Registration, clinical workflows & guidelines and reporting standards in Haiti

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Dear Haiti community,

We are discussing a possible OpenMRS/Bahmni implementation at a hospital in Haiti and therefore we are looking at establishing an exhaustive programme of requirements. This is our step 0 :slight_smile:

At this juncture this implementation does not encompass (yet) connections to national/regional HIS components or HIE services. However we anticipate that this will probably happen in the future. So we want to make sure that all that we plan now does factor in that possibility.

  1. Is there a standard registration process that we should adopt?
  2. Are there mandatory reports that we should produce?
  3. Is there some master terminology data that is being shared somewhere and that we should reuse?
  4. Are there guidelines that we should follow regarding the clinical workflows?

Clearly we hope for the final result to come out as a reusable bi-lingual Bahmni-based distribution for Haiti and to put in common as much as we can with other groups working with OpenMRS and/or Bahmni in Haiti.

If anybody could point us to documents, resources, guidelines, even past RFPs, … etc, that would be super useful!

CC: @nathaelf, @ball, @mseaton

Hi Dimitri,

@nathaelf can discuss the standard processes as a clinical mentor. He leads all of the requirements gathering and execution in Haiti. On the OpenMRS side, there are two major distributions in Haiti at the moment, PIH’s Zanmi Lasante and I-TECH’s iSantéPlus. I-TECH has been developing and supporting iSanté for the last 12 years, which is a custom built EMR for Haiti. We are actively transitioning the custom system to the OpenMRS platform (iSantéPlus) and are working to pilot in December.

Our team is also working on implementing OpenHIE, branded as SEDISH, to support the movement of individual patient records and national level reporting, primarily for HIV care. Both PIH and I-TECH have done a tremendous amount of work to implement these OpenMRS distributions. I think it would be good to compare features and road maps to see how they fit for your clients needs.

Craig

Thank you Craig, that was very informative. I didn’t know that iSanté was not OpenMRS based.
We will certainly want to connect to SEDISH eventually, but in the short term we will probably look at getting things going “in isolation”, at the facility only. However while doing so we will certainly already have to make choices that will facilitate the HIE integration.

Absolutely, would it be possible to gain access to QA or demo servers for both? Even just through a temporary access?

I would be curious to hear about others on this thread see what they suggest. Is there an overall interest for a Bahmni-based Haiti distro?

Dimitri,

Welcome to Haiti, will be good to have you here… :slight_smile:

I’ll second what @craigappl has said. We currently use what we loosely term “the PIH/ZL EMR” in Haiti, which is basically a custom distribution of the Ref App (actually, it predates the Ref App and the Ref App came out of it).

As iSanté (not OpenMRS based) is upgraded to iSantéPlus, we’ve been trying to stay aligned as much as possible with what the I-TECH team is doing. To that end, we’ve create a “Haiti Core” module specifically to share metadata between the two implementations.

I think there’d be interest in a Bahmni-based distro in Haiti. Our own interest would probably depend on how easy it is to run alongside our existing distro–so keeping metadata consistent as much as possible, etc, would be a big plus.

Let’s definitely talk further, some potential for great synergies here. Hit me up with a PM and I can set you up with an account on one of our staging machines.

Take care, Mark

Thanks Mark! Really appreciated. Amazing.

Ok I understand, so (some of) the plan would probably to get Haiti Core to run on our Bahmni-based distro. I think we could definitely convince this potential client that work should remain aligned with what happens with PIH/ZL EMR and iSantéPlus. At this stage this is the kind of input that they are awaiting.

I will definitely PM you about the access to the staging server. @craigappl , would something similar be possible with iSantéPlus you think?

I will get back to them first about what we just discussed on this thread, then let’s move forward with actually looking at those distributions.

Hi @mksd,

I’ll PM you credentials to our online iSantéPlus demo. The Haiti Core module provides a baseline of shared address template, encounter types, identifier types and person attribute types. We haven’t yet shared forms or concepts. iSantéPlus is standardized on the CIEL dictionary for all concepts except a handful of registration concepts that are loaded in using metadatasharing packages. @ball could discuss PIH’s approach to concept maintenance for Haiti.

Our forms are available in the iSantéPlus module in GitHub and we use an ETL process to push the transactional database to a local SQL warehouse database that is used for our iSantéPlusReports module.

Craig

Happy New Year Haiti community! :tada::confetti_ball:

I’m sorry that I gave the impression to let this thread down, I had initially been scouting around while awaiting a formal green light for the project mentioned in my original post. And I must say that I am already very grateful to @mogoodrich and @craigappl to have provided me access to their QA servers so spontaneously. That’s great.
Now things are moving forward! …and we would like to start establishing a roadmap for a Bahmni-based hospital solution for Haiti.

In all likelihood the roadmap will outline a multi-phase approach, possibly spanning over an extended period of time.
Phase 1 though should enable the target site to adopt ‘quickly’ the HMIS solution and at the very least to start capturing medical documentation using Bahmni.

@nathaelf, @ball, @mogoodrich and @craigappl, would it be ok for you guys to organise a design call to discuss both PIH/ZL and iSantéPlus?

Cc @arbaughj @mseaton @mksrom

Sure, I would be will to join a design call.

Take care, Mark

Great Mark. I just setup a Doodle for this, here: https://doodle.com/poll/neetzwi4nr9tafme

Hopefully we can have a first discussion somewhere between now and end of next week. Really looking forward to starting this new project.

Thanks @dmitri, I just took a look at the poll and the times are a little funky for me, see below… I assume you weren’t planning a meeting from 1 in the morning to 3 in the afternoon? I’m assuming Doodle is just messing up the conversions…

Updated!

(Not it wasn’t Doodle’s fault, it was just me…)

Got it… whew! Lots of options, I just filled it out, I hope I got it right.

I know you know this, but, for what it’s worth just to mention again, both PIH/ZL and iSantéPlus are Ref App based, not Bahmni-based, so that is more of the angle I will be able to weigh in on.

Take care, Mark

Yes absolutely, we fully understand that. Quoting my initial post again:

We want to ensure that whatever we do is in line with the community of practice of OpenMRS in Haiti. Furthermore, we would hope to contribute to a common set of resources that help set up and configure OpenMRS distributions in Haiti (Bahmni or not), if that’s a possibility. But let’s discuss all this over the call!

Thanks Mark for being so prompt.

Hi @craigappl , would anyone from I-TECH want to join? We could also talk about iSantéPlus on yet another call. What do you think?

Hi @mksd,

I’m transitioning from I-TECH and @nathaelf is the best person to join the call.

Craig

Thanks for the pointer @craigappl. I hope we will keep seeing you around OpenMRS?


Hi @nathaelf, would you like to join our meeting?
Please see https://doodle.com/poll/neetzwi4nr9tafme

@arbaughj, what about you? It would be great to get your input as well.

Hi @ball and @mogoodrich!

Thanks for responding to the Doodle poll. So would Tuesday 16th @ 9am EST work for you both? If yes I’ll send out a calendar invite.

Is there another time? I have a 9am meeting. My fault if I selected that on the doodle poll.

e

@ball could you do either 10am or 11am the same day?

Either time – Jan 16 at 10am or 11am EST.

e