Greetings to all!
I am the Chief Information Officer at Hôpital Albert Schweitzer Haiti. I have been here for over seven years now. One of my responsibilities includes our health information system. Since the very beginning of my time at HAS, I have continually been asked by our community health and monitoring and evaluation directors about the possibility of using mobile devices for field data collection. We have chosen cell phones as our data entry platform rather than laptops or netbooks because of significantly lower power consumption, simplicity, security and less overhead and maintenance. All Haitians know how to use a cell phone: even sending text messages is very popular. Very few know how to use a computer, mouse, etc.
Much to our delight, mid last year an announcement for OpenMRS-jr was made (Open Medical Records System – junior.) This enables health workers to store medical information about patients quickly and in a way that can be easily analyzed.
OpenMRS-jr is a mobile application developed using the JavaRosa platform. It uses the OpenMRS XForms Module to communicate with OpenMRS.
The initial version of OpenMRS-jr, written by Munaf Sheikh, allowed the following:
- Log in to the app on the phone with a valid username and password
- Download the list of available groups of patients
- Select a group of patients to download, and download the patients onto the mobile device
- Download patient forms onto the mobile device from OpenMRS
- Select a patient, and fill out forms for that patient
- Register new patients
HAS wanted to collect patient information at our remote clinics when patients came to be seen by doctors and nurses. Some of our remote clinics don’t even have cell phone service in the building, but this is not a problem for OpenMRS-jr. We can fill out the forms on the cell phones, and the program sends them later when a connection is available. Because of the expense of Internet on cell phones in Haiti, we opted to use this method (store-and-forward) entirely, using phones with WiFi capability and synchronizing them up on the hospital network.
This will simplify our referral and counter-referral process as well. We want the hospital to know that a patient has been referred from the clinic. When the form is filled out in OpenMRS-jr, patients can be included in a report to notify the hospital of patients that have been referred. Going the other direction (counter-referral), we want the clinic to know that a patient has been seen at the hospital and discharged. We can make a cohort of patients that have recently been discharged from the hospital and synchronize them to the phone.
We also plan to use cell phones and OpenMRS-jr to collect data from our rural health agents. This will include house visits for weighing children, and giving vaccinations, etc. Now, this information can appear directly into the OpenMRS patient dashboard, where the doctors at the hospital can see a more complete patient history.
The application hasn’t been tested extensively on different phones, but in theory it should work on most J2ME compatible phones. We have received a small grant to purchase phones for our clinic providers and rural health workers, and hope to start testing OpenMRS-jr on a Nokia C3.
For additional information and documentation on OpenMRS-jr, visit the OpenMRS Wiki.
As we move forward with mobile data collection, I would welcome any words of wisdom from those who have already walked down this path. Also, if there are any questions on our experience with OpenMRS-jr thus far, I would be happy to try to answer them.