1. OpenMRS Vision Hamish SF Fraser Partners In Health Division of Global Health Equity, BWH Harvard medical School

2. OpenMRS Mission Statement

To build and foster a community of people interested in improving health care in developing countries through information technology

To effect change through collaboration, through open sharing of ideas and code, and most importantly through action

To provide developing countries with enterprise information systems that equal or surpass commercial products

To promote and demonstrate the power of open source software

3. OpenMRS Organization

Originally a verbal agreement between three people Burke, Paul & Hamish

Added Chris shortly after

Now operated as a 4 person board

Coordinated by weekly conference calls, the OpenMRS Wiki and the code repository

Regular meetings every 2 3 months at least once a year in Africa

4. OpenMRS Organization evolution

Planning process with Boston Consulting Group and Rockefeller Foundation

Consultative process with stake holders from global health, medical informatics, open source communities and funders

Developed a plan for an organizational structure, a funding model and a road map

5. OpenMRS organizational chart Near term role Long-term role (potentially part time in '09) Software development & management Board of Directors Release manager Foundation President Implementer Documentation Lead Full-time developer Full-time developer UI Designer Chief Advocate Chief Administrative Officer Full-time developer QA / QC team Full-time developer Full-time developer Developer Documentation Lead Infrastructure Administrator Security Analyst OpenMRS Application Dev. Director QA / QC & Release Director OpenMRS Platform Development Director Chief Software Architect VP of Implementation & Evaluation Reference Site Support Manager Full-time developer Full-time developer M&E Manager Additional admin support(as needed) Centers of Excellence Coordinator(s) Mentorship Administrator Community Communication Manager Partnerships &community support Implementation Partner Manager Development Partner Manager VP of Partnerships & Community Support Implementation & Evaluation 6. Roadmap process

Core teams from Regenstrief Institute, PIH and the MRC traveled to Kenya and Rwanda in March

We visited the two founding sites and compared the strategies and uses of OpenMRS

After interviews with the leadership of the clinical sites and organizations we developed a priority list of key functions

7. OpenMRS Road Map 2009

Data synchronization*

Web forms* (MS Infopath replacement)

More advanced reporting tools*

Linking to cell phones and mobile devices*

Advanced decision support tools*

Improved user interface

Performance optimized for 2M patient records

Tools for primary care

Treatment failure module for HIV in SA

8. Training initiatives 9. Developer training, Rwanda

We are running a training program in Kigali for computer science graduates

One year, mentored training course

• Web development

• Java programming

• OpenMRS programming

• Medical informatics

Ten students able to support OpenMRS rollout as well as PIH and MVP projects

International Development Research Center 10. 11. Training program Wiki site 12. Google Summer of Code

Sponsorship for selected open source projects

Projects and mentors drawn from OpenMRS developers

Students receive stipend for three months work

Third year of program, 14 students this year

Now OpenMRS Internship Program, IDRC funded

13. Community: OpenMRS Wiki 14. Open source code release management 15. OpenMRS reference sites

An OMRS reference site is an implementation that has a closeformalrelationship with OMRS and serves to meet several goals:

• Serve as partner in developing ideas and testing new functionality

• Help ground OMRS software development on actual needs of users on the ground

• Serve as value proof for OMRS capabilities across different environments

• Be a source of resources ( egdeveloper time, grant funding) for OMRS

Reference site relationship should be time-bound,limited to testing specific functionality / meeting learning goals Courtesey BCG 16. Modifying and extending OpenMRS

Ability to configure the system to new requirements without programming

Ability to interoperate with other systems whether open or closed source

Ability to add new functionality/modules i.e. the platform approach

Ability to examine and modify the core code i.e. full open source system

17. Implementations vary widely Morogoro, Tanzania Deschap- elles, Haiti Sauri,Kenya Mbarara,Uganda Zambezia,Mozam- bique NERwanda Harare,Zimbabwe Richmond,SouthAfrica Eldoret,Kenya Nohana,Lesotho Kigali,Rwanda Address Hierarchy Printing Registration module Remote FormEntry Report Template REST Restrict by Role Patient Summary Patient Matching ODA Mock Logic Web Service Obs Group Export module MRN Generator module Mirth Messaging module Logic Web Service Jasper Report Groovy Google Maps Image Viewer Form Import/Export Form Entry Form Data Export Form2Program Flowsheet Double Entry Reconciliation module DHIS Connector Data deletion Compare Lists Clinical Summary BIRT Reporting Module Adaptive Turnaround Document (ATD) X X X X X X X X X X X X X X X X X X X X X X 7 X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 6 12 5 9 4 3 6 6 4 1 Modules Total no. of modules used

Reporting, forms, basic clinical tasks modules highly used

• 3 languages in use

Courtesey BCG 18. Draft of OpenMRS revised vision "Our mission is to foster, with partners, self-sustaining EMR and health information technology implementations that significantly improve the effectiveness of care in resource-poor environments through peer mentorship, proactive collaboration, and an open source code base of the highest quality."--OpenMRS.org Care leads the way

Ultimate goal of improving effectiveness of healthcare in resource-poor environments

Implementations are the community's foundation

Close relationship with reference sites helps maintain focus on ground-level needs

Flexible, open, interoperable core

Interoperable and standards-compliant platform that allows implementations and application developers to start at higher point and configure it for any need

Core source code is open

Partner engagement and support

Robust implementer and application developer communities

Providing expertise and other support to implementer and application developer partners

Capacity through apprenticeship and content dev

Engagement with partners to build local capacity through curriculum development, training, and sharing consulting expertise

Mentorship as formal apprenticeship: Continued commitment to the OpenMRS Internship Program (OIP) and to Google Summer of Code

Openness about our progress, decisions, and plans for the future

Community built around trust

Active community involvement and participation in decision making

Active transparency and community involvement Sustainability

Ability to help community for as long as support is needed

Leveraging commercial support opportunities without straying from our open source roots

19. Breakout session 20. Collaborators and Funders

Partners In Health

Regenstrief institute

Medical Research Council, South Africa

World Health Organization

US Centers for Disease Control

Brigham and Women hospital

Harvard Medical School

University of KwaZulu-Natal

Millennium Villages Project

International Development Research Centre, Ottawa

Rockefeller Foundation

Fogarty International Center, NIH

Boston Consulting Group

Google Inc

21. 22. Partnering with industry

Current partnerships with companies developing modules of OpenMRS

• MIRTH

• Google