Imagine a woman in a rural village in Kenya who has been treated for diabetes at a small local clinic. When she moves to a new town and her symptoms worsen, she visits a different clinic. Without knowing her medical history and how her diabetes has been treated in the past, there’s room for error, misdiagnosis, or incorrect treatment.

This isn’t isolated to rural areas of the developing world; it’s a pervasive problem and one that can be easily solved through electronic medical records (EMR). These digital records replace traditional paper-based systems, allowing healthcare providers to store, access, and share patient information more efficiently, explains Palladium’s Director of Information Systems, Teddy Berihun.

One of the most significant advantages of EMRs is their ability to improve patient care. In developing regions, where healthcare facilities may be scarce and often under-resourced, EMRs provide a streamlined way for doctors and nurses to track a patient's medical history, treatments, and outcomes. This means that even if a patient moves between clinics or regions, their medical information is available whenever needed, ensuring continuity of care.

OpenMRS

However, the implementation of EMRs in developing countries does come with challenges. Many regions lack the necessary infrastructure, ranging from access to computers, to reliable electricity and internet access, to support these systems fully. Additionally, training healthcare workers to use EMRs effectively can be a significant hurdle. But that’s where OpenMRS steps in.

OpenMRS is the largest open-source medical record system used globally and plays a vital role in the push to make EMRs accessible, especially in low-resource settings. As an EMR system, it allows healthcare providers to efficiently manage patient information, ensuring that critical medical data is available when and where it’s needed. This is particularly important in developing countries, where healthcare facilities may be understaffed or lack robust infrastructure.

OpenMRS helps bridge these gaps by providing a reliable, adaptable system that can be tailored to meet the specific needs of different regions and healthcare settings, improving the overall quality of care. OpenMRS is also designed to be more efficient in storing healthcare data specifically.

“It’s a digital public good,” says Berihun, “which means there’s a community of practice around it and no company sponsoring it. Instead, it’s a network of developers, business analysts, quality assurance specialists, implementers, Ministries of Health, and medical practitioners helping to build in new features and ways of working through the product.”

Being open-source means that OpenMRS is freely available for anyone to use, modify, and distribute. “Being backed by an international community also means that a solution developed for one country can quickly and easily be applied to another relevant context,” adds Jacob Odhiambo, Program Director for the Palladium-managed KenyaHMIS III.

This openness is crucial for its widespread adoption, as it lowers the barriers to entry for hospitals and clinics that might not afford expensive proprietary systems. Additionally, because it's open-source, a global community of developers can continuously improve and customise the platform, ensuring it stays up-to-date with evolving healthcare needs. This collaborative approach also fosters innovation, as developers worldwide contribute new features and enhancements, making OpenMRS a powerful tool in the global effort to improve healthcare through technology.

Working on and through OpenMRS was part of the scope of the CDC funded KenyaHMIS project, which has supported the deployment of OpenMRS in over 2,300 facilities that care for over 1.2million patients.

Palladium collaborates with Kenya’s Ministry of Health and other stakeholders through the KenyaHMIS project to implement and use the KenyaEMR system across health facilities. But as Berihun adds, the team has gone above and beyond. Excitingly, Palladium’s team was recently honoured for that work with OpenMRS Transformative Leader Badge.

“This recognition is the highest level of recognition that OpenMRS gives to partners and currently there are only five organisations with this distinction - and we are the only major USAID implementer,” says Berihun.

Transformative Leaders

“There was a lot of excitement when we got the announcement here,” adds Antony Ojwang, a senior solutions architect at Palladium and the OpenMRS Global community representative. “It was really morale boosting to be recognised by a global community of practice.”

The achievement recognises the contributions of the KenyaHMIS teams in designing and developing multiple OpenMRS application modules.

“Additionally, we have the largest number of OpenMRS implementations, with over 2,400 facilities using KenyaEMR and Kenya is leading the implementation of the new OpenMRS 3.0 platform,” adds Ojwang.

Palladium also contributed business analysts, developers and quality specialists to OpenMRS community squads that designed new modules in OpenMRS. This effort transformed OpenMRS from a disease focused EMR to a facility-wide capable Electronic Health Record system with a modern user interface and Palladium was one of the first organisations to pilot test the new designs in KenyaEMR.

“Beyond contributing to the development of OpenMRS as a whole, our teams through KenyaHMIS have directly supported integrations with the OpenMRS community,” Ojwang adds. “The software is a clinical care solution, but facilities often have administration services that need a lot of management.

Our integrations help service those non-clinical departments beyond the patient records.”

Palladium’s team also played a huge role in OpenMRS’ evolution from the 2.0 platform to the recently launched 3.0 platform. “It was a lot of investment from our project in Kenya and ultimately, they were both the brains and hand in pushing that evolution forward,” Ojwang proudly says.

Odhiambo explains that a platform like OpenMRS plays an important role in universal health coverage. “With countries like Kenya and others taking up universal health coverage, a patient centred approach is critical and OpenMRS provides that and more.”

When asked what’s next for the team, well, it’s more of the same. There are many use cases for a platform like OpenMRS and as medical records evolve, so too must the software. “We are excited to be developing advanced EMR features to facilitate universal insurance claims, streamline mobile payment management, and expand facility services, transforming patient care at public health clinics in Kenya and setting a global standard,” shares Odhiambo.

“As we collaborate with the global OpenMRS community, we are committed to building a future where digital health innovations ensure seamless, equitable healthcare for all.” He adds that the team recently co-hosted the 2024 Global OpenMRS implementers meeting together with the Kenya Ministry of Health.

For more, contact info@thepalladiumgroup.com.