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SMART Guideline Implementation: ANC DAK

SMART Guideline Implementation: ANC DAK

Summary of the Problem

  • WHO expert groups want to get best-practice guidelines out into the real world, fast, and update those guidelines as medical knowledge changes. This currently takes years.
  • 2 Central Hypotheses:
    • 1) The OpenMRS 3 framework allows content like that in the ANC DAK to be quickly created into a new sample "ANC package"; and, 
    • 2) Understanding In-Country Content Decision Makers' needs and workflows is mission-critical for successful DAK & O3 package adoption even beyond ANC.  
  • OpenMRS, AMPATH, Mekom, and PIH are being supported by Digital Square's Notice F Award to coordinate design of a DAK-Based OpenMRS 3.x ANC Package that:
    • meets ANC DAK core dictionary, functional, and non-functional requirements
    • has the decision support component of the ANC DAK
    • has program indicators
    • Design: Design related deliverables include published results from user research/assessment and designs for whatever we prioritise.

Links to Know

  • Key Contacts: suruchi dhungana (Product Manager) & Paul Adams (UX Designer)
  • Communication: Slack channel #anc (most discussion and updates are happening in slack)
  •  Issue Tracker: Jira Board here (all issues with label "ANCDAK")
  • Designs: Pending
  • Timeline: June 2022-June 2023

In this page: 

The ANC DAK contains the content needed to execute WHO-recommended ANC care guidelines, such as: workflows, medical codes, decision support rules, metrics, and functional requirements. 

Our 3-Prong Approach

Image source file here.

Open Questions


  • How do we expect the ANC DAK content to be used in the real world? 

  • How does content decision making happen in countries: In Ministries? In Implementations? (i.e. how people decide what content/care pathways should be applied at their sites)

 Detailed Roadmap

2023 Roadmap 


Jan-Feb

Mar-Apr

Apr-May

Jun-JulyAug

Identify & Prep Users for Interviews: ANC Staff/Care providers

Target countries to engage for user interviews: Sierra Leone, Zimbabwe, Ethiopia...)

Status: DONE 

PIH MEKOM AMPATH OHRI

Start Interviews: ANC Staff

Status: IN PROGRESS 

SONDER FELLOW

Data Optimization Pt 1: Need engine to optimize data extraction to just the 1 patient of interest

Status: IN PROGRESS 

OMRS FELLOW


Data Optimization Pt 2: Need engine to optimize data extraction to just the 1 careplan / relevant data of interest

Status: IN PROGRESS 

OMRS FELLOW


Blocker: Careplan Output Bug: Patients who don't qualify are being assigned risk flags by engine

Status: IN PROGRESS 

OMRS FELLOW

Milestone:

COMMUNITY DEMO OF PROTOTYPE 

1st week March

Trigger Logic Definition

Status: IN PROGRESS 

OMRS MEKOM/SONDER


UX Results: Publish results from UX assessments of ANC Staff and Content Decision Makers

Status: IN PROGRESS 

SONDER FELLOW

Publish Designs for ANC UX

Status: NOT STARTED 

SONDER 


Usability testing

Status: NOT STARTED 

SONDER 

____

Status: X 

WHO DOES IT? 

END


Detail  ANC UX Design Activities timeline

  • Research synthesis and OOUX work will be completed by March 10th

  • Between March 6th and 24th, hoping to be working on mock-ups

  • By March 31st, we’ll have research summary document, and a design prototype to test

  • Probably have a bit of down time over Easter weekend then which is 6-12 of April

  • But before and after that test the prototype with users remotely

  • Usability testing will be happening at the latest, the week of April 17th

  • Iterate and apply learnings to the prototype / mock-ups to have something to be finished with in early May


 2022 Roadmap Archive

2022 Roadmap Archive

August

Sept

Oct

NovDec2023...

FHIR IG Deep Dive w/ Bryn Rhodes & FHIR Squad 

Explored existing L3 resources and whether automating intake of a FHIR IG might be valuable approach. (Notes) Outcome: Decided not to have a FHIR IG-heavy approach. 

Status: DONE 

Joined WHO SMART Implementers' call group

Raise awareness among the WHO working group of our work on this project, and address early questions about materials available and what user research had already been done. (Notes)

Status: DONE 

Gap Analysis of Functional & Non-Functional Requirements 

Gap Analysis here

Status: DONE



Identify & Prep Users for Interviews: ANC Staff/Care providers

Target countries to engage for user interviews: Sierra Leone, Zimbabwe, Ethiopia...)

Status: IN PROGRESS 

PIH MEKOM AMPATH OHRI

Identify & Prep Users for Interviews: Content Decision Makers

Status: IN PROGRESS 

PIH MEKOM AMPATH OHRI

Sample Code Set in OCL + Qnr in O3

Need to pick a Qnr. Start by picking a preferred DS rule/care plan. OCL Code Set

Status: DONE 

FELLOW

Review of Key Functional Gaps with Team 

Gap Analysis here

Status: DONE

FELLOW

1st set of Feedback

Initial feedback to share with WHO DAK team. (Doc here)

Status: DONE

FELLOW

Start Interviews: Content Decision Makers

Status: NOT STARTED 

SONDER FELLOW

Test Automation plan

Likely less about FE E2E tests rather than scaleably useful ones, eg (1) OCL-related tests / concept conflict notifications +/- logs, and (2) O3 test framework/test pipeline improvements.

Status: NOT STARTED 

 FELLOWS

Present 1st set of Feedback

Initial feedback shared with WHO DAK team. (Doc here)

Status: NOT STARTED 

FELLOW

UX Results: Publish results from UX assessments of ANC Staff and Content Decision Makers

Status: NOT STARTED 

SONDER FELLOW

Prototype Pkg

O3 ANC MVP Package released (scope: limited concepts, forms, widgets, & clinical view)

Status: NOT STARTED 

TBD 

Start Interviews: ANC Staff

Status: NOT STARTED 

SONDER FELLOW


Publish Designs for ANC UX

Status: NOT STARTED 

SONDER 

Publish Designs for Content Management Flows

Status: SCOPE? 

SONDER 

UAT & Findings Documentation

Status: NOT STARTED 

SONDER 

Plan for Reports

Add to ANC O3 Package

Status: NOT START