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Table of Contents

The OpenMRS Field Guide is a new and incomplete resource that aims to help implementers with the nuts and bolts of beginning and sustaining a successful implementation of OpenMRS, from securing electricity to maintaining data quality.

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There is also an OpenMRS Book for Implementers available: http://booki.flossmanuals.net/openmrs-guide

Assessing Needs

Get the stories and work flows of:

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  • A central server with remote sites connected via Internet
  • Local servers connected to work stations with a wireless local area network
  • Local server connected to work stations by ethernet cable
  • A collection of sites, each with its own server, are connected by Remote FormEntry module or sync feature
  • Paper forms are completed at remote sites and brought to a central location where they are entered into a local server

Entering data at point of care vs. retroactively

See Point of Care page.

Using a vertical program model vs. primary/comprehensive care model

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Existing infrastructure is a critical factor in designing your project. Implementing an electronic medical records system can be a good motivation to build infrastructure such as stable electricity or Internet connectivity that has tangential benefits for other aspects of the health facility. However, it is critical that project goals are modest enough that they will be successfully implemented, embraced by local staff, and have sufficient long-term financial support.

Power infrastructure

OpenMRS is only as reliable as the power system that supports it. Unless electricity is almost 100% stable in your area, you will probably want a primary power source and a backup.

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  • Remote servers connected via Internet. Work stations connected to Internet via wireless router or ethernet cable
  • Local server connected to work stations with a wireless local area network
  • Local server connected to work stations by ethernet cable

Security

Some projects require significant investment to protect ICT and power infrastructure, while others do not. Consider the context. Only local knowledge can guide this decision.

  • Use "passive" security as much as possible (e.g. bars versus locking shutters)
  • Have metal doors with locks, and bars on all windows
  • Use a large, sturdy, lockable metal cabinet to store the server, fans, and backup batteries (such as Baobab proivdes for each implementation)
  • Avoid glass, especially at ground level
  • Having a relatively public location can help minimize theft, but only if solid basic protections are in place
  • Secure solar arrays with locking frames. Based on local conditions, wire mesh or other screening may be required to protect glass from rocks, etc. If available, use impact resistant panels.
  • Widespread community support for the ICT system and/or the services they support can help to minimize the likelihood of theft or vandalism.
  • A laptop may be more likely to be stolen because it is portable and can be used for purposes other than the EMR. A desktop computer is less portable, and a thin client such as a basic touch-screen device may be less vulnerable to theft if it can't act as a standalone computer - i.e. can't function when it isn't connected to a central server. Using a thin client has the added benefit of ensuring that staff will use the device for work purposes rather than browsing the web, making Word documents etc.

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Once you have a good understanding of the kind of system you want to set up, the amount of data you want to collect over time, and the type of system your infrastructure (either pre-existing or built specifically for this project) can support, you can select server and work stations that meet your needs.

Server requirements

Most installations require a minimum of 2GB RAM, 250GB hard disk.

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If you intend to build a point of care system, you should estimate the number of work stations needed based on the number of clinicians or clinic rooms. You might want to consider using thin clients or touch-screen devices, and may want to use mobile devices if for remote clinics. Such devices range from $100 (for a J2ME smartphone capable of running OpenMRS) to $1,000 for some touch-screen appliances.

Mobile devices

If you would like submit forms from the field, and do not need rich access to patient data, you can do so with mobile devices that cost as little as $20. Forms can be sent via SMS, GPRS, or wifi. On the other end of the spectrum are applications that run on more expensive smartphones with features that are nearly equivalent to a regular OpenMRS workstation, except on a smaller screen.

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See Step by step installation for implementers.

Constructing Forms

Building forms is an iterative and non-trivial process. Consider various options for creating and submitting forms, including HTML form entry module, XForms module, FormEntry module (uses InfoPath) and Remote FormEntry module (also uses InfoPath). 

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Many implementations use existing clerks. Some train cleaners to enter data.

Data managers

If you have more than 4 data entry clerks, it is often useful to train data managers to oversee the data entry clerks and ensure that they are maintaining high data quality.

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Eventually this page will document reference implementations using a case study approach aimed at sharing practical experiences in diverse settings with new OpenMRS implementers.

Additional Resources

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