On 12-16 December 2017, Uwe Wahser and Isaiah Nyambuka attended the OpenMRS Implementers Conference in Malawi to assess whether OpenMRS holds promise for GIZ partner hospitals in Kenya.
The GIZ-supported health sector project currently works with 47 hospitals in Kisumu, Kwale, Siaya, Vihiga and Nairobi counties to improve the management processes essential for providing quality services to patients. In early 2017, when the project assessed the hospitals’ IT infrastructure, it found that many of them were already equipped with various electronic medical record systems – usually provided as part of development partner-supported programmes.
However, no one of these systems seems to work across all the different hospital departments. The result is multiple systems, duplication and inefficiencies – both for the staff who have to become familiar with, and maintain them, and for the patients, whose health data are kept in different files rather than in one single patient record.
OpenMRS – an open source solution that works across hospital departments
OpenMRS, which stands for Open Medical Record System, is an open source software which allows developing countries to design electronic medical records according to their needs. Initially, it was created to support HIV care in a couple of settings in Kenya and Rwanda. However, its designers at the Regenstrief Institute in Indiana were aware that patients with HIV can also suffer from, for example, malaria or tuberculosis, and may have maternal health or other primary care needs. OpenMRS is therefore designed as a generic medical record system that captures essential diagnostic data, observations, encounters, and notes on specific patients from all the different hospital departments, and can turn these into summaries, reports, and data views, as needed by the health workers in these different departments to provide quality care.
Once a year, OpenMRS implementers and those who are considering using it meet to learn from one another and to further develop and improve the software. The GIZ experts Wahser and Nyambuka attended last year’s meeting to assess whether OpenMRS could help them tackle some of the challenges their partner hospitals face.
An opportunity for German technical cooperation in the coming years
“The staff in our partner hospitals are tired of working with different patient record systems in each department, including both paper-based and various electronic systems”, says Wahser, Technical Advisor and health informatics specialist. “From what we saw and what we heard from other OpenMRS users at the conference in Malawi, I believe that this electronic medical record system could be a good solution for our partner hospitals, too.”
A five-year programme supported by the US Centres for Disease Control and Prevention (CDC) is currently setting up electronic medical record systems for HIV clinics in all the hospitals which the German project also supports. According to Wahser, German technical cooperation is well positioned, in a follow-up project, to work alongside the CDC programme to extend these systems in such a way that they also cover the data captured by other essential hospital departments.
Nyambuka, also a digital health expert and currently an intern at the German health sector project, took part in a hackathon at the OpenMRS conference. Together with implementers from other countries, he worked on a way to make patient records accessible to not just one, but several facilities in a given region.
Today’s health workers, and patients, demand fast and easy-to-use IT solutions
“The development of IT solutions in the health sector is happening very fast”, says Wahser. “A lot of it is donor-driven and not always ‘in sync’ with the surrounding systems. But at the same time Kenyans are used to fast and simple IT solutions, such as M-Pesa, and that is what they expect. If a hospital is not able to transfer their patient record to another facility, or just to another department, they will ask their doctor why he or she cannot just send it as WhatsApp message. And, to be honest, I think they’ve got a point.”
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