 for coming. Breno, can you see my screen sharing? Yep, we see it perfect size in landscape. Okay, great, because I cannot see what I'm sharing. So in the video, you can put the shared screen with the video side by side. I will appear in a moment. I'm basically sharing the video of my real-time lab, DHS2 lab, for the demonstration. I'm not able to switch my camera, so I'm right here. Good morning. So I'll start with what we call the reporting mode demo. So what you see is DHS2 on the mobile device, as mentioned, and as you picked up, we are developing primarily from mobile devices, because that is sustainable. And you can see these are the flagship applications we were asking about this morning, and you can see two of them, monthly stock report data recording, and then there's also one with calculations that we're not sure of today, but just for you to know that you can also make calculations. And please jump in with any questions that come up. Don't keep them to the end, and Brenner will also make comments and maybe ask some questions, because there's a lot of details that I might not pick up. So very simple. This is my pharmacy. I have my medicines here that you can see very orderly. All of them are labeled, also with barcodes that we show for the real-time mode. And now let's assume it's the end of September. And today I'm the storekeeper, and I'm supposed to carry out my monthly stock count, as we all do every month. So I'm going to select the monthly stock report, and it will bring up all the months. So you can see the months that I have made recordings before. So you see that I have not counted. Let's say I'm counting for September. It's a bit late, but my pharmacy was just open. So I'm going to first select the organization unit. You have a lot free here, but this is just because I have admin rights normally. If you're the storekeeper from my house, you will have only the option from my house, so you will not be able to edit any other pharmacy. And I'm going to now fill in my stock report for September, go to next. And it will bring me up a list of all my items. So what you can see here is we have tabs. So these are optional. You can also have a complete list of all your items. The reason we have done that is because you might have a long list of up to 300 items, and you will have to scroll down through a list. The other issue is that in DHIs too natively, all the items are sorted alphabetically. And there's a storekeeper. You don't want to mix the dressing material x-ray and lab material with your medicine. So this is a possibility of selecting them into different groups. So here we have, let's say, a group for the oral drugs and for the injectable drugs, but you could also have groups then for your dressing material and the lab items. So let's go to the oral drugs because my pharmacy does not have any injectable drugs. And you see you have a very simple table. I have a list of all my items here on the left side, and you have a list of columns for the data that we are going to collect. So in this case, you have the classical columns, the stock distributed redistributed discarded if it expires, record your stock on hand, and you can make a stock correction. So we have only one hour today, so I'll basically only show you the the short version, and that is how to collect the stock on hand. The stock distributed and the other details you will have to basically still collect it from your stock card or your batch card. So for the stock on hand, I'm checking, so I have Cloxacilin. That's the first one I'm going to count. So I'll just click on my screen. This is my Cloxacilin, and I have 5,000 tablets on the shelf. So I have counted. It's a little pharmacy, so not much to... Sorry, I just overlooked something for those who are DHS2 experts. It's because I cannot, on the 11th of October, I'm not allowed to make a enter report for retrospectively for September. There's a user setting. So let me check. Yeah, I should know that. Okay, so I'll start again. I'm entering for October. So in the implementations that we have done so far, you can actually use one until the 50th of the next month. So until the 5th of October, I can enter the stock in September because you don't want the storekeepers to enter data retrospectively for July or August. But that's a setting that you can control. So now I have access. Counting my Cloxacilin, that's easy to do. I don't know if the webcam is larger. I have 5 cans, so I put 5,000. So very simple. And then folic acid. So for the folic acid, I have a tray. I again have 500. And I have a box, an unopened box of 10 cans. So in total, I have 1,500. So I'm going to enter 1,500. So let's count another one. We have some paracetamol here. And here I have 7,000 paracetamol. And I have another 10,000. So this is a system that's proved to be really useful so that you don't have to count hundreds of cans. You just have the loose cans in the tray and all the other ones you have in boxes and you can mark them. This is coming from the supplier, so I'm sure that there are 10,000 inside. And then I have my solbutamol. That last item I'm going to count. So I have 6 solbutamol inhalers here. And I have a box of another 10. So in total, I have 16. And that basically completes my recording. Now for the stock distributed. I haven't set up my stock cards yet. So I'm just launching the pharmacy today. So I'm just going to invent something. So just for the sake of demonstration, so I'm going to enter the stock distributed. Let's say we distributed 4,000 paracetamol and I distributed 2 solbutamol puff inhalers during the month of September. So that basically completes my stock entry. So you could still record the stock received. We don't recommend it. We have just added it because it's still often done. But as shown yesterday by Pierre, if you're integrated with an upstream system, the stock received will be recorded in Medex or M supplier or another system. So no need to bother the storekeeper to enter the second time. And then the stock distributed, we give it to another facility so that it's not considered in your consumption. And then of course, if you have stock that is damaged or is expired or is recalled, then you recorded the stock discarded. And eventually, if you find the discrepancy of your stock, so there's a difference between what you have on the shelf and what you should have according to the calculations, you can make a stock correction. So that's basically all there is. We keep it as simple as possible. There's a single screen. So it's easy to train staff because it doesn't require a lengthy briefing process. In fact, we have launched the system in Somalia in almost 30 facilities and it took one hour to set up every storekeeper to brief them and to train them on how to use the system. So I'm just going to save it. That's all there is to do. So I'm not more than that. The data is now entered and available on. So I would have to synchronize important. You can set up an automatic daily synchronization, but in this case, I'm going to synchronize my data. So you might be able to see a synchronized yesterday afternoon. So I'm going to synchronize my data so that it's not only saved on the local device, but it's also on the server. As mentioned, you can also use the system offline and all your data. And once you have a network connection, then you can synchronize your data. So you could even if you have, we don't have an internet connection for several days, you still can still collect the data. Okay. Is you have any questions or comments on this so far? George, do you mind if I just make a couple of comments and then you confirm? Yeah, so first you have a prerequisite that your stores should be properly organized with a generic labeling of each medicine. So if you have your paracetamol 500 milligram, you should have a generic bar coding to identify that item at a generic level. And secondly, that you also have the stock management using stock cards and bin cards in the same way to issue and receive. And then you're using this to report digitally each month on those two points. Is that right? Just to mention to the bar code is only for the real time system that I will demo now. So for the reporting mode for just for entering for counting, you don't need the bar code. Of course, every every pharmacy should have proper labeling so that you can uniquely identify the items. Right. So a unique identifier. And then another point is that the data entry form, it can be configured both with the tabular form to split the items and also with the different items that are there. This is entirely configurable according to the number of items in which items that you have available in your store, be it, you know, 10 or 20 items or over hundreds of items. This can be entirely configured according to the requirements. Yes, absolutely correct. The system that we're using in Somalia actually have a long list, but we use the item codes then for for sorting the items. You can see some item codes here that are not displayed on the screen. So DHS2 is very versatile. There's different ways of setting this up. Natively all the all the columns are sorting alphabetically, but there is a feature called grouping that allows you to actually arrange the items in a distinct order. So that's also possible. Okay. And then a last general comment that we're looking at this as a solution for where paper-based management is being used. Paper reporting moving to a district and to a higher level. And that by having then the recording digitized, you're making the data more readily available and then being used also for forecasting and demand planning rather than waiting, you know, days or weeks or even months for that data to be made available and complete for that to be done. So this is feeding into a larger process and it's also looking at a move from paper-based management to digital reporting. Just to say that this is in essence a first step towards digitizing facilities and using a digital tool to replace a paper reporting workflow. All right. Back to you, George. If you have any comments or if you want to continue then. Yeah. I think I mentioned so offline online. I'm just checking my notes. Our recommendation is to keep it as simple as possible. So you can see that there are several columns in fact with the implementation with the Red Cross that we presented at the annual conference. We are collecting only the stock on hand and the stock distributed. Nothing else to keep it as simple as possible. And yes, just to mention that it is also possible to make simple calculations. You can look at that in the sandbox. Maybe I will not show it now. We discourage the calculations in general. We think it's better to do them in the upstream system. But if you want just to calculate your coverage time or your stock balance, it is perfectly possible. Maybe I should, I'll change my screen and I'll show you the dashboard now for the basic mode before I go to the demo of the, sorry, the reporting mode before I go to the demo of the build time mode. Okay. I'm going to just need to share my right screen. Start screen check. Okay. Okay. I'm sharing. And if you can please confirm if you can see the DHS2 dashboard. Yeah, we see it clearly George. Okay. So this is a month. This is like a dashboard that gives you some examples of what can be done now just from the data that you have just seen. This is actually from the advanced mode. So you can see this is the first table is basically all the data that you're collecting on the tablet. But you can view several months on the same table. That's the only difference, but you can have all the data. And this is really useful because maybe what you have seen doesn't look very spectacular, but it is because you can share the data in real time. So keep in mind the storekeeper already has this data on their local database in DHS2, but anybody at the district, that regional, that national level can also view all that data directly in DHS2. So here, this is a simple way if you want to calculate your stock discrepancy. So if you have the automatic calculation and the actual stock count, we're not going to do this now. The number of stockouts in a facility over a month. So this is a very useful indicator so you can see how many items at the end of the month were out of stock. And then also very frequently calculated metric is a stock coverage time. So you can see the each item by month from these six items and whether they are out of stock under stock over stock or excessive stock with a color coding. So very easy to see whether your stock is well balanced. And then this one is a bit more technical chart if you're not familiar with it. You can count the number of items and the coverage time and basically you should have a peak in the middle. So you see my stock is very badly balanced because I have either shortages or total over stock. So that's in a nutshell just to show you that there are some possibilities for some simple visualizations. But again the recommendation is to keep it, to keep as many calculations as possible to the upstream system because in all of these calculations are negative in ELMIS system and DHS2 is not really made for this kind of calculations. So if there aren't any questions we'll move on to the real-time mode. No questions Preno? Okay. George just one stock out days was not included in the data entry form. That can be configured. Yes. Why not? Yes. So the stock out days is commonly collected. I think it's cumbersome to collect the data because you basically have to calculate it manually from a stock card. But of course if that's what is currently being used, if that is a national protocol then perfectly correct. It's very common that in the data collection you will have add a column to record the stock out days. Okay. I need to refresh my browser. Okay. Any other comments? How do you get the calculation from the upstream system? You mentioned that this should be done in the upstream ELMIS. Yeah. So what we are exploring with Medexys is that in Medexys for example in Mali you can configure different reports which are based on the data from Medexys and or the data from THS2. And then you could have like a weekly report, a monthly report, this visible in THS2 in the notifications. There's also a possibility of pushing data. So you could also have a calculation for example the stock received instead of recording it. I think we're actually doing that in Mali instead of the storekeeper recording the stock received. The stock received is anyway updated in Medexys and it is then pushed to THS2. So the storekeeper has visibility of what was delivered. Great. Thank you, George. Hi dear. I have a question about why we need to calculate the stock on hand every month? Why we are not using the transaction of like calculated automatically by receiver in and out from the stock? Yeah. Thank you. I'm coming to that in a minute. So we offer both modes. So what I have showed is the reporting mode. That's the simple way. Basically replacing the paper records with a mobile device. I fully agree that eventually we hope that the real-time mode that I would just demonstrate the use will increase. But there's different reasons to offer it. It's a big step to go from paper to the real-time mode. And the real-time mode, as I will show in a minute, it takes some preparation. You have to have barcodes. You have to have trained staff. You also need a good internet connection. So it's not very difficult, but it's not as easy as setting up the basic mode. So our recommendation for the implementation is to start with the reporting mode to make sure that all the store keep, all the facilities first have tablets. I think that is maybe the biggest challenge that all the storekeepers are familiar with using mobile devices. That's also not a given. Some places, some countries, mobile devices are used everywhere in other places. Staff are not that familiar. And once you have basically digitized your first data might, then you can basically consider transiting to the real-time mode. Okay. Brenner, do we have any other questions? I think that's good. We can continue. Your replies, I'm also capturing and sharing in the Slack channel. So go ahead with the demo. Okay. So I'll stop sharing and reshare my other screen. So I'm pretty sure that you can see the real-time mode up right now. Yeah, we see it. I think that's as large as it gets. Go ahead. We see it in full formats. Go ahead. Okay, great. So that's as large as it gets. If I maximize it, it will cut off on the side. So you will see the space on the empty. So this is, I can't say it's a prototype. This is a fully functional version of the real-time mode. So exactly as was just mentioned, why not record the transactions? That's the right question to ask. So this is the system that we presented during the annual conference in Oslo that has been developed by Power Systems implemented by the Red Cross. And that is now also available in the sandbox. So you can connect, you can install the APK file and connect to the sandbox and exploit yourself. And this is the basis for what is being developed by the University of Oslo. And we hope to have a prototype in April next year. So again, we keep it very, very simple. I'm sure you will have opinions that you can think of. If you do write them in the chat window, we are just working on the development. So we will be happy to include anything that we might have missed. So I spear the login with the credentials, which works as usual. So here you have three possibilities. You can either distribute goods, which is hopefully the most common use case. Distribution means that a storekeeper, a nurse will come once a day, once a week, once a month, depending on how the hospital or the clinic is managed. With a list of items can be a pre-printed form or handwritten form to the pharmacist with a request to prepare those goods for delivery to, let's say, the operating theater, the outpatient department. And the storekeeper, the pharmacist, what they do, they in and they out is that basically go to the shelf, pick the items and prepare them and then deliver them to the ward or somebody comes and picks it up. So this is basically the use case this is made for. Then you have the possibility of discarding. Obviously, if you have goods that expired or are damaged or are unusable for whatever reason, you need to discard them and you don't want to include them in your consumption. And then finally, if you find the discrepancy between your stock that you have on your shelf and the stock as recorded in the system, then you need to make a correction to reconcile them. So there could have been mistakes or less was delivered or more was delivered than indicated on the packing list or some goods were misplaced or many reasons. So I'm just going to show the distribution. So you have to select the transactions. I'm selecting distribution. And again, if you are the storekeeper with the user rights, the native functionality in DHS2, you can control that normally a storekeeper will have access to only a single facility. In that case, you don't even have a dropdown menu. The transaction date will default to the day. And now you have a customizable dropdown menu where these goods are going to be delivered to. So let's say I have today received a request from the patriotic department because in addition to just recording your transactions in and out, you also want to know at the end of the day where you have distributed these goods to, because that is also recorded on your stock card. And eventually the system is supposed to replace your stock card, not your batch card, but your stock. So that's all I need to do. Basically select distribution and where I'm distributing to. Then I'll go on proceed. And now I have three possibilities. I have here, this is a list of all the items that you see in the pharmacy here, these 11 items. And you can see the current position. So I can either make a search for the item. So I could search for paracetamol, for example. And then I will find paracetamol. So I don't need that if I have 11 items, but let's say I have 300 items I could search. But of course that's cumbersome to search every time and very time consuming. So the second option I have is to scroll up and down my list and to find that item. But that is also time consuming. And it is prone to error because you might find your item on the list. But then you might be typing in the wrong, I might be typing in the penicillin row instead of paracetamol. So the preferred way of using is this to scan the barcode. So I'm going to now, for example, pick my albendo sol, which is the first item on my shelf. So I'm going to select the barcode scanner and it's scanned the barcode. So you can see it says albendo sol. And the first benefit is it already shows you how much you have, should have in stock. Of course you have that on your stock card also, but now you have it on the screen. So I'll take out the tray. So you can see I actually have 3000. And let's say I'm going to pick 2000, lost the lid. So I'm going to actually take my bin here for the patriotic department and put 2000 in my bin. So yeah, I should say I should enter 2000, of course, to record my transaction. And what you can see on the screen is that it's calculating the remaining stock on hand in real time. So you can see you had 3000, you pick 2000, 1000 is left. And this shows you already one of the big benefits. In principle, you don't need to count your stock at the end of the month. Now you're going to be shocked because we have all been doing that for all our life. And you have to count your stock once a month. So if you were never to count your stock, then eventually you will have a lot of discrepancies and you will never find out. So this is a clever system that is called residual batch counting in the textbooks. Very simple. In this case, I have only 1000 left. And you don't have to do a lot of counting. You can see 1000 is left. So my stocks are correct. Of course, it doesn't always, it's not always that simple. But every time when you are like finishing your bin, and you're opening a new box of 10,000 or 60 or 100, you can always do this batch counting. And it has a big stock count. And it has a big advantage that if there's a mistake, you will detect it immediately. Because at the end of the month, if you have a discrepancy, very difficult to find out what went wrong. Okay, I'm going to move on. I'm going to select my next item, which is my chlorhexidine, a little bottle. So you can see barcodes are not perfect. It happens sometimes I have to still improve my barcodes. But yeah, no computer systems are perfect. Again, I have six chlorhexidine here. So this is actually an empty box. It should not be here. I have six bottles and I have a box of 10. So I know that I have 16. And let's say I'm going to take three of those bottles. Ready for delivery. Again, you can see 16 were there. I take three. That leaves three. 13 plus 10 residual balance counting. So I'm sure my stock is correct. Might be more difficult in a bigger store, but it still works. I can also have good some pallets or okay, I'm going to take my paracetamol. You could also have good some pallets that are counted. So paracetamol, I have 10,000 in the box and I have a tray of 17,000. I'm going to take it off so that you can see. And let's say I'm going to take 2000 of those. Okay, so that leaves 15,000. Again, I don't really have to actively count 10,000, 5,000 are left on the tray. You can easily see that without really thinking much about it. Okay, let's say I completed my count now. I don't know if you can see my tray. Okay, I have a basket here with the goods that I collected. So normally what you will do is you will take it to the dispensing place and you're going to review what you have counted. So you can see the basket, but I'm checking. I have 2000 albinosol, three chlorhexidine and 2000 paracetamol. I can still make corrections. I can delete. I can change the numbers. I could add items, but everything is correct. And I'm just going to select confirm. And I can see here you have a little line all the way on the top of the in the middle of the screen where it says recent activity. You can see patriotic department, 11th of October 1052. That's my local time. That transaction was completed. It's not giving you the details here. I will show it in the analytics, but you see that the record was recorded. If you have an internet connection, you should still synchronize the data so that it's on the server and you have a backup in case the tablet is damaged. Any questions so far? Your comments. I think you can continue for now. We can take a few questions afterwards. Okay. So live demos are a bit risky or very risky, but I'll try it anyway. It might not work. There is one more feature that I have not shown so far. It's a bit shaky honestly, but it does work. So you can see I'm going to use a microphone entry. And the idea is that instead of typing the quantities, it would be easier to just dictate the quantities because you would not have to fiddle with the online keyboard. So I'm going to try this for one or two items. Okay. I have not selected a transaction type, so it gave me an error. So distribution. So let's distribute to the inpatient surgical department this time. And I'm still in my household. Okay. So let's let me see. I'll try the Croy-Xellin again. It didn't work. Three. So you see it didn't, it doesn't work every time. It needs to be improved, but you can see that in principle it worked. So I didn't have to type three. I just dictated it. And the speech-to-text recognition converted my speech into three. And you can see I had, we had 13. And if I pick three, 10, or left, that is correct. So I'm going to stretch my luck and try once again with the Croy-Xellin barcode. I need to improve the lighting. Okay. It's in principle working. 2000 worked perfectly. So I have dictated 2000. I should have shown that I didn't use my hand, but maybe you saw it. And 3000 are left. So I can use the review. And you can see that basically I have entered those two items just by dictating without using the on-screen keyboard. So you can use that in the same way. And I will not confirm that. I'm hearing some background noise. Okay. So actually I'll confirm it. So maybe just a short comment on what we're looking at in the future. So you have seen this is, this tablet PC is quite convenient because it has a strap in the back. And I can just hold it in one hand and move it around. But still we have tested it is actually two years ago in Aden, in Yemen. And if you're a storekeeper and you have to move a tablet up and down all day, this can be quite cumbersome. Also you have to catch the barcode. Fortunately, this application also works very well on a mobile phone. So normally I use my mobile phone, which has a small screen, works perfectly. It's much easier. But there are some gadgets that we're thinking of using in future. So one of them is this little barcode scanner that you case. It has the size of a ring and it has a little button on the side. Here is the yellow button. And this one works like a scanner that you would see in the supermarket. So we're thinking of connecting that cost maybe $30. Requires a Bluetooth connection that might be fiddly. But what basically mean that if you can hold, if you can have the barcode scanner in your hand, in one hand, and you can use the voice recognition, then you have both hands free for picking, you can work because you can still use that hand while you have the barcode scanner on your finger. The other option is to use a kind of small endoscope camera. So this one you could also just strap to your finger and then connect it to a USB. And no promises made, but one idea is to use one of these cameras that you can buy like for $30 that have a camera built in the sunglasses. And then basically you would just put on glasses and use the camera that is integrated in the glasses for scanning the barcode. So I think that basically concludes the demo unless we have some time for some questions. This is great, George. We have a question from Robert Mulder who's asking if it's possible to have some analytics already in the app so that you don't have to go into the web to actually see the data. That's an excellent question. So actually I'm going to show the, so the short answer is that the current version, the recent version of DHIS2 features the local analytics, which is really a fantastic, great enhancement. There are some limitations on the visualizations that can be used, but it really works very beautifully. So we have definitely planned to integrate the analytics into the future DHIS2 application. It will probably not be available in April, but we are thinking of, we're planning to have a second iteration. So hopefully in October next year, you will basically have a little button at the bottom of the screen where you can switch between data entry and analytics and you can basically view your electronic stock card directly on the screen. Does that answer the question? Yeah, that's great, George. And then there's another question or perhaps a general comment, but if you can say something also that the monthly reporting of pharmacy is a great feature, but it depends on accurate entry, accurate dispensing to get an accurate report. Okay, that's a very good point. I think it's important to realize that digital systems are not a panacea and we think that they are a big improvement. You can share the data, but at the end of the day, you are always entering, it's always a human entering data, and there's no system that will ensure that all the data is correct and mistakes can always be made. So I think there's no, there's no digital system, especially in logistics, that can ensure that all the data is correct. If you have an item that is missing in a box or if a box is not counted or not scanned, then your data is still going to be wrong. But I fully agree with the comment and it's important to keep in mind that digitizing your first data my land, providing tablets and the digital solution is only a small part of the whole process. And definitely if you don't have good processes in place with your storekeepers, if they are not well-trained, you know, qualified, motivated, and if the data that is collected is not accurate, then you will not have the correct numbers that's not certain. All right. I think those are the questions that we received in the chat, George. And I think that this is really great that you demoed this and showed how this works. So both the aggregate stock reporting and then the transaction-based real-time stock tool. I think maybe I could just make a few also summary points and you add something. Just hold on. I still have the analytics to show. Sorry. I forgot. I'm just, I don't know. Okay. Let me, I don't know. Brandy, if you can run the analytics tables because I'm having problems to access the menu. I don't know why. Yeah. And that's in the meantime. Thanks a lot. Okay. So let me share my other screen again. George, why don't you just, if I can add, because there was one of the previous questions that there's no need for you to have the web to see the analytics, it will be built in. So George is showing this now, but this will be something that's available within the app. I'm having problems with the database. I'm kind of disconnected. Not seeing the report that I had open on the screen. I was kicked out. So I'm trying to connect again. I don't know. Brandy, are you connected to sandbox staff and could share your screen because you're logged into the demo account. Yes. Thank you. That's all. Okay. Okay. And of course, I need to synchronize my device. I forgot. In the meantime, I will show the line list. Okay. Now I got it. Do you want to just quickly show the app? You're still seeing the line listing, right? Yeah. Can you just show where you went to the menu and what the app looks like for those that are new to DHS2? I know that this is a pedantic for those that are familiar, but for those that are new to DHS2 that they see you go into the apps menu and then you have one specific app called line listing. So that's what George is using now. So what you can see here is basically the digital electronic stock card. So you can see here a list of all the transactions that were made. You have here the date, the item code, the item description. So this is the and you have the quantity that was distributed and you can see where it was distributed to. So you can also, of course, have a report then of all the stock that was discarded or that the corrections that were made. So you have more of reports like received. You can view your current stock and you can also see the distributions for that were for each word or service. Here's a table with basically the complete tracking of all your stocks and the stock on hand. So you can see now the system has refreshed and okay, it's only showing the corrections that I made in the morning to prepare for the demonstration. So I don't know. I'll try to synchronize again and we might see the the distributions that were made. So in the meantime, any questions on that, on the reporting? I have two more questions coming in, George. Can you hear me, George? Yeah, I can hear you. Yes, please. So we have two more questions coming in and also analytics related. How can I group the supplies that I want to download from DHS2 for quarterly reporting? Okay, sorry. I'm not really getting the question, group the items in what sense? Would that be in a monthly stock report on the dashboard? So I wonder if this is related to be able to customize a quarterly report with the specific items that they want to see. So this is coming to the design of a specific visualization. So it would be defining which products you want to see with which data and then having this being reported on for a quarterly period. So I think this is something that's possible to be built. We have a next question. Yeah, go ahead. So you can see here, this is just examples of the visualizations that you could create and it's highly customizable. So you have here months, you could have this by year. I think quarters are also available. It's just a matter of changing the period and it is possible to flexibly configure this kind of visualizations and tables in any way that is required. Great, Prena. Yeah, and then if it's possible to get the metadata for the LMIS forms and this, yeah, go ahead for that, the metadata for the LMIS forms. I mean, I don't understand LMIS forms. You mean to export the data generally? Is that the question? Sure. And the data entry forms, I assume it's referring to, right? Yeah. So the data, all the data that you have in the system, it can be, it can be exported with the import export application, which is native to DHS2. And otherwise, it's also accessible through the API endpoints. If you had a reporting system. Yeah. And this is from Jamal Aljaddan. And I can also add that when you go on to the sandbox site, you can export the metadata using the import export tool. I'll confirm if that's available actually for the demo account, but it should be so you can actually access, you see it there on the left of the screen that George is sharing under the apps, import, export, you can export all of the metadata in the way that it's configured now. You can also configure this in change to add or remove metadata. One of the aspects and George has said it here now is having only the essential data being captured. That's what we're promoting to have only key data, but you can of course add and change that configuration to add more metadata if needed. And then I have a question, which I think is a quick answer. Why are there amounts with negative values? And I think one of the line lists you showed, I didn't see that, but this is a demo. Very good question. No, it's actually a very good question. There are negative values. So actually the way it works is that negative values are prohibited in the distribution and the discard module. But of course, when you make a correction, you can have positive and negative values because you could have stock missing on the shelf or you could have too much on your shelf. If you have too much on your shelf, then you will have to create, you have to enter negative values in order to adjust your stock. So you have seen negative values as possible only in the stock corrected. And you can see here that here a stock correction was made to adjust the stock. So it is definitely positive. It is definitely possible to have negative values for the stock corrected. Correct. Great observation. I think that's it for the questions we have so far unless there are more coming in here now. Yes, there are. All right. So while computing, save the average monthly consumption of a certain commodity. The issue of patient numbers, number of patients consuming that commodity comes into play, especially affecting the stock levels under over or normal stock. Do we have some hints on how this can be handled? Also, this helps inform the redistribution process. Can this be held within the DHS2 dashboard or we would have to link to another system? Good question. So we have basically, we have prepared for what is commonly called triangulation, so for connecting to HMIS data. Our recommendation on the forecasting, I mean, DHS2 could do some very simple calculation like multiplying your average demand with a certain number, but it would be quite difficult to consider patient numbers. Our recommendation would be to collect the patient data, also in DHS2 in one of the HMIS packages, I think there's 40 that are available, and then provide that data to an upstream LMIS system and do the calculation in that system, like we have seen with Medexis or M-supply. But DHS2, the main objective of the facility level stock management tool is just to collect data and to keep track of your stock. But as we explained yesterday, the data model is not really suited, so we don't recommend to try to make any of these more complex calculations. And now, does the Pharmacy Stock Management app store the data collected directly in DHS2 instance? If no one assuming the app is storing its data someplace else, what was the chosen approach in mapping required commodities metadata from the app to the corresponding attributes or data elements in DHS2? So good question. We have a section on the configuration after the break, so maybe we can go into the detail. The short answer is that the app is fully built on a native DHS2 tracker program model. So it is just the user interface that was customized to reduce the number of clicks, but everything behind is just data elements, option sets, tracker program. So it's all native in terms of data model. Right, and that question was from Rajab and we'll be going into this as George said, after the break. So we'll see a bit of how this is done. And then I have two more questions actually. They're coming in often here now, George. So we have a question from Abdukadir asking, our LMIS Month of Report Tool is not grouped by programs. If I want to get one program commodity, how can I get that easily? For example, TPE or HIV? Good question. So this is very common actually. So I have shown before you had you would have different options. So you could either have separate data entry forms for each of the programs like TB, HIV, malaria, and just have separate lists, which are managed separately. Or you could have like you, if you remember, you have seen the tabs on the top of the screen for oral injectable drugs, you could also just have separate tabs. So you have different ways of resolving that, but definitely it is possible to collect this program data separately. Great. And then we have a question from Paul, who's asking, is the metadata available for the pharmacy stock management for testing? And actually, I have a few comments on that before, George, if you want to add something, but so this tool is a prototype that we're sharing here now and George is using. It will be integrated into the core for the April 2023 release. You can't test it, but we'll need to make the APK file available to you. So the code is on GitHub. And if you can compile it and create this, it's fine. But we'll make the file available on the Google Drive. And then you can connect it to the same sandbox server. And you can use the metadata that George has shown. So it's really already configured to that app. It won't be as easily changed as the aggregate, but you can test and do the same different demos or processes that George showed you here. All right. So that I will share in the resources folder. It's not there yet, but we will make it available. All right. There's a hand raised in the Zoom call. I don't know if that question was taken. Yeah. Go ahead. Yes. Can you hear me? Not clear. Okay. Okay. Yeah. And my question is about the line listing. Yeah. When we look at the pharmacy, especially where I am, it's also done in some busy hospital. Actually, the hospital, all the hospitals have pharmacy. And then we have also dispensing unit. And then the dispensing unit is where we consume these drugs. So I don't know for the line listing, what is actually the real target? Do we only record this thing at the pharmacy? Or do we also go down to the dispensing unit? You can record this. And then the second question is actually relating to the line listing. If we, is it going to be a real time, the time you issue out the drug to the patient, and then this is where you record? If so, I think is it possible also maybe to include a few variables on the patient? Because to do for accountability purposes, you may find that you may be recording what you have issued twice. If we don't have a unique information about the person you are issuing the drug. So these are the two questions which I wanted to raise. Thank you. Okay. Thank you. So my answer is that concerning exactly where you're using this application, you could use it at the central pharmacy or the point of dispensing or at both points. You would have to look into that whatever you want to record. Concerning including patient data. So we are not planning to include patient data. We realize that there's a kind of gray area to an electronic medical record system. Or we think that you already have double literal metadata packages, where, for example, the male malaria package, where you are including the medicine distribution. So any information, any record which considers patient data would basically have to be done in another system. We are not planning to integrate that because that would start to become really complicated and too complex. This is really intended as a tool solely to manage your medical stocks. If you want to go beyond that in terms of recording what drugs were given to what patient, rational drug prescription and all of this, you will need to look into an EMR tool or electronic patient registry tool that is also available in THS too. Are there other questions? Okay. Yes. Sorry. The second question was whether this will be real time. Yes. The answer is it's planned to be real time. I'm missing one of the items that are distributed. I don't know why. Maybe I have to synchronize my tablet again. But in principle, you can see that those items that the two items are distributed by typing and with the voice recognition to the inpatient pediatric department, those two distributions are available on the server. You just have to synchronize device, run the analytics table. And yes, we are definitely planning to have this in the local analytics, even if you're offline. We have to see whether that is possible, but eventually we're aiming for that so that whenever you complete a transaction on the mobile device, even if you're offline, then you will be able to see a complete record of all your transactions. I have one more, one last important comment. I was just checking actually two, three, my notes, speaking notes. So first of all, you will be asking, so if you can record all the distributions, then eventually you're going to receive stock in your pharmacy and you have to update your stock on hand. So what we are planning to do is there will be three possibilities. So first of all, in the native THS2 app, we plan to have a receipt mode so that you can also manually enter goods if you're not connected to an upstream system. The second option will be to receive your goods through the bulk load application that is currently available. As mentioned, this is a conventional native tracker program. And there's one data element for the receipt and you can basically just fill in a number in the web portal and that will add stock. And the third possibility that we are have implemented with the Red Cross project and we hope to pilot very soon in Somalia in Nigeria is that you have THS2 app like we have developed for Mali, that when you receive a consignment from the district store, you will scan a QR code and confirm the receipt of the consignment and then all the items and the quantities that are included in that packing list, they will be automatically added to your stock through an API endpoint. The second comment I wanted to make is the frequent request is to manage batches. So this version is not able to manage the stock at the batch level. We are planning to develop a future version that will allow to do that. But we do offer an elegant workaround that we are also testing with the Red Cross in that if you are connected to an upstream system and you have an updated stock on hand and you are strictly applying FAFO, then it is possible to deduct the exact quantities, batch numbers and expiry dates of all the batches in the pharmacy from the upstream record without counting anything. And the last comment I wanted to make is what is next. So we are thinking of a future version, maybe to be developed in 2024 that will allow the user also to scan GS1 data matrix codes on secondary packaging and that would allow then a full batch management mode because the GS1 data matrix code includes the product number, the serialized number, the batch number and the expiry date and then you would have complete management at the batch level, including giving a warning to the storekeeper they have selected the wrong batch if they are not following FAFO. I think that was all my speaking notes I wanted to mention. Are there any other questions? I think that's great George, that's a lot of content in a short time and to remind everybody we'll go through the configuration after the break. We have six minutes until we take the break. So what we'll do George, we can maybe do a quick summary, I'll do a quick summary and we can just, if you have a very important final point to give it there, but we'll try to stop right at 11.30 on the break is planned. The one last question we have here is in one comment from Paul, will I be able to migrate from the malaria WHO, ELMIS metadata to PSM? So it's great that you've applied and used that configuration for malaria and if you can migrate that in principle it should be possible but we haven't had this request yet Paul. So what we'll do is what we can reach out to you and follow up directly to see how that could work but in principle it should be possible. And then we have a comment from Leitzen who says that he would like to think that DHS2 fundamentals so capture events analysis configuration comes in handy on the DHS2 ELMIS integration and I replied and it's true we're focusing on the ELMIS features and the use case but it's entirely relevant, important, essential to understand DHS2, the landscape, the collaboration with the core team within your country and where it's being implemented. Good connection with the HIST groups that are supporting and are the real experts of the software like I've said all of that is essential to this it's not even though we're only focusing on the ELMIS. Now if I do a quick recap here and please come with more questions and continue to engage with us we're very happy to see the level of engagement and very good questions I think throughout but I'll just quickly do a summary that the focus here and what we're proposing is when we're looking at different levels of tools that are available at this facility level and oftentimes a paper-based management which can be fine it can be well done and it can be accurate however that data is oftentimes not readily available for decision making and for informing central level decisions particularly forecasting and demand planning to name one example. So we're looking at how do you move from this paper-based to a digital to a report-based to a transactional based in that you have certain different levels of digital evolution if you want to call it that and we're proposing then these two options. So the first option being the report-based management where you're still doing your using your stock card to manage the quantities that are coming or going from stock the amount that you've issued from stock and at the end of the month you make the report through DHS2 and that data is immediately available digitally. So that's kind of a first step and the first option that we proposed secondly it's the transaction base so it's the real-time stock app that you're managing each transaction from stock and if you have a daily synchronization with the server that data is available each day so you know the stock positions in all of the different sites all right. So report-based and transaction-based these are the two options that we propose now where should this be implemented as George said it's in the final medical store we're not capturing the issuance to patients but rather the last exit or the last issue from the last store in the last mile and that's what really we're targeting when also we're proposing both this aggregate or transaction-based solution. When it comes to the real-time stock tool so the transaction-based stock tool as I said I'm not sure if I said it or if I wrote it in the in the chat but we'll make the prototype available that's what George showed to you here now and then we'll also I'll put a link it's already in my presentation from yesterday but I'll reshare the link on the mock-up of how this will look once it's integrated in the DHS2 capture app so in the April 2023 release so the software release for that scheduled for April we'll have this as an integrated feature in that app so that it's native and you'll see how it will actually look it will not look like what George has shown you here that that is really a prototype it's something that was developed for a different organization but we'll have this integrated as part of the app and it will look and feel and you know function like the regular DHS2 app if you're familiar and have used it before. There are questions about reports and analytics in as a general point that there are native analytics features both on web and on the mobile and you have local analytics which will allow you to also have them available offline you can see your line listing so it will give you your digital stock card when you're using the transaction-based tool so all that will be built in and again it's part of making use of existing features within DHS2 it's not something that we've pushed or had only built for the LMS use case but it's used for other purposes and this is just available to you when you use that app and then some of the other analytics related questions were more based on an actual implementation so if you have the need for a specific program a specific metric or indicator for a monthly or quarterly report a specific type of visualization that should be part of an implementation process where you define the analytics requirements the analytics products or outputs that you need and then that should be built there. We'll have a session with Scott Russ Patrick who's our analytics product manager who will really go through the full feature set for DHS2 and then we'll be able to see what's possible but from that you should choose okay this is what's relevant and important and essential for me to have for this user at the central level or a district or a facility level that they should be able to see and have this these analytics available and then the last point on that and again connecting it to another session we'll have on performance management and George will present this performance management framework that we also recommend what data should be available to whom and in which system again one of the replies I gave that it should also be targeted to say this data should be available to this user for this type of corrective action that it's not simply showing visualizations for the sake of having them but that it should be actionable data connected to some activity or some corrective action that will remedy a problem or a situation all right and then finally my last kind of summary point is that for both of these so both the report based or the transaction based option there is the question of integration they can work on their own and you can collect data and report or manage the transactions but I think the full value and the value added will really be integrating with the central level tool it will be adding workflows and automating workflows that you would otherwise do manually and you would also make data available for decision making like forecasting and demand planning which I've mentioned multiple times to the central system and central tool which will improve then the quality of the supply management and health program management this is really what we're looking for so you can implement these standalone they can help they will digitize the facilities make data immediately available you can triangulate data with health data however with the integration with either of the options which is then an additional again a step you will get even better value with having data available and having this end-to-end solution which was mentioned multiple times so that is the summary and just sort of putting this very specific these very specific features into kind of context into the greater context we'll take a break now for 15 minutes and we'll come back and then look at a configuration how this can be actually implemented all right so thank you everyone see you back here in 15 minutes continue yeah thank you Simona for the help and we'll continue with the then configuration of the of the two different stock reporting and the transactional based stock management options that we showed today that george demoed so we'll actually go through some of the configuration aspects of it and we can discuss the why and why not so for those of you that are new to dhs2 some of the terminology may be you know unfamiliar and this is perfectly normal it takes some time to get into and we'll try to clarify that so feel free to ask and here you may have a lot of small questions about you know what is a data element and indicator and so on so just ask these freely for those of you that have a strong dhs2 background there may be different considerations of why we do it this way and not another way there are multiple ways we could have chosen and I think originally there were over 12 different ways we could have configured some of these different stock data and we came on this so if you also have criticisms and reflections please come with those because we want to clarify why we chose this and why we think this is the best option keeping in mind usability for the storekeeper that the person conducting the data entry the integration aspect of it and also analytics so there's some questions and some things to be explored there so actually before george i hand over to you i will share the word of the day let me know if you can if you can see that so the word of the day is actually two words bubble wrap nobody has asked that yet in the in the channel but there you have it so two words bubble wrap use that for your attendance and george will then hand back over to you to continue with the configuration where i've changed my webcam i had a short comment on the real-time mode just to mention that you have seen that you do need barcodes but no worries so those barcodes can be easily printed natively in with an xl file so i can also provide an xl file you can just type any kind of code any text that you're using for a copy paste a list and then just print the the labels that you have seen with the barcode and the description it's kind of preconfigured and then attach it it is some work to do but it's like one-off so not a big deal okay i'm going to share my screen screen share okay my screen sharing is disabled i don't know if there's a can be activated i'm trying again no i don't know is simona is still in the color i don't know brenda do you have a present present this right you should be able to okay thank you i had to reconnect to my to the calls disabled again okay i'm connected and sharing my screen my window brenda can you see a powerpoint presentation yeah this is perfect george okay looking under okay looking under the hood so as brenda mentioned we have a great variety of participants with different specialities and expertise so some of you i guess are much more experienced in dhs2 than myself others are quite new so it's a bit difficult to address anyway also keep in mind that everything that you have seen today and that all the demos that you will see have been actually configured by brenda myself so we do master that with lots of help from numerous people but we are not dhs2 experts so i hope we can answer some questions but maybe not everything but again the his groups in the region those are the rare experts who work on configuration and implementations every day and they will i'm sure be able to answer all the detailed questions so very briefly in a nutshell maybe i have only this one slide just to instigate some discussions some questions to basically present very briefly how this is built so the reporting mode the with the tabular data entry it is very simply what is called an aggregate data entry form in dhs2 it uses category options for the columns as brenda has mentioned we have explored like a dozen different data models models and the reason we have chosen the category options it has nothing to do with sorry it's not ideological in any way it's very simply because as we have stressed and you correctly picked up yesterday we are building all applications for mobile devices and happens to be that the aggregate data and performance category options is the only way of displaying columns on a mobile device so custom data entry forms do not render on mobile devices and there's no plan to make custom data entry forms available on a mobile device so that's the only option the other option would be to have like separate forms for the stock on hand and the the demand or the consumption that would be kind of cumbersome it's obvious that you would want to have that in a nice table and as i presented you have some standard dashboard stock outs coverage time that you can view in the in the sandbox maybe just to show something briefly concerning simplicity so the going back to the to the Red Cross project that we presented during the annual conference they have opted to collect only stock distributed and stock on hand and to include the interest level which is the order up the level which is presented to the storekeepers they can't edit it but they can view it so you see the this is really according to the philosophy of sticking to the essentials and collecting only the data that is absolutely needed everything else could be calculated in an upstream system so this is basically a choice you have for the implementation and then for the real-time stock mode it is a native tracker program by the way so the reporting mode it would take me about one hour to configure this somebody from with a lot of teacher experience could probably do that in 20 30 minutes the real-time mode is a tracker program also takes about maybe one hour to configure and to end the items so the the medicines are tracked entity instances which have to be entered separately um so what we are recommending and planning to do is that the real-time mode basically has a list of all the transactions that you have seen in the line listing now the paradox of the real-time mode is that while you have all the transactions and you have your current stock on hand you might also want to know what was my stock on the 1st of January and this you cannot easily have natively in the line listing so what we are thinking is of combining the tracker and the aggregate using the tracker to aggregate by creating monthly snapshots so you would basically record all your transactions with the real-time app and have them in the line listing but in addition automatically running the background once a month your stock on hand the total aggregate monthly demand and other data you would want to collect will be automatically saved on an aggregate data entry form so that you can provide the usual statistics and reports and also to mention that his center at the University of Oslo is working on a bulk management feature for the tracker program which will allow to upload and edit a large number of tracked entity instances as well as transactions so this will allow let's say you could register a long list of items if you started using the real-time mode rather than having to register them one by one and as I mentioned you also need to receive your stock so the bulk management is one of the tools that we foresee that if you receive a consignment and you're not integrated with a national enms but you have that data in some shape or form on a csv file then you could basically just bulk load it into dhs2 in in order to update your stock on hand so that you don't have to record every item one by one because if you're receiving a full truckload of medicines at the hospital you don't want to have to record each line separately and into the quantity and then it's important to mention that for either of these we don't offer the usual dhs2 packages that you may know from from hms from the WHO packages one of the main reasons is that there's unfortunately no global convention on item descriptions and if you were to upload a package it would obviously have to include the medicines or the healthcare products that you are managing and then it would not be very practical to upload a catalog let's say what we have the what we're using in our live project with the Red Cross you upload 700 items but then you have to go and change all the item code all the item descriptions so this would have to be anyway customized and that's why you need a project also there's quite a big chance that the the columns that you're using the category options will be customized so it's probably since it takes like half an hour or one hour to configure that it's probably not worthwhile to upload a package and then to edit you might create it from scratch but we have the detailed configuration in the in a PDF file that is linked to our website and you can see exactly how this is configured and you can easily customize it so that's my notes and now I will stop sharing my screen and change to back to dhs2 and either take questions or if there's no questions just run through quickly the the screens in dhs2 how the configuration was made George there is a question in the chat window so in case you have any George do you hear me? I can hear you yes please there is a question kind of going back to the line listing app used in together with the real-time stock tool from Tara Richards can you just expand on this so just if you can recap how the line listing connects to the transaction mode okay let me open it let's keep the window okay I'm going to go back to the line listing and open the distribution report okay so the line I'm not sure I understand the question correctly but the line listing is basically simply a record and representation of all the transactions that were made using the app so you can see here that this morning yeah I distributed those two items once with a keyboard and once with a voice recognition so those 2,000 clocks of Celine and the three bottles of Prohexidine they were that was the transaction they were distributed distributed to the pediatrics and the inpatient ward and that is basically reflected and then you can create various reports so one for the distribution one for expiry for the discards one for the corrections and you can have also report by department that the deliveries were made to but I'm not sure that actually answers the question yeah we can confirm if Tara just comment if this is not clear if there's something else you had in mind but in principle George this is replacing your physical stock card so with the report based you're still capturing you know on paper the transactions and your report at the end of the month whereas here each transaction is managed by the app so if you want to see what's been done you would go here and see the specific transactions as George said right so that's the in a nutshell but let us know if there's something more okay are there any other questions that's it and she confirms that this is clear so we can continue George I'm going to start with the reporting mode and then this is just to prompt questions because I don't want to go through the whole creation in detail that might be too boring but if you have any questions let me know so back to the reporting mode basically also for those who are not so familiar with THS2 on the web this is the THS2 web portal again you can see the data recordings or the simple data collection form that was used this morning so you have the items you have the tabs as I mentioned that is optional otherwise you could have a list of all the items but you can group them in different ways so we also had a variation it's not it's not in this database where you could have tabs one for HIV TB malaria so for the for the different programs depending on on the use case so this is the way the screen looks for the data entry then the way it is configured is basically there's just a data set so very simple so this is like basics of THS2 so you create data set you give it a name something meaningful so like a monthly stock report as I mentioned you can indicate how many days you can after the end of the month you can still enter data as I mentioned I failed because I wanted to enter data for September but on the 11th of October I could have entered data only up to the 5th so this is a great native tool because that way you prevent inadvertent entries in previous months but still if the end of the month is a weekend or a holiday you still allow for a few days for completing the the stock record otherwise you have different configurations as you can see here render sections are stacked that's exactly the feature that gives you the tabs and then you just add the add or remove the item so this is really highly flexible if you want to add let's say the medical form you just select it and move it and it will be added to the data set I will not save it now so you can see that this stage entry form now contains 51 items and the catalog contains in total 722 items and then you can maybe this is an important point so you can create a data set that applies by default to any facility for any program or you could have I'm going to cancel this now because I don't want to save the change you could also have a dedicated data entry form just for the hiv program or just for the tb program to do that separately and you could also have a customized data entry form for each of the facilities so that's easily configurable so that's what is used for the Red Cross implementation but keep in mind that if you have hundreds or maybe thousands of facilities and you have customized stock item lists for each of those facilities this is going to be a lot of work to maintain them so if you can if it's possible to have like a default list for malaria or tb program then that is probably preferable because you don't you don't have that much work in terms of maintenance and then finally to come back to these categories so for those who are familiar you have basically you have the different category options which you create one of very simple to do you have the stock on hand and the stock distributed for example those are the main ones and then from those you create a category by adding you can see these are basically all the columns stock received distributed redistributed in the order that appear on the screen in the data entry form on in the web portal as well as on the mobile device and you can easily add or remove them and then just save so this is straightforward and then the category combination is needed that's a technicality in that case because we have only one level of categories and you just create the data collection form with the same category option to create a category combination and then dhs2 in the background is going to automatically create a category option combination and that completes your your data set configuration yeah maybe I can show us on the data set because that was this question on the grouping so let me go here manage sections so you can see what I have done here is in order to have these tabs with the items and again within every tab the items stock items are listed in alphabetical order all you need to do is to create what is called the group very easy to do and let's say I have this group of the oral drugs and here you can customize exactly which items are appearing on the list and as I mentioned natively without groups the items are always sorted in alphabetical order but here you can actually change the position so you're not if for some reason you want the items not to be in alphabetical order you can do that and in reference to an earlier question so instead of having groups like oral drugs injectable drugs so this is based on the convention that is used by msf doctors with alportus in the red cross as adopted but you could have likewise you could just have a group called malaria hivtb and you can easily create another group remove a group you can open a group and just edit and then add remove items you cannot add one item to two groups but if you remove an item from one group you can move it to add it to another group so very flexible to custom and versatile to customize to your needs so I think that's unless you have questions so brand new you can think of anything else that we should mention for the for the reporting mode I think that concludes what I will not go ahead sure in essence yes I think you went through quite well again for those that are DHL is too conversant this might be just rehashing what you already know however there's clear reasons why we chose to do it this way and for those that are new to dhs2 a lot of the terminology and running through the maintenance app so the maintenance app is where the configuration is done for these different the data elements the data sets and so on so that's the tool that george was using if you see it there in the top right in the apps menu so this is something that the terminology may be new but you understand what logistics data you want to see and this is how you're represented now just one or two things that I think we really need to solidify george is for example you mentioned it I know but I just want to repeat it that the custom data entry forms one thing we've seen and heard in multiple situations is the desire to have the data entry form look just like the paper form we've been using this paper form for years it looks a certain way it has a certain you know a way that it's configured and we can reproduce that using a custom data entry form and that can only be used on the web version the reason why we discourage that we do not recommend it is that it cannot be rendered on the mobile device and there's no plan for that to be done secondly it's also oftentimes a very large form with lots of data lots of metadata lots of information within one single form and what we're looking to do is to simplify the workflow for this end user oftentimes not a dedicated storekeeper that's also issuing stocks this person may need to be treating patients and doing other tasks that are maybe that are higher priorities so we're looking to have essential data that can be easily input and used by a user already with access to the app so that's why we're looking at using standard data entry forms not custom and that this is part of the ability to develop towards that if you're not already using a mobile device you're using a pc you can say sure we can use custom data entry forms that can be the case however you're somewhat limiting the development path for moving to mobile within one year or two years when that time comes when there's the possibility to use a mobile device to extend to different sites and lower resource sites then that option is a bit uh broken so I really wanted to confirm that and and reaffirm that and if there's somebody who's already using an implement to dhs2 and has a question around custom data entry forms please let us know but that's I think one key point for this choice for the others I won't get into using data elements and category options rather than using individual data elements for all of the the stock data if somebody has a question related to that somebody with a dhs2 background we can maybe take that up but I don't want to digress too much we can maybe continue george on the yeah thanks a lot for for mentioning the the custom data entry form issue I realize I mean Brenna myself we have been working on a quite a few implementations and it can be quite difficult so people are used to the certain layout of the form and it might also be a national policy to use certain reporting forms and this is a requirement that cannot be easily changed this can be quite a challenge so this is maybe also an answer why don't you go to the real time mode right the way is this is a big step so even you know implementing changing the reporting modes slightly can be a challenge my advice I know it's easy said would be to generally to think of how to simplify the forms we have also made the observation time and time again that you have huge data and performs and I'm always wondering from the perspective of a medical logistician who has spent 25 years of his life in medical warehouses and in hospital and clinic pharmacies is those poor storekeepers that are requested to enter all those data so rather than thinking of how can you translate your reporting form one to one would be to think how can you simplify it DHS to of course you have certain constraints but it is a very versatile tool and the second issue to consider I know this is not something that you can do overnight is keep in mind that review the data that you're collecting and the data the data collection form that you're using and consider whether any of these data might be available from an upstream system and might be better collected there and have the analytics and the reporting from the upstream system like mid access or end supply rather than trying to put everything in THI store I'm sure that the storekeepers are going to appreciate it and at the end of the day for the public health system you're still going to have all the data that you need and maybe even more data okay so I will then if there's no other questions I'm yeah I think we have answered the question from Bahid yes I'm just absolutely so you're as a man I think yeah that was answered so I will I will move on to the to the tracker program to sort to the configuration of the of the real-time mode so sorry I'm going to close these tabs um so this is all native basically what we have done is when we first explored the possibility of create building the real-time system in THI store we actually succeeded to be precise it was Scott Rospatrick the analytics expert who built the first uh uh tracker program that was fully functional um the problem was that that um tracker program native tracker program required 10 clicks for every item that you would distribute so you have to click down through a menu and you have seen now you have just one button scan and then enter the quantity and then start pressing one button for scanning you have to press press 10 buttons every time and that would not not have been practical so the customization is actually purely the user interface to have basically a one click um use but the data model is completely built on on a very very simple tracker program that is simpler than probably many programs or most of the programs that you're using so you have a you have a tracker program um with few settings I'm just checking if there's there's nothing particularly here um and yes so for the attributes there's only the item code and the item description actually you can see only the in this case the item description and the item code is used only in the background so if you're wondering psm means pharmacy stock management so in case you're also looking at this in the sandbox this is what was built by bow systems and this is the name of the application that is currently uh it has been rolled out actually in June so you have only two attributes very simple then you have the program stages and basically you have a single program stage so again it's really very simple it's repeatable of course because you have you can enter um many many transactions and then the the different fields that you have seen in the line listing um you have it here so these are basically the tab that you have seen the stock distributed that was the green tab on the mobile then you had to discard it that there was a red tab and then you have the correction and then you have the possibility of receiving stocks so you don't have this on the screen but of course it's skated for as I mentioned uh we will in the uh native dhis to module that we're planning for april you will have the option to receive it manually or you can do that through the web portal um or it's through an integration so you need this um data element it is and then you can um you can also use uh enter stock direct on the web portal for receiving so if you want to play around if you want to explore how it works and you want to add stock you just need to go on this stage then the stock on hand so this is calculated so nothing entered but of course you need to cater for that in the data model so this is a field that will include the program was for the stock on hand and then the deliver tool uh it's an option set it's basically shown here for uh data element used for technical reason that's what you have seen emergency room impatient and so on and then you have um then you have the the previous stock balance that is needed for the program rules that's a bit of a tricky uh issue that they will not explain there's one question saying that uh it's an event program now this is actually a tracker program so you can see this a tracker program it would not work with an event because this is like repeatable um stages and then there's some um okay configuration here's a question okay is it just background noise and then you have the yeah okay if you can if you can please mute your microphone if you're not speaking okay i thought somebody wanted to make a comment okay then you have the the usual um data entry form so uh i think that's all there is a program state then you have the access so you can you can select which facilities have access in this case we have just given it to two facilities and then notifications which is currently not under use so that's in a nutshell very very simple two attributes one program stage with these seven data elements that's all that's needed and if you're skilled you can probably set this up in half an hour so i don't know if there's any questions on this otherwise i can show you on the i will now intentionally use the um the tracker um tracker capture i know that you can also enter through the events but anyway very enter through the event it's going to refer me to the tracker menu so this is what it looks like on the web portal in case you wanted to manage it or to view it so you can again see these 11 items here you can see that the item code and the item description is separated is separate while on the mobile device you can see only the item description but the the system is integrated with oracle ERP system the price resource planning system so the code is what is linking the two systems uniquely together using the API um points so if i um so by the way there is this is um maybe i should sorry i'm going to go back because i forgot to show you the program rules i will not explain them i'm not sure that i actually understand them exactly you have a program rule variables that you need to configure and you have some program rules it's written in the um in the user guide and the previous top balance is needed for technical reasons as i mentioned you can't like overwrite you can't have two data values in the field at at the same time so you need to temporarily store um your previous stock on hand so you can do the calculation but then you have the stock on hand calculation and you have this simple program rule um so again a single program rule um for so actually three program rules but then in the program you have a single action that is actually very simple once you have worked it out it's simple but I was quite uh nuts to crack and how to actually make this possible so that's just to tell you that you have a tracker program and you need the program rule variables in the program rule not intricate but not very complicated let's say put it like that so here to mention so if i take an item like i have here the retinal um you have here um the attributes just i can code description and here you basically have a record of the different transactions if you're playing around with it in the sandbox i advise you not to to actually not use these um stages because for a reason that I don't want to explain it's related to the program rules it's it's quite tricky to work out the the correct functioning but in any case if you want to add stock for for experimenting you can do that you just create a new transaction and you enter stock received and it will add it to the item so this is made the basic way how you would add stock um to your facility so you could do that one by one or you could do it through the integration but as mentioned um you can uh we plan to make this available uh through the future bulk load application in the meantime I guess I installed that you have the the biff the third party bow systems import foundry application that was actually um that you can also use uh that we are actually using for our project that's kind that's kind of essential because we cannot otherwise we would have to enter um for testing and so on we would have to enter all of this one by one so let me see programs um okay I will not actually show it now you have to like export the program and then create a template and then you sorry I'm here right and then you can fill data and then you can import it but it takes a little bit of filling to to work it out so I think uh let me check my notes list I think that's what I wanted to show any questions we have one uh simple question George on the uh mobile device for the reporting if the tabs can be shown uh vertically and not horizontally which which may make it easier for mobile devices uh sorry on on the reporting mode yeah uh okay I'm just wondering I think the answer is no but if you had the tabs vertically um I see you want the tabs on the left side vertically and then when you open the tab you still have a vertical table uh as far as I know this is not possible yeah and also from our testing we've been using also tablets it's not necessarily a mobile phone that would be used with maybe a tablet and you would have a bit more space and that may be less of an issue and this is also something that's built in functionality of the of the app so it's used for different purposes for health programs and the horizontal scrolling of the tabs and I don't think that's come up as an issue in general so I'm not sure that that would actually be a problem in the implementation you can hear from others that have used this at scale with the use of the tabs so this is really about maybe aesthetics and functionality when it comes to the to the user interface yeah I mean one thing to keep in mind about tabs tabs are great right they allow to structure but you have seen that I had quite a few and that scrolling um you don't want to have too many tabs because scrolling left and right is not great and you have seen also that I have used actually abbreviations for the tabs because otherwise it would be for long text even more scrolling I'm just wondering whether if you had the tabs like on the left side it would take quite a lot of space so it's always something to consider you have seen that the descriptions are quite long so you already have some scrolling to do in the table so always keep in mind the the usability if you have another column on the left that is basically not used a lot then you would have less space for the columns but my suggestion is if you think that that is useful in principle for maybe other applications then please do open a JIRA ticket for the Android team to to consider it to assess it and to consider it for the roadmap right now I have a question from somebody who's asking if there's a if there's a demo instance where they can play and as I mentioned and I put in the link again to the sandbox and that's there but I've also done for this transaction the real-time stock tool so the transaction-based tool this prototype it's first available in the root folder so there's the apk file which we can you can download and install on your android device it's in the root folder for the the with the academy content I just named it real-time stock prototype so this is already connected to the same sandbox you can log in with the same credentials that you see there demo stock one two three exclamation so you can use this and test this and see how it functions and I repeat once again this is a prototype this is not how we will actually look once it's integrated and part of a you know native features within the dhs2 capture app this will be available from April 2023 release what I've also done is if you go into the announcements channel in Slack I put in a link to the figma mock-up which will show how this workflow and the user interface will look once it's an integrated part of the capture app so this will be part of the regular download you will have the different workflows that are being demoed here looking and feeling like the the regular dhs2 app you will also have the in-app analytics so this is the and even in the mock-up you see the small analytics button at the bottom where you can go into the line listing app and have your digital stock cards transactions and so on so this is will be the integrated solution right now we're showing this prototype you can download it test it and at least see how the workflow is all right so that's for the real-time stock I just wanted to to add because I have been cheating you might have noticed that I've been showing the configuration in our sandbox development because of course Brenner myself we're tinkering on this every day but what I'm showing here this is the I just logged into the sandbox like Brenner said I think he showed it you know I'm sure he showed it yesterday with the login it's available globally this is the actual sandbox and here you have the full configuration of the of the real-time mode so if you're interested how it is set up and you want to play if you want to receive stock it's it's all available you just need to print about it. Great Brenner. Yeah now I have a question because you went through the configuration for the aggregate so the report-based and then you went through also for the real-time stock now particularly for the for the for the reporting this is relatively straightforward there's no you know hocus-pocus there however when you get to an actual implementation you do have to manage the different data sets and the different items now how how can that be done the total number of items that would be available in a hospital or a clinic or down to a community health worker how should that be done and how can that be managed and also thinking of in the case of an integration is there how do we align that data with the ELMIS so that we're reporting on the same items can you just comment a bit on that that there's actually some work to be done on harmonizing the data that we're using George you're on mute if you're speaking now. Yes thanks so I didn't get that are you talking about the analytics or rather about how many how to manage the catalog and the data items the data catalog yeah okay good point so that's absolutely critical and yeah thanks for raising that because actually that was that's actually one of the big benefits that is not obvious you just see a mobile device and you think it's not a big deal you have a list actually this was one of the motivations of the the Red Cross project that I personally worked on like for three years is that we have found that all of the stocks in the orders they were managed exclusive with Excel some people were tinkering with access databases and other tools and it was a frustration until the last day so I spent 25 years you know every day almost correcting wrong item codes wrong item descriptions because of course you're free to enter anything into Excel so the fact that you have a standardized catalog is already a huge benefit that you will then notice once you suddenly you don't have any items to to fix anymore and you basically have a catalog that is shared by everyone so the way this works and this is kind of my daily bread for the implementation is that we have asked all the participating facilities to provide us a list with their items so as an example the Red Cross has a catalog of 20 000 items that they have in the database not only medical but all the other items msf doctors without borders probably similar unicef they also have huge catalog so you don't want to have all of these in your database and that's they're actually used so actually as a catalog I should go to the data elements that's a better way so basically the data element in the maintenance that's already your that's basically your catalog so here you have a list of all all the items that are managed of course you have also some items that are needed for the tracker program but basically this is a list of all the items with item descriptions and the beauty of the system is that of course the data elements can be edited but you have the user rights I'm not shown that but you have a very highly developed sophisticated user management menu and all you need to do is to say you assign the user rights from managing the item catalog to certain limited number of administrators who can add and edit items and then the user is only able other users are only able to add or remove those items from their dataset and then if occasionally you have a new item that has to be added then you have to ask somebody to create the items so for creating a new let's say you have a new product or maybe you have a drug product but you have a new strength so you're adding a pediatric dose a pediatric strength to an exist to an existing one so you can either create a new data element or you could can clone a data element let's say if I have clocks as in tablets 250 and I want to add the 500 milligrams I can just edit here and create a new item with another description they have to be unique you always want to store zero values because of course you want to have be able to report your stockouts that's basically it so if you fill a name and then the his they cannot advise on the best way to quote to quote these items if you want to use codes and you add it to your list the same if you want to deactivate you can remove items so this is how you manage your catalog and then once you have items added the removed here then in the dataset so the stock item listed you're creating for your program for the country or at the facility level here you can just add and remove items so this is kind of baked in it's not obvious but it's a fantastic product catalog tool and of course if you're using if you're integrated with a system like Medex as a supply then you could envisage we have not done that yet but you can envisage that you will synchronize your data catalog between the two systems so if you were to add an item to your national catalog then it could be technically this is possible to actually add Medex as demonstrated you could like push an item from Medex into THS to which could be part of the catalog and the great thing about this is that you avoid mistakes because of course if you're just sending a list to somebody and they're entering it manually you might have mistakes so this is also the way the Oracle integration works that you have these catalogs that are synchronized so you're absolutely sure for the first time that anybody who is ordering or who is reporting the stocks on THS2 is exclusively using item codes and descriptions which completely match the Oracle ERP system okay there was another question on the package I guess I can answer that again Brenner yeah there was a question from Abdel asking about the demo there's a package to download and that can be exported now from the demo side I gave access to the import export tool yeah great so just to reiterate that I mentioned that but I showed it only briefly on the slide that we are not ordering offering a package but we're not planning to develop a package as such that you can download and upload the whole package into your system because we think that you will need to customize it anyway especially the item list so this is unique every organization every country they have their unique lists you will have the Francophone countries using French by the way with the Red Cross I haven't shown that but actually that we have also provided the world time system in in English French Spanish Russian so in Cyrillic and in Arabic right to left so you can use it in different languages but anyway that will have to be customized so that's not really worthwhile of course you could have a package where you like upload this tracker program for your stock management would save you a bit of time but at the end of the day let's say as soon as you want to change the wording of your data elements and you don't you want to call this expired and not discarded you have to change it so since it takes maybe one hour to set this up you're probably better off to just develop it but as mentioned you have the complete guide that will guide you even if you are not experiencing DHS to how to set this up data reporting in the low resource area you don't store your values okay so you will have to you will have to store the zero values absolutely for logistics I understand that in an HMS health management information system context this is different but if I go back to a data entry form of course for logistics it's absolutely critical because if you if you don't show the zero values and there is indeed a separate DHS to setting for that then you will not know whether that stock was not reported or their stock out occurred so the only way of keeping an accurate record is by visualizing the the zeros now whether you could somehow hide fields without a value is beyond my knowledge probably have to ask the his provides on that I'm not sure yeah George that's a good question and that's also good to the question but as you said having the zero value is essential for for logistics and understanding the difference between a stock out for example versus a missing reported value we have only a bit of time left George only five minutes but I have a question I wondered I was wondering if this maybe would have come up from one of the more DHS to expert participants but if you're creating indicators with this data model proposed using data elements and category options there would be a challenge in applying that indicator to many different products how do we foresee that being managed and that's a potential downside but how do we see that being managed in an implementation okay sorry just to show an example so here you have stockouts of this item that's just sorry here's a stock on hand so here you have some stockouts for the metro need us all right in November and this is of course for logistics absolutely critical because it's also one of the main indicators to monitor your stockouts so concerning indicators I mean the indicators you will have to way build the indicators let's say if you want to measure your stock coverage time you have to build them one by one anyway regardless of what data model you're using and there is this this piff app that allows you to also upload and create indicators even predictors right so you can basically create a template for one indicator and then duplicate it across items if you have the UIDs and then upload that so this is I guess you can also I suppose you can also like create new indicators within the import with a metadata import export feature so we are thinking of also maybe in the future if this is accepted if there's enough requests to have a kind of metadata cloning tool that would allow to create several indicators but for the time being as native in DHS we will have to create them one by one but I do recommend looking at this tool and just to add that so George and I we have the role of working then in the core team in the HIST Center here at the University of Oslo we're taking also these requirements and these potential challenges in using DHS2 for LMIS so for one if you have any of these kinds of challenges or barriers that you see in implementing this let us know and we can look at how we can find solutions and eventually raise this to the development team who would then build tools and solutions for having this as something adapted for DHS2 for future releases and then secondly it's related also to what we said about not overusing the system this is not something we would recommend for you to install in your central medical store for example and manage your warehouses this is not what the system is made for and these kinds of limitations show up so when you see these limitations connect with us and we can try to raise it and see how this could fit into the development roadmap maybe I just add to that because that's an excellent point I know I'm sounding like a broken record but you know the question is if you have a lot of indicators or predictors to calculate as we said it's possible but rather than you know spending a lot of time paying a lot of money on the configuration consider whether you actually need and try to simplify because those calculations are certainly available in natively in systems like professional systems like Medexys, Oracle or M supply so try to simplify it for the storekeeper think of rather calculating everything upstream that's kind of our philosophy but still not depriving the storekeepers of dashboards if that is needed but basically considering pushing them with a report as I presented briefly the Red Cross project that is currently being deployed in eight countries 40 facilities for now we only collect the stock on hand and the stock distributed we don't collect anything else and we don't have any calculations in DHIS too because everything is done either in the Oracle system or in that case the organization has a native business intelligence application so try to keep it as simple as possible thank you George we're at 44 minutes we'll take a 15 minute break in just one minute's time thank you so much for going through some of these details similar to some of the other presentations we've gone through a lot of different content relatively quickly however the recording will be available on the YouTube channel so please refer to it and use it as a guide also look into the documentation and the other resources which we've shared and then of course connect with George myself and any others within either your teams you have DHIS 2 experts in countries where it's implemented so there's people that know the system even better than we do from a pure DHIS 2 configuration perspective so engage with them engage with the HIST partners and there's a lot of different options for you know understanding and learning how this can be implemented we'll take then a break we'll come back with then Craig and Gary our friends from M Supply who will have similar presentation to yesterday showing what their system can provide and how it can be used potentially in tandem with DHIS 2 I'm sure there will be lots of interesting questions as there were yesterday challenging questions about which decision to make and which way to go so we'll be welcoming them in 15 minutes time all right so see you back here at the top of the hour thank you everyone thank you for the recording Simona once again so then today we've gone through quite a bit of stock related content configuring stock reporting and the transaction based stock management in DHIS 2 a lot of considerations on how that's configured considerations on implementation analytics integration and so on so I think that's great I remind everybody that after this coming session now we'll have an open Q&A and experts lounges we normally call it in the academies and the DHIS 2 gatherings so we'll be open for questions and to take up any other use cases you may have or we'll just be available for you following that but right now I want to welcome our friends from M Supply so Craig and Gary who will be presenting their software what it can provide and then also answer some of your questions about this integration approach and how we can foresee this working there's already been quite a lot of engagement a lot of tough questions so I'm sure that they'll be also sharing some of their expertise and experience in this field as well all right so without further ado Craig and Gary the floor is yours thanks Brian thank you Craig over to you thank you very much Bruno thank you everybody for giving us the time in this presentation and we will maybe be a little bit provocative and you know and George and us are good friends so we we do this in the spirit of trying to get everybody a really good solution so we also very much welcome questions so don't you can put them in the chat on Slack and Gary will keep an eye on them there or you're welcome to interject and maybe Bruno will know just be putting their hands up etc okay I'll share my screen and let's see how we go here Bruno we've got 45 minutes is that right yep and then we're followed by 15 minutes Q&A but so you can go a bit over as we'll have also the academy uh sorry the Q&A so not so strict on the point okay so the the after the Q&A is the academy as a separate session cool yeah we can take we can add 15 minutes also for specifically for midexes that's fine right okay thank you very much let's see hopefully you can see a screen there yep that's perfect okay so we've got three separate demonstrations or four if you include our dashboard and a few slides in between so we'll just give you a little bit of background and then some demos and then we'll be I think that'll pretty much take the 45 minutes so this is us around the world we've been going since 2001 this year we moved all our work into the mSupply foundation which is a registered not for profit and the motivation there is to be explicit about our aims and that to try and make it make an organisation that can do as much good as possible in the areas that we particularly feel we've got something to contribute so our staff may be based in New Zealand and Nepal a smaller team in Cote d'Ivoire who are Francophone and we have also Portuguese and Spanish speakers on our team so we think we've got quite a few of the working languages covered and yeah so as I mentioned transition to a not for profit trust part of our our work very much at the moment is about converting mSupply over to a new modern open source solution and we're also migrating all our all our various tools we had a separate mobile and a desktop application one of the things we're very proud of is that we've been able to re-engineer that as a single code base that spans web and desktop and mobile all in the one application and we'll show you that a bit later and of course along with the opportunity to rewrite something you can get a chance to not only make it look a bit nicer but address some of the issues that we've always existed in the current desktop mSupply so we would contend hopefully not too crucially that mSupply is the only vertically integrated system that can take you right from quantification running tenders and contract management through to running your central warehouse through to a simpler solution at district store level and right down to using our mobile application to do provide services at service delivery points that a patient facing included there are two countries used mSupply for their COVID vaccinations we include a vaccines dispensing module as well as prescription dispensing we have busy hospitals using mSupply that dispense over 2000 prescriptions a day so over eight hours that works out like one every 15 seconds so very large multi-user systems and so we think it's quite unique to have something that can scale from a single tablet right up to those kinds of super busy hospital dispensaries we have also developed a cold chain app that we have WHO PQS certification for and it's integrated both as a separate application and also in terms of my mobile so we'll show you a little bit more about that shortly and lastly we have used either Grafana or SuperSet to open source dashboard tools to enable you to visualize all your data from mSupply at any time so if we were to say one thing that's makes mSupply special is that it really is offline first so we know DHIS2 Tracker is the same now and we have had several countries where we've installed mSupply for example Laos and Myanmar and where they have thought that their internet was good enough they've installed it and it's failed dismally they've changed over to our offline first solution using synchronization and those two countries have now adopted mSupply as their national system for LMIS so synchronization has often saved us so just to explain what that means it first it operates both in our mobile app and also in our desktop app so the digital diagram shows situation with when the green tick in the middle saying the internet's on and everybody's working away and data is synchronizing between facilities every few minutes so it's pretty much like having a live national system with everybody on the same your dashboards update with everybody's stock immediately then the internet breaks and what happens here is that even the multi-user systems can carry on working independently everybody does their work and when the internet comes back whether that's in five minutes or five days then the the queue of synchronized records gets cleared and everything catches up so we know there's a an age coming where there's a high-speed satellite internet available everywhere but the internet also goes down for different reasons such as a rat choose through a cable or somebody forgets to pay the internet bill so we still think synchronization is an important safety feature at least for the next decade right M supply and DHS to so two two kinds of two models that we'd like to talk about the first one is the one that we have experience within production which is where DHS to is performing its traditional role as a health information system and M supply collects data from all the facilities all the LMAs data and then on a schedule from our cloud server to DHS to cloud server usually for a for a particular country then the data gets sent across so that's that's been used for several years now in Laos and Tim or Lester have just set that up this year very good reliability setups relatively easy you obviously when you're talking about an organizational unit or a particular data element which usually represents some value for an item like the item stock on hand or its average monthly consumption you've both got to be talking about the same using the same IDs so there's a bit of work to set that up but that's a one-off and M supply has something called universal drug codes which provide you with a an immutable code for each each generic item in M supply that's so it makes it a lot easier okay so the second model that you're you're spending a week discussing at the moment is where a M supply just operates at the warehouse level and at the facility level you're using DHS too for your logistics so can we make this work yes and last year we Renau and George set up a seminar and where we we made a brief concept application showing this working so there's a few more challenges to doing it this way it means that there's a little compared to using M supply there's more manual entry we think our understanding is that DHS to track a single user so if the facility expands out beyond what you can manage with a single single Android application I'm not sure if you could split out different DHS to functions onto different Android hardware devices at a facility I think that might be possible but otherwise you do have that challenge of the single device whereas M supply even with our Android application with open M supply now it's possible to build multi-user Android applications at the facility level and lastly there's challenges around item coding so the setup's the same but obviously if you're if you're running a system that's trying to track every item at a facility anytime you add a new item to your catalog you need to then think about how you make a system to make sure that it's quickly added to both systems before any any synchronization attempts are made or any communication attempts so at the moment the side this kind of system isn't used anywhere that we know of reliability should be okay we think it can be made to work we think there'll be some challenges with ease of use as we mentioned single single user on an Android device which is often a phone I think you'll have challenges once you get to transactional data handling the kind of volumes of data that come through even quite small stores and as we mentioned also what we call horizontal scale ability ability to go multi-user will be a bit of a challenge so this is just a matrix which has got far too many things on it but giving you some idea of if you look at the columns we're saying these these are the different kinds of the rows of different areas that are needed within a health system different areas of functionality and and PIR being patient immunization record I think I've got the acronym wrong there and EMR been electronic medical record so in our ideal world we we would have M supply taking care of most of these things I think in DHIS2's ideal world oopsie excuse me we'll go back a slide let's get rid of this where DHIS2 would be taking care of most most of the things and over on the right we've got what is typically in place in many of many of the countries we work at especially in Africa where SAGE has been used for warehouse logistics DHIS2 has been used for a national HIS and often for lower level logistics there's some version of open LMIS that has usually been forked and made specific to the country so effectively a bespoke system and so what we are trying to show here is there's actually a lot of different ways you can configure this and we're not at all suggesting that you should do one way or the other but it's we think that there's a lot of potential to mix and match to get the kind of solution that's right for your country so then the question would be how do you choose so we'd suggest that that's a combination of saying what have we already got installed where are we at now we would be like to be in say 10 years from now we think that's a reasonable time frame to be working towards then you need to think about any special requirements you've got for example if it must work offline that will take out a lot of a lot of possible other systems apart from DHIS2 and MSAPI and then you need to make a plan for how you're going to cross that gap how to get and our suggestion is do it in small stages and continually think about scalability so we sort of think of scalability has been able to handle large volumes vertically scaling as it can it can it handle the whole spread of your health system from top to bottom and thirdly horizontally as facilities become busier and busier as you as hopefully your country's health service is able to provide more and more services can that facility can the system at the facility level scale to be multi-user right that's a lot of talking from me so thank you very much for listening at this point we'll swap the screen share over to Gary and he's going to give you a demo of existing MSAPI thanks Gary thanks Craig okay so in the greatest tradition of software demos we're going to risk it and do it live okay hopefully you should be able to see my screen now yeah we see that MSAPI now here yeah great thank you so I'll give you a quick run through everybody of what this is the existing MSAPI the the current one that's out there Craig's going to cover the open MSAPI the one that's coming soon after me but yeah what you're looking at there is the navigator just showing you you know this is where you access all the functions that you would access generally every day and there's a number of tabs across the top here with handling all the different parts of the system first one that it opens in is the customer tab in MSAPI the customers are the people that you give stock to so this is effectively all the goods outwards here so you can create a customer invoice or we can see a list of the customer invoices and this is the ones where you've you've distributed stock to different places so these are your customers here list of all the invoices and the total amounts that you sent requisitions here this is where obviously your customers have ordered from you either you've entered those manually or they've entered them themselves in their own facility and then they've been transferred to you through the synchronization system that Craig was talking about so we'll have a look at one of these in a bit more detail just have a this one here that was been previously processed so you can see a list of items here it shows the stock on hand that you've got in your store here in a in the supplying store this is the customers stock on hand how much they asked for what you've already given them so you can see that we've already supplied everything they asked for and therefore the remaining to supply is zero and then of course if you're going to send some more you can actually you can choose what to put in here and then send it to them by creating a customer invoice obviously this one's been processed before so there's nothing to process here okay so they're the where the facilities have ordered from a supplying store on the other the next tab the suppliers these are the ones that supply stuff to you so this is all about goods inwards Craig mentioned that supply can do tendering so there's the tenders here where you can put you can construct a tender with all the conditions and then send them out to to selected suppliers automatically or manually you can see here we click on that we can see a list of them if I double click on one these are all being created before you can just see there's a few items being included in this particular tender there are some with some quantities I think there will be some yep there are some suppliers assigned and there's some of them they've even bid on the different items so you can go ahead and then choose which bid you want to or which suppliers bid you want to give the order to for each one for each item when you finished all of that obviously you don't have to use tendering but if you do it will automatically create purchase orders for you you can create those manually yourself as well you can do calculated ones where in supply takes your consumption historical consumption or some other factors some other forecasting information that you put into the system to generate an order for you if you're going to order or you can just create a blank one create one yourself another helpful screen is to show you what's outstanding in your pipeline what you're waiting to receive so you see these are all red which means they've they've passed their their expected delivery date and that's because the data in here is old okay so the next thing to do after you've ordered all the goods then is to receive the goods from your supplier so you can create goods receipt notes in here we can see a list of those here there's a couple waiting to be processed one that's already been processed here see that we've received a couple of items in different batches and expiry dates so this stock has all expired when it was received it from when it was received in and hopefully it's been distributed and hasn't sat on the shelf till it's expired and then finally you would finish the process off by entering a supplier invoice which is all about the financial side prices and things like that whereas the goods receipt is about where you're going to put it in your warehouse the location if you're using locations so the next tab across the top that was all the goods receipt side across the top then you've got your basic stock management functions here where you can do adjustments if you find something wrong with your stock somehow doesn't match what has been entered into mSupply somebody made a mistake or you can do a stock take where you you can create count sheets here's one that was created earlier on but it's just got a list of all the stock that you want to do a stock take on I think this is probably all the stock take in the warehouse and then you have a snapshot quantity which is what you've told mSupply you have in stock and what the current stock in the system and then this is the quantity that's actually been counted so you can edit these in here you can also print sheets out to to give to users to go and count in the warehouse and then you can come and put any changes to the batch and expiry date that you find or the pack size as well and the the quantities that are mismatched you can correct them all here and then when you create the inventory adjustments mSupply will make your stock match exactly what you've counted on the sheets here the other tab of interest here would be the reports tab obviously putting all this information is all very well and good but it's no use if you can't do anything with it so there are hundreds of reports built into mSupply here and you can make custom ones as well very simply lots of these options here also contain many many different type different reports here this is just showing us a lot of transaction based reports obviously they are all about stock movements in and out and adjustments so you would expect there to be a lot of a lot of reports there so you can get all the information out and the other two tabs and mainly for admin and tasks like that the assets functionality is here but for managing currencies and all those kind of things there's also a cash register if you need that usually used in dispensary stores and things like that and the other admin tab here for a log everything's logged underneath and the users as well let me just show you the preferences we're talking about dhs2 so down the bottom here is a dhs2 tab in there in the preferences where you can set up the connection to your database there is another section in mSupply where you actually set up all the org units and the data elements to connect them to your instance of dhs2 and that's not here it's in another part of the system all right so just briefly I'm I'm only logged in I'll just show you a quick cycle in mSupply in ordering so you get an idea of how how it can work in in your context you can see I'm logged into the general warehouse here which is the the basically the national warehouse if I now switch to one of the customers I'll move to one of the customer's store I'll just go to one of the let's go to dispensary this Hogwarts dispensary when I log in there you can see that the the navigator's changed slightly it is a dispensary so the customers tab has become a patience tab I do still have access to the customer based functionality if I need to send stuff to other stores or to other external customers but I now have prescriptions and things like that here but here is normally as a I would normally want to order from my supplier say so if I go to suppliers tab I can create an order here where I would just create an order and I'll order from the general store in here the general warehouse I'll add a load of items from a master list here that's already been set up so these are all added for me now normally there would be average consumption data for all of these items I don't have any data in this data file so it's not it's just showing zeros so it means that there's no calculated suggested quantity here I can just order the quantity that users actually requested and then I can decide how much I'm actually going to give them so I'll just I'll just order two two items here the first two in the list this shows them their stock on hand that they have in their store and once I'm ready and I want to send it to the to my supplier in the system I can just finalize it and click okay so there it is in the list it's finalized and that's gone off to the general warehouse now so if I go back to the to the general warehouse we'll see in the requisitions list obviously on my customers tab in the supplying store I'll see my new order here you can see there's one here that was processed previously back in 2018 so this one is from today and here's the two items that I ordered so here it shows the stock on hand that you've got in your store here in your in the general store so the supplying store this is what the Hogwarts dispensary has so this is what the customer has in store how much they're currently using every month how much they've asked for so how much I remain you know I haven't given them any yet so it's all of the remaining to supply and now I decide how much I'm going to give them I can just enter what I want to give them and then I can once I've done that I can add any comments I want them to see here but then I can create the customer invoice and send it to them so yes yes I want to create it I haven't actually checked see if I've got any stock in here I do have stock that's handy how about that a live demonstration that works even when I haven't tried it beforehand that's got to be a first so now obviously as my supplier I need to send that back to the customer back to the Hogwarts dispensary up here you can see the name of the customer just confirm it and finalize it okay and I'm done so now if I go back from the general warehouse I switch back to the Hogwarts dispensary we'll see that supplier invoice has turned up in their store from the general warehouse here it is with those two items on so all I need to do is check that this matches what I've received and when it has I just need to take it off hold and make any adjustments here that I need to match exactly what was delivered click okay and it's received into stock all right so that shows you a brief cycle all the way through obviously there's some you can finesse that a bit you can have program based requisitions and all that kind of thing um but that's a shown you a basic cycle and how it would work on the ground uh in a distributed system within a country um something else I'll just briefly show you here while I'm speaking is the cold chain side of m supply there is I haven't shown it connected to m supply here but here's a um this is just showing you the screen of a device that's sat on my desk there are three sensors in the house um just measuring temperature um and they're all uh this is the trace of the temperature over the morning um and you can see that it's been fairly static it's not particularly warm in my house um but if we if you click on one you can actually see here click on this arrow oh I have to do it on the tablet or not oh great it's frozen see if I can get that back we've had a full day of live demos uh so we're we're perfectly fine Gary this is looking really great okay thank you um and I don't know why it's not showing I'm refreshing okay hold on let me just quit this make it play again okay there it is okay it's now showing you what's on my screen so that's where I clicked this this one here to see the actual readings so here's a list of all the readings uh there's an alert here because they're actually showing a breach obviously they're too warm for a fridge um but I can I can download or email these to me or to somebody else if I need to um so that's the the traces I can go and investigate each one of those I have a just a quick look at the settings you can see how you can set them up the temperature breach settings are set here so you've got a hot breach and a cold breach and you've got cumulative hot and cold as well and you can set the times and the temperatures for those uh I could have set them at different values so that they wouldn't breach um but you get to see um on the graph you get to see the nice uh breach settings and if I connected them to m supply I would also get notifications here if anything um if any breach occurs obviously it would be connected to the stock I would know exactly which stock it had affected um and I would be able to decide what I'd do with that stock and I would be able to go and investigate um so yeah you can see the sensors here I've got three sensors set up I just a quick look at the settings for those so you can blink it to go and see where the sensor is and you can give it a name and you can change the log interval as well I've just made it a very short one um so you get lots of readings and it looks like a pretty graph all right um so this is this is the standalone version of the cold chain which would link to desktop m supply m supply mobile has this functionality all built into it um so you would see so you'd have the alerts again and the vaccine module all that kind of stuff would be linked into all the the cold chain um and you get a full readout locally and on your dashboards nationally of of all the breaches and and the state of your you know your cold chain and and what the equipment's doing and how it's going okay I think that's that's me done uh Craig back over to you how about that am I unmuted down we hear you now Craig yeah great sorry we're there right I'll just get back to sharing my screen just to uh we see presentation mode but not full screen yeah yeah there we are close enough it's just like there for now uh so just to reinforce thank you very much Gary just to reinforce uh that m supply cold chain actually gives you four different levels of alerting which we think is quite unique so the first one is on the android tablet itself which you could put uh somewhere in your warehouse uh close to your cool rooms or your fridges um if you need more than one cold chain app in uh in your warehouse uh you can have as many as you like each one can support six sensors on the screen and so it's very easy to build quite a quite a large system or just for m supply mobile just to have a single sensor for your one fridge in a small facility so from the cold chain app it uses wi-fi to send uh the sensor data to m supply desktop so uh the alert you see over on the right hand side is an m supply desktop alert telling you uh that there's been a breach so uh this is moving it from uh to uh bringing the alerts to where people are actually working and we think this is really valuable as opposed to relying on somebody going once a day and checking has there been a breach and from m supply desktop it's now inside our synchronization system so it synchronizes up to the central server and the alerts get shown on the m supply dashboard and we are also able to send alerts from our dashboard app uh either by email or via uh common messaging act such as telegram so that provides a lot of security it provides a national overview of your cold chain status right thank you very much uh okay on to open m supply so uh uh we have had funding to do open m supply for uh two and a half years now uh just as covid was starting we uh we received funding from the australian government and uh the first year was spent uh building some other things that were needed like m supply cold chain but also doing research um we end up uh starting with a basically a blank slate a totally new system uh using uh for our server side a programming language called rust and for uh the the user interface side using typescript so uh it's a little bit of an unusual choice and uh the rust is gaining a lot of um adherence these days and has been used widely by the likes of amazon and google for their cloud services because of its reliability and speed so it can handle very large workloads um so uh and secondly it uh one thing that's not often mentioned is it actually also enables very low energy computing so they estimate that a rust application uses 70 times less electricity than the python application to do the same job so it's also enabled us because it's uh got fantastic cross platform support to build a single application that runs on an android device or on a on a local desktop or in a cloud server so um the um uh we're quite thrilled about that and uh means that we'll maintain feature parity between our mobile application our desktop application from this point onwards which will be great and lastly uh one of one of the advantages is that uh uh it's a more complicated language to use but the result is you get programs that are much much safer so um we uh continually see uh vulnerabilities on the internet due to cause due to memory leaks in programs or buffer overflows these kinds of things just aren't possible to do using the rust programming language so technical background let me give you a quick look at uh how it actually looks okay so i'm using i'm just using rust uh with a demo sorry i've named so by with a demo server here uh so from a web browser uh the application works exactly the same uh on windows mac linux and android so we'll just log in here so um let's start off with let's go back to the dashboard so as you can see a much more modern look um uh here we are in english but uh we've so far uh trying to keep the french and the english versions up to date as so let's see how this looks we have to swap languages on the flow it's not too bad change back into french so um the other interesting thing uh we'll just show you briefly here is that we support right-to-left languages including fully flipping the screen in the graphics around so uh we go back to here uh everything is flipped around for uh languages such as arabic it's better to get back out of there than to so uh so starting with the dashboard you can see there's a lot of white space here because we'll be filling this in over the next couple of years as we uh get small widgets that are useful but on the dashboard so what we're trying to do here is prevent present users with two things uh one is what work do i have to do today uh what things are pending for me to action and secondly uh are there any uh actionable uh metrics that i should be looking at such as uh items with no stock items with less than three months of stock these kinds of things so i guess an even more a better metric than that would be items with less than three months of stock that have not been ordered so these are the kinds of things we'll be working on so uh just to let's drop down the bottom here you know how are we going for time you know five minutes to go we'll go quickly so uh you can go a few minutes over like i said we'll have the q and a so if you go a few minutes over it's final okay thank you so a much cleaner interface and uh well so uh much the same functionality that's an open m supply at the moment uh sorry in traditional m supply open m supply is currently a subset and we're slowly adding in features as we get funding and as our priorities changes different countries start to want to implement open m supply and tell us what they need so we've also changed our language you'll see that we don't talk about customers in the same way but uh and suppliers as much as um uh trying to align our language with industry best practice where we normally talk about distribution and replenishment so if people are used to sap in this kind of bigger system you'll be used to this language so uh i'll just show you briefly so i need to be in the right store replenishment internal orders so this is when you're ordering from another store and we've just created one here and i just thought i'd show you that uh um uh you're getting a lot more graphical information so this is when you're going to place an order to another store it's showing you your average monthly consumption over the last few months uh and uh this isn't much use because uh if we put no number here we might uh showing uh there's no consumption search showing that your stock won't change but uh uh giving you a forward projection of what your stock levels will be if you order a certain quantity so yeah etc okay so uh m supply has the uh the same idea as um as sorry open m supply has the same concept as m supply of having multiple virtual stores so down the bottom here you've got a store quicker where you can swap between different stores in your same facility and we find uh uh this is useful again and again because as much as we'd like all systems to be integrated many countries run vertical programs where their vaccine stock is separate to their other stock or their tb medicine stock is separate so virtual stores allow you to run on a single device manage uh your vaccine stock your tb stock and your general stock off off all uh within the one system so that's what that's the way that uh virtual stores are used even down at the lower level right so um the other thing i will just briefly show you is that um uh this is uh uh uh work we're doing at the moment for global fund for use in Papua New Guinea where they have built bespoke modules for uh hiv and tb management and they've asked those to incorporate uh that patient management and counter management back into open m supply so this is where most of our efforts are going at the moment because they want to start using this early 2023 so uh most of our work's going here so um we've actually learned a lot from the way DHIS2 works and if we look at a patient here you'll see that there's a lot of information here and this form is built with what's called a JSON schema which allows you to modify uh what information you collect about each patient on the fly and not on the fly but uh in each um each program or each country can modify this information without having to resort back to m supply developers to change things so that gives you a lot of flexibility to design quite complex systems the way you want so um these uh uh and the other uh the other interesting thing for um uh this uh new feature set in open m supply is that you have a full version history of every edit of every patient and exactly who changed what so uh you end up with a very very detailed history um and a full audit trail of every change to your system and this data synchronizes back to a central server so you've got a very robust uh and uh finely grained uh record of of what's going on and uh that helps very much with accountability but also helping with user training and to explain to people how to use the system better uh let's see if we can look at a care encounter here and you'll see there's a lot of different uh areas to hear where including for example uh body weight history for this patient looking back at old encounter records and things like this very easy to have multi multi select values and uh when you and you'll drop down this because etc right and lastly we just uh leave open m supply there for now and uh have a quick look at uh our dashboard so uh when synchronization is running all the data from every facility every transaction ends up on the m supply central server and is then uh brought into a postgres database where that's kept up to date every minute so that's uh then allows you to use any reporting tool you like that supports postgres and uh that's just about every reporting tool uh currently we recommend one called grafana and this is just an example of a grafana dashboard so uh we just look at a different item look at para see tomorrow and you can see down here the stock the stock levels changed showing you the months of stock in each store available so some have got none some got far too much and our dashboard is also able to be used for things like showing uh which items are expiring the value of expiring stock off into the future and is also able to be used for cold chain data so here from around the country showing you a number of breaches and uh uh because m supply cold chain data is linked to item locations it can't it can't just tell you there's been a breach but it can tell you uh what stock has been affected by that breach and uh the value of that stock and what you should do with it and even track those batches right i think we're just about at the end of our we've covered the hob tv modules uh and just showing you there if open m supply we do have a a roadmap we're at this point here next thing off next cab off the rink for us is integrating m supply cold chain into open m supply and uh gh is too is not quite true because uh open m supply still uses the same m supply central server at the moment so in fact you can use open m supply with gh is too at the moment and it will work so uh what we're talking about there is uh building uh more more finely grained integration into gh is too with open m supply but uh it will work as of today so uh i won't dwell too much here i think we've covered those points uh we've got uh the australian ambulance service with the first users of open m supply and they were extremely positive about the experience and they've been using it for four or five months now and uh it's been very reliable we haven't had uh any significant issues with that uh me and marie are expecting to to start implementing open m supply from the next quarter and they were thrilled one thing was very interesting was uh that uh they made a point that when staff are transferred from one facility to another they might need retraining because uh they've got that common experience across mobile and desktop more thank you all very much we really appreciate you taking the time to listen wow thank you so much uh craig and gary that was really impressive uh everything you've presented um and i think it was good that you uh went a bit over because i think you answered some of the questions that that we had as well i just have one comment because i want to make sure that the participants here get a chance to ask you questions um i do have a lot of questions myself but i'll hold this for the the session immediately after um but the comment is that um i mean you said you would be provocative but i think we agreed with pretty much everything you presented and everything you said uh the comment is on the uh you showed the one slide on how to choose and even the slide before that with the different potential uh architectures and i think there uh you mentioned the dhs-2 ideal implementation and i think that's the only point really to make and it connects to the question from colce in the chat now about uh competing last mile solutions in dhs-2 and m-supply we had a similar comment yesterday when medexas elamis presented and there's a lot of overlap and i think that's what we're trying to get at here and i can make the comment that part of the reason why george and myself are working in the dhs-2 core team is to kind of guide the engagement of dhs-2 implementations the usage and how it can best fill an existing gap within this field dhs-2 had been used for stock data for you know 10 years before we joined the team it had been configured in different ways and used at different levels and what we've tried to come with it is a best practice and also to sort of come with this recommendation as we had in the mentimeter this morning saying we should not consider dhs-2 as an end-to-end solution and then the next step to that is of course the how how do you choose and i think you had the perfect questions there and considering the existing capacity of the different systems where you're at and also where you're trying to go that will give you an indication of what you should choose for places like you mentioned team or less day if you're having already your stock data collected using mSupply mobile at facilities there's no real reason to consider or assess why you should use dhs-2 for last mile logistics if that data is already there what we're looking at and i think one of the key use cases is where the data is available in dhs-2 is there a potential value added for the country considering sustainability and considering also the the total cost of implementing a new solution if that data is available at facility would it be more beneficial to connect that with a central tool like mSupply with all of its amazing features so that's the only real comment from my side and we can expand more on that but there's no i think ideal implementation it's rather looking at what is the reality in each country conducting the success and then seeing what is the best realistically achievable option that also takes into account sustainability and all of these other aspects that influence a successful implementation not only the technical capacity not just checking off the box of you know temperature monitoring or stock management and so on but i'll stop there i want to make sure that the participants get to ask questions that i know gary you've answered quite a few i don't know if you want to comment on some of the questions you've already answered in the chat but craig you as well if you wanted to have a counter comment please go ahead and i'll see if there's any questions from participants here thank you breno i agree with what you say i think yeah there's there's more than one right way to do something and success or failure is really about your your holistic approach that you need to look at your your training capacity and your infrastructure and your management commitment and and your staff capability all these things are just as important as which system you choose actually i'm seeing that all the questions were answered by gary and we just took up the one question orally here from a cozy i actually had one additional comment on the technical side that the latest version of the android capture app so the android dhs2 app you have the option to to have multiple users and up to three different instances so that's a new feature that came in the latest release so just a small clarification there i don't know craig if you've seen or tried the the latest version of that mobile app so there's this multi user support i don't know if maybe you're referring to some other feature that is not covered by that but that was with the head thank you know that that was uh i didn't know about that so that's uh that's valuable um i'm looking forward to finding out more yeah and i would you sorry breno george you have your hand raised you want to say something yeah thanks a lot uh just a quick comment i mean just to concur with uh what breno said i also um had this reflex when i saw like the ideal uh dhs2 world so i don't absolutely don't see it we're not like um you know having a tally or anything um i think i mean we are an open source platform uh the ambition is really to provide um to connecting the first data mile and personally i'm happy for anybody who achieves that with whatever tool and we can see that the gaps are so huge i mean there's very few countries who can claim that they have an end-to-end uh system from the facility or even the patient up to the national system so there's so much work to do and uh i mean if if there are several systems and we can achieve that in 20 years that's great so there's really no um my opinion no room for for competition it should be rather cooperation because it's really a global i think it should be one of the sustainable development goals to connect the all facilities logistically upstream and i hope that this will be like global effort and maybe in 10 years maybe 20 years it can be achieved together thank you sounds good all right i think um i don't want to uh to go over time and i actually have quite a few more points in the questions for uh for the m supply team so what i'll do is just i'll do a quick recap and close off for today and then we can just those who want to stay and continue as part of the conversation and craig and gary you're you're more than welcome we hope you guys can join us that you just stay on but i just will do a quick recap of today that we presented then the stock reporting configuration the demo and configuration of that and also the transaction based tool tool based on tracker and how that can be used both standalone and as part of an integrated solution we really went into the technical aspects and the recording as i said will be available after the after the uh later in the day today so there's no powerpoint slides it was really live demos as you saw george going through all of the different workflows and the different configurations use that as a reference and also come back to us if you have any more questions or comments the sandbox so the demo site which i've shared multiple times it's there i made the import export tool available and confirm with one of the participants here now i think it was jamal that you could export the metadata from there and we'll also share some configuration uh documents for that if you need any more help or guidance please let us know in the chat the prototype of the transaction based tool is also available in the google drive so you can download that and connect to the same server using the same login credentials and as i said the final version integrated will be part of the april 2023 release but you can see a prototype of that on the figma site which also i've included in the announcements channel on slack all right so that's a quick recap of what we went through today the content will be there um and we thank then the m supply team for presenting their tool really impressive with all the features and also all the work that they've done to move to uh open m supply and uh uh we're very keen to to follow along on their journey the approach is again not dogmatic uh it's really open to whatever solution works will applaud you and you know will support you there's more than one way to solve these solutions and there's more than enough work to be done so we're very happy to see that they're um you know succeeding and on this path i think there's quite a few things that we may want to engage with you beyond the lmis i see that we'd engage us with uh papa new guinea with the patient records also with your open source experience i think uh craig and gary it would be interesting to connect with you and some of the other members of the dhs2 team and maybe have a talk and maybe see how we can learn from each other and different experiences so big thank you again to you guys so thank you to everybody word of the day for your attendance is bubble wrap so use that and we'll welcome you back tomorrow morning at 10 am austral time all right thank you and those who want to continue just stay online