A Brief History of Strengthening Health Information Systems in Resource Constrained Countries “No matter how dysfunctional some find the existing system, others find it quite suitable to their needs.”

A brief history... 2  2004: Key future collaborators for OpenMRS meet at a conference  2006: First OpenMRS deployments in Kenya and Rwanda  2008: Bellagio eHealth series o Enterprise Architecture paper published by Health Metrics Network o Delegates call for move ‘from silos to systems’  2009 RF grant making o RF funds OpenMRS to develop business plan and sustainability model o RF funds PATH to apply requirements methodology to logistics management (with PHII) o RF funds JEMBI to develop Health Enterprise Architecture Framework (HEAF) o Rf funds MoH Rwanda: to form eHealth unit, begin Rwanda Health Enterprise Architecture  2010: o CRDM used in Rwanda to capture primary care requirements o RF funds PATH to apply CRDM to insurance information systems o WHO releases SDMX-HD o v1.0 LMIS requirements released  2011: o ISO working group on enterprise architecture releases ‘house’ maturity model of EA o RF funds VillageReach to expand OpenLMIS collaborative o RF recommends funding to OpenHealthTools to form collaborative repository for architectural artefacts o OpenMRS in clinical deployments in ~40 countries

3 Research indicated many silo’d information systems created a burden on countries Initial engagements with private sector suggested that this market (National Health Information Systems) was not yet ripe for significant commercial product investment Past investments and experience with OpenMRS have proved that open source can work and add value in global health Requirements aren’t enough… Why is RF interested in OpenLMIS?

Copy-left FOSS (Free and Open Source Software) is a fundamentally different model for the production of intellectual property; it is a different way to make things jointly At its core is a reversal of traditional property rights These rights are enshrined in the ‘license.’ There are a multitude of different open source licenses…

What does ‘open’ mean? In the context of software, ‘open’ usually means at least the following: –All source code is freely available for download, modification and redistribution –All source code is released under a license which is considered ‘open’ by the Open Source Initiative “We’ll let your people look at the source code” is NOT the same as “open”

Free Software Foundation Definition “Free software” is a matter of liberty, not price. To understand the concept, you should think of “free” as in “free speech,” not as in “free beer.” Free software is a matter of the users' freedom to run, copy, distribute, study, change and improve the software. More precisely, it means that the program's users have the four essential freedoms: 1.The freedom to run the program, for any purpose (freedom 0). 2.The freedom to study how the program works, and change it so it does your computing as you wish (freedom 1). Access to the source code is a precondition for this. 3.The freedom to redistribute copies so you can help your neighbor (freedom 2). 4.The freedom to distribute copies of your modified versions to others (freedom 3). By doing this you can give the whole community a chance to benefit from your changes. Access to the source code is a precondition for this.

A Shared Vision for a National LMIS An effective logistics management information system (LMIS) should ensure that adequate quantity and quality of vaccines, essential medicines, and supplies are always available to meet patient demand. In order to do this, the LMIS must enable: –Capturing accurate routine administration, dispensing, and consumption data. –Real-time, end-to-end logistics management from point of origin to service delivery point. –Demand forecasting, capacity planning, and modeling based on consumption. 7

8 Logistics Management Logistics management. The part of the supply chain that plans, implements, and controls the efficient, effective forward and reverse flow and storage of goods, services, and related information between the point of origin and the point of consumption. Representative Sources: Nelson DP, Adams IC. A Guide to Improving Drug Management in Decentralized Health Systems: The Monitoring-Training-Planning Guide for Program Implementation. Arlington, VA: Management Sciences for Health, Inc.; Owens Jr. RC, Warner T. Concepts of Logistics System Design. Arlington, VA: John Snow, Inc./DELIVER; Owens Jr. R C, Islam A, Whitehouse M. Guidelines for Implementing Computerized Logistics Management Information Systems (LMIS), second edition. Arlington: John Snow, Inc./DELIVER; US Agency for International Development. Cold Chain and Logistics Management: An Essential Part of Safe and Effective Vaccination Programs. Washington DC: US Agency for International Development; 2008.

Health Impact is Achieved When Appropriate Solutions are Implemented

Collaboratively Determining Common Requirements

EPI Store Keeper - Vietnam Pharmacist - Senegal Logistician - Rwanda Stock Picker - Kenya Country Validation with LMIS Users

P11 P10P9P7P8P6P5P4P1P2P3 Page JFMAMJJASONDJFMAMJJASONDJFMAMJJASOND 3. Project SOW and Kick Off 4. Development 5. Deployment 6. M&E 7. LMIS v1 (Scenario A) Project Closure 2. Landscape – Charter Approved 1. Requirements Zambia Example of Applying Common to Create Specific Requirements “The CRDM process has helped us envision a holistic information system, gather inputs from the right people, and move forward into system development with confidence.” Dr. G. Syakantu, Director-Clinical Care and Diagnostics Services, Zambia Ministry of Health “The CRDM process has helped us envision a holistic information system, gather inputs from the right people, and move forward into system development with confidence.” Dr. G. Syakantu, Director-Clinical Care and Diagnostics Services, Zambia Ministry of Health

If you want to go fast, go alone. If you want to go far, go together. African Proverb 17 “What if we go together?”

Requirements Are The Beginning 18

Now It’s Time to Get to Work 19 “It’s easy to have a complicated idea. It’s hard to have a simple idea” – Carver Mead “There is only one move that really counts: the next one” – Chess master Jose Capablanca

20 ขอบคุณ Asante Merci شكرا لك 謝謝您 Cảm ơn bạn

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