University of the Philippines Manila Viral Hepatitis Project Implementation Guide
0.2.1 - CI Build
University of the Philippines Manila Viral Hepatitis Project Implementation Guide
0.2.1 - CI Build
University of the Philippines Manila Viral Hepatitis Project Implementation Guide, published by UP Manila Viral Hepatitis Project. This guide is not an authorized publication; it is the continuous build for version 0.2.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/gpvillanuevasilab/UPVH_WHO_SMART-Template/ and changes regularly. See the Directory of published versions
| Official URL: http://worldhealthorganization.github.io/smart-ig-upvhproject/ImplementationGuide/fhir.who.smart-ig-upvhproject | Version: 0.2.1 | |||
| Draft as of 2022-10-25 | Computable Name: smartigupvhproject | |||
Contents:
The Philippine National Viral Hepatitis program aims to monitor the reporting and treatment of chronic viral hepatitis through standardized data collection from case records.
About half of the 3000 frontline public health facilities in the Philippines use an electronic medical records system (EMR).
To harness viral hepatitis data from these EMRs, there is a need for a secure standardized data exchange system to gather individual cases of Hepatitis B and C, track their treatment status, and conduct population health analysis.
The Department of Health (DOH) and the UP Manila Standards and Interoperability Lab (UPM-SILab) has adopted the Fast Healthcare Interoperability Resource (FHIR) as data exchange format for Hepatitis B and C reporting. Using the WHO SMART Guidelines approach, two forms from the program - the “Case” and “Care” forms - were translated into FHIR format for this purpose.
This project demonstrates the provenance of interoperability from level 1 (DOH narrative policy) to level 4 (EMR transmission) using the WHO SMART guidelines.
Chronic Viral Hepatitis is a major public health problem in the Philippines. A recent study estimates that in 2016, about 9.8% of the population or more than 10 million Filipinos have Chronic Hepatitis B (CHB) (The Polaris Observatory Collaborators, Lancet Gastroenterol Hepatol ,2018). CHB is the leading cause of cirrhosis and hepatocellular carcinoma in the country, the latter of which is the second leading cause of cancer deaths. Chronic Hepatitis C (CHC) affects 0.6 to 0.9% of the population or roughly 600,000 Filipinos. (The Polaris Observatory HCV Collaborators, 2017; Gower E, 2014)
In 2016, the WHO Global Hepatitis Program released the Global Health Sector Strategy on Viral Hepatitis which sets out 2 impact targets and 7 service coverage targets for both CHB and CHC for 2020 and 2030. As the Department of Health moves towards a national action plan on viral hepatitis, one of the key elements would be the monitoring and evaluation of the program to assess if the targets set by the WHO are being met. This would require that a terminology service be in place that should be incorporated into the electronic medical records that are recognized by the Department of Health. One problem is the inability of the hepatitis program to monitor and track care of hepatitis at the primary care level.
Since 2013, the National eHealth Governance Structure has enacted policies that facilitated the deployment of electronic medical records. There are several electronic medical records (EMRs) in the country. Five of these are being used by 1500 rural health units (covering 67% of the population). Unfortunately, there are no standard terminology s sets for monitoring patient with chronic viral hepatitis patients even as their signs and symptoms are recorded in the EMRs.
As the Department of Health moves towards a national action plan on viral hepatitis, one of the key elements would be the monitoring and evaluation of the program to assess if the targets set by the WHO are being met. This would require that a terminology service be in place that should be incorporated into the electronic medical records that are recognized by the Department of Health.
This project has several components:
1. Obtain expert consensus on the terminologies related to chronic viral hepatitis through workshops;
2. Prepare application programming interfaces that employ the consensus/standard terminology
3. Equip EMRs to consume these application programming interfaces
4. Monitor collection of standardized data from EMRs into a dashboard
At the end of the project, the DOH hepatitis program will have a dashboard that shows standardized data from participating electronic medical records.
There are no dependencies for this implementation guide. The source code for the WHO SMART Guidlines IG template is available here.
Feedback specific to this Implementation Guide can provided through:
The specification herewith documented is a demo working specification, and may not be used for any implementation purposes. This draft is provided without warranty of completeness or consistency, and the official publication supersedes this draft. No liability can be inferred from the use or misuse of this specification, or its consequences.