Oncology Work Group/Community

[jeffneiman]

Hello everyone! There’s been a lot of chatter around developing OpenMRS modules for use in Oncology. There have been various discussions on Talk where people expressed interest and or progress on this type of project from people such as @ball, @onkologjia, @seanlegler, @jteich, @mseaton, @rubailly, @johnblack, @terry, and @jdick. I wanted to compile most of what I found into one thread with the intention of connecting all these people together and bringing the discussion back into a spotlight.

Here’s what I’ve found…

What’s been done so far

PIH seems to be leading the charge as @ball posted this talk post below…

@ball

For Partners In Health and the oncology team at University Hospital at Mirebalais, Haiti, we have created an Oncology consult note using HTML Forms and the Reference Application. The form is packaged along with all the metadata (MDS) and “paper” version on the OpenMRS form bank: Form Bank - Resources - OpenMRS Wiki

Note that this form will work outside of the reference application and our software packaging, but looks great using the OpenMRS Reference Application SimpleFormUI and some of the labels are defined in a message property file. These should be easy to modify.

Feel free to share your own forms in the Formbank. @arbaughj and I enjoy the camaraderie.

PS - Thanks to Cordt Byrne for creating the form and @akanter for new concepts.

The patient intake sheet PIH developed is HUM_Oncology_Consult_2015.docx (20.4 KB)

Yusef Mulumba, a BioStat at Uganda Cancer Institute came up with this document, where Dr. @johnblack commented his thoughts.

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Who’s Expressed Interest?

@seanlegler (Harvard Medical Student) posted way back in 2014 …

@seanlegler

Hello all,

I posted this on the implementer forum, but thought I would try here as well. I am a second-year medical student at Harvard and am interested in learning about current and/or future implementations of OpenMRS for oncology.

So far I have been able to gather the following:

Partners in Health currently has some basic oncology functionality for their cancer hospital in Rwanda that is a mixture of data forms, the Reporting module, and a customization of the OrderExension module that allows for the complexity of chemotherapy regimens. I also believe that RG Kar Hospital for Oncology and Radiation Oncology implemented OpenMRS, but I am unsure of the extent to which oncology-specific functionality was created beyond adding concept dictionary terms. Andrew Miller of University of Wollongong’s Graduate School of Medicine has previously looked for others interested in using OpenMRS for oncology, specifically for radiation oncology, but I don’t know if he was able to connect with any collaborators. The Active Projects page has outlined an OpenMRS design for chemotherapy regimens. Finally, it is my understanding that AMPATH has embarked upon comprehensive cancer care in Kenya. I would be curious to know if this cancer-related work included creating any new OpenMRS functionality.

Has anyone else attempted or successfully used OpenMRS for oncology? Is there interest out there in the community to have functionality for chemotherapy ordering or for other features specific to cancer-care?

There are free oncology platforms available online for cancer care currently, such as St. Jude’s POND (pediatrics) and Memorial Sloan-Kettering’s CAISIS programs, however there does not appear to be a free solution that can be integrated into a broader system like OpenMRS. In terms of coordinating, tracking, and evaluating cancer care in locations such as Haiti (where OpenMRS is already used), it seems it would be valuable to have functionality specifically for oncology – and perhaps even to eventually have a more generalizeable module that could one day be integrated into the Reference Application, allowing for ongoing collaboration.

Looking forward to hearing about any potential work on this front or general thoughts that the community has.

Sincerely,

Sean L

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@onkologjia has a group of students working in Kosovo trying o implement OpenMRS in a local clinic. His post is below…

@onkologjia

OpenMRS Lastest Version installed with reference modules

Question:We are a group of students from Kosovo, and we are trying to implement the OpenMRS at the Clinic of Oncology, we have installed all OpenMRS and all reference modules, we are not sure which are the best possibilities to implement it, so the questions that I want to ask are

Which are the best modules to implement it in Oncology?Is there any possible way to add drugs as a drop-down list with a list of many drug concepts?Is there any possible way to add a body scheme to select where are the main doubts of doctors?

Thank you so much, because we are struggling a lot with this problems and we are not sure if we can fully implement this in Oncology.

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@johnblack (an Oncologist in Kampala, Uganda) posted this topic expressing the need for an oncology module in Uganda below…

@johnblack

Hi all!It was nice meeting you in Kampala and thanks for showing interest in making OpenMRS work well for oncology in low resource settings. I learned a lot from the unconference session and got a lot of advice on how we can achieve this. I understand that the team at Bahmni is working on the oncology modules as well as the team in Rwanda. @terry was interested in the stats by WHO that cancer is killing more people than HIV, TB and Malaria combined, which is reason to give it more attention and maybe even lobby for funding efforts to develop OpenMRS oncology modules.

The team at Bahmni is already working on somethings in this line and according to @jteich certain key issues such as flow sheets and clinical care pathways are being discussed and/or developed. Some work is also being done on order sets and @mseaton and @rubailly from Rwanda might be familiar with this. I actually have the Word forms for many of the cancers from Rwanda which @toddandersonpih shared with me. We might just have to make small edits on them and they fit for the Uganda Cancer Institute. I am not sure if the form builder that someone mentioned can allow for that. For instance being able to modify doses of drugs or orders in an order set on the fly depending on availability, without needing to write lots of code.

I have read several papers by @hamish @burke @paul @darius and others concerning EMRs/EHRs in low resource settings and I couldn’t find much information on use in oncology. If anyone has experiences on this it would be very helpful. I would appreciate pointers to published literature on this subject as it is also what my PhD work is relating to (socio-technical issues in implementing EMRs in cancer care in developing countries). I am also much interested in what @hamish suggested: evaluation and evidence base for OpenMRS.

I am also giving links to the documents that I mentioned during the unconference: the CORE Whitepaper from the ASCO and NCI’s caBIG as well as the UK version of that, CICERO discussing requirements for the EHR for oncology. I also share my thesis which was looking at the requirements for the Onco-EHR for low resources settings.

Let’s start a discuss and a community to push this forward.

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How to Move Forward

@johnblack and I met in Kampala (over pork—be a jealous!) to discuss the requirements specific to Uganda which we’ve outlined on a Google Doc which certainly isn’t the best place, but it’s a start.

If a working group hasn’t been created already, maybe we can do that? What about a Talk Community Group titled ‘Oncology’?

Are there any Project Managers interested in taking the lead on this? What about our other Community Leaders? How do we move this project along to make it into a reality?

[raff (Rafal Korytkowski)]

Thanks @jeffneiman for the initial research! I would be interested in leading dev efforts. It’s a project, which may spark interest in @SolDevelo and get us a team of devs to work on it.

[aleksandrakubicka]

Yes, I think it’s something SolDevelo could be really interested in! We need to gather all technical requirements for this project so we can make proper estimates and assign dev team.

[terry (Theresa Cullen)]

that is a great idea. I know that @johnblack has developed multiple requirements in the past. This project will require ongoing clinical as well as technical input ( truly agile) during the development process to be successful–and it would be great of @SolDevelo was interested in that role.

[tomhealy]

Raff,

LMK if you want to use this project as a model for documenting PM process. Seems to be a good opportunity to do so.

[johnblack (Johnblack Kabukye)]

Hi everyone! Sorry I have not been responding to this thread but I have been following it and I have had a couple of discussions with @jeffneiman @terry @burke as well as people at @ugandaemr on the subject of oncology functionality in the OpenMRS ecosystem. It is great to see that there are many people interested in this, and that some work is already being done.

@mseaton recently asked if there is any experience interfacing the cancer registration software CanReg with OpenMRS and an unconference session has been proposed to discuss this and other cancer related issues during the OMRS17 in Malawi. For instance, at the recent AORTIC conference in Rwanda, a set of cancer care guidelines were launched after a lot of work by IBM, American Cancer Society (ACS) and Clinton Health Access Initiative (CHAI) consulting with several oncologists in sub-Saharan Africa. These guidelines are a harmonization of the NCCN guidelines met to take into account the low resource situation in Africa. These NCCN Harmonized guidelines for Sub-Saharan Africa can be accessed freely (after signing up) from the NCCN website. Currently IBM wants to make these computer interpretable. Wouldn’t it be nice to work with them to incorporate them into OpenMRS? Looking forward. //Johnblack

[ball (Ellen Ball)]

Great idea, @johnblack. I look forward to the session at OMRS17.

e

[terry (Theresa Cullen)]

OpenMRS for Oncology

Dear community, Many of you have heard me sing the “OpenMRS for Oncology” song for two years now, and in Malawi last year, we proposed to write up a concept note and try to look for funding to support building oncology functionality in OpenMRS. Luckily, IBM Foundation, American Cancer Society and Clinton Health Access Initiative as well as other cancer care stakeholders in Africa (UNC Malawi, Partners in Health) are also very interested in this and are joining us to get things going. Already…

this work has restarted. please see the above thread for details about the current process…