- 1. OpenMRS in Rwanda Hamish SF Fraser Partners In Health
Division of Global Health Equity, BWH Harvard medical School
2. OpenMRS:open source, modular EMR system
- Developed as a collaboration of PIH, the Regenstrief Institute
and South African MRC
- Uses concept dictionary for data storage
- Modular design simplifies adding new functions and linking to
other systems
- Supports multiple languages
- Released with open source license (April 2007)
- Core of paid programmers with growing community support
Partners In Health Regenstrief Institute Medical reseach council
SA 3. OpenMRS sites - fall 2008 4. Rwanda 5. Rwanda health
indicators
- A small central African country:
-
- Highest population density in Africa, 85% rural
- Achieved rapid economic growth since genocide in 1994, but
still has very poor health outcomes:
-
- Life expectancy 38-44 years
-
- Infant mortality 152/1000
-
- Maternal mortality 1071/100K
6. Accompagnateur, Haiti 7. OpenMRS at PIHsites in Rwanda
- Currently used for 12 PIH supported health centers
- 8 sites have their own server, 6 remote sites maintain a
synchronized copy of the entire database
- Registration, encounter and lab data for patients with HIV, TB
and now heart failure
- Over 8000 patients tracked (Feb. 2009)
- Team of Rwandan data officers trained to enter data, ensure
quality & produce reports
- Clinicians lookup of electronic patient summaries
- Many new research and clinical applications
8. OpenMRS dashboard - HIV Care 9. 10. Patientsummary and alerts
11. Physician looking up ARV patient 12. Cohort builder Not actual
names 13. Government of Rwanda EMR roll out
- The Government of Rwanda is committed to having a strong
national EMR program
- MoH has stated that OpenMRS will be used for the national roll
out to health centers and small hospitals
- MoH wants a non-disease specific system which:
-
- Can assist in the management of all outpatients
-
- Will also continue to be used for HIV management
14. Potential components of integrated nationaleHealth
architecture in RwandaEMR System OpenMRS Nationalreporting
systemTRACNetPharmacysystem PIH Registration and insurance Mutuelle
Mobile healthsystems OpenROSA Radiology / telemedicine system
LaboratorySystem PIH-Lab-system IXF HL7 HL7 HL7? HL7 Dicom HL7
Supply chainsystems Camerwa 15. Connecting sites with limited
internet
-
- #1: Collect Data on paper and ship it back to central
location
-
-
- Make light-weight copy of OpenMRS that support minimal
functionality and distribute it to remote areas
-
- #3: Separate Desktop Application
-
-
- Make completely separate application that works in disconnected
mode e.gOffline EMR, Haiti
-
- #4: Connected installs of OpenMRS with data
synchronization
16. Synchronization
- We created a new component to allow bi-directional
synchronization between OpenMRS instances
- Uses limited internet capability, soon to be usable with USB
memory stick
- 6 sites in Rwanda are now synchronizing
- Working on a general version, requires modification to the data
model
17. 18. Data Synchronization: Vision 19. Challenges for OpenMRS
deployments
- Reliability and support for equipment, power supplies and
software
- Data management and quality control
20. Collaborators and Funders
- Medical Research Council, South Africa
- World Health Organization
- US Centers for Disease Control
- Brigham and Women hospital
- University of KwaZulu-Natal
- Millennium Villages Project
- International Development Research Centre, Ottawa
- Fogarty International Center, NIH
21. 22. Acknowledgements Darius Jazayeri, Joaquin Blaya, Sharon
Choi, Patrice Nevil, Christian Allen, Paul Biondich, Burke Mamlin,
Justin Miranda, Ben Wolfe, Mark Mosely, Paul Farmer
http://www.pih.org http://www.openmrs.org 23. Tracking HIV
patients
- Patient data collection and project evaluation are core
components of improving quality of care
- Accurate analysis requirespatient leveldata
- EMR systems can implement guidelines and support best
practice
-
- Allow real time tracking of patients to ensure they are
followed up and taking ARVs, complementing work of
accompagnateurs
Green bar: Recent clinic visit and ARV pick-up. Red Bar: Neither
event has occurred. Yellow bars: Only one tracking event has
occurred 24. OpenMRS Pharmacy System integration
- The prototype integration project is beingdeveloped in South
Africa for use in a majorpublic hospital in Pretoria.
- Uses MIRTH developed by a US based medical information
integration company Webreach
- This work is being done by Ryan Crichton
25. Rwinkwavu-administration page