Open source for global health is an area of great strategic importance in the international community. The promise of open source projects in global health is to facilitate the implementation of interoperable platforms responsible for storing and sharing electronic health information to improve quality of health care delivery. Pioneering organizations and champions in this area include the OpenMRS Team, Google and Partners in Health. These organizations and numerous others from around the globe have been championing the cause to improve the quality and access to health information systems in developing countries. The dedication of these professionals must be applauded for their selflessness to save lives and reduce human suffering through the advancement of open source electronic medical records.
Deploying medical records systems has historically been challenging even in developed countries. For example in the United Sates, less than 50% of clinicians have adopted EMRs.
Deploying medical records systems has historically been challenging even in developed countries. For example in the United Sates, less than 50% of clinicians have adopted EMRs.
Similarly, deploying medical record systems in emerging markets and developing countries has its many challenges. Issues related to limited availability of computers, sporadic internet access, inadequate storage, intermittent power and infrequent access to in-service training all can reduce the speed of adoption of clinical management systems for global health. Other issues facing adoption of medical records in developing countries include lack of proper motivation and incentives for staff to use medical records and other critical information systems for health. This is a critical issue because there are many existing legacy systems in developing countries. However these systems often do not have adequate numbers of technical support staff to provide necessary training or report writing capabilities to motivate workers at the point of care to enter quality data into the system.
In countries where there are extreme human resources for health (HRH) crises (inadequate trained medical staff, poor retention and motivation for existing staff) there is a vicious cycle; Too few staff to adequately treat clients and poor adoption of information management tools that could improve efficiencies to improve client care by the existing health work force. Yet adoption of information systems to help improve quality of care through outcomes and resource utilization reporting is critical to maximizing the potential of human and capital resources in developing country settings.
A way forward for Open Source in Global Health
Advocates of open source development have implemented an impressive distributive programming team that engages the brightest minds from around the world to lead the development of novel medical record technologies that can be applied to improve efficiencies, while reducing the rate of unnecessary medical errors. Without a doubt the implementation of novel, low cost, easily scalable and user friendly systems to improve clinical, financial, and outcomes reporting will provide a much needed tool kit to the existing human resources for health crises that faces much of the African Continent and other emerging settings. However, one must consider the limitations of deploying open source health records if they do not look to improve the existing incentives for health workers to adopt these systems. Another critical area for expansion it to promote a sustainable local business environment that can create a vibrant home grown technology sector to maintain and expand these systems. Fortunately the trend to foster local capacity is becoming more main stream and a focus of attention.
