Standard-Level Configuration Settings

• Original Project Context: In 2024 April-Sept, OpenMRS Inc supported PATH-DRC with taking the sample HIV Module content work from the CDC TAP program and adding this content package into a demo instance of OpenMRS v3, with the goal being (1) to see how re-useable PATH-DRC members would find that content for DRC’s EMR needs, and (2) to see what specific technical configurations or gaps we encountered in leveraging this sample content. This was in fact one of the very first actual instances of the idea of an OpenMRS v3 Content Package being added to a sample distribution of the O3 RefApp EMR.

• About this page: This wiki page’s documentation aims to serve as a guide for understanding the configurations and customizations made to the OpenMRS 3.0 RefApp EMR for PATH DRC, ensuring that all stakeholders are aware of the system's capabilities and how it has been adjusted based on the specific needs of the project.

Step 1: Using the 3.0 RefApp to set up the Fundamental EMR

First, we used the standard OpenMRS Community O3 RefApp.

The OpenMRS 3.0 Reference Application (O3 RefApp) provides a flexible and extensible platform to support various health programs and contexts. For the PATH DRC project, the standard-level configuration settings were customized to meet the specific needs of the HIV/TB program.

Step 2: Adding the HIV Care and Treatment Content Package

The following configurations were implemented:

1. Global Properties Configuration:

   • Locale Settings: The system's default locale was set to French to ensure that the user interface and forms are presented in the local language, and the locale options allowed was reduced to French and English by updating the locale allowed list global property - https://github.com/openmrs/path-drc-emr/blob/d60de294c4664dd1e190eb4a8ed8b6d0a4a68c07/distro/configuration/globalproperties/i18n-core_demo.xml#L8

   • Default Encounter and Visit Types: Encounter and visit types were configured to align with the workflows of HIV/TB services. [TODO: @nethmi Add link to PR showing the distro config file with the actual DRC visit type names.]

   • Patient Identifier Configuration: Custom patient identifier formats were established to match the national guidelines in DRC. [TODO: @nethmi Add link to PR showing this.]

   • Address template: The address template was updated to match the requirements provided of fields required for patient registration.

2. User and Role Management:

   • Roles and Permissions: User specific roles were not part of the initial scope in 2024 April-Sept.

   • User Interface Customization: The logo displayed in the primary navigation app and the login page was updated to the DRC specific logo - https://github.com/openmrs/path-drc-emr/pull/15

3. Modules Configuration:

   • Reporting Module: This was not part of the scope in 2024 April-Sept.

   • Order Entry Module: Configured to support the ordering of tests and medications related to HIV/TB care. [TODO: @Veronica Muthee or @Grace Potma Add link to area or PR showing the actual distro config file(s) where this had to be configured, e.g. /ocl and /drugs .]

4. Forms:

   • The system was configured to include standard forms relevant to HIV/TB, these are from the OpenMRS’ community artifact the OpenMRS HIV Reference Implementation (OHRI) package’s sample “HIV Care and Treatment” content package.

   • Custom forms were also created using the new OpenMRS v3 “Form Builder” tool, to show how DRC-specific data points could be encoded in an OpenMRS Form. Specifically we took inspiration from the DRC HIV Patient Dossier paper form and took the structure of the paper form and a few sample questions to create an example form that the PATH DRC team could then further expand on.

     • JSON Form/Code for this “mini” version of the DRC HIV Patient Dossier form: https://github.com/openmrs/path-drc-emr/blob/main/distro/configuration/ampathforms/DRC%20Mini%20Dossier.json

     • DRC HIV Patient Dossier form

   • HIV Care and Treatment Content Package: The content package was added as a dependency to the reference application - https://github.com/openmrs/path-drc-emr/pull/9. The required metadata for the content packages were also added - https://github.com/openmrs/path-drc-emr/pull/1/files, https://github.com/openmrs/path-drc-emr/pull/11

Step 3: Contextualizing the O3 RefApp EMR for PATH DRC

The contextualization process for PATH DRC involved modifying the OpenMRS 3.0 RefApp EMR to meet the unique requirements of the DRC healthcare system, especially focusing on HIV/TB services. This process included:

1. Customizations and Modifications:

   • Custom form development: Using the OpenMRS form builder, custom forms were developed to capture data specific to PATH DRC's HIV patient dossier form. This form included additional fields not covered by the standard OHRI forms, ensuring comprehensive data collection for monitoring and evaluation.

   • Localization: Besides setting the default language to French, terminology and labels were adapted to match the local healthcare terminology, making the system more intuitive for users in DRC.

2. Workflow Adaptation:

   • The standard workflows within the O3 RefApp were reviewed and adjusted to fit the existing clinical workflows in DRC. This involved configuring visit schedules, encounter types, and data entry processes to align with how care is delivered in DRC’s healthcare facilities.

3. Training and Support:

   • Training materials for online/in-person sessions and user guides are being developed and customized for PATH DRC. This will include step-by-step instructions on how to use the Form Builder, ensuring that the PATH DRC team/healthcare workers are equipped to use the system effectively.

   • Ongoing technical support until end of September 2024 will be established to address any issues that arise as the system is tested, with a focus on troubleshooting customizations and ensuring the system continues to meet the needs of PATH DRC.