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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:

Hospital Automation Start Date

S/I Hospital and Others Information Automation Start Date
1 Gopalganj 250 Bed General Hospital 07/06/2017
2 Muksudpur Upazila Health Complex 15/08/2020
3 Kashiani Upazila Health Complex 22 October 2020
4 Kotalipara Upazila Health Complex 09/12/2020
5 Tungipara Upazila Health Complex 04-01-2020
6 Singair Upazila Health Complex 02/01/2021
7 Harirampur Upazila Health Complex 15-08-2020
8 Shibalaya Upazila Health Complex 01/01/2021
9 Saturia Upazila Health Complex 20/10/2020
10 250 Bed General Hospital, Kishoreganj 01/01/2021
11 Bhairab Upazila Health Complex 03/03/2021
12 Tarail Upazila Health Complex 09/01/2020
13 Mithamoin Upazila Health Complex 27/05/2020
14 Katiadi Upazila Health Complex 12/16/2020
15 Pakundia Upazila Health Complex 4 February 2021
16 Khulna 250 Bed General Hospital, Khulna 21-07-2020
17 Paikgacha Upazila Health Complex
18 General Hospital Cumilla 12-01-2021
19 Muradnagar Upazila Health Complex 04/04/2021
20 Burichong Upazila Health Complex 14-03-2022
21 Chaddagram Upazila Health Complex August 01, 2023
22 Barguna District Hospital 01-12-2020
23 Amtali Upazila Health Complex 02-02-2022
24 Betagi Upazila Health Complex 20/02/2022
25 Patharghata Upazila Health Complex 20/06/2022
26 Netrokona Sadar Hospital 23-01-2022
27 Shibchar Upazila Health Complex 03/01/2021
28 Rajoir Upazila Health Complex 17/04/2021
29 Dacope Upazila Health Complex 03-06-2021
30 Dumuria Upazila Health Complex 01/08/2021
31 Jhenaidah District Hospital 28/10/2020
32 Mohanganj Upazila Health Complex 13 Oct 2021
33 Kotchandpur Upazila Health Complex 02-01-2020
34 Harinakunda Upazila Health Complex 15-08-2020
35 Barhatta Upazila Health Complex 31/03/2022
36 Gofargaon Upazila Health Complex 21/01/2021
37 Muktagacha Upazila Health Complex 01/12/2020
38 Fenchuganj Upazila Health Complex
39 Biswanath Upazila Health Complex 03 July 2021
40 Sylhet Shahid Shamsuddin Ahmed District Hospital 01-11-2020
41 Beanibazar Upazila Health Complex 25/02/2021
42 South Surma Upazila Health Complex
43 Domar Upazila Health Complex 21 March, 2021
44 Dimla Upazila Health Complex 25th March, 2021
45 Kishoreganj Upazila Health Complex 11-01-2020
46 Nilphamari District Hospital 07 March 2021
47 Jaldhaka Upazila Health Complex 10-01-2021
48 Pirganj Upazila Health Complex 4th Jan, 2021
49 Gurudashpur Upazila Health Complex 8/9/2020
50 Natore District Hospital 1/12/2020
51 Singra Upazila Health Complex 09/02/2021
52 Gopalganj Eye Hospital And Training Institute 01-02-2024
53 Kaliganj Upazila Health Complex 01/07/2020
54 Kaliakair Upazila Health Complex 2024
55 Kapasia Upazila Health Complex 2024
56 Araihazar Upazila Health Complex 03-21-2024
57 Manikganj 250 Bed District Hospital 27/05/2024
58 National Institute of Cardiovascular Diseases, Bangladesh (NICVD)
59 National Institute of Traumatology and Orthopaedic Rehabilitation(NITOR) 2013
60 National Center for Control of Rheumatic Fever & Heart Disease 2024

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.