dhis2-devs team mailing list archive

[Greg Rowles <greg.rowles@xxxxxxxxx>]

Thank you Bob. This is really helpful!

I think I understand some of the complexities that are being worked on. I
can see that HL7's specification on organisationUnit only partially satisfy
our data-warehousing interests - and creating our own aggregated-data
specification will mean challenging (un)common terminology. I'm working on
an architecture for a dictionary/register that incorporates orgunit, data
element + indicator specifications - this information really helps kick
start the process.

Thank you,
Greg



On Thu, Apr 10, 2014 at 12:30 PM, Bob Jolliffe <bobjolliffe@xxxxxxxxx>wrote:

> 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
>>
>
>


-- 

Business Intelligence Planner
*Health Information Systems Programme*
*- - - - - - - **- - - - - - - **- - - - - - - **- - - - - - - **- - - - - *
Mobile  :    073 246 2992
Landline:   021 554 3130
Fax:          086 733 8432
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