How OpenMRS Can Help Countries Flatten the COVID-19 Curve

OpenMRS currently plays a critical role in improving the care and treatment of 12.6 million people living with HIV and monitoring our progress towards HIV epidemic control. As the frontline EHR system for patient care in many countries, OpenMRS can be used for novel coronavirus (COVID-19) screening, treatment, and surveillance efforts, resulting in saved lives.

Today, health care workers at the 5,500+ health facilities using OpenMRS face the challenge of identifying and treating patients infected by COVID-19. As a community, our shared knowledge can inform COVID-19 specific modifications to existing OpenMRS tools that can lead to better patient outcomes. Designed to be adapted to country-specific guidance, our science-based tools are being built using CDC and WHO guidance as a foundation. Our platform and modular approach means that we can quickly make these modifications available to implementations that will help health care professionals rapidly collect, share, and act on critical COVID-19 data. Our community aims to extend existing solutions that use standard content and support prevention and care as well as public health surveillance.

Standard Content

When standard content is available, those using digital solutions such as OpenMRS are able to share information and collaborate more effectively. Clinical and content experts within our community are working together to identify new additions to the CIEL concept dictionary using several CDC and WHO forms related to COVID-19 case identification, case investigation, case reporting, and clinical care.  Current Status: On April 6, 2020, Reference Application 2.10.0 was released, including a starter set of over 200 COVID-19 concepts surveillance and care from the CEIL concept dictionary.

Prevention and Care

Immediate action to prevent further spread and inform treatment can be taken when health care professionals carry out Covid-19 case identification at registration and intake. Two tools in OpenMRS are being developed to capture specific COVID-19 data at this point in the clinical workflow: one, travel information and contacts, and two, clinical data for in-facility treatment. While separate applications exist for community screening (e.g. Commcare) and national reporting (DHIS2), managing patient care requires data in the EHR and links to other critical resources including laboratory data. Current Status: A version of the WHO Covid-19 screening form is being prototyped this week.

Public Health Surveillance

Data collected using these tools can also be used for public health surveillance, from case investigation and contact tracing to monitoring the spread and containment of COVID-19 at the country level. OpenMRS is used for regular reporting of aggregated case-load and patients outcomes for national statistics via standards based upload to DHIS2. This can be extended to upload data on diseases such as COVID-19. This approach can be extended to syndromic surveillance for all patient contacts at a clinic or hospital, by including key symptoms in triage of all patient visits. Current Status: Work is starting on solutions for uploading COVID-19 data to DHIS2 and aggregate reporting in OpenMRS.

Community-Driven Collaboration

Our community offers collaborative spaces and processes where these solutions are rapidly designed, developed, and then released to OpenMRS implementers supporting OpenMRS sites. Within the last month, over 20 subject matter experts, business analysts, program managers, and developers from several implementations have joined our #covid-19 Slack channel. A smaller sub-set of this group is driving our joint effort forward in open community spaces. The COVID-19 Response Squad’s Project Page includes an overview of their current work as well as where and how you can join their efforts – specifically through our Talk discussion forum and a Slack channel dedicated to #covid-19. These channels serve as mechanisms to provide input and feedback in real-time and asynchronously, as these tools evolve.  Any and all implementers and developers are welcome to join the effort by following the conversation on Talk and on our #covid-19 Slack channel. Organizations with a need to add COVID-19 functionality to OpenMRS are encouraged to contact OpenMRS.

Current Opportunities for Collaboration and Investment

As an open-source community, this work relies on contributions made by dedicated individuals as well as forward-thinking organizations implementing OpenMRS. If you are interested in contributing to or investing in any of the following opportunities, please contact us.

  1. Tool design and content management. 
  2. Development of screening forms and aggregate reporting solutions
  3. Quality assurance
  4. Documentation