HospitalRun: Opensource Software in Healthcare Series – 6
- Name: HospitalRun
- Category: EMR & Hospital Resource Management
- Major user(s): CURE Hospital, Kijabe Kenya; primarily sub-Saharan hospitals
HospitalRun is an open-source electronic medical record system and clinical resource management tool that enables users to collect data in an offline setting. It has been developed specifically for use in low-resource areas of the world, and has several features that were implemented to address the unique challenges in providing care in the developing world.
The software was developed in Pennsylvania by CURE International, a nonprofit network of charitable clinical institutions that focuses on pediatric care. Development of the platform began in 2014 as the research team began to explore cloud-based solutions that can enhance care in the developing world.[i]
One of the key challenges with collecting valuable data in developing countries lies in the ability to obtain high-speed internet access. This platform addresses the problems of unreliable network infrastructure and disconnected medical environments. These issues often lead to very fragmented information silos and challenges in saving the data. HospitalRun prioritizes the data collection function and stores it using a PouchDB database (created by Apache CouchDB). When the clinician gains online access, the database syncs.[ii] This makes it ideal for use in situations in which medical providers travel to the patient.
The largest benefit of HospitalRun is the feature that differentiates it from other EMRs, which is its ability to function normally while offline and sync when Internet connectivity is reestablished. The large team of researchers and developers, combined with a network that provides financial support, also indicates a high level of support for users and the ability to continue development that enhances the functionality of the platform. This is often a challenge with other open source solutions due to limited funding.
Additionally, the development of HospitalRun didn’t begin until 2014, and the platform wasn’t available for use until 2016. Since its development is so recent, it is very forward-thinking. This cloud-based solution incorporates Ember, PouchDB, and can be deployed using Docker or as an Electron desktop application. Because it is operating using the latest standards and with the latest technologies, it does not have the same compatibility or operational challenges that may be found with older software applications. It also has near-complete internationalization, meaning it is usable by almost anyone in the world.
It is not a full-fledged hospital management system(HMS,) and should not be mistaken to be able to replace one. At the moment, it could be compared to an offline app that performs specific data collection purposes.
When it is used in the environment that it was created for, i.e. low-resource areas, HospitalRun is a great option, and the offline functionality makes it ideal for certain applications, especially when travel is required to provide care. However, in other settings, this platform may not be the most robust option. This is especially true for any analytics that may be used in looking at aggregate data.
Customization of the product is difficult without a software developer to assist with the process.
HospitalRun does appear to have an issue in which some of the users were unable to view or use any of the tools or files after signing into the program, though it does appear that this has been resolved.[iii]
Additionally, as with most open source programs, security is a primary concern. There is the widespread belief that proprietary software is more secure than those that use open source software. In the case of HospitalRun, there is no clear indication whether the application is HIPAA-compliant or of the type of encryption that is used, although in a previous (now-deleted) support thread, one of the core team members acknowledged that security is a concern, but HIPAA-compliance was never a goal since the application is for use in developing countries.[iv]
[Read About OpenMRS: https://blueehr.com/blogs/openmrs-opensource-software/ ]
[Read About OpenMRS: https://blueehr.com/blogs/openice/ ]
HospitalRun partnered with the JS Foundation in late-2017. This foundation seeks to ensure the support and governance of the software can be maintained in the long-term. While the organization still accepts donations to continue their research, the financial backing of the JS Foundation ensures that this platform will have stability for the foreseeable future.[v]
[i] Cure International. (2016). CURE International Offers Freely Available Open-Source Software Platform to Developing-World Hospitals [Press Release].
[ii] Our World Code. (2017). HospitalRun: A free and easy-to-use software for developing world healthcare.
[iv]Aldesoky, M. (2018). HospitalRun: The Free and Open Source EMR for Developing Countries.
[v] JS Foundation. (2017). HospitalRun Joins the JS Foundation to Open Source World Healthcare Management [Press Release].
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