dhis2-users team mailing list archive

[Carl Leitner <litlfred@xxxxxxxxxxx>]

Hi all,

At this point, the challenges in integrating DHIS2 and iHRIS for indicators are pretty much entirely related to governance and coordination.  The technological tools are there (and they are getting simpler and simpler to use).   If anyone is wanting help in these areas, please reach out to us (IntraHealth) and we should be able to find a way to support you with the tools and provide further guidance.

The main challenges in order of complexity, as I see them, are:
Often the HR and HMIS units do not work in close co-ordination.   The information needs for the HR unit (and other similar stakeholders) are different than for the HMIS unit.  If there is no formal platform (e.g. a TWG)  for these groups to coordinate on and jointly own issues related to information needs and the associated data exchange needed to support this, than any attempt to have  sustainable data exchange will be dead in the water.   This, in my opinion, is the major point of failure. 
Lack of agreement of facility lists, as has already been mentioned.    There are a couple of situations here:
One system (e.g. DHIS2) becomes the authority for the facility data.  In this case, there is existing tooling for iHRIS to load in DHIS2 facility data using a third piece of standards compliant software (more on that below) to handle the data management, an “InterLinked Registry".  This situation can be problematic, as Kayode alludes to,  if the two systems do not agree on what is a facility.   The set of facilities from an HR perspective is larger than the set of facilities that provide clinical services, for example.
DHIS2 and iHRIS each maintain their own independent facility lists.   This is the most common scenario and occurs when the HMIS unit does not agree to adopt all of the facilities that are required for the HR unit.   In this case, we need to ensure that the iHRIS facilities can cross-reference the DHIS2 facilities.   There is significant tooling on this already, again using third piece of standards compliant software.   Note, on the OpenHIE InterLinked Registry call this Wednesday  (see below), Ally will be showing us some of the facility matching/de-duplication tools he developed for Sierra Leone and now extended to be used in other contexts.  Jembi has also worked on a lot of tooling to help automate and monitor the synchronization processes through the OpenHIM software.
There is a third party facility registry that both DHIS2 and iHRIS should synchronize with.  This is a pretty uncommon scenario.
Lack of agreement on the cadre, job or other health worker classification to report on.   There are three types of stakeholders here, and usually each has a different set of classifications for health workers they are interested in. These stakeholders are the HMIS unit with DHIS2, the HR unit with software like iHRIS Manage, and the professional councils with software like iHRIS Qualify.  iHRIS Manage will give you the currently deployed health workers, while iHRIS Qualify would give you total number of available/licensed (though not necessarily deployed) health workers.  There are a couple of other HRIS systems that are also coming: iHRIS Train which is used to manage information a national picture on the health workers graduating from academic institutions and the iHRIS Community Health Worker Registry.

Because of this multiple types of classification, we often need to map the cadres from the source HRIS system into the cadres required for the HMIS/DHIS2.    This mapping can be handled within the HRIS system or can be handled through the use of a Terminology Service (TS) which handles mapping between terminologies.   Though a TS is a bit more overhead, I think it would be warranted in a country such as Nigeria with many HRISs (one for state and one for each professional council) and which is already contemplating a TS as part of their larger eHealth Architecture.  
Finally, there is a technical challenge in that the DHIS2 API changes over time with different versions of DHIS2.   The risks here are contained when we use open international standards for data exchange.   Right now we support the “Care Services Discovery (CSD)” standard for exchange of the facility and org unit hierarchy between the systems.   In the coming year we will see support for the more modern and RESTful FHIR standard.  For data reporting into DHIS2, we need to make better use of the ADX standard to help mitigate issues w/ DHIS2 API changes.  Though the the necessary tooling isn’t in place quite yet, I think we will see it over the next year.
Documentation.   Because these tools have evolved over time, and  because the scenarios have a fairly wide range, we don’t have yet a complete tutorial on all the needed steps.   There is partial documentation, but it needs a bit of tender loving care.    

Note, that we are trying to pull together a training/workshop to address exactly these issues (and explore what you can than do with the data) just after the upcoming DHIS2 academy in Tanzania.   More on that as the plans become more concrete.   We certainly would have the documentation improved by then ;-)

Nothing in the above is particularly special to iHRIS and DHIS2 and are applicable to any HRIS and HMIS.    In Zimbabwe they are going through the same considerations, though they don’t use iHRIS.

Cheers,
-carl


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> On Oct 8, 2016, at 7:25 AM, Bob Jolliffe <bobjolliffe@xxxxxxxxx> wrote:
> 
> Hi Kayode
> 
> I think they can.
> 
> It is just that usually they are not because hmis people generally
> assemble the orgunit hierarchy to support reporting requirements for
> hmis.   Just as LMIS people assemble theirs with logistics logic in
> mind.
> 
> But absolutely nothing which can't be addressed through "local
> arrangements and understandings"
> 
> On 8 October 2016 at 13:16, Kayode Odusote <odusote.kayode@xxxxxxxxx> wrote:
>> Dear Bob,
>> 
>> Getting back to what you said, why can't offices in the Ministry be
>> included in the DHIS2 facility list?  They are also service centres
>> though they are offering administrative services and should need
>> monitoring as well.
>> 
>> Kayode
>> 
>> 
>> On 10/8/16, Bob Jolliffe <bobjolliffe@xxxxxxxxx> wrote:
>>> Hi Lungo
>>> 
>>> Not quite what I said.  It is early days for the SL shining case study
>>> but well worth watching.
>>> 
>>> Cheers
>>> Bob
>>> 
>>> On 8 October 2016 at 11:29, Juma Lungo <jlungo@xxxxxxxxx> wrote:
>>>> Dear Arthur,
>>>> 
>>>> Bob has said it all. To integrate health systems, the culprit is the
>>>> facility list. As the list evolve, the integration die automatically.
>>>> 
>>>> Facility registry is the way to go. Making both, the DHIS2 and iHRIS
>>>> referencing an external database of the facility makes the integration
>>>> permanent. Both, DHIS2 and iHRIS can easily be configured to learn
>>>> facility
>>>> attributes from external database easier.
>>>> 
>>>> See Gerald's case study from Sierra Leone. It is our shining case study.
>>>> 
>>>> One thing you need to take note is, even though right now you are looking
>>>> for a minimum functions for a HR system, the moment you implement demands
>>>> will increase. This is where iHRIS is the best option.
>>>> 
>>>> Best regards,
>>>> 
>>>> Lungo
>>>> 
>>>> 
>>>> ________________________________
>>>> From: Bob Jolliffe <bobjolliffe@xxxxxxxxx>
>>>> To: Arthur Heywood <arthurheywood@xxxxxxxxx>
>>>> Cc: Juma Lungo <jlungo@xxxxxxxxx>; dhis2-users
>>>> <dhis2-users@xxxxxxxxxxxxxxxxxxx>; "calle.hedberg@xxxxxxxxx"
>>>> <calle.hedberg@xxxxxxxxx>; dhis2-devs <dhis2-devs@xxxxxxxxxxxxxxxxxxx>
>>>> Sent: Saturday, October 8, 2016 7:45 AM
>>>> Subject: Re: [Dhis2-users] [Dhis2-devs] Looking for Human Resource System
>>>> to
>>>> integrate with DHIS
>>>> 
>>>> Hi Arthur
>>>> 
>>>> Carl will probably be able to point you to various cases where this
>>>> has been done with dhis2 and ihris.  I am familiar with examples from
>>>> Zanzibar, Kenya and Rwanda which sort of worked but none of which
>>>> could fairly be described as successful in the sense of sustained use
>>>> as far as I know.
>>>> 
>>>> I think the main tricky bit to get right is the harmonization of
>>>> health facilities in the two systems not just as one off, but with
>>>> processes to keep them harmonized.  You might only have 20 indicators
>>>> of interest but you have 1000s of facilities.  As soon as the orgunits
>>>> start diverging the interoperability starts falling apart.  I think
>>>> there was also some interesting work done in Bihar on this problem.
>>>> 
>>>> One conventionasl "wisdom" that has done the rounds over the past few
>>>> years is that a separate facility registry is the solution to this.  I
>>>> am less sure.  In practice you now find that whereas before the
>>>> problem was harmonizing between 2 systems, now it becomes more complex
>>>> because you have 3 :-)  Add more with LMIS etc ..
>>>> 
>>>> So 2 alternative approaches emerge:
>>>> 1. retreat to dhis2 and try and do everything there - sometimes this
>>>> sort of works for many things (which is better than most), but it has
>>>> obvious limits and I don't believe can serve as the basis of long term
>>>> strategy to solve all problems
>>>> 2.  insist that any system that sends data to dhis2 treats dhis2 as
>>>> the authoritative source of facility registry data.  If only they
>>>> would :-)  Unfortunately dhis2 view of the
>>>> physical/geographic/administrative world of the health system can
>>>> diverge sometimes significantly from that of an HRIS system - think of
>>>> MOH employees at offices not involved in health service delivery for
>>>> example.  So there are local arrangements and understandings to be
>>>> made, but in general I think this path holds the most potential,
>>>> 
>>>> In practice I think we have to concede the problems have been unsolved
>>>> for now.  Unless someone can point me otherwise.  The challenge seems
>>>> on the surface to be technically fairly trivial,  But beneath lurk
>>>> demons.
>>>> 
>>>> Cheers
>>>> Bob
>>>> 
>>>> On 8 October 2016 at 07:13, Arthur Heywood <arthurheywood@xxxxxxxxx>
>>>> wrote:
>>>>> Lungo
>>>>> Good to hear from you ... long time no see
>>>>> Thanks for this .... can you tell me where we have a SUCCESSFUL
>>>>> implementation where one can actually get IHRIS data through DHIS and
>>>>> make
>>>>> integrated indicators, use IHRIS indicators for Bottleneck analysis etc
>>>>> 
>>>>> Regards
>>>>> Arthur
>>>>> 
>>>>> **Without deviation from the norm, there can be no progress* *(Frank
>>>>> Zappa)
>>>>> *Skype* arthur_heywood_za
>>>>> Tanzania* +255-773669393 OR +255 673150252
>>>>> 
>>>>> 
>>>>> 
>>>>> 
>>>>> 
>>>>> 
>>>>> 
>>>>> 
>>>>> 
>>>>> On 5 October 2016 at 06:54, Juma Lungo <jlungo@xxxxxxxxx> wrote:
>>>>>> 
>>>>>> Hi Arthur,
>>>>>> 
>>>>>> I would recommend iHRIS.
>>>>>> 
>>>>>> It has many features, integrates nicely with DHIS2, implemented in many
>>>>>> countries and it is being supported by an active community working
>>>>>> closely
>>>>>> with DHIS2 developers.
>>>>>> 
>>>>>> Lungo
>>>>>> 
>>>>>> 
>>>>>> ________________________________
>>>>>> From: Calle Hedberg <calle.hedberg@xxxxxxxxx>
>>>>>> To: Arthur Heywood <arthurheywood@xxxxxxxxx>
>>>>>> Cc: dhis2-users <dhis2-users@xxxxxxxxxxxxxxxxxxx>; dhis2-devs
>>>>>> <dhis2-devs@xxxxxxxxxxxxxxxxxxx>; gerald thomas
>>>>>> <gerald17006@xxxxxxxxx>;
>>>>>> Seleman Ally <seleman_ally@xxxxxxxxx>
>>>>>> Sent: Tuesday, October 4, 2016 10:20 PM
>>>>>> Subject: Re: [Dhis2-devs] [Dhis2-users] Looking for Human Resource
>>>>>> System
>>>>>> to integrate with DHIS
>>>>>> 
>>>>>> Arthur,
>>>>>> 
>>>>>> I'm not directly involved with the HRIS work using DHIS, my current
>>>>>> focus
>>>>>> is on a fully integrated disease surveillance system. Will find out and
>>>>>> get
>>>>>> back to you.
>>>>>> 
>>>>>> Regards
>>>>>> Calle
>>>>>> 
>>>>>> On 4 October 2016 at 15:15, Arthur Heywood <arthurheywood@xxxxxxxxx>
>>>>>> wrote:
>>>>>> 
>>>>>> Calle
>>>>>> In Zambia we are also looking to set up what you call a "core" Human
>>>>>> Resource HMIS ... mainly to do some "Bottleneck analysis" for our MDGi
>>>>>> districts ...
>>>>>> 
>>>>>> Are we able to use a beta version and see what we are able to adapt it
>>>>>> to
>>>>>> our needs (same people being called different professional jobs  etc)
>>>>>> and
>>>>>> then feed back into the development process ....interesting to know how
>>>>>> far
>>>>>> you have progressed?
>>>>>> 
>>>>>> Cheers
>>>>>> a
>>>>>> 
>>>>>> **Without deviation from the norm, there can be no progress* *(Frank
>>>>>> Zappa)
>>>>>> *Skype* arthur_heywood_za
>>>>>> Tanzania* +255-773669393 OR +255 673150252
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> On 26 August 2016 at 23:08, Calle Hedberg <calle.hedberg@xxxxxxxxx>
>>>>>> wrote:
>>>>>> 
>>>>>> Laura,
>>>>>> 
>>>>>> The two main HRIS component designs "within" DHIS2 are the HRHIS in
>>>>>> Tanzania and another in Vietnam (John Lewis or Morten will be able to
>>>>>> tell
>>>>>> you more about that one).
>>>>>> 
>>>>>> South Africa is currently using a customised Tracker app for managing
>>>>>> Community Service and Internships (around 10,000 graduates are applying
>>>>>> for
>>>>>> internship or Community Service posts per annum).
>>>>>> 
>>>>>> We are also working on a "core" workforce registry tightly integrated
>>>>>> with
>>>>>> DHIS2. By "core" I mean it will only deal with actual HR resources
>>>>>> including
>>>>>> position, what they are licensed/authorised to do, and contact details.
>>>>>> Things like continuous education, bursaries, payroll, etc are
>>>>>> processed/managed by other systems. A major advantage of tight
>>>>>> integration
>>>>>> will be the ability to use DHIS2 communication and messages + user
>>>>>> registration to communicate directly with health workers - in
>>>>>> particular
>>>>>> since health workers increasingly will be interacting directly with
>>>>>> DHIS2
>>>>>> on
>>>>>> a daily basis through (daily) capturing of routine data, disease
>>>>>> notifications, various Tracker apps (browser or Android), etc.
>>>>>> 
>>>>>> Your basic requirements seem very similar: your primary need is to
>>>>>> track
>>>>>> the workforce as an INPUT RESOURCE to health service delivery, and not
>>>>>> to
>>>>>> track salaries and CVs and health insurance and employment history and
>>>>>> a
>>>>>> bunch of other "personal" things. So you need to know WHO they are,
>>>>>> where
>>>>>> they actually work and with what (in what position), what they are able
>>>>>> to
>>>>>> do (mostly this relates to formal/legal practice licensing etc, but it
>>>>>> could
>>>>>> be expanded to include specialist knowledge about certain diseases
>>>>>> etc),
>>>>>> and
>>>>>> how to contact them.
>>>>>> 
>>>>>> Regards
>>>>>> Calle
>>>>>> 
>>>>>> On 26 August 2016 at 21:56, gerald thomas <gerald17006@xxxxxxxxx>
>>>>>> wrote:
>>>>>> 
>>>>>> I had use ihris and it is good. If you want help with it I am willing
>>>>>> to
>>>>>> help.
>>>>>> 
>>>>>> On Aug 26, 2016 6:46 PM, "Laura E. Lincks"
>>>>>> <laura.lincks@xxxxxxxxxxxxxxxx
>>>>>> u> wrote:
>>>>>> 
>>>>>> We are looking for a simple Human Resources tool to integrate with a
>>>>>> DHIS
>>>>>> aggregate database. Little is known of the needs of the HRIS, but for
>>>>>> now
>>>>>> it
>>>>>> needs to track personnel details and groups of personnel will need to
>>>>>> be
>>>>>> associated with various programs in a separate DHIS aggregate database.
>>>>>> An
>>>>>> Open Source HRIS is preferable.
>>>>>> 
>>>>>> In searching for tools I have come across the following:
>>>>>> HRHIS in Tanzania developed by the HISP-TZ/University of Dar es Salaam
>>>>>> iHRIS developed by global Capacity Project.
>>>>>> 
>>>>>> I was wondering if anyone had any knowledge of or experience with these
>>>>>> packages or if there were other applications that could be of use to
>>>>>> us?
>>>>>> 
>>>>>> Thanks in advance to anyone with leads or information.
>>>>>> 
>>>>>> Laura E. Lincks
>>>>>> Database Manager/Developer
>>>>>> ICAP - Columbia University
>>>>>> Mailman School of Public Health
>>>>>> 60 Haven Ave, Floor B1
>>>>>> New York, NY 10032
>>>>>> Tel: 212 304 7132
>>>>>> 
>>>>>> ______________________________ _________________
>>>>>> Mailing list: https://launchpad.net/~dhis2-u sers
>>>>>> Post to    : dhis2-users@xxxxxxxxxxxxxxxxxx t
>>>>>> Unsubscribe : https://launchpad.net/~dhis2-u sers
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>>>>>> 
>>>>>> 
>>>>>> ______________________________ _________________
>>>>>> Mailing list: https://launchpad.net/~dhis2-d evs
>>>>>> Post to    : dhis2-devs@xxxxxxxxxxxxxxxxxxx
>>>>>> Unsubscribe : https://launchpad.net/~dhis2-d evs
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>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> --
>>>>>> ****************************** *************
>>>>>> Calle Hedberg
>>>>>> 46D Alma Road, 7700 Rosebank, SOUTH AFRICA
>>>>>> Tel/fax (home): +27-21-685-6472
>>>>>> Cell: +27-82-853-5352
>>>>>> Iridium SatPhone: +8816-315-19119
>>>>>> Email: calle.hedberg@xxxxxxxxx
>>>>>> Skype: calle_hedberg
>>>>>> ****************************** *************
>>>>>> 
>>>>>> 
>>>>>> ______________________________ _________________
>>>>>> Mailing list: https://launchpad.net/~dhis2-u sers
>>>>>> Post to    : dhis2-users@xxxxxxxxxxxxxxxxxx t
>>>>>> Unsubscribe : https://launchpad.net/~dhis2-u sers
>>>>>> More help  : https://help.launchpad.net/Lis tHelp
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> 
>>>>>> --
>>>>>> *******************************************
>>>>>> Calle Hedberg
>>>>>> 46D Alma Road, 7700 Rosebank, SOUTH AFRICA
>>>>>> Tel/fax (home): +27-21-685-6472
>>>>>> Cell: +27-82-853-5352
>>>>>> Iridium SatPhone: +8816-315-19119
>>>>>> Email: calle.hedberg@xxxxxxxxx
>>>>>> Skype: calle_hedberg
>>>> 
>>>>>> *******************************************
>>>>>> 
>>>>>> 
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>>>>>> Post to    : dhis2-devs@xxxxxxxxxxxxxxxxxxx
>>>>>> Unsubscribe : https://launchpad.net/~dhis2-devs
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>>>>>> 
>>>>>> 
>>>>> 
>>>>> 
>>>>> _______________________________________________
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>>>>> 
>>>> 
>>>> 
>>> 
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