The Reunión: Network Collaboration in Practice

members working together to identify components of their national health information systems that they would like to make a priority.

This week, I had the unique opportunity to join the V Reunión de RELACSIS in Mexico City, Mexico that brought 80 people together from 25 Latin American and Caribbean countries. Attendees were mostly public health professionals who determine how best to implement practices that will strengthen and improve their country’s health systems. Many components of the health information system were discussed from electronic patient record keeping, to medical coding, to national epidemiological data.

Health Information System – a set of components and procedures organized with the objective of generating information that will improve health care management decisions at all levels of the health system –Lippeveld et al. 2000

The most lively discussions were prompted by exchange of how-to knowledge — how records are kept; how coding is taught; how epidemiological data is collected; and how to communicate data to policy makers. This was a meeting of professionals who share ground-truth experiences. Presenters equally shared practices that worked well and not so well, mentorship experiences and standard operating procedures.

See V Reunión RELACSIS meeting presentations

I had the pleasure of witnessing true knowledge management in practice that incorporates people, process and technology.

First, the right people were in the room. The participants share a common passion to build systems that will eventually afford the best care to their country’s populations. They also share common practices from epidemiology to statistics, and from information management to demography. Discussions are facilitated by dedicated health information system specialists. They also serve as the networks champions, who advocate for country-led health system development.

the network updating itself.

Second, RELACSIS follows the classic, cyclical knowledge management process:

1. Knowledge generation – Countries implement interventions to close system gaps found in national health system assessments.
2. Knowledge capture – Countries capture health system strengthening experiences in the form of posters, conference presentations, and publications. Professionals within the network who possess specific expertise are identified so that they can be contacted by countries who demand certain knowledge for development.
3. Knowledge synthesis – Learning materials in various subject mattes (i.e. ICD-10 coding, communication) are developed by network members for network members and their colleagues.
4. Knowledge sharing – Members share what they have learned and practices that work via the network website and at the annual face-to-face meeting.
5. Knowledge assessment – Approaches and techniques to strengthening various components of the health system are documented and shared for countries to reference in their development process.

Lastly, RELACSIS leverages technology to share and collaboratively develop information products and provide ongoing mentorship.  Between face-to-face meetings, the network joins virtually to discuss action items identified in the agreed upon work plan. The network used a mix of communication platforms including discussion forums on www.RELACSIS.org, Skype, Illuminate, email and phone. The website is hosted and programmer is based at el Instituto Nacional de Salud Publica in Cuernavaca, Mexico and the content manager is based in Argentina.

the RELACSIS web programmer and content manager/graphic designer

Working virtually has proven to be quite effective. For example, an online learning tool was developed collaboratively with participation from the Commission National Classification of Diseases and PAHO representatives of Argentina, Collaborating Center for the Family WHO International Classifications in Mexico, the Ministry of Public Health of Uruguay, and PAHO/WHO and MEASURE Evaluation of the United States of America. The course is designed to raise awareness of and provide medical training in proper cause of death documentation in Spanish-speaking countries.

Screen shot of an interactive course collaboratively developed virtually for the RELACSIS network

In my opinion, RELACSIS serves as an excellent model of South-to-South, country-led health system development. Many global health pros are scratching their heads on how to achieve this. RELACSIS members identify strengths and weaknesses of national health information systems, learn lessons from member countries, set development priorities as sub-regions, then agree on work plans as one networked region. Human and financial resources found in national health and multi-lateral agencies are identified to help put the work plan into action.

It is important for me to emphasize that RELACSIS is not to be defined by its website, or its face-to-face meetings. It is a network of people who share a common practice and are working together towards a common goal. The rich knowledge exchange is the very essence of this community.

As a knowledge manager, I find the RELACSIS experience to be refreshing and motivating. This network demonstrates how coordination among subject-matter experts, based in “South” countries, who lead health development efforts is totally possible.

Overwhelmingly, participants agreed these efforts could not be possible without political will, commitment and passion to succeed.

…innovation comes from social scenes, from passionate and connected groups of people” said Kevin Kelly in a September 2010 conversation with Wired on “Where Ideas Come From: The Natural History of Innovation.

For your reference, here are a couple links to background reading on health system strengthening in Latin America and the Caribbean and the RELACSIS network:

• RELACSIS background
• Regional Initiative in Health System Strengthening
• RELACSIS discussion forums (public)
• RELACSIS photos

Two members of the MEASURE Evaluation team knee-deep in HIS and KM

I would like to thank my colleague, Beatriz Plaza, for extending a meeting invitation to me, and for consistently contributing her RELACSIS experiences to the annual MEASURE Evaluation Community of Practice Moderators’ Summit of which I lead.

Public Meetings Next Week: Durham-Orange Light Rail Project

Today, I received email notification about a series of public meetings on the proposed light rail project from Durham County to Orange County. Had I not been scheduled for meetings in Mexico City next week, I would definitely be in attendance.

I encourage everyone passionate about mass transit, traffic congestion, air quality, jobs, gentrification, small business, and public affairs to attend! A recent survey conducted by Rockefeller Foundation found investments in mass transit are key to economic growth and job creation.

I am in full support of SMART economic growth in the area. From my experience working on Portland, Oregon’s Yellow Line, a vision and a plan, combined with  a strong community affairs team that incorporates public art and supports local business are key to gaining public buy-in. After all, the public is the transit systems greatest stakeholder.

Public Information Meetings about the Durham-Orange Light Rail Transit

Nov. 12, 4:30 – 7:00 PM     Durham Armory, 220 Foster Street, Durham

Nov. 13, 4:30 – 7:00 PM     Eno Unified Unitarian Fellowship, 4907 Garrett Road, Durham

Nov. 14, 4:30 – 7:00 PM     The William and Ida Friday Center, 100 Friday Center Drive, Chapel Hill

Here’s a question for you: If light rail is approved and plans to build are underway, is the Triangle’s workforce ready for implementation?