Open source medical software delivers in Haiti

Open source medical software delivers in Haiti

Summary: 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.

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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.

Topics: Health, CXO, Legal, Open Source, Software, IT Employment

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15 comments
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  • Is it because it's open source

    or inspite of it? Does the open source aspect of it really contribute to it significantly?

    Example: Is the sucess of Windows and OSX on the desktop an indication that a proprietary OS is better then an open source one?

    Now apply the thought to medical software.
    John Zern
    • significant?

      probably not. but it will give Linux geeks around
      the globe a reason to celebrate, and of course
      brag, even more than they already do, about the
      supposed superiority of open source software.
      SystemVoid
      • superiority of open source

        Well, the article really didn't include details to support (or not) the "superiority" of open souce et al. But it did relate how quickly it was made available for the masses in the medical industry. If you had a computer you could likely run the application; something not as widespread in any with with proprietary ware.
        It wouldn't be superiority of code as much, IMO, as it would be ready access and usability on so many platforms.
        twaynesdomain-22354355019875063839220739305988
    • Is it because it's open source

      Example: Is china the best country to live in, because it is the largest?
      You are comparing apples to oranges.
      ator1940
    • Neither because nor in spite

      It proves that an Open Source product is a viable alternative to get desired result. Being Open Source or Proprietary only is a single minor factor as to what makes any software a success. Business model and quality are what make this a success.
      Viva la crank dodo
      • as to what makes any software a success

        It would seem the biggest issue in Haiti was the ready access. They were lucky it was already initiated and made good use of it. Can you imagine what it might have been like if proprietary had to be sourced, purchased and installed? And hopefully compatible?
        The story is news to me, as was the mention of the hurricane. Good news, too. I'm hoping one of the links in the article will bring me more detail on the issues. Offhand I'm not sure I see exactly WHAT the advanatage provided actually was - how specifically did it help, and how?
        That said, it still seems to me that in both Haiti and the sourth, aid took a very long time to start rolling in. THAT didn't appear to be anything software could have helped. If aid arrival exceeds three days then many survivors die that may otherwise have lived. Neglecting the off miracle here and there where people were still found alive after much more than three days, I'm interested in how and if the article's software had any impact on that problem, too. It's sort of a terrible news, bad news, good news story. Software can't do much about there being no place to land a plane, but what got to me in both instances was that software MIGHT have been good at indicating WHERE to drop medical and food supplies if they couldn't land a plane.
        Guess I'm just detail-hungry today.
        twaynesdomain-22354355019875063839220739305988
      • RE: Open source medical software delivers in Haiti

        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.<a href="http://www.edra41.org/"><font color="LightGrey"> a</font></a><a href="http://www.actioniseloquence.net/"><font color="LightGrey"> b</font></a><a href="http://www.funds-china.com/"><font color="LightGrey"> c</font></a><a href="http://www.isupportbridgewater.com/"><font color="LightGrey"> d</font></a><a href="http://www.cca64.org/"><font color="LightGrey"> e</font></a><a href="http://www.nexumbogazici.com/"><font color="LightGrey"> f</font></a><a href="http://www.h4nholdings.com/"><font color="LightGrey"> g</font></a><a href="http://www.dataseek.info/"><font color="LightGrey"> h</font></a><a href="http://www.pcloshwdb.com/"><font color="LightGrey"> i</font></a><a href="http://www.santaibisnes.com/"><font color="LightGrey"> j</font></a>
        zakkiromi
    • Now apply the thought to medical software.

      Apples and oranges, really. The success of MS product historically is great, but ... has more of a negative or possibly no bearing on its sourcing and implementation in a place like Haiti with no structure to start with.
      twaynesdomain-22354355019875063839220739305988
  • OSS helps the world

    as M$ and other closed source crooks are exploiting poor people.
    Linux Geek
  • RE: Open source medical software delivers in Haiti

    Dana, it's important to highlight the role and potential of open source to help Haiti in particular and for health care in general. PIH are leveraging electronic medical records which seems to be the area of most OSS project activity in health care, but there are projects in many other areas including practice management and VistA, the health care information management system developed by the US Veterans Administration.

    Last June we did study on the potential of OSS in health care and found there over 800 open source projects:

    http://www.blackducksoftware.com/news/releases/2009-06-10

    Nice to see these projects being leveraged and helping in such a crisis.

    Peter Vescuso
    pvescuso
  • The difference (and danger) is beaurocracy.

    Absent the mind numbing and time consuming layers and layers of "decision makers" quick response is possible in most situations.
    The danger is that when there is no center of control and responsibility for an extended period situations deteriorate to where nobody knows what is going on and it turns into an "every man for himself" mob like Somalia.
    Open Source and proprietary systems have their place, strenghts, and weaknesses.
    kd5auq
  • James Taylor raises $550K for Partners In Health

    http://www.berkshireeagle.com/ci_14251671
    ejhonda
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