Bahmni, Scaling in multiple countries
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The document discusses the implementation and development of Bahmni, an open-source electronic medical record (EMR) system designed for low-resource settings. Funded by ThoughtWorks, Bahmni focuses on improving patient care and community health while being adaptable and user-friendly. The system has been successfully implemented in multiple hospitals across different countries, with an emphasis on community involvement and continuous learning.
![Configurable patient dashboard
"sections": {
"patientInformation": {
"title": "Patient Information",
"name": "patientInformation",
"ageLimit": 5,
"patientAttributes": [
"smoking",
"alcohol",
"landHolding",
"rationCard",
"familyIncome",
],
"addressFields": [],
"displayOrder": 0
},
"nutritionalValue": {
"title": "Nutritional Values",
"name": "vitals",
"isObservation": true,
"dashboardParams": {
"conceptNames": [
"Height",
"Weight",
"BMI Status Data"
],
"scope": "latest"
},
"displayOrder": 1
2
6
Observation Control
Drug Order Control
Lab Result Control
Diagnosis Control
Patient Profile Control
Disposition Control
Graph Control
Graph With Reference Data
Control
Orders Control
Programs Control
Pacs Orders Control
Flow Sheet Control
Custom Control
Navigation Links Control
Obs To Obs Flow Sheet
Chronic Treatment Chart
Drug Order Details Control](https://image.slidesharecdn.com/presentationatopenmrsworldsummit1-151213194253/85/Bahmni-Scaling-in-multiple-countries-26-320.jpg)
![Canned and Configurable
3
4
"visitReport" : {
"name": "Visit Report",
"type": "visitReport",
"config": {
"personAttributes": ["caste", "class", "education", "occupation", "primaryContact"],
"visitAttributes": ["Visit Status"]
}
● Configurable for your needs
● Performance optimised SQL
● Presentation based on excel](https://image.slidesharecdn.com/presentationatopenmrsworldsummit1-151213194253/85/Bahmni-Scaling-in-multiple-countries-34-320.jpg)
Bahmni, Scaling in multiple countries
- 1. PEOPLE’S EMR Scaling across multiple countries
- 2. THE STORY SO FAR Our journey 2
- 3. Jan Swasthya Sahyog 3 ▪ Pro-poor hospital in the most underdeveloped part of central India ▪ High quality patient care ▪ Appropriate technology ▪ We love JSS for their social mission
- 4. JSS - EMR 4 ▪ Rescue of a year and half old EMR project ▪ Started off as a project (not product) ▪ EMR that meets the needs of the clinicians
- 5. Why only JSS? 5 ▪ OpenMRS and Odoo provided generic platform ▪ Widespread need for such a system
- 6. What is Bahmni 6 o EMR o Hospital System o OpenMRS distribution o Open Source, AGPL o Multiple Open Source Products o Developed by ThoughtWorks o For community of implementers
- 7. BAHMNI The tapestry of open source 7
- 8. LOW RESOURCE SETTING What are the constraints? What are the available resources? 8
- 10. BAHMNI Usability to enable better patient-care is the focus of the product 1 0
- 11. Bahmni Goals 1 1 ▪ Improve quality of patient care and health of community ▪ Accessible, easy to use and implement ▪ Build community that takes Bahmni places where ThoughtWorks cannot ▪ For the Global South ▪ Community to Tertiary Care
- 12. BAHMNI AND THOUGHTWORKS 1 2 ▪ Committed for the long term ▪ Social mission ▪ Largely funded by ThoughtWorks ▪ Doing implementations to learn and develop the right product ▪ Majority of implementations done by the community not by ThoughtWorks
- 13. ARCHITECTURE 1 3
- 14. Apache Web Server Bahmni MRS Frontend (JavaScript, HTML5, AngularJS) OpenMRS Server (REST API) Java OpenMRS DB (MySQL) Browser Server (Linux) User’s Machine OpenERP Server (XML-WS API) Python OpenERP DB (PostgreSQL) OpenELIS Server (REST API) Java OpenELIS DB (PostgreSQL) Background jobs consuming feeds all communication over http no orchestrator
- 15. Apache Web Server Bahmni MRS Frontend (JavaScript, HTML5, AngularJS) OpenMRS Server (REST API) Java OpenMRS DB (MySQL) Browser Server (Linux) User’s MachineBahmni Lite
- 16. 16 ▪ Choose sub-systems you want ○ sub-systems not chosen are not even deployed ▪ Choose apps you want ○ applies to EMR ○ applies to ERP ○ apps not chosen are not deployed As lightweight as you want it to be
- 17. 17
- 19. DESIGNED FOR DIFFERENT DEVICES 1 9
- 20. DESIGN 2 0
- 21. Registration 2 1
- 22. 2 2
- 24. 2 4
- 25. Discharge summary completely via configuration 2 5
- 26. Configurable patient dashboard "sections": { "patientInformation": { "title": "Patient Information", "name": "patientInformation", "ageLimit": 5, "patientAttributes": [ "smoking", "alcohol", "landHolding", "rationCard", "familyIncome", ], "addressFields": [], "displayOrder": 0 }, "nutritionalValue": { "title": "Nutritional Values", "name": "vitals", "isObservation": true, "dashboardParams": { "conceptNames": [ "Height", "Weight", "BMI Status Data" ], "scope": "latest" }, "displayOrder": 1 2 6 Observation Control Drug Order Control Lab Result Control Diagnosis Control Patient Profile Control Disposition Control Graph Control Graph With Reference Data Control Orders Control Programs Control Pacs Orders Control Flow Sheet Control Custom Control Navigation Links Control Obs To Obs Flow Sheet Chronic Treatment Chart Drug Order Details Control
- 30. 3 0
- 31. Forms using Configuration, not programming 3 1
- 33. Reports 3 3
- 34. Canned and Configurable 3 4 "visitReport" : { "name": "Visit Report", "type": "visitReport", "config": { "personAttributes": ["caste", "class", "education", "occupation", "primaryContact"], "visitAttributes": ["Visit Status"] } ● Configurable for your needs ● Performance optimised SQL ● Presentation based on excel
- 35. Laboratory 3 5
- 36. 3 6
- 37. Odoo 3 7
- 38. 3 8
- 39. Bahmni Offline 3 9 ▪ Web technologies ▪ AngularJS helps ▪ Crosswalk, Ionic Framework ▪ Service Workers ▪ Sqlite on Android; Indexeddb + Lovefield elsewhere ▪ Same user interface, some features
- 41. IMPLEMENTATIONS Implemented at 6 hospitals ■ Jan Swasthya Sahyog | Bilaspur, India ■ Society for Education, Action, Research in Community Health | Gadchiroli, India ■ Lok Biradari Prakalp | Gadchiroli, India ■ Bayalpata Hospital, Possible Health | Accham, Nepal ■ The Banyan | Chennai, India ■ Kaliganj (sub-district) hospital, Bangladesh Over 25 implementations underway across the world, mostly outside the Indian subcontinent 4 1
- 42. Bahmni (and TW) within OpenMRS community 42 Bahmni Product Team ThoughtWorks Implementation Team (~ 2% Bahmni implementations) OpenMRS Platform Bahmni TW Clients Rest of the world OpenMRS Core Team Community Implementations (98% of Bahmni implementations) non-Bahmni OpenMRS Implementations
- 43. Roadmap Principles 1. Performance, security, technical operational improvements and general robustness of the software 2. Strengthen outpatient clinic, secondary care hospitals and vertical programs i. Features that improve patient care ii. Improve implementers user experience 3. Offline i. basic clinical features 4. Tertiary Care (may be)
- 44. 4 4 Bahmni Wiki
- 46. There are many criticisms of technology, indicating that it can take away the human element of health care. ThoughtWorks has shown us how technology can help, and still remain very human. - Dr. Yogesh Jain, JSS 4 6
- 47. THANK YOU For questions or suggestions Contact Vivek Singh: vsingh@thoughtworks.com