scholarly journals South African experience consolidating person-level health data for both service and research in a single environment

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Andrew Boulle ◽  
Alexa Heekes ◽  
Themba Mutemaringa ◽  
Mariette Smit ◽  
Rosemary Foster ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Data Linkage ◽  
Health Information Exchange ◽  
Digital Health ◽  
Health Data ◽  
Data Availability ◽  
Functional Health ◽  
Data Centre ◽  
Single Well

IntroductionThere are few examples of functional health information exchange environments or data linkage centres in the African settings. New opportunities are emerging as unique health identifiers and patient registration systems are being established nationally in many countries, and increasingly individuated health data are available for linkage, often linked to priority global health initiatives such as to support HIV and tuberculosis services. Objectives and ApproachWe sought to establish a province-wide health information exchange and data centre for individuated health data, leveraging a unique identifier and available individuated data. The intention with the Provincial Health Data Centre (PHDC) was to create a single well-governed environment which could simultaneous fulfil the functions of an exchange directly supporting care, as well as support research requests. Often the demands of academics, funders and global agencies for reporting result in data consolidation for research and reporting taking precedence over service delivery. ResultsThrough pragmatic use of data from all sources, the PHDC is able to usefully enumerate many health conditions of interest with sufficient fidelity for both service and research purposes. For research data requests, there has been a huge improvement in data governance alongside increased data availability as a result of the single environment with clear procedures for patient protection, and the benefits of data linkage prior to anonymisation. Many of the inference approaches have benefited hugely from interactions with researchers, which has in turn improved the quality of outputs for routine care. Conclusion / ImplicationsIn maturing digital health environments which are establishing consolidated data environments for the first time, aspiring from the start to a single well-governed environment for both patient care and research, is a virtuous model with many benefits over fragmented data linkage efforts

scholarly journals Maturity assessment of Kenya’s health information system interoperability readiness

2021 ◽  
Vol 28 (1) ◽  
pp. e100241
Author(s):  
Job Nyangena ◽  
Rohini Rajgopal ◽  
Elizabeth Adhiambo Ombech ◽  
Enock Oloo ◽  
Humphrey Luchetu ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Working Group ◽  
Data Exchange ◽  
Enterprise Architecture ◽  
Health Information Exchange ◽  
Digital Health ◽  
Health Information System ◽  
Maturity Level ◽  
Technical Standards

BackgroundThe use of digital technology in healthcare promises to improve quality of care and reduce costs over time. This promise will be difficult to attain without interoperability: facilitating seamless health information exchange between the deployed digital health information systems (HIS).ObjectiveTo determine the maturity readiness of the interoperability capacity of Kenya’s HIS.MethodsWe used the HIS Interoperability Maturity Toolkit, developed by MEASURE Evaluation and the Health Data Collaborative’s Digital Health and Interoperability Working Group. The assessment was undertaken by eHealth stakeholder representatives primarily from the Ministry of Health’s Digital Health Technical Working Group. The toolkit focused on three major domains: leadership and governance, human resources and technology.ResultsMost domains are at the lowest two levels of maturity: nascent or emerging. At the nascent level, HIS activities happen by chance or represent isolated, ad hoc efforts. An emerging maturity level characterises a system with defined HIS processes and structures. However, such processes are not systematically documented and lack ongoing monitoring mechanisms.ConclusionNone of the domains had a maturity level greater than level 2 (emerging). The subdomains of governance structures for HIS, defined national enterprise architecture for HIS, defined technical standards for data exchange, nationwide communication network infrastructure, and capacity for operations and maintenance of hardware attained higher maturity levels. These findings are similar to those from interoperability maturity assessments done in Ghana and Uganda.

hData - A Simple XML Framework for Health Data Exchange

2009 ◽  
Author(s):  
Gerald Beuchelt ◽  
Harry Sleeper ◽  
Andrew Gregorowicz ◽  
Robert Dingwell
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Data Exchange ◽  
Health Information Exchange ◽  
Health Data ◽  
Care Providers ◽  
Future Health ◽  
Data Interoperability ◽  
History Of ◽  
Electronic Health

Health data interoperability issues limit the expected benefits of Electronic Health Record (EHR) systems. Ideally, the medical history of a patient is recorded in a set of digital continuity of care documents which are securely available to the patient and their care providers on demand. The history of electronic health data standards includes multiple standards organizations, differing goals, and ongoing efforts to reconcile the various specifications. Existing standards define a format that is too complex for exchanging health data effectively. We propose hData, a simple XML-based framework to describe health information. hData addresses the complexities of the current HL7 Clinical Document Architecture (CDA). hData is an XML design that can be completely validated by modern XML editors and is explicitly designed for extensibility to address future health information exchange needs. hData applies established best practices for XML document architectures to the health domain, thereby facilitating interoperability, increasing software developer productivity, and thus reducing the cost for creating and maintaining EHR technologies.

scholarly journals Adoption of Health Information Exchange by Emergency Physicians at Three Urban Academic Medical Centers

2011 ◽  
Vol 02 (03) ◽  
pp. 263-269 ◽  
Author(s):  
J. Shapiro ◽  
S. Vaidya ◽  
G. Kuperman ◽  
N. Genes
Keyword(s):  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Clinical Information ◽  
Data Availability ◽  
Emergency Physicians ◽  
Structured Interviews ◽  
Successful Retrieval ◽  
Data Elements

Summary Objectives: Emergency physicians are trained to make decisions quickly and with limited patient information. Health Information Exchange (HIE) has the potential to improve emergency care by bringing relevant patient data from non-affiliated organizations to the bedside. NYCLIX (New York CLinical Information eXchange) offers HIE functionality among multiple New York metropolitan area provider organizations and has pilot users in several member emergency departments (EDs). Methods: We conducted semi-structured interviews at three participating EDs with emergency physicians trained to use NYCLIX. Among “users” with > 1 login, responses to questions regarding typical usage scenarios, successful retrieval of data, and areas for improving the interface were recorded. Among “non-users” with ≤1 login, questions about NYCLIX accessibility and utility were asked. Both groups were asked to recall items from prior training regarding data sources and availability. Results: Eighteen NYCLIX pilot users, all board certified emergency physicians, were interviewed. Of the 14 physicians with more than one login, half estimated successful retrieval of HIE data affecting patient care. Four non-users (one login or less) cited forgotten login information as a major reason for non-use. Though both groups made errors, users were more likely to recall true NYCLIX member sites and data elements than non-users. Improvements suggested as likely to facilitate usage included a single automated login to both the ED information system (EDIS) and HIE, and automatic notification of HIE data availability in the EDIS All respondents reported satisfaction with their training. Conclusions: Integrating HIE into existing ED workflows remains a challenge, though a substantial fraction of users report changes in management based on HIE data. Though interviewees believed their training was adequate, significant errors in their understanding of available NYCLIX data elements and participating sites persist.

scholarly journals Creating A Validation Dataset to Test Record Linkage Algorithms in A Province-Wide South African Health Information Exchange

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Themba Mutemaringa ◽  
Alexa Heekes ◽  
Mariette Smith ◽  
Nicki Tiffin ◽  
Andrew Boulle
Keyword(s):  
Health Information ◽  
South African ◽  
Record Linkage ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Data ◽  
Validation Dataset ◽  
Probabilistic Algorithms ◽  
African Health ◽  
South African Health

IntroductionIncreasing use of digital medical records creates disparate data resources for the same health care client population; and harnessing the benefits of real-time health data requires effective data linkage. A South African Health Information Exchange (HIE) collates and links routine health data from multiple sources, running daily updates through an automated ETL process. Many existing deterministic and probabilistic algorithms link person-level data using demographic identifiers, and can be combined in an optimised methodological pipeline. The performance of such pipelines must be validated against known matched pairs. The HIE uses current algorithms for record linkage, but methods that rely on similar spelling, name frequency and phonetic matching have been optimised for non-African names, and are not as effective. ObjectivesWe assessed common problems arising in the linkage process in the HIE, using this information to compile a curated representative African validation database for optimising existing and new linkage pipelines. ResultsUsing current linkage algorithms, we have identified the proportion of duplicates in the last five years, ranging from 25% in 2015 and stabilising at 10% by 2019. Common causes of duplicates across the whole database include mismatch in first name (37%), surname (17%), date of birth (13%), sex (8%) and South African Identification Number (0.2%). Complications from new-born naming and records of twins affect >8% of all records, and temporary health identifiers assigned at birth, during emergency response, and during poor connectivity of facilities to the provincial patient master index affect 2% of records. ConclusionsBased on these data, we have constructed a South African-specific, representative validation dataset that contains linkage pairs that represent placeholder phrases for newborns prior to naming (e.g. “baby of”), language variations; twins; character insertions, substitution and omissions in names with similar spellings; frequencies of names in the general population; and similar-sounding names.

scholarly journals One country's journey to interoperability: Tanzania's experience developing and implementing a national health information exchange

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alpha Nsaghurwe ◽  
Vikas Dwivedi ◽  
Walter Ndesanjo ◽  
Haji Bamsi ◽  
Moses Busiga ◽  
...  
Keyword(s):  
Supply Chain ◽  
Health Information ◽  
Information Exchange ◽  
Data Exchange ◽  
Health Information Exchange ◽  
Data Availability ◽  
Health Management Information System ◽  
Significant Time ◽  
Time Investment ◽  
Step Procedure

Abstract Background Robust, flexible, and integrated health information (HIS) systems are essential to achieving national and international goals in health and development. Such systems are still uncommon in most low and middle income countries. This article describes a first-phase activity in Tanzania to integrate the country’s vertical health management information system with the help of an interoperability layer that enables cross-program data exchange. Methods From 2014 to 2019, the Tanzanian government and partners implemented a five-step procedure based on the “Mind the GAPS” (governance, architecture, program management, and standards) framework and using both proprietary and open-source tools. In collaboration with multiple stakeholders, the team developed the system to address major data challenges via four fully documented “use case scenarios” addressing data exchange among hospitals, between services and the supply chain, across digital data systems, and within the supply chain reporting system. This work included developing the architecture for health system data exchange, putting a middleware interoperability layer in place to facilitate the exchange, and training to support use of the system and the data it generates. Results Tanzania successfully completed the five-step procedure for all four use cases. Data exchange is currently enabled among 15 separate information systems, and has resulted in improved data availability and significant time savings. The government has adopted the health information exchange within the national strategy for health care information, and the system is being operated and managed by Tanzanian officials. Conclusion Developing an integrated HIS requires a significant time investment; but ultimately benefit both programs and patients. Tanzania’s experience may interest countries that are developing their HIS programs.

scholarly journals One country's journey to interoperability: Tanzania's experience developing a national health information exchange

2020 ◽  
Author(s):  
Alpha Nsaghurwe ◽  
Vikas Dwivedi ◽  
Walter Ndesanjo ◽  
Haji Bams ◽  
Moses Busiga ◽  
...  
Keyword(s):  
Supply Chain ◽  
Health Information ◽  
Information Exchange ◽  
Data Exchange ◽  
Health Information Exchange ◽  
Data Availability ◽  
Health Management Information System ◽  
Significant Time ◽  
Time Investment ◽  
Step Procedure

Abstract Background and purpose: Robust, flexible, and integrated health information (HIS) systems are essential to achieving national and international goals in health and development. Such systems are still uncommon in most low and middle income countries. This article describes a first-phase activity in Tanzania to integrate the country’s vertical health management information system with the help of an interoperability layer that enables cross-program data exchange. Methods: From 2014 to 2019, the Tanzanian government and partners implemented a five-step procedure based on the “Mind the GAPS” (governance, architecture, program management, and standards) framework and using both proprietary and open-source tools. In collaboration with multiple stakeholders, the team developed the system to address major data challenges via four fully documented “use case scenarios” addressing data exchange among hospitals, between services and the supply chain, across digital data systems, and within the supply chain reporting system. This work included developing the architecture for health system data exchange, putting a middleware interoperability layer in place to facilitate the exchange, and training to support use of the system and the data it generates. Results: Tanzania successfully completed the five-step procedure for all four use cases. Data exchange is currently enabled among 15 separate information systems, and has resulted in improved data availability and significant time savings. The government has adopted the health information exchange within the national strategy for health care information, and the system is being operated and managed by Tanzanian officials. Conclusion: Developing an integrated HIS requires a significant time investment; but ultimately benefit both programs and patients. Tanzania’s experience may interest countries that are developing their HIS programs.

scholarly journals Consolidated Person Level Health Data Improve Tuberculosis Surveillance and Patient Care

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Mariette Smith ◽  
Alexa Heekes ◽  
Arne Von Delft ◽  
Themba Mutemaringa ◽  
Nicki Tiffin ◽  
...  
Keyword(s):  
South Africa ◽  
Patient Care ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Digital Health ◽  
Care Facility ◽  
Improve Patient Care ◽  
Health Data ◽  
Register Data ◽  
Western Cape

IntroductionElectronic tuberculosis (TB) register systems influence policy decisions, resource allocation and patient care in many ways, but their limitations have been demonstrated in many high-burden settings like South Africa. While digital health systems in the Western Cape, South Africa have improved over time and benefited from implementation of a unique patient identifier, questions about quality and completeness of register data remain. A Health Information Exchange (HIE), established in 2015, daily integrates routinely-collected person level health data from electronic sources in the Province, including laboratory, dispensing, clinical and encounter data, as well as disease register data for HIV and TB. Objectives and ApproachUsing TB-related datapoints from various electronic platforms and resources, an algorithm was developed to infer cases, visit and treatment information, comorbidities and mortality - defined as a “cascade”. The cascade is recompiled daily incorporating new information added to the HIE, and presented to health care workers and managers as filterable, downloadable reports on an electronic platform. TB Register and inferred cascade data were compared for 2018. ResultsThere were 40,227 cases in the register after 3,010 duplicate entries were eliminated by consolidating personal identifiers and duplicate entries across facilities into single TB episodes. 13,729 additional cases were identified in the HIE cascade. Of these, 6,984 had evidence of treatment; 4,143 were diagnosed and treated only in hospitals - thus less likely to be recorded in the registers. Updated patient contact details and allocation of a primary care facility based on patient visit history, aided in patient care. Conclusion / ImplicationsLeveraging a consolidated environment for person-level health data can substantially enhance and verify disease registers. Appropriate tools can render these data accessible and actionable to improve patient care, minimise errors and missed opportunities to close treatment gaps, and increase accuracy of surveillance and reporting on a programmatic level.

scholarly journals Intention to Use Behavioral Health Data from a Health Information Exchange: A Mixed Methods Study (Preprint)

10.2196/26746 ◽  
2020 ◽  
Author(s):  
Randyl A. Cochran ◽  
Sue S. Feldman ◽  
Nataliya V. Ivankova ◽  
Allyson G. Hall ◽  
William Opoku-Agyeman
Keyword(s):  
Mixed Methods ◽  
Behavioral Health ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Data ◽  
Mixed Methods Study ◽  
Intention To Use

scholarly journals Leveraging the Master Patient Index in Public Health Surveillance through Collaboration between Illinois Department of Public Health and the Illinois Health Information Exchange

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Stacey Hoferka ◽  
Ivan Handle ◽  
Steven Linthicum ◽  
Dejan Jovanov ◽  
William Trick ◽  
...  
Keyword(s):  
Public Health ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Health Data ◽  
Surveillance Systems ◽  
Department Of Health ◽  
Public Health Reporting ◽  
To Receive ◽  
Master Patient Index

In support of Meaningful Use public health reporting, health departments are expanding their capacity to receive electronic health data. The Illinois Department of Health is working with the Illinois Health Information Exchange to build services and applications to improve the quality and utility of surveillance data. The Master Patient Index is an innovative component of the technology that will integrate public health data across surveillance systems. This presentation will cover the application of the MPI to ambulatory syndromic surveillance as well as other surveillance systems and highlight potential use cases.

Development of a Regional Digital Health Record for Geriatric Health Care in Rural Areas: Community-Based Participatory Research Approach (Preprint)

2021 ◽  
Author(s):  
Nils Pfeuffer ◽  
Angelika Beyer ◽  
Peter Penndorf ◽  
Maren Leiz ◽  
Franziska Radicke ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Healthcare Professionals ◽  
Health Information Exchange ◽  
Digital Health ◽  
Healthcare Providers ◽  
Community Based Participatory Research ◽  
Research Approach ◽  
Community Based

BACKGROUND Geriatric patients are often treated by several healthcare providers at the same time. The spatial, informational, and organizational separation of these healthcare providers can hinder an effective treatment of geriatric patients. OBJECTIVE The aim of this study was to develop a regional Digital Health Record (abbreviated in German as ReDiFa) in order to improve health information exchange in geriatric treatment. This study also evaluated the usability of ReDiFa and seeks to identify barriers and facilitators for its implementation. METHODS The development of ReDiFa followed the Community-Based Participatory Research Approach (CBPR) and involved various geriatric healthcare professionals in all stages of development: identification of suitable regions for later implementation, identification of regional stakeholders, identifying specific, regional needs, development of a content concept, programming and testing of ReDiFa. Primary outcomes were usability of ReDiFa, expected implementation barriers and facilitators and the quality of the developmental process. Data were collected and analyzed by using a mixed-method approach. RESULTS 3 focus regions were identified, 22 geriatric healthcare providers participated in the development of ReDiFa and 11 workshops were conducted between October 2019 and September 2020. 12 participants responded to a questionnaire. Main results were, that ReDiFa should support the exchange of assessments, diagnoses, medication, assistive device supply and social information. The ReDiFa was expected to be able to improve the quality and continuity of care. Main barriers expected for implementation were: lack of resources, interoperability issues, computer illiteracy, lack of trust, privacy concerns, and ease-of-use issues. CONCLUSIONS Participating healthcare professionals share similar motivations for developing ReDiFa including improved quality of care, reduction of unnecessary examinations, and more effective healthcare provision. An overly complicated registration process for healthcare professionals and the patients' free choice of their healthcare providers hinder the effectiveness of ReDiFa and result in incomplete patient health information. However, the web-based design of ReDiFa bridges interoperability problems which exists due to different technical and organizational structures of the involved healthcare facilities. ReDiFa is better accepted by healthcare professionals which are already engaged in an inter-disciplinary, geriatric-focused network. This might indicate that pre-existing cross-organisational structures and processes are prerequisites for using health information exchange systems. The participatory design supports the development of technologies adaptable to regional needs. Healthcare providers are interested in participating in the development of a health information exchange system, but they often lack the required time, knowledge and resources.

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