HMIS | HIE Integration Guide

📋 Table of Contents

1. Introduction
2. Integration Requirements Overview
3. Implementation Approach
4. Client Registry Integration
5. Eligibility Check
6. Facility Registry Integration
7. Health Worker Registry Integration
8. Claims Integration
9. Advanced Features
10. Implementation Checklist

📘 Introduction

This implementation guide is designed to assist Health Management Information System (HMIS) integration teams in successfully connecting with the Health Information Exchange (HIE). Following these guidelines will ensure your HMIS properly interfaces with the HIE's critical components, including the Client Registry, Facility Registry, Health Worker Registry, and Claims systems.

Each section outlines the specific integration points, implementation requirements, and expected functionality. Integration components are prioritized as:

• 🔴 Critical (Must Have): Essential functionality that must be implemented for successful integration
• 🟠 Standard (Expected): Expected functionality that should be implemented for comprehensive integration
• 🟢 Advanced: Additional functionality that enhances the integration

🔧 Integration Requirements Overview

Use Official APIs

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Use only the APIs provided through the portal for all integration points - No third-party or unofficial interfaces should be used - All data exchange must occur through these official channels

Best Practices: - Maintain up-to-date API documentation - Implement proper API authentication and security measures - Monitor API usage and performance

🏗️ Implementation Approach

Direct HMIS Integration

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Integration must be implemented directly within the HMIS itself - No outside middleware or external components should be used - All functionality must be native to the HMIS

Technical Considerations: - Ensure HMIS architecture supports direct integration points - Implement proper error handling and logging - Design for performance and scalability

👤 Client Registry Integration

Patient Registration

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Implement patient registration functionality within the HMIS - Include search by ID number functionality - Set a default PIN for patient registration - Ensure patients are aware of this PIN for logging into Afyayangu - Provide mechanism for patients to change their PIN

User Experience Considerations: - Create a simple, intuitive registration process - Provide clear instructions for PIN usage and management

Patient Search

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Implement comprehensive patient search capability - Enable search using all possible identifiers - Ensure search results are accurately displayed - Implement proper error handling for failed searches

Search Parameters: - ID number - Full name - Date of birth - Phone number - Other identifiers as specified in the API documentation

Patient Data Decryption

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Use the keys on Afyalink to decrypt patient data - Ensure all sensitive patient information is properly decrypted before processing - Implement secure key management practices

Security Considerations: - Store decryption keys securely - Implement proper access controls - Log all decryption activities for audit purposes

Patient Data Mapping & Storage

Priority: 🟠 Standard (Expected)

Implementation Requirements: - After successful search, store patient details locally in the HMIS database - Implement local storage to eliminate repeated API calls - Ensure proper data mapping for all required fields

Mandatory Mapping Fields: - CR ID - ID number - Full names - Date of birth - Gender - Phone number - Additional fields as specified in the API documentation

Update Patient

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Implement patient information update functionality - Send updated information with patient PIN in encrypted format - Ensure proper validation of update requests

Technical Considerations: - Implement change tracking for patient updates - Provide confirmation of successful updates - Handle conflicts and error conditions appropriately

Dependents Handling

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Store and display dependents data as part of patient data - Include spouse and children information - Register dependents as next of kin

Data Management: - Ensure proper relationship mapping between patients and dependents - Implement appropriate privacy controls for dependent data - Provide clear visualization of family relationships

Consent Workflow

Priority: 🟢 Advanced

Implementation Requirements: - Implement consent workflow before request processing - Capture and store patient consent - Ensure consent is properly linked to patient records

Legal Considerations: - Comply with relevant privacy laws and regulations - Implement age-appropriate consent mechanisms - Provide clear documentation of consent processes

🔍 Eligibility Check

Search Patient Eligibility

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Implement search for patient eligibility - Display eligibility results clearly - If patient is not eligible, display reason and possible solutions

User Experience: - Use clear visual indicators for eligibility status - Provide actionable information for ineligible patients - Ensure eligibility information is prominently displayed

SHA Patient Visit

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - If patient is eligible, start visit with SHA - Implement proper visit initiation workflow - Ensure visit data is properly captured and stored

Process Flow: - Verify eligibility - Initialize SHA visit - Capture required visit parameters - Confirm successful visit creation

Display SHA Scheme Eligibility

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Display patient eligibility status for SHA schemes: - SHIF - ECCIF & PCIF - POMF - ECDF - Show active coverage periods - Display benefit limits - Indicate waiting periods where applicable - Include clear visual indicators of eligibility status for each scheme

Visual Design: - Use color coding for eligibility status - Implement easy-to-read benefit displays - Provide detailed information on hover or click

🏥 Facility Registry Integration

Search Facility

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Implement facility search by specified parameters - Enable search from within the HMIS - Display search results clearly and accurately

Search Parameters: - Facility code - Facility name - Location - Level - Other parameters as specified in the API documentation

Save Facility Details

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Store facility details locally in HMIS database - Implement caching to eliminate repeated API calls to the Facility Registry - Ensure data is properly mapped and stored

Required Facility Data: - Facility name - Facility level - Facility codes - Location information - Contact details - Other details as specified in the API documentation

Use Facility Details

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Use locally saved facility details to populate organization resource in claims - Ensure consistent facility information across all claims - Implement proper data validation

Technical Considerations: - Handle facility data updates appropriately - Implement fallback mechanisms for missing data - Ensure proper facility identification in all claims

👨‍⚕️ Health Worker Registry Integration

Search Practitioner

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Implement practitioner search by specified parameters - Enable search from within the HMIS - Display search results clearly and accurately

Search Parameters: - ID number - Registration number - Other parameters as specified in the API documentation

Save Practitioner Details

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Store practitioner details locally in HMIS database - Implement caching to eliminate repeated API calls to the Health Worker Registry - Ensure data is properly mapped and stored

Required Practitioner Data: - Full names - License numbers - Registration number - ID number - Specialization - Other details as specified in the API documentation

Use Practitioner Details

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Use locally saved practitioner details to populate practitioner resource in claims - Ensure consistent practitioner information across all claims - Implement proper data validation

Technical Considerations: - Handle practitioner data updates appropriately - Implement fallback mechanisms for missing data - Ensure proper practitioner identification in all claims

💼 Claims Integration

SHA Codes Mapping

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Add/map SHA codes to local HMIS database - Ensure consistent coding for visits started with SHA - Implement proper code mapping and validation

Technical Considerations: - Handle code updates and version changes - Implement search and selection interfaces for codes - Ensure proper code validation before submission

Map Preauth Services

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Include preauthorization checks for services that require preauthorization - Identify services requiring preauthorization before providing care - Implement clear indication of preauth requirements

Service Handling: - Flag services requiring preauthorization - Provide clear visual indicators in service selection interfaces - Block service provision until preauthorization is confirmed when required

Send PreAuth Check

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Send preauthorization requests for services - Store response locally - Implement proper request and response handling

Process Flow: - Identify service requiring preauthorization - Collect required preauth information - Submit preauth request - Process and store response - Proceed based on authorization status

SHA Intervention Amounts

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Display amount payable by SHA for each intervention - Use locally stored data for amount calculation - Ensure amounts are clearly displayed to users

Financial Considerations: - Update payment amounts regularly - Handle partial payments appropriately - Clearly indicate patient responsibility vs. SHA coverage

ICD-11 Search

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Implement ICD-11 search capabilities - Enable search via API or local storage - Provide accurate search results for diagnosis coding

Implementation Options: - API-based search with caching - Local database with regular updates - Hybrid approach for optimal performance

Build Claim Bundle (Registries)

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Build claim bundle using locally accessible data - Include patient, facility, and practitioner data - Prevent duplicated API calls through local data usage

Bundle Components: - Patient information from local storage - Facility details from local storage - Practitioner information from local storage - Visit and encounter details - Other required claim metadata

Build Claim Bundle (SHR, services & diagnosis)

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Populate claim resource using data from licensed practitioners - Include all services provided during patient visit - Add accurate diagnosis information using ICD-11 codes

Data Requirements: - Primary and secondary diagnoses - Procedures and services rendered - Medications prescribed - Other clinical information as required by the claims process

Claim Submission

Priority: 🟠 Standard (Expected)

Implementation Requirements: - Enable claim submission at point of service delivery - Use locally stored reference data for submission - Implement proper submission validation and error handling

Submission Process: - Validate claim data completeness - Submit claim to HIE - Receive and process submission response - Store claim ID for tracking purposes - Provide clear submission status feedback

Poll Claim Status

Priority: 🔴 Critical (Must Have)

Implementation Requirements: - Poll the status of a claim using claim ID - Get updates on the status of the claim - Display status information clearly to users

Status Tracking: - Implement regular polling mechanism - Handle various status codes appropriately - Provide clear visual indicators of claim status - Enable actions based on claim status (e.g., resubmission for rejected claims)

🚀 Advanced Features

Facility Level Context

Priority: 🟢 Advanced

Implementation Requirements: - Implement facility level context functionality - Customize workflows based on facility capabilities - Adapt user interfaces to facility-specific requirements

Contextual Adaptation: - Display appropriate options based on facility level - Hide unavailable features based on facility context - Provide guidance appropriate to facility capabilities

Service Filtering By Facility Level

Priority: 🟢 Advanced

Implementation Requirements: - Enable filtering of services based on facility level - Display appropriate services by facility level - Prevent selection of services not available at the facility

User Experience: - Show only relevant services to reduce confusion - Provide clear indication of service availability - Implement appropriate referral workflows for unavailable services

✅ Implementation Checklist

You may use this checklist to track your integration progress:

Integration Category	Integration Component	Status	Priority
Core Requirements	Use Official APIs	✅	🔴 Critical
	Direct HMIS Integration	✅	🔴 Critical
Client Registry	Patient Registration	🔄	🟠 Standard
	Patient Search	🔄	🔴 Critical
	Patient Data Decryption	⏳	🔴 Critical
	Patient Data Mapping & Storage	🔄	🟠 Standard
	Update Patient	⏳	🟠 Standard
	Dependents Handling	⏳	🟠 Standard
	Consent Workflow	⏳	🟢 Advanced
Eligibility Check	Search Patient Eligibility	✅	🔴 Critical
	SHA Patient Visit	🔶	🔴 Critical
	Display SHA Scheme Eligibility	⏳	🟠 Standard
Facility Registry	Search Facility	✅	🔴 Critical
	Save Facility Details	⏳	🟠 Standard
	Use Facility Details	⏳	🟠 Standard
Health Worker Registry	Search Practitioner	✅	🔴 Critical
	Save Practitioner Details	⏳	🟠 Standard
	Use Practitioner Details	⏳	🟠 Standard
Claims Integration	SHA Codes Mapping	🔄	🔴 Critical
	Map Preauth Services	⏳	🔴 Critical
	Send PreAuth Check	⏳	🔴 Critical
	SHA Intervention Amounts	⏳	🟠 Standard
	ICD-11 Search	🔄	🔴 Critical
	Build Claim Bundle (Registries)	🔄	🟠 Standard
	Build Claim Bundle (SHR, services & diagnosis)	🔄	🔴 Critical
	Claim Submission	🔄	🟠 Standard
	Poll Claim Status	🔄	🔴 Critical
	Facility Level Context	⏳	🟢 Advanced
	Service Filtering By Facility Level	⏳	🟢 Advanced

Legend:

• ✅ Completed
• 🔶 Partially Complete
• 🔄 In Progress
• ⏳ Not Started
• 🔴 Critical (Must Have)
• 🟠 Standard (Expected)
• 🟢 Advanced

Current completion status: 19.23%

This implementation guide is maintained by the HIE Integration Team. For technical support or clarification, please contact the integration support desk.