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Digital Health: Working with Global Goods

This work is licensed under a Creative Commons Attribution 4.0 International License.

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Thank you

to the GIZ DIPC project for supporting the creation of this course.

Special thanks

to the Jembi Mozambique team and all of those in the DIPC project and in the global health community who contributed to the materials.

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Instructor Notes

Delete or hide this slide when sharing slides with participants.

We are excited that you are considering reusing this content. The content is freely available for use under the creative commons license. We welcome you to modify content to appropriately fit the participants needs. For reuse, we recommend that you make your own copy of the materials and modify as you see fit. Please give the GIZ DIPC project, Jembi and Regenstrief credit for reuse of the materials.

Please see the slide notes on this slide for more detail on use of this slide packet.

Estimated time for completion: 3 hours

This work is licensed under a Creative Commons Attribution 4.0 International License.

USING THE MATERIALS

There are multiple ways to use this material and you may use the material as desired. Two suggestions are as follows:

Make a copy and modify the slides to meet the needs of your context.
Make a copy of the slides and use them as they are.

In addition, you will also see some suggestions for interactive discussions in the instructor notes on different slides.

Recommendations:

Include introductions and an icebreaker as necessary depending upon how familiar the participants are with you and each other. An icebreaker will also help enable a participatory environment.
Look at the instructor notes to see suggestions on how to make the course more participatory.

INSTRUCTOR NOTES

In the notes section of the slide, you’ll find additional material that may be helpful to share with learners. In addition, there may be facilitation options and ideas noted in the notes section of the slides.

�TYPES OF SLIDES

There are different types of slides of slides to guide the participants through the materials.

Module introductions (Noted with a module title slide)
Course Material with instructor notes located in the slides notes section of the slide. The instructor notes may contain important concepts that we recommend discussing as well as suggestions for modifications of materials to better fit a specific context.
Exercises / Discussion or reflection questions (Noted with the eyes graphic)

These may be discussions that you want to have as a group in in a Zoom or in-person classroom setting.

Quiz questions (Noted with the question mark graphic)

Consider how you would like to use these. You can use them as a quiz, a self-reflection or as a discusssion. You may want to use a zoom poll or other interactive poll to jump start a discussion. Note: the answers are in the instructor note and you may want to delete these in the participant copy of slides.

COURSE LENGTH

Timing for the course: the material is flexible depending upon the exercises and discussions that you prepare. It is recommended that you plan for 3 - 4 hours. (this will need to be planned)

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Audience

This course is designed to build or enhance abilities to contribute to:

HIS Leadership: HIS program managers, Digital Health advisors, Public Health Specialists, Implementing Partners, and Donors.
System Support Personnel: Software developers, Business Analysts, Trainers, Quality Assurance Technicians, Help Desk Technicians, and HIS specialists.
Clinical staff: Health Care Providers, Data Clerks and Clinical Informaticists.

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Course Description

The Global Goods provides an overview of how global goods can contribute to digital health projects and highlights the value proposition for working with applications that are supported by communities of practice. Participants will learn how evaluate a global good to determine fit for their context and learn how to effectively engage with global health information systems (HIS) communities.

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Learning Objectives

By the end of this course, learners will be able to:

Explain what Global Goods are;
Understand the relationship between global goods and digital public goods for health;
Articulate the value proposition for using a global goods in health initiatives;
Demonstrate knowledge of various types of Global Goods, including relevant sources and lists;
Understand the value of Global Goods Maturity Models;
Assess and rate global goods software maturity levels;
Engage with digital health practitioners and organizations through Global Goods communities and their respective community channels;
Understand communities of practice and the value of being part of a global goods community for different stakeholders.

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Module 1:

Introduction to Global Goods

In this section, participants will learn about the concept of Global Goods and their emergence and significance in the context of digital health.

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Defining Global Goods

In your perspective, what are Global Goods?

Can you name a global good?

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What Are Global

Goods?

Global Goods are a subset of Digital Public Goods

Digital Public Goods (DPG)

Global Goods

As we explore global goods, let’s start with the definitions of two things that seem very similar. You may have heard both of these terms or maybe you have heard neither term. To help get us aligned, we have provided the following definitions for digital public goods and global goods. As you read the definitions, note that one of the key differences is that the global goods are DPGs that are focused on health.

Digital Public Goods (DPGs) - Open-source software, open standards, open data, open AI systems, and open content collections that adhere to privacy and other applicable best practices aimed at helping achieve the United Nations 2030 Sustainable Development Goals

Global Goods - Health-focused DPGs that are impactful, scalable, and adaptable to different countries and contexts, with a perspective to becoming more interoperable deployable and appropriate for low resource settings, particularly Low and Middle Income Countries (LMICs)

Global goods are open-source and freely accessible content, services, or software focused on health that are impactful, scalable, and adaptable globally.
They aim to enhance interoperability and implementation, particularly in low- and middle income countries (LMICs)
The approval process ensures they are non-rivalrous, non excludable, and widely available, following the Digital Principles of Development
Align with the Digital Public Goods (DPG) Standard, they are often registered or nominated as DPGs, especially for software and content global goods

Sources:

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Benefits of Global Goods

Community and Governance

Diverse Funding

Interoperability

Open Source and Accessibility

Aligned with Digital Public Goods Standard

Scalability

Benefits of Global Goods:

Open Source and Accessibility:

They are freely accessible content, services, or software, allowing countries flexibility in adaptation and reducing creation and maintenance costs.

Aligned with Digital Public Goods (DPG) Standard:

Conforming to DPG standards, they are either nominated or registered as DPGs (relevant to software and content global goods).

Community and Governance:

They feature strong community support and clear governance structures at the level where they are created and during implementation, and are regularly updated to match evolving technology and user needs, with growing implementer and supporter bases.

Diverse Funding:

GGs are funded by multiple sources, ensuring continuous support and commitment from a diverse ecosystem of donors. This multi-source funding model helps meet the varied needs of the community and maintains consistent financial support.

Scalability:

Capable of significant deployment, with proven functionality, capability, and security to operate at population or national scale.

Interoperability:

Designed to be interoperable through standards-based approaches, facilitating communication and integration within larger ecosystems.

Sources:

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Value of Global Goods

Why do you think there was a need for Global Goods?

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Why Create Global Goods?

Many health information systems reach pilot stage, but never scale-up
HIS operating in silos are unable to exchange data, leading to gaps and/or duplication in data
Poorly coordinated investments resulting to lack in funding for HIS
Little knowledge available on existing solutions suitable for adoption or adaptation

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Global Good Value Proposition

For Governments

Easier digital tool selection for country context

For Implementers

Mature software adaptable to different contexts

For Developers

Available and modifiable source code

For Donors

Strengthen the coordination among funders

There are multiple stakeholders in the global goods community. Each stakeholder sees the value of a global good in a slightly different way.

For country government stakeholders: The interoperable and open-source nature of global goods supports an ecosystem of choice in which decision-makers can select the tool that is most appropriate for implementation in a specific country or context, and mitigates the risk of vendor lock-in.

For implementers: Global goods are mature software and content tools that adapt to different contexts and that are designed to be interoperable with existing systems. Consider adopting and adapting a global good to meet your digital health needs, rather than “reinventing the wheel”.

For developers: The source code for global goods is available and modifiable, creating more choice and more opportunities for collaboration across organizations and health program areas.

For donors: By strengthening the coordination among funders, the digital health marketplace is better placed to match tools and approaches to the needs of countries and communities.

Source:

The Global Goods Guidebook . 4th ed., Digital Square , 2023.

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Vetting Process

Source: Digital Square. (2023). The Global Goods Guidebook ( 4.0 version)

Request for application

Peer Review Committee

Global Goods Review� Board

Approval Notification

Step 1

Step 2

Step 3

Step 4

In accordance with The Digital Square Global Goods Guidebook, Global Goods undergo the following vetting process:

Digital Square hosts an on-going global call for submissions: Digital Square launched the open call for Global Goods in early 2024. This is an on-going call for applications to identify and promote digital health technologies as global goods. The solicitation period is open for six to eight weeks, allowing ample time for potential global goods to complete the required application.
Evaluation by the Peer Review Committee (PRC): After the solicitation period closes, applications undergo several rounds of external technical review. The Peer Review Committee (PRC) first evaluates the applications according to a Prioritization Framework and Maturity Model. Their combined reviews assess the extent to which the application meets the requirements of being a global good.
Review of the evaluation by the Global Goods Review Committee (GGRC): The compiled evaluations from the PRC are then sent to the Global Goods Review Committee (GGRC), composed of a diverse set of leaders in digital health technology. The GGRC makes the final decision on approving global goods, ensuring the process is transparent and inclusive.
Approval Notification: Approved applications are notified of their approval status and the online Global Goods Guidebook is updated with the details of the new Global Good.

Source:

Global Goods Guidebook

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Using the Guidebook

Using the the Global Goods Guidebook, name two client registry Global Goods that have been implemented in Southern Africa?

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Examples of Global Goods

On the slide, you see some examples of global goods. This is not intended to be the exhaustive list of global goods, however it should serve as an example for the types of software we are talking about in this course.

Bahmni is an open source Hospital Information System (HIS) and Electronic Medical Record (EMR) product led by the Bahmni Coalition, a group of companies and non-profit organizations that provide leadership to Bahmni. It is a project of the OpenMRS Foundation.�Bahmni’s mission is to provide a high-quality, free, open source, comprehensive Health Information Management System (HIMS) solution to improve patient care in low-resource settings. The information that Bahmni makes accessible helps healthcare providers to improve efficiency and quality of patient care, reduce errors in clinical encounters, and advocate for issues related to public health.

CommCare is an open source digital data collection and service delivery platform designed to improve data collection and the quality of frontline services in low-resource settings. CommCare is used across multiple sectors, including healthcare, education, financial services, government, supply chain, gender equality, agriculture, and sanitation.

More information can be found here: �

DHIS2 is an open source, web-based platform for data collection, visualization, analysis, sharing and management of both aggregate and individual-level data, including mobile and offline data collection using the DHIS2 Android app. DHIS2 is mostly used as a Health Management Information System (HMIS), but it is increasingly used in related domains such as health logistics and supply chain management.

iHRIS is a free and open-source software solution that has been used by ministries of health, district health offices, and health care facilities in over 30 countries to collect, maintain, analyze, and manage health workforce data and resources more easily.

ODK is an open-source platform that helps leading researchers, field teams, and Measurement & Evaluation professionals build powerful offline forms to collect the data they need wherever it is.

OpenCRVS is an open-source software solution for civil registration designed specifically for use in low resource contexts.�The core function of OpenCRVS is to formally record the occurrence and characteristics of all vital events. This is done through a process of notification (from the health facility), declaration of the vital event by the informant, validation of the submitted data with supporting documentation, registering the event, and issuing a certificate (e.g., birth certificate) by authorized actors. The system also allows the export of vital statistics data for further analysis and the compilation of statistical reports.

The OpenELIS Global software is an enterprise-level laboratory information system built on open source web-based technologies that has been tailored for public health laboratories in low-and-middle income countries.

The OpenHIM is a middleware component designed to ease interoperability between disparate information systems. It provides secure communications and data governance as well as support for routing, orchestrating, and translating requests as they flow between systems.

OpenLMIS is a powerful, open source, cloud-based electronic logistics management information system (LMIS) purpose-built to manage health commodity supply chains. The OpenLMIS mission is to make powerful LMIS software available in low-resource environments providing high-quality logistics management to improve health commodity distribution in low- and middle-income countries. OpenLMIS increases data visibility, helping supply chain managers identify and respond to commodity needs, particularly at health facilities where lack of data significantly impacts the availability of key medicines and vaccines.

OpenMRS is a scalable, modular, interoperable, open-source electronic medical records platform (EMR), designed for use with other health information systems and in resource-constrained settings. OpenMRS provides health care workers with easier and greater access to data from longitudinal patient records that can inform patient care. Increasingly, data from OpenMRS is also used by digital health leaders to inform the public health decisions needed to achieve the UN Sustainable Development Goals, measure progress towards UNAIDS 95-95-95 targets for HIV epidemic control, respond to outbreaks such as Ebola and COVID-19, and achieve universal health coverage.

RapidPro is an open source platform that allows anyone to build an interactive messaging system using an easy visual interface.�RapidPro was “designed to send and receive data using basic mobile phones, manage complex workflows, automate analysis and present data in real-time”.�RapidPro can be used for sending out health promotion messages, health facility reporting and supporting immunization campaigns. It is used by national governments to establish cost effective communication and management channels with their entire health workforce.�(SORMAS):The Surveillance Outbreak Response Management and Analysis System (SORMAS) is an open source software for early detection of infections and management of epidemic control. SORMAS enables digital data exchange in real time and across national or regional borders.�

Source:

The Global Goods Guidebook . 4th ed., Digital Square , 2023.

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Instructor Notes

Consider your context and choose a few global goods to highlight.

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Perspective:

Trends that may impact global goods.

Linda Taylor, PATH

5 minutes

English

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1. Global Goods are:

Open and accessible health tools focused on global impact.
Proprietary software used in private hospitals.
Mobile applications for personal use.

2. The primary differences between Digital Public Goods (DPGs) and Global Goods lie in:

The geographical scope of implementation, with DPGs being nation-specific and Global Goods having a worldwide application.
The nature of the technology, with DPGs being exclusive to software products and Global Goods extending to include physical hardware components.
The categorization where Global Goods are recognized as a specialized segment within DPGs, primarily targeting health-related endeavors.

3. Which of the following Global Goods is specifically designed to manage health commodity supply chains and improve the distribution of medicines and vaccines in low-resource settings? (You may want to use the global goods guidebook to help you!)

OpenMRS
Bahmni
OpenLMIS
CommCare

Correct answers:

1. a) Open and accessible health tools focused on global impact.

Explanation: Global Goods are open-source health tools that are designed to be adaptable and scalable for use in low-resource settings, typically focused on improving public health outcomes globally. These tools are accessible to all and aim to address key health challenges by providing open, collaborative, and sustainable solutions that can be used worldwide. They are not proprietary or limited to private hospitals or personal use.

2.c) The categorization where Global Goods are recognized as a specialized segment within DPGs, primarily targeting health-related endeavors.

Explanation: Digital Public Goods (DPGs) are open-source solutions, including software, data, AI models, and content, that contribute to achieving the UN's Sustainable Development Goals (SDGs) and are designed to be widely accessible. Global Goods, on the other hand, are a subset of DPGs focused specifically on health-related initiatives. They also align with the DPG principles of openness, scalability, and collaboration, but they specialize in addressing global health challenges. The primary distinction lies in the scope of the sectors they target, with Global Goods concentrating on health.

3.c) OpenLMIS

Explanation: Explanation: OpenLMIS is a cloud-based electronic logistics management information system (LMIS) that manages health commodity supply chains. It is particularly useful in low-resource environments where data visibility and logistics management are critical for improving the availability of medicines and vaccines.

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Module 2:

Global Good Maturity

In this section, learners will be introduced to mechanisms through which digital health stakeholders are able to understand the maturity level of a Global Good for its use in a given context.

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Global Good Maturity

If you were going to implement a global good, what are some key aspects of maturity that you would want to see?

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Maturity Model

A model designed to help governments, donors, developers, and implementers assess the maturity of a Global Good

This allows implementation teams to understand the tool’s readiness to be widely deployed.

The Global Good Maturity Model serves as a standard for assessing how developed and effective digital health tools are across various critical dimensions. It provides a structured set of criteria that help determine if a digital tool is ready for sustainable and large-scale use. These criteria range from the adoption and utilization of the tool in different regions to the support of the community involved in its development and the technical quality of software itself.

This model is essential to ensure that digital health tools are developed with the quality and robustness necessary to be effective and sustainable globally.

A Global Good Maturity Model sets standardized metrics to measure the progress of global goods, allowing for comparison and prioritization for investment. Standardized metrics help measure the global utility, community support, and maturity of each global good.

Sources:

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Overview of Maturity of Global Goods

Linda Taylor, PATH

6 minutes

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Maturity Model Dimensions

Global Utility

Software Maturity

Community Support

Usage

Funding

Global Compliance

Engagement

Support

Governance

Documentation

Standards

Roadmap and Multilingual support

The Global Good Maturity Model (GGMM) rates each global good's maturity as low, medium, or high across three key dimensions noted above. The assessment evaluates global goods across three main dimensions. Global Utility, Community Support, and Maturity. These dimensions are assessed across different levels—low, medium, and high—using various criteria:

Global Utility: Measures the extent of usage, funding adequacy, and other metrics indicating adoption and potential utility.

Country Utilization: based on the number of countries using the tool and the percentage of nationwide or statewide users using it as intended.
Country Strategy: Based on inclusion in eHealth strategies or frameworks of different countries.
Digital Health Interventions: Based on compliance with WHO's Classification of Digital Health Interventions.

Community Support: Assesses the strength of user community support and engagement with the global good.

Community Engagement: Based on engagement of developers, contributors, and implementers on communication platforms.
Community Governance: Based on the presence of formal structures guiding tool development.

Maturity: Evaluates the developmental stage and robustness of the global good.

Software Roadmap: Based on the presence and maintenance of a roadmap for new developments.
User Documentation: Based on the extent and accessibility of user documentation.
Multilingual Support: Based on software support for multiple languages and availability of multilingual documentation.
Standards: Adherence to widely applied health and interoperability standards

This model aims to ensure that digital tools are developed with the necessary quality and robustness, promoting their effectiveness and sustainability globally.

Sources:

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Maturity Model Beneficiaries

Donors

Implementers

Peer Review Committee (PRC) and Investment Review Committee (IRC)

Decision-makers

Innovators

According to the Global Goods Guidebook, the following stakeholders benefit from the GGMM assessments:

Peer Review Committee (PRC) and Investment Review Committee (IRC): During Digital Square solicitations, these committees use the models to prioritize investments in digital health tools based on scalability, adaptability, and sustainability.
Innovators: They can use the models for self-assessment to improve their products, focusing on aspects like community engagement, user documentation, and software scalability.
Implementers: They utilize the models to gauge available community resources.
Decision-makers: They can assess the maturity of global goods to determine suitability for their context before approval.
Donors: They evaluate maturity levels and the impact of investments, guiding future funding decisions for adopting or scaling global goods.

Source:

The Global Goods Guidebook . 4th ed., Digital Square , 2023.

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Examples of GGMM Assessment Indicators

Indicator	Low	Medium	High
Global utility
Country utilization	Less than 2 countries	At least 4 countries	At least 10 countries
Community Support
User documentation	No user documentation	Some user documentation	A full suit of user documentation
Software Maturity
Technical documentation	No substantial documentation	Some technical documentation	Well documented for autonomous use

Table 1: Global Good Maturity Model Guideline of digital intervention tools

As previously explained, there are three high level indicators that Global Goods seek to assess, which include: Global utility, community support, software maturity. According to the Global Good Maturity Model Guideline of Digital Intervention Tools, there are 15 sub-indicators linked to all three high level indicators. The maturity is rated at either low, medium or high for each sub indicator.

Below are the indicators and sub indicators found in GGMM assessments:

Global Utility: 1) country utilization, 2) country strategy, 3)digital health interventions, 4) source code accessibility, 5) funding and revenue

Community Support: 6) developer, contributor, and implementer community engagement, 7) community governance, 8) software roadmap, 9) user documentation, 10) multilingual support

Software Maturity: 11) technical documentation, 12) software productization, 13) interoperability and data accessibility, 14) security, 15) scalability

For this module, learners will be exposed to one sub indicator per indicator, more information can be found here

Sources:

Tom-Aba, Daniel. "The Surveillance Outbreak Response Management and Analysis System (SORMAS): Digital Health Global Goods Maturity Assessment." JMIR Public Health Surveill , vol. 6, no. 2, 2020, https://doi.org/10.2196/15860.

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Using the Guidebook

Find a mobile data collection Global Good tool that is used in more than 130 countries?

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Using the Guidebook

Please identify an open source Global Good for researchers, field teams and M&E professionals that is fully documented and available in over 50 languages.

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Using the Guidebook

Please use the Guidebook to find a well-documented Global Good that supports supply chain functions.

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1. Which of the following indicators is NOT used in the Global Good Maturity Model (GGMM) to assess the readiness of a digital health tool?

Country Utilization
User Documentation
Financial Self-Sufficiency

2. Which of the following is a characteristic of a mature Global Good according to the GGMM?

It has a well-defined governance structure and broad community support.
It is primarily used in a single country with minimal documentation.
It operates in complete isolation without need for interoperability.

3. What is a key benefit of using the Global Goods Maturity Model?

It helps ensure that global goods are expensive and difficult to implement.
It provides a structured approach to evaluate the readiness of global goods for wide-scale deployment.
It restricts global goods to being used only within certain organizations.

Correct Answers:

b) Financial Self-Sufficiency

Explanation: The GGMM focuses on indicators such as country utilization, user documentation, and community engagement. While funding and revenue are considered under Global Utility, financial self-sufficiency is not explicitly a criterion in the maturity model.

2. a) It has a well-defined governance structure and broad community support.

Explanation: A mature Global Good is characterized by having clear governance, strong community support, and the ability to be widely adopted. It is developed in a way that ensures sustainability, transparency, and responsiveness to the needs of users, especially in terms of maintenance and ongoing improvements. Mature global goods are also interoperable and well-documented.

3. b) It provides a structured approach to evaluate the readiness of global goods for wide-scale deployment.

Explanation: The GGMM helps to systematically assess the readiness of Global Goods for large-scale use, focusing on factors such as technical functionality, user base, documentation, and governance. It is a critical tool for decision-makers looking to implement these tools in a sustainable way, ensuring that they are adequately developed and capable of meeting the needs of the target context.

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Module 3:

Shelf-Readiness

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Global Good Usability?

What do you think should be required for a Global Good to be considered usable or “Shelf-Ready”?

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Shelf-readiness for Global Goods

A Shelf-ready software Global Good is:

Quality Assured

Meets the defined requirements and functions

Well-documented

Tools for evaluation, testing and implementation

Interoperable using proper open data exchange standards

Protected against security vulnerabilities

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Shelf-

Readiness

Evaluation Criteria

Installation and Deployment

Quality Assurance and Testing

Security

Alignment with DevOps Best Practices

Supports Standards for Data Exchange

Product Information and Documentation

The Shelf-Readiness Evaluation Matrix is used to perform an assessment of software Global Goods to assess their state of readiness and usability considering several criteria/indicators. According to the Digital Square Shelf-Readiness Evaluation Matrix, a software Global Good must comply with the following criteria to be considered shelf-ready:

Installation and Deployment: The digital solution and its technologies should follow international standards for installation and deployment, and work towards supporting the Instant OpenHIE deployment and configuration requirements, which include “: i) containerisation approaches that are harmonised with Instant OpenHIE; ii) Development of synchronization tools (e.g., OpenHIM mediators) between the software tool and metadata registries (facility, client, terminology) using appropriate IHE profiles of HL7 FHIR.; iii) Scripted configurations and data sets (as required) to showcase the functionality of base use cases; iv) Existing documentation that allows implementers to validate that the initial installation of the tool is as per expected to support IQ (including expected state of successful installation, installation reports validating all services are operational, initial system check tests to support successful and correct installation, etc.)”

Quality Assurance and Testing: The software must meet functional requirements and is developed as expected. The should be evidence of quality assurance practices that show substantiate the safety, security and functionality of the digital solution. According to Digital Square, “Shelf ready software should strive to support the Installation Qualification (IQ), Operational Qualification (OQ), and Performance Qualification (PQ) of software validation during implementation, that demonstrates its readiness for safe and effective use”.

Product Information and Documentation: A shelf-ready tool must have product information and documentation that is understandable to both technical and non-technical users. The information of the digital solution should include a summarized description of the value proposition and main functions of the tool in order to help decision-making processes on the use of the solution in a given context. The product documentation must demonstrate how the tool can safely implemented, used and maintained. The documentation includes operational manuals and guides for developers, implementers and system administrators.

Supports Standards for Data Exchange: Digital solutions that are shelf-ready are categorized in accordance with the OpenHIE architecture framework (business domain service, registry/metadata service, point of service, and interoperability layer) and comply with open data exchange standards. The software must be aligned with OpenHIE architecture in a manner that enables it to support the use cases that it was designed to respond.

Aligns with DevOps Practices: In order to be considered usable and shelf-ready, it is essential that the digital solution follows DevOps Guidelines with all the necessary guidance on considerations to take into account when deploying the solution, including: migration from local hosting to cloud services, change management, and data migration.

Security: Shelf-ready digital solutions follow industry-wide practices when it comes to security, including a well-documented security policy, security assessments and their results, as well as security measures, and must the digital must have gone through vulnerability testing.

Sources:

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Other Context Considerations

Cultural

Considerations

Training and Support

Content Localization

Needs Assessment

Technical Infrastructure

Community

Engagement

In addition, to software Global Good shelf readiness, other complementing criteria that help determine the usability of a software Global Good in a given context may include:

Needs Assessment: First, thoroughly identify the specific challenges and needs of your community. This might involve conducting surveys, focus groups, or consultations with stakeholders.
Technical Infrastructure: Evaluate the existing technical infrastructure in your community. This includes factors like internet access, device availability, and user comfort levels with technology.
Cultural Considerations: Be mindful of cultural norms and preferences within your community. The user interface, content, and delivery methods might need adjustments for optimal user experience.
Content Localization: Adapt the content and user interface to the local language and cultural context. This might involve translating texts, images, and other materials, as well as ensuring the overall design resonates with your audience.
Training and Support: Provide training and support for users within your community. This could involve creating localized training materials, conducting workshops, or establishing a local support network.
Community Engagement: Engage with the Global Good developer community for guidance and support. Often, these communities have experience adapting the software for different contexts and can offer valuable insights.

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OpenMRS is an example of a global good that has been implemented in many countries. In this 3 minute video, Dr. Burke Mamlin, Co-Founder of OpenMRS, describes some of the things to think about when implementing global goods like OpenMRS.

Approximately 3 minutes

“The success of implementing a global good lies in adapting it to meet local needs while leveraging the strength of a global community.”

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1. Which of the following best describes the requirement for "Installation and Deployment" of a shelf-ready Global Good? (You may want to use the GG guidebook for this!)

A) Only developers need access to documentation, as they implement the software.

B) Documentation should be available for technical users only, as non-technical users don’t need details.

C) Both technical and non-technical documentation are required to support proper use and maintenance of the tool.

2. Why is it important for a shelf-ready Global Good to comply with open data exchange standards?

A) It ensures the tool remains proprietary and limits widespread adoption.

B) It helps the software integrate with other systems using open standards like HL7 FHIR.

C) Complying with proprietary standards is more important than open data exchange.

3. How does aligning with DevOps practices affect the shelf-readiness of a Global Good?

A) It complicates the software’s update process, making it harder to manage.

B) It restricts the tool’s deployment to cloud environments only.

C) It streamlines deployment, supports change management, and enables smooth migration processes.

Correct Answers:�1. C) Both technical and non-technical documentation are required to support proper use and maintenance of the tool.

Explanation:�To be shelf-ready, a Global Good must provide comprehensive documentation that supports both technical and non-technical users, ensuring proper deployment and use.

2. B) It helps the software integrate with other systems using open standards like HL7 FHIR.

Explanation:�TOpen standards like HL7 FHIR allow the software to integrate with other systems, ensuring interoperability and scalability.

3. C) It streamlines deployment, supports change management, and enables smooth migration processes.

Explanation: DevOps practices facilitate efficient deployment, change management, and migration, making the software more adaptable to different environments.

�

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Module 4:

Evaluating a global good for your context

This section uses a case study to explore the considerations and processes involved in selecting the appropriate Global Good tool solutions to fit one's project goals, needs and requirements. �

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Tool Selection Case Study

Scenario: Your team has been tasked with creating a software solution for an interoperability layer. You know there are a couple of solutions that have been deployed in other contexts. After educating your team on global goods, there is agreement to assess the possibility of using something that already exists to see if there is an existing tool that meets your needs.

As you begin, it is important to be very clear about the goals of the project. This is helpful to understand the underlying needs and ensure that we capture the key requirements based upon the context of the project.

Example Mission:

In this scenario, the mission is to find a global good that can serve as an interoperability layer. The interoperability layer is an architecture component that enables data sharing between other software applications.

To learn more about an interoperability layer see: https://guides.ohie.org/arch-spec/architecture-specification/overview-of-the-architecture and https://guides.ohie.org/arch-spec/openhie-component-specifications-1/openhie-interoperability-layer-iol. However, the following steps will walk you through the selection process for any application.

Let’s walk through the steps.

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Case Study Process

Overview

Requirements /

Needs Assessment

Demonstrations

High-level Evaluation

Landscape Assessment

Evaluation

Prepare for Demonstrations

Identify Next

Steps

The process to select an appropriate digital tool solution in the context of Global Goods might look something like the steps identified here. Engaging stakeholders in the process is key to success. Here is an example of a case study based upon a real selection process.

Step 1: Identify Use Case and High-level Requirements - Establishes the importance of understanding the business functions that need to be supported by the tool. High-level requirements must be captured, considering key features needed for Electronic Medical Records (EMR) and other healthcare systems, such as patient registration, data security, and information accessibility.

Step 2: Landscape Assessment - Involves evaluating available tools using resources like the Global Goods Guidebook and consulting with expert communities like OpenHIE. This step emphasizes classifying tools as commercial or open-source and considering hosting models and specific health data focus.

Step 3: High-level Evaluation - Focuses on narrowing down choices by checking if tools meet technical requirements, are low-investment, and have successful implementation models, especially in low-resource settings. Prior experience in similar environments (e.g., Low- and Middle-Income Countries) is also evaluated.

Step 4: Prepare for Demonstrations - Involves organizing and scheduling live demonstrations with developers of shortlisted tools to assess their key functionalities and compatibility with existing systems. Specific criteria such as scalability, security, and workflow orchestration are highlighted.

Step 5: Demonstrations - Ensures core evaluators consistently assess each demonstration. Demonstration teams are asked to display relevant interoperability capabilities, and a fair process is maintained by not disclosing competitor details.

Step 6: Evaluation - After the demonstrations, team members review feedback and analyze it collectively to decide on the most suitable tools. Key factors include alignment with initial use cases, cost, capacity building, and scalability.

Step 7: Planning Next Steps - Discusses trial implementation and further testing based on resources and project context. The importance of trying multiple tools and piloting one based on priorities and constraints is noted.

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Step 1

Identify Use Case and High-level Requirements

At the beginning of the assessment process, it is important to be clear about the business functions that the tool needs to support. Key requirements need to be captured. For OpenHIE architecture components like a client registry, a facility registry or an interoperability layer, the OpenHIE Specification provides a high-level overview of requirements to consider. See the OpenHIE Component Specification section for more information on example requirements to consider. ��It will be important to capture high-level functions that the software needs to perform. For example, if you are selecting an Electronic Medical Record (EMR) application, you would want to make sure that the tool can register a patient, support the collection of vitals and other key functions. Key functions for a facility registry might be that the registry can capture key location data regarding the facility and key data about the health services that a facility can support. You may also have requirements about security and who can view and edit specific attributes.

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Requirements to Consider

Technical Requirements

Functionality

Security and Privacy

Scalability

Support for Standards

Cost and Resource Requirements

Capacity Building

Deployment Flexibility

As you are thinking about documenting the requirements you want to evaluate, consider the system's technical, functional, and operational needs. Consider the following criteria:

Technical Requirements: Identify the specific technical capabilities you need. Does the system offer essential features like API support, integration with various data formats, and compatibility with your existing systems?

Functionality: Ensure the system provides key functionalities that your organization needs. For an interoperability layer, we might want to look to determine if it includes key features like transaction viewing, robust error management, and strong data security protocols? Other key functionality for various health applications are outlined in the OpenHIE Architecture Specification.

Security and Privacy: Evaluate whether the system can handle secure communications. Can it ensure encryption, authentication, and authorization to protect sensitive health data and comply with privacy standards?

Scalability: Assess whether the system can scale with your data as your organization grows. Look into its ability to manage increasing transaction volumes and handle future growth projections.

Support for Standards: Check if the system follows industry-standard formats and data exchange protocols. This ensures smooth integration with other health systems and platforms. Examples of standards to consider for different types of application are noted in the OpenHIE Specification. (See examples of health data exchange standards here: https://guides.ohie.org/arch-spec/architecture-specification/standards-and-profiles.)

Cost and Resource Requirements:Consider both upfront and long-term costs, including software licensing, hardware needs, and staffing. Make sure the system fits within your budget and resource availability.

Capacity Building:Determine if the system includes options for staff training or if you will need to rely on external support. Is there built-in training for your team, or does the tool require a significant learning curve?

Deployment Flexibility: Decide if you need a system that supports cloud-based installations, on-premise setups, or both. Flexibility is key depending on your infrastructure and organizational needs.

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Example Requirements

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Step 2

Landscape Assessment

Commercial Tools?

Open Source Tools?

You can use the Global Goods Guidebook as a starting point for a landscape assessment. You might also explore implementations from similar projects in different countries or contexts. Resources like OpenHIE Impact stories and other project materials can be valuable. Depending on your specific needs, you’ll need to decide if you will look at commercial tools that meet your criteria.

Additionally, engaging with communities like OpenHIE can be beneficial; you can ask members about the tools they’ve used for similar use cases.

While here are some things we considered for our example project, your project may have other considerations.

Health Data Focus: Do you want to narrow your search to tools specifically designed to handle health data interoperability?
Tool Classification: Does it matter to you if the tools are commercial or open-source? Do their licensing models or hosting models (cloud vs. on-premise) matter?
Initial Consideration: At this point, compile a list of potential tools that seem capable of addressing the basic technical and functional requirements.

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Landscape Review

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Step 3:

High-level Evaluation

Meets Base Technical Requirements

Implementation Models

Low Investment

Experience in Low- and Middle-Income Countries (LMIC)

Criteria for high-level evaluation

Following the landscape assessment, the example team narrowed down the options to 6-10 tools for further evaluation. They refined this selection by assessing how well each tool aligned with high-level criteria, including the key factors that were critical to the process in the example:

Meets Base Technical Requirements: Verify if the tool meets the base technical requirements essential for functionality in challenging environments (e.g., offline capabilities, data synchronization).
Implementation Models: Ensure the tool is easy to set up and implement, especially in low-resource settings, with straightforward user interfaces and minimal dependency on high infrastructure.
Low Investment: Prioritize tools that require a low investment in terms of both financial cost and human resources for training and deployment.
Experience in Low- and Middle-Income Countries (LMIC): Consider whether the tool has been implemented successfully in similar environments. Select tools that have demonstrated success in similar contexts, particularly in Low- and Middle-Income Countries (LMICs), to enhance reliability and predictability.

Methodology for Narrowing Choices:

In the case study, the team used the following methods to identify some tools that they would focus on for an in depth review.

Online Reviews and Case Studies: Gather information on user satisfaction, performance, and technical capabilities from existing documentation, blogs, and reviews.
Stakeholder Consultations: Engage with key stakeholders (e.g., HIS leadership, technical support staff) to validate alignment with project-specific requirements and contextual challenges.
Direct Communication with Tool Owners: Contact developers or tool providers to discuss their solutions’ adaptability and alignment with the project's unique needs.
Structured Interviews: Conduct interviews with developers or previous users of the tool to gain deeper insights into practical challenges, support availability, and adaptability.

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Business Model and Scalability

Key Functionality

Mediation and Transformation

Supportability and Capacity Building

Example Criteria

Step 4:

Prepare for Demonstrations

Once the team had looked at the tools that the team wanted to further evaluate, the team needed to start preparing for our next step. Zoom demonstrations where preferred and the selected organizations were asked to prepare for a specific length of demonstration. The following are examples of how the case study team prepared for the demonstrations. ��Organize Demonstrations for Shortlisted Tools:

After narrowing the selection to a few key tools, conduct live demonstrations with the tool developers. Demonstrations provide a hands-on opportunity to evaluate the software's functionality.

Scheduling: In our example, we arranged 90-minute sessions for each tool demonstration, which should be presented via web sharing platforms.
We asked them to demonstrate the following key areas:

Overview of the tool's core features.
How the tool handles transactions, security, error management, and logging.
Its capacity to scale and integrate with existing systems.
Workflow orchestration and data transformation capabilities.

Assess Each Tool:

After demonstrations, each tool is evaluated against predetermined criteria. The evaluation should be objective and include both individual assessments and a collective review.

Key Areas to Evaluate:

Business Model and Scalability: Assess whether the tool’s business model (open-source, licensed) fits your needs and whether it can scale to meet future demands.
Functionality: Review critical functions such as transaction viewing, error management, security, logging, and workflow transformation.
Mediation and Transformation: Evaluate how well the tool transforms and routes data, including support for basic and complex workflows.
Supportability and Capacity Building: Determine whether the tool aligns with your organization’s technical capacity and provides sufficient documentation and training resources.

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Selecting Demonstration Participants

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Evaluation Criteria	Low	Medium	High	Comments
Business Model Alignment				Hosted vs. Installed, Open Source or Licensed? Alignment with your needs?
Scalability				Can it handle increasing data and transaction volumes for the next 3-5 years?
Transaction Viewing				Can the system easily track and view transaction statuses?
Transaction Security				Does it support encryption, authentication, and authorization?
Transaction Logging				Does the system log messages, sender info, and response codes?
Error Management				Can the system handle errors and notify users?
Mediation and Transformation				Does it support data transformation and complex workflows?
Support for Low Connectivity				Can the system function in low connectivity environments?
Capacity Building and Documentation				Does it offer training and sufficient documentation for staff?

Example Assessment Form

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Demonstration Element	Rating	Comments
Tool Overview		Did the demonstration cover all aspects of the tool?
Usability		How easy is it to use the tool?
Functionality		Does the tool meet the required functionality (transaction viewing, security)?
Scalability		Can the tool scale for future growth and transactions?
Error Management		Does the tool effectively manage and notify users about errors?
Workflow Support		How flexible is it in handling complex workflows and transformations?
Technical Requirements		Are the technical specifications in line with what your team can handle?

Example Assessment Form

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Other Assessment Considerations

Cost Evaluation Element	Estimated Cost	Comments
Licensing Fees	$XXXX	Costs associated with licenses or open-source models.
Technologist Staffing	$XXXX (e.g., 8 weeks)	Costs for hiring developers or IT staff for implementation.
Consulting Support	$XXXX (e.g., 10 hours)	Fees for external consulting to assist with setup or troubleshooting.
Hosting and Environments	$XXXX	Hosting costs for servers or cloud services.
Training and Documentation	$XXXX	Additional cost for training internal teams on using the software.

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Planning the Agenda

Set clear time expectations
Share the agenda
Share the evaluation criteria

It is important to have an agenda and to ensure that the software teams that you are inviting come prepared to show you want you want to see. In our example, the team prepared a predefined email to send to the organizations that were presenting tools. We included the following information:

----------------------------

Case Study EXAMPLE:

Country eHealth Architecture Interoperability Tool Demonstration

This document is designed to provide presentation guidance to pre-identified interoperability tool developers. Please follow this format during your presentation to the Country interoperability tool evaluation team.

Presentation Timeframe

45 to 50 Minutes to present
20 to 30 minutes for questions from the evaluation team

Presentation Method

Zoom is preferable (we will use our Zoom account)
You can provide handouts for us to share

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Step 5:

Demonstrations

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Step 6:

Evaluation

Suitability for Initial Use Cases

Cost and Resources

Capacity Building

Scalability and Future Proofing

After the demonstrations were completed, the evaluation forms were analyzed and compiled into a report that summarized each group member’s comments. The assessment team then convened to discuss and justify the overall decision.

Decision-Making Based on Evaluation

Based on the scores and evaluations, make the final decision on which tool(s) to implement. While your context and factors may be different, in the case study, we considered the following factors:

Suitability for Initial Use Cases: Does the tool meet the minimum requirements for the specific use cases identified in the project?
Cost and Resources: Compare the costs of each tool (both initial and long-term) with the available budget and resources.
Capacity Building: Ensure the tool offers sufficient support for training staff and building internal capacity.
Scalability and Future Proofing: Select a tool that can handle anticipated data growth and additional use cases.

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Step 7:

Planning Next steps

Does it work in our context?

What would make it work?

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1. What is the purpose of the assessment form used during tool evaluation?

A) To compare user reviews across multiple tools

B) To standardize scoring of tools based on key evaluation criteria

C) To collect participant feedback on demonstration scheduling

2. What is a factor considered during decision-making after the demonstration phase?

A) Presence of multilingual support

B) Ability to adapt to anticipated data growth

C) User interface design flexibility

3. What is one of the four main factors for decision-making after the evaluation phase?

A) Integration with external cloud providers

B) Suitability for initial use cases

C) Number of features included in the tool

4. What is a recommended method to ensure stakeholder engagement during the demonstration phase?

A) Allowing stakeholders to review tools independently

B) Conducting anonymous surveys after demonstrations

C) Ensuring stakeholders feel ownership in the project

Correct Answers:�1. B) To standardize scoring of tools based on key evaluation criteria

Explanation: The assessment form ensures uniform evaluation by rating tools across predefined categories.�

2. B) Ability to adapt to anticipated data growth

Explanation: Scalability and future-proofing, including handling data growth, are emphasized as critical decision-making factors.�

3. B) Suitability for initial use cases

Explanation: Tools need to address the project's immediate needs effectively to ensure a smooth and successful implementation. A tool that aligns well with initial use cases minimizes risks and helps establish a solid foundation for future scalability and integration.

4. C) Ensuring stakeholders feel ownership in the project

Explanation: Engaging stakeholders and fostering ownership ensures effective evaluation and support for the chosen tools.�

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Module 5:

Global Goods Community Engagement

In this section, learners will understand how to work and interact with a Global Goods community.

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Global Goods Community Engagement

Please access the Global Goods Guidebook and identify a Global Goods Community!

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Global Good Community

A network of individuals, organizations, and initiatives focused on promoting Digital Health worldwide by sharing:

Knowledge
Best practices
Technical support and guidance
Free Open Source Digital Health tools

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Community Engagement

Governance

Technical Support

Events and Collaboration

Development

Capacity Building

Community Networking

As previously mentioned, Global Goods are, often times, supported by their respective communities. Below are the main benefits

Of community engagement in the context of Global Goods:

Development:

Access to source code use in your context.
Access to the source code for contributions that support key features needed in your context.
Contributions are reviewed to ensure code quality.
Detailed documentation provided for new contributors.

Events and Collaboration:

Promotion of hackathons for global collaboration on solving problems, introducing features, and addressing bugs.
Beta versions released for community testing and feedback.

Technical Support:

Global Goods Community communication channels serve as a forum for technical discussions, suggestions, and solutions.

Governance:

Inclusive committees and councils with representatives from various countries and sectors.
Strategic decision-making and guidance for software development.
Regular publication of financial reports, meeting minutes, and development roadmaps for transparency.

Capacity Building:

Online courses, video tutorials, and technical documentation available.
Workshops and webinars for training on software development and implementation.

Community Networking:

Local and regional user groups for exchanging experiences and best practices.
Sharing success stories via blogs, social media, and newsletters.
Organizing conferences and workshops to foster networks and partnerships.
Participate in annual conferences and meetings for implementers, developers, and users to exchange experiences, visit sites where Global Goods are implemented, discuss challenges, and collaborate on development.

Sources:

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Identify Contribution Opportunities

Software

Development

Content Creation

Advocacy &

Awareness

User Testing

Fundraising &

Grant Writing

Dr. Burke Mamlin, OpenMRS co-founder describes how to contribute to OpenMRS.

3 minutes

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Balance: Contribution vs Making your own path

Once you’ve decided to implement a global good, you’ll need to have a strategy for implementing. Including how you will contribute to the core vs making the code your own.

Beryl Kanali, Community Coordinator at OpenMRS.

12:11 minutes

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Communities of Practice (CoPs)

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Communities of Practice:

Short and Long Term Value

Strategic advantages

Stay up to date
Innovation
Retaining talent
Development of new strategies

Personal development

Reputation
Professional identity
Collaborative advantages
Marketing

Long Term

Organizations

Problem solving
Time saving
Knowledge sharing
Synergies between several organizations
Reuse of resources

Members

Support in resolving challenges
Access to knowledge
Trust
Fun!
Meaningful work

Short Term

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Community Engagement: Community Platforms

Most global goods have an associated online community platform. This could be a website forum, a social media group, or a dedicated communication channel.

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Engage in the Community

Example Community Platforms

Explore and Find
Join
Interact

Periodic meetings

Online calls

Social media groups

Chats on community platforms

Collaboration platforms

ie. JIRA, Slack

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Welcome!

We look forward to seeing you in the communities!

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Which of the following statements accurately describes a Global Goods Community?
It consists of isolated groups of digital health practitioners working independently.
It encompasses a diverse network of organizations and individuals collaborating across various regions and platforms.
It is a restricted group limited to specific geographical boundaries.

2. In the context of Global Goods communities, governance typically involves:

Encouraging proprietary code development.
Providing exclusive technical documentation
Inclusive decision-making across countries and sectors

3. Which of the following activities is primarily associated with capacity building in Global Goods communities?

Organizing large international conferences
Publishing financial reports and development roadmaps
Conducting online courses and workshops for skill development

Correct Answers:

b) It encompasses a diverse network of organizations and individuals collaborating across various regions and platforms.

Explanation:�A Global Goods Community includes a wide range of stakeholders, such as organizations, developers, donors, and practitioners, working together to develop, maintain, and implement Global Goods. These communities foster collaboration, open communication, and the sharing of best practices across different regions, ensuring that the tools remain relevant and effective on a global scale.

2. a) Inclusive decision-making across countries and sectors

Explanation:�Governance in Global Goods communities is characterized by inclusivity, with decision-making processes involving representatives from various countries and sectors to ensure broad participation.

3. c) Conducting online courses and workshops for skill development

Explanation:�Capacity building focuses on training and development, such as offering online courses, webinars, and workshops to equip members with the necessary skills to contribute to and implement Global Goods.

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What is the primary purpose of Global Goods in digital health?
To provide proprietary software for health management
To support scalable, open-access health tools for global use
To develop country-specific health systems

2. Why is funding a critical indicator in assessing a Global Good's maturity

It ensures only proprietary tools are funded
It reflects sustainability and long-term viability
It eliminates the need for government support

3. Which is a key requirement for a Global Good to be considered “shelf-ready”?

Proprietary documentation only for developers
Compliance with open data exchange standards
Exclusive focus on low-resource settings

4. How does inclusive governance benefit Global Goods communities?

It limits decision-making to specific regions
It focuses only on funding coordination
It promotes balanced decisions across sectors

Overall Quiz