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PIH EMR plans in Malawi

Posted by hfraser on February 12, 2008

I just returned from a 10 day visit to Malawi to finalize plans for the EMR system for the newest PIH hospitals and clinics in Neno. The clinic there belongs to the Malawian government and we have been partnering with them and the Clinton-Hunter Foundation initiative to build a new hospital and build or renovate several smaller clinics in the area. Neno is in the hills of southern Malawi about 90 minutes drive from the main Lilongwe to Blantyre road, and has a post office, a large market and a local government building as well as the clinic. PIH is providing primary care currently with three expat physicians as well as local nurses and other healthcare worker (Malawi has about the lowest number of physicians per head in the world). We are also running an HIV clinic and have several hundred patients on ARV treatment at present. The site has stable power from the grid, and Satellite Internet access set up by PIH.

Malawi is not new to the EMR business, Baobab Health Partnership (www.baobabhealth.org) led by Gerry Douglas have been working there for 7 years and have deployed innovative touch screen electronic data systems in hospitals in Lilongwe and Blantyre. Baobab have recently re-factored their system to run on the OpenMRS data model using Ruby on Rails as the development environment. This has given us the opportunity to explore using their well developed interface and workflow tailored to the Malawi health system while also using all the tools of OpenMRS and the strength of the OpenMRS collaborative. Our plan is to start with a simple patient registration system that prints out a bar coded patient ID card and link that with a tool to allow the physicians to code the patient diagnoses. We will the adapt the Baobab touch screen HIV data capture module to the PIH forms and add a third module for socio-economic data. Initially the two systems are running side by side on the same instance of MySQL but we are exploring the creation of an API to allow Ruby to talk to the OpenMRS middle layer and so become a robust development environment for new forms and interfaces. One of the current SSOC students, Jeff is working with Baobab on an initial version of these tools. More soon…

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