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Some facts about ETHIOPIA

1.104 MILLION KM²

Area

~ 100 MILLION

Total Population

9 REGIONS, 2 CITY ADMINS

Administrative units

CALENDAR AND ALPHABET

Ethiopia has its own calendar and alphabet (i.e. it is 2010 in Ethiopia)

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Information Revolution Pillars

Ethiopia

Information Revolution

PILLAR 1

Cultural transformation for health data use

PILLAR 2

Digitalization and scale-up of priority HIS

HIS Governance

The Connected Woreda Demonstration Projects

Transformed Woredas

Information Revolution Roadmap

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Goals of the IR

To improve the use of high-quality routine information in the health sector, contributing to improved quality, efficiency and availability of primary health and nutrition services at all levels.

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EMR

Data Warehouse

eHA

MFR

DHIS 2

NHDD

Customization and deployment of DHIS 2

Deign and implementation of eHealth Architecture (eHA) including an interoperability layer

Implement a Master Facility Registry (MFR) based on ResourceMap

MoH along with its partners has been implementing EMR at Health centers & hospitals at all regions of the country

A national health data warehouse

National Health Data Dictionary (NHDD) is a terminology service developed based on Open Concept Lab (OCL)

eCHIS

Electronic Community Health Information System (eCHIS) – a point-of-service eHealth application to manage community-level health services

Digitization Pillar

IR MAJOR INITIATIVES

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Ethiopia eHealth Architecture (eHA)

Collaboration between FMOH, JSI/Data Use Partnership (DUP) project, and Regenstrief Institute

The Ethiopia eHealth Architecture is a conceptual model that depicts the information systems, data sources, and integrations that the Federal Ministry of Health proposes to implement and maintain to help achieve its strategic goals.

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Why eHealth Architecture (eHA)?

The eHealth Architecture provides a foundational plan to support the acquisition, exchange, sharing and use of health data.

Making data transparent and accessible

Provides support for a patient based longitudinal health record

MOH health indicators and goals longitudinally

Supports reuse of software applications with efficient components, standardized data and a plan for integration

DATA

HEALTH RECORD

TRACKING

INTEROPERABILITY

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eHealth Architecture Objectives

Maximizing ICT resource utilization through curation, publication and dissemination of the eHealth Architecture diagram.

Creating and maintaining detailed eHealth architecture Roadmap

Advising project teams on integration paths and use of standards.

Creating and maintaining an inventory of existing eHealth and mHealth applications (Projects and Products)

Maximizes IT investments by creating reusable components, standardized data and a plan for integration

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LEGEND:

Institution-Based HIS & Data Sources

National Health ICT Infrastructure

Point of Service HIS

Surveillance IVR

EMR

Nutrition

eCHIS

eLIS

Facility Surveys�(SPA+)

eLMIS/HCMIS

eHMIS

IDSR / ePHEM

HGIS

Shared Services

Master Facility Registry

Health Data Dictionary

Analytics & �Business Intelligence

EHDAP

Population-Based HIS & Data Sources

Census

eRIS

External Systems

Under Development

Functional Application

Ethiopia eHealth Architecture: Current State

IFMIS

Agriculture

Under Development

This architecture is conceptually similar to the architecture diagram published in the Information Revolution Roadmap, while refining the categories and allowing for further development
Point-to-point connections are currently in the process of being developed for MFR and NHDD and do not require an “interoperability” service
The “Interoperability Service” is an important option for mediating information exchange -- the type of integration depends on project requirements
Both “information systems” and “data sources” are included in the diagram, which may help to identify priority areas to implement new information systems that provide functionality around important data sets
Planned information systems and integration mechanisms provides an opportunity to test and refine the architecture model: DHIS2, MFR, NHDD, Data Warehouse, Health Insurance

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LEGEND:

Institution-Based HIS & Data Sources

National Health ICT Infrastructure

eHealth Architecture Governance, Principles, Processes and Standards

Point of Service HIS

Surveillance IVR

EMR

Nutrition

eCHIS

Patient Portal

eLIS

Facility Surveys�(SPA+)

eLMIS/HCMIS

eHMIS

Health Insurance / eHNIIS

IDSR / ePHEM

HGIS

Shared Services

Master Facility Registry

Health Data Dictionary

eHIRIS

Client Registry (EMPI)

Shared Health Record

Interoperability Service

Authentication • Encryption • Routing • Transformation • Queuing • Validation • Translation

Analytics & �Business Intelligence

Data Warehouse

EHDAP

Population-Based HIS & Data Sources

Surveys

Census

CRVS

eRIS

External Systems

Development not started

Under Development

Functional Application

Ethiopia eHealth Architecture: Future State

IFMIS

Agriculture

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Components of the eHA

Provides access to common functionality and data sources

SHARED SERVICES

administered centrally and support institutional capabilities of the FMOH.

Institution-based HIS & Data Sources

Allows to collect data directly from the population.

Population-based HIS & Data Sources

used by health workers to facilitate service delivery

Point of Service HIS

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Components of the eHA

mediates the exchange of health information between information systems in the eHA. It enables transaction scheduling, message routing and encryption, transaction tracking, and error management.

Interoperability Service

a technology-driven approach to enhance strategic and operational decision making by consolidating and analyzing data across organizational units.

Analytics & Business Intelligence

provide important capabilities or data to the FMOH, but fall outside of FMOH governance.

External Systems

The design of the HIS governance supports the inclusion of decisions around strategy, standards, guidelines, capacity building as well as HIS policies and procedures.

Governance

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eHealth Apps inventory

The aim is to identify the various eHealth applications implemented at national, other admin units and health facilities. Most importantly, the inventory will help guide the design of the interoperability layer of the eHealth Architecture (eHA).

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DATA COLLECTION: �STAKEHOLDERS

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The app inventory questionnaire is aligned with the Global Digital Health Atlas (GDHA) of WHO. The data is collected from FMOH, RHBs, Zones, woredas, hospitals, and health centers

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Data is collected using the SurveyCTO mobile app

Apps inventory data

Global Digital Health Atlas (GDHA)

DATA COLLECTION AND DASHBOARDING TOOLS

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Agencies

MOH Directorates

INITIAL DATA COLLECTION�RESULTS

apps identified

Regional Health Bureaus

Ministries (MCIT/MoST)

Hospitals (public/private)

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GOVERNANCE �OF THE eHA

eHA governance is derived from the bigger HIS governance framework

Governance structure and accountability

eHA Technical Working Group – TOR developed, TOR to be reviewed by the Digitization Technical Working Group and later will be submitted to the IR Steering Committee for review and endorsement

Joint Steering Committee (JSC)

Ministers, RHBs, Agencies, Directorates

IR Steering Committee

Chaired by the Minister

Membership: FMOH, donors

Digitalization TWG

Cultural Transformation TWG

Chaired by PPD

Membership: HITD, Program Directorates implementing partners

Chaired by HITD

Membership: PPD, implementing partners

National HIS Governance Structure

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eHA Roadmap Plan (2018, Q1-Q4)

Create inventory of existing eHealth and mHealth applications

App inventory

Implement the interoperability layer based on the identified priority use case(s)

Interoperability Layer

Create detailed eHealth Architecture (eHA) roadmap

eHA Roadmap

Identify and prioritize scenarios for data sharing in support of the Ethiopian DUP data use priorities

Scenarios

Develop establishing key eHealth Architecture Governance and Guidelines

Governance & Guidelines

Formalize publication and dissemination of Ethiopian eHealth Architecture

Publication

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eHA Roadmap Plan (2018, Q1-Q4)

Create inventory of existing eHealth and mHealth applications

App inventory

Implement the interoperability layer based on the identified priority use case(s)

Interoperability Layer

Create detailed eHealth Architecture (eHA) roadmap

eHA Roadmap

Identify and prioritize scenarios for data sharing in support of the Ethiopian DUP data use priorities

Scenarios

Develop establishing key eHealth Architecture Governance and Guidelines

Governance & Guidelines

Formalize publication and dissemination of Ethiopian eHealth Architecture

Publication

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eHA Roadmap Plan (2018, Q1-Q4)

Capacity building

Review and update eHealth Architecture

Review

Identify and approve core interoperability standards

Interoperability standards

Identification and Implementation of Shared Services consistent with eHealth architecture

Shared Services

Development of eHA processes, capability assessments and training documentation

Instantiate the interoperability layer

Instantiation

Pilot interoperability service (layer)

Pilot-test

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Interoperability Service selection

Identify potential scenarios
Determine selection criteria
Perform Evaluation
Select Scenario

Identify IOL Criteria
Identify IOL Tools to Evaluate
Perform Evaluation
Select Tool

Scenario Selection Process

Technology Selection Process

Pilot tool and Scenario

Install tool
Determine data trigger and flow
Determine message specification
Determine test cases

Configure tool
Build workflow
Test
Implement
Evaluate Pilot / Capture learning

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