Mobile Aggregate Data Exchange (mADX)
The Mobile Aggregate Data Exchange (mADX) Profile supports interoperable public health reporting of aggregate health data. These most typically take the form of routine reports (weekly, monthly, quarterly etc.) from a health facility to some administrative jurisdiction such as a health district, though there are numerous other use cases such as international reporting and community health worker reporting. As the motivating context and use cases for this profile is the same as the Aggregate Data Exchange (ADX) profile, they are not repeated here. The mADX and ADX file are intended to be functionally equivalent.
The primary purpose of the mADX profile is to provide an alternative for the exchange and management of the metadata required for routine reporting by replacing the use of SDMX with HL7 FHIR. Metadata data in ADX, or ADX/DSD, is a profile of the SDMX Data Structure Definition (DSD). Challenges in working with it include: Scaling limitations as it requires ongoing maintenance of facility and location lists in the ADX/DSD. Bandwidth limitations when trying to transfer an ADX/DSD for validation of an ADX. Facility and location lists can be large which complicates deployments in resource constrained settings. Management and exchange of code lists for disaggregators.
mADX profiles HL7 FHIR Terminology Services, the HL7 FHIR Measure resource, and HL7 FHIR MeasureReport to produce a mADX Measure resource. Additionally, mADX makes use of the Mobile Care Services Discovery (mCSD) profile for facility and location data. The mADX profile will allow vendors and implementers to utilize the robust ecosystem of tools around HL7 FHIR and promote standards-based routine reporting.
The mADX profile describes the actors, transactions, messages, and steps for validation to send, receive and validate aggregate data for the development of indicators.
The central concern of mADX is the reporting of data tuples. These tuples are sets of values which are keyed according to a data element subject, a temporal dimension, and a spatial dimension. An example data tuple is the number of live births recorded in January 2015 at Nyamandhlovu Clinic. These tuples may include one or more additional disaggregating dimensions by specifying a code list.
mADX is designed to be an alternative to the current ADX framework. It facilitates the transactions with the use of FHIR for increased interoperability and use of FHIR services, such as those described in Mobile Care Services Discovery (mCSD). Users of the current ADX framework may wish to utilize these FHIR services.
mADX defines a Content Data Structure Creator that enables an implementing jurisdiction to formally define the aggregate health data to be exchanged. Metadata for the aggregate data is defined in mADX as a mADX/DSD as ausing a profile of the HL7 FHIR Measure resource and uses a HL7 FHIR Terminology service.
mADX defines a Content Data Structure Consumer that consumes a Measurea mADX/DSD.The Content Creator and Consumer Actors utilize the Measure mADX/DSD to construct and validate mADX messages containing aggregate health data in their jurisdiction.
The mADX Profile contains few constraints regarding the nature and source of coding systems, and there are liberal extension points intended to allow mADX content to be embedded within different envelopes and its message attributes extended in locally-meaningful ways.
- Send Aggregate Report [QRPH-58]
- Retrieve Aggregate Report Definition [QRPH-59]
Profile Status: Trial Implementation (a new Public Comment revision was published on July 23, 2021)
- HL7 FHIR R4 http://hl7.org/fhir/R4