 We've got quite an exciting, interesting session this morning around the topic of DHS2 and architecture. How DHS2 fits into the architecture of national systems in particular, and what that means. You'll only have to suffer me for four or five slides to give some opinionated views about architecture, and then we get down to the really interesting stuff. So first of all the speakers today, besides myself, this is the abbreviated list because all of these guys come with reinforcements. So we have Touran from the Norwegian municipalities going to talk to us about their experience, particularly with the COVID response and how they were faced with some interesting challenges of how to fit DHS2 into the rest of the system to deliver the most value for the users and their work. We've got Dr. Wesley Uga from Ministry of Health in Kenya, also supported by Ayub and Dennis, and I forgot to mention Andres from Norway, and Hiranya Samarasakera from the ICT agency in Sri Lanka, who many of you know have done some very, very exciting stuff also around the COVID response. The order which we're going to go in is not that. We'll start with Wesley, then Hiranya, and then... Okay, so there's some general thoughts, all them opinions, if you like, as I have the floor. I'm always interested when people talk about architecture, they often say, show me your architecture. And then they show you all kind of boxes and lines and drawings and things. And that's always less interesting in a way because I prefer to think of architecture as that thing, that practice that architects do. They do architecture. Architecture is a process of production and because it's human production, it's affected by and it affects many things, including things like fashion. We tend to build things which are fashionable. Architecture tends to reflect what's modern or current. It's obviously affected by power and it affects power. Architecture directs what people can do, how they can do it. Culture, it's not about individuals, architecture affects us as social human beings. And of course, everyday life. We talk a little bit about everyday life and how architecture has an impact on that. And mostly in terms of our health information system architecture, we're talking about everyday work life, what we do for our jobs. So when I say architects do architecture and they produce something, what is it that they produce? One thing is fairly obvious and what a lot of people think is architecture, is those artefacts. Often they're pieces of paper, diagrams and often they become incarnated into machines, but that's only one product of architecture. The other product of architecture I've kind of hinted at is it also produces change social relations, right? The way we interact with each other and kind of importantly architecture produces knowledge, architects produce knowledge about architecture. And that's why we're really fortunate today because we've got some architects with us. In fact, we have a lot of architects out there and part of the opportunity we have this week is to share together knowledge about architecture. It's kind of more difficult with information system architecture, you know, with physical architecture you can see stuff. And we learn a lot by looking around and seeing how buildings are built and the like. Talking of which, town planning. Town planning interestingly enough has always had a great effect on information systems architecture that a lot of people don't realise. A fellow called Chris Alexander, somebody might know Chris Alexander who talked about architectural patterns. He was a town planner and software engineers took up these ideas of having a pattern language and they develop software design patterns. A lot of the software design patterns that a lot of developers are familiar with. They have this route, in fact, in town planning. We learn a lot about architecture, I think, from the built environment and town planning. And it's good that we do because, you know, we've been doing information system architecture for quite a short time certainly compared to how long we've been building things. They've been doing it for much longer. And I like to draw attention, I suppose, a lot of you are in Oslo, I think, for the first time. Some of you have been here before. Oslo is a wonderful city to explore. It's easy to walk through. It's becoming even easier now with these electric bicycles and electric scooters. It's a wonderful public transport system. And all of this is not random. It was designed to be like that. I've never met anybody from the Oslo town planning department. But it's very obvious that they're concerned about human beings and their everyday life. How they get to work. How they get pleasure out of things. How they get exercise. Supporting the quality of social and work life. That's what the town planner of Oslo does. And I think that's really what our information system should be doing as well. And sometimes they can be beautiful as well. They don't have to be ugly. Okay, a little bit about health information systems. Then you're done with me and we'll get on to the real stuff. Just some lessons, I suppose, from what I've seen working with a lot of countries and their architectural plans. One of the mistakes sometimes people make is they don't realize to what extent they have to take into account existing reality. Right? And people are bored of me saying this, but designing architectural products in heaven. And then trying to find a place to fit them on the earth. It's much, much less successful in general than designing things on earth where you approach heaven. And I think we'll see some good examples of that, I hope. It should be driven by use value. In my case, mostly to health workers and citizens. Architecture as production, like all other production, is capitalist society after all. What gets produced is what's paid for. Right? And sometimes what's paid for is not necessarily delivering the most use. It's important to keep attention on where is the use value in the stuff that is built. Complexity needs to be maintained. I see particularly funders think about these big architectural projects and they make a three-year plan to say, this is where it starts, this is where it's finished, and then the plug gets pulled, the money stops and nobody's really thought about, well, how does it carry on? One of the things that people are sometimes surprising is that as architecture grows and evolves, new categories of work also emerge. The kind of jobs that you hadn't realized when maybe you were an initial HISP team doing DHS2 in a country. And now there are different categories of work around things like curatorship of terminologies and facility registries and those kind of things. They're all work. Standards obviously come up a lot in architecture. I don't think it's going to come up too much today, interestingly enough. Some of you who I was chatting with yesterday a little bit about standards, there's lots of analogies for standards. I mean, if you're French, it's standard, it's like the thing you go into battle with. That's actually quite a nice metaphor because it's something that people rally around. Standards also as jazz standards I think is my favorite one. But if you know a jazz standard and if you have five musicians in a room and they all know the basics of whatever, my funny Valentine, then it allows people to be collaborative and creative and still keep to the tune, approximately, deviations. So yeah, that's my, as I say, slightly opinionated introduction to some of the themes of architecture, which I think will emerge in some of the discussions that we have coming up. The order, as I said, we're going to start with you, Wesley, and move along. So thanks for that. Oh, I had something about DHS too. I never mind DHS. You heard enough about DHS too. My presenters on the panel will say all of that in their own different ways anyway. We're going to do QLA afterwards. We've got a comfortable enough session. We've got an hour and a half. I hope we'll have lots of time for discussion. Thank you. So good morning once again. Good morning. Nah, that is more like this life. So once again, my name is Wesley. I work in the Ministry of Health with my brother. I think he'll be able to see him. He's somewhere sitting around there. And I'm going to give you a little, a little journey of our interoperability in Kenya so that you can be able to understand where we've been and where we have. So for those of you who are familiar with Kenya, I think we are among the first countries to implement. And we piloted DHS to a thing for the main part that is back in 2010 in Kuala, when it was moving from DHS one to DHS two. So it's scaled up nationally as early as 2011 and it's actually a de facto reporting platform. That is to say that any significant health data of importance, you're likely to get it in DHS two. So with this has come a number of issues, continuous capacity building and technical support. And most importantly, I should say we have about now about 25 data sets up in within our DHS two. It's more of the landing page where everyone, if I told you delivering health care in Kenya, you'd want your data to be there so that anytime someone asks you where can I get it. If it's DHS two, it's well covered. So what has been some of the things that has made our implementation of digital health or even the interoperability very, very well going. The last thing is I need to inform you is our constitutional 10 to 10, which outlines the right of information in line with the new current government which we have is that we have a developed government. We have a national government. Then we have small 47 governments down there. So the right for information becomes the basis for which each and everything we anchor on, especially on health information. We have to anchor it on that particular part of the constitution. That is the 2020 2030 vision. And then of late we've had the health act, which has given us the enabling legislation. That is to ensure that about anybody delivering health care in whatever format you're doing it. There's some few things you must be able to send to us so that we can be able to know whether private, whether public with a faith based. You're able to share with us some critical data, which is important for, especially as a nation as we plan towards it. These are things I think the establishment of our integrated HIS telemedicine and the rest. Anchoring all these as we in health is the idea that we all work under ICT so we have the national ICT policy 2020. And of late, a very critical thing that has come to throw a curveball within the mix is the data act protection act. I think those of you have been familiar with the quest for everybody to look for privacy to ensure that at least your data is anonymized and nobody else successes it. That is part of what has really been part of our enabling environment. Lastly, we are the several number of health policies. I will not be able to choose a day, but I will move forward and tell you that our aim to develop an enterprise architecture started in 2015. I think that is when I think a lot of all these open MRS and everyone else was moving in. Electronicization, digitalization of data and everything. So this just to remind you so that you will be able to see what has changed as the previous prevent us told you that we these was in heaven. So please have a memory of this when you talk about the heaven. So we had clear operation of what would be our channels, what would be our business service layer and our technology service. And remember encompassing all this is that we believe we're building it on two foundation. The principles standards and policies being a key foundation principle and ensuring that each of those areas will be able to work properly, giving ensuring this procedure and work. Now that is enough. I'm sure a good number of you will be able to look at it and wonder which is which. So I'll be able to look through and tell you this is the center pillar. This is where we have our DHS to where everybody else is trying to send their data into it. So if you look carefully, you'll be able to notice that we'll have, for example, information health. This is about the home and resource, which is a key pillar for those who know the building blocks for WTO. We'll be able to send some of their data here, albeit all this data comes as aggregate, not as individual level. We have the Kenya Master Health Facilities, sending its data to KMSA and also sharing it with it with our DHS too. We have the Logisco Management Information System. I think I've seen a good number of counties running the LMIS. Within Kenya, all the, especially the global funded products, malaria, TB and HIV, it's mandatory that their data must be within DHS too. So you can see again, all this send their data there. We have the National EMR. After the few countries that are running EMR, and I have to tell you that as a country, one of the few challenges we've had is program-based support. So when I say EMR, I need to tell you that these are HIV-related care and treatment EMR. The other EMR, none of them is sending it. So I think in the morning, as you're talking about electronic digitalization of health, we were able to appreciate the fact that when it's program-based, malaria comes and runs with it. Halfway through, the funds get over. Then the new kid in the block is TB. It comes, it's a new race, and we go on and on. So we have our EMR. We have our Chancho. I think the new thing here, covering especially the COVID, the new kid in the block, giving us the summaries of how many people have been immunized, how many are half immunized, fully immunized, all that being sent all through this. And basically, I think you get a grasp of what it is. So we have these two instances. We have our KHS aggregate. We have two instances, and we have the tracker, which covers events and everything. Just by a look of all these things, I think the tech-savvy people will know ERA 502 is very possible, because everybody is digging into one particular resource. But just to give you a clue, one of the few challenges we've had is that each of these runs a different implementation. The only thing that is a common face is that we have a point-to-point structure integration, and many sharing data in this particular format. JZone and XML. We have a beauty about it is we have a standard health facility and community units. That means whoever is sending it, whatever system you're running desperately, identifies through one thing. All of you have a master facility list, which is giving you a code, which is linking that particular data to that particular individual, or that particular site, which is generating it. So KV, a lot of our data exchange across this platform is basically based on API, and some of them as a custom interoperability layer, based on some of them are ADX exchanges. So clearly, if you're with me, you realize standards are not as my previous person said, standards are strange. And the thing to also remember is that all these technologies are running on different technologies with DHS to some running on OpenMRS, OpenMRS, some running on Iris, OpenHIM, OpenConcept, all these particular things that we've been able to see. But at least you understand how the earth is. Now, in the current implementations, these are some of the challenges we are actually encountering. We have no control on data integrity and validation measures. As you've seen, everyone decides to send data in a format he knows it will be able to land on the other side. So our challenge becomes our data integrity, and we cannot be able to validate as long as you've sent us data and it has landed, validation is not able to be done. A lot of these systems, if you've realized, are actually based on partners and who is supporting what. So if, for example, I come in tomorrow and I'm interested in knowing how many male Kenyans are 40, you'll develop a system here and immediately start sending me data about Kenyan males who are 40. So that becomes a very major challenge, sorry. And then the other thing is limited use of common structures. Everyone, some of these are vendor based systems. So we do not have any common structures. So there is this in itself has given us minimal usability of use of integration tools. And you like a centralized coded metadata and the data dictionary. A terminology service layer is a whole new thing, which as you keep learning and just keep rolling on rolling it, we realize is something that we need to develop. So we have limited tolerance for integration and ended up monitoring different security profiles on the few that are sharing segment institutional by these parties because most of these parties, some of them are government owned. So those of you have worked in government, especially in the African setup. If it's government to government someone will just tell you it's the government do we really need standards, your government I'm government so those things become the security profile and the challenges that come with it. Come in and the bigger picture the bigger limitation as we move ahead is limited scalability so that you can be able to plan and implement. Everyone is moving in with a thing and everyone wants to be in the system, but the way we've structured it you cannot be able to make room for growth for it to be expandable. My brother from Rwanda I think talked about finding his room by chance. This is a simple explanation of interoperability. Those of you who came like me from Kenya, we only realize in the room we cannot charge our phone. We cannot charge our laptops, because clearly this is probably what I came with. This is how the socket looks like and I need to develop an interoperability layer to be able to access Norwegian power. Well, I'm sure each of you had an experience as you're moving across, but this is now what has made us as Kenya to be able to develop a Kenya health information system interoperability framework. Free if you in your free time you can Google it as it is you'll be able to get the document and you can see what you're looking at. And we're actually borrowing from other European interoperability framework is telling us that we should be able to. An interoperability framework is an agreed approach for interoperability for organization that wish to work together towards the joint delivery of a public service which as a government is our key aim to be able to give you. So, as we were developing this there are few things that we realized we need to be able to look at and be able to ensure that we work together and we brought a good part of it from the open HIM. And we need to promote the use of interoperability concept and the standard and harmonize health information to enhance application interoperability. To introduce operate appropriate governance mechanism a very key thing, because governance becomes the next thing when everything has already started running to parable to provide an interoperability conceptual framework and to provide guidance on how will you be able to say as Kenya. At which level are we as in interoperability maturity, are we at the young stage are we a middle stage, or are we nowhere because what I have shown you I don't know where you'll place Kenya. But our guiding principles I think you can clearly see them all right, that we need transparency, usability, neutrality, user centricity, inclusion and accessibility and the key element in the room security and privacy and assessment to ensure that the effectiveness and efficiency and lastly to ensuring that the integrity of our data is very good. So, in doing this, we did realize that the technical parts if you're not very careful might not be the only thing we need to look at, as we look at interoperability. So the first thing we look at is the legal, as I've told you Kenya as past and data arc, Kenya data arc 2019, even requiring me not not to save any personal data outside of Kenya, as much as we have cloud challenges that. So all those needs to be there. Just looking at organization level where our policies and care process also fit into this interoperability. We do not want to have them to exist in the vacuum. We need the semantic. I think I talked about the terminology layer. How well can we be able to say when we're referring to one thing across board, everyone understands what we're talking about. And then the last but actually the pillar of it is a technical part, ensuring that the application and the IT infrastructure, anybody trying to deploy something is aware that this particular infrastructure will be able to support interoperability. I think this gives a summary of what I'm talking about having compatible legislation, argument with organization, alignment to our care and share use definition and all those. And this we've actually saw from European Union, and we hope to be able to relay. So after our first heaven, this is our second heaven, which you are currently implementing. And our aim is I think you can be able to look at it very well is that we shall have the different areas in the other common services, which we have this things that will be common. With everybody. You either have a registry for our partners, our health products and technologies, our health workers, those who are able to access the different health systems should be able to have a registry for them. A community unit registry, I think health service in Kenya is delivered in two areas. We deliver health service at the community level and at the health facility. So for the health facility registry, I think we already have it, and the community registry, we have it. Whatever we're calling the client registry is something we're looking at as development of a unique identifier for a patient. As a country, we tend to have common names. I don't know if in your country you can get somebody also called Wesley Orga, but the only the different name is the third name. So Kenya tends to have a lot of that. So that's why we're developing a client registry, sometimes recalling the patient registry. And lastly, having a terminology service layer. The business service layer I think we'll be able to go through them all the different information system that we'll be able to share. Then the analytics at the other end, which is mainly to feed our policymakers and the consumers of this information. And our aim is that we shall have an interoperability layer line in down here. To allow all these different areas to be able to share this information very, very well. A key thing to mention here is that Kenya is targeting towards going to universal health care. And as such, you're really working to have been shared health records. That means if I'm treated in Oslo today and I moved to another city, which is within Kenya, the person who's treating me should be able to access my previous medical record. I think very few countries in Africa have been able to do that. And this is an enabler towards you in a universal health care so that whatever health care you're given, you're able to get it across. We also are being awoken to this lower layer. I think all of you can be able to see this. And a key thing that is becoming, especially for those of us who are managing chronic illness, the mobile apps want to be part of what contributes to your health care so that if the doctor has told you, please walk 20 kilometers in a month. The four kilometers and five kilometers contributes to all universal health care so that if the doctor asks you, those of you who've been with patients, if they asked, have you walked? They always say walk. Yes, I do do a lot of walking. But with that system, we'll be able to clearly see it to that end. So just in finishing, those are my, my agreement. These are the different people who've participated in this whole step as we try and get into having a good interoperability layer in Kenya. Thank you. And if anybody wants to ask Dennis any questions in terms of clarification of anything. We've got time for maybe one or two, but we'll have more time for discussion then at the end. First thing for Dennis. Dennis, sorry, you have to come back. I think Dennis was with us and I will be able to assist me kindly. Come again, have we? You mentioned OpenConcert Lab as a terminology service. How was the integration with the different applications you mentioned? So I don't know if you're referring to the new heaven or the old heaven because the new heaven, I think this is now what we're working on. So part of what we're doing, I think Dennis will be able to guide me to also give Dennis a mic is the development of that some terminology layer. So that's not it. I don't have any other questions. I'm sure you'll have an opportunity to follow up. Is there another one? One more. Let me move on. Yeah, I'm just wondering what technologies you're using for your interoperability layer. Is it custom built or is there anything out there that you you picked up and used? I believe what you've done is with the love standards of what should be for you to be able to share within the interoperability layer. We've defined the different standards and I was able to show the Kenya Health Interoperability framework. So within it we've defined the different standards which everyone should be able to achieve to be able to use that particular layer. The layer itself has not been developed. It's all in progress. So we are hoping that whoever wants to share data at that particular level knows what will be the requirement before they can be able to share data. Thank you. The layer is still in heaven. I think we'll have to move on but the discussion you'll have a chance to come in. Thanks. Very good morning to you everybody. My name is Siranya. I'm representing the Ministry of Technology of Sri Lanka. So in this very short presentation I'm going to share some of our experience building using DHIS to build the national COVID-19 national surveillance system. So I was the former Chief Technology Officer for the government of Sri Lanka during the height of COVID. So I had the opportunity and the privilege to work with many different entities. Ministry of Health, his Sri Lanka group, Dr. Pamod who is a representative here and with various other government organizations to build a connected solution in order to quickly adapt DHIS to respond to the challenges of COVID-19. So this is like a 40,000 foot weave of the Sri Lanka government's digital blueprint. On the bottom most layer, you can see the blue layer. You can see the foundational layer, the infrastructure layer. So Sri Lanka is an island nation. It's 65,000 square kilometers in size, 22 million population. So Sri Lanka government has taken the initiative to build a connectivity to connect almost all essential government entities across the island through something called the Lanka government network, which connects these essential organizations, government entities through five-optic connectivity. On top of that, we have our Lanka government cloud, which is a private cloud purpose built and maintained by the government of Sri Lanka to serve the needs of government digital solutions, including the health. On top of that, then the third layer, which is the newest layer, which is in progress right now. That is the Sri Lanka unique digital identity layer together with our interoperability layer, which we call the National Data Exchange. So that layer is still a work in progress. In green, you can see the shared solutions. On top of that, you can see the orange layer, which are more sector specific, as we call it line of business solutions, which are like health, education, motor traffic, you name it, right? So the ICT agency of Sri Lanka is a fully owned institution, a fully government owned institution, which is the apex body for all things ICT, information communication and technology. So they are responsible to realize that the previously shown blueprint, the government digital government blueprint to come up with public policies with related to digital and ICT and to create a sort of enabling environment in terms of digital laws. I'm happy to say in 2022, we successfully enacted the Personal Data Protection Act, which is a few months, couple of months ago. We are very happy and we are very pleased to have that in place. And comparatively in South Asia, I think Sri Lanka has a really good set of digital laws. We have the electronic transactions act. We have the cyber security laws, etc. So we are I think very well positioned in that sense. So I want to spend more and put more emphasis and focus on the governance of the role of the ICT agency, especially from the point I sat during the COVID-19 solution. So it was a humble beginning, right? It was in January 2020 in the very early days of the spread of COVID in Sri Lanka. It all started here in a very low key in a small room. Few, you know, take enthusiasts and engineers got together and to sort of come up with a very high level concept to sort of design a concept which translated into like a Google Doc, which we opened it up for public comment. And we from down was, I mean, we ended up with this one, right? So this opening up of that Google Doc or the concept and opening it up for comments and collaboration created a huge, you know, sort of a movement. We gathered a lot of volunteers, you know, like in the tech enthusiasts, domain experts from all walks of life, from all, you know, different professions. And we were able to, you know, to come up with a very, very elaborate, you know, ecosystem of solutions. I shamelessly copied this slide from Dr. Pamu's presentation yesterday. So as you can see, DHIS2 became an integral part of this entire ecosystem. This was a very conscious decision. I'm really happy from the former CTO that we made that conscious decision to, you know, build around DHIS2. And as you can see, we started off with, you know, systems to track, you know, tourists, you know, flowing into the country through ports of entries. So we had, you know, Department of Immigration involved. We had so many systems which are built and operated by different silos, especially immigration. I don't think they were, they haven't, at that time, I don't think they were open. They haven't, they have not opened their systems to a level like at this scale. So we had to undergo through a lot of, you know, challenges for obvious reasons. So all these, you know, components, those, all these systems were, you know, in isolation. Of course, there were, you know, new solutions like, you know, ICU bed management and there were a lot of new, net new, you know, solutions that came into the picture. But behind these, there were actual organizations, you know, government entities who are, who are, you know, in control of some of the data, civil registries, Department of Immigration, hospitals, Ministry of Health, you name it, there were so many different organizations. So as the ICT agency, so ICT agency is empowered to, to, you know, sort of be that, you know, conduit across the government. So we had the mandate as well as the authority, I would say, but here in this case, with the, with the, with COVID happening, I think we were, we were lucky that most of these entities were open enough to, you know, collaboratively work with us. And, and ICT played more of a facilitator rather than more of a, what do you say, so, so more than an authority, we were playing a sort of a supportive role there, I must say. Obviously, for obvious reasons, we did not have the required human capacity to build most of these solutions in record time. As you know, like most government entities, we mean, when we build systems, you'll have to go through procurements and tenders, et cetera, right. Here we had to react very, very quickly with zero budget, right. So, so the efforts that the voluntary efforts that were put. You know, helped really well. So we built a community around this. So, coincidentally, the ICT agency had this program, GAPTEC, GAPTEC-LK program running. So we were at the very early stage of that. So this was the idea of this was to create a sort of a community, like a voluntary community, open community around building government technologies, technologies for the government, for the people. So, so most of these take enthusiasm as entrepreneurs, developers, designers, project managers, all of them sort of gathered around this virtually. Luckily, I mean, with the advent of COVID, most were, you know, logged into their homes. Since most of the tech guys were already very familiar with working from home, working remotely. So we had then they had a lot of surplus time. And so we were lucky. So we were able to tap into their, you know, their brains remotely. And so we collaborated virtually. So we had, so we had Slack groups through GitHub. We shared code through through different other collaboration tools. So we were able to engage really actively. This Slack group played a pivotal role. So we had about 500 volunteers connecting Sri Lankan volunteers connecting from all over the world, even even expats living in US, Singapore, Australia. And we had the DHS to some of the core THS to members, you know, contributing like Austin Bob. And there were so many public officials from government entities who are, you know, connected to this and they were actually witnessing how these systems were getting built. So that was a very, very enlightening experience for most of the folks, especially those who were in the government who have been, who have never experienced that kind of movement or like a collaboration happening in an open manner. And it was almost actually free. I mean, they were people were contributing their labor out of fashion. So we were building systems in an open manner. So as the ICT agency, of course we were sometimes liaising with some of the integrating with some of the sensitive systems. So we had to play a sort of a significant role there to ensure the data security, make sure that the integrations are done in a like a secure and reliable manner, etc. And ICT agency was providing the infrastructure. Remember the Lankah government network and the Lankah government cloud. So those really helped us, you know, quickly, you know, roll out, you know, provide infrastructure required for the DHS to and other, you know, peripheral systems integrated systems to, you know, come to light in record time. So DHS to so during this, this, this, this, this conference event, we've been talking about DHS to a lot. So, especially for COVID-19, but beyond that, I think the Sri Lanka government is now seeing the possibilities, the various different other possibilities of DHS to unfortunately, at this moment Sri Lanka is going through a little bit of a rough time in terms of economic situation. So we are seeing real, you know, problem, you know, challenges with regards to agriculture and food security. So with the inroads, the successful inroads that DHS to is making to the education system. I think this is and this is really interesting from from the government's point of view, we are really keen on seeing the possibilities of using DHS to in agriculture food security, disaster management, nutrition, climate, etc. I think DHS to is all already in use in disaster management right now, but we'd like to, you know, see how we can, you know, go to the next level. So with the, with the possible increased adoption of DHS to in other sectors, I think the his his group will have to play like a significant role. I heard during the early presentations that capacity building is key. So even from the government point of view, so we really believe that building capacity in the age organizations really work wherever we have not, you know, built that capacity, we have seen the adoption, you know, plummet and you know, eventually the systems, you know, become redundant. So the capacity building is really crucial. So I mean, we are really keen on from the government point of view, we are really keen on exploring how we can, you know, you know, work closely with the his Sri Lanka and other associated groups to see how we can, you know, really take it to the next level. From an architectural point of view, we are seeing more possibilities of DHS to so there that there are a lot of DHS to solutions systems information systems being used in silos in thematic areas. So DHS to can really act as a sort of a data warehouse or like a data aggregator that we can have analytics and insights, you know, you know, showcased at a very aggregate level. And also as a platform. So if I if I refer back to the larger digital government blueprint, we have a lot of, you know, foundational solutions. So here you can see one of the foundational solutions that we have. This is called the National Spatial Data Infrastructure. This has been there for some time in Sri Lanka. So we have about 120 plus, you know, geo layers. So, so systems like DHS to can definitely, you know, feed data into this, our NSDA infrastructure. Then we have our open data portal, right? So we can, the idea is to have sort of mashups so that we can, you know, build on top of DHS to and use DHS to as a platform. So we are really, you know, keen on exploring the possibilities of DHS to different arrangements in the larger in the national, you know, ecosystem of solutions. So the DHS to as the epidemiology of the COVID-19, you know, changed the DHS to was ultimately at the latter stage was used for the COVID-19 vaccination immunization program so almost all the 22 million citizens were logged on DHS to and actually DHS to was, you know, really pushed to its boundaries and most of the co engineers know that we've been bothering them with with a lot of questions. And we were really happy that that we were able to, you know, push it to the boundaries. And so then we had the challenge of we had the need of building a vaccination certificate. So we wanted to make it a smart vaccination certificate. So at the ground level, at the field level, the people were the citizens were issued like a paper based cardboard based, you know, the vaccination certificate which was not good enough, especially for foreign travel. So we have a lot of Sri Lankans, you know, working overseas. And so that vaccination certificate was unfortunately not good enough as a reliable means to prove their vaccination level. So since we had all the records immunization records on DHS to with the Ministry of Health, he's we came up with the smart vaccination certificates. We built it using the dialogue dialogue is another digital public good that is out there. It's from the ego foundation dialogue is a pretty big solution with which is very featureful. It's very, you know, widely used in India. However, for Sri Lanka, we only relied on its verifiable credentials. So as you can see this, this QR code, that's why we call it a smart vaccination certificate that QR code can be scanned independent of any other third party system. So the scanner will, you know, quickly scan and the scanner will show you the number of vaccinations that you have got, etc, without having to connect to a like a third party system. So that so we have to date we have issued, I think in upwards of 700,000 certificates we have limited it for only for in travel right now. So so we are very happy that we were able to, you know, extend the capabilities of DHS to now this smart vaccination certificate can be issued from DHS to itself. Then we are using more sip more sip is a modular open source identity platform. So Sri Lanka had a really good identity card national identity card system since 1970s. So we have almost 100% coverage. And however, to me, the future needs, you know, future digital needs, if the government is to serve its people through through electronic services, digital services, we really need to be able to identify its citizens digitally. So so Sri Lanka has has been, you know, have been, you know, trying to come up with a electronic version of the national identity card for 1215 years. But unfortunately for various reasons, it didn't work out. But since in 2019, we made a like a huge pivot and you know, decided, okay, we are going open, like, you know, we are not going to do build this identity. The reason that it was, you know, dragging for so long. And we decided and now we have made a proof of concept as of 2020. And right now we have successfully done to isolated POC's sorry pilots using a telecommunication and a banking use case, and we are making progress and and we are really happy that we are committed to to more sip. And yeah, so I mean, so this is this shows Sri Lanka's commitment to digital public goods and we are very serious about using open source so so we have been using open source for quite some time. And, and it's about but we take a more pragmatic approach, even even the most so the foundation layer will be open based on open standards and open technologies and but we are that doesn't mean that we are not open for proprietary, you know, technologies. But in the biometric, because this will be based on biometrics iris, facial and fingerprint. So that will require a lot of support from the commercial vendors as well. Yeah. Thank you very much. Thanks, Roger that that was really fascinating. I'm sure there's tons of questions people want to ask, but maybe we should move on to the next one we'll have a little bit of time at the end. Nobody's talked about power yet. But it's all there in those boxes. So this is a really, really, really fascinating presentation coming up now I think from the way in which DHS to somewhat historically got used in Norway as part of the covert response. Lauren, over to you. Thank you so much for the invitation. We are very happy to be here. And my name is Tore Moschander, and I work in KS. KS is the Norwegian Association of Local and Regional Authorities. I'm here with my colleague, Anders Hallmöft, who works in Bärum municipality. We're going to share our experience on the choice to with you today. And our own premises installation are named fixed Smith's pudding. In Norway, all the municipalities are responsible for tracing and following up each person that are. Okay, I'll try once more. Sorry. My shirt's too long. Okay. I'm here with my colleague Anders Hallmöft, who works in Bärum municipality. We're going to share our experience on the details to with you. Our own premises installation are named fixed Smith's pudding. In Norway, all the municipalities are responsible for tracing and following up each affected person and their close contacts. Immediately. To prevent outbreaks in the community. And then I use this. When the pandemic hit Norway. March 12, 2020. Government enforced the most restrictive measurements in modern history, which in all practicality meant a complete lockdown. No preschools, no schools and everybody had to work from home. The municipalities were responsible for tracing the COVID-19 and prevented from spreading. This means that the contact tracer will call everyone that has tested positive for COVID-19. And all their close contacts. It's a huge amount of work. Common for everyone. They had no system support. Only pen and paper or Excel. 356 municipalities. Serving 5.4 million people had the same issue. No system. One nation, one user story as a contact tracer. I want a system to register positive COVID-19 tests and help me keep track of the spread of COVID-19. This will help us to stop the outbreaks and gain control. Employee in Tromsø had knowledge to de-gize to. And after some research, a few municipalities and KS started the de-gize to journey. All through the pandemic. Six meters boarding continuously developed to be the best system support for contact tracer in the municipalities. Norway has several national registries that contains important information that is useful and necessary in tracing COVID-19. Let's have a look. First, we have the MCIS laboratory database. Here we will find all the positive and negative test results on COVID-19 tests in Norway. We have the electronic population database. Here we will find information about everybody that's living in Norway. With the personal ID number, we can get the person's address, phone number and email address. We can also obtain information about relationships such as parental responsibility for children. And finally, we got the Sysvak. Sysvak gives us individual vaccination status on all the inhabitants in Norway. This provides contact tracers important information in their daily work. By aligning all the data from the national registries, they would have the best overview of where to take action first. How do we use this information? We do a search in the MCIS laboratory database. The results from the MCIS laboratory database will be enriched with personal information from the electronic population database. This gives the contact tracers time to focus on the important things. Instead of using time manually in registration, the contact tracers can easily make a search to the Sysvak to get the vaccine status imported as well. Then the contact tracers easily can eliminate and close everyone who is fully vaccinated and focus on the ones that are exposed or vulnerable and need extra care. Anders, maybe you can tell us a little bit about your experience after you changed system to fix mid-soothing. Yes, thanks. My microphone is on, I can hear you. Yes, thank you Torun. In the early stages of the pandemic, Bärum developed their own program. It was meant to be a tool for the contact tracers to register the people who was infected and keep track of all their close contacts in our municipality. And for a while, this program worked quite well, but that was in a small scale. As soon as the index numbers started to grow, flaws within the program started to pop up. And one of the biggest flaws was the lack of integration with other programs and other IPS. To know who was infected, the laboratory had to call the contact tracer and name the security number of every individual with a positive test result and spell out there's every single name and their home address. When you got up to a thousand positive tests today, this simply takes too much time, both for the laboratory and for the contact tracer. In our old program, we also had to search for people's phone numbers in the yellow pages. We had to look up people on Facebook to see if it was the right person we were talking to. And sometimes we even had to call the hospital or the emergency room and use their valuable time just to get a hold of a phone number. And this process alone could in some cases take up to half an hour. Regarding the inhabitants' vaccination status, we simply had to trust and rely on the information we were given from each individual person. And that was of course a major flaw, especially when so many of Norway's restrictions were based on how many vaccines you had taken and when you got them. So Barum started a search for a new program. And Fiksmit Spudding and DJI's 2 was the one we went for. And it soon turned out that the amount of interoperability in DJI's 2 was just what we needed. The two programs were quite alike in front end. But with DJI's 2, we just had to push two buttons to get all the information previously named. And that meant that we, the contact tracers, were able to use almost all our time on what we were supposed to do. Which was to contact people who was infected, find out where they got infected and of course find out who they might have been infected. And as a positive side effect of this interoperability, the data quality became much better, of course. We no longer had problems or issues with data entry errors like we used to. And for the first time, we could actually trust all the information within our program. And then the Omicron variant came and everything was turned upside down. Each inhabitant had to register positive rapid tests instead of taking the tests at a health institution. That was a game changer. We developed a self-registration solution with secure logon in less than three weeks. Inhabitants could now register rapid test results and close contacts themselves. And again, we used the national registers to increase the data quality and security. The inhabitants could only register positive tests on their own and based on relation registered in the electronic population database. Inhabitants with bad intention was not able to make fake registration that would have caused more strain on the municipalities. The inhabitants' registration crazed a record with all the personal detail already filled out together with the rapid test result. Details about the illness harvest in the self-registration form were also transferred to DJI's too. Anders, what impact did this have on your daily work? As you just said, the self-registration was an absolute game changer for us. We no longer had to call every index, but we could use the information from the self-registration form to filter out those most important to us. That led to a prioritization list of who we ought to contact, made by the chief physicians in our municipality. Here you can see the prioritization list. And the reasoning behind this one was that almost all others were able to find the correct information by themselves. And if not, they could simply call our COVID-19 information center. The people on this list, however, were inhabitants that might need some extra care, some extra advice. And where a COVID-19 infection could have the highest consequences. This was also the stage of the pandemic where we really realized the value of the working list within the program. After a short while, they simply became essential to our workflow. And this was especially cemented when we were able to assign different indexes to certain contact tracers within the program. So to put it simply and to answer Torren's question, the self-registration helped us to reach out to those who needed our help the most. And it helped the contact tracers to work more efficiently. Yeah, due to the interoperability mentioned earlier, we now had quite a lot of reliable data in our program. For example, age, addresses, vaccination status and so on. This was used to generate statistics and quickly became one of the most important decision-making tools, management tools for those responsible for how we as a municipality handle the infection and what restrictions were necessary at what time. For the school system, we generated tables, graphs and lists of how many pupils and how many teachers were infected on each school. We did the same thing for the kindergartens and for the health services. For example, the nursing homes. And with the help of the event reports and the data visualizer tool, the municipalities chief physicians were able to monitor the situation in Bahram in real time, which meant that they could take control and act at a much earlier stage than ever before. Some of this information was also uploaded on the municipality's own website so that the inhabitants could get updated statistical information about the pandemic in Bahram. And this was something the public was extremely happy about and gave the contact tracers and the government in the municipality a lot of goodwill. Inhabitants, they felt that we were transparent and they got a better understanding of the local restrictions that was imposed. And as a side note, a month ago we actually got an award for this solution and the municipality is now considering making similar dashboards for other services. And to us this actually shows us the importance of using systems with good interoperability. And as we have heard and we are looking forward to hearing more about the experiences of others who use DJI's too. Thank you. Thank you very much. Thank you all. I think we have about 20 minutes. I'm sure there's lots emerging from this discussion. There are very, very different presentations highlighting very, very different aspects of the architectural journeys and different architects. I know we said that we might get some support up front. I don't know, Dennis are you here? Dennis Banga, there he is. And I was going to say are you, but I think we've run out of seats. Are you? We have a seat for you of course. So there you go. I've got lots of thoughts and questions, but I want to put this over to you. Do we have a microphone? Yeah, so. Okay, if anyone has questions in the audience. Thank you very much for the really inspiring presentations. I have a question for the last group in Norway. As you said, you have like different municipalities working with the same issue. Did you have a one big installation for Norway and different organization units within the same systems or there were different systems one for each municipality. Thank you. We have one installation for all the municipalities. There are different. So 150 municipalities in Norway use our installation. And because of the privacy legislations and so on, each municipality has their own kind of workspace. And for instance, I cannot see what the other municipalities are working on, but we can send indexes. We can send close contacts to each other if that is necessary. Do you have a question to raise your hand? Could you ask the mayor? Yeah, she mentioned ask the mayor. That's to close municipalities with a border between them. There are a lot of people who work in one of the municipalities and live in another. So it's quite common to have more close contacts in the opposite municipality. So Oscar started this whole DJI's 2 journey and we came along after a year or so. And for them, we helped them by joining DJI's 2 because they no longer had to call us, stand in the phone line queue and so on. They could simply push the button and transfer indexes and close contacts to us. And of course, we had to talk together, of course, sometimes, but these talks were now more of how to do things together than just giving information. Thanks. I'm Mike, the product manager for Tracker. I want to direct towards Sri Lanka first to say I think the community owes Sri Lanka quite a bit for all of the efforts you did around COVID. So thank you very much. And thank you for sharing your experiences and working with us. We also as a platform, we learned a lot about performance and have tried to be responsive and then bring the fixes that we learned back into the platform. I wondered if you had any thoughts now after having built from nothing to 22 million registrations, things that you would do differently or recommend to other countries that are now moving towards this kind of scale. What would be kind of some key recommendations if they're going to get to that level. Yes. So I can start and probably run again contribute. So looking back, one crucial decision we had to take the early days of pandemic. I think in February itself was like we were using like for most of our isolated DHS to instances run by programs we have been using Ministry of Health standalone servers. So that was our first option. And we in fact doing the first prototype. But the thing is, like, if we had opted to, I mean, go on that path, even for the immunization, we would have been in trouble because I mean, looking back, I think it was a good decision for us to opt for the government cloud, because it was very scalable and it has too much of resources. Because I mean, I'm not going to share the exact spec of the service, the DHS instances that we are running at the moment, but for many reasons we are using a lot of processing power and RAM. And if you had users use the DHS, I mean, the Ministry of Health service, the standalone service, we would have been in major trouble. And on the other hand, the ICT agency which manages the cloud, they have their own dedicated resources and they have the network engineers and all who could, I mean, kind of manage it. So that's about this server part of it. And when it comes to other performance issue, one good thing that we did was like we identified it before. And then we engage with the DHS to quote him at UIO, because I mean, it's not like all of a sudden your DHS to system fails and you try to reach out for support, it won't work. So probably like what I would advise you is to kind of have some monitoring tools and to predict what might happen in future and engage beforehand because I mean, you know, they have so many other tasks that they already do in addition to supporting countries. So you have to predict what is going to happen early and engage in support. And the other thing share your stories, right. I mean, you are not going to be the first one who's going to encounter the same issue and probably there may be other people in the community who have had the same issue. And, and again, I think even for the core team, it would make more sense to support on issues that more countries are having than a very specific issue a single country is having. So these are some main concerns that I mean like main learnings from whatever we went through, but kind of I was appreciate the support of the core team because like maybe exactly one year ago and what it is now they have been major improvements when it comes to performance. So that's something I have from my and your idea. Yeah, I think getting on to the cloud. Because unfortunately, we did not have a lot of, you know, time to, you know, sort of test things out. I mean, in a perfect situation, we will go in a perfect situation. We could have done testing, et cetera, and go live, but due to the urgency so we had to, you know, put it to test put it to task in production production. So I think one learning is like, I think if we can do it in a more methodical manner so as in tested in an isolated, you know, simulated environment. So and so having it on the cloud helped us, you know, elevate some of the problems because we were just throwing infrastructure at the problem. So which does in the short term and until we figure out and clustering is of course, I mean, horizontal scalability is important. I think we tried out with clustering setups and I think I think in hindsight, I think we could have could have done a little bit of optimization on the post test side. I must also mention, like they were very receptive to Bob's comments. I think Bob is still critical about some disk performance when it comes to the servers we are using, but they are very receptive. They're trying to address it, but I don't like with this present Sri Lankan situation economic crisis, it may not be possible. Like I mentioned in my presentation, I did, you know, hit the limits of our cloud as well. So we had, you know, provision some SSDs. I can remember I to again, you know, you know, it brought into the problem to solve it. And yeah, yeah. So maybe I can share briefly about Kenya. So the maturity and the evolution of the DHS to us come a long way. Looking at it went past and scaled up nationally in 2011. And at that moment, we, the user was mostly aggregate or the essential data sets at that time. And then more programs started onboarding the platform. And we started implementing different programs for maternal and also for impatient mobility. So it happened now, more facilities started reporting in patient mobility within the platform. And you see the maturity also it's evolving. At that time, mostly the aggregator was the main team. And then also the truck around 2018 started having more features which were supporting country implementation and also country needs. And with the implementation now impatient within the same system. And see now we have aggregates and trucker not trucker events, which is also in the trucker domain being implemented also on the same system. Yeah, it came to a point where by the two systems, the two programs would not run in the same platform. Because the trucker was so heavy on the computing resources that are needed. And so the minister had to make a decision to separate those entities. And also at that point also we were having the data protection act, which was being developed because the patient also was collecting. And so on the performance of the minister also had to invest also in resources in terms of being able to have more resources on the trucker and also separate those two entities into different servers and also continuously see how to implement. I think now the two instances run separately, but integrated when it comes to aggregation or the aggregate indicators which need to go to the trucker. Yeah, so but for the Kenya news case was the separation of concerns based on the maturity of the infrastructure. Thank you. Dennis, can I ask you a question? We actually have a question for the audience if you want to go to the first tour. Here you go. Dennis, I'm really conscious of the difficulty of your heaven and earth problem. One of the things that seem to characterize both what's happening in Sri Lanka and what's happening in Norway is very strong ICT agency in Sri Lanka providing cross government sort of enterprise support, which makes it easier for accessing the population register for example and things like that. Do you have any comments about that in terms of where you are in terms of cross ministry, cross government collaboration? Do you have an ICT agency like Sri Lanka? Yes, so still when it comes to the governance in our country, we have an ICT authority that is responsible in terms of controlling what the different government entities are having or when it comes to the infrastructure, when it comes to also maybe they're also providing some common services to the different entities within the government. So there is that body that's able to do that. But also looking at now back to what Wesley talked about the constitution that we have that acts as the blueprint for our country. It outlines also some authority also in comes to the county governments. So they also have like the healthcare is devolved. So you find also within them also they have also Ministry of ICT, even within the county governments and also we have the over anchoring body of ICT also within the country. So there is that regulation but what the national does is creating policies and disseminating regulations. So that's aligned and so what the other ministry is trying to do is to align to those different regulation and different policies that are there. But not to our scenario when it comes now to the integration between different entities. I know Wesley is going to share briefly on that. I think we'll have time for one more question. Wesley is going to comment. Yes, so I might be a commenter that said what were the lesson lines, what would have done better. I think one of the few things that happened especially with our Earth different from heaven is the idea of failure to plan knowing where we're going because it's more of like today I want data on LMIS on DHS that comes on top. Tomorrow you need data from the lab comes on top. So we realize that the fact that we are the agency of just ensuring everything runs in DHS means we do not plan, we do not have an infrastructure. We do not have standards and we're more interested in the end just saying we have the data in the DHS please go and have a look at it. So that's one thing we'll be able to learn and the major thing which we're learning as we move ahead is the impact of legislation. A lot of these things have happened and then boom 2019 we have Kennedy to act. So I think if you remember that legislation that innovation tends to come the way before the legislation. So the legislation later disrupt interrupt or reorganize you. So if you plan with that in mind I think it really makes a lot of sense for those particular products. Thank you. A great thanks Mark Landry bubble fund just similar question around governance I had building on what Bob asked. In Kenya with your HIS interoperability framework you have that HIS I think you refer to it as the Interagency Coordination Committee and I know in Sri Lanka you're talking towards your your architecture blueprint but what's functioning how is it working how is the governance of this when you go from your as is architecture to your to be architecture. How is that being managed and oversight being implemented how is the coordination going what's working what's not where your pain points etc. So for example if you remember the area where I looked about the registries and the rest a good number of them are working but the issue is now they're not sharing data. And the challenge I'll be able to share you tell you previously that as we exist at the moment we have not have an enabling framework that managers knowing who works to who who responds to who we have a new constitution outlining different registries not giving us who will be the overall in charge. So some of the silos that probably have been essential for service delivery for example the Kenya master facility rates the product registry are in existence. Now how you get them to work together for that common purpose of having an interoperable thing is now what becomes a challenge because no one is the overarching authority. Everyone is independent so a lot of things are based on goodwill. So if the product people do not want to share their master list there's nothing you can do you just have to hope that one day they'll realize they need some data from you. When they need the data from you is when you tell them please give me the help of the agency in execution. So that is part of the problem that we also have to say that the governance structure and the governance of such systems. We are yet to polish it up because we have different actors managing different things. The health act as we speak at the moment as parts of it implemented parts of it not implemented. We have the Kenya data act which is established at the office. The data commissioner is now caught on some ability that will be the situation in Kenya. Maybe Sri Lanka. From Sri Lanka case. Yes, I mean we are ICT the ICT agency has been positioned really well to address it you know cross the government. But not without its challenges. We do have challenges. Especially when governments change. So we have to kind of refresh that mandate. So especially with the incumbent government they have positioned the ICT agency reposition the ICT agency and emphasize the role of ICT agency to sort of achieve the whole of government approach. On top of that along with the digital government blueprint. The ICT agency has come up with an engagement model. Right. So the engagement model that you saw there with volunteers is just one engagement model. Similarly we have engagement models to the number one is the ICT agency takes care of certain elements that is the foundational layer. So they are the entire foundational layer, the connectivity, the private cloud, private government cloud. The digital identity like you know foundational layers is completely taken care of by the ICT agency. The shared ones and the line of business ones is more collaborative with the line agencies. So therefore we have a publicized sort of engagement model. So which is well known in the in the government organizations. So that's so basically we have that future state architecture or the blueprint. So that's where we are you know sort of walking towards. Yeah. I think our participants are just getting warmed up though. I think a very, very warm thanks to everybody who's contributed. I think one thing that it shows is that we are missing the fact is, is we don't have enough forums to discuss architecture we got to make a very conscious effort to do that.