I-TECH and CHARESS Teams Present Lessons Learned at the Global Digital Health Forum

Posted on December 12, 2018August 1, 2019

Casey-Iiams Hauser, Senior Informatics Implementation Specialist, presents on laboratory information systems at the Global Digital Health Forum in Washington, D.C.

The Fifth Annual Global Digital Health Forum was held from 10-11 December in Washington, D.C., attracting more than 300 participants to the FHI 360 Conference Center. At the forum, representatives from the new Digital Initiatives Group at I-TECH (DIGI) and its partner in Haiti, CHARESS, shared knowledge and lessons learned from 15 years of experience implementing digital health solutions worldwide.

The theme for this year’s forum was “A Shared Language for Digital Health,” and built on a foundation of the World Health Organization’s Classification of Digital Health Interventions.

“I welcome the messages from donors funding digital health work that they are shepherding a new era through the Digital Investment Principles,” said Joanna Diallo, DIGI Managing Director. “The conference provided DIGI an opportunity to present our contributions to global goods like OpenELIS, OpenMRS, and OpenHIE.”

Diallo moderated a panel titled “Different Labs Need Different Systems: An Exploration of Open Source Laboratory Information Systems Use in Global Health and the Community of Practice that Brings Them Together.” Jan Flowers, DIGI Faculty Co-Lead and Director of Global Health Informatics at the University of Washington Clinical Informatics Research Group, and Casey Iiams-Hauser, Senior Informatics Implementation Specialist with DIGI, were panelists, along with Steven Wanyee of IntelliSOFT, a former member of the I-TECH Kenya team.

The panel highlighted LIS as a critical component of national health information systems (HIS) architecture, exploring a complementary suite of open source LIS that are implemented across low- and middle-income countries, describing the laboratories and use cases each serves.

“The forum is a fantastic opportunity to meet with funders, on-the-ground implementers and technologists to discuss our work and learn about new initiatives and technologies,” said Iiams-Hauser. “We can leverage this knowledge for success both in our existing health information projects and in future partnerships.”

CHARESS HIS Lead Nathaelf Hyppolite participated in a session highlighting the development, implementation, and transition of EMR in developing countries, drawing on I-TECH and CHARESS’s work in Haiti. Participants heard about the benefits of an interoperable EMR: a unified data format, the ability to back up data, and that same data can be used to generate reports via DHIS2 from both the cloud servers and hardware EMR system. Hyppolite also shared the advantages and limitations of transitioning to an OpenMRS and OpenHIE platform, which bring experts together to share knowledge, standards, and best practices, as well as collaborate on technologies.

This focus on community and communication was noted by Diallo and the other participants. “DIGI really appreciated the opportunity to learn more about new standards and technologies, how to best approach digital health governance work, and how a shared language will help us collaborate and work together to ultimately improve health outcomes,” said Diallo.

Evaluating Laboratory Systems to Move toward Accreditation in Côte d’Ivoire

Cote d'Ivoire Past Program

Posted on July 24, 2017December 30, 2022

In 2017, in collaboration with the Côte d’Ivoire Ministry of Health and Public Hygiene (MSHP), the National Public Health Reference Laboratory (LNSP), and a local accreditation organization, the Regional Center for Health Evaluation and Accreditation (CRESAC), I-TECH conducted a baseline assessment of laboratory services at 50 laboratories across Côte d’Ivoire.

The purpose of the joint assessment was to determine the laboratory’s capacity to provide HIV and clinical diagnostic services. More specifically, I-TECH aimed to determine the number of laboratorians and HIV counseling and testing staff trained and certified in HIV testing; the quality and timeliness of HIV and clinical diagnostic tests; and the status of each laboratory in order to prepare them for laboratory accreditation under the SLIPTA (WHO’s Stepwise Laboratory Improvement Process Towards Accreditation) scheme.

Strengthening Laboratory Policy in Côte d’Ivoire

Cote d'Ivoire Past Program

Posted on July 24, 2017December 30, 2022

In 2017, Côte d’Ivoire’s National Public Health Reference Laboratory (LNSP) and I-TECH convened a series of strategic planning meetings with the objective of reviewing and updating the vision, mission, and objectives of the previous National Laboratory Strategic Plan. These meetings and collaboration with various partners resulted in a revised plan, the 2017-2022 National Laboratory Strategic Plan.

The five-year strategic plan was agreed upon by representatives from key ministry structures, donors, and other stakeholders with influence on the laboratory system. Their joint actions resulted in a common mission: “To provide a biological diagnosis of quality to the populations living in Côte d’Ivoire by using reliable tests, carried out according to national and international guidelines, in compliance with quality assurance procedures, biosafety procedures, biosecurity and bioethics.”

Ivoirian OpenELIS Software Developers Build Skills In Seattle

Cote d'Ivoire Health Information Systems Health Systems Strengthening Human Resources for Health Laboratory Systems

Posted on February 8, 2013November 1, 2019

The weather has been rainy, and the midwinter days are short, but for two software developers from Côte D’Ivoire, four mid-winter weeks in Seattle offer a rare chance to develop skills under the close mentorship of University of Washington I-TECH experts.

DrKone — Dr Kone presents his capstone project to the Seattle OpenELIS team.

“There is no opportunity in Côte D’Ivoire to build software development skills like this,” said Dr Constant Kone on a recent afternoon as the grey Seattle rain pelted against the window of his borrowed office at I-TECH. His colleague Mr Kamalan Fourier, typing intently on his laptop across the table they share, nodded in agreement.

For several years, I-TECH has coordinated the implementation of the OpenELIS software in national public health laboratories in Côte D’Ivoire, an effort that is led by a highly skilled UW-based health informatics team. The open source laboratory informatics software was customized by the I-TECH team to match the workflow and local needs in Côte D’Ivoire.

But after the initial push to develop and install the software, there was a need for ongoing support, bug fixes, and additional features. “We get continual requests to add new features,” says Jen Antilla, a training specialist on the Seattle team, “for example to respond to new lab processes or build new reports that users need. And like any software, there will always be bugs to fix. We want to build the capacity to respond to those requests locally, in the labs where OpenELIS is running.”

Mr Kamalan Fourier — Mr Fourier presents his capstone project to the team.

Like all I-TECH programs, the Côte D’Ivoire deployment of Open ELIS is on a trajectory towards local ownership and sustainability, but that path is made more complicated by the lack of skilled software developers in Côte D’Ivoire. I-TECH began recruiting for local software developers in April 2012, and recognizing that most applicants would require additional training, the team started designing a custom training course to build the Open ELIS development skills of the new hires in Côte D’Ivoire.

As the first trainees, Dr Kone and Mr Fourier are in Seattle for four weeks, which is the intensive first phase of a planned nine month training program that will continue remotely after they return home.

Central to the training is a problem-based curriculum developed by Antilla and her colleagues, which moves the learners through a typical software development cycle: gathering requirements, designing the solution, developing it into the Open ELIS codebase, and testing it before implementation.

Paul Schwartz reviews the work presented by his Ivoirian colleagues, and provides feedback.

“It gives them the opportunity to learn about the different facets of Open ELIS as well as the tools and process needed to build a new feature,” says Antilla. “And to do so under the direct guidance of a mentor who’s spending lots of face-to-face time with them. When they return to Côte D’Ivoire they will continue with similar exercises a few hours each week, under a remote mentorship of our team, for the next 8 months.”

In the next few months Open ELIS will be fully implemented at a new site in Côte D’Ivoire, the lab at the Institut Pasteur. For the first time there will be local developers on-site with the skills to solve problems locally for their colleagues, with ever-decreasing support from Seattle.

And the I-TECH team in Seattle looks forward to having skilled colleagues at the point of deployment, sharing of the load.

“There’s nothing quite like having the opportunity to build a personal relationship over 4 weeks together in Seattle,” said Paul Schwartz, the senior software engineer on the Seattle team. “I look forward to working shoulder to shoulder with them after they return. Even when those shoulders are half a world away in West Africa!”