For two weeks in February the Ona team traveled to Sri Lanka to build and deploy a FHIR native app for diabetes screening. We are collaborating with the Health Information Systems Programme Sri Lanka (HISP SL), the Sri Lanka Ministry of Health, and the World Diabetes Foundation (WDF). The Government of Sri Lanka is in the process of finalizing and beginning implementation of their national Digital Health Blueprint, which defines “an architectural vision for an interconnected and interoperable digital health ecosystem within Sri Lanka.”
A core principle of the blueprint is “to be software/implementation agnostic”, which aligns well with a standards based approach using interchangeable off-the-shelf products that adhere to common standards. Following the government’s lead we provided an overview of the standards, platforms, and tools in the digital health ecosystem that serve the needs they identify in the Digital Health Blueprint. We discussed how Fast Healthcare Interoperability Resources (FHIR) and the WHO SMART Guidelines can fit into their vision without creating a dependency on any specific software or being tied to a particular implementation.
We also discussed our experiences learning from AeHIN member states’ adoption of FHIR. For example, we reviewed the FHIR profiles and implementation guides the Malaysian Ministry of Health uses in MY Core to create a common language across their health systems customized for their needs. We then discussed how our ongoing project with HISP SL and WDF gives us the opportunity to see FHIR tools in action, such as a centralized FHIR data store with a FHIR API and a configuration driven FHIR native mobile app, with OpenSRP.
In this project, we are collaborating with HISP SL and WDF to build and deploy a community based Android app for diabetes screening. To align this project with the government’s national digital health blueprint, we will use FHIR as a data store and SMART Guidelines-compatible FHIR content and configurations to manage healthcare workflows. Through pairing sessions with the HISP SL team we are sharing what we have learned about creating FHIR resources and building FHIR app configurations. Before our two week visit was over the HISP SL team created the FHIR configuration files and demoed a working diabetes screening app!
Our work together on this project shows how using FHIR to separate health content from health software multiplies the benefits of adaptability, speed, and sovereignty to empower implementers, technologists, and governments. This project also demonstrates how FHIR APIs can serve as a national patient registry, and fill other roles in Sri Lanka’s national Digital Health Blueprint, by integrating with EHRs currently used in clinics and facilities. Focused projects, aligned with national interests and state-of-the-art standards, let stakeholders invest in health architecture and outcomes without locking them in to specific healthcare software.
We are inspired by Sri Lanka’s commitment to solving their health system’s needs through a standards-based approach that allows them to incorporate existing technologies and positions them to benefit from future advances. The Ministry of Health and HISP SL are prioritizing solving their digitalization challenges without lock-in. We are privileged to be able to contribute to this by sharing our experiences and expertise in the FHIR global health ecosystem.