With USG funding, the University of Washington I-TECH project works to support the government of Cote dIvoire (GoCI) to strengthen laboratory systems at 3 central and 6 regional labs by developing a user-friendly, highly functional lab information system (OpenELIS) contributing to a coherent national laboratory health information system. I-TECH will also help develop a skilled health workforce through quality training programs at central labs and will implement a training information management system (TrainSmart).I-TECH helps PEPFAR achieve cost-efficiencies with its open-source lab information software (no license fees), whose core code base and functional modules can be modified for additional labs, reducing scale-up costs. I-TECH uses extensive remote communication to clarify system requirements and proposes increased use of self-guided video tutorials for user and system administrator training. Development of an evidence-based national in-service training strategy will increase cost-effectiveness of training investments.I-TECH works to transition activities to Ivoirian entities by working closely and providing training and mentoring for in-country counterparts.M&E strategy: For OpenELIS and TrainSmart, I-TECH uses site visits, remote support, and feedback mechanisms in the software to manage feedback and enhancement requests. Based on input from in-country stakeholders, I-TECH may identify other M&E outcome and output indicators to ensure project progress and accountability.No vehicles have been bought or are planned.

I-TECH is developing, installing, and providing training for OpenELIS, an open-source electronic laboratory information system, at 3 central laboratories: the national public health reference laboratory (LNSP), the Pasteur Institute (IPCI), and CDC/Retro-CI. With FY 2012 funding, I-TECH will focus on the following objectives:

1)Ongoing support for OpenELIS maintenance, use, and enhancement at RETRO-CI and LNSP. I-TECH will continue to provide a combination of on-site and remote technical support to address system bugs and perform iterative system enhancement as needed. Priority areas may include: interoperability with priority facility-level clinical information, stock management, or billing systems; off-site secure access to test results for authorized providers; additional interfaces with common laboratory analyzers and methods to enable sites to create and manage new interfaces themselves; and improved automated reporting on indicators defined by the ministry of health and aids (MSLS) and LNSP (National Laboratory).2)Continue development and installation of OpenELIS versions tailored to meet the data management needs of IPCI and the (CIRBA). Given the quantity and diversity of laboratory units at IPCI, the initial OpenELIS installation will only include the HIV-specific units. I-TECH will develop a plan to expand functionality for 6 additional IPCI laboratory units, selected according to joint CDC and IPCI priorities. For the OpenELIS installation at CIRBA, I-TECH will provide technical assistance (TA) and mentoring to assist the software developer to make changes to meet CIRBAs needs.3)Adapt OpenELIS and support its implementation in up to 6 regional clinical labs. I-TECH will identify adapt OpenELIS for use at the appropriate level of complexity.4)I-TECHs Seattle-based core developers can mentor any identified staff at each lab using distance communication technologies. I-TECH will support 2 system administrator positions, 1 for IPCI and 1 to serve part-time at Retro-CI and part-time as a project manager for CATSIS/GTT (Technical Working Group) to advance the adoption and future direction of OpenELIS in Côte dIvoire. Further, having identified a partner IT school, I-TECH will discuss a partnership with the school to develop and carry out a course on OpenELIS system administration. Funding may be necessary to support the school in piloting the course. This objective supports the goal of transition to country management of future development of OpenELIS.5)I-TECH will develop and implement training and mentoring plan to build capacity of in-country software specialists who can support OpenELIS development. This will involve a one-month training program for 2 trainees, followed by remote mentorship and supervision of applied work so that trainees have a practicum component of their learning that also supports development goals for OpenELIS.6)I-TECH will provide TA on standardized reporting of laboratory data, and on appropriate policies in keeping with a national Health architectural vision. I-TECH will provide support to the LIS working group to define the national reporting infrastructure and national standards. Future system design work to support clinical laboratory applications of OpenELIS would be based upon these national standards and appropriately serve the national reporting infrastructure.

With prior-year funding, I-TECH is working to strengthen the quality and impact of in-service and pre-service training efforts, ensuring that they result in the transfer of learning from classroom to job site. I-TECH will hire and second 2 training advisors to the National HIV/AIDS Care and Treatment Program (PNPEC) develop terms of reference and form a technical working group (TWG) to engage stakeholders, and initiate a desk review for strengths and gaps in training programs.With FY 2012 funding, I-TECH will collaborate with PNPEC and other partners to:1. Develop a national training strategy and to improve coordination between the Ministry of Health and AIDS (MSLS), donors, and PEPFAR and non-PEPFAR implementing partners to strengthen the national in-service and pre-service training programs. I-TECH will provide technical assistance to PNPEC, the MSLS training and research division, national training schools for health and social workers INFAS, INFS), and university medical and pharmacy faculty to develop a national in-service and pre-service training strategy that takes into account the needs of the national HIV treatment program as well as PEPFAR targets. I-TECH will support PNPEC to establish a technical working group (TWG) for training to engage in-country partners and ensure country ownership. The assessment will consist of a desk review and additional activities as necessary to identify successful training methodologies, identify evidence of outcomes, and analyze possible gaps. Via a participatory process, I-TECH will assist in developing a strategy that includes recommendations on appropriate relative level of emphasis for interventions according to I-TECHs in-service and pre-service training frameworks; a costing and feasibility analysis; and recommendations on requirements for a strengthened zonal training infrastructure.2. Provide direct TA to carry out specified components of the strategic plan. Possible areas include: 1) for any gaps in the standardized curriculum, identify required competencies required for specific cadres and develop/adapt new content within standardized training materials; 2) develop a standard model and curriculum in support of clinical coaching; 3) initiate a pre-service curriculum strengthening process through writers workshops for faculty; and 4) provide technical assistance to design a national platform for distance learning and continuing medical education.3. Strengthen the capacity of PNPEC and other partners to plan, coordinate, monitor and evaluate in-service training based on timely and accurate data on training activities. I-TECH will introduce a web-based health care worker training tracking database called TrainSMART (Training System Monitoring and Reporting Training Tool). I-TECH will work with MSLS to conduct a rapid needs assessment in order to better understand the data management and reporting needs for in-service training of HCWs. The assessment will also help determine whether TrainSMART should be implemented at the national or regional level, and identify the roles and responsibilities of governmental authorities and partners in data management and data entry. Then I-TECH will provide on-site training on the use of TrainSMART. Continuous HQ TA will be available to troubleshoot user issues. Three months after the initial user training, I-TECH staff will make a follow-up on-site visit to address questions, assure proper usage, and provide training on data use.