OpenHIE--Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

···

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.



1, how OpenHIE overcome latency ? since its contain many path of

different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.

2, if any document about implementation best practic please provide

links ?

Regards,

Sovannoty

---------- Forwarded message ---------

        From: MeanSambath PBH <msambath.pbh@gmail.com>

        Date: Thu, Mar 9, 2017 at 2:49 AM

        Subject: OpenHIE

        To: Hong Roith - PBH <hroith.pbh@gmail.com>

        Cc: Tapley Jordan <tjordanwood@urc-chs.com            >,

Sam Eng <seng@urc-chs.com >,
Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH <msambath@pbhcam.org >,
Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

            Greeting

from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting,
achieving SDGs with ICT

            Yesterday,

we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts)
here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both
MoH HIS consultants also here with me. A consultant on
standard (Platinir, hired by US CDC/MoH) will use
OpenHIE architecture as principle for his document of
standard and interoperability for MoH.

            Please send me

questions if you have any concerns/problems or any thing
that you want to check about OpenHIE……Paul is
father/founder of OpenHIE/OpenMRS is here too (who we
met in Rwanda). It will be great if you could share a
link that you host OpenHIE? in Myanmar, they used MEDIC
CR as client registry—most of concern of using OpenHIE
is about GOVERNANCE NOT TECHNOLOGY , experience from
country who implement OpenHIE.

            OpenHIE will conduct

first OpenHIE conference this year In Tanzania

** A brief on
OpenHIE**

              OpenHIE has a set of standard

workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

              OpenHIE Implementers network mailing

list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

                OpenHIE = Open Health Information

Exchange = One of health information exchange
framework which AeHIN adopted.
Health Information can be exchanged when systems are
interoperable. (ohie.org.)

                OpenHIM = Open Health Information

Mediator is an application or a set of applications
(a middleware component) (http://openhim.org/ ) that works at the
“Interoperability Layer” of the
OpenHIE architecture.

** OpenHIE
is architecture** . That
architecture has 8 components:

1 - a
client registry (think of a database of people where
there is one unique number
for every person)

2 - a
health worker registry (a database where there is
one unique number fo every
health worker)

3 - a
facility registry (a database where there is one
unique number for every health
facility)

4 - a
terminology service (a database of all terms used in
the health information
system; one unique number for every term AND
relationships of these terms to
each other)

5 - a
health management information system (a special
system where you can aggregate
health data for purposes of decision-making)

6 - a
shared health record (a special database of services
rendered to patients) –
this may be similar to the patient’s Electronic
Health Record

7 - an
interoperability layer that connects all of the
systems above with the systems
below

8 -
edge system (any software that connects to the
interoperability layer that is
not yet mentioned above). It is called edge because
it is at the periphery of
the architecture (example are electronic medical
records running in health
facilities)

                There are open source

software for each of the 8
components:

1 OpenEMPI
and MEDIC-CR for client registry

2 iHRIS
for worker registry

3 Facility
Registry for facility registry

4 Apelon
for terminology service (container) and SNOMED,
ICD10, LOINC (whats inside the
container)

5 HMIS
(=DHIS2)

6 shared
health record = OpenMRS data structure

7 OpenHIM

8 OpenMRS,
OpenEMR, GNU Health, CHITS, etc

              The AeHIN Interoperability Lab are

supposed to
connect these 8 components to each other.

Sambath

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

Thank you for the questions Sambath

The OpenHIM is built to allow it to scale to the needs of the implementation. The OpenHIM deployment would be designed around the number of requests a second and the expected response times. What I mean by this is there is a big difference with the OpenHIM needing to handle 1 request every 5 seconds versus 500 requests every second etc (@Jembi team (RC, PD etc) any thoughts?). As for OpenEMPI I know that the software has been deployed in the USA as implementations (@Shaun G any thoughts?).

MedicCR is an alternative CR too and the Mohawk team have done some scalling and testing with I believe over 10 million patients. I wonder if they have some insight to share with this.

···

On Mon, Mar 13, 2017 at 6:55 AM, msambath sambath reatanaksambath@gmail.com wrote:

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of
different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.**

It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
** 2, if any document about implementation best practic please provide
links ? **
Around best implementation practice, there is the data and link to the implementation guide found at: https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:
OHIE Client Registry Wiki Home Page: https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page: https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page: https://wiki.ohie.org/display/SUB/OpenHIE+Implementers
Subscribe: ohie-implementers+subscribe@googlegroups.com
Post: ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email too.

Regards

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

To unsubscribe from this group and stop receiving emails from it, send an email to ohie-implementers+unsubscribe@googlegroups.com.

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To view this discussion on the web visit https://groups.google.com/d/msgid/ohie-implementers/D4EC31BD.7B24%25reatanaksambath%40gmail.com.

For more options, visit https://groups.google.com/d/optout.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.



1, how OpenHIE overcome latency ? since its contain many path of

different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.

2, if any document about implementation best practic please provide

links ?

Regards,

Sovannoty

---------- Forwarded message ---------

        From: MeanSambath PBH <msambath.pbh@gmail.com>

        Date: Thu, Mar 9, 2017 at 2:49 AM

        Subject: OpenHIE

        To: Hong Roith - PBH <hroith.pbh@gmail.com>

        Cc: Tapley Jordan <tjordanwood@urc-chs.com            >,

Sam Eng <seng@urc-chs.com >,
Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH <msambath@pbhcam.org >,
Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

            Greeting

from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting,
achieving SDGs with ICT

            Yesterday,

we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts)
here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both
MoH HIS consultants also here with me. A consultant on
standard (Platinir, hired by US CDC/MoH) will use
OpenHIE architecture as principle for his document of
standard and interoperability for MoH.

            Please send me

questions if you have any concerns/problems or any thing
that you want to check about OpenHIE……Paul is
father/founder of OpenHIE/OpenMRS is here too (who we
met in Rwanda). It will be great if you could share a
link that you host OpenHIE? in Myanmar, they used MEDIC
CR as client registry—most of concern of using OpenHIE
is about GOVERNANCE NOT TECHNOLOGY , experience from
country who implement OpenHIE.

            OpenHIE will conduct

first OpenHIE conference this year In Tanzania

** A brief on
OpenHIE**

              OpenHIE has a set of standard

workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

              OpenHIE Implementers network mailing

list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

                OpenHIE = Open Health Information

Exchange = One of health information exchange
framework which AeHIN adopted.
Health Information can be exchanged when systems are
interoperable. (ohie.org.)

                OpenHIM = Open Health Information

Mediator is an application or a set of applications
(a middleware component) (http://openhim.org/ ) that works at the
“Interoperability Layer” of the
OpenHIE architecture.

** OpenHIE
is architecture** . That
architecture has 8 components:

1 - a
client registry (think of a database of people where
there is one unique number
for every person)

2 - a
health worker registry (a database where there is
one unique number fo every
health worker)

3 - a
facility registry (a database where there is one
unique number for every health
facility)

4 - a
terminology service (a database of all terms used in
the health information
system; one unique number for every term AND
relationships of these terms to
each other)

5 - a
health management information system (a special
system where you can aggregate
health data for purposes of decision-making)

6 - a
shared health record (a special database of services
rendered to patients) –
this may be similar to the patient’s Electronic
Health Record

7 - an
interoperability layer that connects all of the
systems above with the systems
below

8 -
edge system (any software that connects to the
interoperability layer that is
not yet mentioned above). It is called edge because
it is at the periphery of
the architecture (example are electronic medical
records running in health
facilities)

                There are open source

software for each of the 8
components:

1 OpenEMPI
and MEDIC-CR for client registry

2 iHRIS
for worker registry

3 Facility
Registry for facility registry

4 Apelon
for terminology service (container) and SNOMED,
ICD10, LOINC (whats inside the
container)

5 HMIS
(=DHIS2)

6 shared
health record = OpenMRS data structure

7 OpenHIM

8 OpenMRS,
OpenEMR, GNU Health, CHITS, etc

              The AeHIN Interoperability Lab are

supposed to
connect these 8 components to each other.

Sambath

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

···

On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit: https://groups.google.com/forum/#!forum/ohie-implementers there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of
different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.**

It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency is when handling with HTTP requests, we use the asynch
file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating
‘request has been received’ and the response may be updated to a
different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the client depends on a synchronous
response, the only way to deal with this is to set a long timeout and
wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
** 2, if any document about implementation best practic please provide
links ? **
Around best implementation practice, there is the data and link to the implementation guide found at: https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:
OHIE Client Registry Wiki Home Page: https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page: https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page: https://wiki.ohie.org/display/SUB/OpenHIE+Implementers
Subscribe: ohie-implementers+subscribe@googlegroups.com
Post: ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.



1, how OpenHIE overcome latency ? since its contain many path of

different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.

2, if any document about implementation best practic please provide

links ?

Regards,

Sovannoty

---------- Forwarded message ---------

        From: MeanSambath PBH <msambath.pbh@gmail.com>

        Date: Thu, Mar 9, 2017 at 2:49 AM

        Subject: OpenHIE

        To: Hong Roith - PBH <hroith.pbh@gmail.com>

        Cc: Tapley Jordan <tjordanwood@urc-chs.com            >,

Sam Eng <seng@urc-chs.com >,
Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH <msambath@pbhcam.org >,
Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

            Greeting

from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting,
achieving SDGs with ICT

            Yesterday,

we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts)
here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both
MoH HIS consultants also here with me. A consultant on
standard (Platinir, hired by US CDC/MoH) will use
OpenHIE architecture as principle for his document of
standard and interoperability for MoH.

            Please send me

questions if you have any concerns/problems or any thing
that you want to check about OpenHIE……Paul is
father/founder of OpenHIE/OpenMRS is here too (who we
met in Rwanda). It will be great if you could share a
link that you host OpenHIE? in Myanmar, they used MEDIC
CR as client registry—most of concern of using OpenHIE
is about GOVERNANCE NOT TECHNOLOGY , experience from
country who implement OpenHIE.

            OpenHIE will conduct

first OpenHIE conference this year In Tanzania

** A brief on
OpenHIE**

              OpenHIE has a set of standard

workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

              OpenHIE Implementers network mailing

list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

                OpenHIE = Open Health Information

Exchange = One of health information exchange
framework which AeHIN adopted.
Health Information can be exchanged when systems are
interoperable. (ohie.org.)

                OpenHIM = Open Health Information

Mediator is an application or a set of applications
(a middleware component) (http://openhim.org/ ) that works at the
“Interoperability Layer” of the
OpenHIE architecture.

** OpenHIE
is architecture** . That
architecture has 8 components:

1 - a
client registry (think of a database of people where
there is one unique number
for every person)

2 - a
health worker registry (a database where there is
one unique number fo every
health worker)

3 - a
facility registry (a database where there is one
unique number for every health
facility)

4 - a
terminology service (a database of all terms used in
the health information
system; one unique number for every term AND
relationships of these terms to
each other)

5 - a
health management information system (a special
system where you can aggregate
health data for purposes of decision-making)

6 - a
shared health record (a special database of services
rendered to patients) –
this may be similar to the patient’s Electronic
Health Record

7 - an
interoperability layer that connects all of the
systems above with the systems
below

8 -
edge system (any software that connects to the
interoperability layer that is
not yet mentioned above). It is called edge because
it is at the periphery of
the architecture (example are electronic medical
records running in health
facilities)

                There are open source

software for each of the 8
components:

1 OpenEMPI
and MEDIC-CR for client registry

2 iHRIS
for worker registry

3 Facility
Registry for facility registry

4 Apelon
for terminology service (container) and SNOMED,
ICD10, LOINC (whats inside the
container)

5 HMIS
(=DHIS2)

6 shared
health record = OpenMRS data structure

7 OpenHIM

8 OpenMRS,
OpenEMR, GNU Health, CHITS, etc

              The AeHIN Interoperability Lab are

supposed to
connect these 8 components to each other.

Sambath

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled etc. For the highlevel set of workflows please see: https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

···

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

To unsubscribe from this group and stop receiving emails from it, send an email to ohie-implementers+unsubscribe@googlegroups.com.

To post to this group, send email to ohie-implementers@googlegroups.com.

To view this discussion on the web visit https://groups.google.com/d/msgid/ohie-implementers/CACMjOH%3Dzcof5CCJbbhV7icurjFz1Hz4C860Oqr9hq_mUO7AOkw%40mail.gmail.com.

For more options, visit https://groups.google.com/d/optout.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit: https://groups.google.com/forum/#!forum/ohie-implementers there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of
different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.**

It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency is when handling with HTTP requests, we use the asynch
file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating
‘request has been received’ and the response may be updated to a
different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the client depends on a synchronous
response, the only way to deal with this is to set a long timeout and
wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
** 2, if any document about implementation best practic please provide
links ? **
Around best implementation practice, there is the data and link to the implementation guide found at: https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:
OHIE Client Registry Wiki Home Page: https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page: https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page: https://wiki.ohie.org/display/SUB/OpenHIE+Implementers
Subscribe: ohie-implementers+subscribe@googlegroups.com
Post: ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.



1, how OpenHIE overcome latency ? since its contain many path of

different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.

2, if any document about implementation best practic please provide

links ?

Regards,

Sovannoty

---------- Forwarded message ---------

        From: MeanSambath PBH <msambath.pbh@gmail.com>

        Date: Thu, Mar 9, 2017 at 2:49 AM

        Subject: OpenHIE

        To: Hong Roith - PBH <hroith.pbh@gmail.com>

        Cc: Tapley Jordan <tjordanwood@urc-chs.com            >,

Sam Eng <seng@urc-chs.com >,
Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH <msambath@pbhcam.org >,
Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

            Greeting

from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting,
achieving SDGs with ICT

            Yesterday,

we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts)
here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both
MoH HIS consultants also here with me. A consultant on
standard (Platinir, hired by US CDC/MoH) will use
OpenHIE architecture as principle for his document of
standard and interoperability for MoH.

            Please send me

questions if you have any concerns/problems or any thing
that you want to check about OpenHIE……Paul is
father/founder of OpenHIE/OpenMRS is here too (who we
met in Rwanda). It will be great if you could share a
link that you host OpenHIE? in Myanmar, they used MEDIC
CR as client registry—most of concern of using OpenHIE
is about GOVERNANCE NOT TECHNOLOGY , experience from
country who implement OpenHIE.

            OpenHIE will conduct

first OpenHIE conference this year In Tanzania

** A brief on
OpenHIE**

              OpenHIE has a set of standard

workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

              OpenHIE Implementers network mailing

list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

                OpenHIE = Open Health Information

Exchange = One of health information exchange
framework which AeHIN adopted.
Health Information can be exchanged when systems are
interoperable. (ohie.org.)

                OpenHIM = Open Health Information

Mediator is an application or a set of applications
(a middleware component) (http://openhim.org/ ) that works at the
“Interoperability Layer” of the
OpenHIE architecture.

** OpenHIE
is architecture** . That
architecture has 8 components:

1 - a
client registry (think of a database of people where
there is one unique number
for every person)

2 - a
health worker registry (a database where there is
one unique number fo every
health worker)

3 - a
facility registry (a database where there is one
unique number for every health
facility)

4 - a
terminology service (a database of all terms used in
the health information
system; one unique number for every term AND
relationships of these terms to
each other)

5 - a
health management information system (a special
system where you can aggregate
health data for purposes of decision-making)

6 - a
shared health record (a special database of services
rendered to patients) –
this may be similar to the patient’s Electronic
Health Record

7 - an
interoperability layer that connects all of the
systems above with the systems
below

8 -
edge system (any software that connects to the
interoperability layer that is
not yet mentioned above). It is called edge because
it is at the periphery of
the architecture (example are electronic medical
records running in health
facilities)

                There are open source

software for each of the 8
components:

1 OpenEMPI
and MEDIC-CR for client registry

2 iHRIS
for worker registry

3 Facility
Registry for facility registry

4 Apelon
for terminology service (container) and SNOMED,
ICD10, LOINC (whats inside the
container)

5 HMIS
(=DHIS2)

6 shared
health record = OpenMRS data structure

7 OpenHIM

8 OpenMRS,
OpenEMR, GNU Health, CHITS, etc

              The AeHIN Interoperability Lab are

supposed to
connect these 8 components to each other.

Sambath

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

···

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

To unsubscribe from this group and stop receiving emails from it, send an email to ohie-implementers+unsubscribe@googlegroups.com.

To post to this group, send email to ohie-implementers@googlegroups.com.

To view this discussion on the web visit https://groups.google.com/d/msgid/ohie-implementers/CACMjOH%3Dzcof5CCJbbhV7icurjFz1Hz4C860Oqr9hq_mUO7AOkw%40mail.gmail.com.

For more options, visit https://groups.google.com/d/optout.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit: https://groups.google.com/forum/#!forum/ohie-implementers there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of
different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.**

It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency is when handling with HTTP requests, we use the asynch
file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating
‘request has been received’ and the response may be updated to a
different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the client depends on a synchronous
response, the only way to deal with this is to set a long timeout and
wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
** 2, if any document about implementation best practic please provide
links ? **
Around best implementation practice, there is the data and link to the implementation guide found at: https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:
OHIE Client Registry Wiki Home Page: https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page: https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page: https://wiki.ohie.org/display/SUB/OpenHIE+Implementers
Subscribe: ohie-implementers+subscribe@googlegroups.com
Post: ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.



1, how OpenHIE overcome latency ? since its contain many path of

different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.

2, if any document about implementation best practic please provide

links ?

Regards,

Sovannoty

---------- Forwarded message ---------

        From: MeanSambath PBH <msambath.pbh@gmail.com>

        Date: Thu, Mar 9, 2017 at 2:49 AM

        Subject: OpenHIE

        To: Hong Roith - PBH <hroith.pbh@gmail.com>

        Cc: Tapley Jordan <tjordanwood@urc-chs.com            >,

Sam Eng <seng@urc-chs.com >,
Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH <msambath@pbhcam.org >,
Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

            Greeting

from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting,
achieving SDGs with ICT

            Yesterday,

we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts)
here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both
MoH HIS consultants also here with me. A consultant on
standard (Platinir, hired by US CDC/MoH) will use
OpenHIE architecture as principle for his document of
standard and interoperability for MoH.

            Please send me

questions if you have any concerns/problems or any thing
that you want to check about OpenHIE……Paul is
father/founder of OpenHIE/OpenMRS is here too (who we
met in Rwanda). It will be great if you could share a
link that you host OpenHIE? in Myanmar, they used MEDIC
CR as client registry—most of concern of using OpenHIE
is about GOVERNANCE NOT TECHNOLOGY , experience from
country who implement OpenHIE.

            OpenHIE will conduct

first OpenHIE conference this year In Tanzania

** A brief on
OpenHIE**

              OpenHIE has a set of standard

workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

              OpenHIE Implementers network mailing

list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

                OpenHIE = Open Health Information

Exchange = One of health information exchange
framework which AeHIN adopted.
Health Information can be exchanged when systems are
interoperable. (ohie.org.)

                OpenHIM = Open Health Information

Mediator is an application or a set of applications
(a middleware component) (http://openhim.org/ ) that works at the
“Interoperability Layer” of the
OpenHIE architecture.

** OpenHIE
is architecture** . That
architecture has 8 components:

1 - a
client registry (think of a database of people where
there is one unique number
for every person)

2 - a
health worker registry (a database where there is
one unique number fo every
health worker)

3 - a
facility registry (a database where there is one
unique number for every health
facility)

4 - a
terminology service (a database of all terms used in
the health information
system; one unique number for every term AND
relationships of these terms to
each other)

5 - a
health management information system (a special
system where you can aggregate
health data for purposes of decision-making)

6 - a
shared health record (a special database of services
rendered to patients) –
this may be similar to the patient’s Electronic
Health Record

7 - an
interoperability layer that connects all of the
systems above with the systems
below

8 -
edge system (any software that connects to the
interoperability layer that is
not yet mentioned above). It is called edge because
it is at the periphery of
the architecture (example are electronic medical
records running in health
facilities)

                There are open source

software for each of the 8
components:

1 OpenEMPI
and MEDIC-CR for client registry

2 iHRIS
for worker registry

3 Facility
Registry for facility registry

4 Apelon
for terminology service (container) and SNOMED,
ICD10, LOINC (whats inside the
container)

5 HMIS
(=DHIS2)

6 shared
health record = OpenMRS data structure

7 OpenHIM

8 OpenMRS,
OpenEMR, GNU Health, CHITS, etc

              The AeHIN Interoperability Lab are

supposed to
connect these 8 components to each other.

Sambath

Good morning Sambath

Yes Medic CR is one of the EMPI technologies that is being used as part of OpenHIE. It is curated by the Mohawk team (who are members of this community) and some of hte community have expereinces in working with MEDIC CR too. There is a dedicated community: Client Registry community that is involved in the CR work, refinement and definitions and if you have a team member who is really wanting to get deeply involved in the ins and outs of what constitutes a CR etc then I’d recommend joining the community (details below):
Post: client-registry@googlegroups.com
Subscribe: client-registry+subscribe@googlegroups.com
Unsubscribe: client-registry+unsubscribe@googlegroups.com

(https://wiki.ohie.org/display/resources/Mailing+Lists)

···

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Monday, March 13, 2017 at 2:37 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled etc. For the highlevel set of workflows please see: https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

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For more options, visit https://groups.google.com/d/optout.

On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit: https://groups.google.com/forum/#!forum/ohie-implementers there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of
different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.**

It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency is when handling with HTTP requests, we use the asynch
file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating
‘request has been received’ and the response may be updated to a
different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the client depends on a synchronous
response, the only way to deal with this is to set a long timeout and
wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
** 2, if any document about implementation best practic please provide
links ? **
Around best implementation practice, there is the data and link to the implementation guide found at: https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:
OHIE Client Registry Wiki Home Page: https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page: https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page: https://wiki.ohie.org/display/SUB/OpenHIE+Implementers
Subscribe: ohie-implementers+subscribe@googlegroups.com
Post: ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.



1, how OpenHIE overcome latency ? since its contain many path of

different app (I very consent about overhead processing) I mean
overall delay for response to a request for client. since my team
have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it
is very slow.

2, if any document about implementation best practic please provide

links ?

Regards,

Sovannoty

---------- Forwarded message ---------

        From: MeanSambath PBH <msambath.pbh@gmail.com>

        Date: Thu, Mar 9, 2017 at 2:49 AM

        Subject: OpenHIE

        To: Hong Roith - PBH <hroith.pbh@gmail.com>

        Cc: Tapley Jordan <tjordanwood@urc-chs.com            >,

Sam Eng <seng@urc-chs.com >,
Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH <msambath@pbhcam.org >,
Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

            Greeting

from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting,
achieving SDGs with ICT

            Yesterday,

we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts)
here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both
MoH HIS consultants also here with me. A consultant on
standard (Platinir, hired by US CDC/MoH) will use
OpenHIE architecture as principle for his document of
standard and interoperability for MoH.

            Please send me

questions if you have any concerns/problems or any thing
that you want to check about OpenHIE……Paul is
father/founder of OpenHIE/OpenMRS is here too (who we
met in Rwanda). It will be great if you could share a
link that you host OpenHIE? in Myanmar, they used MEDIC
CR as client registry—most of concern of using OpenHIE
is about GOVERNANCE NOT TECHNOLOGY , experience from
country who implement OpenHIE.

            OpenHIE will conduct

first OpenHIE conference this year In Tanzania

** A brief on
OpenHIE**

              OpenHIE has a set of standard

workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

              OpenHIE Implementers network mailing

list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

                OpenHIE = Open Health Information

Exchange = One of health information exchange
framework which AeHIN adopted.
Health Information can be exchanged when systems are
interoperable. (ohie.org.)

                OpenHIM = Open Health Information

Mediator is an application or a set of applications
(a middleware component) (http://openhim.org/ ) that works at the
“Interoperability Layer” of the
OpenHIE architecture.

** OpenHIE
is architecture** . That
architecture has 8 components:

1 - a
client registry (think of a database of people where
there is one unique number
for every person)

2 - a
health worker registry (a database where there is
one unique number fo every
health worker)

3 - a
facility registry (a database where there is one
unique number for every health
facility)

4 - a
terminology service (a database of all terms used in
the health information
system; one unique number for every term AND
relationships of these terms to
each other)

5 - a
health management information system (a special
system where you can aggregate
health data for purposes of decision-making)

6 - a
shared health record (a special database of services
rendered to patients) –
this may be similar to the patient’s Electronic
Health Record

7 - an
interoperability layer that connects all of the
systems above with the systems
below

8 -
edge system (any software that connects to the
interoperability layer that is
not yet mentioned above). It is called edge because
it is at the periphery of
the architecture (example are electronic medical
records running in health
facilities)

                There are open source

software for each of the 8
components:

1 OpenEMPI
and MEDIC-CR for client registry

2 iHRIS
for worker registry

3 Facility
Registry for facility registry

4 Apelon
for terminology service (container) and SNOMED,
ICD10, LOINC (whats inside the
container)

5 HMIS
(=DHIS2)

6 shared
health record = OpenMRS data structure

7 OpenHIM

8 OpenMRS,
OpenEMR, GNU Health, CHITS, etc

              The AeHIN Interoperability Lab are

supposed to
connect these 8 components to each other.

Sambath

Carl, thanks for this. We have been thinking of putting together a table of different requirements and having that available to sites so that they can figure out what EMPI technology they may want to use. We can share that with you if you want ( CDC is
commenting on it, as it is for our case based reporting need)…

Thanks again for your help. terry

···

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Monday, March 13, 2017 at 2:37 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org

Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

To unsubscribe from this group and stop receiving emails from it, send an email to
ohie-implementers+unsubscribe@googlegroups.com.

To post to this group, send email to
ohie-implementers@googlegroups.com.

To view this discussion on the web visit
https://groups.google.com/d/msgid/ohie-implementers/CACMjOH%3Dzcof5CCJbbhV7icurjFz1Hz4C860Oqr9hq_mUO7AOkw%40mail.gmail.com
.

For more options, visit
https://groups.google.com/d/optout
.

On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com

Date: Monday, March 13, 2017 at 11:25 AM

To: ohie-implementers@googlegroups.com

Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Friday, March 10, 2017 at 2:14 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar <tash.sundar@jembi.org >,
Trevor Gowing trevor.gowing@jembi.org

Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post:
ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng seng@urc-chs.com, Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH msambath@pbhcam.org, Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE
folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture, and
next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check
about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE
NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

** A
brief on OpenHIE**

OpenHIE
has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE
Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE
= Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable. (ohie.org.)

OpenHIM
= Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

** OpenHIE
is architecture**. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for
    every person)

2

  • a health worker registry (a database where there is one unique number fo every health
    worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system;
    one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health
    data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this
    may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet
    mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records running in health facilities)

There
are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the
container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

Dear Terry,

Could you share with me a table of different requirements?

Thanks

Sambath

Email: reatanaksambath@gmail.com

Cambodia

···

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Monday, March 13, 2017 at 2:37 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

To unsubscribe from this group and stop receiving emails from it, send an email to
ohie-implementers+unsubscribe@googlegroups.com.

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To view this discussion on the web visit
https://groups.google.com/d/msgid/ohie-implementers/CACMjOH%3Dzcof5CCJbbhV7icurjFz1Hz4C860Oqr9hq_mUO7AOkw%40mail.gmail.com
.

For more options, visit
https://groups.google.com/d/optout
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On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar <tash.sundar@jembi.org >,
Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post:
ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng seng@urc-chs.com, Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH msambath@pbhcam.org, Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE
folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture, and
next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check
about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE
NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

** A
brief on OpenHIE**

OpenHIE
has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE
Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE
= Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable. (ohie.org.)

OpenHIM
= Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

** OpenHIE
is architecture**. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for
    every person)

2

  • a health worker registry (a database where there is one unique number fo every health
    worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system;
    one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health
    data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this
    may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet
    mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records running in health facilities)

There
are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the
container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

Terry:

Please share that with me too. I’m helping out in Tanzania with thinking through a CR with the primary use case being CBS.

Thanks.

···

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Monday, March 13, 2017 at 2:37 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org

Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

To unsubscribe from this group and stop receiving emails from it, send an email to
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.

For more options, visit
https://groups.google.com/d/optout
.

On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com

Date: Monday, March 13, 2017 at 11:25 AM

To: ohie-implementers@googlegroups.com

Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Friday, March 10, 2017 at 2:14 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar <tash.sundar@jembi.org >,
Trevor Gowing trevor.gowing@jembi.org

Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post:
ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng seng@urc-chs.com, Christophe Grundmann <cgrundmann@urc-chs.com >,
Mean R Sambath PBH msambath@pbhcam.org, Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE
folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture, and
next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check
about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE
NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

** A
brief on OpenHIE**

OpenHIE
has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE
Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE
= Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable. (ohie.org.)

OpenHIM
= Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

** OpenHIE
is architecture**. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for
    every person)

2

  • a health worker registry (a database where there is one unique number fo every health
    worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system;
    one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health
    data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this
    may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet
    mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records running in health facilities)

There
are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the
container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

I will share once we finish our internal review to make sure that what I put together is ok. Should be early next week. Thanks

···

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Monday, March 13, 2017 at 2:37 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org

Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

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.

For more options, visit
https://groups.google.com/d/optout
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On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com

Date: Monday, March 13, 2017 at 11:25 AM

To: ohie-implementers@googlegroups.com

Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Friday, March 10, 2017 at 2:14 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: Ryan Crichton ryan@jembi.org, Pierre Dane <pierre@jembi.org >,
Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org

Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post:
ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To:
msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng <seng@urc-chs.com >, Christophe Grundmann
cgrundmann@urc-chs.com, Mean R Sambath PBH <msambath@pbhcam.org >, Reatanaksambath Mean
reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you
could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

A brief on OpenHIE

OpenHIE has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE = Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable.
(ohie.org.)

OpenHIM = Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

OpenHIE is architecture. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for every person)

2

  • a health worker registry (a database where there is one unique number fo every health worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system; one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records
    running in health facilities)

There are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

Thank you.

···

On Fri, Apr 7, 2017 at 2:46 PM, Cullen, Theresa thcullen@regenstrief.org wrote:

I will share once we finish our internal review to make sure that what I put together is ok. Should be early next week. Thanks

Sent from my iPhone

On Apr 6, 2017, at 10:49 PM, Steven Wanyee swanyee@gmail.com wrote:

Terry:

Please share that with me too. I’m helping out in Tanzania with thinking through a CR with the primary use case being CBS.

Thanks.

On Friday, April 7, 2017, Cullen, Theresa thcullen@regenstrief.org wrote:

Carl, thanks for this. We have been thinking of putting together a table of different requirements and having that available to sites so that they can figure out what EMPI technology they may want to use. We can share that with you if you want ( CDC is
commenting on it, as it is for our case based reporting need)…

Thanks again for your help. terry

From: ohie-implementers@googlegroups.com on behalf of Carl Fourie carl@jembi.org

Date: Thursday, March 16, 2017 at 2:11 AM

To: msambath sambath reatanaksambath@gmail.com

Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
pierre dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing <trevor.gowing@jembi.org >,
“Fyfe, Justin” justin.fyfe1@mohawkcollege.ca

Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Good morning Sambath

Yes Medic CR is one of the EMPI technologies that is being used as part of OpenHIE. It is curated by the Mohawk team (who are members of this community) and some of hte community have expereinces
in working with MEDIC CR too. There is a dedicated community: Client Registry community that is involved in the CR work, refinement and definitions and if you have a team member who is really wanting to get deeply involved in the ins and outs of what constitutes
a CR etc then I’d recommend joining the community (details below):
Post:
client-registry@googlegroups.com
Subscribe: client-registry+subscribe@googlegroups.com
Unsubscribe: client-registry+unsubscribe@googlegroups.com

(https://wiki.ohie.org/display/resources/Mailing+Lists)

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

To unsubscribe from this group and stop receiving emails from it, send an email to

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To view this discussion on the web visit
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.

For more options, visit
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For more options, visit
https://groups.google.com/d/optout
.

Regards,

~Steven Wanyee Macharia~

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Monday, March 13, 2017 at 2:37 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org

Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

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On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com

Date: Monday, March 13, 2017 at 11:25 AM

To: ohie-implementers@googlegroups.com

Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Friday, March 10, 2017 at 2:14 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: Ryan Crichton ryan@jembi.org, Pierre Dane <pierre@jembi.org >,
Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org

Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post:
ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To:
msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng <seng@urc-chs.com >, Christophe Grundmann
cgrundmann@urc-chs.com, Mean R Sambath PBH <msambath@pbhcam.org >, Reatanaksambath Mean
reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you
could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

A brief on OpenHIE

OpenHIE has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE = Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable.
(ohie.org.)

OpenHIM = Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

OpenHIE is architecture. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for every person)

2

  • a health worker registry (a database where there is one unique number fo every health worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system; one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records
    running in health facilities)

There are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

Regards,
~Steven Wanyee Macharia~

Hi all

Could any one help to answer below questions

……….

I have a problem with MedicCR

I send this request

$adr01_llp="\vMSH|^~&|NIST_Pearl_PIX_Source^^|NIST^^|CR1^^|MOH_CAAT^^|20141104174451||ADT^A01^ADT_A01|NIST-20141104174451|P|2.3.1\rEVN||20101020\rPID|||RJ-438^^^&2.16.840.1.113883.3.72.5.9.1||JOHNSTON^ROBERT^^^^^L|MURRAY^^^^^^L|19830205|M|||1220 Centennial Farm Road^^ELLIOTT^IA^51532||^PRN^PH^^^712^7670867||||||481-27-4185\rPV1||I\r".Chr(28)."\r";

this below is response

MSH>^~&|DESKTOP-QPUANNN|Fake Jurisdiction|NIST_Pearl_PIX_Source|NIST|201704061100||ACK^A01|8926ee73-0b4d-4f98-9fbf-1a0bcaa83b03|P|2.3.1 MSA|AR|NIST-20141104174451 ERR|^^^207&Application internal error&&&Object reference not set to an instance of an object.

this below is log

4/6/2017 11:00:44 AM : ClientRegistry.exe Error: 0 : 4/6/2017 11:00:44 AM : System.NullReferenceException: Object reference not set to an instance of an object.
at MARC.HI.EHRS.CR.Messaging.PixPdqv2.ComponentUtility.CreatePerson(PID pid, List1 dtls, OidData aaut) at MARC.HI.EHRS.CR.Messaging.PixPdqv2.ComponentUtility.CreateComponents(ADT_A01 request, List1 dtls)
at MARC.HI.EHRS.CR.Messaging.PixPdqv2.PixHandler.HandlePixAdmit(ADT_A01 request, Hl7MessageReceivedEventArgs evt)

I think something wrong with my request hl7’s string but i don’t know where?

Best Regard,

···

On Fri, Apr 7, 2017 at 2:46 PM, Cullen, Theresa thcullen@regenstrief.org wrote:

I will share once we finish our internal review to make sure that what I put together is ok. Should be early next week. Thanks

Sent from my iPhone

On Apr 6, 2017, at 10:49 PM, Steven Wanyee swanyee@gmail.com wrote:

Terry:

Please share that with me too. I’m helping out in Tanzania with thinking through a CR with the primary use case being CBS.

Thanks.

On Friday, April 7, 2017, Cullen, Theresa thcullen@regenstrief.org wrote:

Carl, thanks for this. We have been thinking of putting together a table of different requirements and having that available to sites so that they can figure out what EMPI technology they may want to use. We can share that with you if you want ( CDC is
commenting on it, as it is for our case based reporting need)…

Thanks again for your help. terry

From: ohie-implementers@googlegroups.com on behalf of Carl Fourie carl@jembi.org
Date: Thursday, March 16, 2017 at 2:11 AM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
pierre dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing <trevor.gowing@jembi.org >,
“Fyfe, Justin” justin.fyfe1@mohawkcollege.ca
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Good morning Sambath

Yes Medic CR is one of the EMPI technologies that is being used as part of OpenHIE. It is curated by the Mohawk team (who are members of this community) and some of hte community have expereinces
in working with MEDIC CR too. There is a dedicated community: Client Registry community that is involved in the CR work, refinement and definitions and if you have a team member who is really wanting to get deeply involved in the ins and outs of what constitutes
a CR etc then I’d recommend joining the community (details below):
Post:
client-registry@googlegroups.com
Subscribe: client-registry+subscribe@googlegroups.com
Unsubscribe: client-registry+unsubscribe@googlegroups.com

(https://wiki.ohie.org/display/resources/Mailing+Lists)

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

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Regards,

~Steven Wanyee Macharia~

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Monday, March 13, 2017 at 2:37 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

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For more options, visit
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On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane <pierre@jembi.org >,
Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post:
ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To:
msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng <seng@urc-chs.com >, Christophe Grundmann
cgrundmann@urc-chs.com, Mean R Sambath PBH <msambath@pbhcam.org >, Reatanaksambath Mean
reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you
could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

A brief on OpenHIE

OpenHIE has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE = Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable.
(ohie.org.)

OpenHIM = Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

OpenHIE is architecture. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for every person)

2

  • a health worker registry (a database where there is one unique number fo every health worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system; one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records
    running in health facilities)

There are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

Regards,
~Steven Wanyee Macharia~

Hi Msambath,

Have you tried using the Hapi Test Panel to test the format of your messages? You can download it here: http://hl7api.sourceforge.net/hapi-testpanel/

Thanks,

Pierre

···

On Fri, Apr 7, 2017 at 2:46 PM, Cullen, Theresa thcullen@regenstrief.org wrote:

I will share once we finish our internal review to make sure that what I put together is ok. Should be early next week. Thanks

Sent from my iPhone

On Apr 6, 2017, at 10:49 PM, Steven Wanyee swanyee@gmail.com wrote:

Terry:

Please share that with me too. I’m helping out in Tanzania with thinking through a CR with the primary use case being CBS.

Thanks.

On Friday, April 7, 2017, Cullen, Theresa thcullen@regenstrief.org wrote:

Carl, thanks for this. We have been thinking of putting together a table of different requirements and having that available to sites so that they can figure out what EMPI technology they may want to use. We can share that with you if you want ( CDC is
commenting on it, as it is for our case based reporting need)…

Thanks again for your help. terry

From: ohie-implementers@googlegroups.com on behalf of Carl Fourie carl@jembi.org
Date: Thursday, March 16, 2017 at 2:11 AM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
pierre dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing <trevor.gowing@jembi.org >,
“Fyfe, Justin” justin.fyfe1@mohawkcollege.ca
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Good morning Sambath

Yes Medic CR is one of the EMPI technologies that is being used as part of OpenHIE. It is curated by the Mohawk team (who are members of this community) and some of hte community have expereinces
in working with MEDIC CR too. There is a dedicated community: Client Registry community that is involved in the CR work, refinement and definitions and if you have a team member who is really wanting to get deeply involved in the ins and outs of what constitutes
a CR etc then I’d recommend joining the community (details below):
Post:
client-registry@googlegroups.com
Subscribe: client-registry+subscribe@googlegroups.com
Unsubscribe: client-registry+unsubscribe@googlegroups.com

(https://wiki.ohie.org/display/resources/Mailing+Lists)

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

To unsubscribe from this group and stop receiving emails from it, send an email to

ohie-implementers+unsubscribe@googlegroups.com.

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ohie-implementers@googlegroups.com.

To view this discussion on the web visit
https://groups.google.com/d/msgid/ohie-implementers/CAFNRjWjpBF4Oxww0_HwLvuQQH9HViEay7VJmq4SuKik5R0q6Ng%40mail.gmail.com
.

For more options, visit
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You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

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For more options, visit
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.

Regards,

~Steven Wanyee Macharia~


Regards,
~Steven Wanyee Macharia~

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Monday, March 13, 2017 at 2:37 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

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.

For more options, visit
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On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane <pierre@jembi.org >,
Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post:
ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To:
msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng <seng@urc-chs.com >, Christophe Grundmann
cgrundmann@urc-chs.com, Mean R Sambath PBH <msambath@pbhcam.org >, Reatanaksambath Mean
reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you
could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

A brief on OpenHIE

OpenHIE has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE = Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable.
(ohie.org.)

OpenHIM = Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

OpenHIE is architecture. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for every person)

2

  • a health worker registry (a database where there is one unique number fo every health worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system; one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records
    running in health facilities)

There are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

Dear Terry,

Could you share with us document of Open HIE requirement table?

Thanks

Sambath

···

On Fri, Apr 7, 2017 at 2:46 PM, Cullen, Theresa thcullen@regenstrief.org wrote:

I will share once we finish our internal review to make sure that what I put together is ok. Should be early next week. Thanks

Sent from my iPhone

On Apr 6, 2017, at 10:49 PM, Steven Wanyee swanyee@gmail.com wrote:

Terry:

Please share that with me too. I’m helping out in Tanzania with thinking through a CR with the primary use case being CBS.

Thanks.

On Friday, April 7, 2017, Cullen, Theresa thcullen@regenstrief.org wrote:

Carl, thanks for this. We have been thinking of putting together a table of different requirements and having that available to sites so that they can figure out what EMPI technology they may want to use. We can share that with you if you want ( CDC is
commenting on it, as it is for our case based reporting need)…

Thanks again for your help. terry

From: ohie-implementers@googlegroups.com on behalf of Carl Fourie carl@jembi.org
Date: Thursday, March 16, 2017 at 2:11 AM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
pierre dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing <trevor.gowing@jembi.org >,
“Fyfe, Justin” justin.fyfe1@mohawkcollege.ca
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Good morning Sambath

Yes Medic CR is one of the EMPI technologies that is being used as part of OpenHIE. It is curated by the Mohawk team (who are members of this community) and some of hte community have expereinces
in working with MEDIC CR too. There is a dedicated community: Client Registry community that is involved in the CR work, refinement and definitions and if you have a team member who is really wanting to get deeply involved in the ins and outs of what constitutes
a CR etc then I’d recommend joining the community (details below):
Post:
client-registry@googlegroups.com
Subscribe: client-registry+subscribe@googlegroups.com
Unsubscribe: client-registry+unsubscribe@googlegroups.com

(https://wiki.ohie.org/display/resources/Mailing+Lists)

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Regards,

~Steven Wanyee Macharia~

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
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On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Monday, March 13, 2017 at 2:37 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton <ryan@jembi.org >,
Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
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    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

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On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane <pierre@jembi.org >,
Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post:
ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To:
msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng <seng@urc-chs.com >, Christophe Grundmann
cgrundmann@urc-chs.com, Mean R Sambath PBH <msambath@pbhcam.org >, Reatanaksambath Mean
reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you
could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

A brief on OpenHIE

OpenHIE has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE = Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable.
(ohie.org.)

OpenHIM = Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

OpenHIE is architecture. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for every person)

2

  • a health worker registry (a database where there is one unique number fo every health worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system; one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records
    running in health facilities)

There are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

Regards,
~Steven Wanyee Macharia~

We haven’t finished it yet. I apologize.

To be clear, the table that we are working on is only to assist in the empi decision. I will try to get this done this week.

Thanks. Terry

···

On Apr 17, 2017, at 2:01 AM, msambath sambath reatanaksambath@gmail.com wrote:

Dear Terry,

Could you share with us document of Open HIE requirement table?

Thanks

Sambath

From: Steven Wanyee swanyee@gmail.com

Date: Friday, April 7, 2017 at 7:03 PM

To: “Cullen, Theresa” thcullen@regenstrief.org

Cc: Carl Fourie carl@jembi.org, msambath sambath reatanaksambath@gmail.com, “OpenHIE Implementers Network (OHIN)” <ohie-implementers@googlegroups.com >,
Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing <trevor.gowing@jembi.org >,
“Fyfe, Justin” justin.fyfe1@mohawkcollege.ca

Subject: Re: [ohie-implementers] Re: OpenHIE–Latency

Thank you.

On Fri, Apr 7, 2017 at 2:46 PM, Cullen, Theresa
thcullen@regenstrief.org wrote:

I will share once we finish our internal review to make sure that what I put together is ok. Should be early next week. Thanks

Sent from my iPhone

On Apr 6, 2017, at 10:49 PM, Steven Wanyee swanyee@gmail.com wrote:

Terry:

Please share that with me too. I’m helping out in Tanzania with thinking through a CR with the primary use case being CBS.

Thanks.

On Friday, April 7, 2017, Cullen, Theresa thcullen@regenstrief.org wrote:

Carl, thanks for this. We have been thinking of putting together a table of different requirements and having that available to sites so that they can figure out what EMPI technology they may want to use. We can share that with you if you want ( CDC is
commenting on it, as it is for our case based reporting need)…

Thanks again for your help. terry

From: ohie-implementers@googlegroups.com on behalf of Carl Fourie carl@jembi.org

Date: Thursday, March 16, 2017 at 2:11 AM

To: msambath sambath reatanaksambath@gmail.com

Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton ryan@jembi.org, pierre dane pierre@jembi.org, Tash Sundar <tash.sundar@jembi.org >, Trevor
Gowing trevor.gowing@jembi.org, “Fyfe, Justin” justin.fyfe1@mohawkcollege.ca

Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Good morning Sambath

Yes Medic CR is one of the EMPI technologies that is being used as part of OpenHIE. It is curated by the Mohawk team (who are members of this community) and some of hte community have expereinces
in working with MEDIC CR too. There is a dedicated community: Client Registry community that is involved in the CR work, refinement and definitions and if you have a team member who is really wanting to get deeply involved in the ins and outs of what constitutes
a CR etc then I’d recommend joining the community (details below):
Post: client-registry@googlegroups.com
Subscribe: client-registry+subscribe@googlegroups.com
Unsubscribe: client-registry+unsubscribe@googlegroups.com

(https://wiki.ohie.org/display/resources/Mailing+Lists)

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Monday, March 13, 2017 at 2:37 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar <tash.sundar@jembi.org >, Trevor
Gowing trevor.gowing@jembi.org

Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com

Date: Monday, March 13, 2017 at 11:25 AM

To: ohie-implementers@googlegroups.com

Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org

Date: Friday, March 10, 2017 at 2:14 PM

To: msambath sambath reatanaksambath@gmail.com

Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org

Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post: ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng seng@urc-chs.com, Christophe Grundmann cgrundmann@urc-chs.com, Mean R Sambath PBH msambath@pbhcam.org, Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you
could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

A brief on OpenHIE

OpenHIE has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE = Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable.
(ohie.org.)

OpenHIM = Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

OpenHIE is architecture. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for every person)

2

  • a health worker registry (a database where there is one unique number fo every health worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system; one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records
    running in health facilities)

There are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

You received this message because you are subscribed to the Google Groups “OpenHIE Implementers Network (OHIN)” group.

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To view this discussion on the web visit
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.

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To view this discussion on the web visit
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For more options, visit
https://groups.google.com/d/optout
.

Regards,

~Steven Wanyee Macharia~


Regards,

~Steven Wanyee Macharia~

Dear Terry

Could share some info on your initiative on OpenHIE at your country? Using Medic CR or OpenEPMI?

Thanks

Sambath

···

On Apr 17, 2017, at 2:01 AM, msambath sambath reatanaksambath@gmail.com wrote:

Dear Terry,

Could you share with us document of Open HIE requirement table?

Thanks

Sambath

From: Steven Wanyee swanyee@gmail.com
Date: Friday, April 7, 2017 at 7:03 PM
To: “Cullen, Theresa” thcullen@regenstrief.org
Cc: Carl Fourie carl@jembi.org, msambath sambath reatanaksambath@gmail.com, “OpenHIE Implementers Network (OHIN)” <ohie-implementers@googlegroups.com >,
Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing <trevor.gowing@jembi.org >,
“Fyfe, Justin” justin.fyfe1@mohawkcollege.ca
Subject: Re: [ohie-implementers] Re: OpenHIE–Latency

Thank you.

On Fri, Apr 7, 2017 at 2:46 PM, Cullen, Theresa
thcullen@regenstrief.org wrote:

I will share once we finish our internal review to make sure that what I put together is ok. Should be early next week. Thanks

Sent from my iPhone

On Apr 6, 2017, at 10:49 PM, Steven Wanyee swanyee@gmail.com wrote:

Terry:

Please share that with me too. I’m helping out in Tanzania with thinking through a CR with the primary use case being CBS.

Thanks.

On Friday, April 7, 2017, Cullen, Theresa thcullen@regenstrief.org wrote:

Carl, thanks for this. We have been thinking of putting together a table of different requirements and having that available to sites so that they can figure out what EMPI technology they may want to use. We can share that with you if you want ( CDC is
commenting on it, as it is for our case based reporting need)…

Thanks again for your help. terry

From: ohie-implementers@googlegroups.com on behalf of Carl Fourie carl@jembi.org
Date: Thursday, March 16, 2017 at 2:11 AM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton ryan@jembi.org, pierre dane pierre@jembi.org, Tash Sundar <tash.sundar@jembi.org >, Trevor
Gowing trevor.gowing@jembi.org, “Fyfe, Justin” justin.fyfe1@mohawkcollege.ca
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Good morning Sambath

Yes Medic CR is one of the EMPI technologies that is being used as part of OpenHIE. It is curated by the Mohawk team (who are members of this community) and some of hte community have expereinces
in working with MEDIC CR too. There is a dedicated community: Client Registry community that is involved in the CR work, refinement and definitions and if you have a team member who is really wanting to get deeply involved in the ins and outs of what constitutes
a CR etc then I’d recommend joining the community (details below):
Post: client-registry@googlegroups.com
Subscribe: client-registry+subscribe@googlegroups.com
Unsubscribe: client-registry+unsubscribe@googlegroups.com

(https://wiki.ohie.org/display/resources/Mailing+Lists)

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Thu, Mar 16, 2017 at 4:26 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear Carl

My team si working on testing Medic CR, does this OHIE community help on MEDIC CR or have other Medic CR forum

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Monday, March 13, 2017 at 2:37 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: “OpenHIE Implementers Network (OHIN)” ohie-implementers@googlegroups.com, Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar <tash.sundar@jembi.org >, Trevor
Gowing trevor.gowing@jembi.org
Subject: Re: [ohie-implementers] Re: FW: OpenHIE–Latency

Hi Sambath

That question has a lot of assumptions to address to give an accurate answer. Some of the assumptions are around the architecture, the choice of standards and profiles and the technologies used
etc. For a more architectural design answer I would say:

The patient database system would need to be able to send and recieve information as outlined in the OHIE architecture workflows (assuming OpenHIE architecture) for the particular workflows and
use cases that you require. I.e. if there is just patient lookup and registration then only the standards and profiles associated to that; however if adding save and query clinical infomration then there is more about the types of data and how taht is profiled
etc. For the highlevel set of workflows please see:
https://wiki.ohie.org/display/documents/OpenHIE+Workflows

Now for the technologies you refer to OpenEMPI and OpenHIM (again Jembi team and others jump in to correct and ellaborate): A Patient Database (assuming something that exists at a clinic level
and wants to connect and communicate with the HIE at a centra level) would need to be able to be able to play the role of POS in the following workflows:

Again I’ll shout out to the CR community to chime in and support (@Shaun G and others)

I hope this is adding value Sambath?

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 9:06 AM, Reatanaksambath Mean
reatanaksambath@gmail.com wrote:

Dear Carl,

Thanks for your reply. What are required functions that a patient database system should have to connect with OpenHIM/OpenEPMI (like PMI, HL7…)? does it work without HL7?

Thanks

Sambath

On Mon, Mar 13, 2017 at 1:54 PM, Carl Fourie
carl@jembi.org wrote:

Good Day Sambath

To see all posts to the list please visit:

https://groups.google.com/forum/#!forum/ohie-implementers
there you can see the history. We’ll look to answer you question on the main list so that others outside of Jembi can weigh in too.

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath
reatanaksambath@gmail.com wrote:

Dear All,

Greeting from Cambodia

I posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….

Thanks

Sambath

From: msambath sambath reatanaksambath@gmail.com
Date: Monday, March 13, 2017 at 11:25 AM
To: ohie-implementers@googlegroups.com
Subject: Re: OpenHIE–Latency

Dear All,

Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?

Thanks

Sambath

From: Carl Fourie carl@jembi.org
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath reatanaksambath@gmail.com
Cc: Ryan Crichton ryan@jembi.org, Pierre Dane pierre@jembi.org, Tash Sundar tash.sundar@jembi.org, Trevor Gowing trevor.gowing@jembi.org
Subject: Re: OpenHIE

Good Day Dr Sambath

I have reached out to our team in South Africa and have synthesised the response to the questions below:
** 1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.**
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency
is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate “200” response, indicating ‘request has been received’ and the response may be updated to
a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a “fire and forget” approach to sending data in. However if the
client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages
with the OpenHIM because of the way some systems handle sockets that doesn’t fit well with the OpenHIM’s request response model. We would be very interested in understanding your experience here
**2, if any document about implementation best practic please provide links ? **

Around best implementation practice, there is the data and link to the implementation guide found at:
https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:

OHIE Client Registry Wiki Home Page:
https://wiki.ohie.org/display/SUB/Client+Registry+Community

OHIE Client Registry Wiki Meeting Page:
https://wiki.ohie.org/display/resources/Client+Registry+Community+Call

If there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe
questions that implementers and team exploring OpenHIE have. The page and joining details are below:

Wiki page:
https://wiki.ohie.org/display/SUB/OpenHIE+Implementers

Subscribe:
ohie-implementers+subscribe@googlegroups.com

Post: ohie-implementers@googlegroups.com

I hope this has been helpful and we would encourage your team to reach out to us on the mailing list and or the team on this email
too.

Regards

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

Physical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)

Email Disclaimer:

  • This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the
    author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for
    the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.*

On Fri, Mar 10, 2017 at 8:09 AM, Mean R Sambath
reatanaksambath@gmail.com wrote:

Dr Mean Reatanak Sambath
Executive Director at Partnership for Better Health/Cambodia

Expertise and lecturer on health informatics

Tel: 855 12 727919
Sent from my iPhone 6 plus

Dr Mean Reatanak Sambath

Tel: 855 12 727919
Sent from my iPhone 6 plus

Begin forwarded message:

From:noty.open.org.khnoty@open.org.kh
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msambath@pbhcam.org
Cc: Roith Hong hroith.pbh@gmail.com, Tapley Jordanwood tjordanwood@URC-CHS.COM
Subject: Re: OpenHIE

Dear Dr. sambath

I have two question about OpenHIE.

1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request
ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.

2, if any document about implementation best practic please provide links ?

Regards,

Sovannoty

---------- Forwarded message ---------

From: MeanSambath PBH msambath.pbh@gmail.com

Date: Thu, Mar 9, 2017 at 2:49 AM

Subject: OpenHIE

To: Hong Roith - PBH hroith.pbh@gmail.com

Cc: Tapley Jordan tjordanwood@urc-chs.com, Sam Eng seng@urc-chs.com, Christophe Grundmann cgrundmann@urc-chs.com, Mean R Sambath PBH msambath@pbhcam.org, Reatanaksambath Mean reatanaksambath@gmail.com

Hi Roith,

Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT

Yesterday, we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture,
and next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.

Please send me questions if you have any concerns/problems or any thing that you want to check about OpenHIE……Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you
could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE NOT TECHNOLOGY , experience from country who implement OpenHIE.

OpenHIE will conduct first OpenHIE conference this year In Tanzania

A brief on OpenHIE

OpenHIE has a set of standard workflows (https://wiki.ohie.org/display/documents/OpenHIE+Workflows)

OpenHIE Implementers network mailing list https://wiki.ohie.org/display/SUB/OpenHIE+Implementers).

OpenHIE = Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable.
(ohie.org.)

OpenHIM = Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/ )
that works at the “Interoperability Layer” of the OpenHIE architecture.

OpenHIE is architecture. That architecture has 8 components:

1

  • a client registry (think of a database of people where there is one unique number for every person)

2

  • a health worker registry (a database where there is one unique number fo every health worker)

3

  • a facility registry (a database where there is one unique number for every health facility)

4

  • a terminology service (a database of all terms used in the health information system; one unique number for every term AND relationships of these terms to each other)

5

  • a health management information system (a special system where you can aggregate health data for purposes of decision-making)

6

  • a shared health record (a special database of services rendered to patients) – this may be similar to the patient’s Electronic Health Record

7

  • an interoperability layer that connects all of the systems above with the systems below

8

  • edge system (any software that connects to the interoperability layer that is not yet mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records
    running in health facilities)

There are open source software for each of the 8 components:

1
OpenEMPI and MEDIC-CR for client registry

2
iHRIS for worker registry

3
Facility Registry for facility registry

4
Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the container)

5
HMIS (=DHIS2)

6
shared health record = OpenMRS data structure

7
OpenHIM

8
OpenMRS, OpenEMR, GNU Health, CHITS, etc

The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.

Sambath

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Regards,

~Steven Wanyee Macharia~


Regards,

~Steven Wanyee Macharia~