Principles for Digital Development | 1st of 3 presentations

Defining Scale for Digital Health Solutions

Photo credit: Brian Taliesin/PATH

Kate WilsonDirector, Digital Health Solutions

October 27, 2014

10/26/2014

It’s not about us.

It’s not about tech.

It’s not about money.

It’s about IMPACT.

Source: www.ict4dprinciples.org Photo credit: Kate Wilson

Why most IT projects struggle to scale

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Why the whole software continuum matters?

Claims Backlog in Ghana

*”CFS2” conditions for sustainability and scalability, “SDLC” software development life cycle, “OS” operating systems, “TCO” total cost of ownership.

DeployDevelopDesign

Context

Problems

Users

Processes

Requirements

CFS2*

Specifications

Data Model

User Interface

Device Types

Interfaces

Standards

SDLC*

Dev Tools

Data base

OS*

Network

Road Map

User Training

Migration Plan

Infrastructure

TCO*/Budget

Support Staff

Maintenance

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Analysis

Most people start hereNeed a bit more focus here

PATH’s definition of scale in digital health

A digital health intervention is at scale when the information

system product is institutionalized in the practices of the people

using it and the government or

community policiessupport its continued usage after catalytic

funding ends.

Photo credits: Kate Wilson, D Lukinsky

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Health Need

Analysis &

Design

Develop & Test

Deploy & Operate

Data Use

Scale

The PATH approach to digital health solutions

Digital Health Solutions Continuum

Impact

Photo credits: Kate Wilson

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Sources

de

Financement

Structure

d'appro-

visionnement

1er point

de stockage

2ème point

de stockage

3ème point

de stockage

ETAT BANQUE

MONDIALE

FONDS

MONDIAL

PNA

(Population)

U

S

A

I

D

UNICEF USAIDPNA

PNA

Systèmes d'approvisionnement des produits pharmaceutiques au SENEGAL. Avril 2008

F

N

U

A

P

G

A

V

I

MEDICAMENTS

ESSENTIELSARVs

PALUDISMEY compris ACT TB IO

ARVs

Ped

REACTIFS

sécurité du sang

(+ test HIV)

VACCINS Préservatifs ContraceptifsDispositifs

Médicaux

Etat

Bailleurs

multilatéraux

Bailleurs

bilatéraux

ONG/Privé

J

I

C

A

DLSIPEV

RM

Dépôt district

CS PS

DSR

OMS FNUAPJICA

PRA

SEIPS District

CHR SEIPSRelais

Communautaire

Centre de dépistage

VIH/SIDA

PATIENT

Grossistes

privés /

Population

Grossistes

privés

Grossistes

privés

Officines

Structure

dispensatriceDPCHU CHN Case de Santé

I

P

P

F

G

D

F

U

N

I

TA

I

D

C

L

I

NT

O

N

CNTS CLINTON CNLS GDF FHI

CNTS PPJ

Banque de

sangCCA

Cliniques

privés

PNT

Ministère de la Santé

et de la Prévention MédicaleProcurement systems for pharmaceutical products – Senegal, Apr 2008

Is this health supply chain designed to scale?

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Global CommonArchitecture

• Requirements

• Standards

• Guidelines

Country SpecificArchitecture

• Requirements

• Standards

• Guidelines

Global Common Solutions

• Software

• Hardware

• Services

Country SpecificSolutions

• Software

• Hardware

• Services

Services in global context

Products in global context

Products in country context

Services in country context

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3 4

Building blocks of scalable HIS

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CRDM








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3 4


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Global common architecture: CRDM

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Common requirements developed to:1. Provide countries with a starting

point to create local versions of requirements tested in Albania, Senegal, Vietnam, Rwanda

2. Prepare tenders for information systems (e.g., Rwanda, Vietnam)

3. Provide solution providers a self assessment tool for existing solutions as in the case of Village Reach, SAGE Group plc, and Partners in Health

4. Provide implementation agencies a tool for strengthening country LMIS as in the case of JEMBI in Rwanda, PATH in Albania

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CRDM


Piloted in Tanzania and

Zambia







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3 4


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CRDM was used in Zambia & Tanzania to:1. Develop and align stakeholders to a

shared vision of computerized LMIS

2. Establish governing principles for guiding the development and operations of the LMIS

3. Determine and document country specific LMIS requirements for 800 products, drugs, lab supplies, and medical supplies

4. Develop a project scope and budget and secure funders for implementation

5. Build local capacity and partnerships with USAID|DELIVER, SCMS, Crown Agents, MoH, and Medical Stores Limited

Country specific architecture

“The CRDM process has helped us envision

a holistic information system, gather inputs

from the right people, and move forward

into system development with confidence.”

Dr. G. Syakantu, Director-Clinical Care and Diagnostics Services, Zambia Ministry of Health


CRDM



Zambia


OpenLMIS






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Global common solutions: OpenLMIS

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• PATH provided technical support to the project management team in developing a product vision and roadmap, and during the development and implementation phases of openLMIS.


CRDM



Zambia


OpenLMIS


eLMIS





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3 4


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Country specific solutions: eLMIS

eLMIS started nationwide deployment in Zambia & in Fall, 2013:

1. Built on OpenLMIS code base

2. Country specific solution deployed by JSI via support through USAID/DELIVER project.

3. Adding new features to the software solution through 2014 in both countries.

If you want to go fast, go alone. If you want to go far,

go together. --African proverb

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Healthcare

Principles for Digital Development | 1st of 3 presentations