Health care service delivery in Suriname, a small country on the northeastern coast of South America, has long been complex given the country's diverse population, scattered geography, and health system challenges resulting from limited capacity. Increasing prevalence of chronic diseases like diabetes and hypertension, alongside persistent infectious diseases such as malaria and dengue fever in recent years has placed a significant burden on Suriname’s health care infrastructure. Further compounding the challenge, the country’s primary health institutions have used different health information systems to track patient care—hindering data sharing and coordination of care among health care providers.
Recognizing the importance of streamlined health information systems, Suriname partnered with CHISU to address its fragmented systems and enhance health care delivery. Through CHISU, a technical team developed the requirements for a tailored health information exchange platform (HIEP) to facilitate seamless data exchange and improve coordination of care among health care providers.
Streamlined data exchange means better coordination of care across providers so that patients can receive consistent and comprehensive health care services. Additionally, the HIEP will facilitate analysis of data aggregated across health services, providing valuable insight to improve public health planning. Transitioning from manual data entry to automated processes will improve data quality, minimize errors, and improve efficiency, which will help overburdened health workers focus on patient care. And while improved patient care is the priority, the HIEP will also contribute to population-based statistics to guide future health care initiatives in Suriname with better data.
Understanding the health information ecosystem
The technical team started with a comprehensive review of the Suriname Health Information Exchange Conceptual Framework, a roadmap of the various systems and processes used to manage health information in the country. The evaluation provided a foundational understanding of the existing challenges and opportunities within Suriname’s health ecosystem, which guided subsequent decision-making to shape HIEP development.
Functional requirements
After reviewing the Information Exchange Conceptual Framework, we began the requirements-gathering process. Key HIEP requirements are summarized below:
- Notifications: Recognizing the importance of timely communication for quality health care, the team outlined requirements for a system capable of generating email notifications for health care providers and stakeholders. The notifications aim to improve response times, reduce errors, and enhance overall health care communication.
- Data quality: We introduced robust data quality and validation requirements to ensure the accuracy and reliability of health data exchanged within the HIEP. A data quality engine for data validation, error detection, and quality assurance plays a crucial role in safeguarding data, enhancing both the trustworthiness and usefulness of the health data shared within the HIEP.
- Authentication and authorization: We specified stringent authentication and authorization mechanisms to uphold the confidentiality and security of the Surinamese population’s health information. These requirements establish protocols to 1) verify user identities, 2) manage permissions, and 3) protect sensitive data from unauthorized access or misuse. This ensures privacy and the security of sensitive health information—fostering patients’ trust and confidence in the system.
- Subscriber management: Our evaluation revealed efficient management of user accounts and permissions as a critical aspect of HIEP functionality. The team delineated requirements for subscriber management systems to facilitate user registration, access control, and user account administration.
- Routing exchange: Seamless transfer of health data among disparate systems required routing exchange functionalities. This enables efficient data routing, ensuring timely and accurate information exchange across the different health information systems used by different providers. This is vital for the right information to reach the right people at the right time to improve the speed and accuracy of health care decision-making.
- Logging and audit trail: Comprehensive logging and audit trail capabilities are essential for monitoring and tracking system activities. The team specified requirements for logging mechanisms to record user actions, system events, and data exchanges. This is a critical aspect of accountability, transparency, and compliance with regulatory standards.
- Mediation: A mediator is a middleware component designed to ease interoperability among disparate information. This functionality is imperative to address interoperability challenges arising from different data formats and standards. These requirements established the mechanisms for data transformation, harmonization, and reconciliation that are vital for seamless integration of health information from diverse sources. This enhances the usefulness of health data shared within the HIEP.
Creating a foundation for better health information for better health outcomes
Suriname has laid a solid foundation for successful HIEP implementation with these foundational requirements developed in collaboration with CHISU’s technical experts. These requirements form a blueprint for a robust HIEP that promises improved data exchange, enhanced coordination of care, and, ultimately, citizens’ increased access to health information—empowering them to make data-informed health care decisions that lead to better health outcomes. This is a significant step toward a healthier and more connected health care system in Suriname.