I-TECH Network Presents at End-of-Year Conferences

Posted on December 28, 2023February 2, 2024

It was a busy fall season for teams throughout the I-TECH Network, several of which had robust representation at end-of-year conferences including the International Conference on AIDS and STIs in Africa (ICASA) 2023 the Global Digital Health Forum (GDHF) 2023.

Welcome additions to I-TECH’s regular lineup of conferences were Infectious Disease Week (ID Week) 2023 and the 40th Annual Oregon Rural Health Conference, attended by representatives of I-TECH’s new network partner, the UW Center for Stewardship in Medicine (CSiM).

Representatives from the network presented more than a dozen posters, spoke at panels and discussions, and led an interactive workshop. Read below for more details (links to presentations will be posted as they are made available).

ICASA 2023, 4-9 December, Harare, Zimbabwe

The theme of this year’s conference was “AIDS is not over: Address inequalities, accelerate inclusion and innovation.” I-TECH Network partner the Zimbabwe Technical Assistance, Training, and Education Center for Health (Zim-TTECH) and its partners Pangaea Zimbabwe AIDS Trust (PZAT) and Zvandiri presented several posters representing their work to innovate and improve access at the training and community levels.

Zim-TTECH:

Gloria Gonese at ICASA 2023

Romana R Katekwe, Edson Chidovi, Frances Petracca, Batsirai Makunike, Gloria Gonese, Kerry Thomson, Zwashe Bangani, Haddi Cham, Mirriam Mugwise, Emmanuel Govha, Stefan Wiktor, “Improving Access to Quality Improvement Training through Off-line Electronic Learning: A Case Study from Zimbabwe”
Langalokusa Sibanda, Peace Ntini, Richard Mashapa, Gloria Gonese, Rickie Malaba, Tendayi Mharadze, Ralph Makuyana, Methembe Ndlovu, Ruth Levine, Vivian Bertman, Abigail K. Korn, Kerry A. Thomson, Owen Mugurungi, Tsitsi Apollo, Getrude Ncube, Mirriam Mutseta, Beauty Nyamwanza, Batsirai Makunike-Chikwinya, Stefan Wiktor, “DREAMS Ambassadors Increase HIV Self-Testing Uptake by Male Partners of Young Women in Zimbabwe”
Anjali Vasavada, Phibion Manyanga, Sandra Murwira, Lucia Gondongwe, Ponesai Nyika, Batsirai Makunike-Chikwinya, Gloria Gonese, Stefan Wiktor, George Mamire, Kerry A. Thomson, “Acceptance of Free Cervical Cancer Screening Among Zimbabwean WLHIV: Implications for Integration of HPV Testing into Routine HIV Care”
Rumbidzai Dhliwayo, Lennox Dziva, Ponesai Nyika, Chiedza Mupanguri, Gloria Gonese, Tsitsi Apollo, Owen Mugurungi, Talent Maphosa, Haddi Jatou Cham, Batsirai Makunike-Chikwinya, Stefan Wiktor, “Assessing Implementation and Outcomes of Screening for Advanced HIV Disease (AHD) Among Persons Living with HIV in Five Provinces of Zimbabwe”
Gloria Gonese, “High HIV disease burden among older clients aged ≥50years attending selected health facilities in Zimbabwe, Oct 2020 through March 2023”

PZAT:

Precious Moyo, Joseph Murungu, Shamiso Nyakuwa, Casper Hera, Imelda Mahaka, Blessing Mushangwe, Phibion Manyanga, Gloria Gonese, Batsirai Makunike, Takunda Sola, Getrude Ncube, Tendayi Mharadze, Rickie Malaba, Stefan Wiktor, “Key Populations Outreach Activities for Scaling Up HIV Prevention Care and Treatment Services in Harare, Zimbabwe”
Precious Moyo, Joseph Murungu, Shamiso Nyakuwa, Casper Hera, Imelda Mahaka, Blessing Mushangwe, Phibion Manyanga, Gloria Gonese, Batsirai Makunike, Takunda Sola, Getrude Ncube, Tendayi Mharadze, Rickie Malaba, Stefan Wiktor, “Layering Enhanced Economic Strengthening Interventions to Reduce Vulnerabilities Among Sexually Exploited Minors and Young Women Selling Sex in Zimbabwe”
Sitshengisiwe Ruzibe, Casper Hera, Precious Moyo, Joseph Murungu, Shamiso Nyakuwa, Imelda Mahaka, Langalokusa Sibanda, Peace Ntini, Gloria Gonese, Batsirai Makunike, Mirriam Mutseta, Getrude Ncube, Tendayi Mharadze, Rickie Malaba, Kerry A. Thomson, Stefan Wiktor, “Services for Sexually Exploited Minors and Young Women Selling Sex Enrolled in DREAMS program, Matabeleland North, Zimbabwe”

Zvandiri:

Vivian Chitiyo, Tanyaradzwa Napei, Billiart Tapesana, Ann Selberg, Edson Chidovi, Gloria Gonese, Kerry Thomson, Talent Maphosa, Haddi Cham, Ngwarai Sithole, Tsitsi Mutasa-Apollo, Nicola Willis, Stefan Wiktor, “Minimizing Interruption in Treatment (IIT) through Peer Connections of Adolescents and Young People Living with HIV in Zimbabwe”

GDHF 2023, 4-6 December, Washington, D.C.

The Digital Initiatives Group at I-TECH (DIGI), and others from I-TECH, presented their work in a number of ways at this year’s Global Digital Health Forum. GDHF is a leading global public health industry conference for technology vendors, donors, researchers, government representatives, and implementing organizations working in low- and middle-income countries.

Hannock Tweya and Caryl Feldacker at GDHF 2023

Posters:

Feldacker C, Murethi M, Ndhlovu D, Bisani P, Kathumba D, Samala B, Oni F, Wagaba K, Kagereki E, Wassuna B, Tweya H, “Mobile Electronic Medical Record Systems: The Community-based ART Retention and Suppression (CARES) App Design for High-Quality, Integrated Antiretroviral Therapy in Lilongwe, Malawi”
He Y, AbuShweimeh R, Kouabenan YR, Assoa PH, Puttkammer N, Gloyd S, Wagenaar BH, Komena P, Kamelan N, Iiams-Hauser C, Pongathie A, Kouakou A, Hoffman N, Flowers J, Abiola N, Perrone LA, “Determinants of Routine Implementation for Electronic Laboratory Information Systems in Côte d’Ivoire: a Mixed-Methods Implementation Science Study”
He Y, Kouabenan YR, Assoa PH, Puttkammer N, Gloyd S, Hoffman N, Wagenaar BH, Komena P, Kamelan N, Iiams-Hauser C, Pongathie A, Kouakou A, Flowers J, Abiola N, Perrone LA, “Perceptions and Experiences of Data-Driven Decision-Making and Data Dashboard for HIV Viral Load Testing and Early Infant Diagnosis in Côte d’Ivoire”
Gadabu O, Manyiyo B, Yiga H, Chigoriwa C, Chirowodza L, White C, Mankowski P, Mutesasira M, Gita C, Maxwell L, Muserere C, Flowers J, “A FHIR Training Workshop to Facilitate Interoperability Between the IMPILO EHR and the LIMS System in Zimbabwe”
Secor, A, presented by Patric Prado, “Electronic Medical Record Data Missingness and Interruption in Antiretroviral Therapy among Adults and Children Living with HIV in Haiti: A Retrospective Longitudinal Study”

Virtual Panel:

“Building Next-Gen Digital Health Solutions On FHIR With Open Health Stack” Presenter: Patric Prado

Individual Presentations:

“Efficiently Leveraging Individual-level Health Data For Population-level Data For Decision Making: A Call To Action For FHIR-based Secondary Data Use” Presenter: Piotr Mankowski
“Implementation of An Online Course By MOH For Health Workers In Kenya: Strategies And Lessons For Success” Presenter: Robert Oboko
“Applying Critical Reflection To Reimagine Global Digital Health Interventions: Introducing The (Re)imaginator” Presenter: Beth Dunbar
“Advancing National Health Information Systems Maturity: Lessons Learnt On Implementing The Informatics-Savvy Health Organization (ISHO) Assessment And Action Planning Framework For Health Leaders In Zambia” Presenter: Kendi Mburu
“Online Learning as an Innovation And Sustainability Initiative In Digital Health In Low And Middle Income Countries” Presenter: Robert Oboko

Topic Lounge Discussions:

“Perceptions On The Quality Of Electronic Medical Records In LMIC” Presenter: Jan Flowers
“Bringing Into Production A Health Information Exchange Architecture In Côte D’Ivoire: Using Open Standards And Software To Enable Cross-site Patient Histories And Real Time Dashboarding. Côte D’Ivoire HIE” Presenter: Casey Iiams-hauser

Interactive Workshop:

“Creating, Leading, And Managing Informatics-Savvy Health Organizations (ISHO): Concept, Principles, And Application”

ID Week 2023, 11-15 October, Boston, Massachusetts

IDWeek is the joint annual meeting of the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP). This year, CSiM presented:

“Asymptomatic Bacteriuria Underestimates True Inappropriate Prescribing for Non-Urinary Tract Infections” Presenting author: Whitney Hartlage, PharmD

40th Annual Oregon Rural Health Conference, 11-13 October, Sunriver, Oregon

For this year’s Annual Oregon Rural Health Conference, Rupali Jain, PharmD, and Natalia Martinez-Paz, CSiM Manager, shared lessons learned in Cohort 2 of their Intensive Quality Improvement Cohort (IQIC) program and how Critical Access Hospitals can approach QI in the post-COVID-19 healthcare environment.

Session title: “Case Study: Asymptomatic Bacteriuria Quality Improvement Projects in Critical Access Hospitals”

Digitizing HIV Case Management to Support Patient-Centered Care in Jamaica

DIGI Jamaica Jan Flowers Nancy Puttkammer

Posted on December 1, 2023

In collaboration with the Caribbean Training and Education Center for Health (C-TECH), Jamaica Ministry of Health and Wellness, JASL, and technical working group members, the Digital Initiatives Group at I-TECH (DIGI) is supporting the development and implementation of a mobile health client engagement tool in Jamaica.

The tool facilitates communication between clients living with HIV and their healthcare providers in between their care visits, through a digital case management system and two-way text messaging services. The tool gives clients anytime access to a text-message-based health library and the ability to ping their care team for telemedicine services. This digital health intervention seeks to strengthen the therapeutic alliance and enhance patient medication adherence.

This digital health intervention is made possible through funding and support from the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) via a sub-award granted to the Caribbean Training and Education Center for Health (C-TECH) and DIGI through the International Training and Education Center for Health (I-TECH).

Transitioning OpenELIS Training and Implementation to Local Professionals in Côte d’Ivoire

Cote d'Ivoire DIGI Jan Flowers Laboratory Systems Leadership & Management

Posted on December 24, 2022December 30, 2022

For nearly a decade I-TECH has worked in Côte d’Ivoire in collaboration with the US Centers for Disease Control and Prevention to develop and implement an electronic laboratory information system (LIS) in key laboratories. In order to respond to evolving data needs and ensure timely access to quality laboratory data, an electronic LIS requires ongoing development and continuous user training and technical support.

Previously, from 2015-2017 I-TECH worked closely with the Ivorian Ministry of Health and Public Hygiene (MSHP)’s Directorate of Informatics and Sanitary Information (DIIS) to identify, develop and reinforce the capacity of local professionals to lead and conduct LIS training, deployment, and maintenance activities in anticipation of national roll-out of the LIS at 96 general hospital laboratories. As part of this effort, and in collaboration with the DIIS, I-TECH trained users and deployed LIS at 13 national and regional level laboratories. Between 2013 and 2015, the total number of local professionals competent in LIS deployment increased to 24 local LIS support providers, while the number of in-country LIS trainers increased to 27. Within ten months, local IT providers and trainers trained over 75 health care workers to use an LIS and implemented an LIS at 36 laboratories. During supervision visits to 26 laboratories, within 4 to 6 months post-installation, 25 out of 26 (96%) of laboratories were actively using the LIS.

More recently, Côte d’Ivoire International Training and Education for Health (I-TECH CIV), I-TECH’s local partner in Côte d’Ivoire, has started working directly with CDC and DIIS and continued to engage I-TECH computer developers and deployment strategists to continue the progress with LIS.

I-TECH continues to make considerable progress with code base development for OpenELIS. For more information, visit the OpenELIS Global website.

Implementing a National Laboratory Information System in Mauritius

DIGI Jan Flowers Laboratory Systems Mauritius Nancy Puttkammer Surveillance

Posted on March 18, 2022March 18, 2022

Since 2020, the Digital Initiative Group at I-TECH (DIGI) has worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to deploy a national laboratory information management system (LIMS) using the OpenELIS platform. The LIMS connects the national reference laboratory to regional laboratories and flu clinics around the country to quickly process COVID-19 tests, as well as send results notifications to patients via text message or email.

The OpenELIS system, while implemented to support COVID-19 surveillance, was also designed to be able to support most routine lab workflows, including HIV viral load testing and other other infectious diseases (e.g., HIV, Ebola, Zika, Chikungunya), which ensures MOHW can quickly trace, respond to, and manage cases.

DIGI continues to support MOHW with LIMS training, LIMS maintenance, and national laboratory strengthening.

Optimizing the COVID-19 Testing Process at the Airport in Mauritius

COVID-19 DIGI Jan Flowers Laboratory Systems Mauritius Nancy Puttkammer

Posted on March 18, 2022June 1, 2023

As a measure to help stop the spread of COVID-19, the Government of Mauritius began requiring that all arriving passengers submit to COVID-19 health screenings upon arrival in Mauritius. To rapidly process the influx of tests and quickly notify passengers of their results, the Digital Initiatives Group at I-TECH (DIGI) worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to digitize the COVID-19 screening declaration form for all passengers arriving to the Mauritius International Airport and supported MOHW in opening a COVID-19 reference laboratory at the airport to rapidly process the tests and send notifications of COVID-19 tests passengers.

The airport laboratory is connected to the National Reference Laboratory via OpenELIS, which allows all the data captured on the digital form, such as passenger information and COVID-19 screenings/test results, to assist public health officials from all over Mauritius to carry out surveillance and contact tracing efforts.

Since opening in December 2020, the airport reference laboratory has returned over 250,000 tests and continues to process thousands of tests to passengers and citizens of Mauritius daily.

Jan Flowers

Jan Flowers is a Clinical Faculty member and Research Scientist in the University of Washington School of Nursing, and is faculty co-lead of the Digital Initiatives Group at I-TECH (DIGI). Her area of focus is on innovative strategies and technologies for healthcare systems strengthening in resource constrained settings through appropriate electronic collection and use of quality health data for evidence-based decision making.

She has led informatics organizations and teams for over 20 years, focused on technology policy and law, health information systems evaluation and maturity modeling, open source communities of practice building, health technology engineering and implementation, patient centered technologies and mHealth, and standards-based interoperability for improved care at the point of service, surveillance, and program monitoring.

Ms. Flowers serves on the board of directors for both OpenMRS and OpenELIS Foundations, and the founder of the OpenHIE LIS Community of Practice, which develops and shares common standards and best practices amongst the open-source LIS community. She holds an MS in Health Law & Policy from the University of California San Francisco jointly with UC Hastings Law School, and a BS in Psychology from the University of Washington.

Program Highlights

Creating a Data Warehouse to Support COVID-19 Surveillance in Mauritius

The Digital Initiatives Group at I-TECH (DIGI) worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to implement a national laboratory information system (LIMS) using OpenELIS and expanded it to create a national-level data warehouse. The data warehouse captures all the information that has been input into OpenELIS ...
Read More

Digitizing HIV Case Management to Support Patient-Centered Care in Jamaica

Implementing a National Laboratory Information System in Mauritius

Optimizing the COVID-19 Testing Process at the Airport in Mauritius

OpenELIS Selected for Google’s Innovative Season of Docs Program

DIGI Nancy Puttkammer

Posted on August 30, 2019November 1, 2019

Google has selected OpenELIS Global, a laboratory information system stewarded by the Digital Initiatives Group at I-TECH (DIGI), as a participant in the first year of its Season of Docs, a unique program that pairs technical writers with real-world open source projects. DIGI implements OpenELIS Global in Côte d’Ivoire and Haiti and manages contributions to the software as a part of the global developer community.

“We rely on talented contributors from the global health software community to ensure that our tools have the biggest impact and are available to the widest audience possible,” explained Casey Iiams-Hauser, Senior Digital Health Specialist with DIGI and the OpenELIS Global Product Owner. “By being transparent about our challenges and triumphs, we benefit from peer-to-peer sharing to problem solve for the benefit of the whole community.”

Technical writer Areesha Tariq was paired with the OpenELIS Global project as a part of the initiative. Based in Islamabad, Pakistan, Areesha has a background in software engineering and her writing focuses predominantly on user guides. She will work to improve OpenELIS Global end-user documentation by turning the current user manual into more pragmatic and accessible job aids.

Areesha is excited to join the team, saying, “I feel great to be selected as the technical writer for OpenELIS Global. It will be a new learning experience to work in an open-source community. I hope that I will be able to complete the project and continue working with the team so that I can contribute to a global cause.”

By participating in Google’s Season of Docs initiative, DIGI will not only benefit from Areesha’s contributions, it will also have the opportunity to increase awareness of OpenELIS in the global community by having our projects posted to the initiatives website and reviewed by a large number of technical writers, open source organizations, and contributors. “We are excited to be a part of Season of Docs,” said DIGI Managing Director, Joanna Diallo. “During the application process we met a number of highly qualified technical writers and observed a lot of interest in ‘global goods’ like OpenELIS.”

The idea for DIGI’s technical documentation project grew out of a proposal to PATH’s Digital Square project, which like Google’s Season of Docs, invests in critical technology that can be accessed worldwide. DIGI’s proposal was only partially funded by Digital Square to develop practical designs and generalizable approaches to achieve interoperability among open-source, clinic-level data management systems via the OpenHIE framework. These systems include OpenELIS; OpenLMIS, a laboratory management information system; and OpenMRS, an electronic medical records (EMR) system. However, the OpenELIS documentation scope of work remained unfunded.

“Having focused our thinking already on OpenELIS documentation gaps for the Digital Square application allowed us to pull together our Season of Docs application quickly,” explained Diallo. “It was fortuitous timing – and it is inspiring to see both PATH and Google investing in open source organizations.”

New Digital Group Offers Full Range of Digital Health Services

DIGI Nancy Puttkammer

Posted on August 29, 2019November 1, 2019

In winter 2019, the International Training and Education Center for Health (I-TECH) launched a new unit: the Digital Initiatives Group at I-TECH (DIGI). The DIGI team builds upon 15 years of experience at I-TECH designing, developing, implementing, and evaluating health information systems (HIS) around the world.

The group — co-led by Dr. Nancy Puttkammer, Assistant Professor in the Department of Global Health, and Jan Flowers, Clinical Faculty and Director of Global Health Informatics in the Clinical Research Group (CRIG) — provides services to help programs scope and build technical solutions to manage program or clinical data.

“The shared faculty lead role helps the group leverage diverse resources from departments across the university,” said Joanna Diallo, DIGI Managing Director.

By promoting open-source “global goods” that are supported by implementer communities, DIGI helps partners such as Ministries of Health to be able to own and continue to develop long-term solutions.

In April, Flowers received a Digital Square award to lead an online community of practice on open-source lab information systems like OpenELIS, and Dr. Puttkammer received a Digital Square award to design and test practical and generalizable solutions for interoperability between OpenELIS and two other leading open source tools: OpenMRS and OpenLMIS.

DIGI partners with global communities to develop and enhance digital tools and provide technical assistance for effective implementation and sustainability. The team works closely with on-the-ground experts and stakeholders to guide and facilitate governance, capacity building, and continuous quality improvement using a maturity model lens.

DIGI works in the following technical areas:

Software Design & Development
Health Data Exchange Standards
Health Systems Architecture
Information Security
Evidence-Based Evaluation and Implementation
Digital Health Workforce Development

“With investment from the I-TECH center to launch DIGI, we have been able to approach the work in a new way that is flexible and responsive and promotes cross project sharing,” explained Dr. Puttkammer. “We hope this will continue to strengthen the department’s standing as a leader in digital health.”

HIS Strategic Planning in Cameroon

DIGI Health Information Systems Health Policy Leadership & Management Nancy Puttkammer

Posted on August 5, 2019

National strategies, policies, and governance define the implementation environment for health information systems (HIS) and are recognized as a foundational building block for health system goals, including universal health coverage and control of HIV and other infectious diseases. I-TECH is supporting Cameroon’s Ministry of Health (MOH) to develop a national eHealth strategic plan by September 2019. A goal of the project will be to develop governance structures and processes, which can continue onward beyond the strategic planning process under MOH leadership, for on-going strategic direction, coordination, and oversight of investments in the national HIS.

National Data Warehouse and Dashboards in Botswana

Botswana DIGI Health Information Systems Nancy Puttkammer

Posted on August 5, 2019

I-TECH has worked with the Ministry of Health and Wellness, Centers for Disease Control and Prevention, and other implementing partners in Botswana to develop and implement robust national health information system that enable greater efficiency and accountability and strategic use of information. I-TECH’s work on the National Data Warehouse ensures the availability of strategic information to monitor progress toward reaching epidemic control, with particular focus on Treat All, linkages to care, and HIV clinical cascade for 90-90-90 care continuum.