OPENMRS: Software Project with heart
Author: Dr. Barry Levine
Much of the developing world uses paper medical records. One can imagine the difficulties encountered by physicians when meeting with patients in this case. Paper records might be lost or difficult to find. One example, a physician I met visits a hospital in Vietnam to assist. He brings medical students to help him locate the patients’ records. He mentioned it might take 4-5 hours to find the records of interest. This scenario makes it very difficult to work effectively with the patients, understanding the patients’ medical history, prescribing medications without accurate knowledge of the patients history including allergies, finding patterns of patient complaints over time, etc. In addition, one can imagine how difficult it would be for health ministries to understand, from an epidemiological perspective, public health issues, pandemics, etc.
Using a medical record system would greatly assist in these scenarios. Unfortunately, commercial systems are extremely expensive. For example, the major system used in the United States, Epic, installed at University of California costs hundreds of millions of dollars. There are other installations that cost one billion dollars. Therefore, the developing world does not have the financial resources to purchase these systems.
One solution for providing EMRs to the developing world, especially with resource constraints – financial, internet access, power – is consideration of open source EMRs. OpenMRS is an open source EMR and was conceived by Paul Biondich and Burke Mamlin from the Regenstrief Institute, Indiana, along with Hamish Fraser from Partners In Health in September 2004. OpenMRS is currently used in many locations globally, including Asia, Latin America, United States, Europe and Africa.
The OpenMRS community consists of many dedicated software developers freely contributing their time to assist in the provision of essential health efforts. One example of the developers’ efforts includes the deployment of OpenMRS during the recent catastrophic ebola outbreak in West Africa. Developers added features to OpenMRS to greatly assist the efforts of clinicians in providing patient care during the outbreak.
OpenMRS software developers improve the core system, as well as add new features for specific use cases. The project leaders guide the development efforts, keeping in mind the system is used in many different medical settings in the global arena. The settings include the use of mobile technology used by community health workers when they visit villages that do not have internet access and, due to severe financial constraints, might not be able to visit the hospital.
It is compelling to assist in these efforts since these contributions will likely save lives! My current focus is two-fold. I frequently travel to East Africa to meet with leaders of hospitals and clinics who are interested in implementing OpenMRS at their sites. I assess their sites to ensure they are ready to use the system in various modes. Once the site is ready I will proceed to implement the system, orienting the system to their needs.
The second part of my focus is in leading graduate students to develop new features (modules) for the system. For example, one of my students developed a module to analyze the visit notes clinicians created after a patient visit (https://wiki.openmrs.org/display/docs/Visit+Notes+Analysis+Module). The module enables the clinician to immediately review the longitudinal history of the patients’ problems, treatments and tests. For you techies, the module employs natural language processing and named entity recognition – our results were published (http://ieeexplore.ieee.org/document/7359782/?reload=true&arnumber=7359782). Students are able to learn/use interesting Computer Science and save lives resulting from their efforts!
Folks interested in joining the community should browse to http://openmrs.org/ to learn more.
I am currently a Professor of Computer Science at San Francisco State University, (http://cs.sfsu.edu/) where I have worked since 1981. I have a Ph.D. in Computer Science. I have served as Department Chair at SFSU, as well as starting Computer Science programs in Armenia and Kenya and evaluated programs both in the United States and globally. One effort that was particularly exciting was my effort in a World Bank project at starting universities across Africa.
My current focus involves Health Informatics. I created a graduate course in Health Informatics at SFSU. I have been participating in the open source medical record system, OpenMRS (http://openmrs.org/), community for several years. I have implemented the system for one country and continue to lead graduate students in developing new features (modules) for OpenMRS. I frequently travel to East Africa where I assess clinics/hospitals in preparation for deploying OpenMRS at those locations
<Editor’s Note (Juan Jesus Ros Guzman): Thank you for your post on the Information Systems Blog>