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Thank you Theo for bringing this interesting topic!
I want to share here the experience from my country where MOH is very application oriented. There is already a fully rolled out application to manage the LMIS, HMIS, Laboratory Information System, Disease surveillance, HIV patient and even OVC. There is also a lot of new initiatives that are taking place to computerize one aspect or another of the national HIS.
We can say that this has somehow paid off since despite the close proximity of two Ebola affected countries remains Ebola free. Unfortunately those systems are still working in silos making it difficult to get a comprehensive view of the health information produced. The country is beginning to understand the problem but given that “owning the data” mean “owning the power and thus the money” each party is not seeing integration or interoperability as something good for them. In this context, I think the interoperability process should start by a behavioral change agenda…my two cents to the debate,
Romain
HMIS Advisor MEASURE Evaluation/JSI -
We all agree here that EA is something needed to guide our HIS Strengthening activities. We need a Plan or Blueprint (David Boone) to guide our action but the existing framework TOGAF, DoDAF, GEA and alike are well developed but somehow not easy adapt to the HIS context. HIS as many subsystems with so many internal workflow making it difficult to be fully pictured in a single EA, therefore having “High level EA and specific EA for the different building blocks (Chris Wright) can be one approach to solve the problem. I think that following the work started by Sally and all [1] our focus should be on customizing or adapting existing EA frameworks to make them easy to understand and apply to Health Information System Strengthening domaine. Simplification is key to democratize the process and make it a tool at the disposal of all stakeholders to use it under the leadership of government to plan their HIS strengthening interventions as said earlier by Pepela Wanjala.
[1]Sally Stansfield, MD, Nosa Orobaton, MD, DrPH, MBA, David Lubinski, MA, MBA, Steven Uggowitzer, B.Eng. Elec., and Henry Mwanyika, MS, “Case for a National Health Information System Architecture; a Missing Link to Guiding National Development and Implementation,” 2008.
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