Besides being an international community of people trying to improve patient care through electronic medical record systems, OpenMRS is a platform for creating medical record systems. Only within the last year, with OpenMRS 2.0, have we started down the path of creating an “out of the box” EMR and that is still in its infancy.
OpenMRS has been used to create widely used EMRs within Kenya, Rwanda, Ghana, the Philippines, India, and Haiti to name a few. Given that the need for information management in clinical care in developing countries is massive and we don’t believe that there’s one solution that will everyone’s need, we are really only in competition with ourselves.
So, out of the box, OpenMRS really isn’t a complete solution for anyone (yet). Those who have adopted the platform to create EMR solutions have created systems that have been vetted in many countries and felt to be equal or superior to proprietary solutions. That is due, in large part, to the great work by teams in those various countries.
In general, we don’t recommend that people (or countries) select a particular EMR; rather, that they define the requirements and local need and then try to find the best solution to meet those needs. This is the process that countries like Kenya, Rwanda, the Philippines, etc. have done.
In short, anyone looking for a shrink-wrapped solution in a country that hasn’t already got a team providing an OpenMRS-based solution will probably be better off with a proprietary solution unless they are creating a strategy for the long-term and want to own their own solution, in which case OpenMRS might be worth investigating.
Great answer, thanks. I’ve got more questions for you!
I’m confused about the terms MRS and EMR. I thought they were interchangeable, but it seem shere that you are using MRS to refer to a platform and EMR to refer to an implementation. Is that the general usage?
Also, was the strategy to have OpenMRS be primarily a platform rather than an out-of-the-box system chosen for the project by the fact that it was too difficult to create something that worked out of the box, or chosen because it encouraged implementers to make it match local needs? Or both?
[quote=“zak_rogoff, post:3, topic:257”]
I’m confused about the terms MRS and EMR. I thought they were interchangeable, but it seem shere that you are using MRS to refer to a platform and EMR to refer to an implementation. Is that the general usage?[/quote]
Nope. We chose “OpenMRS” because, when we started, we already had RMRS (the Regenstrief Medical Record System started in the 1970s), MMRS (Mosoriot Medical Record System created by Bill Tierney in Kenya as a proof of concept for medical record systems in Kenya), and AMRS (the AMPATH Medical Record System that was used to start OpenMRS)… and “OpenEMR” was already taken. So, “OpenMRS” was a natural name to choose. When abbreviating, people (including myself) tend to use EMR, since MRS looks like a married woman. I’m sure Wikipedia has technical definitions for these, but they’re basically the same thing in our world. Technically speaking, a “Medical Record System” does not need to be electronic, since it lacks the “E”.
We didn’t have the illusion or the goal of solving everyone’s problems. We started out quite the opposite, in fact. We (Regenstrief and our AMPATH colleagues in Kenya) had problems to solve in Kenya and PIH (Partners in Health) had problems to solve in Rwanda. Terry Hannan was kind enough to bring us together at an AMIA Conference in 2004 and we realized that combining our efforts on a platform would allow both groups to succeed without requiring that we use the exact same solution (which wouldn’t have worked). Since we don’t believe a one-size-fits-all solution exists, a customizable platform made sense. We also strive to empower local developers to create their own solutions rather than giving people solutions that create dependencies on others.
As time has progressed and the platform gets more solid, we’ve created a new front-end that allows us to start delivering more out-of-the-box functionality… but like everything else, it takes time to get there. Ideally, by 2.2 or 2.3, we’ll have something an average person would consider an EMR out-of-the-box.
This makes a lot of sense. It also seems (I’m new to this) like the out-of-the-box solution promote independence and autonomy in a different way, since it would mean that less local developer expertise would be required.
I guess the ideal thing would be something that’s highly customizable without much expertise, but I’d guess that’s something that even MRS’s with the most highly-paid developers are still working on.
Haha yeah, that is a little soupy, but I do like the idea of a separate name for it. Maybe it would be cool to give it a name name. You know, like OpenMRS Nightingale after Florence Nightingale (that’s actually kind of scary sounding, but you get the idea).