Lessons from Deploying an EMR in Rural India
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- The document discusses lessons learned from deploying an electronic medical records (EMR) system called Bahmni in rural areas of India. - The first deployment was at JSS Hospital, a 300 bed facility serving 800,000 people from 2500 villages. Challenges included unreliable internet, low-cost devices, and training staff unfamiliar with computers. - A second deployment was at SEARCH Hospital in Gadchiroli, which serves 25,000 patients annually. Additional challenges there included lack of electricity, local language support, and migrations of existing data. - Key lessons included having backups, scripts for easy deployment, carrying all necessary equipment, remote support tools, and focusing on real user feedback and reports to
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Lessons from Deploying an EMR in Rural India
- 1. LESSONS FROM DEPLOYING AN EMR IN RURAL INDIA Gurpreet Luthra - Community Lead (Bahmni) 1 _zenx_
- 6. LOCATIONS IN INDIA 3 SEARCH LBP Hemalkasa
- 9. • 30 Beds • Two Operating Theatres • Fully equipped Lab • 300 patients for OPD • 800,000 people from 2500 villages • 150 - 200 health care workers • 10 doctors • 3 day waiting period! 6 JSS, BILASPUR
- 11. CHALLENGES 8 8 • On-site BAs • Internet for Deployment? • Agile without Showcases? • Software as a bottleneck? • What if the system breaks down? Backup? • UX Challenges • Low Cost Devices • Training people who have never operated a computer
- 12. FIRST DEPLOYMENT AT JSS (JUNE-2013) 9 9
- 13. THE STORY OF THE SLOW MACHINE A true story of an incident that occurred at JSS 10
- 21. SEARCH, GADCHIROLI 18 • Dr Abhay Bang and his wife Dr Rani Bang • Dec 1985 • 50% drop in Infant Mortality Rate • Masters in Public Health from John Hopkins University
- 22. SEARCH, GADCHIROLI 19 • S.E.A.R.C.H: Society for Education, Action and Research in Community Health • 25,000 patients each year • 20 bed indoor facility • 450+ surgeries each year (special camps)
- 23. SEARCH, GADCHIROLI 20 • Excel Based Registration since 2011 • 65000 rows • Research • Study & Control Areas • Surveys
- 24. SEARCH, GADCHIROLI (2 MONTH PRE-DEPLOYMENT) 21 • Made Bahmni configurable (not just JSS!) • Lots of Jasper Reports • Patient Registration Card • Migration Scripts • Krishna font transformer
- 27. SEARCH - 20 DAY DEPLOYMENT 24
- 28. 25
- 29. 26 SEARCH - 20 DAY DEPLOYMENT
- 30. 27 SEARCH - DEPLOYMENT CHALLENGES • Mobile !? • Electricity !? • Internet !? • LAN !? • Data Errors
- 31. 28 SEARCH - DEPLOYMENT CHALLENGES • Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support?
- 32. 29 LEARNINGS • Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support? • Local YUM Repo • Carry QA Database • Scripts for one click Backup and Deploy • Infra skills • EasyNetMonitor • Local Language support (non-trivial) • Phased Rollouts (for validation) • Carry everything! (keyboards, extension chords, network cables, stickies, boards, etc)
- 33. 30 LEARNINGS • Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support? • Real System, Real Feedback • Team Viewer • Migrations on SSD / Vagrant • Single view of system status • Daily Dairy • Local Stackoverflow?? • Training/Backup Laptop • Games for Learning Computers • Pay attention to Reports • Need for Offline support
- 34. 31 A HAPPY DAY! • Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support?
- 35. 32 RELATED LINKS • https://www.thoughtworks.com/insights/blog/dr-prakash-amtes- lok-biradari-brotherhood-people • http://jssbilaspur.org • http://www.searchgadchiroli.org/ • http://lokbiradariprakalp.org/ • https://www.thoughtworks.com/global-health
- 36. Join the community. Implement Bahmni. Gurpreet Luthra Community Lead (Bahmni) @_zenx_ www.bahmni.org THANK YOU