Health IT

Hi Timothy
There are a couple of EMR systems used fairly widely in Haiti. One is our system OpenMRS, and the other is the I-Tech system ISante. In general both systems have focused mostly on HIV in the past but are now being used for other diseases and clinical problems including primary care.

What specifically do you do with the current system? How many sites or users do you plan?

OpenMRS is more work than Access to set up (if it doesn't already suitable forms and reports built in). Once it is going it is reliable and can scale well to large numbers of patients and new diseases and problems. It is open source and is going to be used more widely in Haiti over the next year or so.

Regards

Hamish

Mr. Gorin,
You might consider the following:
http://openmrs.org/wiki/OpenMRS
http://wiki.gnumed.de/bin/view/Gnumed
--Brylie Oxley
GNU.media Intern
Woolman Semester

http://woolman.org

This is a very important question, Timothy, and one which many are asking. It depends a great deal on which functionalities you are after, which resources (human and financial) you have, and what you expect to do with the product. We were also struggling with this and decided to launch a study to document the functionalities and costs of the various open-source options out there. We are currently evaluating several OpenMRS products, World Vista, DREAM software, MEDCAB, PCHR (Primary Health Care Record), SmartCare, Fuchsia, and a couple of others. When we have all the data assembled, you will be able to see clearly what the strengths and limitations of each system are. Then you can decide yourself which is the best option.
If anyone out there would like to collaborate on this study, please let me know at

Timothy:

Do you have a need to have the data that is being stored in the individual clinics shared in a central system? There are many options for a central storage EMR but most are expensive and require the equipment and a location for the central servers. One last thing is are you looking for a tracking and reporting for diseases or patient data?

There is a system that has support for Microsoft/MAC/Linux and they are working on the translation tool to Spanish/French/German. Here is the link http://www.patientos.com/emr/demo/

Regards,
Timothy Miller, PhD NSCHBC

Timothy -

Hamish mentioned iSante. iSante currently includes workflows for HIV Tx, and maternal health, and (as noted) is being expanded.

iSante is a PHP-Java-MySQL system that runs on either Linux or Windows hosts. The system was developed for Ministry of Health and MOH-supported facilities, and deployments are supported by the US CDC office in Haiti. Its been installed in about 70 facilities countrywide, about 50 of whom actively use the system. iSante is deployed on just under 30 servers - some dedicated ones at the larger sites, some shared (but with partitioned data). All sites replicate both de-identified and identified versions of the clinical data for a variety of centralized services including data warehouse/analysis, fault-tolerance/backup, and inter-facility transfers.

Hamish and I are working on improving the ability of both iSante and OpenMRS to exchange patient level data.

Sorry for the belated, and quick summary, but happy to follow up if that's helpful.

Bill Lober

Timothy -

There are a lot more options now than in years past. I will be in Haiti
mid-June installing our system in a clinic there and have been invited to
present our solution to some other locations in country.

We have used open source tools, but are not open source. Our system works
in 50 different languages (including Haitian Creole) and uses biometrics for
patient identification.

I am in the midst of migrating to a new server, but the "old" site is
likely to be running. http://semrsys.com One of the reasons for the
move is that the database isn't playing well with international character
sets, so the language features on the demo aren't a great representation of
what we can do. I expect the demo will look better next week.

Rogers

Peter,
This study sounds great, do you have any idea of when you'll think you'll finish it? Also, misys performed an application evaluation of three systems (OpenMRS, Tolven, and PatientOS), you can see them at http://www.misysoss.com/research-a-reviews.


Warm regards,
Joaquin

___________________________________________________________________
Founder, eHealth Systems Chile
Research Fellow, Harvard Medical School/Partners In Health
Moderator, GHDOnline.org<http://www.GHDOnline.org>

Timothy:

Oracle XE is a free database. It is reportedly easy to work with. You can
download it at:
http://www.oracle.com/technology/software/products/database/xe/htdocs/102xewi...

<http://www.oracle.com/technology/software/products/database/xe/htdocs/102xewi...
main free database is MySQL. It is being used on the OpenMRS system and
runs a lot of websites. I think it is more difficult to set up.

Dennis