openmrs in rwanda
DESCRIPTION
OpenMRS in Rwanda. Hamish Fraser Director of Informatics and Telemedicine, Partners In Health Assistant Prof. Harvard Medical School Co-founder, OpenMRS Collaborative. Overview. Rwanda Health Care System OpenMRS sites Training Rrogram Rwanda National OpenMRS Rollout - PowerPoint PPT PresentationTRANSCRIPT
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OpenMRS in Rwanda
Hamish FraserDirector of Informatics and Telemedicine,
Partners In HealthAssistant Prof. Harvard Medical SchoolCo-founder, OpenMRS Collaborative
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Overview
• Rwanda Health Care System• OpenMRS sites• Training Rrogram• Rwanda National OpenMRS Rollout• National eHealth Architecture
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Rwanda health indicators• A small central African country:
– Population 9 M people – Highest population density in Africa, 85% rural
• Achieved rapid economic growth since genocide in 1994, but still has very poor health outcomes:– Life expectancy 38-44 years– Infant mortality 152/1000– Maternal mortality 1071/100K– Medium income $230– HIV prevalence 3%– Malaria prevalence 46%
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OpenMRS origins
• First OpenMRS site – Eldoret, Kenya February 2006
• Second site – Rwinkwavu, Rwanda August 2006
• Third site– Richmond Hospital, South Africa
September/October 2006
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OpenMRS Sites in Rwanda
• Clinics run by Ministry of Health – Supported by Partners In Health
• The TRAC clinic– Large HIV clinic run by the MOH
• Town of Mayange– Millennium Villages project
• National Tuberculosis program – OpenMRS-TB
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Rwanda
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OpenMRS at PIH sites in Rwanda
• Currently used in 12 PIH –supported health centers
• 8 sites have own server– 6 remote sites have synchronized copy of entire database
• Registration, encounter and lab data – TB, HIV, and now heart failure patients– Over 10,000 patients tracked (Sep. 2009)
• Team of Rwandan data officers trained to enter data, ensure quality & produce reports
• Clinicians use electronic patient summaries• Many new research and clinical applications
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OpenMRS dashboard - HIV Care
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Physician looking up ARV patient
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OpenMRS-TB, bacteriology dataBacteriology management tools include a customizable timeline of smears, cultures,
treatment status dates, culture conversion dates, and other clinical observations.
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Report of MDR-TB cases
BIRT report
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National OpenMRS rollout
• MOH and PIH are augmenting OpenMRS for roll out in hundreds of clinics in Rwanda
• One month ago we were asked to move ahead with the HIV clinics supported by the GFATM
• We are developing a new version for primary care
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Proposed primary care version of OpenMRS for Rwanda
13
Patient Registration
Clinical Diagnostics
Prescription Drugs Mutuelles de Santé
1
2
3 5
Laboratory testing 4
<insert relevant illustration>
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Patient registration system (prototype)
14
1
Patient Identification
Patient Registration
Patient Summary
• Barcode affixed to patient’s health passport provides a unique identifier to each person
• Can be used at any clinic or hospital
• May move to 2 D barcodes
• Progression of vitals (i.e. height, weight, blood pressure)
• Serious allergies and/or drug reactions
• Current prescriptions • Current treatment
program• Next appointment /
appointment history• Assists nurse or
physician’s assistant in quickly assessing status
• Contents stored include: name, age, gender, phone #, insurance, address
• Time saved for clinics – no need to reenter patient’s personal information every visit
• Check for duplicate records / names
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Kigali Developer training• There is a shortage of Java programmers who
can work on eHealth systems like OpenMRS
• A year ago we set up a training program for computer science graduates to learn these skills
• The students graduated last week and are working on modules for the OpenMRS rollout for HIV
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eHealth Architecture Project• Rwanda has embarked on a plan to create
national eHealth architecture
• This will define the functions of each components and interoperability standards for each
• A meeting was hosted by WHO last week in Kigali. Over 100 people from Rwanda, other African countries and the developed world worked on these specifications and interoperability profiles
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Open standards and interoperability
• To be sustainable information systems need to be designed with compliance with open standards
• Leverage the expertise and experience of groups in each area: – Laboratory, Pharmacy, EMR, Reporting and
surveillance• Business as usual is hundreds of incompatible
systems with limited functionality and high cost
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Potential components of integrated national eHealth architecture in Rwanda
EMR SystemOpenMRS
National reporting system
TRACNet
Pharmacy system
PIH
Registration and insuranceMutuelle
Mobile health systems
OpenROSA
Radiology /telemedicine
system
Laboratory System
PIH-Lab-system
IXF/SDMX
HL7HL7
HL7?HL7
DicomHL7
Supply chain systems
Camerwa
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Challenges for OpenMRS Deployments
• Equipment, power supplies and networks• Data management and quality control• Evaluation• Sustainability• Training
– Programmers– IT staff– Data entry staff and managers– Users
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Conclusions• OpenMRS is now heading for widespread use in
Rwanda
• There are studies showing benefits from OpenMRS in process and delivery of care as well as reporting
• Open standards for data exchange are essential in scaling information systems and reducing costs.
• Open source software allow the creation of better, more flexible and sustainable tools and allow local communities to build and modify them
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Collaborators and Funders • Partners In Health• Regenstrief institute• Medical Research Council, South Africa• World Health Organization• US Centers for Disease Control• Brigham and Women hospital• Harvard Medical School• University of KwaZulu-Natal• Millennium Villages Project• International Development Research Centre, Ottawa• Rockefeller Foundation• Fogarty International Center, NIH• Boston Consulting Group• Google Inc
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Question?
People in the web conference please hold your questions
until the panel at 11 am