By Frank Verbeke

1. 1
Hospital Information Management
with OpenClinic in Africa
Dr. Frank Verbeke
Vrije Universiteit Brussel

2. 2
OpenClinic software
 Integrated hospital information management
– Patient identification
– Patient administration
– Financial / health insurance management
– Health record management
– Paraclinical information (Lab, Imaging/PACS,
Physiotherapy)
– Pharmacy management
– Statistics & epidemiology
– Human resource management
– Asset management

3. 3
OpenClinic software (2)
 Open technologies
– Java/jsp web application
– Multi operating system (Windows, Linux, Mac)
– Database independence (MS SQLServer,
MySQL, Oracle, Postgresql)
– Multi-webbrowser (Internet Explorer, Firefox,
Opera, Safari)

4. 4
OpenClinic software (3)
 Open source licensing (no license fees)
 Unlimited # users
 Unlimited # patients
 Unlimited # beds
 Highly customizable to local requirements
– Regulations
– Documents
– Health system organisation

5. 5
OpenClinic implementations in
Rwanda
 CHUK (Kigali)
– Hospital admissions & consultations
– Administrative and clinical procedures
 Patient identification
 Archiving
 Invoicing
 Medical record
– Patient tracking
 Admission, discharge and transfer management
 Electronic Agenda
– International standards based clinical encoding
 Diagnoses: ICD10, ICPC2, KPGS
 3BT clinical theasaurus
 National Military Hospital of Kanombe (Kigali)
– Third level reference hospital (full implementation)

6. 6
OpenClinic in Rwanda (2)
 District hospitals
– Full implementation coverage (functional analysis -> user
training)
– Sites
 Rutongo
 Nyamata
 Kibagabaga
 Muhima
 Rwamagana
 Gihundwe
 Mental health
– Psychiatric reference hospital Ndera + 3 peripherical sites
– DSM-4 integration

7. 7
OpenClinic in Rwanda (3)
 Private clinics / hospitals
– Polyclinique du Carrefour
– Polyclinique Bien Naître
– Polyclinique La Médicale
– Hôpital de la Croix du Sud
– Biomedical Center
 Universities and training centers
– University of Rwanda, College of Medicine & Health Sciences
 Rockefeller e-Health Center of Excellence
– Kigali Health Institute (KHI)
 Master in Health Informatics
 Rwanda Medical and Dental Council
– Identification of health professionals

8. 8
Kigali City Interhospital Network
 Interconnects all OpenClinic based health facilities in
Kigali (OpenClinic datacenter based)
– Secure virtual private network
– Exchange of information
 Patient related
 Bed occupancy
 Centralised clinical statistics
– Research and resource planning
– Integrating private health sector
– Integrating health insurances (RAMA)

9. 9
OpenClinic in DRC & Tanzania
 RDC
– First OpenClinic project in 1990 in Dondo (vaccination
management in Northern Ubangi region)
– University teaching hospitals (EU-funded eb@le-
sante project)
• CHU Kinshasa
• CHU Lubumbashi
• CHU Kisangani
• HPGR Bukavu
 Tanzania
– CCBRT Disability Hospital if Dar es Salaam
• Reference disability Hospital

10. 10
OpenClinic in Burundi
 Centre Médico-Chirurgical de Kinindo (CMCK)
– Feasability test (2008)
– Complete implementation started in 2011
 Military hospital of Kamenge (Bujumbura)
– Reference site
 Clinique de l’oeuil
– Private ophtalmology clinic
 CISNU
– United Nations Integrated Services medical center
 Handicap International
– National Disability Center at Gitega
 University Teaching Hospital of Kamenge
– Third level reference hospital
 Clinique Prince Louis Rwagasore
– Third level reference hospital

11. 11
OpenClinic in Burundi (2)
 Hôpital Prince Régent Charles
– Complete implementation (administration → clinical)
 Hôpital Autonome de Ngozi
– Complete implementation (administration → clinical)
 Hôpital de district de Muramvya
– Complete implementation (administration → clinical)
 Hôpital de district de Kirundo
– Complete implementation (administration → clinical)
 Hôpital de Ruyigi
– Private reference hospital
 Hôpital KIRA
– Private reference hospital

12. 12
OpenClinic in Mali
 National Agency of Telemedicine and Medical Informatics (ANTIM)
 Association of ‘Médecins de campagne’ (AMC)
– 20 health centers
 Health profession councils
– Physicians
– Pharmacists
– Nurses
– Midwives
 University Teaching Hospital Gabriel Touré (Bamako, 2012)
 University Ophtalmology Teaching Hospital IOTA (Bamako 2013)
 National Centre for Blood Transfusion (CNTS)
– OpenClinic Blood Bank Edition
 Provincial reference hospital of Ségou
 District hospitals Commune 2,3 and 4 of Bamako

13. 13
OpenClinic in Ivory Coast, Senegal,
Congo Brazzaville and Gabon
 Senegal
– University Teaching Hospital Aristide le Dantec (Dakar)
• LIMS implementation
– Centres de Santé de Référence (DH)
• Sokone + 2 Postes de Santé (HC)
• Foundiougne + 2 Postes de Santé (HC)
• Koungheul + 2 Postes de Santé (HC)
• Passy + 2 Postes de Santé (HC)
 Congo Brazzaville
– ELIKIA private hospital
 Gabon
– Occupational Health Clinic Mandji (Port Gentil)

14. 14
OpenClinic support network
 Virtual Private Network
– Remote assistance (Kigali, Bujumbura, Belgium)
– Remote updates setup
– Information exchange (inter hospital networking)
– All OpenClinic sites connected via Internet
– Vital element
 Quick response to intervention requests
 Low cost (no traveling ex-pats involved)

15. 15
OpenClinic Datacenter edition
 Central merging of health information from different sites (The
Global Health Barometer, http://www.globalhealthbarometer.net)
– Administrative
– Financial
– Medical / epidemiological
 Centralized activity analysis, performance monitoring & reporting
– Mortality
– (Co)morbidity
– Cost of care, disease cost calculation
– Health insurance statistics
– Clinical activity monitoring
– Bed occupancy, workload

DHIS2 integration (DXF2 message format)

16. 16
OpenClinic Health Information
Network
OC
Health
Center
Paper
report
E-Report District
hospital
Health
Center
Health
Information
Management
Structure
District
hospital
Paper
report
E-Report.
OC OC
Memory stick
Internet
Memory stick
Internet
Standard
edition
Health Center
edition
Datacenter
edition