Digital Square Investing in 10 Proposals to Strengthen Digital Health Software Tools

Digital Square is pleased to announce that ten proposals were selected for investment as part of our second round of funding, Notice B. More information on the criteria for funding can be found in the Call for Proposals—Notice B, located on the Digital Square Wikipedia page. A total of $1.2 million is being invested into these digital health software tools. The funding recipients have also committed a total of $400,000 to co-invest alongside Digital Square’s funding.

Through Notice B, Digital Square is investing in the following proposals:

·   Strengthening the Open Civil Registration and Vital Statistics (OpenCRVS) System

·   Strengthening and Expanding the Open Health Information Mediator (OpenHIM)

·   DHIS2 Community of Practice

·   Illuminate Data with a DHIS2 Business Intelligence Connector

·  OpenMRS Sync 2.0 Module Development, Implementations and Maintenance

·  Packaging OpenSRP for Scale and Community-Driven National Adoption

·  Global Healthsites Mapping Project: Building a Curated Open Data Commons of  Facility Data with OpenStreetMap

·  Building an Open Source LIS Technologies Community of Practice

·  OpenLMIS Advocacy and Community Engagement

·  Expanding the Bahmni Hospital System as a FOSS Project

Digital Square invests in existing digital health software tools to ensure they are properly resourced for sustained development. To be eligible for funding, software tools must  be global goods, which are adaptable to different countries and contexts, and are often Free and Open Source Software (FOSS). More information on what qualifies as a global good, and what a mature global good looks like, can be found on our Wikipedia page.

Notice B was implemented using an Open Proposal Process and Platform (OPP&P) hosted by the University California, San Francisco. Concept notes and proposals were publicly posted, giving submitters the opportunity to find collaborators and provide and receive feedback from peers. The iterative feedback and proposal process allowed submitters to refine and strengthen their concepts before final submission. More information on our proposal process can be found here.

Digital Square’s next round of investment for digital health software global goods, Notice C, launched on June 19, 2018. Concept notes are due on our new Open Proposal Platform by July 20, 2018.

Position Available: Consultant Drupal Developer, Digital Square

Job Description

PATH is an international organization that drives transformative innovation to save lives and improve health, especially among women and children. We accelerate innovation across five platforms-vaccines, drugs, diagnostics, devices, and system and service innovations-that harness our entrepreneurial insight, scientific and public health expertise, and passion for health equity. By mobilizing partners around the world, we take innovation to scale, working alongside countries primarily in Africa and Asia to tackle their greatest health needs. Together, we deliver measurable results that disrupt the cycle of poor health.

PATH is currently recruiting a technical consultant the period June 8, 2018 – December 31, 2018; with a possibility of continuation upon performance assessment and funding availability

Background

Digital Square, an initiative within PATH’s Digital Health program, is one of PATH’s innovative responses to Global Health challenges to be a driver of change. Conceived from the lessons of the inefficiencies and redundancies of investments in digital technologies, Digital Square brings global and regional actors together to create a new way of thinking about, and a new way of doing, development. 

One of the most integral attributes of Digital Square is our ability to foster the creation, sustainability, and interoperability of global goods - digital solutions for health development. We do so through an open proposal process hosted on an Open Proposal Platform (OPP). Each round of funding is called a “Notice” cycle. Digital Square is preparing to begin Notice C and is in the process of building an OPP. The OPP is built in the coding language Drupal. Digital Square is looking for a Drupal developer to assist in the building, maintenance, and testing of the site before the launch of Notice C, on June 19, 2018, and through the lifecycle of the process, approximately six months for routine maintenance and upkeep support.

Specific Activities

  • Assist building Digital Square’s Open Proposal Site
    • Respond to the in-house developer’s questions
    • Initiate and participate in calls with the in-house developer and staff in regard to the OPP.
    • Identify and fix bugs in the system.
  • Assist in maintenance of Digital Square’s Open Proposal Site
    • Be available to trouble-shoot problems with the OPP during the full six-month Notice cycle.
    • Provide telephone and email support

Service availability

  • Telephone support: 9:00 A.M. to 5:00 P.M. Monday- Friday PST
  • Email support: Monitored 9:00 A.M. to 5:00 P.M. Monday-Friday PST
    • Emails received outside of office hours will be collected, however no action can be guaranteed until the next working day.
    • 24 hours (during business hours) for issues classified as High priority.
    • Within 48 hours for issues classified as Medium priority.
    • Within 4 working days for issues classified as Low priority.

Deliverables

  • Submit monthly detailed invoices showing amount of days worked
  • Submit monthly report providing short descriptions of the services provided with screen shots of issues solved, working links, and/or other demonstrations of work produced.
  • Assist in the creation of technical documentation for the OPP

Required Skills and Experience

  • Master’s degree in computer science preferred with a minimum seven years’ experience in web design
  • Demonstrated experience with Drupal, PHP, Perl, MySQL, PostgreSQL, relational database design, web application design
  • Experience consulting and delivering time-bound results
  • Demonstrated ability to produce clear written materials, track progress of activities and communicate information strategically
  • Must have legal authorization to work in the United States.

PATH is dedicated to building an inclusive workforce where diversity is valued.

PATH is an equal opportunity employer. Every qualified applicant will be considered for employment. PATH does not discriminate based on race, color, religion, gender, sexual orientation, gender identity, genetic information, age, national origin, marital status, disability status, political ideology, military or protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

OpenLMIS Version 3.3 – Foundational Features to Support Immunization Supply Chains

Written by Mary Jo Kochendorfer, OpenLMIS Product Manager &
Tenly Snow, OpenLMIS Community Manager

*This post originally appeared on the OpenLMIS website

openlmis blog.png

The latest release of the OpenLMIS software, version 3.3, is a major accomplishment for the Initiative and for immunization stakeholders globally.

This release is the result of collaboration across organizations and countries to imagine, define, and build standards-based software that truly meets the needs of immunization programs and helps make life saving vaccines available when and where they’re most needed.

The OpenLMIS 3.3 release debuts a foundational feature set specifically for  supporting immunization programs in managing the transactional movements of vaccines and cold chain inventory within multi-level supply chains. New features allow for greater visibility, accountability, and efficiency in vaccine management.

"It is exciting to see that OpenLMIS 3.3 is being released now. JSI participated in the Copenhagen workshop focused on elaborating and prioritizing immunization (EPI) work flows that are being incorporated into version 3.3. We're quite pleased to see that participants from JSI managed projects in Tanzania, Zambia and Ethiopia were able to share their actual experiences and materially contribute to the features now incorporated into this version. We believe OpenLMIS 3.3, will offer an open source, comprehensive solution to many countries wanting to automate their logistics processes and operational management of EPI work flows. We're quite committed to working within the OpenLMIS community to offer JSI implementation services to assist countries to implement OpenLMIS version 3.3." -Edward Wilson, Director, Logistics Services, JSI

The OpenLMIS vision for interoperability is rooted in standards, and the Initiative takes a collaborative approach to achieving end-to-end visibility by interoperating with other systems using industry best practices. With standards-based interoperability, countries can determine which systems are best for which function and which systems should be user-facing without giving up the ability to push and pull data across all systems for critical data for decision making.

"We're excited to help make our first contribution to OpenLMIS as part of the community.   We feel this investment in 3.3 towards establishing a modern analytics foundation will quickly enhance the ability to improve real-time analytics and reporting across the platform.  By building this in a modular way, we hope to create value not just to OpenLMIS but health systems reporting in general." - Matt Berg, CEO, Ona

A Critical Juncture

Global momentum to accelerate next-generation immunization supply chains (iSC) has illuminated the need for visible, accessible data in vaccine management.

Immunization supply chains are facing a time of decreasing resources and increasing risk, underlining the importance of managing  data at all levels. In response to consistent requests to add functionality to address the needs of iSC, OpenLMIS is proud to release the first set of vaccine-specific features in the core OpenLMIS software.

"The new OpenLMIS 3.3 vaccine module is an important milestone for the immunization supply chain (iSC). Developed specifically for managing vaccine storage and distribution, and integrating key features on cold chain equipment inventory, functionality, and temperature monitoring, the vaccine module offers countries a robust and open source solution for improved data visibility and iSC performance. The fact that it is integrated into OpenLMIS’s core software for any health product means that EPI programs can collaborate with other programs—RH, HIV, malaria, TB, etc.—to leverage funds for implementation and sustained support." - Chris Wright, Consultant, Supply Chain Information Systems, Gavi Secretariat

3.3 Vaccine Features

Robust data visualization and analytic infrastructure, cold chain inventory management, integration with a Remote Temperature Monitoring (RTM) platform, and vaccine stock management are some of the key features in the system.  

For more details on available features, a 2-page PDF Vaccine Module Overview is available for download.

Responsive Design Built on Experience

To build a product that is truly responsive to the needs of end users, the OpenLMIS Community leveraged the experience of its partners in the 3.3 development by building on the accomplishments of previous OpenLMIS EPI implementations, such as VIMS in Tanzania (JSI, VillageReach, CHAI), SELV in Mozambique (VillageReach), and SIIL in Benin (VillageReach, AMP).

OpenLMIS also listened to users through user-centered design workshops and by engaging global stakeholders in the prioritization of feature sets.

Software development partner Soldevelo was a major contributor to the development of the 3.3 feature set, and the broader OpenLMIS Community played a key role in reviewing the product roadmap and new feature development to ensure that end users are heard and the needs of EPI programs globally are met.

"The SolDevelo team has worked closely with Villagereach on the requirements, design and implementation of the new features in OpenLMIS 3.3 that enable support for vaccines programs and provide extended tools for the fulfillment process. We are proud to have played a significant part in getting this work complete and happy for the opportunity to constantly enhance the OpenLMIS platform." - Sebastian Brudzinski, SolDevelo

Standards-based Integration

In the 3.3 release, OpenLMIS collaborated with Nexleaf in implementing a system agnostic, standards-based integration between OpenLMIS and an Remote Temperature Monitoring (RTM) platform, ColdTrace.   

The integration leverages the Fast Healthcare Interoperability Resource (FHIR) standard,  to allow anyone using OpenLMIS to utilize any RTM platform that follows the FHIR standard. This integration provides users with the important information, like, is the cold chain working at the facility?  at the right time. Read more on the blog.

In this release, OpenLMIS has established a proof-of-concept integration with OpenSRP, a mobile health application that allows point-of-care staff to register, track immunizations, and record stock levels. This integration demonstrates how OpenLMIS can integrate with frontline mobile applications to reduce the use of paper registries and reporting burdens through digital tools that improve client identification, registration, and inventory management.

Within the OpenLMIS/OpenSRP workflow, an nurse can see how many vaccinations she has completed that day to suggest the number of vials that were used, linking service delivery and inventory data. She can also address issues of stock availability, wastage, and usage and equity.

Data Analytics and Reporting

To address end-to-end visibility and risk management across systems, OpenLMIS, through collaboration with Ona, has invested in an open-source analytics infrastructure that can support:

  1. high-volume transactional data capture (anything from monthly to every minute transactions)

  2. ad-hoc root cause analysis across systems including filters and drill-down disaggregation of interesting data points

  3. routine, easy-to-use reports and default dashboards and visualizations

With this tech stack and infrastructure, data captured from multiple sources including OpenLMIS can be aggregated, merged, cleaned, and organized in a way that allows for near-real time visualizations either with this new analytics infrastructure or by leveraging a third party Business Intelligence tool (such as Tableau) already in use in the country            

Implementer Toolkit

The OpenLMIS Community has also released the first iteration of an Implementer Toolkit - a single source of information and resources for users  to both contribute to and reference when thinking about or planning to implement an electronic LMIS. Visit the Toolkit on openlmis.org.

"As an organization with a deep history working with governments to improve vaccine coverage rates, VillageReach is extremely excited about the new features in this release.  We have seen first-hand the need to improve the toolset available to countries looking to improve the data they have about vaccine availability from warehouse to last mile. Improved reporting functionality and the ability to link supply chain data with service delivery data is an important tool to meeting vaccine coverage and equity goals." -Emily Bancroft, President, VillageReach

------

OpenLMIS would not be where it is today without the support of all OpenLMIS partners and donors, and we are incredibly grateful for their continued guidance and participation in this growing initiative. See the 3.3 Release Notes for the full details of the release, and download the Vaccine Overview PDF.

The OpenLMIS Initiative’s mission is to make powerful LMIS software available in low-resource environments – providing high-quality logistics management to improve health commodity distribution in low- and middle-income countries. OpenLMIS increases data visibility, helping supply chain managers identify and respond to commodity needs, particularly at health facilities where lack of data significantly impacts the availability of key medicines and vaccines. Learn more at openlmis.org, or by writing to info@openlmis.org

Position Available: Deputy Director of Operations, Digital Square

Tracking Code: 8787

Job Description

*Please include a cover letter with your resume describing your interest and how you meet the qualifications. Your application can be submitted here. 

PATH is an international organization that drives transformative innovation to save lives and improve health, especially among women and children. We accelerate innovation across five platforms—vaccines, drugs, diagnostics, devices, and system and service innovations—that harness our entrepreneurial insight, scientific and public health expertise, and passion for health equity. By mobilizing partners around the world, we take innovation to scale, working alongside countries primarily in Africa and Asia to tackle their greatest health needs. Together, we deliver measurable results that disrupt the cycle of poor health.

PATH’s Digital Health Program is dedicated to scaling Information and Communication Technology (ICT) in lower/middle income countries (LMICs).  Our work is focused on supporting countries to use digital technology and data use approaches to accelerate and amplify their health investments, goals and outcomes. An important driver and component of that work is the digital transformation of global health itself. PATH’s Digital Health program works with government ministries of health, the information and communication technology sector, the global health sector and donors to improve the use of digital technologies and data for improved health services, systems and financing, and the information systems, technologies and enabling environment factors that improve the availability and quality of those technologies and the data they support.

Digital Square, an initiative within PATH’s Digital Health program, is one of PATH’s innovative responses to Global Health challenges to be a driver of change. Conceived from the lessons of the inefficiencies and redundancies of investments in digital technologies, Digital Square brings global and regional actors together to create a new way of thinking about, and a new way of doing, development.  

Based in Washington, DC, the Deputy Director for Operations will be a key member of the Digital Square leadership team. S/he will support both the day-to-day management and administration of the Digital Square program as well as provide support to the Director of Operations for the Digital Health Portfolio, based in Seattle, WA, as a key member of the overall Operations team within the Digital Health program.

Responsibilities

  • Develop and/or refine existing systems, processes and norms for award and subaward management in line with PATH and donor policies.
  • Accountable for all donor communications, management of donor deliverables, and ensuring appropriate PATH approvals. Oversight of all donor management communications including but not limited to: weekly calls, narrative and financial reporting, ad hoc requests.
  • Oversee and coordinate the administration of Digital Square sub-awards to partner for investments in Global Goods.
  • Communicate, coordinate, and negotiate with internal and external partners, donors, and stakeholders, and keep both Digital Square and the Digital Health program leadership apprised of project changes and milestone delays.
  • Proactively manage changes in project scope and create contingency plans in a constantly changing environment.
  • Advise the Digital Square team on best practices around project implementation and ensure compliance in every aspect of project implementation.
  • Manage the Digital Square Project Administrator.
  • Contribute to business development activities including program strategy, proposal management, cost & compliance, and technical proposal development for Digital Square.

Required Experience

  • Master’s degree in management preferred.
  • At least 7-10 years’ experience in full-scope project or program management, preferably in the global health field.
  • Experience working in and with developing countries.
  • Strong background in project management, financial management, project reporting and risk management tools.
  • Demonstrated experience implementing complex, multi-country projects, preferably within an international NGO.
  • Demonstrated ability to communicate effectively in either written or oral form.
  • Demonstrated ability to work well with cross-functional, cross-geographical teams to accomplish objectives.
  • Advanced computer skills, including MS Project, Word, Excel, PowerPoint, SalesForce, SmartSheet, and SharePoint.
  • Ability to travel domestically and internationally 20-50 percent of the time.
  • Must be fluent in English.

Must have legal authorization to work in the United States.

PATH is dedicated to building an inclusive workforce where diversity is valued.

PATH is an equal opportunity employer. Every qualified applicant will be considered for employment. PATH does not discriminate based on race, color, religion, gender, gender identity, sexual orientation, genetic information, age, national origin, marital status, disability status, political ideology, military or protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

 

 

 

 

 

Job Location

Washington, District of Columbia, United States

Company Location

United States, Washington, D.C.

Position Type

Full-Time/Regular

Introducing Digital Square, an innovative co-investment approach that’s changing business-as-usual

By Claire Droll, Communications and Advocacy Officer, Digital Health, PATH

  BID Learning Network (BLN) members exchange ideas at a BLN event in Arusha, Tanzania. The BLN is one example of a peer learning platform that will be amplified by the African Alliance.

BID Learning Network (BLN) members exchange ideas at a BLN event in Arusha, Tanzania. The BLN is one example of a peer learning platform that will be amplified by the African Alliance.

Last month at the Global Digital Health Forum, I introduced Digital Square to many colleagues. “Digital Square is an innovative co-investment mechanism,” I said. “Yes, but what exactly does Digital Square do?” was a common response.

Here’s what we do.

Digital Square is a partnership of the world’s leading digital health experts from 30+ organizations and countries working together to strengthen digital health systems in emerging economies.

We maximize the value of scarce development resources by coordinating investments behind ‘tried and true’ global good technology solutions. Multiple donors – including USAID and the Bill & Melinda Gates Foundation – are already buying into this innovative new funding approach.

Think of Digital Square as a funnel.

I like to draw a picture of a funnel when I explain Digital Square’s co-investment approach. We align funding from many different sources to support tested, scalable digital health tools that have gone through Digital Square due diligence (specifically, through our Open Proposal Process).

Why does coordinated investment matter?

 Digital Square employs an innovative new funding model.

Digital Square employs an innovative new funding model.

 

Often, investments into digital health tools – like mobile phone applications for health workers, electronic health record systems, and disease surveillance systems – are made in a siloed way. This means that a single donor, company, foundation, or individual contributes money or other resources into a single, oftentimes new tool to address a specific disease (despite the fact that a similar tool might already have been developed and tested by another program).

As part of the global health community, you know that these kinds of siloed investments, and in particular those which fail to build on what’s already been developed and tested, lead to a number of problems: inadequate and volatile funding streams, fragmentation, duplication, and a high cost burden for in-country health programs which end up utilizing competing tools. Most importantly, these challenges mean that data isn’t being shared effectively for wider decision-making.

How do we know that the global goods in our portfolio are sound investments? Because Investments support the scale-up of digital health tools that have been proven to work. Each of these tools has been rigorously reviewed by our expert Peer Review Committee and Governing Board. Specifically, each has the potential to 1) be deployed to significant scale, 2) be used across multiple countries, 3) receive funding from multiple sources, 4) be interoperable with existing standards and systems, 5) be (usually) free and open-source, and 6) benefit from a strong community of support. Right now, Digital Square is supporting investments into 7 global goods, each of which meets many of those standards.

Each of the global goods elevated by Digital Square also benefits from a community of support. Digital Square grew out of a forty-partner USAID Broad Agency Agreement (BAA) process that completed in 2016. Many of those BAA partners remain involved in Digital Square. Some are expert members on our PRC, others have been selected through the Open Proposal Process to receive funding and implement global goods, and many join monthly partner calls.

Digital Square: supporting global goods and the environment in which they thrive.

Bringing digital health tools to scale in developing countries and ensuring their sustainability requires several elements to be in place: national leadership and commitment, an environment where global goods can scale, digitally-literate healthcare workers, and robust local capacity in software development and other critical digital technical skills.

Digital Square is helping to develop digital health capacity through the African Alliance of Digital Heath Networks (‘the African Alliance’). The African Alliance provides an umbrella platform to cultivate the human capital needed to develop strong national digital health systems. Promoting country ownership of digital innovation and offering a hub for south-south learning, the African Alliance helps foster the sustainability of investments made through Digital Square. The African Alliance will amplify the impact that the BID Learning Network and other mature peer learning mechanisms have had in building capacity on the continent to date.

In 2018, the African Alliance is incubating digital health experts and champions on the continent through a number of activities. Several workshops at African summits are planned, and the team is working with the World Health Organization Regional Office for Africa and the International Telecommunication Union to launch a new Digital Leadership Program. This will begin with two workshops, one in East Africa, and one in West Africa, where up to 60 fellows from Ministries in 20 countries will hone their digital health leadership skills.

Meet us in the Digital Square.

We intentionally chose Digital Square as the name for our collaborative partnership. A square in a town or village is a place where people can meet and tap into the collective energy and ideas of the community. Digital Square provides this place for the global health sector. Partners meet in the Digital Square to seed and grow big ideas – like the African Alliance – for how technology can improve health in developing countries.

Join us! Help us disrupt business-as-usual by investing in sustainable global goods, growing the African Alliance of Digital Health Networks, authoring a thought piece, and more. Contact Claire Droll (cdroll@path.org) to learn more about how you can get involved.

What to watch in 2018 in digital health: Conversations from the Global Digital Health Forum

By Claire Droll, Communications and Advocacy Officer, Digital Health, and Lauren Hodsdon, Program Assistant, BID Initiative, PATH

  Photo: PATH/Gabe Bienczycki. The 2017 Global Digital Health Forum experienced a 30 percent increase in participation from 2016.

Photo: PATH/Gabe Bienczycki. The 2017 Global Digital Health Forum experienced a 30 percent increase in participation from 2016.

Last month, more than 550 individuals in the digital health field – representing ministries of health, implementing organizations, and other partners – met for the fourth annual Global Digital Health Forum (GDHF) in Washington, DC. The conference, which experienced a 30 percent increase in participation from 2016, has established itself as a landmark annual event in the space. Over the course of three days, speakers and participants engaged in over 80 sessions, roundtables, and workshops to share lessons learned and best practices.

Here are some of the major themes that emerged from the conversations that you’ll want to track in 2018:

1) Countries are demonstrating (really) strong leadership.

It’s no secret that country ownership of digital health strategies and programming is pivotal to ensure their lasting success. Around the world, countries are in the driver’s seat when it comes to strategy development and implementation, a reality that became abundantly clear during the Forum. More than 48 countries were represented at this year’s GDHF, and over 30 percent of participants came from outside of the United States.

Countries played a central role on keynote panels – for example, Olasupo Oyedepo, Project Director of the ICT4HEALTH Project (Nigeria), and Boonchai Kijsanayotin, Chair of the Asian eHealth Information Network (Thailand), set the tone for the entire Forum during the opening session. They also drove the bulk of technical sessions on everything from Kenya’s “enforcement” of their eHealth Policy to Liberia’s success with a new Electronic Integrated Disease Surveillance and Response system.

2) National and regional roadmaps are a way to overcome siloed digital health systems, projects, and investments.

In 2017, PATH celebrated the extension of its Data Use Partnership with the Government of Tanzania, beginning the implementation of the country’s Digital Health Investment Road Map. Supported by a $15 million investment from the Bill & Melinda Gates Foundation and designed in consultation with more than 80 partners, this first-of-its-kind Road Map identifies 17 priority investments to strengthen Tanzania’s data and health sector in a comprehensive way.

At this year’s GDHF, Dr. Gibson Kibiki, Executive Secretary of the East African Health Research Commission, introduced another landmark road map: the Digital Regional East African Community Health Initiative (Digital REACH Initiative) Roadmap. This document represents an innovative regional effort to bring together governments of the EAC countries, development partners, the private sector, and others to improve health outcomes by creating an enabling environment and implementing strategic regional digital health programs. A priority Digital REACH Initiative deliverable is the creation of the East Africa Open Science Cloud for Health, a real-time regional data warehouse that helps overcome fragmentation by storing and managing health data across the region.

Finally, the World Health Organization Regional Office for Africa (WHO AFRO) and the International Telecommunication Union (ITU) recently launched a cross-sectoral Roadmap for Africa. This effort promotes the adoption of information and communications technology by building digital health capacity at all levels of the health system. In 2018, the initiative will host two workshops in East and West Africa to equip a cohort of promising local fellows with fundamental digital health skills.

3) Digital health tools should (usually) be open source.

Digital health tools share a set of common characteristics. They’re designed to be interoperable, are used across multiple countries, receive support from a strong community of users, have been deployed at significant scale, and have demonstrated effectiveness. They’re also usually open source. One of the nine Principles of Digital Development, open source refers to technology based on collaborative efforts and community development. It’s accessible, adaptable, and seeks to deliver shared benefit for all.

Many beloved digital health tools – like iHRISOpenLMISOpenMRS and DHIS2 – are open source. Numerous recent reports like the World Bank Report Digital Dividends praised open source solutions and called for additional investments to scale their use and impact.

With all these benefits, it’s easy to forget that providing open source solutions is neither simple nor free. In a recent blog post on the Open Source session at the GDHF, Tenly Snow, OpenLMIS Community Manager, unpacked the dilemma behind open source. “Open source doesn’t mean it’s free – there are upfront and ongoing costs for implementing and sustaining a core open source product. Managing the partners, conversations, and processes needed to achieve feature development and community consensus for the software and initiative requires significant coordination and effort. Democracy takes work!” However, this doesn’t mean it’s not worth the effort. One key benefit of open source is that it creates the opportunity for countries to share the challenges and build common solutions, which reduces the costs of doing it alone.

At the end of the day, it’s important to consider the benefits and challenges of implementing both open and proprietary solutions, and to support countries in implementing the system that works best in their context.

4) Adaptive management is here to stay.  

In development, it’s very common to develop a project plan, implement that plan as prescribed, and – only after the project ends – reflect on adjustments that could have been made to overcome obstacles. Adaptive management turns this model on its head. It is an iterative decision-making process that provides a framework to revisit and refine strategies and programs. It’s hardly a new concept, but adaptive management has recently gained renewed traction in the digital health community as an effective approach to enhance real-time impact.

Adaptive management emerged as both an explicit and implicit theme throughout the GDHF. It is the guiding philosophy behind the many “global goods,” or digital health tools that are meant to be adapted to fit local needs and contexts, shared at the Forum. PATH is also embracing adaptive management at a programmatic level.

5) The sector has matured significantly.

The fourth GDHF showcased the enormous maturation of the digital health sector in recent years.  A telling example is the WHO Classification of Digital Health Interventions v1.0, or shared language to describe the uses of digital technology for health. Also referred to as a taxonomy, the classification categorizes the variety of ways in which digital and mobile technologies are being used to support health system needs. It represents an initial synthesis of proven practices in the space, and provides the foundation for the forthcoming 2018 WHO Guidelines on Digital Health Interventions. The WHO Guidelines will deliver evidence-based recommendations to countries on how to plan for and invest in digital health interventions.

We don’t want to be dramatic, but the classification is a really big deal. With consistent, shared language to describe digital health concepts, tools, systems, and interventions, we can better facilitate dialogue between public health practitioners and technology-oriented audiences. The taxonomy, in conjunction with the WHO Guidelines on Digital Health Interventions and the complementary Digital Health Atlas, will help maximize the use of digital health interventions as solutions to big development challenges.

Late in 2017, PATH also synthesized a set of 8 trends that are defining the future of global digital health. The major themes from the Forum – both those set forth above and others captured in recent pieces from our partners* – align with these trends. As we begin 2018, we look forward to progressing these themes and accelerating our collaboration through events such as the GDHF.

 

*Our colleagues at Measure Evaluation and OpenLMIS also authored blogs reflecting on the 2017 Global Digital Health Forum.

Navigating digital transformation—8 trends defining the future of global digital health

By Skye Gilbert

This was originally posted on the PATH blog, you can find it here

 Digital innovations, such as using smartphones to track malaria in remote areas, are essential to achieving health equity now and in the future. Photo: PATH/Gabe Bienczycki.

Digital innovations, such as using smartphones to track malaria in remote areas, are essential to achieving health equity now and in the future. Photo: PATH/Gabe Bienczycki.

Whether on the political, scientific, or cultural front, the world today is in a state of flux. Reviews from BCG, McKinsey, Deloitte, and Accenture highlight major demographic shifts, the increasing importance of technology in health, and the convergence of business and technical considerations. Digital platforms and solutions are emerging as a source of hope, inspiration, and connection.

The Digital Health team at PATH has spent the last year reviewing global analyses, listening to end users and partners in the field, and exchanging perspectives throughout the global digital health community about issues that are both driving and impacting the global health sector.

Globalization and localization of digital health

As political and economic power shift to rapidly growing countries, local institutions are increasingly influential in the traditional aid sector. Local governments have the capacity and resources to invest in infrastructure and take on new levels of responsibility. Local businesses and nonprofits are increasingly capable of managing technical partnerships in support of development.

What this means for global digital health:

  • Traditional donors more strongly encourage local hiring and innovation.
  • International organizations curate peer networks and foster global innovation hubs that allow diverse, virtual teams to innovate and diffuse innovations faster and better.
  • These global networks and hubs enable the next wave of global digital health innovations.

Growing power of (some) end users

The GSMA forecasts mobile internet subscriptions will hit 56% by 2020. A large percentage of these users are on social media networks, which provide a direct link between end users and local and global communities, as well as a new way to exert influence on their own health and society. This growth, however, is not equitable. Women in South Asia are 38% less likely to own a mobile phone than men, and the gender gap in digital access is growing in Africa. Digital health investors and implementers should consider gender and cultural issues to help address equity gaps.

What this means for global digital health:

  • Low-income populations monitor and manage their own health digitally, resulting in lower rates of noncommunicable diseases.
  • Public health programs use social media platforms to share information and gather feedback.
  • Women use technology to gather critical health information, make peer connections, and link directly to experts.

Digital data transforms health systems

A fully digitized health system connects families living in remote areas to health providers. It diversifies and expands the biodata available for computational analysis, ensuring that innovations in personalized medicine address global needs equitably. And digitization drives down costs in health system by enabling earlier identification of disease, leaner supply chains, and more efficient operations. The enormous potential value of data can be realized with fast, high-volume, real-time data processing. Cloud-based solutions allow programs to affordably manage and find value from big data.

What this means for global digital health:

  • Strong cloud-based governance and regulatory frameworks address country concerns about data sovereignty.
  • Countries migrate to robust cloud-based solutions and invest in local infrastructure and staff to meet the system requirements of big data.

Broadening to community-wide resiliency

In our connected world, a local crisis has the potential to impact the global community. Loss of homes due to climate change, increased migration, human conflict, and extreme poverty all pose risks to health, and all require interventions that extend far beyond the traditional health system. Organizations that use information and communication technology for development, including those focused on improving health outcomes, will need to broaden beyond historic aid siloes and understand how different sectors impact each other to improve the resiliency of communities in crises.

What this means for global digital health:

  • Digital platforms break down programmatic barriers by bridging data divides and proving the value of connecting silos.
  • Digital platforms continue to increase responsiveness to crises and accelerate recovery timelines.
  • Funders support cross-sectoral solutions that holistically address individuals and community needs.

Merging of digital health sectors–global with local and public with private

While health equity increases throughout the world, remaining inequality has become more visible because of increased access to information and decreasing physical proximity between the healthy and unhealthy. Twenty years ago, those with the lowest life expectancies were concentrated in low-income countries. Today, in high-income cities like Seattle in the US (where PATH is headquartered), life expectancy may vary by more than 15 years, depending on neighborhood.

What this means for global digital health:

  • The global digital health sector plays a role in supporting low-income communities in wealthy countries, bringing expertise in building solutions for low-resource settings.
  • As middle-income communities grow in countries like India and China, the global digital health sector works with private-sector partners that bring more sophisticated software and services.

More support for human-centered care

Over the coming years, longer lifespans, demographics shifts, and a growing global middle class will alter the global burden of disease and demands on health systems. Noncommunicable, chronic conditions that require ongoing management will increase. Whether bolstering mental health or managing hypertension, interventions need to be part of a holistic, interactive solution that takes individualized, lifelong approaches.

What this means for global digital health:

  • Digital tools empower end users to adopt or reinforce health behaviors (rather than delivering digital solutions via health provider intermediaries).
  • Public health programs efficiently monitor the health of communities to prioritize interventions.
  • Interventions that have worked for wealthier populations are adapted to work in low-resource settings.

More support for cost-saving solutions

Lower-income countries already struggle to resource their health systems; meanwhile, new health technologies, longer-living populations and noncommunicable diseases will continue to drive up costs per patient.

What this means for global digital health:

  • Digital health interventions are developed to increase affordability of preventing, treating, and monitoring population health.
  • Digital information systems provide visibility into cost-containment opportunities and enable monitoring of which solutions are successful.
  • New business and health insurance models are developed to achieve universal health coverage.
  • Health insurance providers have sophisticated approaches to cost containment without sacrificing patient outcomes and are increasingly present as advisors, partners, and implementers in low-resource settings.

Growing focus on data ownership, ethics, and rights

Demand for data has never been higher. Traditional players in the sector (including PATH) want data to improve program effectiveness and get ahead of the anti-globalization sentiment that threatens global development programs. New players (e.g., an increasingly engaged private sector) need data to learn how to best add value in the sector. Yet as data grows in value, data suppliers and owners form an increasingly complex and fragmented network, each with their own motivations for data use. This network often exists outside a comprehensive regulatory environment, creating a “wild west” atmosphere for the management and use of health data.

What this means for global digital health:

  • New ownership and privacy policies protect fundamental human rights.
  • Data monetization drives social outcomes (rather than risking them).
  • Collective, successful navigation ensures future growth for the sector, and digital global health’s ability to make lives better rather than worse.

 

 What do these 8 global trends mean for the global digital health sector? Click to enlarge. Illustration/PATH.

What do these 8 global trends mean for the global digital health sector? Click to enlarge. Illustration/PATH.

New ways of thinking for global digital health

Our hope is that this synthesis inspires our peers to discussion and debate among our peers, starting at this week’s Global Digital Health Forum (see an overview from Amanda BenDor, one of the cochairs). Over time, a common perspective on the evolutions of the global digital health sector can inform a powerful, collective response. At PATH, we continue to see digital innovations as essential to achieving health equity now and in the future. And we know that we’ll need to work together as a community to go far in achieving this important goal.

For more information on global trends, these materials have great insights:

General

Globalization and localization of digital health

Growing power of (some) end users

Broadening to community-wide resiliency

Merging of digital health sectors

More support for human-centered care

The 2017 Global Digital Health Forum–Celebrating new ways of thinking for global digital health

By Amanda BenDor; This blog originally appeared on the BID Initiative blog

The annual Global Digital Health Forum is scheduled for December 4-6th in Washington DC.  Though the Forum features amazing presentations every year, one of the most valuable aspects of this event is having the world’s digital health implementers, donors, and champions in one space.  The dialogue and strong relationship building between ministries of health leaders, technical developers, and other players in our field is what makes this conference special.

This year’s theme – The Evolving Digital Health Landscape: Progress, Achievements and Remaining Frontiers – captures the spirit of progress made in the past several years to improve digital health systems and takes a critical look at the continued need for innovation to improve health outcomes. PATH joins the Forum once again to share our experiences and technical knowledge through a variety of workshops and presentations.

What excites me about the field of global digital health is that the community is collaboratively working together to unlock new paradigms in global health, demonstrating the value and impact digital technologies and systems have on health outcomes. For example, governments are taking ownership of their eHealth visions and strategies – engaging more with private sector as well as donors and NGOs. Health information system interoperability is making inroads through standardized health architecture approaches, harnessing open standards and open source systems.  And the way we work is evolving: donors and partners are coordinating and collaborating in new and different ways through programs such as the Health Data Collaborative, accelerating alignment of investments and resources.

As one of the Co-Chairs of the Global Digital Health Network, which co-sponsors the Forum, I’ve been preparing for this event since the summer.  Here are a few of the topics I’m excited to see featured at the Forum this year.

Sustainability and Scale

We are at the point in digital health where platforms and mobile technologies are scaling and have scaled.  I’ve always enjoyed the conversations around “What does scale really mean” and the Forum will indeed address this question and more. Additionally, I’m excited to hear experts share their stories as well as important insight on how to continue supporting scaled solutions.  The BID Initiative will be featured in several sessions on scale including a hands-on workshop to highlight their experience building immunization systems for scale in Tanzania and Zambia.

Digital Impact on Population Redistribution

One of the trends both driving and impacting the global digital health sector is population redistribution, specifically displacement of persons due to political conflict.  The Forum will feature a session exploring how aid organizations are harnessing data and analytics to save lives in some of the world’s most fragile states.  I am looking forward to learning how we can further apply advanced analytics in all of our digital health work.

Digital Financial Transactions and Digital Currency

One of my favorite topics, Blockchain, is being featured this year!  Digital payments are not new but how our field adapts to integrate blockchain technology remains a question. The Forum will feature a panel of experts who will share their experiences applying blockchain technology, such as Bitcoin, outside of the global health sector. This is an important trend to watch as the growth in digital currency will have increasing impact on digital health in the next five to ten years.

Open Source

The enthusiasm around open source tools and platforms is not new.  However, how to apply an “open approach” is trending, particularly through open standards and open data. I’m excited to see how the global digital health community is embracing open source technology and using approaches such as  OpenHIE to make systems, mobile applications, and other digital platforms interoperable.

Digital Health Toolkits

Applying digital health tools as well as how to operationalize digital health programs can be daunting, which is why toolkits are useful resources for implementers at all levels of the health system. The toolkit fair will help implementers decide which resources to turn to when planning, implementing and evaluating digital health systems.

There are so many other exciting topics at this year’s Forum.  You can view all of the speakers and session descriptions through the online agenda.  You can also follow the conference on Twitter at #GDHF2017 and we will share the PATH and BID Initiative presentations as they happen. Whether you are able to join the Forum in person or you plan to follow along virtually, I hope to hear from you about what global digital health trends and programs have excited you over the past year.

What is a global good? Harnessing DHIS 2 to strengthen HIV/AIDS reporting in DRC

By Amanda BenDor

Capturing health information data is essential to track patient services, manage resources, and support decision-making in a health system. Digital systems can improve accuracy of data captured, increase visibility throughout the health system, and enable new kinds of analytics that are costly or difficult with paper-based systems. However, implementation of robust digital health information systems is not easy in resource-constrained countries. One notable challenge to building digital health systems is the relatively low level of digital access in countries like the Democratic Republic of the Congo (DRC). For example, less than 5% of the DRC population uses the internet, and less than 40% have a mobile SIM card

Undeterred, the DRC is committed to navigating these constraints in order to strengthen their health system. For example, the country is making dramatic strides to expand internet coverage nationwide. In partnership with the Gavi Alliance, the government is deploying very small aperture terminal (VSAT) Satellite technology to connect health zones throughout the country. VSAT is a satellite communication system that handles data, voice, and video signals providing access to locations with very weak internet and mobile coverage.

Taking advantage of increased digital connectivity DRC has adopted the global good district health information system 2 (DHIS). DHIS 2 is a health management information system that allows users to collect, manage, and visualize health data. The DRC Government is using DHIS 2 to develop its National Health Information Management System, and is currently supporting a nation-wide rollout to all health zones in the country to capture monthly aggregate data of health indicators at health facilities.

PATH’s work in DRC–harnessing a global good

In addition to introducing a National Health Information System, the DRC and PATH—through the Integrated HIV/AIDS Program (IHAP) Haut Katanga and Lulaba (HK/L) project—are going one step further and implementing DHIS 2 at the point of care. Doing so allows for the capture of essential HIV/AIDS service delivery data for reporting, monitoring, and quality improvement. 

Launched in 2017, IHAP HK/L is a 5-year, USAID-funded project that builds on ProVICplus. IHAP HK/L supports 153 facilities and communities in 16 health zones by providing a comprehensive package of HIV testing, care, and treatment services in the Haut Katanga and Lualaba provinces in the southern part of the DRC.  Data about these services is not only captured for monthly reporting to monitor DRC’s progress of President's Emergency Plan for AIDS Relief (PEPFAR) 90-90-90 indicators, but also enables decision-makers to monitor services and enact data-led decisions to improve services and policy.

IHAP chose DHIS 2 to manage HIV/AIDS data because of its flexibility and alignment with the 9 Principles for Digital Development.  Like other global goods DHIS 2 is open-source, easy to implement and scale, well-documented, interoperable through open standards, and adaptable to country and project-specific needs. Implemented in over 40 countries DHIS 2 has now been used in the DRC for several years.

Transitioning from paper to digital systems

Prior to the implementation of DHIS 2 staff at health facilities in the DRC entered HIV/AIDS service delivery data by hand into a 30-page register book called a Canevas Unique. Data from the register books were then entered into an excel system by IHAP staff, only after being validated at a monthly meeting at the health zone level. Operational challenges—like delays and errors in entering data—inhibited not only timely reporting but also data-led action to improve HIS/AIDS services. 

Transitioning from this paper-based system to a digital platform will mitigate many of these challenges.   

“We see the value of the DHIS 2 platform and are eager to scale not only for our team but also to the health facilities we are supporting,” says Venant Cikobe, National M&E Specialist for the IHAP-HK/L program. “DHIS 2 will give us more flexibility to collect, analyze, and visualize data.  We also like that offline reporting is available—this is important since internet connectivity is not very reliable in all of the health zones.”

Scaling and expanding data use

The IHAP-HK/L team first set up DHIS 2 for its own staff in the summer of 2017 to replace the excel forms used to capture, triangulate, and report PEPFAR data. While customizing the system the IHAP-KL/L team created unique dashboards of PEPFAR indicators ensuring system alignment with DATIM and other reporting protocols.

The IHAP-KL/L team is planning to scale the DHIS 2 system at the facility level replacing the Canevas Unique paper-based system. The goal is to enable faster data entry and support more complete quality data of HIV programs. As DHIS 2 is rolled out for use at all 153 facilities the team will build capacity of facility staff to use DHIS 2 to see reporting trends of essential HIV/AIDS prevention and treatment services. The IHAP-HK/L team in Lubumbashi is preparing for a hands-on training of the program’s 20 site coordinators to efficiently and effectively engage them in the process to scale the platform.

Until DHIS 2 has been scaled to all 153 facilities the team is looking at how to make use of DHIS 2 and other data now to inform decision making. Using clinical data from the patient tracking system Tier.Net, as well as reporting data from other sources, PATH is harnessing Tableau and other tools to develop interactive graphs and maps to better contextualize how data feeds into the 90-90-90 indicators.

The work PATH is supporting through IHAP-HK/L has the potential to improve HIV prevention, care, and treatment services in the country by creating a culture of data use. The data collection and use skills being built through IHAP-HK/L are transferable to other health programs as well as sectors outside of health. IHAP’s success will lay the groundwork for digitizing and transforming health information use across the country.

What is a "global good"?

By Carl Leitner

Too often, “innovation” in the fields of health and information communications technology (ICT) is equated with the creation of something entirely new. Instead of re-inventing a technology or solution that already exists—which leads to duplication and waste—we can leverage those that already exists.

Digital Square believes there’s innovation in building upon existing tools that we know work and bringing these tools together in new ways to address health system priorities. Global goods are digital health tools that are proven to deliver results and which can be used in multiple countries and contexts. Often open-source, these tools should be easy to implement, scale, and be interoperable across commonly used systems.

Digital Square is coordinating investments in global goods to help ensure they have reliable funding streams. These investments sustain high-quality products that are a part of the national health information infrastructure and allow for continued growth in functionality according to countries’ needs. OpenLMIS is an example of a global good solution. It’s an open-source, customizable, and tested electronic logistics management information system. OpenLMIS supports facilities in low-resource settings to ensure they have the resources and commodities they need such as: medicines, immunizations, and other medical supplies. Without tools like OpenLMIS, supply chain systems have to rely on pen-and-paper data collection which causes delays and errors in the supply chain.

Global goods matter not only because they cut down on fragmentation and duplication in the health sector and beyond. They matter because when they’re scaled appropriately, global goods save lives and are positively impacting the health of people around the world.

If you’re interested in making a global good investment, telling us about a global good that has been successful, or simply learning more, connect with the Digital Square team at digitalsquare@path.org.