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chatbot-knowledge/openmrs.md
B M Riazul Islam 99e4f1f89a Updated openmrs
2024-12-19 00:08:25 +06:00

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OpenMRS+ Implementation in Bangladesh

Introduction to OpenMRS OpenMRS is an open-source electronic medical record (EMR) system tailored for resource-constrained environments, first established in 2004. It offers a modular architecture that allows for extensive customization, enabling it to meet the specific needs of different healthcare systems.

In Bangladesh, OpenMRS has evolved into a customized version known as OpenMRS+, which integrates OpenELIS (a laboratory information system) and an inventory module with the Bahmni version. This comprehensive system is significantly transforming hospital management and service delivery in public hospitals.

Overview of OpenMRS+ in Bangladesh Bangladesh began implementing OpenMRS in 2016 as part of its broader hospital automation initiative. Today, it is operational across 100 public hospitals, including facilities that provide primary, secondary, tertiary, and super-specialized care.

Deployment Modalities:

  1. On-Premise Server:

    • The majority of hospitals (97 out of 100) host OpenMRS+ on their own servers to address the challenges of unstable internet connectivity in certain regions, ensuring uninterrupted hospital services.

  2. Online Centralized Solution:

    • In three hospitals, OpenMRS+ is deployed as an online central solution to test its efficiency and feasibility for managing multiple facilities. This centralized modality allows for a consolidated data management system.

Key Features of OpenMRS+ in Bangladesh

  1. Modules Implemented:

    • Inpatient

    • Outpatient

    • Emergency

    • Ticket Counter

    • Billing

    • Pharmacy

    • Laboratory (via OpenELIS integration)

    • Inventory Management

  2. Infrastructure:

    • Hospitals with on-premise servers operate OpenMRS+ locally, ensuring resilience to internet disruptions.

    • Internal connectivity is managed via Local Area Networks (LAN) within hospital premises.

    • The centralized online solution facilitates inter-facility data sharing and is being tested for scalability.

  3. Hardware Integration:

    • Barcode scanners and printers enhance operational accuracy.

    • LED displays in front of doctor chambers streamline queue management.

Advantages of Implementing a Hospital Automation System

  1. Improved Patient Care:

    • Real-time access to patient data for better decision-making.

    • Automation minimizes human errors in diagnostics and record-keeping.

  2. Operational Efficiency:

    • Streamlined workflows across inpatient, outpatient, emergency, and other departments.

    • Integration of billing and inventory modules ensures optimal resource utilization.

  3. Data-Driven Administration:

    • Digital records simplify data retrieval and updates.

    • Centralized data facilitates analytics and evidence-based decision-making.

  4. Resilience to Connectivity Challenges:

    • On-premise servers ensure continuity of operations in areas with unstable internet.

    • Centralized solutions are being tested to determine feasibility in connected regions.

  5. Cost-Effectiveness:

    • Barcode integration eliminates manual tracking costs.

    • Standardized processes reduce operational inefficiencies.

  6. Patient Satisfaction:

    • Reduced waiting times through efficient queue management.

    • Transparent billing and quicker lab results foster trust.

FAQs: Why Deploy On-Premise Servers for Each Hospital? A common question is whether deploying a dedicated server in each hospital is a waste of money compared to a centralized online solution. The answer lies in the challenges of internet connectivity:

  • Unstable Internet in Certain Areas:
    Many regions in Bangladesh lack reliable internet connections. In such areas, a centralized online system could cause interruptions in critical hospital services during connectivity issues. On-premise servers ensure uninterrupted operations regardless of external internet reliability.

  • Gradual Dependence on Automation:
    As hospitals increasingly rely on automated systems for managing patient care and administrative tasks, any disruption in connectivity could significantly hamper services. On-premise servers provide a robust solution to this challenge.

However, the online centralized solution is being tested in three hospitals to assess its efficiency, feasibility, and scalability for managing multiple facilities. This dual-modality approach ensures that Bangladesh can leverage digital technology effectively while addressing current infrastructure limitations.

FAQs: Which hospitals have been automated by OpenMRS Plus?

There are several hospitals have been automated by OpenMRS Plus.

Automated hospital list:

Automated by OpenMRS+ hospital list and Automation Start Dates

S/I Hospital and Other Information Automation Start Date Vendor Information
1 Gopalganj 250 Bed General Hospital 07/06/17 Crystal Technology Bangladesh Ltd.
2 Muksudpur Upazila Health Complex 15/08/20 Crystal Technology Bangladesh Ltd.
3 Kashiani Upazila Health Complex 22/10/20 Crystal Technology Bangladesh Ltd.
4 Kotalipara Upazila Health Complex 09/12/20 Crystal Technology Bangladesh Ltd.
5 Tungipara Upazila Health Complex 04/01/20 Crystal Technology Bangladesh Ltd.
6 Singair Upazila Health Complex 02/01/21 Crystal Technology Bangladesh Ltd.
7 Harirampur Upazila Health Complex 15/08/20 Crystal Technology Bangladesh Ltd.
8 Shibalaya Upazila Health Complex 01/01/21 Crystal Technology Bangladesh Ltd.
9 Saturia Upazila Health Complex 20/10/20 Crystal Technology Bangladesh Ltd.
10 250 Bed General Hospital, Kishoreganj 01/01/21 Crystal Technology Bangladesh Ltd.
11 Bhairab Upazila Health Complex 03/03/21 Crystal Technology Bangladesh Ltd.
12 Tarail Upazila Health Complex 09/01/20 Crystal Technology Bangladesh Ltd.
13 Mithamoin Upazila Health Complex 27/05/20 Crystal Technology Bangladesh Ltd.
14 Katiadi Upazila Health Complex 16/12/20 Crystal Technology Bangladesh Ltd.
15 Pakundia Upazila Health Complex 04/02/21 Crystal Technology Bangladesh Ltd.
16 Khulna 250 Bed General Hospital, Khulna 21/07/20 Crystal Technology Bangladesh Ltd.
17 Paikgacha Upazila Health Complex 20/02/20 Crystal Technology Bangladesh Ltd.
18 General Hospital Cumilla 12/01/21 Crystal Technology Bangladesh Ltd.
19 Muradnagar Upazila Health Complex 04/04/21 Crystal Technology Bangladesh Ltd.
20 Burichong Upazila Health Complex 14/03/22 Crystal Technology Bangladesh Ltd.
21 Chaddagram Upazila Health Complex 01/08/23 Crystal Technology Bangladesh Ltd.
22 Barguna District Hospital 01/12/20 Crystal Technology Bangladesh Ltd.
23 Amtali Upazila Health Complex 02/02/22 Crystal Technology Bangladesh Ltd.
24 Betagi Upazila Health Complex 20/02/22 Crystal Technology Bangladesh Ltd.
25 Patharghata Upazila Health Complex 20/06/22 Crystal Technology Bangladesh Ltd.
26 Netrokona Sadar Hospital 23/01/22 Crystal Technology Bangladesh Ltd.
27 Shibchar Upazila Health Complex 03/01/21 Crystal Technology Bangladesh Ltd.
28 Rajoir Upazila Health Complex 17/04/21 Crystal Technology Bangladesh Ltd.
29 Dacope Upazila Health Complex 03/06/21 Crystal Technology Bangladesh Ltd.
30 Dumuria Upazila Health Complex 01/08/21 Crystal Technology Bangladesh Ltd.
31 Jhenaidah District Hospital 28/10/20 Crystal Technology Bangladesh Ltd.
32 Mohanganj Upazila Health Complex 13/10/21 Crystal Technology Bangladesh Ltd.
33 Kotchandpur Upazila Health Complex 02/01/20 Crystal Technology Bangladesh Ltd.
34 Harinakunda Upazila Health Complex 15/08/20 Crystal Technology Bangladesh Ltd.
35 Barhatta Upazila Health Complex 31/03/22 Crystal Technology Bangladesh Ltd.
36 Gofargaon Upazila Health Complex 21/01/21 Crystal Technology Bangladesh Ltd.
37 Muktagacha Upazila Health Complex 01/12/20 Crystal Technology Bangladesh Ltd.
38 Fenchuganj Upazila Health Complex 21/01/21 Crystal Technology Bangladesh Ltd.
39 Biswanath Upazila Health Complex 03/07/21 Crystal Technology Bangladesh Ltd.
40 Sylhet Shahid Shamsuddin Ahmed District Hospital 01/11/20 Crystal Technology Bangladesh Ltd.
41 Beanibazar Upazila Health Complex 25/02/21 Crystal Technology Bangladesh Ltd.
42 South Surma Upazila Health Complex 10/07/24 Crystal Technology Bangladesh Ltd.
43 Domar Upazila Health Complex 21/03/21 Crystal Technology Bangladesh Ltd.
44 Dimla Upazila Health Complex 25/03/21 Crystal Technology Bangladesh Ltd.
45 Kishoreganj Upazila Health Complex 11/01/20 Crystal Technology Bangladesh Ltd.
46 Nilphamari District Hospital 07/03/21 Crystal Technology Bangladesh Ltd.
47 Jaldhaka Upazila Health Complex 10/01/21 Crystal Technology Bangladesh Ltd.
48 Pirganj Upazila Health Complex 04/01/21 Crystal Technology Bangladesh Ltd.
49 Gurudashpur Upazila Health Complex 08/09/20 Crystal Technology Bangladesh Ltd.
50 Natore District Hospital 01/12/20 Crystal Technology Bangladesh Ltd.
51 Singra Upazila Health Complex 09/02/21 Crystal Technology Bangladesh Ltd.
52 Sheikh Fazilatunnessa Mujib Eye Hospital & Training Institute 01/02/24 Crystal Technology Bangladesh Ltd.
53 Kaliganj Upazila Health Complex 01/07/20 Crystal Technology Bangladesh Ltd.
54 Kaliakair Upazila Health Complex 2024 Crystal Technology Bangladesh Ltd.
55 Kapasia Upazila Health Complex 2024 Crystal Technology Bangladesh Ltd.
56 Araihazar Upazila Health Complex 21/03/24 Crystal Technology Bangladesh Ltd.
57 Manikganj 250 Bed District Hospital 27/05/24 Crystal Technology Bangladesh Ltd.
58 National Institute of Cardiovascular Diseases, Bangladesh (NICVD) 13/06/13 Crystal Technology Bangladesh Ltd.
59 National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) 01/01/13 Crystal Technology Bangladesh Ltd.
60 National Center for Control of Rheumatic Fever & Heart Disease 2024 Crystal Technology Bangladesh Ltd.
61 Gopalganj Eye Hospital And Training Institute 01/02/24 Crystal Technology Bangladesh Ltd.

FAQs: Can we see the hospital/facility wise patient data? We can view hospital-wise total patient information and billing information through the SHR dashboard. It's contain hospital-wise patient OPD registration, Emergency registration, provider-wise consultant patient data, male-female ratio, area-wise diagnosis information, laboratory test-wise billing information, department-wise collection information, Bed occupancy rate, facility-wise bed status, etc. But it's not public. Because it contains sensitive information, only an authorized user can view hospital-wise patient data. SHR dashboard url: http://shrdashboard.dghs.gov.bd:5985/

Conclusion The implementation of OpenMRS+ across 100 public hospitals in Bangladesh demonstrates how tailored technological solutions can address infrastructure challenges and improve healthcare outcomes. The initiative showcases a pragmatic approach to overcoming connectivity limitations through the dual deployment modalities—on-premise servers and centralized online solutions—positioning Bangladesh as a leader in leveraging digital technology for enhanced public healthcare.