Hi all,
At this point, the challenges in integrating DHIS2 and iHRIS for indicators are pretty much entirely related to governance and coordination. The technological tools are there (and they are getting simpler and simpler to use). If anyone is wanting help in these areas, please reach out to us (IntraHealth) and we should be able to find a way to support you with the tools and provide further guidance.
The main challenges in order of complexity, as I see them, are:
-
Often the HR and HMIS units do not work in close co-ordination. The information needs for the HR unit (and other similar stakeholders) are different than for the HMIS unit. If there is no formal platform (e.g. a TWG) for these groups to coordinate on and jointly own issues related to information needs and the associated data exchange needed to support this, than any attempt to have sustainable data exchange will be dead in the water. This, in my opinion, is the major point of failure.
-
Lack of agreement of facility lists, as has already been mentioned. There are a couple of situations here:
-
One system (e.g. DHIS2) becomes the authority for the facility data. In this case, there is existing tooling for iHRIS to load in DHIS2 facility data using a third piece of standards compliant software (more on that below) to handle the data management, an “InterLinked Registry". This situation can be problematic, as Kayode alludes to, if the two systems do not agree on what is a facility. The set of facilities from an HR perspective is larger than the set of facilities that provide clinical services, for example.
-
DHIS2 and iHRIS each maintain their own independent facility lists. This is the most common scenario and occurs when the HMIS unit does not agree to adopt all of the facilities that are required for the HR unit. In this case, we need to ensure that the iHRIS facilities can cross-reference the DHIS2 facilities. There is significant tooling on this already, again using third piece of standards compliant software. Note, on the OpenHIE InterLinked Registry call this Wednesday (see below), Ally will be showing us some of the facility matching/de-duplication tools he developed for Sierra Leone and now extended to be used in other contexts. Jembi has also worked on a lot of tooling to help automate and monitor the synchronization processes through the OpenHIM software.
-
There is a third party facility registry that both DHIS2 and iHRIS should synchronize with. This is a pretty uncommon scenario.
-
Lack of agreement on the cadre, job or other health worker classification to report on. There are three types of stakeholders here, and usually each has a different set of classifications for health workers they are interested in. These stakeholders are the HMIS unit with DHIS2, the HR unit with software like iHRIS Manage, and the professional councils with software like iHRIS Qualify. iHRIS Manage will give you the currently deployed health workers, while iHRIS Qualify would give you total number of available/licensed (though not necessarily deployed) health workers. There are a couple of other HRIS systems that are also coming: iHRIS Train which is used to manage information a national picture on the health workers graduating from academic institutions and the iHRIS Community Health Worker Registry.
Because of this multiple types of classification, we often need to map the cadres from the source HRIS system into the cadres required for the HMIS/DHIS2. This mapping can be handled within the HRIS system or can be handled through the use of a Terminology Service (TS) which handles mapping between terminologies. Though a TS is a bit more overhead, I think it would be warranted in a country such as Nigeria with many HRISs (one for state and one for each professional council) and which is already contemplating a TS as part of their larger eHealth Architecture.
-
Finally, there is a technical challenge in that the DHIS2 API changes over time with different versions of DHIS2. The risks here are contained when we use open international standards for data exchange. Right now we support the “Care Services Discovery (CSD)” standard for exchange of the facility and org unit hierarchy between the systems. In the coming year we will see support for the more modern and RESTful FHIR standard. For data reporting into DHIS2, we need to make better use of the ADX standard to help mitigate issues w/ DHIS2 API changes. Though the the necessary tooling isn’t in place quite yet, I think we will see it over the next year.
-
Documentation. Because these tools have evolved over time, and because the scenarios have a fairly wide range, we don’t have yet a complete tutorial on all the needed steps. There is partial documentation, but it needs a bit of tender loving care.
Note, that we are trying to pull together a training/workshop to address exactly these issues (and explore what you can than do with the data) just after the upcoming DHIS2 academy in Tanzania. More on that as the plans become more concrete. We certainly would have the documentation improved by then 
Nothing in the above is particularly special to iHRIS and DHIS2 and are applicable to any HRIS and HMIS. In Zimbabwe they are going through the same considerations, though they don’t use iHRIS.
Cheers,
-carl
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···
On Oct 8, 2016, at 7:25 AM, Bob Jolliffe bobjolliffe@gmail.com wrote:
Hi Kayode
I think they can.
It is just that usually they are not because hmis people generally
assemble the orgunit hierarchy to support reporting requirements for
hmis. Just as LMIS people assemble theirs with logistics logic in
mind.But absolutely nothing which can’t be addressed through “local
arrangements and understandings”On 8 October 2016 at 13:16, Kayode Odusote odusote.kayode@gmail.com wrote:
Dear Bob,
Getting back to what you said, why can’t offices in the Ministry be
included in the DHIS2 facility list? They are also service centres
though they are offering administrative services and should need
monitoring as well.Kayode
On 10/8/16, Bob Jolliffe bobjolliffe@gmail.com wrote:
Hi Lungo
Not quite what I said. It is early days for the SL shining case study
but well worth watching.Cheers
BobOn 8 October 2016 at 11:29, Juma Lungo jlungo@yahoo.com wrote:
Dear Arthur,
Bob has said it all. To integrate health systems, the culprit is the
facility list. As the list evolve, the integration die automatically.Facility registry is the way to go. Making both, the DHIS2 and iHRIS
referencing an external database of the facility makes the integration
permanent. Both, DHIS2 and iHRIS can easily be configured to learn
facility
attributes from external database easier.See Gerald’s case study from Sierra Leone. It is our shining case study.
One thing you need to take note is, even though right now you are looking
for a minimum functions for a HR system, the moment you implement demands
will increase. This is where iHRIS is the best option.Best regards,
Lungo
From: Bob Jolliffe bobjolliffe@gmail.com
To: Arthur Heywood arthurheywood@gmail.com
Cc: Juma Lungo jlungo@yahoo.com; dhis2-users
dhis2-users@lists.launchpad.net; “calle.hedberg@gmail.com”
calle.hedberg@gmail.com; dhis2-devs dhis2-devs@lists.launchpad.net
Sent: Saturday, October 8, 2016 7:45 AM
Subject: Re: [Dhis2-users] [Dhis2-devs] Looking for Human Resource System
to
integrate with DHISHi Arthur
Carl will probably be able to point you to various cases where this
has been done with dhis2 and ihris. I am familiar with examples from
Zanzibar, Kenya and Rwanda which sort of worked but none of which
could fairly be described as successful in the sense of sustained use
as far as I know.I think the main tricky bit to get right is the harmonization of
health facilities in the two systems not just as one off, but with
processes to keep them harmonized. You might only have 20 indicators
of interest but you have 1000s of facilities. As soon as the orgunits
start diverging the interoperability starts falling apart. I think
there was also some interesting work done in Bihar on this problem.One conventionasl “wisdom” that has done the rounds over the past few
years is that a separate facility registry is the solution to this. I
am less sure. In practice you now find that whereas before the
problem was harmonizing between 2 systems, now it becomes more complex
because you have 3Add more with LMIS etc …
So 2 alternative approaches emerge:
- retreat to dhis2 and try and do everything there - sometimes this
sort of works for many things (which is better than most), but it has
obvious limits and I don’t believe can serve as the basis of long term
strategy to solve all problems- insist that any system that sends data to dhis2 treats dhis2 as
the authoritative source of facility registry data. If only they
would
physical/geographic/administrative world of the health system can
diverge sometimes significantly from that of an HRIS system - think of
MOH employees at offices not involved in health service delivery for
example. So there are local arrangements and understandings to be
made, but in general I think this path holds the most potential,In practice I think we have to concede the problems have been unsolved
for now. Unless someone can point me otherwise. The challenge seems
on the surface to be technically fairly trivial, But beneath lurk
demons.Cheers
BobOn 8 October 2016 at 07:13, Arthur Heywood arthurheywood@gmail.com > > > > wrote:
Lungo
Good to hear from you … long time no see
Thanks for this … can you tell me where we have a SUCCESSFUL
implementation where one can actually get IHRIS data through DHIS and
make
integrated indicators, use IHRIS indicators for Bottleneck analysis etcRegards
Arthur*Without deviation from the norm, there can be no progress (Frank
Zappa)
Skype arthur_heywood_za
Tanzania +255-773669393 OR +255 673150252On 5 October 2016 at 06:54, Juma Lungo jlungo@yahoo.com wrote:
Hi Arthur,
I would recommend iHRIS.
It has many features, integrates nicely with DHIS2, implemented in many
countries and it is being supported by an active community working
closely
with DHIS2 developers.Lungo
From: Calle Hedberg calle.hedberg@gmail.com
To: Arthur Heywood arthurheywood@gmail.com
Cc: dhis2-users dhis2-users@lists.launchpad.net; dhis2-devs
dhis2-devs@lists.launchpad.net; gerald thomas
gerald17006@gmail.com;
Seleman Ally seleman_ally@yahoo.com
Sent: Tuesday, October 4, 2016 10:20 PM
Subject: Re: [Dhis2-devs] [Dhis2-users] Looking for Human Resource
System
to integrate with DHISArthur,
I’m not directly involved with the HRIS work using DHIS, my current
focus
is on a fully integrated disease surveillance system. Will find out and
get
back to you.Regards
CalleOn 4 October 2016 at 15:15, Arthur Heywood arthurheywood@gmail.com > > > > > > wrote:
Calle
In Zambia we are also looking to set up what you call a “core” Human
Resource HMIS … mainly to do some “Bottleneck analysis” for our MDGi
districts …Are we able to use a beta version and see what we are able to adapt it
to
our needs (same people being called different professional jobs etc)
and
then feed back into the development process …interesting to know how
far
you have progressed?Cheers
a*Without deviation from the norm, there can be no progress (Frank
Zappa)
Skype arthur_heywood_za
Tanzania +255-773669393 OR +255 673150252On 26 August 2016 at 23:08, Calle Hedberg calle.hedberg@gmail.com > > > > > > wrote:
Laura,
The two main HRIS component designs “within” DHIS2 are the HRHIS in
Tanzania and another in Vietnam (John Lewis or Morten will be able to
tell
you more about that one).South Africa is currently using a customised Tracker app for managing
Community Service and Internships (around 10,000 graduates are applying
for
internship or Community Service posts per annum).We are also working on a “core” workforce registry tightly integrated
with
DHIS2. By “core” I mean it will only deal with actual HR resources
including
position, what they are licensed/authorised to do, and contact details.
Things like continuous education, bursaries, payroll, etc are
processed/managed by other systems. A major advantage of tight
integration
will be the ability to use DHIS2 communication and messages + user
registration to communicate directly with health workers - in
particular
since health workers increasingly will be interacting directly with
DHIS2
on
a daily basis through (daily) capturing of routine data, disease
notifications, various Tracker apps (browser or Android), etc.Your basic requirements seem very similar: your primary need is to
track
the workforce as an INPUT RESOURCE to health service delivery, and not
to
track salaries and CVs and health insurance and employment history and
a
bunch of other “personal” things. So you need to know WHO they are,
where
they actually work and with what (in what position), what they are able
to
do (mostly this relates to formal/legal practice licensing etc, but it
could
be expanded to include specialist knowledge about certain diseases
etc),
and
how to contact them.Regards
CalleOn 26 August 2016 at 21:56, gerald thomas gerald17006@gmail.com > > > > > > wrote:
I had use ihris and it is good. If you want help with it I am willing
to
help.On Aug 26, 2016 6:46 PM, “Laura E. Lincks” > > > > > > <laura.lincks@icap.columbia.ed > > > > > > > wrote:
We are looking for a simple Human Resources tool to integrate with a
DHIS
aggregate database. Little is known of the needs of the HRIS, but for
now
it
needs to track personnel details and groups of personnel will need to
be
associated with various programs in a separate DHIS aggregate database.
An
Open Source HRIS is preferable.In searching for tools I have come across the following:
HRHIS in Tanzania developed by the HISP-TZ/University of Dar es Salaam
iHRIS developed by global Capacity Project.I was wondering if anyone had any knowledge of or experience with these
packages or if there were other applications that could be of use to
us?Thanks in advance to anyone with leads or information.
Laura E. Lincks
Database Manager/Developer
ICAP - Columbia University
Mailman School of Public Health
60 Haven Ave, Floor B1
New York, NY 10032
Tel: 212 304 7132
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