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Bahmni - Open Source EHR System (By Ranjan Sakalley)

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Bahmni - affordable, simple and scalable EMR system that can be installed from a primary health care clinic to a integral part of a national health records strategy/implementation.

This presentation was originally presented at AEHIN: https://aehin.hingx.org/bahmni

Published in: Healthcare
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Bahmni - Open Source EHR System (By Ranjan Sakalley)

  1. 1. Bahmni OpenSourceEHRSystem - Ranjan Sakalley (Lead Developer) S i m p l e . A f f o r d a b l e . S c a l a b l e
  2. 2. Bahmni - Focus on all aspects of patient care 2
  3. 3. Bahmni Implementations 3 • Possible - Accham, Nepal • JSS Hospital, Ganiyari(Bilaspur), India • SEARCH Hospital, Gadchiroli, India • The Banyan Mental Health Clinic - Chennai, India • Union Health Clinic - Kaligonj, Bangladesh (pilot primary health care centre for national rollout) Coming soon – • Bahmni Offline - Community Health Workers for Dhaka division of Bangladesh • Bahmni for large TB program for 3 global NGOs in 16 countries
  4. 4. Learnings from implementations 4 • Extremely low to reasonably low computer literacy levels in staff • Cannot depend on Internet for hosting, in most places (remote hospitals) • Requires physical presence for technical tasks (Extremely busy clinical and non-clinical staff) • Disruption cost is quite high, esp. in case of system problems. Low risk appetite. • Service delivery context differs vastly, leading to unique data requirements
  5. 5. Bahmni – design principles and guidelines 5 • Design for resource constrained settings - no internet required • Simplicity of use - easier to learn and use with minimal supervision • Adaptable - use on variety of devices - tablets/computers • Configurable - location specific user interface changes, languages (internationalization) • Modular - choose parts from a super-set • Build for Integrations - allow others to integrate easily • Use Open Source Software – affordable and customizable
  6. 6. Bahmni – a union of well-built OSS tools 6 • OpenMRS • OpenERP/Odoo • OpenELIS • DCM4CHEE (Oviyam2) • New EMR UI for OpenMRS Leveraging – • Domain expertise built over years of development and support • Vibrant communities that are progressively adding features and integrations • Customizable Open Source code
  7. 7. OpenMRS • Well known Open Source Medical Record System • Patient Management • Concept Dictionary – Diagnosis – Tests – Procedures – Drugs, and more • Heart of the Bahmni system • Very friendly and encouraging community
  8. 8. OpenERP/Odoo • Well known Open Source Resource Management System • Billing and inventory management • Extremely flexible, wide community of contributors and implementers
  9. 9. OpenELIS • Open Source Lab Management System • Contributions from the Bahmni team towards new API additions and more
  10. 10. DCM4Chee – Oviyam2 • Open Source Library – robust implementation of DICOM standard • Oviyam2 – web based DICOM viewer • to make investigation orders which are sent to digital radiology devices. sends patient and the investigation details to the radiology technician. • Bahmni also allows you to view the radiology results (DICOM images) from within Bahmni.
  11. 11. Bahmni User Interface
  12. 12. Bahmni User Interface • Focus on simplicity and intuitive user interface • Responsive - use on different devices • Pre-built dashboards that can be customised • Pre-built library of EMR reports that can be customised • Offline applications for android and chrome coming soon • Open Source, driven by the ThoughtWorks team
  13. 13. Integrations and Interoperability • All bahmni components communicate with each other using standard Atom feeds over Http Protocol (authorized clients can easily program to listen) • Each Bahmni component publishes a log of relevant events happening - other subcomponents can listen to this feed using standard libraries • New components (for e.g. an offline android application) may make use of the same mechanism • Bahmni provides rich data interface over standard REST API - this means that given the right credentials, components can pull and push data updates directly
  14. 14. Integrations and Interoperability • Bahmni can be enhanced at multiple levels to add new integrations. - Adding custom OpenMRS module to integrate with other systems (eg. Bangladesh SHR) - Adding custom OpenERP modules - Adding/Importing new standard definitions in OpenMRS - Adding new components based on standards - HL7 standard for Radiology Order built for PACS(Picture Archiving and Communication System) integration • Bahmni is modular - new components (like a new lab management system) can be plugged in and old ones removed (in this case OpenELIS)
  15. 15. Standards • Bahmni supports various international standards – • DICOM for communicating digital medical images • Bangladesh SHR system communicates using standard HL7 (FHIR) data formats – an enhancement to Bahmni and OpenMRS
  16. 16. Engineering Standards • Standard Communication – HTTP / REST/ Atom feeds • Web standards for our apps • Standard and predictable data formats for communications based on OpenMRS • Most Stable and Free OS supported – Centos 6 • Proven free open-source engines – MySQL, PostGreSQL • Extensibility using well known OpenMRS / OpenERP module systems
  17. 17. Bahmni as part of a Shared Health Record System 17 Central Registries – Terminology – Personnel/Providers – Locations – Patients (MCI) –[ National Health ID ] – Encounters Centralised Reporting (DHIS2)
  18. 18. Bahmni as part of a Shared Health Record System 18 Bahmni on facility (primary clinic to multi-specialty hospital) • Works just like any other Bahmni instance, and more. • New Bahmni OpenMRS module to regularly sync reference data – terminology, locations, personnel etc. • Sync patient and encounter data – FHIR HL7 format • Push data recorded at facility for national integration • Operational reports for the hospital • Ability to import patients in the central registry • Sync on demand – no need to be online all the time
  19. 19. Bahmni as part of a Shared Health Record System 19 Bahmni Offline for Community Health Workers (CHWs) • Publicly Hosted Bahmni server for CHWs • Not tied down to a physical facility • Offline usage • Integrated with SHR system using the same OpenMRS module
  20. 20. THANKYOU For questions or suggestions Contact rsakalle@thoughtworks.com @rnjn @BahmniOrg https://www.bahmni.org

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