Reaching Health Standards and Creating a Client Registry in Haiti

Many countries face complex political and funding environments, infrastructure challenges such as unreliable internet connectivity, and limited scalability due to technological, environmental, and human constraints. These circumstances have contributed to an environment where Haiti faces challenges as it seeks to provide healthcare for a population of 11 million. 

Haiti’s original approach to a health information architecture included a set of facility-based EMRs built specifically for Haiti, and a rudimentary information exchange pattern to consolidate that data centrally in a consolidated server with tried and true technologies. Successfully used without major updates or alterations for over a decade, the architecture and components needed modernization to take advantage of more robust, scalable, and sustainable technologies and approaches in order to meet the needs of the users of the systems and data to achieve the overarching health goals of the Haiti government.

One of the key challenges in the Haiti HIV program is a highly transient patient population that struggles with continuity of care & treatment as they receive care across different facilities and centers, and struggling with collecting timely and accurate results to the appropriate provider for decision making. All of which can contribute to the HIV epidemic when patients are not able to maintain treatment and reach or maintain viral suppression. A social, community-driven approach was necessary to move towards modernization through harmonization and reusable and scalable standards for an implementation that improved the current care experience and addressed the healthcare challenges and the issues specific to HIV care and treatment in a sustainable and community adopted way. In 2018, the University of Washington Digital Initiatives Group at I-TECH (DIGI) was brought on to start work with the health information system (HIS) working group established in Haiti to modernize the full architecture to support improved patient identification and information workflows that support a full continuum of care.