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Yearb Med Inform 2010; 19(01): 13-20
DOI: 10.1055/s-0038-1638681
Original Article
Georg Thieme Verlag KG Stuttgart

Human Factors for Capacity Building. Lessons learned from the OpenMRS Implementers Network

C. J. Seebregts
a   Biomedical Informatics Research, eHealth Research and Innovation Platform, Medical Research Council, Cape Town, South Africa
b   School of Computer Science, University of KwaZulu-Natal, Durban, South Africa
,
B. W. Mamlin
c   Regenstrief Institute, Indianapolis, USA
d   Indiana University School of Medicine, Indianapolis, USA
,
P. G. Biondich
c   Regenstrief Institute, Indianapolis, USA
d   Indiana University School of Medicine, Indianapolis, USA
,
H. S. F. Fraser
e   Brigham and Women’s Hospital, Boston, USA
f   Partners in Health, Boston, USA
,
B. A. Wolfe
c   Regenstrief Institute, Indianapolis, USA
,
D. Jazayeri
f   Partners in Health, Boston, USA
,
J. Miranda
f   Partners in Health, Boston, USA
,
J. Blaya
e   Brigham and Women’s Hospital, Boston, USA
g   eHealth Systems, Santiago, Chile
,
C. Sinha
h   International Development Research Centre (IDRC), Ottawa, Canada
,
C. T. Bailey
i   eHealth and Informatics Unit, Knowledge Management and Sharing Department, World Health Organization, Geneva, Switzerland
,
A. S. Kanter
j   Millennium Villages Project, Earth Institute, Columbia University, New York, USA
› Author Affiliations
The Open MRS Implementers Network is partially supported by a grant from the Canadian International Development Research Centre (IDRC) ICT4D program: “Developer Network and Open Source PDA Software for Health Data Collection” (Grant Number 101974-001) with additional inputs from the South African Medical Research Council (SA-MRC), the World Health Organization and the Rockefeller Foundation. PIH is supported by WHO and the Regenstrief Institute is supported by the US Centres for Disease Control. The authors gratefully acknowledge ongoing support and contributions from Heloise Emdon, Chaitali Sinha and Steve Song, IDRC and Prof Bill Tierney, Regenstrief Institute and University of Indiana.
Further Information

Corespondence to:

Christopher J Seebregts
Biomedical Informatics Research
eHealth Research and Innovation Platform Medical Research Council
PO Box 19070
Tygerberg 7505
South Africa
Phone: +27 21 938 0318   
Fax: +27 21 938 0526   

Publication History

Publication Date:
07 March 2018 (online)

 
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Summary

Objectives: Theoverallobjectiveofthisprojectwastoinvestigateways to strengthen the OpenMRS community by (i) developing capacity and implementing a network focusing specifically on the needs of OpenMRS implementers,(ii) strengthening community-driven aspects of OpenMRS and providing a dedicated forum for implementation-specific issues, and; (iii) providing regional support for OpenMRS implementations as well as mentorship and training.

Methods: Themethodsusedincluded(i)face-to-facenetworkingusing meetings and workshops; (ii) online collaboration tools, peer support and mentorship programmes; (iii) capacity and community development programmes, and; (iv) community outreach programmes.

Results: Thecommunity-driven approach,combined withafewsimple interventions,has been a key factor in the growth and success of the OpenMRS ImplementersNetwork.Ithascontributed toimplementations in at least twenty-three different countries using basic online tools; and provided mentorship and peer support through an annual meeting, workshops and an internshipprogram. The OpenMRS Implementers Network has formed collaborations with several other open source networks and is evolving regional OpenMRS Centres of Excellence to provide localized support for OpenMRS development and implementation. These initiativesare increasingthe range of functionalityand sustainability of open source software in the health domain, resulting in improvedadoption and enterprise-readiness.

Conclusions: Socialorganizationandcapacitydevelopmentactivities are important in growing a successful community-driven open source softwaremodel.


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Keywords

Medical record systems - computerized patient records - free and open source software - medical informatics

 


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  • References

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  • 2 Bukachi F, Pakenham-Walsh N. Information technology for health in developing countries. Chest 2007; Nov; 132 (05) 1624-30.
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  • 3 Titlestad OH, Staring K, Braa J. Distributing Development to Enable User Participation: Multilevel Design in the HISP Network. Scandinavian Journal of Information Systems 2009; 21 (01) 27-50.
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  • 4 Levison L, Fraser HSF. Requirements for an OpenSource Pharmacy Dispensing and Stores Management Software Application for Developing Countries, Paper presented at Making the eHealth Connection Conference. Bellagio, Italy, July 13 Aug. 8, 2008 edn.
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  • 5 Mamlin BW, Biondich PG, Wolfe BA, Fraser H, Jazayeri D, Allen C. et al. Cooking up an open source EMR for developing countries: OpenMRS a recipe for successful collaboration. AMIA Annu Symp Proc 2006; 529-33.
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  • 6 Mamlin BW, Biondich PG. AMPATH Medical Record System (AMRS): collaborating toward an EMR for developing countries. AMIA Annu Symp Proc 2005; 490-4.
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  • 7 Tierney WM, Rotich JK, Hannan TJ, Siika AM, Biondich PG, Mamlin BW. et al. The AMPATH medical record system: creating, implementing, and sustaining an electronic medical record system to support HIV/AIDS care in western Kenya. Stud Health Technol Inform 2007; 129 (Pt 1): 372-6.
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  • 8 The OpenArchitectures, Standards and Information Systems Project. IDRC; www.idrc.ca/en/ev- 116782-201-1-DO_TOPIC.html.
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    CrossrefPubMedGoogle Scholar
  • 10 Allen C, Manyika P, Jazayeri D, Rich M, Lesh N, Fraser H. Rapid deployment of electronic medical records for ARV rollout in rural Rwanda. Proc AMIA Symp 2006; 840.
    PubMedGoogle Scholar
  • 11 Allen C, Jazayeri D, Miranda J, Biondich PG, Mamlin BW, Wolfe BA. et al. Experience in implementing the OpenMRS medical record system to support HIV treatment in Rwanda. Stud Health Technol Inform 2007; 129 (Pt 1): 382-6.
    PubMedGoogle Scholar
  • 12 Kanter AS, Negin J, Olayo B, Bukachi F, Johnson E, Sachs SE. Millennium Global Village-Net: Bringing together Millennium Villages throughout sub-Saharan Africa. Int J Med Inform. 2009 Sep 17.
    PubMedGoogle Scholar
  • 13 Douglas G, Gadabu O, Joukes S, Mumba S, McKay MV. et al. Using touchscreen electronic medical record systems to support and monitor national scale-up of antiretroviral therapy in Malawi. PloS (accepted)
    PubMedGoogle Scholar
  • 14 Seymour RP, Tang A, DeRiggi J, Munyaburanga C, Cuckovitch R, Nyirishema P, Fraser HSF. Training Software Developers for Electronic Medical Records in Rwanda. Proc Med Info. 2010 (in press).
    PubMedGoogle Scholar
  • 15 Braa J, Hedberg C. The struggle for district-based health information systems in South Africa. Inf Soc 2002; 18 (02) 113-27.
    CrossrefPubMedGoogle Scholar
  • 16 Braa J, Monteiro E, Sahay S. Networks of action: Sustainable health information systems across developing countries. MIS Quarterly: Management Information Systems 2004; 28 (03) 337-62.
    CrossrefPubMedGoogle Scholar
  • 17 Braa J, Kanter AS, Lesh N, Crichton R, Jolliffe R, Seebregts CJ. Comprehensive Yet Scalable Health Information Systems for Low Resource Settings: A Collaborative Effort in Sierra Leone. Submitted..
    PubMedGoogle Scholar
  • 18 Fraser HSF, Biondich P, Moodley D, Choi S, Mamlin BW, Szolovits P. Implementing electronic medical record systems in developing countries. Inform Primary Care 2005; 13: 83-95.
    PubMedGoogle Scholar
  • 19 Janamanchia B, Katsamakas E, Raghupathi W, Gao W. The State and Profile of Open Source Software Projects in health and medical informatics. International J Med Inform 2009; 78: 457-72.
    PubMedGoogle Scholar
  • 20 Lakhani KR, von Hippel E. How open source software works: “free” user-to-user assistance. Research Policy 2003; 32 (06) 923-43.
    CrossrefPubMedGoogle Scholar
  • 21 Xu B, Jones DR, Shao B. Volunteers’ involvement in online community based software development. Information & Management 2009; 46: 151-8.
    CrossrefPubMedGoogle Scholar
  • 22 Kimaro HC, Titlestad OH. Challenges of user participation in the design of a computer based system: the possibility of participatory customisation in low income countries [Electronic Version]. Journal of Health Informatics in Developing Countries. 2008 02. 1-9 from http://www.jhidc.org/index.php/jhidc/issue/view/4
    PubMedGoogle Scholar
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    CrossrefPubMedGoogle Scholar
  • 24 Shaw V. A Complexity Inspired Approach to CoEvolutionery Hospital Management Information Systems Development. Case Studies from the “South”. (2009). PhD Thesis, University of Oslo..
    PubMedGoogle Scholar

Corespondence to:

Christopher J Seebregts
Biomedical Informatics Research
eHealth Research and Innovation Platform Medical Research Council
PO Box 19070
Tygerberg 7505
South Africa
Phone: +27 21 938 0318   
Fax: +27 21 938 0526   

  • References

  • 1 AbouZhar C, Boerma T. Health information systems: thefoundations of public health. Bulletin of theWorld Health Organisation (83:8); 2005; 578-83.
    PubMedGoogle Scholar
  • 2 Bukachi F, Pakenham-Walsh N. Information technology for health in developing countries. Chest 2007; Nov; 132 (05) 1624-30.
    CrossrefPubMedGoogle Scholar
  • 3 Titlestad OH, Staring K, Braa J. Distributing Development to Enable User Participation: Multilevel Design in the HISP Network. Scandinavian Journal of Information Systems 2009; 21 (01) 27-50.
    PubMedGoogle Scholar
  • 4 Levison L, Fraser HSF. Requirements for an OpenSource Pharmacy Dispensing and Stores Management Software Application for Developing Countries, Paper presented at Making the eHealth Connection Conference. Bellagio, Italy, July 13 Aug. 8, 2008 edn.
    PubMedGoogle Scholar
  • 5 Mamlin BW, Biondich PG, Wolfe BA, Fraser H, Jazayeri D, Allen C. et al. Cooking up an open source EMR for developing countries: OpenMRS a recipe for successful collaboration. AMIA Annu Symp Proc 2006; 529-33.
    PubMedGoogle Scholar
  • 6 Mamlin BW, Biondich PG. AMPATH Medical Record System (AMRS): collaborating toward an EMR for developing countries. AMIA Annu Symp Proc 2005; 490-4.
    PubMedGoogle Scholar
  • 7 Tierney WM, Rotich JK, Hannan TJ, Siika AM, Biondich PG, Mamlin BW. et al. The AMPATH medical record system: creating, implementing, and sustaining an electronic medical record system to support HIV/AIDS care in western Kenya. Stud Health Technol Inform 2007; 129 (Pt 1): 372-6.
    PubMedGoogle Scholar
  • 8 The OpenArchitectures, Standards and Information Systems Project. IDRC; www.idrc.ca/en/ev- 116782-201-1-DO_TOPIC.html.
    PubMedGoogle Scholar
  • 9 Seebregts CJ, Mamlin BW, Biondich PG, Fraser HS, Wolfe BA, Jazayeri D. et al. The OpenMRS Implementers Network. Int J Med Inform 2009; Nov; 78 (11) 711-20.
    CrossrefPubMedGoogle Scholar
  • 10 Allen C, Manyika P, Jazayeri D, Rich M, Lesh N, Fraser H. Rapid deployment of electronic medical records for ARV rollout in rural Rwanda. Proc AMIA Symp 2006; 840.
    PubMedGoogle Scholar
  • 11 Allen C, Jazayeri D, Miranda J, Biondich PG, Mamlin BW, Wolfe BA. et al. Experience in implementing the OpenMRS medical record system to support HIV treatment in Rwanda. Stud Health Technol Inform 2007; 129 (Pt 1): 382-6.
    PubMedGoogle Scholar
  • 12 Kanter AS, Negin J, Olayo B, Bukachi F, Johnson E, Sachs SE. Millennium Global Village-Net: Bringing together Millennium Villages throughout sub-Saharan Africa. Int J Med Inform. 2009 Sep 17.
    PubMedGoogle Scholar
  • 13 Douglas G, Gadabu O, Joukes S, Mumba S, McKay MV. et al. Using touchscreen electronic medical record systems to support and monitor national scale-up of antiretroviral therapy in Malawi. PloS (accepted)
    PubMedGoogle Scholar
  • 14 Seymour RP, Tang A, DeRiggi J, Munyaburanga C, Cuckovitch R, Nyirishema P, Fraser HSF. Training Software Developers for Electronic Medical Records in Rwanda. Proc Med Info. 2010 (in press).
    PubMedGoogle Scholar
  • 15 Braa J, Hedberg C. The struggle for district-based health information systems in South Africa. Inf Soc 2002; 18 (02) 113-27.
    CrossrefPubMedGoogle Scholar
  • 16 Braa J, Monteiro E, Sahay S. Networks of action: Sustainable health information systems across developing countries. MIS Quarterly: Management Information Systems 2004; 28 (03) 337-62.
    CrossrefPubMedGoogle Scholar
  • 17 Braa J, Kanter AS, Lesh N, Crichton R, Jolliffe R, Seebregts CJ. Comprehensive Yet Scalable Health Information Systems for Low Resource Settings: A Collaborative Effort in Sierra Leone. Submitted..
    PubMedGoogle Scholar
  • 18 Fraser HSF, Biondich P, Moodley D, Choi S, Mamlin BW, Szolovits P. Implementing electronic medical record systems in developing countries. Inform Primary Care 2005; 13: 83-95.
    PubMedGoogle Scholar
  • 19 Janamanchia B, Katsamakas E, Raghupathi W, Gao W. The State and Profile of Open Source Software Projects in health and medical informatics. International J Med Inform 2009; 78: 457-72.
    PubMedGoogle Scholar
  • 20 Lakhani KR, von Hippel E. How open source software works: “free” user-to-user assistance. Research Policy 2003; 32 (06) 923-43.
    CrossrefPubMedGoogle Scholar
  • 21 Xu B, Jones DR, Shao B. Volunteers’ involvement in online community based software development. Information & Management 2009; 46: 151-8.
    CrossrefPubMedGoogle Scholar
  • 22 Kimaro HC, Titlestad OH. Challenges of user participation in the design of a computer based system: the possibility of participatory customisation in low income countries [Electronic Version]. Journal of Health Informatics in Developing Countries. 2008 02. 1-9 from http://www.jhidc.org/index.php/jhidc/issue/view/4
    PubMedGoogle Scholar
  • 23 Jacucci EO. Hanseth et al. Introduction taking complexity seriously in IS research. Information Technology and People 2006; 19 (01) 5-11.
    CrossrefPubMedGoogle Scholar
  • 24 Shaw V. A Complexity Inspired Approach to CoEvolutionery Hospital Management Information Systems Development. Case Studies from the “South”. (2009). PhD Thesis, University of Oslo..
    PubMedGoogle Scholar

   Permissions and Reprints