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Integrating OpenMRS with Smart Forms on Android Louis Fazen

Louis.Fazen@gmail.com Yale University School of Public Health

AccessMRS

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Kenya Community Health Volunteers (CHVs)

AMPATH

Burnt Forest Sub-District Hospital

Chulaimbo Sub-District Hospital

Endebess Sub-District Hospital

Khunyangu Sub-District Hospital

Moi Teaching and Referral Hospital (modules 1-4)

Mosoriot Rural Health Training Centre

Port Victoria Sub-District Hospital

SATELLITE CLINIC................................SATELLITE TO: SATELLITE CLINIC................................SATELLITE TO:

Mt. ElgonNational Park

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LakeVictoria

Busia

Ministry of Health-AMPATH Clinic Sites

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B2

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Kakamega

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CHV Responsibilities (KEPH, AMPATH)

Republic of Kenya Ministry of Health, Afya House. Taking the Kenya Essential Package for Health to the Community: A Strategy for the Delivery of Level One Services. Kenya MOH. Nairobi, Kenya. April, 2006

Neonatal and Infant CareExclusive Breastfeeding Education,

Respiratory Rate, Infant Danger Signs, etc.

Children Under 5: MUAC, Malnutrition, Diarrhea, Vaccination and

Deworming Schedule, OVC Services etc.

Family Planning:Directive FP Counseling,

Condom Distribution

Adult and Chronic Diseases:Diabetes, HIV, TB, Disability,

Wound Care, Scabies

Antenatal CareLMP, Danger Signs, Safe Delivery

Postnatal CarePostnatal Danger Signs,

Obstetric Fistula

Preventive Health ServicesDissemination of IEC Materials,

Prevention of Malaria, ITNs, HIV, STIs etc.

Water Safety and SanitationCholera, Latrine Construction

Monitoring and EvaluationData Collection, Aggregation, Analysis and MOH Reporting

Diagnosis and Referral:Refer fever, malaria, etc. to appropriate health center

Community Organization:Community barazas, household registration

and mapping

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SmartPhone?

Neonatal and Infant CareExclusive Breastfeeding Education,

Respiratory Rate, Infant Danger Signs, etc.

Children Under 5: MUAC, Malnutrition, Diarrhea, Vaccination and

Deworming Schedule, OVC Services etc.

Family Planning:Directive FP Counseling,

Condom Distribution

Adult and Chronic Diseases:Diabetes, HIV, TB, Disability,

Wound Care, Scabies

Antenatal CareLMP, Danger Signs, Safe Delivery

Postnatal CarePostnatal Danger Signs,

Obstetric Fistula

Preventive Health ServicesDissemination of IEC Materials,

Prevention of Malaria, ITNs, HIV, STIs etc.

Water Safety and SanitationCholera, Latrine Construction

Monitoring and EvaluationData Collection, Aggregation, Analysis and MOH Reporting

Diagnosis and Referral:Refer fever, malaria, etc. to appropriate health center

Community Organization:Community barazas, household registration

and mapping

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SmartPhone Capabilities

Video IEC MaterialsEducational videos by local clinicians

Display of Health Facilities Introduction to Staff and Services

Health Behavior and Demonstration(breastfeeding, umbilical cord care)

WHO Videos Exhibiting Danger Signs and Symptoms

Websites and Electronic MaterialsTransfer of all previous clinical content

to electronic media (text, images)

Clinical Decision SupportSmartForms: Suggesting Patient-Specific Forms

Branching logic in XformsIntegration of IEC Materials, Electronic Forms, Maps

Electronic ResourcesMedical Dictionary,

GPS, OpenStreetMap data,local health center overlays on maps,

Timer for Respiratory RateCalculator, Calendar, Alarm, etc.

Monitoring and EvaluationData Collection, Electronic Form Submission,

Automated Analysis, MOH Reporting

Diagnosis and Referral:Background Synchronization with

OpenMRS EMR system

Community Organization:Phone with airtime, data bundles,

Electronic Money Transfer,Synchronized phone numbers

Device Security:Encryption, SSL, Network Security with Remote Device Management

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CHV Requirements   Integrate into existing CHV Workflows

  Register new patients   Simple UI to organize, edit and submit forms remotely   Integrate with existing materials (flipcharts, logbooks, etc.)

  Cost-effectiveness   Installation, in-field training, maintenance, device management, hardware,

data transmission costs

  Security   Secure data transmission to OpenMRS servers and encryption of

downloaded patient data on phone   Connectivity

  Limited coverage, asynchronous data transmission, & offline resources

  Quality of Care   Improve quality of care provided by CHVs to their local communities

through Clinical Decision Support Systems

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SmartForms 1: Integrated IEC Materials

IEC Materials

Data Collection

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SmartForms 2: CDS Algorithms

IEC Materials

Data Collection Background Synchronization

Patient-SpecificSuggested Forms

DMOH Reports

Clinical Information

CDS Algorithms

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Android Demonstration

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AccessMRS: Dashboard   Dynamic Patient Lists   Patient-specific SmartForms in Suggested Clients   Asynchronous patient registration   Simple, Intuitive Interface   Background synchronization

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AccessMRS: Patient Dashboard   Suggested SmartForm reminder   Signature-based authorization to view clinical data   Clinical data from OpenMRS for offline use   History of all previously completed forms   Organization of previous visits by date categories

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AccessMRS: Forms   Organization of Forms

  Suggested To Do Forms (SmartForms)   Incomplete Forms, Completed Forms, Additional Forms

  Integrated branch of ODK Collect (AccessForms)   Create personal reminders and notes on forms

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Thank you!

Ken Drazan Foundation, Schauer Foundation

This project was generously supported by:

This project is open-source. (github: bfazen)

Louis.Fazen@gmail.com