Open source medical software delivers in Haiti

One of the big success stories in the wake of the Haiti earthquake is being driven by open source. (You can help.)

Partners in Health has been on the ground in Haiti for 20 years. During that time it has learned many lessons about delivering IT resources in an environment without infrastructure. Most of its communications are satellite links.

Since 2004 PIH has also been co-sponsor of an open source medical records system called OpenMRS. (The other partner is the Regenstrief Institute of Indiana.)

For the last two weeks PIH has been orchestrating medical response to the earthquake, and has drawn great praise. But what makes it possible is a Web-based medical record, originally created to track programs against drug-resistant TB.

Fred Trotter writes that it’s not just the open nature of the code that makes OpenMRS a perfect tool for the job here, but its pricing model. “Can you imagine the headache that per-seat or per-doc or per-patient EHR (Electronic Health Record) licenses would have caused in -any-Haiti clinic?”

Disasters like this also teach, he adds:

Emergencies highlight the fact that health software users may have -very- different needs than the software vendor’s vision or even their own understanding. I know that the OpenMRS project will change substantially in response to the earthquake in Haiti. More importantly those changes will spread to other areas of the world… but those other users of OpenMRS will get the Haiti lessons -before- the mudslide/tsunami/earthquake/bombing happens in their area.

It’s important here to note a big architectural difference between OpenMRS and other health record systems From the group’s overview:

OpenMRS is based on the principle that information should be stored in a way which makes it easy to summarize and analyze, i.e. minimal use of free text and maximum use of coded information. At its core is a concept dictionary which stores all diagnosis, tests, procedures, drugs and other general questions and potential answers.

This is important because one of the chief criticisms of Electronic Medical Record (EMR) systems generally is their lack of free text and extensive use of codes for information. For Regenstrief, which did the heavy lifting on OpenMRS, this is a feature and not a bug.

Fred Trotter compares the success of OpenMRS in Haiti to that of the VA’s VistA software after Hurricane Katrina. In both cases it was the ability to deliver data quickly where it was needed that saved lives.