Caribbean/PAHO—Jamaican case study

The Ministry of Health and Wellness (MOHW) in Jamaica is the preeminent Government organisation whose mandate is ‘To ensure the provision of quality health services and to promote healthy lifestyles and environmental practices’. The Ministry, together with its Regional Health Authorities (RHAs), Agencies and related organisations, make up the public health system. The MOHW is responsible for the standards, regulations, policies, and monitoring systems to support quality health services. Healthcare delivery is the mandate of four Regional Health Authorities. The MOHW identified a number of priorities which are articulated at the sector level in its Strategic Business Plan. These priorities are also aligned with national initiatives of the Government of Jamaica. Among these is Information Systems for Health (IS4H), which the Pan American Health Organisation/World Health Organisation (PAHO/WHO) [10] has described as ‘the integrated effort for convergence of interconnected and interoperable systems, data, information and knowledge, processes, standards, people, institutions supported by ICTs that help to produce information for planning and decision-making’. Thus, IS4H provides a mechanism for managing interoperable systems with open data that comes from different sources within and outside the health sector and that is ethically used, through effective ICT tools, to generate strategic information for the benefit of public health. IS4H was advanced through a system of governance involving a national Steering Committee and collaboration with national stakeholders and key initiatives, including the Vision 2030 Jamaica—National Development Plan, the Data Protection Bill, Cybercrimes Incident Reporting, and Open Data Portal. An IS4H Plan of Action drives the initiatives which are foundational. OpenEHR Reference Model was introduced to the CARICOM Member States IS4H Technical Working Group during 2015. It is understood to be a virtual community working for decades and has achieved this objective with a primary focus on electronic health records (EHR) and related systems. Components and systems conforming to openEHR are described as ‘open’ in terms of data, models, and APIs. They share the key openEHR innovation of adaptability, due to the archetypes being external to the software, and significant parts of the software being machine-derived from the archetypes. The archetype specification is now an ISO standard (ISO 13606-2) [11]. These are now being used by several national governments to specify national e-health information standards. Several countries are already adopting OpenEHR, and in the Pan American Region, Brazil is one such country as well as in other WHO Regions, Norway, Russia, Slovenia, the United Kingdom, Singapore and Sweden. The Caribbean Member States have been made aware of the OpenEHR Reference Model but there is a need for a deeper understanding and for competence so that design and implementation can commence and our countries may adapt the standard in their eHealth applications. OpenEHR can form a key aspect of the data and information architecture for Caribbean Member States and CARPHA and advance the journey towards interoperability.