[Chris Wright]

Thanks for the good discussion around the benefits and challenges of a MFL. The title of this thread also mentions other health information registries, and I’m curious what the experience has been in establishing:
–master client registry, linked with EMRs, civil registries, etc. for unique identifier
–master provider registry (linked to an HR MIS) that includes both public and private providers and based on provider type and licensing status
–master commodity registry linked to the EML, the national medicines regulatory authority, and pharmaceutical distributors (private and public).

A second question is related to program registries, especially vertical programs like family planning, immunization, malaria elimination, HIV and TB. Many of these programs are converting their paper registries into digital systems, essentially replicating paper registries in digital form without thinking through continuity of care or a client-centered approach. Do we need a central programs registry, or can well-design EMRs and a data warehouse replace them and, through interoperability, achieve the continuity of care and higher level data visibility across programs that we would like to achieve?

[Chris Wright]

One of the challenges I’ve seen with the Enterprise Architecture approach is how to keep it a manageable process. The health sector is a large and complex enterprise, and trying to develop a comprehensive architecture for every business processes is a daunting prospect. By using EA at the very highest levels to define (in very simplistic terms) the essential business processes and how they interrelate is a start, then one can use an EA approach to delve more deeply into discrete building blocks or domains of the health system. I’ve used EA strictly for developing architecture and requirements for supply chain MIS, and I know others have used the same approach for human resource MIS and hospital management systems. This all happen before there was a comprehensive EA defined, and the learning on these subsystems has been beneficial in getting stakeholders on board to tackle the need for higher level EA definition to guide interoperability between existing and proposed subsystems.

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