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When the first patients trickled into Hôpital Universitaire de Mirebalais (University Hospital) at the end of March, they triggered a cascade of seemingly banal computer tasks that represents one of the largest undertakings in the history of open-source electronic medical records (EMRs).

In the U.S. and other developed countries, hospitals invest millions of dollars on proprietary medical record systems that gather enormous volumes of data. Such hefty investments aren’t an option in the countries where Partners In Health works, and rarely is the necessary infrastructure in place. In Haiti and other PIH sites, clinics and hospitals have often relied on paper records, which can be difficult to manage and easily destroyed in a fire or flood.

In recent years, however, a global community of doctors, software developers, academics, and tech enthusiasts has come together with a single focus: Building and deploying EMRs that are open source, meaning anyone can use the application for free and modify the code to meet their needs. No patents, no licensing fees, just a collaborative effort. PIH was an early adopter. In 2004, we collaborated with the Regenstrief Institute to create OpenMRS, a formal community of individuals and organizations that contribute their coding expertise to a single open-source EMR platform. Nowadays, software developed under the OpenMRS banner is used in more than 40 countries. 

Our goals were simple yet audacious, given the status quo, Evan Waters, director of PIH’s medical informatics team, said.

But building an open-source EMR for University Hospital—a 300-bed teaching facility in central Haiti with seven different p...—would be a “feat of epic proportions,” as Renee Orser, business analyst for PIH’s medical informatics team, said. It had to be highly intuitive for a staff with a wide range of computer literacy. Furthermore, as anyone from PIH’s Monitoring, Evaluation and Quality teams will tell you, collecting data is only useful if they can be extracted, analyzed, and put to work.