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7. OpenMRS as a global good: Impact, opportunities, challenges, and lessons learned from fifteen years of implementation

Author

Theresa Cullen, Neha Verma, Burke W. Mamlin, Soumyadipta Acharya, Jan Flowers, and Alain B. Labrique

Subjects
Knowledge management, Databases, Factual, 020205 medical informatics, Computer science, business.industry, Medical record, Interoperability, Health Informatics, 02 engineering and technology, Digital health, 03 medical and health sciences, 0302 clinical medicine, Documentation, Scale (social sciences), Server, 0202 electrical engineering, electronic engineering, information engineering, Global health, Electronic Health Records, Humans, 030212 general & internal medicine, business, Delivery of Health Care, Implementation
Abstract

Introduction OpenMRS is an open source medical record system that was first released in 2004. This research study analyzed OpenMRS implementations by conducting a survey of implementers and by reviewing publicly available data reported to the OpenMRS Community to learn about the utilization and impact of OpenMRS over the past 15 years. Methods Data about the use of OpenMRS were collected by conducting a survey of OpenMRS implementers that included both quantitative and qualitative questions. Data were also gathered from the OpenMRS community-hosted Atlas website and the OpenMRS Community Annual report to arrive at a comprehensive view of OpenMRS implementations. Results OpenMRS has been implemented in over 62 countries worldwide (Community Annual report). The survey was responded to by 16 organizations with projects spanning 16 countries, which were launched over 15 years (2004–2019). Fourteen of these sites reported a total of 1,436,357 patients; 4,248,248 visits; 18,028,204 encounters; 312,068,205 observations; and 5088 users, of which 3933 were health providers, recorded in the system database. Implementers reported a positive impact from implementing OpenMRS in streamlining operational processes for healthcare delivery; improved interoperability; improved reporting; improved availability and quality of data for decision making, advocacy, and research; and, improvement in the quality of healthcare delivery. Key challenges in implementing OpenMRS included finding skilled technical staff; acceptability of electronic health records by clinical staff; poor training provided to staff when transitioning from a paper-based to an electronic system; technical challenges, including infrastructure availability (computers, servers, equipment, connectivity, power); missing clinical/programmatic functionality in OpenMRS; poor documentation; and, difficulties faced when contributing code to the open source project. Conclusion OpenMRS has a broad reach globally in a variety of settings. Organizations have reported a positive impact on health care delivery after implementing OpenMRS. Several risks and challenges were identified by implementers that need to be addressed to deliver successful implementations. Continued investment in the development of OpenMRS is needed to sustain and scale its impact.

Published
2021

8. The Promise of Information and Communication Technology in Healthcare: Extracting Value From the Chaos

Author

Burke W. Mamlin and William M. Tierney

Subjects
Information management, Telemedicine, Health Information Exchange, Knowledge management, 020205 medical informatics, 02 engineering and technology, 03 medical and health sciences, 0302 clinical medicine, Documentation, 0202 electrical engineering, electronic engineering, information engineering, Electronic Health Records, Humans, Medicine, Social media, 030212 general & internal medicine, Wearable technology, business.industry, Patient portal, Health information exchange, General Medicine, Information and Communications Technology, Remote Sensing Technology, ComputingMilieux_COMPUTERSANDSOCIETY, business, Social Media, Cell Phone, Confidentiality, Medical Informatics
Abstract

Healthcare is an information business with expanding use of information and communication technologies (ICTs). Current ICT tools are immature, but a brighter future looms. We examine 7 areas of ICT in healthcare: electronic health records (EHRs), health information exchange (HIE), patient portals, telemedicine, social media, mobile devices and wearable sensors and monitors, and privacy and security. In each of these areas, we examine the current status and future promise, highlighting how each might reach its promise. Steps to better EHRs include a universal programming interface, universal patient identifiers, improved documentation and improved data analysis. HIEs require federal subsidies for sustainability and support from EHR vendors, targeting seamless sharing of EHR data. Patient portals must bring patients into the EHR with better design and training, greater provider engagement and leveraging HIEs. Telemedicine needs sustainable payment models, clear rules of engagement, quality measures and monitoring. Social media needs consensus on rules of engagement for providers, better data mining tools and approaches to counter disinformation. Mobile and wearable devices benefit from a universal programming interface, improved infrastructure, more rigorous research and integration with EHRs and HIEs. Laws for privacy and security need updating to match current technologies, and data stewards should share information on breaches and standardize best practices. ICT tools are evolving quickly in healthcare and require a rational and well-funded national agenda for development, use and assessment.

Published
2016

9. OA07.06 Patient Knowledge and Expectations Related to Return of Genomic Results in the Lung-MAP (SWOG 1400) Biomarker-Driven Clinical Trial

Author

Roth, J., primary, Trivedi, M., additional, Gray, S., additional, Patrick, D., additional, Burke, W., additional, Delaney, D., additional, Watabayashi, K., additional, Litwin, P., additional, Shah, P., additional, Crew, K., additional, Yee, M., additional, Redman, M., additional, Papadimitrakopoulou, V., additional, Kelly, K., additional, Gandara, D., additional, Hershman, D., additional, and Ramsey, S., additional

Published
2019
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11. Short-term safety outcomes of mastectomy and immediate implant-based breast reconstruction with and without mesh (iBRA): a multicentre, prospective cohort study

Author

Potter, Shelley, primary, Conroy, Elizabeth J, additional, Cutress, Ramsey I, additional, Williamson, Paula R, additional, Whisker, Lisa, additional, Thrush, Steven, additional, Skillman, Joanna, additional, Barnes, Nicola L P, additional, Mylvaganam, Senthurun, additional, Teasdale, Elisabeth, additional, Jain, Abhilash, additional, Gardiner, Matthew D, additional, Blazeby, Jane M, additional, Holcombe, Chris, additional, Achuthan, R, additional, Adwan, I, additional, Aggarwal, S, additional, Ahmed, M, additional, Akelund, M, additional, Akolekar, D, additional, Al-Jibury, O, additional, Amanita, M, additional, Appleton, D, additional, Archampong, D, additional, Asgiersson, K, additional, Athwal, R, additional, Augusti, A, additional, Ayaani, S, additional, Bains, S, additional, Baker, B, additional, Baker, E, additional, Baldota, S, additional, Banerjee, D, additional, Barker, S, additional, Barr, L, additional, Barry, P, additional, Basu, N, additional, Bathla, S, additional, Bishop, N, additional, Boland, G, additional, Branford, O A, additional, Bright-Thomas, R, additional, Brindle, R, additional, Brock, L, additional, Brown, V, additional, Bux, F, additional, Byrne, G, additional, Cain, H, additional, Caldon, L, additional, Callaghan, M, additional, Carbone, A, additional, Carpenter, R, additional, Cawthorn, S, additional, Chagla, L, additional, Challoner, T, additional, Chalmers, C, additional, Chalmers, R, additional, Chambers, S, additional, Chana, M, additional, Chand, N, additional, Chandran, V, additional, Chandrashekar, M, additional, Charfare, H, additional, Chatterjee, J, additional, Chatterjee, S, additional, Chattopadhyay, R, additional, Chaudry, A, additional, Chin, K, additional, Chong, K, additional, Chouhan, A, additional, Choy, C, additional, Christopoulos, P, additional, Clarke, D, additional, Clarke, S, additional, Clayton, E, additional, Clifford, R, additional, Cocker, D, additional, Collin, T, additional, Collis, N, additional, Conroy, F, additional, Constantinou, C, additional, Conway, A, additional, Cook, J, additional, Coombs, N, additional, Cox, K, additional, Critchley, A, additional, Dakka, M, additional, Dani, M, additional, Daoud, R, additional, Darragh, L, additional, Darvesh, S, additional, Dash, I, additional, Datta, S, additional, Davies, E, additional, Dawson, S, additional, De Sousa, E, additional, Debnath, D, additional, Deol, H, additional, Devalia, H, additional, Di Micco, R, additional, Dicks, JR, additional, Dickson, J, additional, Dobner, N, additional, Dobson, G, additional, Dunne, N, additional, Egbeare, D, additional, El Sharief, D, additional, Elfadl, D, additional, Eltigani, E, additional, Enver, D, additional, Erel, E, additional, Evans, A, additional, Exarchos, G, additional, Fage, E, additional, Fatayer, H, additional, Fenn, C, additional, Ferguson, D, additional, Foulkes, R, additional, Franks, J, additional, Fung, V, additional, Galea, M, additional, Gandamihardja, T, additional, Gandhi, A, additional, Garnsey, C, additional, Gateley, C, additional, Gattuso, J, additional, Gawne, S, additional, Geerthan, N, additional, Ghattura, A, additional, Giaramadze, A, additional, Gill, J, additional, Godden, AR, additional, Goh, S, additional, Govindarajulu, S, additional, Goyal, S, additional, Graja, T, additional, Granger, S, additional, Green, M, additional, Grover, K, additional, Gui, G, additional, Gurung, R, additional, Gutteridge, E, additional, Hakim, A, additional, Halka, A, additional, Hamilton-Burke, W, additional, Hamo, I, additional, Harding-Mackean, C, additional, Hargreaves, A, additional, Harries, S, additional, Harris, K, additional, Harris, P, additional, Harrison, S, additional, Harvey, J, additional, Hashem, M, additional, Hassan, U, additional, Henderson, J, additional, Henton, J, additional, Hignett, S, additional, Hodgkins, K, additional, Horgan, K, additional, Horn, S, additional, Hu, J, additional, Hussain, A, additional, Iddon, J, additional, Iqbal, A, additional, Irri, R, additional, Irvine, T, additional, Irwin, G, additional, Iskender, A, additional, Ismail, A, additional, Ives, C, additional, James, K, additional, James, R, additional, Jiwa, N, additional, Jobson, M, additional, Joglekar, S, additional, Johnson, L, additional, Johnson, R, additional, Jones, L, additional, Ju Hwang, M, additional, Kalles, V, additional, Kanesalingam, K, additional, Karat, I, additional, Kaushik, M, additional, Kennedy, K, additional, Khalifa, E, additional, Khan, H, additional, Khanbhai, M, additional, Khawaja, S, additional, Khout, H, additional, Kiernan, T, additional, Kim, B, additional, Kirkpatrick, K, additional, Kiruparan, P, additional, Kirwan, C, additional, Kishore, M, additional, Kneeshaw, P, additional, Knight, A, additional, Kohlhardt, S, additional, Krupa, J, additional, Krupa, K, additional, Kuruvilla, R, additional, Laban, C, additional, Lai, LM, additional, Laidlaw, I, additional, Lambert, K, additional, Langlands, F, additional, Lansdown, M, additional, Laurence, N, additional, Laws, S, additional, Ledwidge, S, additional, Lefemine, V, additional, Lennon, H, additional, Linforth, R, additional, Little, K, additional, Luangsomboon, A, additional, Lund, J, additional, Maalo, J, additional, MacLennan, L, additional, Macmillan, RD, additional, MacNeil, F, additional, Mahapatra, TK, additional, Mallidis, E, additional, Mallon, P, additional, Manoloudakis, N, additional, Maraqa, L, additional, Marla, S, additional, Masood, S, additional, Massey, J, additional, Masudi, T, additional, Matey, P, additional, Mazari, F, additional, McCulley, S, additional, McEvoy, K, additional, Mcintosh, J, additional, McIntosh, S, additional, McKenzie, S, additional, McManus, P, additional, McNicholas, J, additional, Michalakis, I, additional, Mills, N, additional, Mitchell, G, additional, Monib, S, additional, Mullan, M, additional, Murphy, C, additional, Murphy, G, additional, Murphy, J, additional, Murthy, B, additional, Musa, S, additional, Nagra, G, additional, Nangalia, R, additional, Narayanan, S, additional, Nasr, R, additional, Navin, C, additional, Newton, R, additional, Nicholson, S, additional, Nuru, N, additional, O'Connell, R, additional, O'Donoghue, J, additional, Ogedegbe, A, additional, Olayinka, OS, additional, Olsen, S, additional, Osborn, G, additional, Osborne, C, additional, Osman, H, additional, Otieno, C, additional, Pakzad, F, additional, Park, A, additional, Parker, S, additional, Partlett, P, additional, Parvaiz, A, additional, Parvanta, L, additional, Patel, G, additional, Peel, A, additional, Peiris, L, additional, Pennick, M, additional, Peppe, A, additional, Perry, D, additional, Pilgrim, S, additional, Piper, J, additional, Poonawalla, S, additional, Popa, E, additional, Pope, V, additional, Pugh, P, additional, Rainsbury, D, additional, Ramsey, K, additional, Rasheed, T, additional, Rathinaezhil, R, additional, Rattay, T, additional, Ravichandran, D, additional, Reed, M, additional, Refsum, S, additional, Remoundos, D, additional, Rigby, K, additional, Robertson, S, additional, Robinson, A, additional, Robinson, J, additional, Roche, N, additional, Roy, PJ, additional, Runkel, M, additional, Rusby, J, additional, Saha, S, additional, Saidan, Z, additional, Salab, M, additional, Saleh, M, additional, Salem, F, additional, Sami, A, additional, Samlalsingh, S, additional, Sarfraz, N, additional, Shah, R, additional, Shaheed, S, additional, Sharaiha, Y, additional, Shetty, G, additional, Shotton, R, additional, Sircar, T, additional, Skene, E, additional, Sloan, S, additional, Smith, B, additional, Smith, J, additional, Soldanova, L, additional, Soliman, F, additional, Soumian, S, additional, Stevens, J, additional, Steventon, C, additional, Stewart-Parker, E, additional, Stringfellow, T, additional, Sutaria, R, additional, Sutton, R, additional, Sweetland, H, additional, Swiech, B, additional, Tadiparthi, S, additional, Tafazal, H, additional, Taheri, N, additional, Tait, C, additional, Tan, M, additional, Tang, S, additional, Tansley, A, additional, Tate, S, additional, Tayeh, S, additional, Taylor, A, additional, Taylor, J, additional, Thawdar, P, additional, Thomas, C, additional, Thomas, S, additional, Thomson, S, additional, Thorne, A, additional, Tillett, R, additional, Tolkien, Z, additional, Tomlins, A, additional, Topps, A, additional, Tsang, F, additional, Turner, EJ, additional, Turton, P, additional, Udayasankar, S, additional, Ugolini, F, additional, Vaughan Williams, E, additional, Vidya, R, additional, Vijaynagar, B, additional, Vinayagam, R, additional, Volleamere, A, additional, Voynov, V, additional, Waheed, S, additional, Walker, T, additional, Walsh, U, additional, Warner, R, additional, Waters, R, additional, Wilkins, A, additional, Williams, K, additional, Wilson, G, additional, Wiltsher, M, additional, Wooler, B, additional, Wright, C, additional, Wright, M, additional, Wyld, L, additional, Youssef, M, additional, Zabkiewicz, C, additional, Zammit, C, additional, Zeidan, B, additional, and Zheng, D, additional

Published
2019
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13. Regenstrief Institute's Medical Gopher: A next-generation homegrown electronic medical record system

Author

Douglas K. Martin, Blaine Y. Takesue, Jon Duke, Brian E. Dixon, Justin Morea, Burke W. Mamlin, Linas Simonaitis, and Paul R. Dexter

Subjects
Electronic Data Processing, Decision support system, Knowledge management, Medical Records Systems, Computerized, business.industry, Health information technology, Software development, Information Storage and Retrieval, Health Informatics, Documentation, Clinical decision support system, Health informatics, Hospitals, University, World Wide Web, User-Computer Interface, Workflow, Humans, Medicine, Patient Care, business, Software, Agile software development
Abstract

Objective Regenstrief Institute developed one of the seminal computerized order entry systems, the Medical Gopher, for implementation at Wishard Hospital nearly three decades ago. Wishard Hospital and Regenstrief remain committed to homegrown software development, and over the past 4 years we have fully rebuilt Gopher with an emphasis on usability, safety, leveraging open source technologies, and the advancement of biomedical informatics research. Our objective in this paper is to summarize the functionality of this new system and highlight its novel features. Materials and methods Applying a user-centered design process, the new Gopher was built upon a rich-internet application framework using an agile development process. The system incorporates order entry, clinical documentation, result viewing, decision support, and clinical workflow. We have customized its use for the outpatient, inpatient, and emergency department settings. Results The new Gopher is now in use by over 1100 users a day, including an average of 433 physicians caring for over 3600 patients daily. The system includes a wizard-like clinical workflow, dynamic multimedia alerts, and a familiar ‘e-commerce’-based interface for order entry. Clinical documentation is enhanced by real-time natural language processing and data review is supported by a rapid chart search feature. Discussion As one of the few remaining academically developed order entry systems, the Gopher has been designed both to improve patient care and to support next-generation informatics research. It has achieved rapid adoption within our health system and suggests continued viability for homegrown systems in settings of close collaboration between developers and providers.

Published
2014

14. (300) Developing clinical decision support for chronic pain by understanding clinician information needs during primary care visits

Author

S. Anders, Sarah M. Downs, C. Hale, Burke W. Mamlin, R. Hurley, C. Robert, L. Militello, and Elizabeth C. Danielson

Subjects
medicine.medical_specialty, Anesthesiology and Pain Medicine, Neurology, business.industry, Family medicine, Chronic pain, medicine, Information needs, Neurology (clinical), Primary care, medicine.disease, business, Clinical decision support system
Published
2017

44. The OpenMRS Implementers Network

Author

Seebregts, Christopher J., primary, Mamlin, Burke W., additional, Biondich, Paul G., additional, Fraser, Hamish S.F., additional, Wolfe, Benjamin A., additional, Jazayeri, Darius, additional, Allen, Christian, additional, Miranda, Justin, additional, Baker, Elaine, additional, Musinguzi, Nicholas, additional, Kayiwa, Daniel, additional, Fourie, Carl, additional, Lesh, Neal, additional, Kanter, Andrew, additional, Yiannoutsos, Constantin T., additional, and Bailey, Christopher, additional

Published
2009
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49. The LHCD launcher for Alcator C-Mod—Design, construction, calibration and testing

Author

Hosea, J., primary, Beals, D., additional, Beck, W., additional, Bernabei, S., additional, Burke, W., additional, Childs, R., additional, Ellis, R., additional, Fredd, E., additional, Greenough, N., additional, Grimes, M., additional, Gwinn, D., additional, Irby, J., additional, Jurczynski, S., additional, Koert, P., additional, Kung, C.C., additional, Loesser, G.D., additional, Marmar, E., additional, Parker, R., additional, Rushinski, J., additional, Schilling, G., additional, Terry, D., additional, Vieira, R., additional, Wilson, J.R., additional, and Zaks, J., additional

Published
2005
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