OpenMRS : Opensource Software in Healthcare Series – 1
Is opensource software right for you?
Learn about blueEHR: the alternate to open source:
- Name: OpenMRS
- Category: Electronic Health Records
- Programming Language: Javascipt
- Major user(s): No major networks. Primary use is in small research and clinical sites worldwide, with concentration in sub-Saharan Africa and India.
Open-source software presents an opportunity for medical facilities with frugal resources to better leverage existing resources and ultimately provide a superior standard of care. Generally speaking, there are benefits and drawbacks to any open-source solution. Despite being one of the most popular open-source platforms, OpenMRS is no different.
Founded in 2004 by Partners in Health, OpenMRS has developed a global community of users in both research and clinical settings. The platform is flexible and customizable. A network of volunteers from many professional backgrounds continue working on OpenMRS to increase its functionality. As a non-profit organization, the company has been focused on addressing the unique challenges found in the poorest nations. It has operated successfully in rural areas everywhere from South America to Russia and Africa.[i]
Perhaps the largest benefit of OpenMRS is its cost. Proprietary systems are prohibitively expensive, rendering them impractical for almost all health care facilities in developing countries. There will be ancillary costs, including hardware and infrastructure purchases, training, and possibly maintenance costs, but these are miniscule compared to the cost of a commercial solution.
Like other open source health information systems (HIS), OpenMRS is also easy to access. Anyone may simply download it from the web, affording many organizations the opportunity to test the system and ensure it meets their needs prior to a widespread deployment. The platform is also available through apps for both iOS and Android devices, allowing for portability and mobility.
The other widely-touted feature of OpenMRS is that it allows for customization by users with no programming knowledge. Medical informatics and system analysis skills are still necessary, but it is generally easier to use than other software options. It is coded using a ‘concept dictionary’ that stores diagnoses, test results, pharmacological and it does not require additional programming to add new forms or diseases.[ii] There are enhanced modules available for specific uses as well, which provides for another level of customization.
OpenMRS is based on international HL7 standards for medical data exchange, which allows for interoperability with other health informatics systems. Given that HIS tend to be fragmented, inaccurate, and incomplete in developing countries, this interoperability is a tremendous benefit that leads to better long-term patient outcomes.
OpenMRS is generally regarded to be a great solution for clinics with low volume. It doesn’t appear to have the same benefits as other platforms, including modules to capture a larger view of operations, such as inventory and financial data.
There is also still much concern about the level of privacy and security that can be provided by an open source software. While it has not yet proven to be more or less secure than proprietary HIS, this remains as an element that is closely monitored.
While there exists a dedicated group of programmers that collaborate on a global scale and are committed to providing support and increasing the functionality of the platform, the technical assistance available for end users is not nearly as comprehensive as a commercial platform. This requires that many users either hire someone to support and maintain the system or they assume the task of learning it themselves. When questions or problems arise, the user must be proactive in communicating with other users or the developers about how to address the problem.
The other aspect to consider with OpenMRS is whether it will be sustainable and continue to advance with the pace of technology. With the level of global support for the platform, which includes annual conferences, organized support teams, and financial donors, OpenMRS will likely remain one of the larger open source HIS in the market.
The platform also has additional features that are in production or being beta tested that will prove to be very valuable. Examples here include an anatomical drawing tool, user interface improvements, and data trend monitoring.
[i] Winters-Miner et. al. (2015). Practical Predictive Analytics and Decision Systems for Medicine. London: Elsevier.
[ii]Aminpour, F., Sadoughi, F., &Ahamdi, M. (2014). Utilization of open source electronic health record around the world: A systematic review. Journal of Research in Medical Sciences, 19(1), pp. 57-64.
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