183 lines
15 KiB
Markdown
183 lines
15 KiB
Markdown
## OpenMRS+ Implementation in Bangladesh ##
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**Introduction to OpenMRS**
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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.
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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.
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**Overview of OpenMRS+ in Bangladesh**
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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.
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**Deployment Modalities:**
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1. **On-Premise Server:**
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* 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.
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2. **Online Centralized Solution:**
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* 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.
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**Key Features of OpenMRS+ in Bangladesh**
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1. **Modules Implemented:**
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* Inpatient
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* Outpatient
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* Emergency
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* Ticket Counter
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* Billing
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* Pharmacy
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* Laboratory (via OpenELIS integration)
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* Inventory Management
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2. **Infrastructure:**
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* Hospitals with on-premise servers operate OpenMRS+ locally, ensuring resilience to internet disruptions.
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* Internal connectivity is managed via Local Area Networks (LAN) within hospital premises.
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* The centralized online solution facilitates inter-facility data sharing and is being tested for scalability.
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3. **Hardware Integration:**
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* Barcode scanners and printers enhance operational accuracy.
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* LED displays in front of doctor chambers streamline queue management.
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**Advantages of Implementing a Hospital Automation System**
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1. **Improved Patient Care:**
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* Real-time access to patient data for better decision-making.
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* Automation minimizes human errors in diagnostics and record-keeping.
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2. **Operational Efficiency:**
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* Streamlined workflows across inpatient, outpatient, emergency, and other departments.
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* Integration of billing and inventory modules ensures optimal resource utilization.
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3. **Data-Driven Administration:**
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* Digital records simplify data retrieval and updates.
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* Centralized data facilitates analytics and evidence-based decision-making.
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4. **Resilience to Connectivity Challenges:**
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* On-premise servers ensure continuity of operations in areas with unstable internet.
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* Centralized solutions are being tested to determine feasibility in connected regions.
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5. **Cost-Effectiveness:**
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* Barcode integration eliminates manual tracking costs.
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* Standardized processes reduce operational inefficiencies.
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6. **Patient Satisfaction:**
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* Reduced waiting times through efficient queue management.
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* Transparent billing and quicker lab results foster trust.
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**FAQs: Why Deploy On-Premise Servers for Each Hospital?**
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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:
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* **Unstable Internet in Certain Areas:**
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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.
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* **Gradual Dependence on Automation:**
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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.
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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.
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***
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**FAQs: Which hospitals have been automated by OpenMRS Plus?**
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There are several hospitals have been automated by OpenMRS Plus.
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**Automated hospital list:**
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# Automated by OpenMRS+ hospital list and Automation Start Dates
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| S/I | Hospital and Other Information | Automation Start Date | Vendor Information |
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|-----|-----------------------------------------------------------------------------|------------------------|----------------------------------|
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| 1 | Gopalganj 250 Bed General Hospital | 07/06/17 | Crystal Technology Bangladesh Ltd. |
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| 2 | Muksudpur Upazila Health Complex | 15/08/20 | Crystal Technology Bangladesh Ltd. |
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| 3 | Kashiani Upazila Health Complex | 22/10/20 | Crystal Technology Bangladesh Ltd. |
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| 4 | Kotalipara Upazila Health Complex | 09/12/20 | Crystal Technology Bangladesh Ltd. |
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| 5 | Tungipara Upazila Health Complex | 04/01/20 | Crystal Technology Bangladesh Ltd. |
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| 6 | Singair Upazila Health Complex | 02/01/21 | Crystal Technology Bangladesh Ltd. |
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| 7 | Harirampur Upazila Health Complex | 15/08/20 | Crystal Technology Bangladesh Ltd. |
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| 8 | Shibalaya Upazila Health Complex | 01/01/21 | Crystal Technology Bangladesh Ltd. |
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| 9 | Saturia Upazila Health Complex | 20/10/20 | Crystal Technology Bangladesh Ltd. |
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| 10 | 250 Bed General Hospital, Kishoreganj | 01/01/21 | Crystal Technology Bangladesh Ltd. |
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| 11 | Bhairab Upazila Health Complex | 03/03/21 | Crystal Technology Bangladesh Ltd. |
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| 12 | Tarail Upazila Health Complex | 09/01/20 | Crystal Technology Bangladesh Ltd. |
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| 13 | Mithamoin Upazila Health Complex | 27/05/20 | Crystal Technology Bangladesh Ltd. |
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| 14 | Katiadi Upazila Health Complex | 16/12/20 | Crystal Technology Bangladesh Ltd. |
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| 15 | Pakundia Upazila Health Complex | 04/02/21 | Crystal Technology Bangladesh Ltd. |
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| 16 | Khulna 250 Bed General Hospital, Khulna | 21/07/20 | Crystal Technology Bangladesh Ltd. |
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| 17 | Paikgacha Upazila Health Complex | 20/02/20 | Crystal Technology Bangladesh Ltd. |
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| 18 | General Hospital Cumilla | 12/01/21 | Crystal Technology Bangladesh Ltd. |
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| 19 | Muradnagar Upazila Health Complex | 04/04/21 | Crystal Technology Bangladesh Ltd. |
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| 20 | Burichong Upazila Health Complex | 14/03/22 | Crystal Technology Bangladesh Ltd. |
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| 21 | Chaddagram Upazila Health Complex | 01/08/23 | Crystal Technology Bangladesh Ltd. |
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| 22 | Barguna District Hospital | 01/12/20 | Crystal Technology Bangladesh Ltd. |
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| 23 | Amtali Upazila Health Complex | 02/02/22 | Crystal Technology Bangladesh Ltd. |
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| 24 | Betagi Upazila Health Complex | 20/02/22 | Crystal Technology Bangladesh Ltd. |
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| 25 | Patharghata Upazila Health Complex | 20/06/22 | Crystal Technology Bangladesh Ltd. |
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| 26 | Netrokona Sadar Hospital | 23/01/22 | Crystal Technology Bangladesh Ltd. |
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| 27 | Shibchar Upazila Health Complex | 03/01/21 | Crystal Technology Bangladesh Ltd. |
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| 28 | Rajoir Upazila Health Complex | 17/04/21 | Crystal Technology Bangladesh Ltd. |
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| 29 | Dacope Upazila Health Complex | 03/06/21 | Crystal Technology Bangladesh Ltd. |
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| 30 | Dumuria Upazila Health Complex | 01/08/21 | Crystal Technology Bangladesh Ltd. |
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| 31 | Jhenaidah District Hospital | 28/10/20 | Crystal Technology Bangladesh Ltd. |
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| 32 | Mohanganj Upazila Health Complex | 13/10/21 | Crystal Technology Bangladesh Ltd. |
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| 33 | Kotchandpur Upazila Health Complex | 02/01/20 | Crystal Technology Bangladesh Ltd. |
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| 34 | Harinakunda Upazila Health Complex | 15/08/20 | Crystal Technology Bangladesh Ltd. |
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| 35 | Barhatta Upazila Health Complex | 31/03/22 | Crystal Technology Bangladesh Ltd. |
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| 36 | Gofargaon Upazila Health Complex | 21/01/21 | Crystal Technology Bangladesh Ltd. |
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| 37 | Muktagacha Upazila Health Complex | 01/12/20 | Crystal Technology Bangladesh Ltd. |
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| 38 | Fenchuganj Upazila Health Complex | 21/01/21 | Crystal Technology Bangladesh Ltd. |
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| 39 | Biswanath Upazila Health Complex | 03/07/21 | Crystal Technology Bangladesh Ltd. |
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| 40 | Sylhet Shahid Shamsuddin Ahmed District Hospital | 01/11/20 | Crystal Technology Bangladesh Ltd. |
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| 41 | Beanibazar Upazila Health Complex | 25/02/21 | Crystal Technology Bangladesh Ltd. |
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| 42 | South Surma Upazila Health Complex | 10/07/24 | Crystal Technology Bangladesh Ltd. |
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| 43 | Domar Upazila Health Complex | 21/03/21 | Crystal Technology Bangladesh Ltd. |
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| 44 | Dimla Upazila Health Complex | 25/03/21 | Crystal Technology Bangladesh Ltd. |
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| 45 | Kishoreganj Upazila Health Complex | 11/01/20 | Crystal Technology Bangladesh Ltd. |
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| 46 | Nilphamari District Hospital | 07/03/21 | Crystal Technology Bangladesh Ltd. |
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| 47 | Jaldhaka Upazila Health Complex | 10/01/21 | Crystal Technology Bangladesh Ltd. |
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| 48 | Pirganj Upazila Health Complex | 04/01/21 | Crystal Technology Bangladesh Ltd. |
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| 49 | Gurudashpur Upazila Health Complex | 08/09/20 | Crystal Technology Bangladesh Ltd. |
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| 50 | Natore District Hospital | 01/12/20 | Crystal Technology Bangladesh Ltd. |
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| 51 | Singra Upazila Health Complex | 09/02/21 | Crystal Technology Bangladesh Ltd. |
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| 52 | Sheikh Fazilatunnessa Mujib Eye Hospital & Training Institute | 01/02/24 | Crystal Technology Bangladesh Ltd. |
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| 53 | Kaliganj Upazila Health Complex | 01/07/20 | Crystal Technology Bangladesh Ltd. |
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| 54 | Kaliakair Upazila Health Complex | 2024 | Crystal Technology Bangladesh Ltd. |
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| 55 | Kapasia Upazila Health Complex | 2024 | Crystal Technology Bangladesh Ltd. |
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| 56 | Araihazar Upazila Health Complex | 21/03/24 | Crystal Technology Bangladesh Ltd. |
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| 57 | Manikganj 250 Bed District Hospital | 27/05/24 | Crystal Technology Bangladesh Ltd. |
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| 58 | National Institute of Cardiovascular Diseases, Bangladesh (NICVD) | 13/06/13 | Crystal Technology Bangladesh Ltd. |
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| 59 | National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) | 01/01/13 | Crystal Technology Bangladesh Ltd. |
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| 60 | National Center for Control of Rheumatic Fever & Heart Disease | 2024 | Crystal Technology Bangladesh Ltd. |
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| 61 | Gopalganj Eye Hospital And Training Institute | 01/02/24 | Crystal Technology Bangladesh Ltd. |
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***
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**FAQs: Can we see the hospital/facility wise patient data?**
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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.
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SHR dashboard url: http://shrdashboard.dghs.gov.bd:5985/
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**Conclusion**
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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. |