A process for contextualising digital health terminology standards for Uganda’s health information systems: A use case of HIV information management services

Abstract

Background: Uniform interpretation of digital health messages is important to achieve semantic interoperability of electronic health information systems (eHIS). Whereas international digital health terminologies such as ICD, LOINC and SNOMED-CT exist, their design considerations regarding health processes, data collected, and technologies, among others do not necessarily match Uganda’s eHIS contextual needs. Objective: This research aimed to design a process that could be used to contextualise international digital health terminologies for Uganda’s eHIS. Methods: The Design Science approach was used in designing the contextualisation process while utilising a foundation contextualisation approach for mapping terminologies. Results: The contextualisation process constitutes six major phases; assessing the national digital health information system context, extracting data elements in the national digital health information system, mapping existing national data elements to international terminologies, identifying and coding unmatched data elements, validating contextualised terminologies and digitising the validated terminologies. The terminology standards contextualisation process was validated using the Delphi technique and the HIV Information Management Services use case. The validation results showed that the contextualisation process was relevant, usable, adaptable and interoperable to Uganda’s eHIS. Conclusion: Accordingly, this study demonstrated how international digital health terminologies could be contextualised for Uganda’s health information systems. The contextualisation process could also be applied to other disease information management services in Uganda.