Laboratory Interoperability with DHIS2
Connecting lab results data in diagnostic systems to DHIS2-powered health information systems can support faster and more effective disease surveillance, outbreak response, and patient follow up.
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Overview
In many health systems, laboratory results are recorded in two different systems that are not connected with each other. The Laboratory Information System (LIS) is built specifically to support laboratory workflows, tracking a specimen from intake through testing to reported result, and making that result available, in a timely and complete way, to the laboratory staff and clinicians. The Health Information System (HIS), on the other hand, is used to collect data that supports management of a larger health program, such as disease surveillance or malaria control, or to provide an electronic medical record for individual patients. Delays and data entry errors that result from manually transcribing lab results from the LIS to the HIS limit the speed and effectiveness of outbreak response and can contribute to errors or oversights in patient care.
Integrating laboratory systems with DHIS2 — the HIS software platform of choice for the majority of low- and middle-income countries — helps address these issues by removing the retyping step and sending the result electronically instead, making it immediately available to everyone who needs it. This speeds up decision making, reduces duplicate work, and improves data quality.
Solving the problem of LIS-HIS interoperability is not easy. Lab systems are not generally designed with DHIS2 in mind, and the kinds of lab data that are collected and used varies between systems, health programmes, and countries. There is no universal solution that works “out of the box” for all countries and contexts. However, the potential advantages of successful LIS-DHIS2 integration are significant, including faster outbreak detection and response and better patient follow up.
HISP UiO has worked with global health partners to develop tools and resources to make it easier to connect DHIS2 to Laboratory systems. At the same time, HISP groups in the global HISP network — and other implementation partners — have supported countries in making LIS-DHIS2 integrations work in practice.
Key Features
Interoperability between DHIS2, diagnostic machines, and Laboratory Information Systems streamlines data sharing and supports more effective disease surveillance and patient tracking. Explore some of the key features of DHIS2-LIS integration below.
Improve reporting speed & accuracy
- Data sharing between LIS and HIS using DHIS2’s open API to allow bidirectional data exchange, pulling lab results and pushing demographic or case data between DHIS2 and external LIS or EMR platforms.
- Automated data exchange, minimizing manual data entry errors and improving reporting speed by supporting automated import of lab results and status updates, making lab data available to stakeholders in near real time.
- Trigger automatic notifications based on test results using DHIS2 alert and messaging features, including sending emails to disease surveillance teams to initiate response actions or SMS messages to patients to provide information on the test outcome.
Holistic programme management
- Link individual lab test orders and results directly to patient profiles or to case-based disease surveillance programs in real time with DHIS2 Tracker programs.
- Get a holistic view with unified dashboards that combine lab results with logistics, clinical data, and public health metrics in a single platform, supporting outbreak monitoring and response or public health programme management.
- Track laboratory turnaround time from sample collection to test results to monitor and improve lab system performance.
Support for offline and low-connectivity environments
- Collect lab data in remote settings using the DHIS2 Android mobile app to capture and reconcile diagnostic machine data, leveraging the app’s robust offline mode designed for users in low-connectivity environments.
- Updated patient records at the point of care using DHIS2 Tracker programs on the DHIS2 Android app to manage individual patients, including follow up on lab results, as part of an e-Registry or lightweight EMR for primary healthcare.
Interoperability based on local & global standards
- Flexible configuration supports alignment with local standards, including mapping LIS and diagnostic machine data formats and aligning outputs with national health indicators in DHIS2.
- Linking results and patients through unique IDs based on the specimen ID codes generated in the larger surveillance program or HIS, or other unique identifiers.
- Standards-based interoperability with FHIR ensuring that lab data elements and medical codes match cleanly across distinct software systems.
Reference Implementation for Lab Result Reporting
A DHIS2 reference implementation is a well-documented, functional example that demonstrates one way to solve an integration problem. It is meant to be adapted to your own context rather than deployed as-is. The DHIS2 integration team has developed a reference implementation that presents a working integration between a Laboratory Information System (LIS) and a DHIS2 Tracker program, leveraging FHIR for semantic interoperability, which is designed to support timely lab result reporting for a case-based disease surveillance program. A similar approach could be used to automate entry of lab results into an electronic medical record (EMR) or e-Registry based on DHIS2.
Impact Stories
The examples below show how countries and organizations have integrated laboratory systems with DHIS2 to improve health system performance.
Connecting laboratory test results with patient records in Tanzania and Ethiopia
The Ministries of Health of Tanzania and Ethiopia have integrated laboratory data from GeneXpert machines with DHIS2 to achieve seamless transfer of TB and COVID-19 test results, improving program management and patient follow-up.
Integrating laboratory COVID-19 testing results with Tracker in Rwanda
HISP Rwanda developed a custom web layer to allow for bulk upload of sample and test data, improving efficiency and reducing time from sample collection to results dissemination.
DHIS2 & LabBook integration in Guinea, Togo & Benin
Ministries of Health in three West African countries have connected DHIS2 with a free and open-source Laboratory Information System to streamline lab reporting and support improved disease surveillance.
Resources and Documentation
Get started with DHIS2 Laboratory Integration with these helpful resources:
Developed with Global Partners
HISP UiO has worked with the U.S. CDC to develop tools and resources to support laboratory integration with DHIS2 in support of our long-term collaboration on strengthening disease surveillance and response in low- and middle-income countries.