How Digital Square supports standards

Standards for Health Information Exchange

Digital health technology is at the core of modern, equitable health care systems. When designed and employed effectively, systems can seamlessly exchange information, leading to improved clinical decisions and outcomes, care coordination, and operational efficiency. This interoperability is made possible through health data standards for digital technologies, which ensure data is uniformly and efficiently exchanged across systems. Digital Square supports the global digital health community, including country governments, in understanding, aligning, and applying these standards.

Creating interoperable systems prepared to swiftly advance digital health transformation

Interoperable software enables different systems to speak the same language, regardless of differences in interfaces, platforms, and technologies. A suite of interoperable information systems can track and communicate varied data such as staff availability, number of supplies or equipment, or patient health records.

This smooth data exchange is possible because the software exists in an integrated digital ecosystem that adheres to a common set of standards rather than in data silos. According to Health Level Seven International (HL7), a nonprofit standards development organization, software standards act as “a set of rules that allow information to be shared in a uniform and consistent manner across any application.” Interoperability based on standards enables not only faster implementation but also higher-quality data and improved maintainability, thus positively impacting healthcare workers’ and patients’ lives

Investing in standards development, adoption, and dissemination is key for having interoperable systems. This investment is recognized as essential to the delivery of public services by the United States Agency for International Development (USAID) and is integral to the World Health Organization’s (WHO’s) digital health strategy. Standards investments also lead to a wide range of improvements. As government and facility workforces adopt and become familiar with these systems, digital tools can generate the following benefits to advance health outcomes:

• Facilitate operational ease and efficiency for policymakers, health workers, and facility managers.
• Create new opportunities for data sharing, visualization, and analytics to enable quicker decision-making.
• Reduce the time and cost of troubleshooting information technology (IT) and operational problems such as managing stockouts, conducting data entry, and implementing digital workarounds.
• Reuse existing work and lower the cost of the development of new features and software among users, increasing efficiencies in the health system.
• Provide the basis for systems and people to collaborate so the focus can be on the health and well-being of patients.

By establishing a common foundation and set of tools, software can rely on consistent input from other systems, creating space for stakeholders to swiftly propel digital innovations forward while focusing on what counts: the provision and management of health care.

Engaging with countries and the broader global goods community to support the development of and adherence to standards

Digital Square is committed to transforming digital ecosystems to advance health equity and is therefore, very active in the standards space. The initiative has adopted a multipronged approach to supporting adherence to standards by focusing on advocacy, leadership on standards committees, knowledge sharing, support for global goods partners, solving for country and partner needs, and collaboration with global leaders.

Advocacy

Digital Square’s advocacy efforts promote the appropriate use of standards in health system design and support technical teams in adopting standards in their tools. This work also considers ways to improve upon these tools and advocates for consistent ways to standardize software to address common problems implementers face.

Leadership on standards committees

Digital Square also holds active and chairing positions across many standards development organizations. In these roles, our technical team helps refine and develop standards, building on our experience working with global goods partners and country implementers. The following are committees where Digital Square holds leadership roles, including chair and co-chair positions:

• Integrating the Healthcare Enterprise’s (IHE’s) IT Infrastructure Technical Committee. This committee supports the implementation of standards-based interoperability solutions to improve information sharing, workflow, and patient care. The committee assesses the feasibility and scope of proposals, develops detailed documentation of approved proposals, and develops and maintains the IHE Technical Framework. Much of our engagement has been in co-authoring standards profiles (i.e., mCSD, PMIR, SVCM) related to the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) systems and OpenHIE activities.
• HL7 Belgium. This committee provides advice and accelerates standardization to consequently improve time to market and safety of connected health systems. It also grows and sustains the HL7 implementer community, gathers health care standardization efforts, and contributes to the HL7 Fast Healthcare Interoperability Resources® (FHIR®) community. Finally, HL7 Belgium showcases Belgium’s FHIR adoption as a strong example of rapid and proper adoption of a new standard.
• Open Health Information Exchange’s (OpenHIE’s) Architecture Review Board. The board makes decisions about standards and specifications for OpenHIE. Committee members develop and inform a dynamic, viable, and reusable OpenHIE architectural model based on countries’ experiences implementing standards.

Digital Square staff are also members of the following committees:

• IHE’s Quality, Research, and Public Health Committee
• IHE’s pharmacy committee
• HL7
• ISO TC 215 Working Group