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Zanmi Lasante (ZL) IT (L-R) Wesly Official, Peterson, Dupuy Rony Charles, Claude, Pierre Charles Mingot, Edwenson Raphael, Jean Baptiste Prince, |  Partners In Health (PIH) Boston Medical Informatics (L-R) Mike Seaton, James Mbabazi, Ellen Ball, Mark Goodrich, Cosmin Ioan, and Dave DeSimone |
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Background
The Partners In Health (PIH) program in Haiti, known locally as Zanmi Lasante (ZL), operates clinics and hospitals at 12 sites across the Central Plateau and the lower Artibonite, two of the country's poorest regions.
ZL HIV EMR (2001 - present): The HIV EMR system was introduced in Haiti around 2001 and is still operational at all ZL health facilities. That system continues to be an invaluable tool for our many HIV patients and funders. Data entry clerk transcribe lengthy paper forms into this EMR which pre-dates OpenMRS.
Currently all ZL facilities have OpenMRS implementations. Functionality differs between these implementations.
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Lacolline V1 (2012 - 2015): Patient registration was introduced at the Lacolline health center to replace an EpiInfo system. The Lacolline EMR produced plastic ID cards to patients, registered new patients with demographic information, collected information at check-in to the clinic, and recorded diagnoses from paper dossier by data entry clerk after the visit in the outpatient clinic. Patient registration and payments were entered at point-of-care. This EMR guided requirements and development of the sophisticated Mirebalais EMR. OpenMRS V1.9 with custom modules.
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MDRTB EMR (2014 - present): Multidrug-resistant TB (MDRTB) EMR in Cange and Hinche with local servers. An earlier ZL MDRTB EMR (2009) was cloud-based and required reliable internet. OpenMRS V1.9 with MDRTB module.
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Mirebalais EMR (2013 - present): The initial implementation of the ZL EMR. Record every patient who arrives for care at the University Hospital at Mirebalais (HUM) (Outpatient (SSPH), Emergency, Inpatient, Surgery, Women’s Health, Radiology, Dental, etc) and data entered at point-of-care (new patient registration, patient check-in, clinical consult, vitals, radiology orders, PACS integration, surgery, chemotherapy, appointment scheduling, drug dispensing, etc). Recent additions include mental health assessment, emergency triage workflow, mental health assessment, insurance information, and medical procedures. The Mirebalais EMR MVP was used to create the OpenMRS 2.0 and the OpenMRS Reference Application.
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Mental Health EMR (2016 - present): All ZL mental health patient assessments are captured on multiple laptops while at University Hospital at Mirebalais, patient data is recorded directly into the Mirebalais EMR. For the other clinical facilities, OpenMRS is installed on the laptops of the Mental Health staff. This is necessary because internet is unavailable at those facilities. The laptop is their local EMR server. On a monthly basis, the laptops are brought to a centralized location with internet where data export and backups are possible. The Mental Health EMR has the same software as the Mirebalais EMR, but the deployment is different with these "mobile" laptops and disconnected databases. OpenMRS 1.10 + Reference Application.
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Beyond the HIV EMR, all these systems use OpenMRS:
Technical specifications
The ZL EMR is built with the OpenMRS Reference Application and Platform 1.10 along with customized of workflow, htmlforms, and reports. The ZL EMR is available in Haitian Kreyol, French, and English.
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