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Implementing Health Mgt. Information Systems in Lesotho. Background on PIH Lesotho. Partners in Health – Boston-based NGO working on public health in seven countries Founded in Haiti in 1987 Started work in Lesotho 2006
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Background on PIH Lesotho • Partners in Health – Boston-based NGO working on public health in seven countries • Founded in Haiti in 1987 • Started work in Lesotho 2006 • Works with the MOH to provide access to HIV, TB treatment and primary care
Work in 6 rural health clinics and MDR-TB clinic in Botsabelo • Most sites are 6-10 hours drive, 1 site not accessible by road • Work with Mission Aviation Fellowship (MAF) and Lesotho Flying Doctors Services (LFDS) to access sites by air
PIH-Lesotho Goals for a HMIS • Monitor cohorts of patients for trends and analysis • Track progress of individual patients • Automated reporting • Procurement
Challenges to Implementation • No/limited power at sites • Communications difficult • Transportation to sites is difficult • Patient files must remain onsite
Initial Solutions • Develop a long-term solution to power and Internet while simultaneously collecting patient data in the short term • Take digital photos of patient data for data entry in Maseru
Long term solutions • Solar/generator power for clinics • VSAT for Internet connectivity • Clinic based data entry • Web-based MedicalRecords System
OpenMRS Medical Records System • Free open source medical records system • Developed by Regenstrief Institute and Harvard Medical School through Partners in Health • Goal is to create a customizable medical records systems platform • Free to download • Compatible with Linux for a completely free software model • Data is encrypted and secure • More info at www.openmrs.org
Key outcomes of implementing OpenMRS in Lesotho • Over 5,600 patients monitored in the EMR • Ability to quickly identify cohorts for follow-up by community health workers • Aggregate program-wide reporting • Drug ordering
What does it cost? • Biggest outlays are for power and Internet • For an offline clinic with power, initial costs are very low ($600 for a low-power desktop computer) • For multiple sites with synchronized data, Internet connection is necessary