... and passing the baton
It's been a great year, both in terms of the OpenHMIS project and for me personally. There's been a gap in my reports as I wrapped up my time in Kenya and travelled back to Canada. I've given a few in-person reports of my year, but it's time for the official written summary.
Initial project goals
Before I left for Kenya, other people had already invested a lot of thought and planning in the beginning stages of OpenHMIS, and we had a high-level description of what we wanted to accomplish in “phase one.”
Essentially, the goal of phase one of the OpenHMIS project was to prove that OpenMRS is a viable solution to the point-of-care clinical data and management needs of hospitals and clinics in Kenya. To accomplish this, we would have to add the required features that OpenMRS lacked and install the system at multiple pilot sites, successfully supporting or improving their existing workflows. As a third goal, we wanted to maintain and build relationships with Kenyan individuals and organizations to increase their investment in the technology we are developing and ensure the sustainability of the project.
About the first half of my year was spent getting up to speed with the software and tools I would be working with, and preparing the features we would need to install our software at our first pilot site, the AIC Marira clinic, which would include a custom patient registration form and a brand new cashier module, allowing the clinic to bill for their services, drugs, and supplies. The cashier software is especially important for African hospitals as it will help accurately account for financial transactions with patients and includes features to mitigate abuse of the system. The registration and cashier systems are now installed and running at two pilot sites near Nairobi.
Much of the rest of my year was dedicated to designing and building a pharmacy module, as well as inventory and work order modules to support the pharmacy feature. Although I wasn't able to see the completion of these modules while in Kenya, it was encouraging to see that we were able to make good progress on three separate modules in the time that it initially took us to build one, thanks to the knowledge and investment leveraged from our first months of work. We hope to see the pharmacy module finished and installed at our pilot sites by the end of this year.
The Pilot Sites
Running our software at pilot sites was a critical goal in the proof-of-concept stage of the project, and we were fortunate to be able to partner with both faith-based and a state-run facilities.
In November 2012 we installed the first version of our software at the AIC Marira clinic, a satellite clinic of Kijabe Hospital. The registration system was an immediate success, and the benefit was obvious to the clerks using it. The cashier system required a bit more work to iron out, as some requirements seem to become obvious only once you try to use the software. Also there were communication issues that delayed settling on the correct list of items and prices. However, as of early 2013, Marira has switched to using our cashier system full time.
Our other pilot site is Tigoni District Hospital, a state-run hospital that we visited in January. They agreed to have us install our software and provided us with a lot of detail on the requirements of running their pharmacy. I left Kenya before installing at this site, but got the good news from Wes in July that he and Joseph had delivered equipment to the Hospital and will be supporting them as they begin to use OpenHMIS.
Wes and I made some important connections in Kenya during the year. We worked with CHAK throughout the year and continue to look at ways to make our partnership mutually beneficial. We were happy to meet Joseph and have him hired as an intern at CHAK with OpenHMIS development and maintenance as his primary focus—we hope that he will be a valuable asset as he gains experience with our software.
At the Kenya OpenMRS user forum we met with other teams with very important experience using OpenMRS; we each shared some of our work, goals, and the challenges we face, with the intent to learn more about the various OpenMRS initiatives in Kenya and how we may be able to collaborate and reduce duplicated effort.
Wes and I are pleased with how the beginning stages of the OpenHMIS project have unfolded. Still, there is a lot of work left to be done. Features that have yet to be implemented and tested at pilot sites include:
- Advanced finance integration
The OpenHMIS team is in need of skilled programmers, since I'm stepping away from the project for the foreseeable future. Fortunately, we are expecting a developer from Germany to arrive in Kenya this month and begin full-time work on the software. However, Wes will be leaving Kenya at the end of the year after a two-year term, unsure of how soon he will return to work on OpenHMIS. We hope and pray that other mission-minded IT professionals will hear about this project and consider a one- or two-year term working in and around Nairobi.
SIM gave us some cross-cultural training before we went to Kenya, so I knew that I should be looking out for culture clash when working with and relating to people from a very different culture than mine. Still, I think the OpenHMIS team had some specific lessons to learn in this area. When aiming to offer assistance to a country or a group of people in need, it's just as important to empower and equip local people to be co-problem solvers as it is to import help or solutions. We continue to work toward partnerships with Kenyans that will make OpenHMIS effective and sustainable.
Also, as in all areas of life, if you need something to go smoothly, make sure you've rehearsed it thoroughly before the performance! Sometimes the simplest lessons are the hardest to learn!
Thanks to everyone who has followed my updates during the past year and supported me with notes, emails, and the simple yet appreciated Facebook likes. It's been a pleasure relaying the details of a small part of what's going on in Kenya. I hope it's made people feel a bit more internationally connected, and provided an example of an unconventional yet successful mission to people who need God's love.
Please share OpenHMIS with anyone who might be interested in technology-focused mission opportunities!