Custom

The CHT Core Framework includes functionality that allows sharing data with any API-based system. Developers have configured CHT integrations with OpenMRS, KenyaEMR, Bahmni, DHIS2, RapidPro, Apache NiFi, OpenHIM, custom electronic medical records (EMR), and several other systems.

Overview

Integrating a CHT App into your digital health ecosystem starts with identifying an integration use case. It’s important to first understand all the components present in the ecosystem (EMR, laboratory system, community health information system, etc) and then plan out what the workflow will look like operationally. It is important to consider what information is needed at each point, will it be available to them, what happens if it is not, is this workflow even useful for them.

One of the biggest challenges in developing integrations between systems is patient matching and/or deduplication. Sometimes this can be controlled operationally, other times it requires complicated algorithms or human intervention.

Below are a few example integration use cases:

1. Lost to Follow-up: EMR generates a list of patients that require follow-up in the community, that list is sent to the CHT and healthworkers receive a task in the CHT to find those patients and refer them to the health facility.
2. Referrals from the community: When a CHW does an assessment and determines the patient should be referred to a health facility, send the referral information to the EMR.
3. Contact Tracing: Similar to Lost to Follow-Up, the EMR generates a list of contacts to be followed up with and this is sent to the CHT so that a tracer can call those contacts to see if they have symptoms.
4. Interactive Messaging: Integrate with a messaging platform (such as RapidPro) to allow community members to initiate self-screening assessments, which can then be sent to the CHT for follow-up by a healthworker.

As you design your use cases, creating a sequence diagram will be helpful in illustrating what the flow will look like. Here is an example sequence diagram for an integration use case with RapidPro.

Integration Design Patterns

There are a number of different interactions that may occur between digital health systems. Below are some common use cases:

1. Creating a patient in the CHT creates that patient in another system
2. Creating a patient in another system creates that patient in the CHT
3. Submitting a form in the CHT triggers an event in another system
4. Submitting a form in the CHT sends data to another system
5. Activity in another system triggers an event in the CHT
6. Activity in another system stores the results in the CHT
7. Another system needs to look up data in the CHT

Sending data to other systems

Using the outbound push feature, you can configure the CHT to send data to another system. Before starting, you’ll want to make sure you understand the APIs of the destination system and have login credentials with adequate privileges.

To send data to other systems from the CHT, you will need to do the following:

1. Enable outbound in app_settings
2. Specify when data is sent
3. Specify where data is sent
4. Specify what data is sent
5. Set up credentials for the destination system

Enable outbound

Enable the mark_for_outbound transition in app_settings.

When data is sent

Whenever a document is changed (such as submitting a form, creating a new contact, or editing an existing one) you can configure outbound to send data to another system. The relevant_to property in the outbound configuration is used to identify which activities will trigger the sending of data.

Where data is sent

The destination property in the outbound configuration is used to specify where to send data. This will normally be the API endpoint of the destination system or interoperabiliy layer.

What data is sent

You configure what data is sent using the mapping property. You will map data from the CHT to the format required by the destination API endpoint.

Authentication

Credentials for the destination system are stored in CouchdDB. You will need to set this up before you can test your configuration.

Requests from other systems

The CHT has a complete RESTful API that other systems can utilize to interact with data in the CHT.

The most common uses are:

1. Looking up data in the CHT from another system
2. POSTing data to the CHT from another system

Look up data in the CHT

The CHT has a number of different API endpoints that can be used to look up data.

You can use the contacts_by_phone endpoint will return the fully hydrated contact information for those patients.

You can use the hydrate endpoint to obtain this information. to look up the complete information for that contact.

POST data to the CHT

The CHT API also allows you to POST data. Using these endpoints, you can create new records in your CHT API. You can store activities that took place in another system on that contact’s profile in the CHT, and even create tasks for CHWs in the CHT based on activities that took place in the other system.

You can do this by submitting a JSON Form to the records endpoint.

You would do this by simply configuring a task to be generated based on criteria available in the report that was created in Example 1.

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