Lessons from Deploying an EMR in Rural India

LESSONS FROM DEPLOYING AN EMR IN RURAL INDIAGurpreet Luthra - Community Lead (Bahmni)

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_zenx_

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www.bahmni.org

LOCATIONS IN INDIA

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LOCATIONS IN INDIA

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LOCATIONS IN INDIA

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SEARCH

LOCATIONS IN INDIA

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SEARCH

LBP Hemalkasa

JSS, BILASPUR

4http://www.tompietrasik.com/2013/01/07/jss-india-public-healthcare-film/

JSS, BILASPUR

5http://www.tompietrasik.com/2013/01/07/jss-india-public-healthcare-film/

• 30 Beds • Two Operating Theatres • Fully equipped Lab • 300 patients for OPD • 800,000 people from 2500 villages • 150 - 200 health care workers • 10 doctors • 3 day waiting period!

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JSS, BILASPUR

JSS, BILASPUR

7http://www.tompietrasik.com/2013/01/07/jss-india-public-healthcare-film/

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CHALLENGES

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• On-site BAs

• Internet for Deployment?

• Agile without Showcases?

• Software as a bottleneck?

• What if the system breaks down? Backup?

• UX Challenges

• Low Cost Devices

• Training people who have never operated a computer

FIRST DEPLOYMENT AT JSS (JUNE-2013)

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THE STORY OF THE SLOW MACHINEA true story of an incident that occurred at JSS

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JSS, BILASPUR

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SEARCH, GADCHIROLI

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SEARCH, GADCHIROLI

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SEARCH, GADCHIROLI

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SEARCH, GADCHIROLI

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SEARCH, GADCHIROLI

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SEARCH, GADCHIROLI

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SEARCH, GADCHIROLI

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• Dr Abhay Bang and his wife Dr Rani Bang

• Dec 1985

• 50% drop in Infant Mortality Rate

• Masters in Public Health from John Hopkins University

SEARCH, GADCHIROLI

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• S.E.A.R.C.H: Society for Education, Action and Research in Community Health

• 25,000 patients each year

• 20 bed indoor facility

• 450+ surgeries each year (special camps)

SEARCH, GADCHIROLI

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• Excel Based Registration since 2011

• 65000 rows

• Research

• Study & Control Areas

• Surveys

SEARCH, GADCHIROLI (2 MONTH PRE-DEPLOYMENT)

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• Made Bahmni configurable (not just JSS!)

• Lots of Jasper Reports

• Patient Registration Card

• Migration Scripts

• Krishna font transformer

KRISHNA FONT

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Chitra

िचत्रा

fpRzk

KRISHNA FONT

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https://github.com/Bhamni/bahmni-java-utils/blob/master/font-transformer/src/test/java/org/bahmni/fonttransform/KrishnaFontTransformerTest.java

SEARCH - 20 DAY DEPLOYMENT

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SEARCH - 20 DAY DEPLOYMENT

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SEARCH - DEPLOYMENT CHALLENGES

• Mobile !? • Electricity !? • Internet !? • LAN !? • Data Errors

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SEARCH - DEPLOYMENT CHALLENGES

• Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support?

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LEARNINGS

• Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support?

• Local YUM Repo • Carry QA Database • Scripts for one click Backup and Deploy • Infra skills • EasyNetMonitor • Local Language support (non-trivial) • Phased Rollouts (for validation) • Carry everything! (keyboards, extension chords,

network cables, stickies, boards, etc)

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LEARNINGS

• Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support?

• Real System, Real Feedback • Team Viewer • Migrations on SSD / Vagrant • Single view of system status • Daily Dairy • Local Stackoverflow?? • Training/Backup Laptop • Games for Learning Computers • Pay attention to Reports • Need for Offline support

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A HAPPY DAY!

• Krishna Font to Unicode Errors • Linux !? • Backups !? • 32 bit machine? • Remote Support?

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RELATED LINKS

• https://www.thoughtworks.com/insights/blog/dr-prakash-amtes-lok-biradari-brotherhood-people

• http://jssbilaspur.org • http://www.searchgadchiroli.org/ • http://lokbiradariprakalp.org/ • https://www.thoughtworks.com/global-health

Join the community. Implement Bahmni.

Gurpreet Luthra Community Lead (Bahmni)

@_zenx_

www.bahmni.org

THANK YOU