Implementing Health Mgt. Information Systems in Lesotho

Background on PIH Lesotho Partners in Health – Boston-based NGO working on public health in seven countries Founded in Haiti in 1987 Started work in Lesotho 2006 Works with the MOH to provide access to HIV, TB treatment and primary care

Work in 6 rural health clinics and MDR-TB clinic in Botsabelo Most sites are 6-10 hours drive, 1 site not accessible by road Work with Mission Aviation Fellowship (MAF) and Lesotho Flying Doctors Services (LFDS) to access sites by air

PIH-Lesotho Goals for a HMIS Monitor cohorts of patients for trends and analysis Track progress of individual patients Automated reporting Procurement

Challenges to Implementation No/limited power at sites Communications difficult Transportation to sites is difficult Patient files must remain onsite

Initial Solutions Develop a long-term solution to power and Internet while simultaneously collecting patient data in the short term Take digital photos of patient data for data entry in Maseru

Long term solutions Solar/generator power for clinics VSAT for Internet connectivity Clinic based data entry Web-based Medical Records System

OpenMRS Medical Records System Free open source medical records system Developed by Regenstrief Institute and Harvard Medical School through Partners in Health Goal is to create a customizable medical records systems platform Free to download Compatible with Linux for a completely free software model Data is encrypted and secure More info at www.openmrs.org

Key outcomes of implementing OpenMRS in Lesotho Over 5,600 patients monitored in the EMR Ability to quickly identify cohorts for follow-up by community health workers Aggregate program-wide reporting Drug ordering

What does it cost? Biggest outlays are for power and Internet For an offline clinic with power, initial costs are very low ($600 for a low-power desktop computer) For multiple sites with synchronized data, Internet connection is necessary