Developing a solution to enhance COVID-19 data exchange
COVID-19 knows no boundaries across geographies. To support robust pandemic response, health data should flow just as seamlessly across communities and up to the national level—allowing for timely, informed decision-making and the use of reliable information that can enhance cooperation across borders.
The COVID-19 pandemic has underscored the importance and intrinsic benefits of accurate, real-time data. In most countries, the health data landscape is highly fragmented with disjointed data sources across the health system, often without any sort of common data repository. And while the use of demographic data is critical in supporting COVID-19 response work—such as communicating risk to the public and planning targeted interventions among specific populations—the health data that get collected are primarily limited to clinical and health system indicators such as confirmed cases and deaths, test positivity rate, and hospital capacity.
What are the solutions to help close these data gaps?
To this end, Digital Square and OpenHIE (Open Health Information Exchange) have been co-leading a COVID-19 task force to address the global goods community’s COVID-19 data sharing and interoperability needs. This task force aims to ensure that rapidly deployed digital health solutions can be integrated into national digital health architectures and contribute to long-term health system improvements.
One project undertaken as part of this task force is the work that Jembi Health Systems did to develop a generic COVID-19 data exchange solution that could be adapted to country needs, supporting the collection and use of COVID-19 case reporting and lab data. With funding from Digital Square, and in collaboration with the task force and IntelliSOFT, Jembi developed a prototype solution to strengthen COVID-19 case reporting and lab result submission using Fast Healthcare Interoperability Resources (FHIR).
FHIR is a standards framework that defines how health data can be exchanged between different computer systems, regardless of how the data are stored in those systems. It allows health information, from clinical to administrative data, to be readily and securely accessible. The standards development organization HL7 (Health Level Seven) uses a collaborative approach to develop and upgrade FHIR.
The prototype that Jembi developed uses a middleware component, OpenHIM (Open Health Information Mediator), that is designed to ease interoperability between different information systems. To make this prototype more accessible and to support additional use cases and workflows, Jembi packaged this work in Instant OpenHIE (Instant Open Health Information Exchange) and expanded the effort to include several other packages—including one specifically for COVID-19 surveillance. By offering this solution as an Instant OpenHIE package, users are provided with an easy way to set up and explore the COVID-19 data exchange solution either locally or in the cloud.
And how does this prototype help to address the issue of data gaps, particularly regarding the collection of demographic data? It does this through the COVID-19 FHIR implementation guide that Jembi developed for use alongside the prototype—providing instructions for mapping data and identifying constraints. An example is designing a questionnaire to capture demographic variables in a patient registry, such as sex, age, ethnicity, income, and education.
As ongoing pandemic response remains crucial in countries around the world, the Digital Square and OpenHIE COVID-19 task force is continuing to identify gaps and establish standards for data exchange priorities. Digital Square is coordinating with its global goods community to enhance practical application of the task force’s outputs. Digital Square is also working to identify funding opportunities to support the software updates and adaptations that are needed to implement data exchange standards as partners in the community adapt and strengthen technologies for COVID-19 response and, ultimately, recovery.
For more technical information about the COVID-19 data exchange solution and Instant OpenHIE COVID-19 package structure, see this blog post from Jembi: Leveraging the OpenHIM & Instant OpenHIE to Support COVID-19 Data Exchange.