Open-source EMR opens doors to quality care

In my Editor's Corner in FierceMobileHealthcare last week [1], I highlighted a program in the Mekong River Basin in Southeast Asia that relies on a very basic technology--the mobile phone--to disseminate health information and collect data on infectious diseases. That program actually was just one of several health IT projects in developing countries that formed the basis for an endlessly fascinating session at last week's American Medical Informatics Association annual scientific symposium.

In many ways, the session was a mini-reunion for those of us privileged to attend the Rockefeller Foundation's Making the eHealth Connection [2] conferences in the bucolic setting of Bellagio, Italy, in the summer of 2008. It came almost exactly a year to the day since the plan developed in Bellagio got put into action by none other than Archbishop Desmond Tutu [3], the Nobel Peace Prize laureate from South Africa. Tutu called health IT "the great equalizer" for millions of people who otherwise would not have access to care.

Presenters at the AMIA session included Dr. Andrew Kanter, a biomedical informatics specialist at Columbia University in New York, who is heavily involved in the Millennium Villages Project [4]. That program focuses on providing health services, technology, education and agricultural services to help eradicate poverty in 14 villages in sub-Sarahan Africa. As head of medical informatics for the Millennium Villages Project, Kanter is leading implementation of several forms of technology that are intended to work from the bottom up to improve health at the local level.

Among the technologies Kanter is working with is OpenMRS [5], an open-source EMR platform developed in Kenya to be the foundation of self-sustaining health IT implementation in parts of the world stricken by HIV/AIDS, malaria, tuberculosis and other diseases that make the H1N1 virus look like the sniffles. And people at the local level find ways to make the systems work within the confines of the resources they have. Electricity not reliable in a certain community? That's OK, health workers can use their cell phones to collect and send data to a server running OpenMRS. Dealing with people who speak different languages? Some resourceful OpenMRS developers have built a Snomed-enabled, multilingual terminology structure to assist with data collection and reporting.

Sure, there have been some headaches and quite a bit of cultural resistance. But these implementations take a fraction of the time of a major hospital IT rollout. And best of all, there's no multibillion-dollar gamble with taxpayer money and few interoperability issues. Just saying. - Neil [6]