dhis2-devs team mailing list archive

[Bob Jolliffe <bobjolliffe@xxxxxxxxx>]

Hi Greg

Not sure I have space in short email to give my orientation on this
discussion, but I'll try.

First of all you are right about the limited relevance of standardized
clinical vocabularies to 'our' domain.

I say limited because if you are looking at calculating aggregate
dataelements (whether these are indicators or not is another conceptual
mismatch we come up against) from transactional data stored in an EHR, then
there can be some relationship between the dataelement for "number of
malaria cases" and the ICD10 B52.X codes used for coding diagnosis but its
not necessarily a simple one.  And when you stray into important routine
reporting dataelements which don't have an origin in an EHR calculation
like 'number of bednets distributed', 'number of nurses at facility' etc
then the clinical vocabularies are not useful at all.  Sometimes its hard
to explain this to someone who asks why are you not using LOINC, Snomed-CT
or what have you.

So unlike clinical vocabularies, there is no international standard for
routine reported aggregate health data.  Which creates a problem because
standards are being seen as the underlying fabric of building ehealth
systems.  Though note that when these same people talk of ehealth systems
they are for the most part talking of EHR and HIE.

The IMR was I believe a useful starting point in trying to reach global
harmonisation of indicators, particularly across donors and international
organisations.  Though it does not have any of the consensus building
trappings and formalities of a standards organisation.  Its an application.
 So it cannot of itself produce standard vocabularies.

Given the august position and standing of WHO, work that is coordinated by
them does enjoy some sort of international legitimacy.  So there is also
work on things like the global health observatory and xmart which provides
"standard" indicator definitions and codes and is some way linked to IMR.

Do not go down the SDMX-HD road.  We have been down it (I was co-editor of
the SDMX-HD normative document so I know).  The underyling assumption of
"cubular" data is a poor fit for the type of data we collect and exchange
(I actually think it is more suited as an output standard for indicator
publication, than as an input standard for dataelement value exchange).

DHIS2 does not use use an underlying SDMX model.  We have borrowed some
ideas in the implementation of our datavalueset which is used for exchange
in dxf2.

Exchange of dataelement definitions and codes is relatively trivial
compared to disaggregation.  Our categorycombo model has proved hard to
translate to things like sdmx codelists - for good and bad reasons.

There is a process (which is not moving fast) which was started at Helina
workshop last year to address the standardisation problem and how it might
impact on dxf2.  Speak to Vincent.

There is also the openHIE process.  Do not consider what you do to be
different, or in competition to openHIE.  We as HISP are active members
within that community so what we do *is* also HIE.  In fact openHIE have
taken a decision back in February that we shall form an hmis sub-community
within openHIE which might also concern itself with some of the issues
above.   That should really kick off very soon and the broader hisp
community will be encouraged to participate in that.

Bob




On 10 April 2014 08:57, Greg Rowles <greg.rowles@xxxxxxxxx> wrote:

> Hi All
>
> For Data Elements:
> As far as I can understand DHIS2 makes use of SDMX cube model (
> http://www.w3.org/2011/gld/wiki/Data_Cube_Vocabulary)
>
> For Indicators:
> There isn't much standardization although WHO developed a tool that
> references components of SDMX (
> http://apps.who.int/gho/indicatorregistry/App_Main/view_indicator.aspx?iid=3326
> )
>
> For Data Sets:
> I see [Dublin Core] are referred to for data set (meta data)
> specifications.
>
> I'll try get hold of Patrick Whitaker - he seems to be a domain
> specialist. Everything points to SDMX and ISO/TS 17369:2005.
>
> Regards,
> Greg
>
>
>
> On Wed, Apr 9, 2014 at 10:41 PM, greg.rowles@xxxxxxxxx <
> greg.rowles@xxxxxxxxx> wrote:
>
>> Hi Everyone
>>
>> We're in the process of developing a design spec for a (master)
>> data-dictionary that caters for the many variations of datasets we have
>> here in South Africa. I've been challenged on my claim that there are no
>> 'data standards' around aggregated data elements or indicator definitions
>> in our space. Jason suggested I put this forward to the DHIS2 community...
>>
>> I cannot find anything useful. Everything is focused on standardization &
>> interoperability at patient-level. HL7, LOINC, SNOWMED, ICD10 are all down
>> a level on aggregated data. Does anyone have any articles or reference
>> material on the issue?
>>
>> For over a decade now HISP-SA has been the proud custodian of SA's
>> (unofficial) MFL + (official) NIDS - in the hands of Calle. Now that we are
>> moving to DHIS2, with an expanded National Indicator Data Set, we also need
>> to start managing a Master[Facility]List at OU5, a M[Ward]L at OU6,
>> a M[Environmental-Health-Services]L at OU5, a M[School-Health-Services]L at
>> OU5, a M[Reporting-Unit]L at OU6, a M[Ward-Based-Outreach-Team]List at OU7.
>>
>> There are standards and guidelines for implementing a MFL but we have
>> 'extended circumstances' here in SA. We are looking at building a
>> sophisticated solution using DHIS2 for each of the unique Hierarchy
>> arrangements. We are also looking towards the Australian DD for hints on
>> building an 'information services' type-of platform out of our hybrid
>> MFL+DD. Unfortunately there are feelings that we will be replicating what
>> is already available in the openHIE software suite or we may risk losing
>> buy in.
>>
>> Anyone have info on standards for aggregated data? I'm fully comfortable
>> driving ahead with these plans but derailment seems a possibility without a
>> 'standards oriented' defense. There are also strong feelings that openHIE
>> is a superior offering to our conceptual design (even though DHIS2 would be
>> the underlying platform and data would continue to flow through
>> transactional instances of DHIS2).
>>
>> Any ideas, comments or feedback?
>>
>> Greg
>>
>> ----- Forwarded message -----
>> From: "Jason Pickering" <jason.p.pickering@xxxxxxxxx>
>> To: "Greg Rowles" <greg.rowles@xxxxxxxxx>
>> Subject: Standards for Aggregated Data Definitions (Element and
>> Indicators) in Health
>> Date: Wed, Apr 9, 2014 20:05
>>
>> Hi Greg,
>>
>> I think it is a very valid question and not something to be ashamed of at
>> all. In terms of what WHO offers, you can check this out
>>
>> http://www.who.int/gho/indicator_registry/en/
>>
>> In addition, there are some internal HISP reccomendations (which I have
>> heard of but never actually seen) in terms of how to create names of data
>> elements and indicators. For instance, not using "Number of confirmed
>> malaria cases" but rather "Confirmed malaria cases".
>>
>> I think in general though, there is a gap, and something which needs a
>> lot more attention. HISP has been very focused on the technology, and less
>> so on the semantics and M&E processes. I think Bob Joliffe and Ola though
>> would have something to contribute here, so would encourage you to send
>> this mail to the user/dev list for more feedback from the community.
>>
>> Cheers,
>> Jason
>>
>>
>>
>> On Wed, Apr 9, 2014 at 7:01 PM, Greg Rowles <greg.rowles@xxxxxxxxx>wrote:
>>
>>> Hi Jason
>>>
>>> I'm a little embarrassed to copy in any other DHIS2 heavy-weights
>>> because I might embarrass myself with this question:
>>>
>>> Do you know of any existing standards or guideliness on the development
>>> of aggregated data-element and indicator definitions? Everything I find
>>> points to patient-centric data definitions (ICD10, LOINC, SNOWMED). HL7
>>> appears to be more about interoperability standards and not about
>>> aggregation terminology.
>>>
>>> Aggregated data is required for reporting to WHO so I assume there are
>>> standardization guidelines or existing codified definitions somewhere? If
>>> not - there is a gap...?
>>>
>>>  Regards,
>>> Greg
>>>
>>> --
>>>
>>> Business Intelligence Planner
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>>
>>
>
>
> --
>
> Business Intelligence Planner
> *Health Information Systems Programme*
> *- - - - - - - **- - - - - - - **- - - - - - - **- - - - - - - **- - - -
> - *
> Mobile  :    073 246 2992
> Landline:   021 554 3130
> Fax:          086 733 8432
> Skype:      gregory_rowles
>