1. Implementing Health Mgt. Information Systems in Lesotho

2. 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

3. 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

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

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

6. 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

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

9. 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

12. 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

13. 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