Good day team,
My name is Kondwani Kuthyola, Product Manager under Baobab Health Trust, Malawi. We are in the early stages of developing a Terminology Service for the country. However, it is still fuzzy at this stage on how we should go about this. For starters, we are following the OPENHIE guide on developing Terminology Services and at this point in time, we have “Analysed the current environment” and “identified a few stakeholders”. However, before we go too deep into it, we though we’d get clarification on the below points from the team and any other information that is necessary for us:
- In cases where healthcare providers don’t understand how to use existing terminologies, are there special bodies that provide training to ensure better clinical accuracy?
- Looking at the documentation, implementing a centralised Terminology Service makes more sense but Malawi has a big issue with network reliability as well as frequent power cuts (especially in the remote and hard to reach areas). What would be the best approach to this taking into account similar implementations in other African countries?
- There is lack of experience of internal human resources in terms of classification, mapping, coding and standards. How best can we deal with this constraint?
- For determining the project scope, it might help us a lot if you could share sample user stories from successful implementations as basis for building user stories that fit the Malawi Use Case.
- What data standards are common and in widespread use particularly in African countries knowing we have similar disease conditions?
- Based off other literature, ICD 10 is listed as a Healthcare Billing Terminology, SNOMED CT is listed as a Clinical Terminology, LOINC is listed as a Clinical and Laboratory Terminology and then RxNorm is listed as a Pharmacy Terminology. Does this mean that one would have to implement each one of these if there are use cases for each or using SNOMED for instance would take care of all use cases? Is it possible to append to a reference terminology (i.e. SNOMED, LOINC), custom standard terminologies that are/were developed by a nation?
- In terms of the implementation software, what are the best tools both open source and commercial that one would utilise?
- What are some open source mapping tools that could be utilised?
- Are there already existing data inventories from other implementers (preferably from African countries) that we could utilise as a basis.
- What have been the common challenges faced during implementation and how have they been resolved?
- What tools are recommended especially during requirements gathering phase?
- Are their contacts we can talk to if we need a demo on some of the implementations that have been done?
Looking forward to collaborating with you all.