Automating Indicator Data Reporting from an EMR to Aggregate Data System Using OpenMRS and DHIS2
Background and Purpose: Electronic HIS are considered essential for managing health information. However, due to challenges of implementing interoperability across HIS, often electronic data are manually printed and re-entered into aggregate data systems. In 2009, World Health Organization (WHO) developed Statistical Data and Metadata Exchange for Health Domain (SDMX-HD) to facilitate health indicator exchange. To date, no documented implementation has demonstrated a practical application of SDMX-HD in automating indicator data reporting. This study demonstrates the use of OpenMRS, to generate and transmit indicator data to DHIS2 using key principles of SDMX-HD.
Methods: We deployed OpenMRS and DHIS2 in a test environment at the US Centers for Disease Control and Prevention (CDC) Public Health Informatics Laboratory. OpenMRS was configured to send aggregate indicator data using DHIS reporting module and DHIS2 was prepared to receive them. The two applications were then linked and data exchange process was initiated in OpenMRS using demo data.
Results: Fourteen data elements with disaggregation were generated and transmitted to DHIS2 successfully. A report with the 14 data elements was accurately generated from DHIS2.
Discussions: Results indicate that indicator data can be sent automatically from OpenMRS to DHIS2, eliminating manual data entry. The success of this test will help evaluate the impact of implementing an automated generation of reporting indicators to reduce human resources needed to fulfill reporting requirements; and to improve data quality, completeness and timeliness. These impacts demonstrate that HIS scale-up can have a positive role in improving health service delivery, M&E, and public health planning.
Keywords: Health information systems, Electronic medical records, Data exchange, Indicators, Resource-constrained settings, Aggregate data
Porter LE, Bouey PD, Curtis S, Hochgesang M, Idele P, Jefferson B, Lemma W, et al. Beyond indicators: advances in global HIV monitoring and evaluation during the PEPFAR era. J Acquir Immune Defic Syndr. 2012 Aug 15;60 Suppl 3:S120-6.
Oluoch T , Santas X, Kwaro D, Were M, Biondich P, et al. The effect of electronic medical record-based clinical decision support on HIV care in resource-constrained settings: A systematic review, Int. J. Med. Inform. (2012), http://dx.doi.org/10.1016/j.ijmedinf.2012.07.010
Silow-Carroll S, Edwards J N, Rodin D. Using Electronic Health Records to Improve Quality and Efficiency: The Experiences of Leading Hospitals. Commonwealth Fund pub. 1608 Vol. 17 (2012) accessed at http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/Jul/1608_SilowCarroll_using_EHRs_improve_quality.pdf on 05/06/2013
Mutale, Wilbroad, et al. "Improving health information systems for decision making across five sub-Saharan African countries: implementation strategies from the African Health Initiative." BMC Health Services Research 13.Suppl 2 (2013): S9.
UNAIDS. Monitoring and Evaluation Fundamentals: An Introduction to Indicators. Available at: http://www.unaids.org/en/media/unaids/contentassets/documents/document/2010/8_2-Intro-to-IndicatorsFMEF.pdf
Office of the Global AIDS Coordinator. PEPFAR Next Generation Indicators Reference Guide. 2009. Available at http://www.pepfar.gov/documents/organization/81097.pdf on 6/19/2013
Office of the Global AIDS Coordinator. PEPFAR Blueprint: Creating an AIDS-free Generation, 2012. Available at http://www.pepfar.gov/documents/organization/201386.pdf
WHO, SDMX-HD (Health Domain) Technical document- Indicator Exchange Standard, 2009. Accessed at http://www.sdmx-hd.org/projects/sdmx-hd-standards/files on May 21, 2013
ISO. ISO 17369:2013 Statistical data and metadata exchange (SDMX). Iso.org. accessed at http://www.iso.org/iso/home/store/catalogue_ics/catalogue_detail_ics.htm?csnumber=52500 on May 21, 2013
Office of the Global AIDS Coordinator. PEPFAR Next Generation Indicators Reference Guidance. 2013. Available at: http://www.pepfar.gov/documents/organization/206097.pdf
Smyth ET, McIlvenny G, Barr JG, Dickson LM, Thompson IM. Automated entry of hospital infection surveillance data. Infect Control Hosp Epidemiol 1997;18:486-491.