goals for implementing openmrs

• data quality

  • credible

  • reliable

  • national scale

  • perception/ownerships

• end users

  • patient safety perspective

  • health care quality

• embody best practices in the workflow

  • clinical processes

• patient data

  • accessibility

  • e-system paper

  • research

  • improve healthcare delivery

• cost / resources

  • saving money and time

  • e.g. drug stockouts

  • building in-country economies (sustainability)

• integrating systems

  • standards

• standardization

  • between organizations and at different organizational levels

issues at various levels

high (national)

• attitudes toward IT and resources for IT

  • "other prerequisites that should be prioritized ahead of IT"

• lack of a proven methodology

  • enterprise architecture: people are tentative on implementing because there isn't a good

• lack of buy-in from necessary stakeholders

  • private organizations

  • donors

  • government

• attrition & brain drain

  • investing in staff and then seeing them go to better paid assignments

medium (organizational)

• managing change

  • autonomy or organization

• absence of leadership to support such initiatives

  • policies

  • lack of buy-in

• infrastructure that can support an EMR

  • need reliable telephone, network, power

• past failures

  • negative bias resulting from failed implementations

• expectations not properly set

  • overpromising and underdelivering

  • trying to deliver everything all at once

low (personal)

• lack of a value proposition to users

  • incentives

  • work reduction

• skills and training

  • lack of basic computer skills

solutions

high (national)

• resources

  • government support

  • blue prints

• provide evidence to governments, organizations

  • ministries of health, ministries of finance

  • baseline assessment before an implemention is done

  • applicability assessment to see if successful implementations map to your own problems

• communication

  • best practices

medium (organizational)

• setting expectations properly

  • using a phased approach for implementation (planning)

• eliminate pain points

  • do things that would be impossible to report via paper

  • reduce redundancy

low (personal)

• improving skill sets through training

  • games

• community champion to spread the word

• incentives

• eliminate pain points

  • make it easier for the users (time)

• get feedback from users on their experience

  • but simple feedback, just like skype does after every call

action items

• write up of using the MVP concepts

  • (evelyn will be putting up a wiki)

• best practices / lessons learned

  • (evan will talk to m. downey to get a placeholder)

• mentor area for matchmaking newcomers (dawn and nareesa)

  • (gabou will be interested in doing something for west africa)

• video demos

  • (evelyn will get a placeholder setup)

• form repository

  • (alvin will get a placeholder setup)

  • Alvin: the goal was to make available a URL where people can view forms made by other people and be able to copy their htmlformentry code. Thinking that the best way to do this is through an actual OpenMRS installation (called OpenMRS-FORMS) and allowing users to create their forms using their own namespace (eg, amarcelo_diabetes_encounter_form). Ideas anyone?