<ul><li>Academic Model for the Prevention and Treatment of HIV/AIDS (AMPATH) </li></ul>The IU-Kenya Program responded with AMPATH, a comprehensive program for HIV/AIDS.
Starting from two clinics, by 2001 they needed a new building to handle the number of patients
And as they grew, their information management needs grew too
45000 2001 2007 2004 In 2004, AMPATH had 3000 patients and was scaling to 30,000+ over 1-2 years
Our Introduction <ul><li>February 2004 </li></ul><ul><li>Asked to be “consultants” </li></ul><ul><li>One week trip to Eldoret, Kenya </li></ul>We were brought in for a week to tell them how to scale up their system. MS Access had served them well, but was being stretched beyond capacity.
But they needed an enterprise electronic medical record (EMR) and two guys building an EMR with 10% of their time…well, it was a herculean task.
We looked to see if others had solved the problem. There were silos of effort, mostly with MS Access-based systems built to meet immediate needs.
Then we met Partners In Health. They were installing their system in Rwanda and wanted to rebuild it. A perfect match for us. The impossible became possible.
Understanding the Environment <ul><li>Reporting-driven </li></ul><ul><li>Top down </li></ul><ul><li>Vertical systems </li></ul><ul><li>Acute care </li></ul><ul><li>Proprietary and predatory </li></ul>The existing culture was very top-down.
<ul><li>Active transparency </li></ul><ul><li>Community-based development and ownership </li></ul><ul><li>Freely available </li></ul><ul><li>Capacity through apprenticeship </li></ul><ul><li>Patients are first, others follow </li></ul><ul><li>Avoid imagined needs </li></ul><ul><li>Re-use, don’t re-invent </li></ul><ul><li>Flexible, standards-based foundation </li></ul><ul><li>Follow thought with action </li></ul>Our values…
Google has helped us tremendously through their Summer of Code.
Google Summer of Code made us aware of how communities can be sustained through internet technologies. We worked hard on our website.
We use technology like RSS to make conversations and changes more transparent and to enhance communication & scalability
Getting to Maybe: How the World is Changed Then Tom Inui pointed out this book to us and we learned that OpenMRS is an example of a “social transformation.” We hadn’t realized there was a theoretical framework for what we were doing.
<ul><li>Being distressed by a problem </li></ul><ul><li>Deciding something must be done </li></ul><ul><li>“ Getting to maybe” </li></ul><ul><li>Understanding the system which led to discontent </li></ul><ul><li>Encountering “powerful strangers” </li></ul><ul><li>Rapid growth by “finding flow” </li></ul><ul><li>Threatened powers fight back </li></ul><ul><li>Connecting with much larger forces </li></ul>So far the book is dead on. Unfortunately, step #7 is next!
<ul><li>What got us this far? </li></ul>So, we reflect on the values that got us this far
Freely Available Not only do we serve free food, but we strive to take every ingredient and every recipe made within the kitchen and make it freely available to everyone. Also know as “open source.”
It’s amazing how profitable it can be to give something away. -OpenMRS
“ Active” Transparency We don’t stop there. We actively work at communicating our thought processes to the community and encouraging others to do so as well.
The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires. – William Ward
Community-based development and ownership The community gives us our only chance for a fully realized system. Getting others involved requires us to share ownership of what’s evolving with everyone who takes part.
Open Source Community <ul><li>how we underestimated the larger open source community </li></ul>Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. -Margaret Mead
Capacity Through Apprenticeship We consistently encourage those that we help to then go and help others, so that we may someday be made obsolete.
Not by age but by capacity is wisdom acquired. -Titus Maccius Plautus
Patients are first… others follow In all this, we are physicians. So underlying all the efforts, we must always focus on what’s important.
Avoid imagined needs We started off with the mistaken belief that a big system required a big design. We learned to make decisions based on priority and need instead of attempting to envision what we might need.
There's a difference between knowing the Path and walking the Path. -The Wachoskis, authors of “The Matrix”
Re-use, don’t re-invent We’ve achieved significant efficiencies through re-use. OpenMRS uses libraries from several open source projects.
Obviously, the highest type of efficiency is that which can utilize existing material to the best advantage – Jawaharlal Nehru
Flexible, standards-based foundation Utilizing existing standards, focusing on providing a strong & flexible foundation, and creating opportunities for innovation within that playground has served us immensely well.
As they say on my own Cape Cod, a rising tide lifts all the boats… -John F. Kennedy
Follow thought with action We’re pragmatists by nature. A lot of people come with good ideas, but we’ve found that often those fall through the cracks unless we quickly move to turn that idea into something tangible. Theory is great, but only when followed by action.
You’ll never plow a field by turning it over in your mind -Irish Proverb