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Updated the files that provide content for smart.who.int/dak-tb in order to align with TB DAK specific content and to reflect the current state of different artifacts
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6 changes: 3 additions & 3 deletions input/pagecontent/adapting.md
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Expand Up @@ -2,12 +2,12 @@ The following page provides a reference to resources that can guide countries in

To implement WHO recommendations in country settings, governments must interpret and then adapt the content in line with local policies, procedures, and digital tools.

This implementation guide provides the generic content required in digital systems, independently of a specific software application and with the intention that countries can adapt it to meet local needs.
This implementation guide provides the generic content required in digital systems, software agnostic, with the intention that countries can adapt it to meet local needs.

WHO guidelines articulate and endorse rigorously tested recommendations for health interventions to be adopted within country programs. When applied correctly and consistently, guideline recommendations save lives. To ensure that countries can effectively benefit from digital health investments, the SMART Guidelines approach is intended to facilitate the accurate reflection of WHO’s clinical, public health and data use guidelines in the digital systems that countries are adopting.

For more on layers of knowledge representation and how they are used in WHO’s SMART Guidelines approach, see [WHO’s SMART Guidelines](https://www.who.int/teams/digital-health-and-innovation/smart-guidelines) and this [Lancet article](https://www.thelancet.com/journals/landig/article/PIIS2589-7500(21)00038-8/fulltext).

The standards-based technical artifacts in this implementation guide are at the third layer of knowledge representation (L3: Machine-readable recommendations). It provides code necessary for software developers to incorporate standardised logic from WHO guidelines into digital systems, testable for conformance to standards including fidelity to recommendations. A standards-based technical implementation guide builds on operational (L2) by mapping L2 content to value sets and Health Level Seven International Fast Healthcare Interoperability Resources (FHIR) standards. Alongside data standards from L2, this allows for semantic and syntactic interoperability at scale. The logic derived from guidelines, which might include clinical decision support and calculations for performance indicators, which may be encoded into Clinical Quality Language (CQL). This ensures that key indicators can be consistently extracted to support patient care, as well as case surveillance and programme monitoring. The machine-readable representations in this implementation guide are intended for adaptation into countries’ digital health service delivery and reporting systems. Digital solutions comprising L3 machine-readable recommendations may then be testable for conformance to interoperability standards.
The standards-based technical artifacts in this implementation guide are at the third layer of knowledge representation (L3: Machine-readable recommendations). It provides code necessary for software developers to incorporate standardised logic from WHO guidelines into digital systems, testable for conformance to standards including fidelity to recommendations. A standards-based technical implementation guide builds on operational (L2) by mapping L2 content to value sets and Health Level Seven International Fast Healthcare Interoperability Resources (FHIR) standards. Alongside data standards from L2, this allows for semantic and syntactic interoperability at scale. The logic derived from guidelines, which might include clinical decision support and calculations for performance indicators, may be encoded into Clinical Quality Language (CQL). This ensures that key indicators can be consistently extracted to support patient care, as well as case surveillance and programme monitoring. The machine-readable representations in this implementation guide are intended for adaptation into countries’ digital health service delivery and reporting systems. Digital solutions comprising L3 machine-readable recommendations may then be testable for conformance to interoperability standards.

The fourth layer (L4: Executable—reference applications and services) focuses on software applications and services within a digital ecosystem. It is intended to include executable reference software that accurately represents the intentions, operational, and functional requirements of the WHO recommendations; addresses user and health system needs; and comprises machine-readable data and calculations within interoperability standards, as documented in the L1–L3 layers. As a fully functional application, it is intended to serve as a generic starting point, ready to be localised to the specific operational context of the users, population, and health system within which it is deployed. Additional products at this layer include terminology services to support consistent data representation for interoperability; reusable software libraries including software development kits; application programming interfaces; and function as a service to support updates to FHIR content and capabilities across subscribed digital systems.
The fourth layer (L4: Executable—reference applications and services) focuses on software applications and services within a digital ecosystem. It is intended to include executable reference software that accurately represents the intentions, operational, and functional requirements of the WHO recommendations; addresses user and health system needs; and comprises machine-readable data and calculations within interoperability standards, as documented in the L1–L3 layers. The fully functional applications referenced in L4 are intended to serve as a generic starting point for localization to the specific operational context of the users, population, and health system within which it is deployed. Additional products at this layer include terminology services to support consistent data representation for interoperability; reusable software libraries including software development kits; application programming interfaces; and function as a service to support updates to FHIR content and capabilities across subscribed digital systems.
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# SMART

Feel free to modify this index page with your own awesome content!
*The following web pages were modified to align with TB DAK content and to reflect the current status of artifacts:*

Home --> Changes
Home --> Dependencies
Home --> References
Home --> Adapting Guidelines for Country use

Business requirements --> Concepts
Business requirements --> Generic Personas
Business requirements --> User Scenarios
Business requirements --> Business Processes

Data Models and Exchange--> System actors
Data Models and Exchange--> Sequence Diagrams
Data Models and Exchange--> Transactions
Data Models and Exchange--> Indicators and Measures
Data Models and Exchange--> Codings

Deployment --> Security and Privacy Considerations
Deployment --> Testing
Deployment --> Test data
Deployment --> Reference Implementations
Deployment --> Trust Domains
Deployment --> Downloads
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Note that the terminologies included in this implementation guide will need to be updated, because the ideal mechanism for distribution (as an expression) is not currently supported by the content logical definition constructs available in the FHIR ValueSet resource and all known implementations of it. Before use in a production environment, ensure you have the latest value sets based on the definitions for each value set (as defined in the inclusion/exclusion criteria for each one).
**This content is not yet available. The page will be updated as soon as the content is ready to be shared.**

The following terminology artifacts are included for this implementation guide:
Note that the terminologies included in this implementation guide will need to be updated, because the ideal mechanism for distribution (as an expression) is not currently supported by the content logical definition constructs available in the FHIR ValueSet resource and all known implementations of it. Before use in a production environment, ensure you have the latest value sets based on the definitions for each value set (as defined in the inclusion/exclusion criteria for each one).

### CodeSystems
{% include list-simple-codesystems.xhtml %}
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Key concepts and abbreviations are described here. Additional terms are defined in the Glossary and List of Abbreviations in the WHO Digital Adaptation Kit for <mark>[insert health domain here]</mark> (link forthcoming)
### Concepts
Please consult the "Glossary" section of the TB DAK for the key terms and the "Abbreviations" section for the abbreviations used in the DAK.

<table class="list">
<thead>
<tr>
<th>Term</th>
<th>Description</th>
</tr>
</thead>
<tbody>
<tr>
<td><a href="https://build.fhir.org/ig/HL7/fhir-ips/ValueSet-whoatc-uv-ips.html">Anatomical Therapeutic Chemical code (ATC)</a></td>
<td>A unique code assigned to a medicine according to the organ or system it works on and how it works.</td>
</tr>
<tr>
<td>Certificate</td>
<td>A document attesting a fact. In the context of the vaccination certificate, it attests to the fact that a vaccine has been administered to an individual.</td>
</tr>
<tr>
<td><a href="http://hl7.org/fhir/uv/cpg/">Clinical practice guidelines (CPG)</a></td>
<td>Clinical practice guidelines are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options.</td>
</tr>
<tr>
<td><a href="https://cql.hl7.org/">Clinical Quality Language (CQL)</a></td>
<td>This is a HL7 specification for the expression of clinical knowledge that can be used within both the Clinical Decision Support (CDS) and Clinical Quality Measurement (CQM) domains.</td>
</tr>
<tr>
<td>Data dictionary</td>
<td>A centralized repository of information about the data elements that contains their definition, relationships, origin, usage, and type of data. For this digital adaptation kit, the data dictionary is provided as a spreadsheet.</td>
</tr>
<tr>
<td>Data element</td>
<td>A unit of data that has specific and precise meaning.</td>
</tr>
<tr>
<td><a href="https://www.hl7.org/fhir/overview.html">Fast Healthcare Interoperability Resources (FHIR)</a></td>
<td>A standard describing data formats and elements and an application programming interface for exchanging electronic health records.</td>
</tr>
<tr>
<td>Functional requirement</td>
<td>Capabilities the system must have in order to meet the end-users’ needs and achieve tasks within the business process.</td>
</tr>
<tr>
<tr>
<td><a href="https://build.fhir.org/implementationguide.html">Implementation Guide (IG)</a></td>
<td>A set of rules about how FHIR resources are used (or should be used) to solve a particular problem, with associated documentation to support and clarify the usage. This IG is based on WHO guidance, as it is represented in the Digital Adaptation Kit for <mark>[insert health domain here]</mark>, to support the adoption of open standards for interoperability.</td>
</tr>
<tr>
<td>Indicator</td>
<td>Summary measures that capture relevant information on different attributes and dimensions of health status and performance of a health system.</td>
</tr>
<tr>
<td><a href="http://hl7.org/fhir/uv/ips/">International Patient Summary (IPS)</a></td>
<td>An electronic health record extract containing essential healthcare information about a client.</td>
</tr>
<tr>
<td>Non-functional requirement</td>
<td>General attributes and features of the digital system to ensure usability and overcome technical and physical constraints. Examples of non-functional requirements include ability to work offline, multiple language settings, and password protection.</td>
</tr>
<tr>
<td><a href="https://www.snomed.org/gps">Systemized Nomenclature of Medicine – Clinical Terms Global Patient Set (SNOMED CT GPS)</a></td>
<td>A systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting.</td>
</tr>
</tbody>
</table>

### Abbreviations

<table class="list">
<thead>
<tr>
<th>Term</th>
<th>Description</th>
</tr>
</thead>
<tbody>
<tr>
<td>BPMN</td>
<td>Business Process Model and Notation</td>
</tr>
<tr>
<td>CDC</td>
<td>Centers for Disease Control and Prevention</td>
</tr>
<tr>
<td>CDS</td>
<td>Clinical decision support</td>
</tr>
<tr>
<td>CHW</td>
<td>Community health worker</td>
</tr>
<tr>
<td>CQL</td>
<td>Clinical Quality Language</td>
</tr>
<tr>
<td>DAK</td>
<td>Digital Adaptation Kit</td>
</tr>
<tr>
<td>DE</td>
<td>Data element</td>
</tr>
<tr>
<td>DMN</td>
<td>Decision Model and Notation</td>
</tr>
<tr>
<td>DT</td>
<td>Decision support table</td>
</tr>
<tr>
<td>DTDS</td>
<td>Digital tracking and decision support</td>
</tr>
<tr>
<td>ED</td>
<td>Event-driven</td>
</tr>
<tr>
<td>eHealth</td>
<td>Electronic health</td>
</tr>
<tr>
<td>EMR</td>
<td>Electronic medical record</td>
</tr>
<tr>
<td>FHIR</td>
<td>Fast Healthcare Interoperability Resources</td>
</tr>
<tr>
<td>HW</td>
<td>Health Worker</td>
</tr>
<tr>
<td>HL7</td>
<td>Health Level Seven International</td>
</tr>
<tr>
<td>HMIS</td>
<td>Health management information system</td>
</tr>
<tr>
<td>ICD</td>
<td>International Classification of Diseases</td>
</tr>
<tr>
<td>ICD-11</td>
<td>International Classification of Diseases (version 11)</td>
</tr>
<tr>
<td>ICF</td>
<td>International Classification of Functioning, Disability and Health</td>
</tr>
<tr>
<td>ICHI</td>
<td>International Classification of Health Interventions</td>
</tr>
<tr>
<td>ID</td>
<td>Identification</td>
</tr>
<tr>
<td>IG</td>
<td>Implementation guide</td>
</tr>
<tr>
<td>IHE</td>
<td>Integrating the Healthcare Enterprise</td>
</tr>
<tr>
<td>ISCO</td>
<td>International Standard for Classification of Occupations</td>
</tr>
<tr>
<td>ITU</td>
<td>International Telecommunication Union</td>
</tr>
<tr>
<td>LOINC</td>
<td>Logical Observation Identifiers Names and Codes</td>
</tr>
<tr>
<td>M&amp;E</td>
<td>Monitoring and Evaluation</td>
</tr>
<tr>
<td>MAPS</td>
<td>mHealth Assessment and Planning for Scale</td>
</tr>
<tr>
<td>mHealth</td>
<td>Mobile Health</td>
</tr>
<tr>
<td>MOH</td>
<td>Ministry of Health</td>
</tr>
<tr>
<td>NMFL</td>
<td>National Master Facility List</td>
</tr>
<tr>
<td>NFXNREQ</td>
<td>Non-functional requirement</td>
</tr>
<tr>
<td>OpenHIE</td>
<td>Open Health Information Exchange</td>
</tr>
<tr>
<td>PrEP</td>
<td>pre-exposure prophylaxis</td>
</tr>
<tr>
<td>SMART</td>
<td>Standards-based, Machine-readable, Adaptive, Requirements-based and Testable</td>
</tr>
<tr>
<td>SNOMED CT</td>
<td>Systematized Nomenclature of Medicine - Clinical Terms</td>
</tr>
<tr>
<td>VVM</td>
<td>Vaccine Vial Monitor</td>
</tr>
<tr>
<td>WHO</td>
<td>World Health Organization</td>
</tr>
</tbody>
</table>
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The following standards and profiles are referenced in this implementation guide:

* Integrating the Healthcare Enterprise (IHE):
The following standards are referenced in this implementation guide:

* [Audit Trail and Node Authentication (ATNA) Profile](https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html)
** Standardized terminologies and classifications:**

* [Sharing Valuesets and Concept Maps (SVCM) Profile](https://profiles.ihe.net/ITI/SVCM/index.html)

* [Mobile Care Services Discovery (mCSD) Profile](https://profiles.ihe.net/ITI/mCSD/index.html)

* The International Patient Summary (IPS):

* [Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) IPS Implementation Guide, published by HL7 International - Patient Care Work Group](http://hl7.org/fhir/uv/ips/index.html)

* World Health Organization (WHO):

* [WHO International Classification of Diseases 11th Revision (ICD-11)](https://icd.who.int/en)

* [WHO Family of International Classifications](https://www.who.int/standards/classifications)
* [WHO Family of International Classifications](https://www.who.int/standards/classifications)

- [WHO International Classification of Diseases 11th Revision (ICD-11)](https://icd.who.int/browse/2024-01/mms/en)
- [International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)] (https://icd.who.int/browse10/2019/en)
- [International Classification of Functioning, Disability and Health (ICF)] (https://icd.who.int/dev11/l-icf/en)
- [International Classification of Health Interventions (ICHI)] (https://icd.who.int/dev11/l-ichi/en)

* [LOINC version 2.73](https://loinc.org/news/loinc-version-2-73-is-now-available/)

* [SNOMED GPS] (https://www.snomed.org/gps)
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**This content is not yet available. The page will be updated as soon as the content is ready to be shared.**

### Package

This is the technical package containing the artifacts in this Implementation Guide:
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**This content is not yet available. The page will be updated as soon as the content is ready to be shared.**

The FHIR Measure is used to describe the indicator in a computable format. These indicators may be aggregated automatically from the digital tracking tool to populate a digital health management information system (HMIS).

Measures included in this implementation guide are listed in the [Artifact Index - Measures](artifacts.html)

For the operational descriptions of indicators and references, see the Digital Adaptation Kit (DAK) for <mark>[insert health domain here]</mark>, including Web Annex C of the DAK. Summary indicator content from the DAK is also represented in the <a href="indicators.html">Indicators and Performance Metrics</a> page.
For the operational descriptions of indicators and references, see <a href="indicators.html">Indicators and Performance Metrics</a> page.



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# Mappings
# Mappings

**This content is not yet available. The page will be updated as soon as the content is ready to be shared.**
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