2009 Implementers Group Meeting Program Mobile Interoperability

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<html><head><title></title></head><body>h1. Reasons for Meeting:
Currently OMRS does not have a functionality to send SMS, but there are various means of connecting mobile devices to OpenMRS. These tools vary in the types of data sent, the visual interface for the mobile device user, the type and cost of mobile device used, and the role of server side software in addition to OpenMRS.

Notes taken by (Isaacholeman 12:58, 14 September 2009 (EDT)). Would really appreciate help completing anything I missed!

How is OMRS useful for mobile platforms

As various mHealth tools are developed we expect increasing demand to have large amounts of data managed and visualized, as well as demand for various mHealth tools to exchange data. There was general consensus that OpenMRS could serve as a meeting ground that mHealth tools might integrate with.

DHIS/OMRS
DHIS manages aggregate and non patient level data.
Anything that works with OpenMRS will also work with DHIS. Potentially anything done with mobile for OMRS could work with DHIS. OMRS stores patient level data, DHIS pulls data out of OMRS, aggregates it for DHIS. Previously talking about using SDMX to pass data from OMRS to DHIS. Current plan has DHIS using same data tables as DHIS – mobile devices modify data tables via OMRS, and DHIS can also access these tables.

What do mobiles do for OMRS, and how

  1. SMS template (values separated by commas, saved as a draft sms in the phone) can be parsed by the Xforms module in OMRS. Works on cheap phones simple to set up, but UI for structured data collection not very good.
  2. PDAs – collect data and sync wither server in person. UI is flexible but handsets are expensive, data isn't transferred immediately.
  3. JavaRosa – Produces Xforms on the phone, uses GPRS to send Xform to server. Alternatively, can be synced via sms with Mesh4X. Also bluetooth or via physically adding memory card.
  4. PicaRosa – Very like JavaRosa but better for low end phones (how low end? Does this mean $30 phones or just anything not a smart phone). Data sent via GPRS.
  5. FrontlineForms – FrontlineSMS has a WYSIWUG forms creator, forms can be sent to and filled out on many low end ($25US and up) java enabled phones. Data is communicated to FSMS server via SMS or (if available) GPRS, and FSMS server sends data to OMRS server via web services (whether FSMS and OMRS are on same machine or connected over internet).
  6. Open Data Kit – developed on Android, will initially communicate data via wifi. UI very robust, devices are expensive and rarely available in Africa.
  7. MocaMobile: for android phones, passes Java Objects. Focuses on communication of complex obs (images and video), though handsets are expensive and not available in Africa.
  8. Grameen's project in Ghana uses web forms (not XForms) to record a visit to an individual. Need better notes about this.
  9. HISP in India uses a custom j2me app to send data to OMRS.

Collaboration around XForms module

Some general agreement that various mHealth groups that interact with OMRS can collaborate by using the XForms module as the point of access from OMRS to mobile and vice versa.

Future Development of XForms module
CellLife in South Africa is hoping to devote resources to developing Xforms module. How could their efforts serve the broader
community?

  1. when there is an intermediary place where data stops (eg frontlinesms) they should format it. For plain sms going straight to x forms, maybe module could help expose concepts more friendly.

Mobile Patient Identification/Creation

With Xforms module You could use any ID that is in the identifier table in OMRS. If a form comes in from a mobile device with unique patient identifiers, the module creates a new patient.
Issue: While the unique ID may in fact be a new patient, it could also be the ID for an existing patient entered incorrectly. How are people sorting new patients from errors in entering patient Ids?

FrontlineSMS:Medic team is building a patient que that will catch each form that has come into the system with a unique patient ID. A data manager at the server will check the que and either approve patients as new, merge to an existing patient profile, or send SMS back to health worker to clarify.

Idea for collaboration: We should make this something the xforms module does, rather than just something FrontlineSMS does, so other mobile platforms can use it as well.

Potential future direction: Allow someone at the openmrs server to assign patients to mobile health workers, so that they can select existing patients from a list rather than the error prone method of typing ID.

Mobiles for non patient level data

Discussed using some combination of a mobile platform, OpenMRS, and DHIS. DHIS can be used to manage aggregate, non-patient level data.

Collaboration moving forward: If a mobile tool integrates with OMRS, it should be possible to manage non patient level or household data using DHIS.

Sending data/directions to health workers

Use Case: Produce a list of ART patients that did not show up for their appointment to pick up ARVs that week. Determine the number of the health worker who is geographically closest to each individual patient, and send an SMS to that health worker giving then enough info to track the patient and report back on their status.

Potential solution - SMS reports: Corhort builder usually produces large reports for analysts, managers etc. Perhaps we can use this and something in the logic service to produce a list based on defined cohort criteria, then get specific info about each patient on the list (such as location) and prepopulate follow up SMS.

Core logic service is becoming a module. Could use it to create the patient reminders.
Nyoman Ribeka nribeka@regenstrief.org

Collaboration moving forward: this logic can be built into OMRS, so it could be used by multiple mobile platforms. Discussing this further would be good topic for a second mobile meeting later in the week.

Sharing data/directions directly with clients/patients

Use cases:

  1. next appointment reminder
  2. test results
  3. reminder after missed appointment or missed treatment interaction.

Ghana group doing the most work on this area. Contact Aliya Walji (awalji@grameenfoundation.org) /Bruce MacCleod (macleod@usm.maine.edu) – Interested in how to send out information/Mobile data input

Patient having access to their personal data via mobile

  1. Viewing comprehensive medical data (e.g. with Google health) might require a smart phone like interface, which isn't yet appropriate for the environments most work group participants work in.
  2. Specific types of data could be communicated with SMS (e.g. appointment reminders, certain test results)

Decision support from OMRS → mobile

  1. not much time to discuss this.

Appropriate Devices

  1. no time to discuss

Capturing phone numbers in OMRS

  1. capturing phone numbers in OMRS. Currently hacky, you have to make modifications to the patient attribute. This would allow you to share phones among multiple patient profiles. You could also make it a patient phone ID, in which case it would be unique.

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