To pick up this thread again. We had a very interesting discussion on the SHR call last night / yesterday where the team discussed the approach to FHIR within the SHR community and possible the broader OHIE community. A great point that came out of this is that FHIR will be a good place to guide the adoption and possible development of information models to support areas of care. What we spoke about wanting to avoid is seeing developers assuming a custom information model is FHIR because of transport etc…
Where we’d like to take that is to map this back as best we can to an architecture and design to see how it fits into OHIE etc.
···
On Fri, Sep 30, 2016 at 5:12 AM, Suranga Kasthurirathne surangakas@gmail.com wrote:
Hi all,
To add to one part of the question being discussed:
As far as the SHR goes, OpenMRS does already support a FHIR API, which is quite usable. We are currently considering our next step in terms of FHIR, and we MAY be in a position to get a little funding for this.
To this end, i’m trying to solicit FHIR requirements from the OpenMRS community, and of course, you!
I don’t want to hijack this tread, but i’d be happy to be part of the call on the 2nd Oct.
Of course, you are also welcome to reach out to me and share your needs. I’m looking at you @ryan, @angshuman and of course, many others.
FYI: One of many things that we’re considering is getting CIEL into the FHIR terminology stream…
Regards
Carl Fourie
Senior Program Manager | Digital Health Division
Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org
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On Mon, Sep 26, 2016 at 2:44 AM, Carl Fourie carl@jembi.org wrote:
Thanks Alvin for the breakdown and unpacking of the REACH approach. There is a lot of “gold” in this mail and it will take me a while to mine it all but first thoughts and comments are:
- I like the idea of passing the question of FHR vs XML technologies to REACH. Would some of the concil members be willing to participate in the discusison and share thier thoughts on appropriateness of appraoch for their countries. I think getting many voices into the mix will allow us to hear from as many members as possible.
- Thank you for clarifying the role of REACH as the “validation panels” and the steps that are enviaged to be followed. To your point of the OpenHIE community being the “architects of design” I think that is a good ask and a great place to do this is the new OpenHIE Implementers Network (OHIN). The OHIN is looking for new usecases and design questions to grapple with and to help members solve (through a peer learning approach) as well as use these to strengtheing the OHIE architecture etc.
Out of curiousity would the question around Drug terminology be something you’d be interested in flying by the OHIN?
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Best Regards,
Suranga
Regards
Carl Fourie
Senior Program Manager | Digital Health Division
Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org
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On Sat, Sep 24, 2016 at 11:47 AM, Alvin Marcelo admarcelo@up.edu.ph wrote:
Hi Carl,
Thanks for asking.
We sort of anticipated this discussion to come sooner or later. And I have hunch both sides can argue in favor or against the other (and make valid cases). So knowing this will happen, Dr Boonchai and I decided a governance mechanism should be put in place (at least in Asia) to make sure things like this are addressed decisively so we can move forward.
AeHIN has trained 30 members on TOGAF and 12 received certification. Majority are embedded in MOHs. Only a handful are working on IT, most are health professionals. Collectively we call them the AeHIN Regional Enterprise Architecture Council for Health or REACH. They wear two hats: they provide EA support internally to their ministry and externally to AeHIN (through a conforme they signed when they applied for the training).
We have agreed amongst ourselves that REACH will be architects of compliance – they won’t design architectures. Rather they will just check if a prescribed architecture was followed according to the method. They will be on the lookout for their country primarily and the region secondarily.
This brings us to the question 'who then are the architects-of-design? ’
We were hoping the OpenHIE community will serve that purpose. Architects-of-design give artifact proposals and architects-of-compliance check if those map well to the business need. That then becomes the working architecture.
For our geographic scope then, I propose the ff steps:
- Preliminary vision and context setting (AeHIN did this at our Regional Interoperability Meeting last August 15, 2015 in Manila. Very high level, mostly principles)
- Defining the business architecture
- Defining the information architecture
- Defining the technology architecture
- Looking for opportunities and solutions
- Migration planning
- Implementation governance
- Architecture change management
It gets hard starting with #2 because priority business needs vary depending on each country to wit:
Philippines, Indonesia, Malaysia, and Vietnam - UHC
Myanmar - linking HIV and TB registries (UHC is emerging)
Thailand - drug terminology (UHC achieved)
Bhutan - telemedicine
In our Nanjing workshop last month, six countries agreed drug terminology was a common area of interest. It didnt require sensitive personal information but it can serve as an initial test of our governance. (The logic was if we can’t even get interoperability with non-sensitive data, we probably won’t with personal). In any case, you can’t argue with countries coming together to set priorities.
Fhir vs XML? I suggest raising this with the REACH. They then bring it back to their countries – see which matches local business needs, then they make a recommendation as a regional body. Final decision will be by their ministers…
Alvin
On Sep 23, 2016 7:47 PM, “Carl Fourie” carl@jembi.org wrote:
I’ll do the unthinkable and cross post here to the OpenHIE implementers Network too (please forgive me all) but Ryan raises some interesting thoughts and I wonder if the implementers network has any thoughts about FHIR etc and Ryan’s views? @Alvin and Boonchai: do you have any thoughts from your networks and teams? @Thomas Fogwill: how are you guys toying with this? @other groups: happy to hear thoughts and opinions here.
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Regards
Carl Fourie
Senior Program Manager | Digital Health Division
Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org
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On Fri, Sep 23, 2016 at 1:05 PM, Ryan Crichton ryan@jembi.org wrote:
Hi Carl,
Thanks for calling this out. I really think we need to actually be working on how to support FHIR based alternatives to our current workflows. As it stands at the moment I couldn’t in good conscience suggest that a new implementation of OpenHIE go with the older XML specifications if they are just starting out. Technology has moved on and the knowledge set of developers that are currently active don’t often cover these older methods of communication.
FHIR provides a nice way to get developer involved with technologies they understand. I don’t think the standards that we are current specifying need to go away, but rather we should have an innovation stream and a set of alternative so that we aren’t turning people away due to the heft of the standards specs.
Cheers,
Ryan
On Fri, Sep 23, 2016 at 11:43 AM Carl Fourie carl@jembi.org wrote:
Thanks Angshuman!
Would be great to have your voices as part of the conversation too. Also recently we put out our SHR specificaiton documents of the SHR community and there is an emerging question around FHIR in there. We have a call scheduled for 2 Oct and it would be great if there was any light you could shed on your experiences there too!
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Ryan Crichton
Lead Developer, Jembi Health Systems | SOUTH AFRICA
Mobile: +27845829934 | Skype: ryan.graham.crichton
E-mail: ryan@jembi.org
Regards
Carl Fourie
Senior Program Manager | Digital Health Division
Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org
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On Fri, Sep 23, 2016 at 11:32 AM, Angshuman Sarkar angshus@thoughtworks.com wrote:
Hi Carl,
I think this is a great idea. Our project in Bangladesh, already uses FHIR.
I would be very interested to listen and chime in, when you discuss this on OHIE.
regards
~angshu
On Fri, Sep 23, 2016 at 2:55 PM, Carl Fourie carl@jembi.org wrote:
And that is a cat amougnst the pigeons statement!
We’ve seen a few emails pop up and there be strong motivation for FHIR use in interoperability, Carl L and Ryan C being 2 people that I know who are looking into FHIR (Pierre Dane too - and I’m sure others).
I’d really like to put this on the table and look at how we, as OHIE Architecture, sees FHIR in the long term and how we bring it in or kick it out. @Ryan C: yesterday you had some key ideas why we hsould be considering FHIR - would you be able ot share this with the group via email
As a note: this would be great to get onto the call but we often run out of time so lets use the longevity of email to try bring this together.
Regards
Carl Fourie
Senior Program Manager | Digital Health Division
Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl.fourie@jembi.org
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