Oromia Regional Health Bureau (ORHB) is one of the few regions who have independent ICT Directorate. This directorate is dedicated to ICT solutions in the regional health administrative units and corresponding health facilities in the regions. Since the establishment of the ICT 2017, the directorate is working on phenomenal advancement on the methods and practice of collecting, analyzing, presenting and disseminating information that can influence decisions in the addressing Information revolution & achieving Woreda transformation the key agendas of HSTPII. It entails a radical shift from traditional way of data utilization to a systematic information management approach powered by corresponding level of technology. Thus providing the bedrock for the successful implementation of different Health information systems.

Health information system is one of the six building blocks of the health system that plays a cross cutting role in generating quality data for evidence based decision making and improving equity and quality of health services at all level of the health system.  To improve culture of information use; the existing HMIS is revised and implemented, community health information system is strengthened, civil and vital registration system (CVRS) put in place.  Similarly, as part of the initiative to digitalize the health information system DHIS2 is introduced, the manual CHIS is partially digitalized and electronic community health information system(eCHIS) is being implemented, human resource information system(HRIS), electronic medical recording(EMR-MRU) and other digitalization initiatives have been implemented. A detail of implementation status of different reforms is presented below .

DHIS2

DHISBased on the findings of an assessment conducted on the eHMIS in 2015, the FMOH introduced DHIS2 at the end of 2017, replacing the eHMIS software after intensive discussions about both types of software . The assessment findings showed that despite intensive efforts to improve the efficiency of the eHMIS, data quality and information use had been a challenge for a few years .  The eHMIS was unable to deliver the information needed to advance improvements in health outcomes as set in HSTP .  DHIS2 is District Health Information Software 2 (DHIS2) is a free and open source software platform developed by the Health Information Systems Program (HISP) and supported by the University of Oslo’s Department of Informatics . DHIS2 is used to aggregate statistical data collection, validation, analysis, management, and presentation . DHIS2 is the world’s largest health management information system (HMIS) platform, in use by 67 low and middle-income countries .

In 2011 alone a total of 3,284 experts have been trained on DHIS2 updaters and Other DHIS2 related trainings .Participants from all woreda health offices, hospitals, and zones were mentored and coached on how to use DHIS2, specifically relating to data entry, importing /exporting data and data analysis .  This effort has elevated the region performance to the first stages entering 97% of service delivery report in couple of days .

eCHIS

As part of the initiative to digitalize the health information system, the FMOH has introduced an application called Electronic Health Information System (eCHIS) that digitalizes the existing manual family folder and service workflows to record and report the households and members’ health and related data . The eCHIS is primarily a mobile-based application that works in an offline environment .  However, it needs connectivity for data synchronization to the server and to facilitate digital referral linkages .  It is also capable to create a digital link between unique identifiers and health information about households and individuals, and prevent the creation of duplicative household or individual records .   It also enables electronic sharing of household and individual information between HEWs and Midwives at the Health center level .   Theapplication makes for the health extension workers to easily monitor updates on patient status .  One other important advantage of the application is that it facilitates a referral linkage between the health post and health centers (FMOH website) .

In 2011 Oromia Regional Health Bureau (ORHB) has owned this initiative and stared implementation in 426 health posts in 10 Zones and 15 Woredas .  The implementation has started by participating in the national TOT and immediately after, by providing regional level TOT training for six days for about 60 participants invited from selected region, zone and partners .

A total of 1172 end users from 10 zones, 15 woreds, 93 health center and 426 HPs have been trained in two rounds .  The participants are Mainly Midwives and Health Extension workers, it has also included HIT from Health centers, HEW coordinators from Health Centers and Woredas . All training have been done using translated training manuals and power points .

The  other  major  task  accomplished  this  year  Installation,  configuration,  distribution  and  supportive maintenance of the 426 tablets distributed for HEWs not only that out regional staff have been committed to be involved in the translation of the application to the use and practice of the software user friendly . The region has also taken its own initiatives in creating awareness about the software by conditioning review meetings twice with all stake holders and Regional level application launching program .  In addition, the region has motivational program for those HEWs who have outstanding performance .

In 2011 HEWs have managed to register 122,364 House Holds with its all properties and 386680 members .

HealthNet

MSEonLanHealth Net is a Virtual Private Network (VPN) service, provided by Ethio Telecom (ETC), that connects FMOH, RHBs, Woreda Health Offices, hospitals, and Health Centers through Virtual private network for secure and efficient transmission of data, with the objective of achieving the HSTP’s Information Revolution agenda includes the Connected Woreda strategy .   Health Net uses the existing public communication lines of ethio telecom but maintains the security of the communication so no external party can interrupt the communication or receive any data that is exchanged within the health system . Through Health Net, users will be able to securely and efficiently share health data (Like DHIS2 and HRIS) voice (like tele-Medicine and teleconferencing), and video (Tele radiology) .

Health Net is a Virtual Private Network (VPN) service, provided by Ethio Telecom (ETC), that connects FMOH, RHBs, Woreda Health Offices, hospitals, and Health Centers through Virtual private network for secure and efficient transmission of data, with the objective of achieving the HSTP’s Information Revolution agenda includes the Connected Woreda strategy .   Health Net uses the existing public communication lines of ethio telecom but maintains the security of the communication so no external party can interrupt the communication or receive any data that is exchanged within the health system .  Through Health Net, users will be able to securely and efficiently share health data (Like DHIS2 and HRIS) voice (like tele-Medicine and teleconferencing), and video (Tele radiology) .

All Zonal Health offices, 98 % of Towns except Bishan Guracha , 80 % Woredas , 65 % Health Centers have been connected to the national Health Net connection are currently using it to access DHIS2 online and for Internet Purposes .

HRIS

In any organization managing the data of human resource is a crucial task. In the health sector, all regions have this problem specially in Oromia region, this task was more challenging than others due to all the HR data was handled manually and more so the number of staff the region managing is very huge number. TenaHRIS application has included different modules from personal information, leave management, training, Attendance module and many more sub modules to manage all HR related data.

Currently TenaHRIS_Manage system is implemented at RHB, 18 ZHD, 12 administrative towns and 56 Hospitals. A total of 52372 HR profiles have been entered and available in the TenaHRIS  system at the region server from over all 72000 staffs and updating of HR data is done at ZHDs by HR data clerks at Zonal Lever and hospitals by HR staffs trained on TenaHRIS software.  17 Zone health offices have inserted 75% and more, 3 Zones are less than 50 % and 35 Hospitals above have filled all and are above 75 %.

EMR

The Medical record unit service is fundamental and most basic starting point of care provisional elements of the health systems. At Health facilities, any patients’ healthcare service provision begins with/from MRU. It is undeniable fact that the manual patients’ demographic data recording still couldn’t respond the “One card for one patient at one facility for lifelong” service principle of our health systems. It is evidence that ICT will be an increasing critical element in healthcare reform particularly at MRU service point. To offer effective and efficient service at MRU needs manpower and facilities such as recording tools, shelves, computers with installed EMR software. EMR was implemented in the ORHB health facilities in different phases.

The implementation of TenacareEMR-MRU has significantly improved the card room working procedures and consequently improved quality of service delivery at health facilities. All functional hospitals are using the TenacareEMR-MRU system. Below table shows the current status of TenscareEMR-MRU