I am an epidemiologist at an ETU in Lunsar, Sierra Leone and we are very interested in rolling out openMRS into our ETU which will be opening very soon (less than 2 weeks). I’d like to know if you guys could help facilitate that, and what kind of timeline we’d be looking at? We are all new to openMRS, but I come from a software company in the US that did public health case management software, and tend to pick up things pretty quickly. Could you give me more information on openMRS and what we would need to do in order to use it for our ETU?
The short answer is that it’s complicated. And at some level it depends whether you’re just interested in capturing data (and whether that’s going to be point of care by docs wearing PPE), or in driving workflow.
Doing retrospective data entry is straightforward. It involves building your organization’s forms using the XForms or HTML Form Entry module, and having a plan to get the data entered. (E.g. data captured on paper in the red zone, scanned/photographed and transmitted out, then transcribed into OpenMRS.)
Also, check out the latest release of the CIEL dictionary, which contains a lot of content related to Ebola.
To do real-time data capture in red zone, you probably want forms that are designed to be easy to enter by tapping on a tablet while wearing PPE. OpenMRS doesn’t have this out of the box (though I haven’t tried building a plain form and just making everything 2x as large). The hackathon described here started working on this, but it isn’t ready yet.
As far as driving ETU workflow, that’s also not something that comes out of the box. (Basically, OpenMRS 2.1 is built around patients having multiple visits to a facility over time, whereas the ETU use case is about intensive care, and planning out ward rounds.)
Some community volunteers have been working on building an ETU EMR based on the needs of the Save the Children-operated Kerry Town ETU in Sierra Leone described here.
However since this is based on volunteer effort, it is making slow progress. You can see what’s there (not much!) at devtest03.openmrs.org (login as admin/Admin123). What it will take to finish building this out is more developer effort…
Hi Alison
Thanks for getting in touch.
I am the OpenMRS point person for the ETC response for SL andDarius is the technical lead working on this project. I would reiterate what he said about the status of the project with the proviso that we are working to speed development up fast. Starting simple and building on that is of course going to be important if you want something fast. do you have requirements and workflow mapped out yet? do you have prototype forms and just as important the outputs you need in terms of patient summaries, reports etc.
Do you have programmers in your team? A business analyst?
Regards
Our team does not have programmers, but I can serve as a BA for the team (I come from a private company that did public health case management software and I functioned as a BA in that role).
We are in the process of procuring tablets and stylists for use in the hot zone for our clinicians - in addition, one of our ETUs will have server capacity as well.
Unfortunately, no one our team has ever worked with openMRS and so we are unfamiliar with how the software works. Are there any sort of training materials you could point me to? I don’t know what XForms are and we don’t have html capacity.
We do have a data flow and business process - we are working on finalizing our forms right now - we have our triage form, our admissions/epi form, and our medical record form. We’ve also developed our indicators and I can tell you what we need in terms of reports (simplest would just be a patient line list with all variables that we can manipulate in a statistical software).
Thanks for the information! I’d love to test out the progress that has been made, but the link you gave me (devtest03.openmrs.org) doesn’t open anything. Is that link still functional?
Thanks Ellen! I’ve been playing around with it. We are very excited about what we see! Are you currently in Sierra Leone? We’d love a meeting, if possible.
Allison, take a look at the tickets on this JIRA board to see the work we have laid out to do, and comment here on how closely that seems to map to your workflow.
Also, how closely do your forms compare to the Save the Children forms here? Some volunteers have been mapping this forms to make sure the underlying concepts are included in the CIEL concept dictionary.
Darius, yes, I’ve reviewed the tickets and have started to recruit programmers to help finish these in a timely manner (hopefully).
We are willing and able to adopt Save the Children forms to a point. They have more forms than we do - they have a slightly different flow- I have modified their powerpoint flow to reflect more closely our flow and I can share that.
As another example, our initial clinical review liked the first two pages of their Inpatient form. However, our ETC in Liberia has a form for treatment that has additional medications and standing orders for medications that we would like to incorporate. I can share that part of the form as well.
Should I just go ahead and create a wiki page for IMC ETCs?
Excellent. Start a new page for IMC ETC. Aram from Save the Children and I have been discussing reorganizing the pages just for this moment when other fantastic groups like IMC join in. Welcome and talk to you soon.
Alison, I am putting out regular updates to the OpenMRS CIEL concept dictionary to support the Ebola response (and in general). If you have additional requirements for concepts, or have specific forms you can share, we can provide you feedback and assistance with normalizing of the fields and loading of the concepts via a dropbox (if you send me a direct email).
Hi Alison
Welcome to the project. It is excellent that we can share the designs and tools we are all creating and avoid reinventing the wheel. It is very much the philosophy of OpenMRS to do that and ensure the widest benefit for all the work and ideas of our cord team and collaborators around the world.
We think that the planning and prototyping for Kerry Town should be helpful for other projects like yours. A key issue now is to ensure that we rapidly deliver the first version so that staff can start collecting data and give us feedback for version 2.
That means that in addition to the collaboration we need to ensure there is a separate track for your project that deals with local customization and timelines, separate from Kerry Town.
I look forward to being in touch and best wishes
Hamish Fraser
Leeds Institute of Health Science, University of Leeds, UK