Thanks Carl and Shawn,
Under 1, we do not have the answer yet. The concept note has a health sector client registry that can link to the National ID data systems as defined with specific Use Cases. eGA is leading the way on laws/policy reform as it relates to e-anything. The MOH HMIS is also looking at data policy (which would include data sharing/use) – but am not sure how far along this is.
There is a lot of discussion ongoing about how personal information is managed, and many different stakeholders involved.
I copied Mturi on this email, as he may know the status of some of the proposed new eGA laws that should address some of these areas, as he is co-leading the EA work in Tanzania.
Niamh
From: Carl Fourie [mailto:ca...@jembi.org]
Sent: Wednesday, September 07, 2016 7:43 AM
To: Elaine Baker <elaine.b...@gmail.com>
Cc: OpenHIE Implementers Network (OHIN) <ohie-imp...@googlegroups.com>; Happy Mariki Danford <sho...@gmail.com>; Sriyanjit Perera <ii...@cdc.gov>; Darcy, Niamh <nda...@rti.org>; Shaun Grannis <sgra...@regenstrief.org>
Subject: Re: [ohie-implementers] Request for comments on client registry way forward document for Tanzania
Hi Elaine
Thanks for posting this and calling out to Shaun to help bring in the Client Registry community too. I'd be excited to see comments coming in on the list (a way for others to grow too). A few questions that weren't immediately clear to myself:
1 - under governance and policy it would be good to explore who carries the responsibility for curating the CR / MPI information.
2 - are there any regulatory or policy considerations around privacy that Tanzania has that one should be considering? I.e. in RSA we have Protection of Personal Information (POPI) Act and (paraphrasing) a person must be able to ask an institution what data they have about them and be able to have that data given to the requesting person. Are there privacy or constitutional concerns around how personal data is managed in Tz?
Cheers
Regards
Carl Fourie
Senior Program Manager | Digital Health Division
Jembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl....@jembi.org
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UNICEF sponsored a set of 3 videos re: unique IDs for health, with a focus (as one might expect) on use cases specific to children. The 3rd of these videos goes into some detail about how CRs may be leveraged; it may be found here: https://vimeo.com/152392600. If folks are interested, the preceding videos 1 and 2 can be found here and here, respectively: https://vimeo.com/151342311, https://vimeo.com/156650602).
There are good reasons to want to have a health CR separate from the national ID database that may be managed by the ministry of the interior. One reason is that it can take a decade or more to achieve the inter-ministerial consensus needed for a single, all-government ID number to be operationalized. Rolling out a dedicated ID purely for health purposes is much simpler from a governance standpoint – and often much quicker to implement. As an additional motivation, for many of our most vulnerable populations, it will impede their care-seeking behaviour if they have to present their national ID number to get care. As Carl has mentioned – the unique privacy and confidentiality policies that apply to health data can encourage this care-seeking behaviour where a health-only ID is used. (This particular issue is discussed in video #2, above).
I hope this info might be helpful.
Warmest regards,
Derek.
PS: apologies… these videos will soon be posted up the AeHIN site, but they aren’t there, yet.
Derek Ritz, P.Eng., CPHIMS-CA
ecGroup Inc.
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I had an opportunity, a few months ago, to learn details about Thailand’s nation-wide, all-citizens ID system. Thailand is using this national ID system for health purposes, as well as for many of the use cases you list for IPRS. There are many aspects that are working wonderfully. Some of the challenges faced by the health system in Thailand, however, are related to (as you point out) issues of privacy and confidentiality. Some at-risk, and sometimes marginalized populations (e.g. MSM, FSW, intravenous drug users, etc.), are not care-seeking and there is some evidence that it is because they don’t want to reveal their national ID#. There have also been challenges related to non-citizen populations who should be receiving care/treatment are not identified for health purposes but are not because they are non-citizens and so ineligible for the national ID card. (NOTE: a separate/parallel scheme is attempting to provide ID services for these non-citizen populations).
I look forward to this ongoing conversation; it is an important topic. Unambiguously identifying our subjects of care is a foundational aspect for any health system.
Warmest regards,
Derek.
Derek Ritz, P.Eng., CPHIMS-CA
ecGroup Inc.
This communication is intended only for the party to whom it is addressed, and may contain information which is privileged or confidential. Any other delivery, distribution, copying or disclosure is strictly prohibited and is not a waiver of privilege or confidentiality.
From: Steven Wanyee [mailto:swa...@gmail.com]
Sent: Wednesday, September 14, 2016 3:33 AM
To: Derek Ritz (ecGroup)
Cc: Darcy, Niamh; Carl Fourie; Elaine Baker; OpenHIE Implementers Network (OHIN); Happy Mariki Danford; Sriyanjit Perera; Shaun Grannis; Mturi Elias
Subject: Re: [ohie-implementers] Request for comments on client registry way forward document for Tanzania
Derek:
Thanks for posting this information and for sharing these videos.
We have struggled with this same issue in Kenya since we did the first proof of concept for our version of CR here. The Kenya MOH is currently piloting the National Unique Patient Identification (NUPI) solution in a country in Western Kenya. The current NUPI is generally based on the OEC architecture of course with lots of improvement.
Whereas I agree with you about separating a health CR from a national ID database, there are however as expected lots of advantages to exploring how the health sector can best benefit from such a service without negatively affecting health seeking and/or delivery of quality healthcare services. I was deeply involved in exploring that in Kenya with the Ministry of Interior who built and manage the Integrated Population Registration Services (IPRS) which now integrates with the Civil Registration System. The lessons I think we can learn in Kenya is from experiences of IPRS providing identity services to multiple sectors; finance sector to the bank, revenue authority, consumer services e.g. MPESA, education sector to the Higher Education Loans Board, agriculture and lands sector in terms of property identify, deeds, etc, Revenue Authority, ports of entry, etc. How can the health sector too benefit? With strong measures around privacy and confidentiality, I believe the health sector can benefit immensely.
Thanks.
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