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Lessons from Deploying an EMR in Rural India

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I share experiences of deploying Bahmni in parts of rural India, and our challenges/learnings from it.

Bahmni is an open source hospital system developed for low resource settings. For more details visit: http://bahmni.org

Published in: Healthcare
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Lessons from Deploying an EMR in Rural India

  1. 1. LESSONS FROM DEPLOYING AN EMR IN RURAL INDIA Gurpreet Luthra - Community Lead (Bahmni) 1 _zenx_
  2. 2. 2 www.bahmni.org
  3. 3. LOCATIONS IN INDIA 3
  4. 4. LOCATIONS IN INDIA 3
  5. 5. LOCATIONS IN INDIA 3 SEARCH
  6. 6. LOCATIONS IN INDIA 3 SEARCH LBP Hemalkasa
  7. 7. JSS, BILASPUR 4 http://www.tompietrasik.com/2013/01/07/jss-india-public-healthcare-film/
  8. 8. JSS, BILASPUR 5http://www.tompietrasik.com/2013/01/07/jss-india-public-healthcare-film/
  9. 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
  10. 10. JSS, BILASPUR 7http://www.tompietrasik.com/2013/01/07/jss-india-public-healthcare-film/ 7
  11. 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. 12. FIRST DEPLOYMENT AT JSS (JUNE-2013) 9 9
  13. 13. THE STORY OF THE SLOW MACHINE A true story of an incident that occurred at JSS 10
  14. 14. JSS, BILASPUR 11 11
  15. 15. SEARCH, GADCHIROLI 12
  16. 16. SEARCH, GADCHIROLI 13
  17. 17. SEARCH, GADCHIROLI 14
  18. 18. SEARCH, GADCHIROLI 15
  19. 19. SEARCH, GADCHIROLI 16
  20. 20. SEARCH, GADCHIROLI 17
  21. 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. 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. 23. SEARCH, GADCHIROLI 20 • Excel Based Registration since 2011 • 65000 rows • Research • Study & Control Areas • Surveys
  24. 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
  25. 25. KRISHNA FONT 22 Chitra िचत्रा fpRzk
  26. 26. KRISHNA FONT 23 https://github.com/Bhamni/bahmni-java-utils/blob/master/font-transformer/src/test/java/org/bahmni/fonttransform/KrishnaFontTransformerTest.java
  27. 27. SEARCH - 20 DAY DEPLOYMENT 24
  28. 28. 25
  29. 29. 26 SEARCH - 20 DAY DEPLOYMENT
  30. 30. 27 SEARCH - DEPLOYMENT CHALLENGES • Mobile !? • Electricity !? • Internet !? • LAN !? • Data Errors
  31. 31. 28 SEARCH - DEPLOYMENT CHALLENGES • Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support?
  32. 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. 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. 34. 31 A HAPPY DAY! • Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support?
  35. 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. 36. Join the community. Implement Bahmni. Gurpreet Luthra Community Lead (Bahmni) @_zenx_ www.bahmni.org THANK YOU

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