IHRIS and DHIS2 Interoperability

This article describes OpenHIE standards based data exchange and interoperability between iHRIS and DHIS2.

The assumptions are:

• DHIS2 has the list of facilities and the geographic hierarchy
• iHRIS wants to load in the DHIS2 facilities and geographic hierarchy
• iHRIS wants to export the number of health workers for each facility to DHIS2. This may be disaggregated, for example, by:
  • Sex/Gender (Male vs Female)
  • Cadre (Nurse, Doctor, Midwife,... )

We will be making use of an InterLinked Registry of Health workers and Health facilities to achieve this interoperability. This software that will help us do this is OpenInfoMan.

Care Services Discovery (CSD)

CSD is the main means for exporting (and importing) facility lists and organizational unit hierarchy from DHIS2 in a standards based way and compliant with the OpenHIE architecture. This data exchange is documented in more detailed here:

 https://wiki.ohie.org/pages/viewpage.action?pageId=16482605

In the sequence diagram in the above link, you should think of:

• FR = Facility Registry = DHIS2
• HWR = Health Worker Registry = iHRIS
• ILR = InterLinked Registry = OpenInfoMan

DHIS2 and OpenInfoMan

We are going to export meta-data from DHIS2 to OpenInfoMan. OpenInfoMan will take the exported meta-data and transform it into the CSD standard. OpenInfoMan then shares that information out as an InterLinked

What is a health facility in DHIS2?

The most important question that needs to be answered is what is a health facility in the DHIS2 instance you are using. In DHIS2 there is no universal way of saying which of the Organisation Units is a health facilities. However, there are two typical ways:

• Every Organisation Unit at a fixed level (or below) is a health facility. Often this is at level 4 and below.
• There are one or more Organisation Unit Groups that have been created and the Organisation Units for health facilities are assigned to one of these Organisation Unit Groups

An example of Organisation Unit Groups for a Health Facility is:

• Medical Clinic
• Provincial Hospital
• District Hospital
• Nursing School
• Administrative Office
• TB HC Treatment Center (CT)
• Prison Clinic

DHIS2: Data Export

Once we know which Organisation Units are health facilities, we can setup the export of DHIS2 metadata into the CSD format. There are existing transformations that can be used and we would just need to modify them based on the specifics on the health facilities in DHIS2.

What we will be doing is:

1. In OpenInfoMan, create a new CSD document to hold the DHIS2 facility data
2. In OpenInfoMan, copy and modify one of the transformation scripts to be used for our DHIS2 instance (See #OpenInfoMan DHIS2 Adapter Below)
3. In DHIS2, Perform the DXF Meta-Data Export (available under the Import-Export app in DHIS2) which includes:
   • organisationUnits
   • organisationUnitGroups
   • organisationUnitLevels
4. In OpenInfoMan, we will upload the DXF MetaData export via the DHIS2 Adapter

Now health facility data in DHIS2, including the organisation unit structure, from DHIS2 is available in the CSD directory.

If you would like to automate this process, for example with cronjob, you can:

• use the DHIS2 web api to download the meta-date export
• use an HTTP POST of a CSD Care Services Request for the stored function.

OpenInfoMan DHIS2 Adapter

There is an DHIS2 adapter for OpenInfoMan which can be found here:

 https://github.com/openhie/openinfoman-dhis

If you install this adapter, you will have a web interface on your server to:

• upload a DHIS2 metadata export (unzipped XML)
• specify conditions on when an organization unit is a facility (by group code or level)
• let you select if you want DHIS2 users transformed to CSD health workers

You will need to include the following data in your meta-data export:

• organisationUnits
• organisationUnitGroups
• organisationUnitGroupLevels

If you want to also transform users into health workers you will also need:

• userRoles
• userCredentials
• userAuthority

[Screenshot]

Automating DXF->CSD

If you want to automate this via a cronjob you will need to submit a valid Care Services Discovery HTTP POST (which is called the ITI-73 Query for Services transaction ).

An example posted message where we are selecting all organisation units with group codes for a mental health clinics and administrative buidings might look like this. The exact available group codes for your system can be found by browsing the DHIS2 web-api: <source lang='xml'>

   <careServicesRequest>
     <dxf></dxf>
     <groupCodes>
       <groupCode>MENTAL_HEALTH_CLINICS</groupCode>
       <groupCode>ADMINISTRATIVE_BLDG</groupCode>
     </groupCodes>
     <levels/> 
     <URL>http://demo.dhis2.org</URL><--! THIS IS THE "NAME" OF YOUR DHIS2 INSTANCE-->
     <OID/>
     <usersAreHealthWorkers/>
   </careServicesRequest>

</source>

If you want to import users as health workers, you can change the line:

        <usersAreHealthWorkers/>

to:

      <usersAreHealthWorkers>1<usersAreHealthWorkers>