Dr Mean Reatanak SambathExecutive Director at Partnership for Better Health/CambodiaExpertise and lecturer on health informaticsTel: 855 12 727919Sent from my iPhone 6 plus
Dr Mean Reatanak SambathTel: 855 12 727919Sent from my iPhone 6 plus
Begin forwarded message:From: "noty.open.org.kh" <no...@open.org.kh>
Date: March 9, 2017 at 9:38:26 AM GMT+6:30
To: msam...@pbhcam.org
Cc: Roith Hong <hroit...@gmail.com>, Tapley Jordanwood <tjord...@URC-CHS.COM>
Subject: Re: OpenHIEDear Dr. sambath
I have two question about OpenHIE.
1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.
2, if any document about implementation best practic please provide links ?
Regards,
Sovannoty
---------- Forwarded message ---------
From: MeanSambath PBH <msamba...@gmail.com>
Date: Thu, Mar 9, 2017 at 2:49 AM
Subject: OpenHIE
To: Hong Roith - PBH <hroit...@gmail.com>
Cc: Tapley Jordan <tjord...@urc-chs.com>, Sam Eng <se...@urc-chs.com>, Christophe Grundmann <cgrun...@urc-chs.com>, Mean R Sambath PBH <msam...@pbhcam.org>, Reatanaksambath Mean <reatana...@gmail.com>
Hi Roith,
Greeting from Nai Pyi Taw, Myanmar, 5th AeHIN General meeting, achieving SDGs with ICT
Yesterday, we have a half day session on OpenHIE, and we have OpenHIE folks (about 10 experts) here, more than 100 people talk about OpenHIE and its architecture, and next agenda is about patient master index. Both MoH HIS consultants also here with me. A consultant on standard (Platinir, hired by US CDC/MoH) will use OpenHIE architecture as principle for his document of standard and interoperability for MoH.
Please send me questions if you have any concerns/problems or any thing that you want to check about OpenHIE…..Paul is father/founder of OpenHIE/OpenMRS is here too (who we met in Rwanda). It will be great if you could share a link that you host OpenHIE? in Myanmar, they used MEDIC CR as client registry—most of concern of using OpenHIE is about GOVERNANCE NOT TECHNOLOGY , experience from country who implement OpenHIE.
OpenHIE will conduct first OpenHIE conference this year In Tanzania
A brief on OpenHIE
OpenHIE = Open Health Information Exchange = One of health information exchange framework which AeHIN adopted. Health Information can be exchanged when systems are interoperable. (ohie.org.)
OpenHIM = Open Health Information Mediator is an application or a set of applications (a middleware component) (http://openhim.org/) that works at the "Interoperability Layer" of the OpenHIE architecture.
OpenHIE is architecture. That architecture has 8 components:
1 - a client registry (think of a database of people where there is one unique number for every person)
2 - a health worker registry (a database where there is one unique number fo every health worker)
3 - a facility registry (a database where there is one unique number for every health facility)
4 - a terminology service (a database of all terms used in the health information system; one unique number for every term AND relationships of these terms to each other)
5 - a health management information system (a special system where you can aggregate health data for purposes of decision-making)
6 - a shared health record (a special database of services rendered to patients) -- this may be similar to the patient's Electronic Health Record
7 - an interoperability layer that connects all of the systems above with the systems below
8 - edge system (any software that connects to the interoperability layer that is not yet mentioned above). It is called edge because it is at the periphery of the architecture (example are electronic medical records running in health facilities)
There are open source software for each of the 8 components:
1 OpenEMPI and MEDIC-CR for client registry
2 iHRIS for worker registry
3 Facility Registry for facility registry
4 Apelon for terminology service (container) and SNOMED, ICD10, LOINC (whats inside the container)
5 HMIS (=DHIS2)
6 shared health record = OpenMRS data structure
7 OpenHIM
8 OpenMRS, OpenEMR, GNU Health, CHITS, etc
The AeHIN Interoperability Lab are supposed to connect these 8 components to each other.
Sambath
Dear All,Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?ThanksSambath
From: Carl Fourie <ca...@jembi.org>
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath <reatana...@gmail.com>
Cc: Ryan Crichton <ry...@jembi.org>, Pierre Dane <pie...@jembi.org>, Tash Sundar <tash....@jembi.org>, Trevor Gowing <trevor...@jembi.org>
Subject: Re: OpenHIE
Good Day Dr SambathI have reached out to our team in South Africa and have synthesised the response to the questions below:
1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate "200" response, indicating 'request has been received' and the response may be updated to a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a "fire and forget" approach to sending data in. However if the client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages with the OpenHIM because of the way some systems handle sockets that doesn't fit well with the OpenHIM's request response model. We would be very interested in understanding your experience here
2, if any document about implementation best practic please provide links ?
Around best implementation practice, there is the data and link to the implementation guide found at: https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:
OHIE Client Registry Wiki Home Page: https://wiki.ohie.org/display/SUB/Client+Registry+Community
OHIE Client Registry Wiki Meeting Page: https://wiki.ohie.org/display/resources/Client+Registry+Community+CallIf there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe questions that implementers and team exploring OpenHIE have. The page and joining details are below:
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Good Day SambathTo see all posts to the list please visit: https://groups.google.com/forum/#!forum/ohie-implementers there you can see the history. We'll look to answer you question on the main list so that others outside of Jembi can weigh in too.
Regards
Carl FourieSenior Program Manager | Digital Health DivisionJembi Health Systems | SOUTH AFRICA
Mobile: +27 71 540 4477 | Office: +27 21 701 0939 | Skype: carl.fourie17
E-mail: carl....@jembi.orgPhysical Address: Unit 3B, 5A-C, Tokai on Main, 382 Main Road, Tokai, Cape Town, South Africa (Map Link)Email Disclaimer:This e-mail contains proprietary and confidential information some or all of which may be legally privileged. It is for the intended recipient only. If an addressing or transmission error has misdirected this e-mail, please notify the author by replying to this e-mail and then deleting same. If you are not the intended recipient you must not use, disclose, distribute, copy, print or rely on this e-mail. Jembi Health Systems NPO, its subsidiaries and associated companies is not liable for the security of information sent by e-mail and accepts no liability of whatsoever nature for any loss, damage or expense resulting, directly or indirectly, from the access of this e-mail or any attachments hereto.
On Mon, Mar 13, 2017 at 7:08 AM, msambath sambath <reatana...@gmail.com> wrote:
Dear All,Greeting from CambodiaI posted a question in community as below email—how I can see my post in community—I support to get back an email from the group. By the way, please see my question here
Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?
Our PMRS (PHP/MySQL) linked to OpenEPMI/OpenHIM have about 3M records….ThanksSambath
From: msambath sambath <reatana...@gmail.com>
Date: Monday, March 13, 2017 at 11:25 AM
To: <ohie-implementers@googlegroups.com>
Subject: Re: OpenHIE--Latency
Dear All,Does OpenEPMI or OpenHIM is deal with larger medical record data about 4M record? Or more?ThanksSambath
From: Carl Fourie <ca...@jembi.org>
Date: Friday, March 10, 2017 at 2:14 PM
To: msambath sambath <reatana...@gmail.com>
Cc: Ryan Crichton <ry...@jembi.org>, Pierre Dane <pie...@jembi.org>, Tash Sundar <tash....@jembi.org>, Trevor Gowing <trevor...@jembi.org>
Subject: Re: OpenHIE
Good Day Dr SambathI have reached out to our team in South Africa and have synthesised the response to the questions below:
1, how OpenHIE overcome latency ? since its contain many path of different app (I very consent about overhead processing) I mean overall delay for response to a request for client. since my team have testing implement OpenHIM with OpenEMPI a simple request ADR_A19 and return two ADR_A19_QUERY_RESPONSE it take about 2.5 s it is very slow.
It is difficult to fully understand without knowing more details but some thoughts around this: The OpenHIM has been performance tested before and only adds about 80ms of overhead on a request under load. A general pattern that we employ to manage any latency is when handling with HTTP requests, we use the asynch file queuing system and our asynchronous http response chaining. This means that the client may get an immediate "200" response, indicating 'request has been received' and the response may be updated to a different status later on within the OpenHIM depending on the results of the mediators and if there are any issues with processing of the message. This strategy works well for systems that use a "fire and forget" approach to sending data in. However if the client depends on a synchronous response, the only way to deal with this is to set a long timeout and wait for the response.
But more to the question on OpenEMPI: the first thing we would need to do is see which system is causing the slow down, do requests directly to OpenEMPI take this long? Or is the OpenHIM causing the delay? There have been some known issues using HL7 v2 messages with the OpenHIM because of the way some systems handle sockets that doesn't fit well with the OpenHIM's request response model. We would be very interested in understanding your experience here
2, if any document about implementation best practic please provide links ?
Around best implementation practice, there is the data and link to the implementation guide found at: https://ohie.org/client-registry/#implementor and I would also suggest looking at the OpenHIE Client Registry Community pages and calls:
OHIE Client Registry Wiki Home Page: https://wiki.ohie.org/display/SUB/Client+Registry+Community
OHIE Client Registry Wiki Meeting Page: https://wiki.ohie.org/display/resources/Client+Registry+Community+CallIf there are questions that are more about linking tools together and getting setup I would really encourage you and your team to join the OpenHIE Implementers Network where we discuss and answe questions that implementers and team exploring OpenHIE have. The page and joining details are below:
The OpenHIM allows RESTFUL connections to itself and the Patient Database should be able to connect to a RESTFUL service and manage more than just BASIC AUTH (preferably PKI) and then depending on the communication interfaces from OpenEMPI the Patient Database should be able to generate the correct message for create, update patient and consume the correct messgae from Query. The specs of these as per the OpenHIE architecture are in the links shared.
Again I'll shout out to the CR community to chime in and support (@Shaun G and others)
I hope this is adding value Sambath?
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Carl, thanks for this. We have been thinking of putting together a table of different requirements and having that available to sites so that they can figure out what EMPI technology they may want to use. We can share that with you if you want ( CDC is commenting on it, as it is for our case based reporting need)..
Thanks again for your help. terry
From: <ohie-implementers@googlegroups.com> on behalf of Carl Fourie <ca...@jembi.org>
Date: Thursday, March 16, 2017 at 2:11 AM
To: msambath sambath <reatana...@gmail.com>
Cc: "OpenHIE Implementers Network (OHIN)" <ohie-implementers@googlegroups.com>, Ryan Crichton <ry...@jembi.org>, pierre dane <pie...@jembi.org>, Tash Sundar <tash....@jembi.org>, Trevor Gowing <trevor...@jembi.org>, "Fyfe, Justin" <justin...@mohawkcollege.ca>
Subject: Re: [ohie-implementers] Re: FW: OpenHIE--Latency
Good morning Sambath
Yes Medic CR is one of the EMPI technologies that is being used as part of OpenHIE. It is curated by the Mohawk team (who are members of this community) and some of hte community have expereinces in working with MEDIC CR too. There is a dedicated community: Client Registry community that is involved in the CR work, refinement and definitions and if you have a team member who is really wanting to get deeply involved in the ins and outs of what constitutes a CR etc then I'd recommend joining the community (details below):
To view this discussion on the web visit https://groups.google.com/d/msgid/ohie-implementers/CAFNRjWjpBF4Oxww0_HwLvuQQH9HViEay7VJmq4SuKik5R0q6Ng%40mail.gmail.com.
For more options, visit https://groups.google.com/d/optout.
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……….
I have a problem with MedicCR
I send this request
$adr01_llp="\vMSH|^~\&|NIST_Pearl_PIX_Source^^|NIST^^|CR1^^|MOH_CAAT^^|20141104174451||ADT^A01^ADT_A01|NIST-20141104174451|P|2.3.1\rEVN||20101020\rPID|||RJ-438^^^&2.16.840.1.113883.3.72.5.9.1||JOHNSTON^ROBERT^^^^^L|MURRAY^^^^^^L|19830205|M|||1220 Centennial Farm Road^^ELLIOTT^IA^51532||^PRN^PH^^^712^7670867||||||481-27-4185\rPV1||I\r".Chr(28)."\r";
Thank you.
Good morning Sambath
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Regards,
~Steven Wanyee Macharia~
--Regards,
~Steven Wanyee Macharia~