WHO trauma registry module? (IRTEC)

hello! I searched the wiki and can’t find anything like this - I’m interested in any examples people can share about using OpenMRS to automate data collection for an injury/trauma patient registry, here’s an example of the type of registry we are using currently WHO IRTEC injury registry summary Feb2020.pdf - Google Drive

imagine that you’re implementing OpenMRS as your EMR in a hospital where you are currently manually abstracting the data from handwritten paper medical records for each relevant patient based on the elements in this form Rwanda Trauma reg Core Elements.pdf - Google Drive but you want to create templates for clinical documentation that will INCLUDE these elements and can be coded in a way that they can be easily identified and pulled into a dhis2 database that is the registry - I hope that makes sense, I’m just starting to learn OpenMRS

Basically, I want to know if anyone is working on this? no need to re-invent the wheel if so!

cc: @dkayiwa @ibacher @grace @ssmusoke @mksd @mozzy

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Hi @krebse welcome here.

That makes perfect sense and this is what we intend to tackle with the new-to-be-born OpenMRS 3.0 packages. @grace to tell you more about this :slight_smile:

One of the possible use cases for those packages is to become the OpenMRS corresponding packages of DHIS2’s analytics package, see here:

  • EPI
  • HIV
  • Malaria
  • TB
  • RMNCAH

And many more, such as the one you suggested.

OpenMRS 3.0 packages are in the early days of their design, so no one is working on this as such. But that doesn’t mean that nobody out there has worked on encounter forms that cover some or all of WHO IRTEC. Not that I know of, @ball?

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HI @krebse ,

At PIH we developed and are using an Emergency Triage application in OpenMRS. It’s not so much a registry, but a point-of-care application that allows users to enter in vital signs and symptoms of a patient and it responds with the triage severity of the patient (red, orange, yellow or green). These patients are ordered on a patient queue of those awaiting care. Also, we’ve built an export that could be used as something like a registry.

See some documentation on this functionality here: Emergency Department Triage Application - Projects - OpenMRS Wiki

Note that this uses the South Africa Triage Scale (SATS) and not the WHO scale (ETAT).

We have it in use at a large hospital in Haiti and are evaluating it for use at a hospital in Sierra Leone currently.

This may not be quite what you are looking for but I hope it helps!

Dave

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Thank you so much for this great information! I am so unfamiliar with this forum and all of this kind of approach with openMRS that I don’t even know how to propose an appropriate way forward. :joy:. That said, if any of you who have read this and responded to it are willing to have a call with me to teach me a bit more about how to proceed and be productive in this quest I would really appreciate it!

I have reached out to contacts at the WHO who work on IRTEC and hopefully will have an answer from them within the next day or two to know if they are actively working on this kind of automation and digitization of their resource. What we are hoping becomes possible is probably 3 to 7 years from now ultimately, implementation of an electronic medical record of any kind in a resource constrained health system is a tall order, but no reason not to dream and make sure that were considering important aspects in our planning!

Thank you! It’s so interesting that they have not implemented this at the PIH hospitals in Rwanda, though the emergency departments are pretty small, and it was just before Covid began ruining everything that I know they were actively working on improving their standards of emergency care at those sites, especially Kirehe where they are near a big paved road and see a good amount of road traffic crash and injury patients.

I would love any feedback that you guys can offer on how I can begin trying to find Rwandan openMRS developers Who might be interested in potentially joining our project/research team versus at least be able to respond to some terms of reference with a quote for their services, so we can make an appropriate budget for this proposal. I’m pretty creepy, and cross-referenced the wiki site and noted that @cioan is active here as well. wanted to tag all resources who might be able to answer this question as it seems he’s still active with PIH in Boston though maybe you are as well Dave?

This is the same triage system that’s in use here in Rwanda at least two emergency departments, and I am certain that it is responsible for saving many lives. I described it to some contacts who are working in the context of the national digital health strategy and they thought it sounded like a really important module to build into a highly functional EMR

I guess I’ll throw that out there for anybody who is reading this, I’m an emergency physician from the states but I live in Rwanda and Am trying to help build out their emergency care and injury prevention resources. if any of you are developing resources that may be useful as tools to improve emergency care, EMR-based modules or supplements like this triage score please feel free to reach out to me as a clinical resource. I hope that your community has tons of offers like these, but based on some other experience in the private sector at least it can be difficult to access clinicians to give you end user feedback

Hi @krebse , both @ddesimone and I are working for PIH. We were involved from the beginning in the entire development process of this app. I would be happy to answer to any questions you might have regarding the ED triage app we built for Mirebalais Hospital. It might also be helpful if we put you in contact with our ED doctors who drove the requirements for this app? Here is the source code for this app:

Thanks! I’m already in contact with PIH admin and emergency clinical folks but I appreciate the offer. Sorry about what Haiti is going through these days, it must be extra hard to see having worked there. If we manage to move these ideas forward perhaps then it would be helpful to connect with PIH clinical folks but for now we’re focused on knowing what it will take to build what we’re interested in, after we know that it will be more helpful to discuss alternative ideas I think - getting in contact with PIH developers who work in Rwanda would be helpful though, even if only for them to help us understand who works on openMRS here.

I’m speaking with the WHO IRTEC team in a few hours, if anyone has specific questions relative to openMRS coding that I should ask them please let me know!

Yes indeed I think it would be great for you to have a quick chat with @grace and/or I to see how our upcoming work on OpenMRS 3.0 packages can align with implementing WHO IRTEC within OpenMRS.

I would love to join but I will have very limited availability until September 13th. Can this wait a little?

not sure if it works for me to just reply to an email but I’m going to try it - no problem to wait, I think I have the background info that I needed and I am investigating all this in the context of a funding application that if we are lucky enough to win would not flow until maybe May 2022 - it seems that there are many examples of OpenMRS outputs to dhis2 so I think what we’re interested in is very possible and the details can keep being discussed over time !

@grace and @mksd I’m speaking with Jembi tomorrow and will ask about the current status of OpenMRS builds here in Rwanda and mention my connections with you folks through this board and OpenMRS 3.0 - please let me know the best way to schedule a brief call with one/both of you to learn more and thanks for your help in advance!

@krebse sorry about the late reply, I was on leave and then gradually catching up with work. Are you still willing to meet @grace and/or I about this? If yes, what about next week?

110%! and no worries, I’m underwater due to other responsibilities till next week anyways - I’m quite flexible next week so please feel free to propose a date/times (I’m on CAT) and venue - I’m working through the OpenMRS 3.0/OHRI bootcamp so have learned bits on my own and am in talks with Jembi relative to this proposal - very happy to keep connecting and learning in either case

Sorry please refresh me, what does the proposal refer to?

interoperable, digital, road traffic injury data systems inclusive of HIS/EMR that serves the emergency department - want to integrate everything into the clinician workflow ideally to avoid duplication of effort to collect data elements that are relevant to an injury registry - I think it will all be possible with OpenMRS/Bahmni and dhis2