Clinic management software
Started by Gauti Reynisson on 19 Jan 2010
Last edited by Sophie Beauvais on 25 Jan 2010
Hi GHDOnline,
We are a group of MIT Sloan business students and we have been lurking on this forum for a while now. We are working with a clinic in Kampala during the month of January, aiming to help them come up with a strategic plan for the next few years.
The clinic is quite advanced when it comes to IT. They are using a bookkeeping software (Quickbooks) and a medical records software (the Singapore developed Encore). However, we feel they are not close to reaping the full benefits of IT for running their company.
We want to come up with ideas on how to move forward, but before we reinvent the wheel, we wanted to ask you guys for ideas on the following questions:
1. Do you know of clinics in Uganda which have successfully implemented (i.e. are actually using it consistently) an EMR system?
2. Do you know of clinics, anywhere in Africa, who have used OpenMRS as an integrated tool in day to day operations of a general clinic?
3. Do you know of IT support company in Kampala which has experience in rolling out software in clinics? Including staff training and "process" consulting?
There are many things we'd like to change, but we are trying to make sure the changes can be followed through after we leave and would therefore appreciate any input on how to create the right kind of support for our clinic in Kampala.
Many thanks in advance,
Gauti Reynisson
Keywords: IT Training, OpenMRS, Software
Aliya Walji
Hi Gauti,
I don't have much knowledge in this area, but one person I can think that would probably be able to provide a lot of assistance, is Melissa Ho, from Berkeley, who has been working in IT/Healthcare in Uganda for a while now. I suspect she'll have a lot of information and connections to get you started.
This is her website (should have contact info on it, I assume):
http://www.ictdchick.com/
Thanks,
Aliya
Aliya Walji
Technical Program Manager - ICT Innovation
Grameen Technology Center
+233540923923 • Skype: aliya.walji
8:40 AM, 19 Jan 2010 | Permalink
Jessica Haberer, MD, MS
Hi Gauti,
The Immune Suppression Syndrome Clinic (HIV clinic) in Mbarara, Uganda
(southwestern part of the country) has an excellent OpenMRS system in place
and serves somewhere around 10,000 patients. I¹d be happy to put you in
touch with the clinic for details.
Best,
Jessica
9:44 AM, 19 Jan 2010 | Permalink
Gauti Reynisson
Thanks for the info!
We'll follow up on this,
Regards,
Gauti
4:37 AM, 20 Jan 2010 | Permalink
Nicholas Musinguzi
Gauti,
I am the Data Manager and was instrumental in the implementation of the Openmrs system at the ISS Clinic that Jessica mentioned above. Our information system has been in existence since 2004 when we used an access based system and switched to the mysql based openmrs late 2006. We have over 18,000 patients whose data exists in our system. We have contributed data to International Consortia like Artlinc and Iedea East Africa. We have a patient summary sheet printed out at every patient encounter summarizing the patient's last visit vitals and general status. This summary sheet has been praised by many to have decreased the amount of time clinicians spend per patient without compromising quality of care. A paper has been published on this.
On the other hand, I don't know of any IT company that handles roll out and support training for Health Information systems. I do know that Makerere University Computer Science Department was initially contracted by WHO to support sites implementing openmrs. They have since then revoked that contract and prefer to use experienced implementers to provide support to new sites.
I am happy to fill in on any farther details that you might be interesting in knowing.
Nicholas
9:49 AM, 20 Jan 2010 | Permalink
Andrew Sideman
Dear Gauti,
You might consider getting in touch with Uganda Chartered Healthnet (UCH) in Kampala.
UCH is a local NGO which was set-up to provide information and technology support and consulting to the health sector.
AED-SATELLIFE has worked closely with them on numerous technology projects including the Uganda Health Information Network, a two-way wireless communications system for public health data collection and clinical information dissemination operating in five districts with over 600 health care users serving ~1m people.
We have also relied on UCH extensively to provide on-site technical consulting and training for our projects in other countries in Africa, including deployment of the mobile-phone based GATHERdata platform for digital surveillance and reporting.
Here is a link to UCH's website: http://www.healthnet.or.ug/
You can contact Kakaire Nyende through that site.
Please be in contact if you want further information.
Best regards,
Andrew Sideman
AED-SATELLIFE
10:14 AM, 20 Jan 2010 | Permalink
Joaquin Blaya
Hi Gauti,
In response to your original questions, if there are sites using OpenMRS in day to day operations, I would say that many use it in daily activities but usually with data entry personnel doing the input, and not as many have tried to have clinicians use it. There is a summary of implementation sites, that is pretty incomplete, but gives you an idea.
As far as support companies in Kampala, I don't know of any, but another good contact is Carl Fourie at Jembi, a South African non-profit that is creating implementation nodes in different countries to support OpenMRS. His email is .
Warm regards,
Joaquin
___________________________________________________________________
NLM Fellow, Decision Systems Group, Brigham & Women's Hospital
Research Fellow, Partners In Health
Moderator, GHDOnline.org<http://www.GHDOnline.org>
5:03 PM, 25 Jan 2010 | Permalink
Kamal Jethwani
Hey,
I'm looking for a similar software for an initiative we launched in India
this year. I'd like this software to be cheap and adaptable to the various
clinical settings that I want to use them in : OPD, Health camps and In
patient settings (to create somewhat of a pseudo - EMR kind of system). I
have programmers who could do it, but I feel the protocols we may thus
create may be incomplete, and at best, of limited use in the future.
If someone has the expertise / is interested in providing the brain behind
such a protocol (just from the clinical perspective), I can put in the money
and expertise to get it done via a non profit in India (Decimal Foundation).
Thank you!
Kamal Jethwani MD,MPH
Harvard Medical School
5:09 PM, 25 Jan 2010 | Permalink
Debbie Coultis
Are you trying to link QuickBooks so that you can do online transactions and have them link back to accounting software? If that is your intent, it is doable at a low cost. See Tech Soup for enrolling in program. I don't remember the URL, but you can order software and some hardware at very low cost. Versions of QuickBook are among offerings. With some versions of QuickBooks, you get a free webpage to do secure transactions.
5:49 PM, 25 Jan 2010 | Permalink
Debbie Coultis
Here is the URL for TechSoup: http://home.techsoup.org/pages/default.aspx
5:56 PM, 25 Jan 2010 | Permalink
Gauti Reynisson
Thanks again for all the help!
We have discussed the issue with our clinic and presented the option of using OpenMRS. They will be looking further into that option.
One additional (crucial) question is which financial system, if any, people are using with OpenMRS? I'm sorry to bother you with these questions, but we have very limited internet access and we have not been able to research this well enough here on site.
Debbie, I forgot to mention that our clinic is a for-profit organization. I'm afraid Tech Soup is not for us, but thanks for the pointer... didn't know about this initiative.
Again, thanks for all the help,
Gauti and team
4:44 AM, 26 Jan 2010 | Permalink
Jorn Klungsoyr
Hi,
Just wanted to say that you may contact Makerere University, Department of Software Innovations. Contact Peter Wakholi and Michael Nitigeya to get support for OpenMRS implemmentations in Uganda.
Email addresses: pwakholi AT cit.mak.ac.ug and mniyitegeka AT cit.mak.ac.ug
Best regards,
Jørn
____________________________________________________________________________
Jorn Klungsoyr
openXdata - Centre for International Health, University of Bergen, Norway
www.openxdata.org / www.cih.uib.no / www.openrosa.org / www.open-mobile.org
5:24 AM, 26 Jan 2010 | Permalink
judy wawira
openmrs is still the most implemented. It has a big implementation in AMPATH, kenya where i studied . i am currently an openmrs developer so if you need someway around it drop me an email... judywawira AT gmail.com
@Kamal..i am a medical doctor and would be glad to assist you with the clinical analysis...
7:35 AM, 26 Jan 2010 | Permalink
Joaquin Blaya
I would also encourage you to email the OpenMRS implementers list asking your question about what financial software has been used. That email list is at .
Joaquin
___________________________________________________________________
NLM Fellow, Decision Systems Group, Brigham & Women's Hospital
Research Fellow, Partners In Health
Moderator, GHDOnline.org
5:48 PM, 1 Feb 2010 | Permalink
Michael Lipnick
Howdy,
I have been working on a few health IT projects in Kampala, based out of Makerere/Mulago. I think the Healthnet Uganda group is great. We have worked together in the past. Lately I have been working with Appfrica Labs (a Kampala-based software company)... we are working on an open source SMS results manager for OpenMRS to launch in Uganda/Rwanda later this year (www.resultsSMS.org). The Appfrica group has some experience with OpenMRS and since they are local might be useful to you. I am in Boston primarily and look forward to hearing where you go with your project. Out of curiosity, with which clinic are you involved in Kampala?
Regards,
Michael
12:20 AM, 3 Feb 2010 | Permalink
Jessica Haberer, MD, MS
Hi Michael,
I'm interested in linking the SMS/IVR system I've been using in Mbarara, Uganda with an OpenMRS clinic database. We'd also like to add in some other wireless adherence monitoring technology we've been developing. Would you be able to advise me on options for setting that up?
I'm based at MGH, so perhaps a phone call makes sense?
Thanks,
Jessica
8:53 AM, 3 Feb 2010 | Permalink
Andrew Kanter, MD MPH
Jessica,
We just finished doing a link between RapidSMS and OpenMRS which uses the Xforms module. We convert the SMS to Xforms and submit them and that seems to work. The RapidSMS system is now called ChildCount+ (www.childcount.org).
Best,
Andy
3:00 PM, 2 Mar 2010 | Permalink
Peter Millard
We recently had the same question when we were in the planning stages of adoption of an EMR system in Mozambique. We found it very difficult to ascertain the features that the various non-proprietary systems have, and are currently working on a study to delineate the features of each system.
The systems we would like to evaluate incude:
OpenMRS (several different varieties)
WorldVista
DREAM (Sant Egidio)
MEDCAB
Primary Health Care Records (PHCR)
PIH-EMR (Partners in Health, OpenMRS?)
SmartCare (Zambia)
SICLOM (Brasil)
Fuchsia (MSF)
If readers would like to collaborate on this project, please contact me at .
Peter Millard, MD, PhD
Faculdade de Medicina
Universidade Cátolica de Moçambique
CP 821
Beira, Mozambique
University main tele (00258)233-11824
http://www.ucm.ac.mz/cms/index.php
5:29 AM, 7 Mar 2010 | Permalink
Hamish Fraser, MBChB, MRCP, MSc
Hi Peter, thanks for your question.
This type of assessment is very useful especially if you can share it with the wider community in some way. There are several key questions that need clarification before comparing systems. The first is what clinical problems to you need to address?
My own work at PIH initially focussed on MDR-TB and HIV management using a web based EMR system we developed about a decade ago. The HIV-EMR is still in active use in Haiti but we are working on transitioning that to OpenMRS and will (a little sadly...) stop using that system. Our decision to collaborate with Paul and Burke at Regenstrief on the development of OpenMRS was in part to get away from a disease specific, vertical system approach. So in addition to the widespread use of OpenMRS for HIV management there are three countries suporting MDR-TB treatment using a customized version we built based on our earlier MDR-TB EMR. OpenMRS is also used for primary care by the Millenium Villages Project and that is a big push for us in Rwanda and now Haiti. There are versions/tools for oncology, heart disease and surgical care.
The systems you list vary in their clinical breadth. Fushia is HIV only. I think SICLOM is too though it's a while since I looked at it. Smartcare is broadening its coverage i think from their web site.The other systems look moe general.
Secondly what envoronments are you loooking at, larger hospitals of samll remote health centers, or a combination.
Thirdly do you plan for medical staff, nurses and others to use the system directly or to fill out paper forms that were entered and reports printed.
Finaly do you plan other hospital management features like clinic scheduling, lab systems or pharmacy management.
We can share more information about the different uses of OpenMRS and the different environments it works in.
Regards
Hamish Fraser
10:24 PM, 7 Mar 2010 | Permalink
Peter Millard
Thanks, Hamish. OpenMRS is of course one of the systems we will study and we do plan to publish our results. We are concentating on outpatient EMRs and not paper based systems (like they use in Eldoret, Kenya). It is a big surprise to me that OpenMRS can be used in primary care, and we definitely want to learn more. When we were investigating 2 years ago it seemed like it would continue to be an HIV (maybe also TB) system but that there was no funding for developing primary care capability. I think we have identified key informants for OpenMRS, but if you know other informants for the other products, contact me offline and I will send you more info and the study questionnaire.
10:48 AM, 10 Mar 2010 | Permalink