation

• digitalization pillar

• DHIS2

• eHA and interoperability layer

• MFR

• NHDD

• eCHIS

• POS to collect data at health post

• Data Warehouse

• EMR

• other initiriaves- telemedicine

• Governance of HIS ( joint steering committee; IR steering committee; Digitalization TWG  (lead by the HITD director)

• eHA

• conceptual model that shows systems implemented and systems planned and how the data will integrate

• MOH, JSI and Regenstrief 

• Future state includes shared service, HIS systems, Point-of-Service and an interoperability layer 

• Components of eHA 

• governance 

• Shared service - MFR and terminology services are being implemented first and will be administered centerally 

• Interoperability service 

• Analytics - currently have a system called EDAP 

• Initiatives 

• Application inventory  - being implemented with the airm of collecting information about systems deployed or under development. 

• data from 16 moh directorates, 10 agencies, 7 hospitals  - 44 unique applications so far 

• Piloting the interoperability layer 

• stakeholders 

• FMOH, universities, 

• Roadmap 

• Using the inventory to inform this 

• Identifying scenarios and use cases 

• establishing the interoperability layer and piloting it 

• establishing governance 

• Publication of eAH document and share it (living document) 

• Determine what other shared services need to be included 

• Capacity building for eAH 

• Lessons learned 

• governance is critical 

• starting with small use cases 

• capacity building

• standards- terminology and messaging

• value of developing maturity models to measure improvement of the eHA periodically

• apps inventory to help inform the eHA roadmap- will be imported

• On-going challenges 

• Cultural changes needs to drive the technology 

• Identifying clinical business processes to guide eAH use case selection 

• Competing prioritues 

• Comparisonof OpenHIM and OpenFN

• did evaluation based on the requirements (functional and nonfunctional)

• will make decision on which one to use based on our experience between these two solutions

• Steering Committee

• two technical working groups (chaired by different departments of HITD and PPD) 

• digitization- all falls under the HITD (HITD TWG questions/ decisions will fall under this; eHA TWG will present to the HITD TWG)

• larger group includes members from both the HITD and the Cultural TWG

• Shared challenges

• what did we do to solve the challenges

• strengthen the TWG that is working on the HITD

• increase awareness to foster decision making related to governance

• produce documents but need to respond to these concerns

• building capacity within so that the MoH can lead these efforts

• APP inventory

• app inventory questionairre adopted from the global health inventory

• includes multiple details (API, standards used, detailed questions included)

• developed mobile app to collect the standard data

• Rolling out DHIS

• reporting rate/ quality of data being reported

• used to be two different systems-- harmonize with one system (DHIS2); started in 2017

• core customized to ethiopian context

• own calendar

• indicator revision 

• different approaches to deployment

• two versions (one on line and one off line- off line in health centers; data entry and then export the file using flash drive) 

• current focus on data completeness; will be able to talk about data quality in DHIS 2 later