Understanding the Differences Between Bahmni and Ozone HIS

Software Ozone HIS
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Hello everyone,

I’m interested in learning more about how Bahmni and Ozone HIS differ, especially since both are built on the OpenMRS platform and aim to provide comprehensive Health Information Systems (HIS) by integrating services like Odoo, OpenELIS, PACS, and more.

Seeking insights from @mksd, @grace, @ibacher , @angshuonline , @burke …

From my initial understanding:

  • User Interface (UI):
    • Bahmni has its own UI built with AngularJS, and recent developments indicate a shift towards ReactJS for new development (for example IPD)
    • Ozone HIS utilizes the OpenMRS 3 (O3) UI, which is based on modern frontend technologies.
  • Integration Mechanisms:
    • Bahmni integrates various services using ATOM feeds.
    • Ozone HIS employs Enterprise Integration Patterns (EIP) with Apache Camel for integration.
  • Laboratory Information Management Systems (LIMS):
    • Bahmni uses OpenELIS, odoo …
    • Ozone HIS integrates with OpenELIS (as well as Senaite LIMS) odoo …
  • Clinical Workflows Support:
    • Both platforms support key clinical workflows including patient registration, appointments, consultations, orders, prescriptions, and medical records management.
  • Focus on Low-Resource Settings:
    • My understanding is that both has been designed to be scalable and adaptable, both systems are suitable for low-resource environments and have been implemented in various healthcare settings in developing countries.
  • Open-Source Foundations:
    • Both projects have an open-source core, allowing for customization and community contributions. (Note: Ozone HIS may offer additional “pro” features that are not open-source.)

Based on this, I have a few questions:

  1. Additional Key Differences:
  • Are there other significant differences between Bahmni and Ozone HIS in terms of features, architecture, or integration approaches that I should be aware of?
  1. Feature Comparison:
  • Is there a current feature comparison or analysis available that outlines what each system offers, including any planned features for Ozone HIS?
  1. Open-Source vs. Pro Versions:
  • Bahmni appears to be entirely open-source with no paid “pro” features.
  • Does Ozone HIS offer features that are only available in a paid or “pro” version? If so, what are these features, and how do they affect extensibility and customization?
  1. Migration and Extensibility:
  • If someone is currently using Bahmni, can they switch to Ozone HIS with the same level of freedom and feature set?
  • Are there any limitations or proprietary components in Ozone HIS that might hinder customization or require purchasing a pro version?

5. Alignment with OpenMRS O3 Initiative:

  • Impact on Choice Between Bahmni and Ozone HIS:
    • Considering that the O3 initiative was designed to align the UI across implementations through the use of micro frontend (MFE) components, how does this affect the decision to choose Ozone HIS over Bahmni?
    • Does Ozone HIS’s use of the O3 UI and MFEs offer significant advantages in terms of interoperability and access to shared components from the OpenMRS community or a potential App Store?
    • Is the development direction or roadmap of the OpenMRS O3 UI more aligned with or influenced by Ozone HIS?

6. Integrating O3 UI and MFEs with Bahmni:

  • Possibility and Requirements:
    • Is it feasible to integrate the O3 UI and its micro frontend components with Bahmni?
    • Given that Bahmni is also based on the OpenMRS platform, what would be required to make this integration work?
    • Are there existing efforts or projects aimed at bringing O3 MFEs into Bahmni to enable sharing and reuse of components?

Additional Considerations:

  • Extendability and Future-Proofing:
    • From an implementor’s perspective, which platform offers greater freedom for customization and extension without being blocked by proprietary components?
    • Are there any hidden limitations in Ozone HIS that might require opting for a pro version to access certain features?
  • Technology Stack and Alignment with OpenMRS O3:
    • Since Ozone HIS uses the O3 UI, is it more future-proof or better aligned with the OpenMRS roadmap compared to Bahmni?
  • Community Support and Maturity:
    • Given Bahmni’s longer history and established community, does it offer better support and reliability?
    • How active and responsive is the Ozone HIS community, considering it’s relatively new?

Summary:

I’m aiming to choose a platform that is open, extendable, and won’t lead to being “blocked” by proprietary features or licensing restrictions. The O3 initiative’s goal of aligning UIs across implementations and fostering a community of shared MFEs is appealing. Ozone HIS, using the O3 UI, seems to align closely with this vision, potentially offering advantages in modularity and access to community-developed features. Conversely, Bahmni is proven and entirely open-source but might require additional work to integrate with the O3 ecosystem.

I would greatly appreciate any insights, experiences, or advice you can share regarding these concerns, especially on how the O3 initiative impacts the choice between Bahmni and Ozone HIS.

Thank you for your time!

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First of all, thank you for taking the time to write this post! It’s thorough, insightful, and raises many excellent points and questions.

Before addressing your specific questions, I’d like to clarify a couple of important distinctions.

It’s not quite accurate to directly compare “Ozone” and Bahmni – it’s more like comparing apples and pears. :blush:

However:

  • :white_check_mark: You can compare the Ozone HIS demo with Bahmni.
    • This is because the Ozone HIS demo achieves similar goals to Bahmni in that it can be used as a starter, off-the-shelf HIS solution.
  • :x: You cannot compare the entire Ozone HIS platform with Bahmni. Here’s why:

Ozone is an expandable ecosystem of digital health applications, all integrated by Ozone’s IOL (interoperability layer). You can find more details about this here.

Ozone is designed to be lightweight by leveraging existing open-source technologies rather than building new ones from scratch. A couple of key examples:

  • We vet and package existing open-source apps to become part of the Ozone HIS ecosystem. For instance, you can see the criteria for selecting apps here. This approach differs from Bahmni, which is largely centered around its own EHR system (Bahmni EMR or bahmniapps). Bahmni’s focus is on developing and maintaining an EHR, whereas Ozone HIS is an ecosystem of apps maintained by their respective communities, such as O3.
  • We focus on identifying what data should be exchanged between two apps and when, to support frontline healthcare workers effectively.
  • Each data flow is configurable to be reusable and customizable for different implementations.

A few other key distinctions:

  • Ozone doesn’t enforce strict workflows within the HIS; it’s a peer-to-peer system. We focus on data exchange between apps that can be adapted to different healthcare needs.
  • Ozone is FHIR-only, meaning all data flows involve exchanging FHIR resources between apps. If an app lacks a sufficient FHIR API, we either advocate for improvements within the app’s community or create a lightweight FHIR-facade for it. Unfortunately, this is one area where some code development is often necessary.
  • Ozone offers flexibility through a growing catalog of supported apps. While we promote the sample Ozone HIS demo (which includes O3, etc.), this is just one possible configuration. One of Ozone’s core goals is to continuously identify valuable open-source digital health apps, allowing implementers to choose and configure their HIS according to their needs.

Lastly, you could even integrate Bahmni EMR into a version of Ozone HIS, although this is not yet officially supported.

In summary, Ozone HIS is a FHIR-based, interoperable platform that allows implementers to build instant custom HIS solutions from a catalog of apps.

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Now, in light of all the above, your questions! …

Are there other significant differences between Bahmni and Ozone HIS in terms of features, architecture, or integration approaches that I should be aware of?

See my previous post.

Is there a current feature comparison or analysis available that outlines what each system offers, including any planned features for Ozone HIS?

The Ozone roadmap is typically highlighted during our interim release announcements. As we continue to improve our structure, it will soon be more visible on GitHub. For now, I’m happy to share this snapshot (from the product brief, as of September 2024):

image
image1340×1048 126 KB

Does Ozone HIS offer features that are only available in a paid or “pro” version? If so, what are these features, and how do they affect extensibility and customization?

Yes, there is one feature exclusive to the pro/enterprise version: centralized authorization. This feature allows for the creation and management of HIS users from a single location, which is particularly beneficial when integrated with active directories. Everything else, including Ozone Analytics, remains open-source.

If someone is currently using Bahmni, can they switch to Ozone HIS with the same level of freedom and feature set?

Yes, as a matter of fact this has been achieved by a number of implementers out there.

Are there any limitations or proprietary components in Ozone HIS that might hinder customization or require purchasing a pro version?

As said above, the only limitation in Ozone HIS is centralized authorization, which is part of the pro/enterprise features. Additionally, if you need a maintenance support plan, that comes bundled with the pro version. Pro users benefit from automatic upgrades as apps are updated or new apps are added to the ecosystem. Everything else in Ozone HIS remains open-source and highly customizable.

Considering that the O3 initiative was designed to align the UI across implementations through the use of micro frontend (MFE) components, how does this affect the decision to choose Ozone HIS over Bahmni?

In light of everything I’ve mentioned, this question isn’t directly related to Ozone but should be addressed in a separate O3/Bahmni discussion. It’s more relevant in the context of the parallel evolution of O3 and Bahmni EMR.

Does Ozone HIS’s use of the O3 UI and MFEs offer significant advantages in terms of interoperability and access to shared components from the OpenMRS community or a potential App Store?

Based on my understanding, your question seems more focused on O3’s relationship with Bahmni rather than Ozone itself, and – again – would be better addressed in a separate discussion thread specifically about O3/Bahmni.

Is the development direction or roadmap of the OpenMRS O3 UI more aligned with or influenced by Ozone HIS?

Absolutely not. In fact, it’s quite the opposite, though to a limited extent. Ozone’s data flows involving the EMR app might depend on what O3 can do as O3 is used as flagship EMR to looks at and follow. So, as O3 gains more features, additional data flows may be created. A great example of this kind of situation is with O3’s medication dispensing screens currently under development (by @PIH), the Ozone team will focus on ensuring that information about drugs dispensed from the pharmacy or ERP app is integrated into the EMR, provided O3 can support this functionality, which seems likely soon.

Is it feasible to integrate the O3 UI and its micro frontend components with Bahmni?

Again, this would be better addressed in a separate discussion thread specifically about O3/Bahmni.

Given that Bahmni is also based on the OpenMRS platform, what would be required to make this integration work?

Same here, not an Ozone question.

Are there existing efforts or projects aimed at bringing O3 MFEs into Bahmni to enable sharing and reuse of components?

Same here, not an Ozone question.

From an implementor’s perspective, which platform offers greater freedom for customization and extension without being blocked by proprietary components?

Probably Bahmni, since it is entirely open-source. That said, Ozone Pro imposes minimal limitations, and there’s nothing preventing implementers from replicating the features of Ozone Pro themselves if they prefer not to purchase the pro version.

Are there any hidden limitations in Ozone HIS that might require opting for a pro version to access certain features?

No, there are no hidden limitations in Ozone HIS. Any pro features are clearly advertised, and there are no hidden catches. Additionally, these distinctions will be further clarified when the new Ozone website launches in October.

Since Ozone HIS uses the O3 UI, is it more future-proof or better aligned with the OpenMRS roadmap compared to Bahmni?

Ozone HIS only uses the O3 UI if you choose O3 as your EMR app. Therefore, the question of future-proofing and alignment with the OpenMRS roadmap is not directly an Ozone question. I would recommend re-asking this in a separate thread, focused on the relationship between O3 and Bahmni in the context of future alignment.

Given Bahmni’s longer history and established community, does it offer better support and reliability?

That’s a great question, and any response from us would naturally be biased. However, it’s worth noting that the new OpenMRS Distro HIS, which leverages Ozone HIS, will strengthen its ties to the wider OpenMRS community for the foreseeable future, ensuring robust community support, development, and usage. That said, Bahmni has an established community with proven support and reliability over the years, so the Bahmni team would be better suited to provide their perspective on this. Let’s be reminded that the development of Ozone started in early 2020, so almost five years ago.

How active and responsive is the Ozone HIS community, considering it’s relatively new?

Very, as you can see :muscle: :slight_smile:

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Good read @sanjayap and @sudishrestha !

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Allow me to add that since Ozone HIS is committed to using its various apps as is, any new features or bug fixes deemed necessary by Ozone will not be developed independently (e.g., through a fork). Instead, they will be developed collaboratively with the OpenMRS community, which helps to continually improve O3.

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Dear @mksd

Thank you very much for taking the time to provide such a detailed and insightful response to my questions. Your explanations have significantly clarified the distinctions between the Ozone HIS ecosystem and Bahmni, and I appreciate the depth of information you have shared. :pray:

I was glad to learn about the flexibility Ozone offers with its growing list of supported apps. Finding out that we can choose and configure the HIS according to our specific needs is very interesting.

I am planning to install Ozone HIS locally to gain hands-on experience and explore these features in more detail. I’m excited to experiment with different configurations and see how the interoperability layer facilitates integration with various apps.

Thank you again for your valuable insights, and I apologize if some of my questions were repeated. I look forward to potentially engaging further as we delve deeper into Ozone HIS.

Best regards, Horaira

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