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I-Tech Kenya Presentation @ Nairobi Research Buzz

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  • 1. OpenMRS/KenyaEMR Successes, Challenges, Opportunities...
  • 2. Contents Introduction to OpenMRS Introduction to KenyaEMR Development Implementation Successes Challenges Lessons Opportunities Communities and Associations
  • 3. OpenMRS Domain: Medical Records System Open source software platform (API) Reference application (Web App) Based on a concept dictionary Designed to be extended via modules/plug-ins Written mainly in Java (Spring/Hibernate) Web technologies (JSP/HTML/CSS/JS e.t.c.) Code hosted on github.com
  • 4. OpenMRS Architecture
  • 5. KenyaEMR Suite of modules to customize/extend OpenMRS Build specifically for Kenya to comply with the MOH EMR standards and Development lead by I-TECH Kenya Currently covers (Mainly): HIV and TB care Mother Child Health (including PMTCT) Future plans: Primary Health Care (PHC) DHIS/PIS/LIS interoperability Billing... e.t.c.
  • 6. Development Development 3 developers in total Requirements mainly generated by MOH All code is open source and is hosted on github.com Development, test and demo servers available Testing mostly done by I-TECH, MOH and volunteers 3-month release cycle (ideally, might change in future)
  • 7. Implementation Implementation 4 regions with 1 coordinator in each region Enlist support of MOH and other partners on the ground Enlist local capacity for network and infrastructural upgrades and installations Training conducted to users from multiple facilities at a time System support provided through an escalation stack beginning with facility champions right u
  • 8. Successes Nearly 150 active implementations Managed to keep hardware costs low by using N-Computing Growing OpenMRS-Kenya community Well covered development road map in spite of the small size of our team Contributed code to OpenMRS core Empowering students through a programming boot camp held in 2013 Supported a fairly successful DHIS2-KenyaEMR interoperability pilot implementation
  • 9. Challenges Inefficiencies in requirements gathering Reliance on OpenMRS core development milestones Reliance on a concept dictionary not managed locally Young open source culture (gradually maturing) Multiplicity of stakeholders: difficult to coordinate Streamlining deployment process (Manual → VM → Scripts → Fully fledged installers) Unreliable power Low computer skills Extraneous (Terrain, security, strikes e.t.c.)
  • 10. Lessons Distribution management: Need to ensure all implementations run the same KenyaEMR distro Active communication: Publicize our work and stay abreast with what others are doing Foster close end-user/client involvement Eliminate/reduce training-to-use lead time Important to mirror existing tools (low computer skills) Test/research unexpected deployment technology interactions (e.g. VirtualBox + VSpace) Important to strengthen local capacity
  • 11. Opportunities - Developers Design and develop health systems that support interoperability “out of the box” Invest in skills to work within the OpenMRS/KenyaEMR ecosystem Submit code to OpenMRS/KenyaEMR (Open Source Spirit) Innovate to create OpenMRS modules to address unique challenges
  • 12. Opportunities - Implementers Free to deploy OpenMRS/KenyaEMR anywhere (FOSS) Innovative/entrepreneurial solutions to unique implementation problems Unreliable power (solar PCs?) Expensive hardware (N-computing?) Ease of deployment (Virtual machines?) Disaster recovery (Off-site backups/data centers?) Affordable and reliable Internet (interoperability, centralized upgrades, capacity building) Participate in testing the system and making feature requests and bug reports
  • 13. Opportunities - Trainers Adopt/expand existing curriculum and provide certification Diversify to reach out to different target groups Developers Implementers Concept curators/experts End users
  • 14. Opportunities – Comm. Managers Mobilize stakeholders towards common goals: Significant EMR features? Convergent developmen Manage mailing lists and community meetings Organize capacity building events: Hackathons? Showcases? Mentorship?
  • 15. Communities and Associations OpenMRS Global Mailing lists IRC Categories (Development, Implementation e.t.c.) Annual implementers' conference OpenMRS-Kenya Mailing list Face-to-face meetings KeHIA (www.kehia.org) Membership association Professional networking
  • 16. Thank you. Questions?