From CommCare's support of community health workers to RapidSMS's ability to monitor childhood illnesses, a number of OMC technologies are being used to improve healthcare delivery in developing regions. As part of this effort, the OMC is also connecting these technologies to larger and more domain-specific systems like OpenMRS -- an open source medical record system used in over 20 developing countries.

Reasons to Bring Mobile to OpenMRS

In most deployments of OpenMRS, clinicians fill out a paper form with patient data. They place that form into the patient's folder and every few days, data clerks enter that information into the OpenMRS server. Once in the server, the data is available for clinical studies, administrative reports and sometimes printed patient summaries. While this is an improvement over a purely paper-based system, it also has a major flaw -- useful patient data (clinical alerts, lab tests, drug interactions) are not readily available to clinicians for decision making.

To address this issue, the Open Data Kit (ODK) team has been working with the OpenMRS and OpenXData communities to bring mobile phone connectivity using ODK to OpenMRS. Specifically, ODK now has OpenMRS form filling and patient record syncing -- two features that push patient data collection and observation to the mobile phone.

What makes this work different from other OpenMRS mobile projects is the integration with the ODK tools and the Android mobile operating system. ODK provides a generic data collection framework built around XForms while Android enables strong multimedia, location, visualization and database support. Our goal is to bring as much of the OpenMRS desktop experience to the phone.

Adding OpenMRS Form Filling

To address form filling, ODK Collect has been extended to support OpenMRS forms. Clinicians can download forms directly from OpenMRS, enter data as they see patients, and submit the data directly to OpenMRS. The application supports input constraints to minimize errors, form logic to speed entry, and barcode scanning to capture the patient's ID. If clinicians wish to add images, audio or video to the patient record, that data can be captured and uploaded to OpenMRS as well. As seen in the video below, form filling works over GPRS or WiFi and has good offline support.

Adding OpenMRS Patient Syncing

To manage patient record syncing, we have also built a new tool called ODK Clinic. Think of ODK Clinic as an entire medical record system on a phone. Clinicians can download a customizable patient list and view each patient's entire record. There is support for zoomable graphs of numerical data like lab results and if the clinician adds a new measurement or visit note, those changes are synchronized to OpenMRS over GPRS or WiFi. This functionality is demonstrated in the video below.

Expanding OpenMRS Functionality for All

Although both features work well, there is still some work to do. Over the next few months, the ODK team will be working with others in the OMC community to standardize the system so mobile clients like CommCare and servers like RapidSMS can leverage this OpenMRS functionality. Once this work is finished, we will release this support for broader public consumption. Those interested in helping with this ongoing effort, should join the ODK mailing list and help us bring mobile to OpenMRS.