Chapter 7. Integration concepts

Table of Contents

7.1. Integration and interoperability
7.2. Objectives of integration
7.3. Health information exchange
7.3.1. 1:1 integration
7.3.2. n:n integration
7.3.3. Architecture, standards and mapping
7.4. Aggregate and transactional data
7.5. Different DHIS2 integration scenarios
7.5.1. Data input
7.5.2. Data sharing
7.6. DHIS2 maturity model
7.7. Implementation steps for successful data and system integration
7.7.1. Step 1: Define strategy, stakeholders and data usage objectives
7.7.2. Step 2: Document Specifications and Requirements
7.7.3. Step 3: Carry Out Specifications and Identify Gaps
7.7.4. Step 4: Iteration and User Testing
7.7.5. Step 5: Scale-Up
7.7.6. Step 6: Ongoing Support
7.8. Specific integration and interoperability use cases
7.8.1. Logistics Management

DHIS2 is an open platform and its implementers are active contributors to interoperability initiatives, such as openHIE. The DHIS2 application database is designed with flexibility in mind. Data structures such as data elements, organisation units, forms and user roles can be defined completely freely through the application user interface. This makes it possible for the system to be adapted to a multitude of local contexts and use-cases. DHIS2 supports many requirements for routine data capture and analysis emerging in country implementations, both for HMIS scenarios and as a basic data collection and management system in domains such as logistics, laboratory management and finance.

7.1. Integration and interoperability

Based on its platform approach, DHIS2 is able to receive and host data from different data sources and share it to other systems and reporting mechanisms. An important distinction of integration concepts is the difference between data integration and systems interoperability:

  • When talking about integration, we think about the process of making different information systems appear as one, making electronic data available to all relevant users as well as the harmonization of definitions and dimensions so that it is possible to combine the data in useful ways.

  • A related concept is interoperability, which is one strategy to achieve integration. We consider DHIS2 interoperable with other software applications because of its capability to exchange data. For example, DHIS2 and OpenMRS are interoperable, because they allow to share data definitions and data with each other. Interoperability depends on standards for data formats, interfaces, codes and terminologies. These would ideally be internationally agreed-upon standards, but in practice may also consist of de facto standards (which has wide acceptance and usage but is not necessarily formally balloted in a standards development organisation) and other more local agreements within a particular context.

DHIS2 is often used as an integrated data warehouse, since it contains (aggregate) data from various sources, such as Mother and Child health, Malaria program, census data, and data on stocks and human resources. These data sources share the same platform, DHIS2, and are available all from the same place. These subsystems are thus considered integrated into one system.

Interoperability in addition will integrate data sources from other software applications. For example, if census data is stored in a specialized civil registry or in a vital events system, interoperability between this database and DHIS2 would mean that census data would also be accessible in DHIS2.

Finally, the most basic integration activity (that is not always taken into account in the interoperability discussion) is the possibility to integratedata from existing paper systems or parallel vertical systems into DHIS2. Data will be entered directly into DHIS2 without passing through a different software application. This process is based on creating consistent indicator definitions and can already greatly reduce fragmentation and enhance data analysis through an integrated data repository.