Notice C

Promoting the collaborative development of proposals for investments in digital health global goods

Digital Square supports investments in digital health global goods, which are tools that are adaptable to different countries and contexts. Mature digital health global good software is software that is (usually) Free and Open Source (FOSS), is supported by a strong community, has a clear governance structure, is funded by multiple sources, has been deployed at significant scale, is used across multiple countries, has demonstrated effectiveness, is designed to be interoperable, and is an emergent standard application.

We are using an open proposal process. Your concept notes and proposals will be publicly posted, giving you and other submitters the opportunity to find collaborators and provide and receive feedback from your peers.

Concept-Notes (48 total)

Displaying 16 - 20

Enhancement of the Medicines Registration Application Pharmadex

Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

1.   Executive Summary

High-quality and affordable medicines are the foundation for a country’s ability to provide effective health care. National medicines regulatory authorities (NMRAs) use product registration as a mechanism for assuring the quality of pharmaceuticals and health commodities; however, the registration process is complicated and time consuming. When countries have weak medicine registration systems—backlogs of drug registration applications, inefficient drug testing systems, and incomplete data on suppliers and products—they can waste millions of dollars and put people at risk of using unsafe medicines.

Management Sciences for Health (MSH) has developed a web-based tool, Pharmadex, to help NMRAs streamline the process. Pharmadex is being used by four NMRAs to ensure that they have the most updated medicines available and approved for prescribing. We propose to add features such as multiple language support, user-configurable logos, and ability for each country to define their own fields and variables to ensure that NMRAs that have requested an application for use can easily adopt Pharmadex for their country contexts.

2.   Consortium Team

Profile of Organization’s Relevant Qualifications

MSH, founded in 1971, will lead software development. We have more than 30 years of experience with developing tools to facilitate pharmaceutical management functions, and we currently have eight electronic tools that address the different needs of pharmaceutical managers—from inventory management to treatment adherence tracking. Further information is available here:

http://siapsprogram.org/tools-and-guidance/

7_MSH_Tools

Profile of Relevant Experience

MSH is currently working to publish the tool source codes under an open source license and make it available to the public on GitHub. Some tools, including Pharmadex, need enhancements to maximize their effectiveness for the global eHealth community. To move this effort forward, we are teaming up with our previous software development partners. The international team will bring experience from the United States, Ukraine, Uganda, and the four countries that are using country-specific versions of Pharmadex to this initiative: Bangladesh, Ethiopia, Mozambique, and Namibia.

4_Countries_Pdx

Qualifications of Key Members

MSH will serve as the prime and lead software development. We will be responsible for ensuring all objectives are achieved and all deliverables are developed by the stated deadlines.

The team will be comprised of the following individuals, who have successfully developed and customized Pharmadex in four countries. They have the expertise necessary to add features to Pharmadex to make it customizable for use in additional countries:

  • Kim Hoppenworth, Pharmaceutical Software Specialist and Tester
  • Oleksii D. Kurasov, Consultant, Software Developer for both Phase 1 and 2
  • Kate Kikule, Medicines Registration and Inspection Specialist and Software Tester

Please refer to Appendix A. CVs of Key Members for additional information on these individuals’ qualifications and experience.

Number of Years in Operation

MSH, a global nonprofit organization founded in 1971, has 47 years’ experience in 150 countries working shoulder-to-shoulder with countries and communities to save lives and improve the health of the world’s poorest and most vulnerable people by building strong, resilient, sustainable health systems.

3.   Project Description

MSH developed the web-based version of Pharmadex with funding from the US Agency for International Development (USAID) under the SIAPS program. We developed the system after assessing the availability of similar open source software within global eHealth, and not finding a product to meet identified needs. Electronic registration increases transparency and efficiency and facilitates the standardization of processes, which benefits the government, registration applicants, and most importantly, the public by expediting access to safe, high-quality medicines. Pharmadex is a fully auditable workflow and includes the following functionality:

  • An administrator can configure and manage the system
  • An applicant (distributor or manufacturer) can submit and track an application or amendment
  • A coordinator can assign and track evaluations
  • An evaluator can evaluate and track evaluations
  • A regulator can approve, renew, suspend, or cancel a product
  • A health care user can search for and verify approved products

Pharmadex complies with most of the Principles for Digital Development. Pharmadex has been:

  • Designed with users from two continents and four countries
  • Developed based on the ecosystem in the different countries
  • Developed based on open source standards
  • Developed after an assessment showed that no FOSS alternative existed
  • Developed to ensure data security and privacy, such as through user roles

Through this funding, we will enhance Pharmadex so that it is fully compliant with the Principles for Digital Development and will achieve the following:

  • Easy scale up to NMRAs in other countries
  • Increased sustainability by incorporating the internationally recognized Common Technical Document (CTD) medicines registration procedures
  • Establishment of an international community around Pharmadex
  • Enhanced applicability

MSH has already received requests from other countries that are interested in adopting Pharmadex. As more countries recognize the importance of a strong medicine regulatory system, especially registration, the availability of a generic version of Pharmadex will appeal to many countries. The existing country-specific (non-generic) version of Pharmadex is currently available as an open source application on GitHub, and a demonstration version is available here: pharmadex.msh.org. The current version of the tool requires that countries make a lot of changes to adopt it efficiently, which is resource intensive. Our proposed generic version of Pharmadex will be readily available for installation and use and will also be available as an open source application.

Technical Approach

We will base the generic version of the application on our experience with the four existing country-specific versions and on a design that MSH developed that standardizes the registration procedure. We will add features such as multiple language support, user-configurable logos, and ability for each country to define their own fields and variables, for example, if they want to add a field for ISP mobile money in a country-specific format.

In addition to developing a generic version of Pharmadex, MSH will make additional enhancements depending on available funding:

  • Development of a wholesaler inspection module
  • Interoperability with DHIS2
  • Information synchronization: health facility list from DHIS2 and then inspection results from Pharmadex
  • List of DHIS2 monitored medicines verified via synchronization with Pharmadex
  • Improved reporting tools, with a focus on user-defined reports and visualizations
  • Improved graphical user interface (GUI) focusing on improved usability (intuitive and logical flow)
  • Implementation of international clinical standards such as ICD-10
  • Creation of a platform for a Pharmadex support community
  • Inclusion of European Medicines Agency standards for pharmaceutical formulations: standardterms.edqm.eu

4. Use Cases, User Stories

Pharmadex has been developed and customized for four countries: Bangladesh, Ethiopia, Mozambique, and Namibia, all of which are highly appreciative of the system. With the implementation of Pharmadex in Mozambique, the average number of days to register a single medicine (from submission to final decision) decreased from 400 to 176 days over one year, which exceeded the project goals. Namibia reduced the medicine registration dossier backlog from 711 to 100 days in a year, reflecting an 86% improvement in process efficiency. Please refer to the following link to review details our success in Namibia: http://apps.who.int/medicinedocs/en/d/Js21681en/

5. Digital Health Technologies

Pharmadex is a Java-based application built in Apache Web Service and MySQL relational database. The application can run on a desktop or an Android tablet/smart phone. The server can either be cloud based or run on a local Microsoft or Linux server. The software is available on the MSH GitHub site: github.com/MSH/Pharmadex.

6. Community Feedback

MSH and the core developers will use the existing GitHub platform to develop the code, which will open up the opportunity for digital health community members to contribute ideas. To further optimize the tool, we will get initial feedback from our existing country users and also reach out to new users from the countries that have requested the application about half-way through the project to assess their experience. We will also invite these users to test the application in the final stages of development.

7. Self-Assessment on the Global Goods Maturity Model

The self-assessment is available here: https://goo.gl/1sWS51

8. Digital Health Atlas

MSH is currently registered with the Digital Health Atlas under the name Kim Hoppenworth, khoppenworth@msh.org.

9. Workplan and Schedule

Pharmadex links with and contributes to the World Health Organization Digital Health Interventions Framework under area 3.0 Health System Managers: “3.2.4 Register licensed drugs and health commodities.”

Phase 1: Generic Version for Medicines Registration

We have already designed the generic version (Phase 1) of the application to include a language module and ability for each country to define their own fields and variables. We will start the project by documenting the specifications for the development team. The development cycle is expected to be completed within 60 days, followed by 30 days of testing and documentation updates. After 90 days, we will add the generic version to the MSH GitHub open source repository.

Gantt Chart for Phase 1

Phase 1 Gantt

Phase II: Enhancement with Inspection Feature

Other changes (Phase 2) will depend on available funding. We propose to develop the wholesaler inspection module in Phase 2. The countries where we have implemented country-specific versions of Pharmadex have requested this functionality. This module could take up to six months to develop and implement. The analysis and design of Phase 2 will start once Phase 1 is in development; therefore, Phase 2 will be initiated during Phase 1.

Gantt Chart for Phase 2

Phase 2 Gantt

M&E Plan

MSH has extensive experience working with monitoring and evaluation systems—especially under the USAID activity monitoring, evaluation, and learning plan framework. This ensures that proper indicators are developed and tracked appropriately to ensure quality on-time delivery.

MSH will choose progress indicators to track the development of the application’s new features and functionality. They will be as follows for each phase:

  1. Multiple language functionality available and tested
  2. Inspection module available and tested
  3. Country-specific system settings changed to be generic

Sustainability Plan

During the project, MSH will set up a community page and also ensure that Pharmadex is available on the Digital Health Atlas. This will help implementing countries access a knowledge base created by other users and give easy access to all documentation needed.

10. Project Deliverables

We will provide the following deliverables for Phase 1:

  1. Database relational diagram/database map
  2. Developers’ manual
  3. Installation manual
  4. User manual

We will provide the following deliverables for Phase 2:

  1. SRS
  2. Expanded database relational diagram/database map
  3. Expanded developers manual
  4. Expanded installation manual
  5. Expanded user manual

All source code material and documentation will be available on GitHub after both phases of the project.

11. Tagging

  • #Medicineregistration
  • #Wholesalerinspection
  • #Drugauthority
  • #Medicinesquality
  • #Datacollection
  • #Workflowmanagement

12. 2-sentence overview

Description. Pharmadex is an application that will help national regulatory authorities register medicines in the country, thereby, making it easier to ensure that medicines prescribed and dispensed are of high quality—safe and efficacious.

Outcome. Digital Square’s investment will ensure that any country can easily install and adopt Pharmadex to increase the transparency of their medicines registration process, and assure that the public receives approved and safe medicines in a timely way. The investment will further ensure that the tool’s source code is freely available on GitHub and that it has a community communication forum available for users to facilitate communication and increase sustainability.

Application Status: 
Approved – Contingent on Funding

Enhancing the Interoperability of SENAITE Health Laboratory Information Management System (LIMS)

Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

Executive Summary

 

Laboratories are a pillar of any care, treatment, and prevention program and the data they generate are critical for clinical decision-making, disease screening, monitoring, blood safety and surveillance.

Laboratory Information Management System (LIMS) are a crucial component for the effective management and operation of a clinical laboratory and the assurance of reliable and timely laboratory results. At its core, LIMS software serves to automate the labor-intensive clerical activities associated with the processing of laboratory results to improve the accuracy and the turnaround time of results. Automation of laboratory activities removes the element of manual reporting, increases productivity, and allows access to retrospective data for analysis. Data generated by these laboratories must be shared throughout the enterprise health (eHealth) architecture, or the health information systems (HIS) ecosystem, that manages information in a care, treatment, and prevention program.

To increase the resilience, reuse, and sustainability of open-source LIMS software, we propose enhancing the interoperability, security, and quality control of SENAITE (formerly known as Bika LIMS)1, the leading open-source LIMS platform. This proposal is designed to provide support to an existing global good to ensure that it is properly resourced for sustained development.

 

Consortium Team

 

Our team is made up of the following organizations:

  • Naralabs (https://naralabs.com/) is an implementer and founding member of the Senaite LIMS project2. Based in Barcelona, Spain, Naralabs is a company specializing in LIMS and offers professional technology services and engineering, such as consulting, implementation, training, system maintenance, and technical support. Senaite LIMS is currently being used in Argentina, Australia, Canada, Colombia, Costa Rica, France, Germany, Guatemala, India, Liberia, Namibia, Nigeria, Portugal, Puerto Rico, South Africa, Spain, Trinidad and Tobago, United States, Botswana and Zimbabwe.

  • RTI International (https://www.rti.org/) works with governments and nongovernmental organizations in 92 countries. RTI possesses an array of subject-matter expertise, among them: health information systems (HIS), information and communications technologies (ICT), health informatics, epidemiology, and disease surveillance. RTI has in-depth experience in HIS strengthening. Recently, in Tanzania and Zimbabwe, RTI provided technical assistance to the ministries of health in areas that included strategy, capacity building, ICT, and data demand and information use. In both countries, RTI led the national rollout of the District Health Information System 2 (DHIS2). In Zimbabwe, for the CDC-funded Zimbabwe Health Information and Support Project (ZimHISP), RTI led the LIMS deployment. RTI will serve as the organizational management lead and point of contact for this proposal.

 

Project Description

 

Our team aims to enhance the interoperability of SENAITE through the integration of DHIS2 and tooling to HL7 communication.

We believe that together these enhancements will have a dramatic effect on the viability and reach of this open-source project in health world.

Through OHIE we will engage the LIS community of practice to strengthening existing requirements to advice about the development of the DHIS2 interoperability and HL7 standards integration process, as well as test the product. This community of professionals aim to empower Open Source solution for health enviorments and define standards for its use.

Since Digital Square Proposal “Building an Open Source LIS Technologies Community of Practice”3 has been awarded, we are considering to collaborate I order to work on the standards and the definition of a roadmap in order to improve coordination between collaborators, companies and Ministries of Health.

SENAITE is an open-source LIMS used in enterprise environments and is freely available on GitHub4 under GNU General Public License v2.0. It currently ships with an integrated RESTful JSON API and has a modular design and clean user interface. It is a derivative work of Bika LIMS software, uses Plone CMS, and is built with Python.

As told in the consortium team section, Senaite LIMS has been deployed in more than three low or middle-income countries: Colombia, Costa Rica, Guatemala, Liberia, Namibia, Nigeria, Puerto Rico, South Africa, Trinidad and Tobago, Botswana and Zimbabwe.

The software has been applied to a health domain, some examples are: it is being used as the LIMS platform for the electronic registry, exchange and management of information across a group of health laboratories eHealth Africa operates. It is also implemented in Gaborone (Botswana) with a customized layer to that better fulfill with Botswana Harvard AIDS Institute Partnership Hospital needs as the main LIMS system. It has been implemented for the Ministry of Health of Liberia together with the University of Massachusetts Medial School. It is being used and implemented in Zimbabwe for the Ministry of Health and Chld Wellfare of Zimbabwe in several walk-in-clinics in order to study, control and fight VIH in the country. Another example of Senaite usage in critic health environments is its use and implementation for The Caribbean Public Health Agency (CARPHA).

 

 

Integration of DHIS2

 

Across Africa, national reference laboratories conduct tests to confirm epidemic-prone diseases. This laboratory-diagnosis confirmation is critical to an appropriate and timely response to disease outbreaks. The challenge is how to ensure that disease confirmation information is available to all stakeholders who need this information in a timely manner. Many countries have or are planning on adopting a system like DHIS2 for disease surveillance5. This means that both aggregate weekly disease case counts and individual case notifications can be managed and analyzed using DHIS2.

To ensure that laboratory results information is available in a timely manner to all concerned parties, we propose designing and implementing the integration between the SENAITE and DHIS2. We aim to achieve this through the interoperability layer (IL) of the OpenHIE architecture. Interoperability between these two systems would reduce the burden on laboratory and other staff tasked with tracking down this information and entering it into multiple systems, and it would speed up the availability of laboratory results for response efforts. The disease surveillance functionality of DHIS2 is improving and given this more countries will likely look to use DHIS 2 for their disease surveillance data, reinforcing the importance of interoperability between DHIS 2 and laboratory information systems.

 


Illustration 1: Interoperability Layer of OpenHIE Architecture

 

 

Implementation of HL7 standards on Senaite LIMS

 

Health Level-7 or HL7 refers to a set of standards, guidelines, and methodologies by which various systems, in a healthcare context, should transfer clinical and administrative data between software applications of various healthcare providers.

Hospitals and other healthcare providers have different computer systems used from billing to patient tracking. All of these systems should communicate with each other when they receive new information, or when they wish to retrieve information.

Such guidelines or data standards are a set of rules that allow information to be shared and processed in a uniform and consistent manner. These data standards are meant to allow healthcare organizations to easily share clinical information. This ability to exchange information should help to minimize the tendency for medical care to be geographically isolated and highly variable.

Senaite LIMS comes with a RESTful JSON API that allows queries from health care systems (medical software or hardware) but this API is not HL7 compliant.

The implementation of a layer for Senaite API will allow Senaite LIMS to return data in JSON format compliant with FHIR specifications. Senaite LIMS will support data retrieval from HL7 compliant (v2+v3) applications by default, either by using ER7 (Pipe and hat) encoding over MLLP (Minimum Link Layer Protocol) or FHIR (Fast Healthcare Interoperability Resources) JSON/XML encoding over HTTPS.

 


Illustration 2: HL7/FHIR layer


Senaite will also be able to retrieve data from a wide range of software systems, even if they are not HL7compliant or do not support any of the two data transfer mechanisms mentioned above. To achieve this goal, Senaite will support the addition and configuration on-demand for new custom interfaces for data transfer and communication.

 

Tagging

DHIS2, HL7, FHIR, Interoperability, Health surveillance, LIMS, Reference Laboratory, Automation, Open Source, Data Recompilation.

 

 

Footnotes 

5According to a presentation by the University of Oslo at the Dakar, Senegal, July 2017 DHIS2 for Disease Surveillance Academy, the following countries are piloting or using DHIS2 for disease surveillance: Cameroon, Guinea, India, Mali, Rwanda, Sierra Leone, South Africa, and Tanzania.

Application Status: 
Out of Scope

Escrowed data retention and retrieval solution for digital health application platforms based on distributed blockchain technology starting with DHIS2

Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

1 - Executive summary

Decentralized databases promise to revolutionise medical records, but not until the global digital health community identifies long term strategies for utilisation and short term tactics for testing and integration into existing systems architecture. The core tenets of blockchain technology — a decentralized and encrypted way of distributing, sharing, and storing information — seem appealing for health data. In particular it offers the potential for distributed responsibility for the longitudinal and immutable storage of anything from open to hierarchically encrypted data sets.

One potential modality for quick innovation with blockchain technology is via its practical application as a means to provide immutable storage and audit logging as an addon to existing systems (for example, on a platform such as DHIS2). We propose leading a software R&D effort to build a 3rd party escrowed data retention and retrieval solution for digital health application platforms based on distributed blockchain technology starting with DHIS2 as the first target platform.

2 - Consortium Team

eSHIFT Partner Network is the prime organization for the project. It is a Swiss-headquartered not-for-profit association established to help great ideas scale into the national health systems of developing countries so that populations achieve better health outcomes.  At the core of eSHIFT is our network of commercial and non-commercial members with many years of expertise, providing strategic advice on, and implementation of, information management and digital health solutions to both national level and global-health bilateral actors. eSHIFT also hosts HISP Geneva, the Swiss node of the HISP network of global partners supporting the DHIS2 and improvement of health information systems in low and middle income countries.

eSHIFT has a number of projects currently underway in conflict zones, politically complex and/or resource constrained settings. The efforts documented herein, if made easy to use and accessible, could have very positive broad sustainable impacts to the successful ongoing operations of many country-level DHIS2 implementations.

Entuura Ventures Ltd. (a founding eSHIFT member organization) is a consulting and engineering company incorporated in Belize. The company supports a variety of digital health information related multinational projects and activities. These projects involve supporting international multilateral organisations and key donors in the global health domain. Entuura has established a specialty practice in DHIS2 consulting, IT systems support and secure hosting. Entuura currently supports the University of Oslo HISP group in several country DHIS2 implementations, including more strategic work around IT security, mobile device management, systems administration and DHIS2 implementation governance.

We believe the following organisations will be engaged to participate in and augment the outcomes of this effort.  Each has already been approached (to various levels of endorsement/commitment):

  1. Major Technical University in Switzerland which hosts a Decentralized and Distributed Systems Lab, a global leader in blockchain technology.  (This lab has software developers and blockchain subject matter experts) (to be announced in next phase of this process);
  2. LogicalOutcomes.net and their existing University affiliations having computer science resources with blockchain experience (software developers);
  3. UiO/HISP (core DHIS2 code) & HISP Vietnam (DHIS2 API) as required for integration.
  4. WHO / Health Data Collaborative (HDC).  In particular the HDC affiliated ‘WHO/IER group working on WHO standards based DHIS2 addon applications’;
  5. Any number of country MoHs (which we have existing relations) to inform this project;
  6. Private sector actors working towards similar objectives  (e.g. Health Bank, a Swiss based entity with very complementary developed world focus )

3  - Project description

Problem statement

Digital health platforms such as DHIS2 have little or no intrinsic means for immutable data retention. Also, methods and means for securely encrypted offsite backups for disaster recovery or system auditability are too complex or generally elude the capacities for systems administrators to implement. Global public goods designed to improve the delivery and quality of these elements of platform operations are needed.

Blockchain technology now offers interesting potential in the health domain, in particular, associated with individual patient records. We propose an initiative which both addresses these technical challenges and explores whether blockchain technology may be a relevant and useful technology solution. 

Benefits
One potential modality for quick innovation with blockchain technology is via its practical application as a means to provide immutable storage and audit logging as an addon to existing systems.  This could be useful in use cases for legal repudiation of fraudulent activity or tampering; think, for example, applications where medical evidence of war crimes is being gathered.  From a technical perspective, on a platform such as DHIS2, we could envision rapid short term benefits to include:

  1. A means to backup into a blockchain regularly reported health data offering a ‘forever’ record of health data sets which transcends changes in the underlying HIS system;
  2. Backup and recovery of encrypted whole data sets within blockchain nodes which are the responsibility of entity(ies) outside the primary user.  Nodes could further be stationed at multilateral or bilateral agencies so that the “global good” of the data and its retention transcends the national government (be held by supra-national legal structures such as those governing UN Agencies);
  3. For individual records, offer the potential for these records to have their (via DHIS2 Tracker Capture) data mirrored within the blockchain, with potential for access by other DHIS2 and digital health systems.  In effect, this works towards a “record per person in the blockchain”;
  4. For managing sensitive records (e.g. in association with SGBV, conflict situations, migrant populations) encrypt and store digital artifacts immutably in the blockchain.  This opens possibilities for countries compliance e.g. UDHR, protection of women & children (Primero);
  5. For datasets where long term auditability is critical, leverage blockchain ledger to store checksum information against such datasets contained within DHIS2, thus offering assurance data has not been tampered since it was originally entered;
  6. A means to capture standardised information. A prime example here would be vital events/civil registration (beginning where MOVE is already implemented within DHIS2 e.g. Bangladesh).

Approach

This proposal covers the first two phases of a software project. The entire project, which is beyond the scope of this proposal, would consist of an R&D effort to build a 3rd party escrowed data retention and retrieval solution for digital health application platforms based on distributed blockchain technology:

Phase 1: Specification (2 months)

  1. Develop a detailed Target Product Profile for blockchain use in global digital health applications using the specific example of DHIS2 (as a 1st starting example))
  2. Address blockchain challenges of data security and in particular data deletion (esp GDPR).

Phase 2: Minimum Viable Product (6 months)

  1. Developing the first minimum viable product to allow for e.g. complete and secure backup of DHIS2 data sets and/or auditable checksumming information in blockchain ledger;

Phase 3: Additional features and applications (12-18 months)

  1. Building out a set of blockchain nodes across diverse actors in Switzerland, a jurisdiction wherein the regulatory environment around data confidentiality is trusted and robustly applied;
  2. Developing one or more DHIS2 addon applications which would evolve over time to support the various objectives listed above.  In order of priority:
    1. Audit logs of system changes within the blockchain stored as blockchain transactions;
    2. Add capability to store DHIS2 Tracker transactions as blockchain transactions;
    3. In future, expand to other, well used and supported, digital health systems (e.g. OpenMRS, OpenLMIS, OpenELIS, OpenSRP etc..
  3. Once more than one software is speaking via developed addon modules to our blockchain, begin looking at cross-cutting storage and retrieval of longitudinal individual records;

Resourcing and Proposed Timeline
We foresee the whole R&D process (if it were fully funded) to take 18-24 months, and it would require work effort that is well beyond the scope of this grant alone. However, completing Phases 1 and 2, to obtain a minimum viable product, would be an excellent seed for assessing the approach, adapting and providing an initial blockchain solution for backing up DHIS2 data sets.   At this time we are engaged towards rapidly identifying and engaging the most experienced software developers and blockchain systems experts. All artefacts become global public goods.

Ideas for Potential Longer-Term Sustainability
Managing access to the digital health blockchain (credentials, users) and associated PKI infrastructure (as required) would have to be done by an entity, which would require ongoing, operational funding.  An entity orchestrating the blockchain and nodes would need to be identified and could ultimately be used to sustain ongoing system development and management.   Use in more, financially resourced, first world and commercial settings is also an option.  Another possibility may be to source some form of venture philanthropy. 

Broader Usefulness
Even if this effort does not lead to ongoing running systems or projects, the domain of blockchain and health is currently fraught with a lot of hype and not a lot of sound information and guidance on what the long term relevancies actually could be for the domain of global digital health in LMICs and fragile settings.  We foresee, at a minimum, this innovative effort generating some global public goods which significantly contribute to expanding the community’s knowledge set.

4 - Tagging

Data Storage and Aggregation
Data Exchange Across Systems
Research Information System
Data Interchange
Health Information Repositories
Blockchain
Auditibility
DHIS2 Distributed Backup

 

Application Status: 
In Scope

Expert Community Engagement to Address Privacy and Security in DHIS2 Centric Solutions

Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

1 - Executive summary

The DHIS2 platform is one of the more widely deployed Health Information System (HIS) components in Low and Middle Income Country (LMIC) contexts. Its more recent ability to track patients through care pathways coupled with the release of standardised patient-orientated add-on Apps endorsed by WHO (e.g. TB Patient tracking, Malaria Patient Tracking) has created both new opportunities and challenges that were not as apparent while the platform was predominantly focused on routine aggregate reporting of health data from facilities.

In particular, while challenges of security and privacy, in relation to the handling and storage of patient identifiable health data, are often raised as a concern, there are a lack of guidelines, best practices, audit tools or case examples that implementers can reference or apply to ensure they approach their projects with these concerns foremost in their mind. It is only a matter of time before a highly damaging patient data-breach occurs in a DHIS2 related LMIC national health project.

We propose therefore to engage the expert community, via a rapid Target Product Profile (TPP) process, to determine the security and privacy assets that need to be adapted and/or developed, which, if adopted by implementers, would help reduce the security and privacy risks for patient-centric solutions developed in LMIC contexts using DHIS2. For this proposal, one of these assets would be developed to full maturity.

2 - Consortium Team

eSHIFT Partner Network is a Swiss not-for-profit association established to help great ideas scale into the national health systems of developing countries so that populations achieve better health outcomes.  At the core of eSHIFT is our network of commercial and non-commercial members with many years of expertise, providing strategic advice on, and implementation of, information management and digital health solutions to both national level and global-health bilateral actors. eSHIFT also hosts the Swiss node of HISP (HISP Geneva), the network of global partners supporting DHIS2 and improvement of health information systems in low and middle income countries.

eSHIFT has a number of projects currently underway in conflict zones, politically complex and/or resource constrained settings. The efforts documented herein, if made easy to use and accessible, could have very positive broad sustainable impacts to the successful ongoing operations of many country-level DHIS2 implementations..

SageHagan GmbH (a founding eSHIFT member organization) is a boutique consulting company headquartered in Switzerland that focuses on the International Development and Humanitarian sectors. SageHangan has an established specialty practice in DHIS2 planning and implementation and proactively contributes to joint evolution of the DHIS2 platform in partnership with the University of Oslo (UiO) and the DHIS2 HISP Community.   

Entuura Ventures Ltd. (a founding eSHIFT member organization) is a consulting and engineering company incorporated in Belize. The company supports a variety of digital health information related multinational projects and activities. These projects involve supporting international multilateral organisations and key donors in the global health domain. Entuura has established a specialty practice in DHIS2 consulting, IT systems support and secure hosting. Entuura currently supports the University of Oslo HISP group in a number of country DHIS2 implementations, including more strategic work around IT security, mobile device management, systems administration and DHIS2 implementation governance.

The TPP Expert Panel(s) will be made up of members drawn from a wide range of stakeholders. Categories of experts are likely to include: DHIS2 Developers (drawn from the HISP development community); Security and Cybercrime Experts; Privacy Experts and Health Data Privacy Advocates; Legal Experts in Health Data Ethics and Human Rights; Clinicians; MoH Representatives from one or more LMIC contexts; DHIS2 Implementation Experts; HIS/eHealth experts from the Multilateral Agencies; and representatives from the donor stakeholder community. Other categories of expertise may be included in the rapid TPP process if identified as appropriate.

3  - Project description

Background & Problem Statement

The DHIS2 community is increasingly implementing technical solutions that capture patient-identifiable data. This can range from collecting data in fragile settings via DHIS2 mobile Apps through to tracking the treatment of HIV-positive patients over the course of their lifetimes.

There is significant anecdotal evidence that security and privacy concerns are not necessarily adequately addressed when designing these solutions, and therefore the potential exists for accidental or intentional exposure of sensitive patient data. In fragile settings, or in settings where health or ethnic status has social impact, this could lead to endangerment of the patient if the data were to fall into the wrong hands.

The key cause of this problem appears to be a lack of appropriate workbooks, guides, tools, and knowledge for both implementers and users of the DHIS2 platform that can be used to assess and plan solutions which adequately address security and privacy concerns.

Expected outcomes

It should be noted that while the focus for this proposal is DHIS2,  the outcomes would be generally beneficial to other patient-centric settings in LMIC contexts.

The proposed process is expected to identify the what for addressing security and privacy concerns for patient-centric solutions developed using DHIS2 in low and middle-income contexts. It will engage a wide variety of traditional and non-traditional experts and stakeholders, and establish the list of key security and privacy assets that need to be adopted, adapted and/or developed, with enough detail that the identified assets can be further developed. Many different national and international national policies exist (e.g. HIPAA, GDPR and others) that can be tapped to inform what would be appropriate in an LMIC setting. The types of assets that are likely to be identified as useful include:

  • Security Categories (areas that should be addressed in an audit and/or review)

  • Privacy Categories (areas that should be addressed in an audit and/or review)

  • Workbooks and/or Guidelines including applicable existing standards;

  • Templates and/or Checklists;

  • Assessment tools;

  • Best practices white papers in domains of policy, management and operations, and technology;

  • Case studies; and

As a specific deliverable for this grant, one of the assets -- a workbook for designing systems that address patient privacy -- would be fully developed to a completed product and tested in a real context.

Benefits

The beneficiaries of the larger process include: Patients, Ministries of Health, Implementers, and their funding partners.

Approach

eSHIFT’s  approach to efforts of this nature is to leverage modern communications and apply - where possible - Agile methods to activities. Rather than engaging in physical meetings, participating experts will be expected to provide inputs via a virtual presence. SageHagan previously led the process to develop a workbook for multi-stakeholder action in the scale-up of ICT/mHealth interventions.  We would draw heavily on management structure and methods used for that project in this endeavour.

The outputs of each step in the process will hosted online by eSHIFT.

The overall effort is split into three phases (funding at this stage is sought for Phases 1 and 2 only):

  • Phase 1 - Security and Privacy TPP for patient-centric systems in LMICs: covers the engagement, research and expert working-group activity for a rapid TPP process which will determine the scope of any Security and Privacy assets that need further development.

  • Phase 2 - Develop one of the Privacy Assets, as identified by the TPP, focusing on guidance for how to apply patient-privacy principles when designing or implementing DHIS2-centric solutions.

  • Phase 3 - Security and Privacy Asset Development for patient-centric systems in LMICs: Further stakeholder funding will be sought from International Partners to build out and validate other priority assets that are identified by the rapid TPP process.

Resourcing and Proposed Timeline

As host to HISP Geneva, eSHIFT will act as project manager and secretariat for Phases 1 and 2. Together, these require an average of 2.5 PTE over the durations of Phase 1 and 2 (project coordination, research assistance, internal domain expert, and editor/content resources) .

We may choose to host update/final meeting(s) in a physical location(s), but only if needed, and e.g. as side-meeting(s) to other event(s) that may attract a quorum of participants.

It is expected that Phase 1 (TPP process) will be a six-month elapsed activity, consisting of:

  1. A preliminary setup and engagement phase (1 month);
  2. An initial kickoff meeting;
  3. 3 x 4-week iterative cycles that include a virtual working session (half day), feedback window (one week), and research/content development activity (3 weeks);
  4. A final meeting with follow-on content preparation, publishing, and communication (1 month).

It is expected that Phase 2 (product process) will kick-off in month 5 of Phase 1, and will consist of:

  1. A preliminary setup and engagement phase (1 month);
  2. An initial kickoff meeting;
  3. 3 x 4-week iterative cycles that include a virtual working session (half day), feedback window (one week), and research/content development activity (3 weeks);
  4. A final meeting with follow-on content preparation, publishing, and communication (1 month)
  5. Testing of the approach on a live patient-centric project (elapsed 3 to 6 months).

 4 - Tagging

  • Health Information Repositories
  • Data Auditability and Integrity
  • DHIS2
  • Systems Availability
  • Systems Administration
  • Health management information system (HMIS)
  • Data Security and Confidentiality
  • Human rights and ethics
  • Shared Health Record
  • Risk-based health data de-identification


Application Status: 
Approved - partially funded

Fighting Absenteeism with Biometrics

Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support

I. Executive Summary

Absenteeism, or unscheduled absence from work, is a persistent problem in health facilities worldwide. The cause of absenteeism among health workers is multifaceted but the net effects are clear and highly disruptive to already-struggling health services. Most importantly, reduced numbers of staff result in diminished service provision and compromised service quality, as those health workers that do report to work are often overburdened with the tasks of their absent colleagues. This retards the ability of governments to achieve quality health outcomes for their citizens and reach goals like universal health coverage (UHC).

Tracking attendance, as part of a comprehensive package of performance management and retention strategies, can help decrease absenteeism and promote greater transparency and accountability in the health sector. In the spirit of trust but verify, biometric methods of identification and collection of attendance data can help ministries of health track if workers are on the job and how long they are working each day.

In Uganda, IntraHealth added a prototype time and attendance tracking module into the Ministry of Health’s version of iHRIS, the flagship human resources solution for health systems and a global public good. Initial results are very encouraging. Unapproved absences dropped 62% across 4,500 pilot facilities as health outcomes improved. The Ugandan program team is now challenged with rolling out their absenteeism system nationwide. At the same time, ministries of health in other countries are looking for similar functionality for their iHRIS deployments as well as biometric identity confirmation for users of OpenMRS, the open source medical record system platform for developing countries.

In Fighting Absenteeism with Biometrics, IntraHealth International proposes to work with Jembi Health Systems to build on the Ugandan pilot and develop a time and attendance monitoring module for the core iHRIS code base and a biometric user identity system for the OpenMRS code base. This OpenMRS module will provide a much-needed biometric identity functionality to help ministries of health, as well as their constituent facilities, to track and manage health worker attendance and user identities with confidence. These modules will benefit the Ugandan Ministry of Health immediately and will allow the more than 20 other countries that use iHRIS and OpenMRS to deploy time and attendance tracking into their systems, enhancing the ability of human resource managers and facility administrators to mitigate health worker absenteeism and increase the quality and availability of service delivery.

II. Consortium Team

For 39 years in 100 countries, IntraHealth International has partnered with local communities to make sure health workers are present where they’re needed most, ready to do the job, connected to the technology they need, and safe to do their very best work. IntraHealth International has a long history in developing successful data tools for digital health applications. From mobile apps to management software to multi-language interactive voice response, we offer health workers and managers the tools and technology they need to do their very best work.

We developed iHRIS, a free and open source software for managing health workforce information, that is utilized in over 20 countries around the world. iHRIS helps countries in low-resource settings capture high-quality data on health worker numbers, skills, qualifications, locations, and more. With this information, nations can address health workforce shortages and solve other challenges across the health sector and beyond.

The time and attendance module development will be led by the following IntraHealth staff and supported by a full range of health experts, project managers, and back-up software developers:

  • Luke Duncan, Digital Health Assistant Director, has over 20 years of experience in software development, including leading the developing of iHRIS, the flagship human resources solution for global health, and multiple data interoperability standards and reference designs to connect iHRIS, DHIS2, and OpenMRS. 

  • Richard Stanley, Senior Technical Advisor, has over 20 years of experience in information and communication technologies, including high-quality research and rapid data analytics for monitoring and evaluations in Somalia, South Sudan, Uganda, Egypt, and Sudan. He holds a PhD from the University of Oxford, UK.

  • Dennis Kibiye, Informatics Developer, has eight years of experience in software development, including leading the Ugandan customization and configuration of iHRIS, its nationwide deployment, and the development of the time and attendance prototype module.

  • Nobert Mijumbi, Regional Health Workforce Technologist, has eight years of experience in software development, including supporting the Ugandan customization and configuration of iHRIS and the development of the time and attendance prototype module.

  • Dana Acciavatti, Digital Health Senior Portfolio Manager, has 17 years of experience strengthening systems that support health workers, including leading project management for IntraHealth's portfolio of digital health projects and iHRIS in particular.

Jembi Health Systems is an African non-profit company, headquartered in South Africa, and specializing in digital health and open source software development and implementation. Jembi has a successful track record developing and implementing open source software in the health sector including in a number of African countries.

It has contributed to many open source software development projects, including OpenMRS, OpenHIM, and OpenHIE. Jembi curates the reference technology for the interoperability layer (www.openhim.org) of theOpenHIE and related reference profiles like Hearth.

The following Jembi staff will support this initiative:

  • Carl Fourie, Senior Program Manager, has ten years of experience providing insight and guidance to architectural teams and currently leads Jembi's OpenHIE activities.

  • Pierre Dane, Director of Technology, has over 15 years of technical experience and leads Jembi’s technical division with a strong focus on systems development and interoperability.

III. Project Description

Problem Statement

Absenteeism, or unscheduled absence from work, is a persistent problem in health facilities worldwide. The cause of absenteeism among health workers is multifaceted and the result of factors both external and internal to each individual, such as weak workforce leadership or low levels of motivation and compensation. The net effects are clear and highly disruptive to already-struggling health services:

  • Reduced numbers of staff result in diminished service provision and compromised service quality, as those health workers that do report to work are often overburdened with the tasks of their absent colleagues.

  • Staff who are absent from their assigned duty stations may still be counted—and compensated—as full-time employees, resulting in payroll fraud that robs governments of financial resources for health programs.

  • Absenteeism in the face of pandemic threats is particularly alarming, as an unwillingness to report to work in the midst of an emergency only compounds the crisis and erodes patients’ trust in the health system.

  • Finally, minimum staffing levels are required for governments to achieve quality health outcomes for their citizens and reach goals like universal health coverage (UHC).

Tracking attendance, as part of a comprehensive package of performance management and retention strategies, can help decrease absenteeism and promote greater transparency and accountability in the health sector. In the spirit of trust but verify, biometric methods of identification and collection of attendance data can help ministries of health track if workers are on the job, and how long they are working each day. A number of biometric identification equipment manufacturers, such as SimPrints, have hardware on the market in sub-Saharan Africa with published APIs that can connect to smartphones or laptops to provide data for the attendance record.

iHRIS Time and Attendance Module

In Uganda, the government sought a way to incorporate time and attendance tracking, attendance monitoring tools, and biometric identity management into their version of iHRIS, the flagship human resources solution for health systems and a global public good, that is used by over 20 low and middle income countries to manage health workforce data, including Uganda, Tanzania, Kenya, Namibia, Botswana, and more.

Responding to this need, IntraHealth created a prototype iHRIS module for tracking clinical staff in ministry of health facilities. This module incorporates both biometric machines and mobile phones to scan staff fingerprints and produce duty rosters, track attendance, and create human resource summaries. Initial results are very encouraging. Unapproved absences dropped 62% across 4,500 pilot facilities, and there was a statistically significant correlation to increased health outcomes in the same clinics. The initial results are so compelling that Uganda is now challenged to scale the solution nationwide. At the same time, ministries of health in other countries are looking for similar functionality for their iHIRS deployments.

OpenMRS User Verification Module

OpenMRS is the digital health global good for patient medical records that is used in South Africa, Kenya, Rwanda, Lesotho, Zimbabwe, Mozambique, Uganda, and many other countries. OpenMRS open source software code can be found at https://openmrs.org/. Ministries of health who use OpenMRS seek ways to confirm the identity of OpenMRS users to safeguard patient data and as an indicator of worker attendance.

An initial UgandaEMR Fingerprint module was developed for OpenMRS deployments in Uganda, yet it is focused on patient identification and it is specific to one technology, the Digital Persona 4500 fingerprint reader from CrossMatch.

In Fighting Absenteeism with Biometrics, IntraHealth International proposes to work with Jembi Health Systems to build on the Ugandan pilot and develop a time and attendance monitoring module for the core iHRIS code base and a biometric user identity system for the OpenMRS code base that will provide a much-needed biometric identity functionality to help ministries of health, as well as their constituent facilities, to track and manage health worker attendance and user identities with confidence.

A robust time and attendance monitoring module in the core iHRIS software code will benefit the Ugandan Ministry of Health immediately, and will allow the more than 20 other countries that use iHRIS and OpenMRS to deploy time and attendance tracking and biometric user identity into their systems too, enhancing the ability of human resource managers and facility administrators to mitigate health care worker absenteeism and increase the quality and availability of service delivery.

The development of a biometrics module for health workers in iHRIS and OpenMRS also offers a pathway for biometric identification for users of DHIS 2.

Technical Approach

IntraHealth International will build on the Uganda prototype to develop a robust time and attendance module for the core iHRIS software that is based on the Ugandan Ministry of Health use case yet generalized to be applicable to other country contexts. IntraHealth will work with Jembi Health Systems to develop a similar module for OpenMRS that follows the same generalized use case to extend biometric functionality to OpenMRS deployments.

The initial version of the core iHIRS module will include the following functionality:

Unique User Profile

Each staff member will have a unique user profile that includes basic information like their title, position, duty station, employment status, expected number of days of employment per month, and biometric identifier (i.e. fingerprint, retinal scan, etc.). The actual biometric identifier will be encrypted in a separate database. As attendance is recorded, the profile will be augmented with calculations including days worked, days absent, reason for absence (i.e. sick, leave, training, etc.) and the percentages of each for the month.

Secure Biometric Identity

The module will interact with a representative sample of existing third-party biometric machines and mobile phone applications that are already on the market in Uganda and across sub-Saharan Africa. These biometric identity solutions will be configured so that biometric data will be encrypted and not accessible to unauthorized staff. The solutions will only confirm that the biometric marker is in its file and linked to a unique user identity, positively matching with the presented biometric marker.

Comprehensive Reporting

The attendance data can be queried on multiple levels, including analyzed on a per-person, per-facility, and per administrative region basis, based on the user permissions of the data requestor. Regular duty rosters and attendance reports will be automatically sent to the respective parties who need to know, such as the facility manager, regional manager, and payroll manager. A national dashboard with anonymized data will be available to the public for greater health system accountability.

This suite of time tracking and biometric identity functionality will enable the success of the Ugandan pilot to be replicated across the country and shared across iHRIS deployments, increasing iHRIS’ utility as a trusted human resource management system and global public health good. 

OpenMRS User Verification

Jembi will build on the core iHRIS module’s Secure Biometric Identity solution and adapt it for OpenMRS user identity use cases. At this point, we believe that OpenMRS biometric user identity use cases will be complementary to the core functionality of the iHRIS module and the bulk of Jembi’s software development activity will be developing the specific biometric identity interface to OpenMRS.

Use of Digital Health Technologies

We anticipate that this activity will utilize the following digital health tools, technologies, and standards:

Work Plan, Schedule, and Deliverables

Month 1-2: Phase 1 - Functionality Definition. Work with the Ugandan Ministry of Health and the South African Ministry of Health to gather additional requirements and use cases to enhance the current prototype software and assess the landscape of biometric identity solutions available across sub-Saharan Africa. Deliverables:

  • IntraHealth: Defined use cases applicable for multiple country contexts.

  • Jembi: Review of representative biometric solutions available in African markets.

Month 3-6: Phase 2 - Iterative Module Development. Using iterative Agile software development processes and following open source software best practices, expand on the existing prototype module, adding multi-country usability to the three core functionalities. Start development on an OpenMRS interface to the biometric identity functionality. Deliverables:

  • IntraHealth: Beta version core iHRIS time and attendance module.

  • Jembi: Beta version OpenMRS User Verification module.

Month 7-8: Phase 3 - Initial Large-Scale Testing and Debugging. Perform a thorough testing of the new iHRIS module with Ministry of Health staff from multiple countries to ensure it is producing accurate and usable data and reports that fulfill the original use cases. Continue development on an OpenMRS interface to the biometric identity functionality. Deliverables:

  • IntraHealth: User-tested release candidate version of the iHRIS module.

  • Jembi: User-tested release candidate version of the OpenMRS module.

Month 9: Phase 4 - Release to Core Software. Fully incorporate the iHIRS module into the core iHRIS software, including developing upgrade instructions and user guides and publishing the module as a component of the core iHRIS software. Test, debug, and document the OpenMRS interface. Deliverables:

  • IntraHealth: Module published in the core iHRIS software.

  • Jembi: OpenMRS interface submitted to its repository.

A GANTT chart of the project can be found at https://docs.google.com/spreadsheets/d/1ayUXQALzQNdoYfz42uCPT9DSnOyM6R5hdSSEhazUKJc/edit?usp=sharing

Digital Health Atlas

OpenMRS Uganda Registration: https://digitalhealthatlas.org/public/10/assessment

iHRIS Uganda Registration: https://digitalhealthatlas.org/public/141/assessment

Monitoring and Evaluation

IntraHealth International and Jembi Health Systems have robust monitoring and evaluation processes to ensure project compliance and success.

We will start this engagement with a deep discussion with representative software developers and policy-makers who will form an advisory group to confirm our initial needs assessment and create a clear future vision of the iHRIS time and attendance module and OpenMRS biometric module, with documented success criteria.

As we proceed through the development process, we will monitor our progress with regular check-ins with the advisory group to make sure that we are still building toward our future vision. We will also bring in stakeholders from other governments to ensure our modules have the greatest overall utility across multiple countries.

Once we begin Phase 4, we’ll evaluate our overall efforts to measure how well we’ve met our initial objectives and the extent to which the new modules are allowing software developers and country governments to build comprehensive performance management and retention strategies that decrease absenteeism and promote greater transparency and accountability in the health sector.

IV. Two-Sentence Overview

Fighting Absenteeism with Biometrics will help health systems better manage scarce frontline health worker resources, and achieve Universal Health Coverage goals, by verifying users of iHRIS and OpenMRS, two widely used health systems solutions, and tracking their time and attendance at their duty stations.

Digital Square will be funding IntraHealth International and Jembi Health Systems to develop a time and attendance monitoring module for the core iHRIS code base and a biometric user identity system for the OpenMRS code base that will provide a much-needed biometric identity functionality to help ministries of health, as well as their constituent facilities, to track and manage health worker attendance and user identities with confidence.

V. Community Feedback

Our key engagement point with the broader digital health community will be through our advisory group, made up of representative software developers and policy-makers. This group will be initially populated from the Ugandan context, as that’s the origination point for our initial use cases. We’ll aim to quickly expand this group by bringing in iHRIS and OpenMRS experts from their respective communities and health policy experts from the Global Digital Health Network, and similar technology and policy communities.

We expect this advisory group to give regular input and guidance on the technology solution design and the context in which it will work, including:

  • Use cases to inform software development and testing
  • Technology choices, especially biometric devices
  • Software architecture to ensure interoperability with existing systems

As we proceed through the development process, we will engage with the advisory group through regular check-ins at the start and end of each phase, to make sure that we are still building toward our future vision. We will also bring in stakeholders from across the greater digital health community at the end of each phase to ensure our modules have the greatest overall utility across multiple countries.

VI. Use Cases, User Stories

Health Worker at iHRIS Facility

Health worker is able to indicate they are present at the health facility by checking into it via iHRIS, using both a login and a biometric identifier, such as a fingerprint. The biometric identifier confirms the person checking in is the staff member, and not someone who has access to the staff member’s user ID and password. The same process is repeated when the staff member leaves the health facility to check them out of the facility. The iHRIS module uses these check-in and check-out activities to calculate the staff member’s time at the facility.

iHRIS Facility Staff Managers

The staffing manager at an iHRIS facility can log into iHRIS and develop a duty roster of which staff should be working which shifts at the facility over specific time periods, for example, 8 hour shifts over the next month, who is not expected to work and if needed, why they are not scheduled for duty (ie. vacation, training, other excused absences).

Staffing manager can view reports on individual and aggregate staff time and attendance at that facility and analyze the data. The district, regional, and national staffing managers can login to iHRIS and see staffing trends down to the facility level and analyze the data. Data analysis can include trends at a specific facility and its attendance performance relative to other facilities, regions, etc.

Health Worker at OpenMRS Facility

Health worker is able to log into OpenMRS by confirming their identity using both a login and a biometric identifier, such as a fingerprint. The biometric identifier confirms the person logging in is the staff member and not someone who has access to the staff member’s user ID and password. The login activity is repeated whenever the user logs in. Time at the facility is not tracked.

OpenMRS Manager

OpenMRS manager at a facility can view individual and aggregate facility reports on logins by staff and attempted or failed logins, and analyze the data. District, regional, or national OpenMRS managers can view reports down to the facility level and analyze the data. Data analysis can include trends at a specific facility and login activity relative to other facilities, regions, etc.

iHRIS or OpenMRS Software Developer

A software developer working on either system can add the respective module to their system, incorporating one of the listed biometric readers to validate staff identity. Software developer can also extend the existing modules, building on their framework to include new biometric readers, new data analysis, or visualizations. 

VII. Self-Assessment on the Global Goods Maturity Model

Both iHRIS and OpenMRS are benchmarked against the Global Goods Maturity Model through a self-assessment process and have similar levels of global utility and community. iHRIS seemingly has slightly higher software maturity.

iHRIS

https://docs.google.com/spreadsheets/d/1rO_Lu3sSYriJ4Su2clPiiQfebGEv2fhUC0LX5uT-s30/edit#gid=249752520

OpenMRS

https://docs.google.com/spreadsheets/d/1SU1Ngn7nxLRurNTxmzm_Oiv6vTM81OQITbxHawaIT7k/edit#gid=249752520

VII. Tagging

  • Health system managers

  • Human resource management

  • Health workforce identification information

  • Biometrics

  • Health worker

  • Human resource management

  • Time and attendance

  • Uganda

  • iHRIS

  • OpenMRS

Application Status: 
Approved - partially funded

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