Regenstrief Institute, Partners in Health
Open Medical Record System (OpenMRS) consists of a software platform and a reference application that enables customized design of electronic medical records systems.
Proprietary medical record systems, paper records
Improve prevention and treatment interventions in low resource settings through more efficient information management.
OpenMRS relies on the assistance of developers from the OpenMRS community to improve the system.
OpenMRS can be downloaded online. The Android app is available for download from the Google Play Store. Experts note that acquisition of the code to run the platform could be more straightforward; simply download the source code.
Experts note that OpenMRS has been used by a number of high profile organisations such as Save the Children and in diverse and challenging circumstances eg. West African Ebola outbreak
OpenMRS has been downloaded 255,889 times in 212 countries from July 27, 2010 to July 16, 2017. There are 1,845 reported implementation sites with over 6.3 million active patients as of December 2016.
Connectivity requirement for the product/service to work (mobile internet, SMS, voice, fixed internet, Wi-Fi, other [specify]).
Coverage required for the product/service to work (2G, 3G, 4G, LTE, broadband, dial-up, other [specify]).
Device features required for the product/service to work (bluetooth, Wi-Fi, camera, IVR, GPS, accelerometers/motion sensors, physiologic biosensors, biometric identifiers, SIM, memory card (e.g microSD), other [specify]).
Device(s) type required for the product/service to work (smartphone, feature phone, computer, tablet, other [specify]).
Connectivity requirement for the product/service to work. Some apps/services can work offline. If no, specify if network connectivity is needed at any point (e.g connectivity needed for download).
Is the product/service able to receive and send back information to the user?
Rates of user vs downloads/subscriptions – Compliance rate for the eHealth service
Support according to the literacy level required from the user. If yes, specify type of literacy support. If no, the user is intended to be literate.
Operating system required and software version (Android, IOs, Windows, other [specify])
Power supply required for the product/service to work (uninterrupted prower supply (UPS), ocassional power supply [minimum time required], other).
Education and behavior change, human resource management, decision support, data collection & analytics, electronic medical records, Healthcare provider- CHW training, telemedicine/remote diagnostic, stock management, disease surveillance and reporting
– Central concept dictionary: Definitions of all data (both questions and answers) are defined in a centralized dictionary, allowing for robust, coded data
– Security: User authentication
– Privilege-based access: User roles and permission system
– Patient repository: Creation and maintenance of patient data, including demographics, clinical observations, encounter data, orders, etc.
– Multiple identifiers per patient: A single patient may have multiple medical record numbers
– Data entry: With the FormEntry module, clients with InfoPath (included in Microsoft Office 2003 and later) can design and enter data using flexible, electronic forms. With the HTML FormEntry module, forms can be created with customized HTML and run directly within the web application.
– Data export: Data can be exported into a spreadsheet format for use in other tools (Excel, Access, etc.)
– Modular architecture: An OpenMRS Module can extend and add any type of functionality to the existing API and webapp.
– Patient workflows: An embedded patient workflow service allows patient to be put into programs (studies, treatment programs, etc.) and tracked through various states.
– Cohort management: The cohort builder allows you to create groups of patients for data exports, reporting, etc.
– Relationships: Relationships between any two people (patients, relatives, caretakers, etc.)
– Patient merging: Merging duplicate patients
– Localization / internationalization: Multiple language support and the possibility to extend to other languages with full UTF-8 support.
– Support for complex data: Radiology images, sound files, etc. can be stored as “complex” observations
– Reporting tools: Flexible reporting tools
– Person attributes: The attributes of a person can be extended to meet local needs
OpenMRS can be used on mobile devices to submit forms from the field via SMS, GPRS or wifi. OpenMRS has also developed an Android application that covers most of the functionality of the web application. The Android application communicates with OpenMRS with REST and supports working offline.
Basic infrastructure requirements to implement OpenMRS include reliable power source, connectivity to the Internet and/or a local area network (for implementations with multiple locations), computers, virus protection, basic computer maintenance, and a server. The storage space required depends on the size of the project, but most installations require a minimum of 2GB RAM and 250GB hard disk.
Experts note that the provision of an API should make migration of data from existing datastores or integration relatively easy. Experts express concern over the fact that the tests in the GitHub repository appear to not be well developed.
OpenMRS University holds an online “office hours” session every week to teach developers and implementers about OpenMRS and answer questions. Support materials for developers and implementers are available on the OpenMRS Wiki page. OpenMRS also hosts a discussion forum, OpenMRS Talk, as a channel for communication and support.
An on-site IT professional is needed for the first 2-3 months of implementation. It is recommended that implementers develop a maintenance plan to ensure long term operation of OpenMRS. Experts also note that deployment will require a knowledgeable and dedicated team to procure resources for hosting and maintenance.
The OpenMRS framework was used to develop an EMR system at a University Hospital in Haiti and was used to register 8,700 unique patients within the first month of use. OpenMRS has been used to develop an electronic medical record system in Kenya that has stored over 720,000 patient records, 4.9 millions encounters, and 178 millions observations as of February 2014.
Partners in Health, Thoughtworks, AMPATH
Allen, C., Jazayeri, D., Miranda, J., Biondich, P.G., Mamlin, B.W., Wolfe, B.A., Seebregts, C., Lesh, N., Tierney, W.M., Fraser, H.S. Experience in implementing the OpenMRS medical record system to support HIV treatment in Rwanda. Stud Health Technol Inform. 2007;129(Pt 1):382-6.
Manders, E.J., José, E., Solis, M., Burlison, J., Nhampossa, J.L., Moon, T. Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique. Stud Health Technol Inform. 2010;160(Pt 1):411-5.
Thompson, A., Castle, E., Lubeck, P., Makarfi, P.S. Experience implementing OpenMRS to support maternal and reproductive health in Northern Nigeria. Stud Health Technol Inform. 2010;160(Pt 1):332-6.
Tierney W.M., et. al. Experience implementing electronic health records in three East African countries. Stud Health Technol Inform. 2010;160(Pt 1):371-5.
Tierney W.M., et. al. The AMPATH medical record system: creating, implementing, and sustaining an electronic medical record system to support HIV/AIDS care in western Kenya. Stud Health Technol Inform. 2007;129(Pt 1):372-6.
The OpenMRS platform is compliant with HL7 standards and can be configured to meet local standards and requirements.
Experts are pleased to see a totally open-source platform for medical database management and customization. Experts find the presence of an active and engaged community of open-source developers and the participation and endorsement of a number of top academic and non-governmental institutions to be encouraging.
There is a demo instance so that users can test the platform interface.
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