A PhD student in the Harvard-MIT Division of Health Sciences and Technology (HST) used his training and interests to facilitate medical care in South America. Working in Lima, Peru with other researchers, Joaquin Blaya proved that providing health care workers personal digital assistants (PDAs) with the appropriate software was a technological coup. The PDAs loaded with OpenMRS were used to record test results on patients being treated for tuberculosis. Moving off the paper system of recording medical information, the workers were able to reduce the time it took to process data by 15 days.

Patients with drug resistant tuberculosis undergo a two year regime of powerful antibiotics, including injections six days a week during the first six months, with monthly testing. The test results dictate the course of treatment. The half-month delay in getting information from the outback to the city medical facility disrupted the treatment plan.

PDAs used to collect tuberculosis bacteriology data in Peru were found to reduce delays, errors, and workload, "You can monitor patients in a more timely way. It also prevents results from getting lost," says Chilean-born Blaya.

In an MIT D-Lab course, Blaya made contact with Partners in Health, a nonprofit whose mission is to promote health care in resource-poor areas. Working with them and Peru’s sister organization, Socios en Salud, he and faculty members from HST and the Brigham and Women's Hospital, Blaya launched the PDA project. "The way to solve healthcare problems is by involving the community," he says.

Previously, healthcare workers visited more than 100 care centres and labs twice a week, recording patient test results on paper. Returning to their main office they transcribed those results onto two sets of forms per patient – one for the doctors and one for the health care administrators.

The process took an average of three weeks or more per patient. Sometimes, results were temporarily misplaced, delaying reporting. Multiple hand transcriptions exposed the data to error.

With the new system, health care workers enter data into their handheld devices, using medical software designed for this purpose. When the workers return to their office, they sync up the PDAs with their computers.

OpenMRS is an open-source, enterprise electronic medical record system framework intended to assist in building and managing health systems in the developing world, where AIDS, tuberculosis, and malaria affect millions of lives. Their mission is “to foster self-sustaining health information technology implementations in these environments.” The current version of the tracking software, is at their website. Blaya used an early version of the software for his Peru study.

The researchers recently reported in the International Journal of Tuberculosis and Lung Disease that Peruvian health care workers enthusiastically embraced the programme, which has expanded to all five districts in Lima. In addition to saving time, the handheld devices are also more cost-effective than the paper-based system.

The government of Rwanda is using OpenMRS as a national medical record system, at all health facilities, as part of the country’s Vision 2020. The OpenMRS system is now fully operational on a Linux server in Rwinkwavu Hospital.

The OpenMRS Implementers meet annually in South Africa where the software was originally deployed for AIDS workers. The organization divided the OpenMRS community into 3 groups: Developers, defined as technical people who write and contribute code to the core code base or the modules; Implementers, defined as semi-technical people who do not write code but are expert at configuring and implementing OpenMRS, installing modules, configuring reports, and project management; Users, defined as non-technical people who have an interest in how OpenMRS can be used. The 2009 meeting date has yet to be decided. X

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