The session will share how Tanzania is applying Enterprise Architecture approach to address the health system challenges and ensuring the digital technologies are aligned with Tanzanian health sector goals, vision, mission, and objectives. The Government of Tanzania through the MOHCDGEC continues to promote the use of Technology in the transformation of health service delivery and attainment of UN Sustainable Development Goal particularly SDG No.3 “Ensure healthy lives and promote wellbeing for all at all ages”. Over ten years, there has been tremendous progress in the development and roll-out of different digital health technologies with the intention to improve health service delivery in the country. However, investments in digital health technologies need to be aligned with health sector business goals, vision, and mission. In order to maximize and improve health outcomes, there are some challenges that need to be addressed holistically, these includes; duplication of efforts, fragmented data systems, as well as inadequate standards that constrain systems interoperability and exchange of data in the health sector. These challenges have cascading effects in the health sector, such as inefficiencies, data inconsistency, increased workload, and data redundancy. In responding to this, the Ministry through the Data Use Partnership (DUP) initiative is working to standardize and harmonize data systems, by developing Tanzania Health Enterprise Architecture blueprint (TZHEA). The TZHEA will define the structure and operation of the health sector. The intention is to determine how the sector can most effectively achieve its current and future objectives using digital health.

Today, the e-Health landscape in most LMICs and particularly Uganda is characterized by fragmented and piecemeal applications deployed by multiple organizations. Worse still, these eHealth systems are usually custom-built using different architectures and technologies, with interoperability and security of patient’s data low on the list of priorities. The e-Health solutions that have been successful in one locale are often unable to be integrated with other data systems or adopted by other similar programs. This has in effect not only resulted into duplication of effort but has also created a very complex eHealth environment where health information is both difficult to secure and share. Although standardization is seen by a number of LMICs including Uganda as the key to interoperability challenges, the ehealth standardization arena is troubled with many challenges including the huge number of available standards, which compete, overlap and sometimes contradict one another. A number of eHealth frameworks have been implemented by HICs as a way of resolving the integration and interoperability challenges of eHealth systems. However, these cannot be adopted in totality for LMICs more so for Uganda. This is because they require large capital investments, availability of high-level management and technical expertise, as well as powerful communications and electrical infrastructure. Thus, this session aims to discussing how to realize an Enterprise Architecture framework (based on applicability of existing Enterprise Architecture Approaches such as TOGAF) to digitally-enable and standardize eHealth implementations to support HIE across health systems in LMICs and particularly Uganda.

Large -scale implementation of Information Communication and Technology (ICT) in healthcare continue posing challenges in controlling costs, standards, and coordination of diverse stakeholders. Health Enterprise Architecture (HEA) refers to the structured alignment of health sector needs to ICT implementation. It describes the current state of an enterprise’s data, information systems, hardware, and organizational structures and the desired future status with increased efficiencies including the strategic plans for how to transition to the desired status. HEA comprises dynamic tools and processes that control complexities through automation and information exchange leading to improvement of data quality and timeliness of information. HEA implementation also leads to improved health program performance, controlled investments and risks, and improved health outcomes. Countries are at different stages in developing and implementing HEA. Kenya has developed the Kenya HEA (KHEA) and a USAID funded project, Health Informatics Governance and Data Analytics (HIGDA) initiated its implementation in selected counties(sub-national units). This presentation will discuss the role that HEA plays in enhancing ICT Governance towards large scale automation and interoperability. The session will highlight the progress made by Kakamega County Health Department in institutionalizing Heath Informatics Governance through the domestication and operationalization of the KHEA. The session will describe the steps that the County took to implement the KHEA and the consequent determination of maturity levels to guide action steps towards operationalizing automation and Interoperability. The session will then provide the results of this implementation by describing how it resulted in increased County ownership of ICT initiatives, increased budgetary allocation and, and improved stakeholder co-ordination. The results will also highlight the governance approaches that were used to implement health facility interoperability layers to enable information exchange between disparate health information systems and systems upgrades to meet the required standards.