Some insight on prospective projects
We are passionate about our work and can easily come up with one hundred ideas of what needs to get done next. Our years spent working in remote locations as well as in international organisations has lead us to develop a critical mind and wanting to work always more towards more efficient solutions. We are currently focusing our efforts on three main projects that will materialise in the next months.
Middle East DHIS 2 Academy and Conference
eSHIFT members have been heavily active in delivering DHIS2 implementations and related activities in various settings in the Middle East. Lessons learned, include needs ranging from managing mobile applications, to the needs for assessments in various fragile settings, to Level 1 training needs for NGOs, especially those present in Turkey. There has been increasing investment in Arabic translations of the core DHIS2 and related applications. There has also been significant interest expressed by many parties for an academy and/or an executive conference covering regional specific strategic issues.
The purpose would be to support bringing Middle East region together around digital health, creating an open dialogue based on the countries needs, their expectations and what can be achieved through a strategic implementation of their health information systems. A successful outcome, we feel, would be that this work is led directly from the region.
Expert Community Engagement to Address Privacy and Security in DHIS2 Centric Solutions
The DHIS2 platform is one of the more widely deployed Health Information System (HIS) components in Low and Middle Income Country (LMIC) contexts. Its more recent ability to track patients through care pathways coupled with the release of standardised patient-orientated add-on Apps endorsed by WHO (e.g. TB Patient tracking, Malaria Patient Tracking) has created both new opportunities and challenges that were not as apparent while the platform was predominantly focused on routine aggregate reporting of health data from facilities.
In particular, while challenges of security and privacy, in relation to the handling and storage of patient identifiable health data, are often raised as a concern, there are a lack of guidelines, best practices, audit tools or case examples that implementers can reference or apply to ensure they approach their projects with these concerns foremost in their mind. It is only a matter of time before a highly damaging patient data-breach occurs in a DHIS2 related LMIC national health project.
We propose therefore to engage the expert community, via a rapid Target Product Profile (TPP) process, to determine the security and privacy assets that need to be adapted and/or developed, which, if adopted by implementers, would help reduce the security and privacy risks for patient-centric solutions developed in LMIC contexts using DHIS2. For this proposal, one of these assets would be developed to full maturity.
Target Product Profiles for DHIS2 Platform Implementation and Aural-Oriented Android Application Development in Secure and Fragile Settings
From our work in many complex settings, eSHIFT has identified very specific needs for developing two Target Product Profiles (TPPs) that can serve as frameworks and specifications to the digital health community serving in fragile settings — and who are increasingly seeking to leverage digital platforms to manage sensitive, personal information. A core element of eSHIFT’s mission is to identify global public goods that arise from the projects it does; these proposed TPPs are a perfect example of building on our foundations and lessons learned to document open standards with and for the community.
In particular, the technical roadmap for DHIS2, with the upcoming release of new features and functionalities including improved ‘tracker’ functionality, storage of digital artifacts as data elements, as well as with the new Android SDK, arguably facilitates the development of high-risk applications and widens an existing gap in standards and best practices for managing sensitive information and any individual records end-to-end in DHIS2. Conversely, the direction of DHIS2 and its new features can be seen as a springboard opportunity for documenting certain best practices in these areas, based on the lessons learned in practical implementation scenarios.
Escrowed data retention and retrieval solution for digital health application platforms based on distributed blockchain technology starting with DHIS2
Decentralized databases promise to revolutionise medical records, but not until the global digital health community identifies long term strategies for utilisation and short term tactics for testing and integration into existing systems architecture. The core tenets of blockchain technology — a decentralized and encrypted way of distributing, sharing, and storing information — seem appealing for health data. In particular it offers the potential for distributed responsibility for the longitudinal and immutable storage of anything from open to hierarchically encrypted data sets.
One potential modality for quick innovation with blockchain technology is via its practical application as a means to provide immutable storage and audit logging as an addon to existing systems (for example, on a platform such as DHIS2). We propose leading a software R&D effort to build a 3rd party escrowed data retention and retrieval solution for digital health application platforms based on distributed blockchain technology starting with DHIS2 as the first target platform.