Interoperability and the Impacts of Health Information Systems

Dykki Settle, Director of Information Systems and Technology for IntraHealth International, recently attended two conferences devoted to the topic of health information systems. He spoke with the HRH Global Resource Center about these meetings and shared his insights about this rapidly evolving and increasingly important field.

What was the first meeting you attended?

The first was the World Health Organization’s (WHO) June conference, "Framework for Interoperability for Public Health Tools Meeting," which was attended by many of the leaders in national health information systems.

What were the key points of this meeting?

Software is part of the answer as long as it is used in context and addresses underlying health information needs. One of the primary issues under discussion was the ability of tools to communicate and exchange information, as well as the need to consider how sustainability, training and infrastructure affect the interoperability of health information tools. There was confusion about the boundaries of these tools. The focus was on data use and reuse, how to exchange information to avoid duplication, reduce the burden of information collection and strengthen the abilities of countries to sustainably use data delivery for strengthening their health systems.

The attendees included WHO teams such as the Health Metrics Network and representatives from the University of Oslo, the Centers for Disease Control and several leading initiatives for information system development. These groups came together to discuss how to build a comprehensive health information system from the ground up. There were good conversations showing agreement about what is needed and how to maximize the opportunities of such a system while minimizing the negatives.

Can you tell us about the other conference you attended on your trip?

The second meeting was the Innovation and Challenges in Health Informatics conference in Durban, South Africa, held in conjunction with OpenMRS. While the group at the first meeting was mainly concerned with national health information systems, this meeting was for those working on facility-based clinical health information systems. The emphasis was on patient care and records management, but there were also discussions of interoperability at this level, particularly between systems that track patient records, pharmacy and laboratory systems.

What were the primary differences between the two conferences?

There was very little overlap between the two meetings, which highlights the gap between the need for interoperability between national and facility-level information systems. The two teams have different issues and methods, and the language they use to discuss their systems is dissimilar. The groups don’t recognize the value of the other. It is clear to me that there is a lot of information national health systems could use from the facility level to better support the health infrastructure and that facilities don’t understand the kind of valuable information they could get from a national system. For example, if facilities could get data from the national level about health workers, they could better manage patient load and also feed information on health worker needs to the national level to enable better health worker training plans.

Why do you think these meetings are happening now?

All of the health information teams are working in silos