Health Information Systems Interoperability Maturity Toolkit: Model

The model consists of five levels of maturity: Nascent, Emerging, Established, Institutionalized, and Optimized. The toolkit assesses the country's level of maturity across several domains, including leadership and governance, compliance with data exchange standards, data ethics, HIS interoperability monitoring and evaluation, business continuity, financial management, financial resource mobilization, and human resources. At the Nascent level, the country lacks a systematic approach to HIS, with activities happening by chance or as isolated efforts. The country has no governing body for HIS, and no structure, processes, or procedures are in place to guide or enforce compliance with data exchange standards. At the Emerging level, the country has defined HIS processes and structures, but they are not systematically documented. No formal or ongoing monitoring or measurement protocol exists, and no tracking or ad hoc tracking is done of HIS interoperability activities. At the Established level, the country has documented HIS processes and structures, and the structures are functional. Metrics for performance monitoring, quality improvement, and evaluation are systematically used, and mechanisms to track and measure performance of HIS interoperability work are government-approved and government-led. At the Institutionalized level, the government and stakeholders use the national HIS systems and follow standard practices. The HIS governing body is formally constituted and has a scope of work that includes the people responsible for data governance oversight. The governing body oversees interoperability directly or through a separate technical working group (TWG). At the Optimized level, the government and stakeholders routinely review interoperability activities and modify them to adapt to changing conditions. The HIS governing body is government-led, consults with other ministries, and monitors implementation of HIS interoperability using a work plan. It mobilizes resources—financial, human resources (HR), and political—to accomplish its goals. The toolkit assesses the country's level of maturity in each of the domains, with the following levels of maturity: - Leadership and governance: The country has a governing body for HIS, and the governing body is formally constituted and has a scope of work that includes the people responsible for data governance oversight. - Compliance with data exchange standards: The country has developed or adopted and implemented a regulatory framework for compliance, and the government enforces the regulatory framework for compliance. - Data ethics: The country has an approved health data regulatory framework, and the health data security and privacy laws have been implemented, and there are guidelines on how to operationalize the laws in the HIS. - HIS interoperability monitoring and evaluation: The country has mechanisms to track and measure performance of HIS interoperability work, and results from monitoring of HIS interoperability are used for planning. - Business continuity: The country has a government-approved business continuity plan (BCP) in place at the national or subnational levels of the HIS. - Financial management: The country has clear financial management structures, including budgets, developed for the national HIS, including interoperability in the country based on HIS work plans. - Financial resource mobilization: The country has a costed work plan at national and subnational levels that covers both the information and communications technology (ICT) infrastructure and personnel for HIS needed for HIS strengthening, including HIS interoperability. - Human resources: The country has an HR policy and/or strategic plan that identifies the HIS, digital HIS, and interoperability skills and functions needed to support the national HIS and its digital HIS and interoperability. The toolkit provides a framework for countries to assess their level of maturity in HIS interoperability and to identify areas for improvement.