Did You Know: If you want to support different departments with OpenMRS, you can, without big integrations!
A few recent calls have made me realize that we need to more clearly state what we mean by “EMR with HIS-Lite features” versus “HIS”. Because, we need both:
- ~80-90% of sites who use/need the OpenMRS EMR are small-to-medium sized (
+ 
) - ~10-20% of sites are very large (
)
So we need an approach for both - we cannot neglect one or the other, because Ministries of Health around the world want a system that can serve all levels of sites. Silo’d or small-pilot-style software are no longer acceptable with many countries, because governments have to pick-and-choose what they can support with their limited funds.
Imagine these 3 scenarios
| Site Size | Workflow Complexity | IT Support | Recommendation |
|---|---|---|---|
| A tiny health centre or clinic |
Simple. Few staff; from 1 nurse to maybe a few doctors. | Minimal or zero regular in-person IT support. | EMR + “Lite” modules |
| A bigger health centre or small-medium hospital |
Fairly simple; has Lab and Pharmacy departments but not complex. | Some; occasional. | EMR + “Lite” modules; also consider adding fit-for-purpose integrations like with an LIS if the site handles a lot of labs. |
| A large, complicated, top-tier referral hospital |
Many doctors, departments, specialists, etc. May be called “Level 5” or “Quaternary”. | In-person IT department with multiple staff. | Strongly consider OpenMRS HIS, Ozone, or another combined fit-for-purpose solutions: EMR + LIS + ERP + RAD/PACS + HR etc. This is why the OpenMRS HIS distro project is so important. Can start by testing if the “lite” modules are sufficient - e.g. some Level 4 facilities in Kenya found the lite billing sufficient. |
Fortunately, various teams and orgs have been working together over the last ~2 years to build modules + esms (and in many cases built on past work too) that extend the O3 EMR to have more functionality for those sites that need Billing, Labs, Stock, etc, but just the basics:
Lite Modules
| “Lite” Module | GitHub | Slack Channel | Notes |
|---|---|---|---|
| Billing Lite | Billing ESM: github.com/openmrs/openmrs-esm-billing-app | #openmrs-billing | Feature-flagged in O3 where it needs some more dev work; but customized versions are used in ~3,000 sites in KE and UG. |
| Stock/Inventory Lite | Stock/Inventory ESM: github.com/openmrs/openmrs-esm-stock-management | #stock-management | Ongoing improvements right now by Stock Squad; aiming to make part of O3 EMR. |
| Pharmacy/Dispensing Lite | Dispensing ESM: GitHub - openmrs/openmrs-esm-dispensing-app: OpenMRS Frontend Module for Medication Dispensing | #dispensing | Incorporated into EMR/RefApp; used in multiple production settings |
| Lab Lite | Lab ESM: github.com/openmrs/openmrs-esm-laboratory-app | #o3-labs-tests-squad | Incorporated into EMR/RefApp, used in multiple production settings. |
(Does anyone think I missed any?)
The 3 main approaches explained: EMR vs Platform vs HIS
To try and explain this more, I’ve created a new page on the wiki called “Choosing Your OpenMRS Approach”:
Have a look and let me know what you think! 