OpenMRS Developers' Guide

The Need for Health IT

Patient registration clerks using OpenMRS 

Before you get started as a developer in the OpenMRS project, you may find it useful to learn just a brief background of Health IT, what it is, and why it matters.

For many years, Health IT applications have been created and used to to effectively record and manage patient medical records. Traditionally, patient data were recorded in paper records. However, advances in the field of medicine are introducing the need to manage very large amounts of data. Because paper medical records are inherently passive, they can not evaluate or trigger meaningful actions in response to their content. These challenges led to the development of many different electronic medical record (EMR) systems. These software tools promote meaningful use of patient health records.

Over the past several decades, several commercial and open source EMR tools have been developed and implemented with varied levels of success. OpenMRS is one of them!

Improving health care quality

EMRs can help improve the quality of healthcare in multiple ways.

Accuracy

The adoption of health IT can significantly reduce the potential for medical errors. For example, an EMR can resolve incidents where hand-written physician records are misinterpreted, and incorrect medication provided to a patient.

Efficiency

EMR systems can improve the efficiency of data exchange between multiple health IT applications. They can also prevent duplication of services, thereby reducing chances of unnecessarily extending a patient's hospital stay and maximizing use of hospital resources.

Better patient care

Data collected by an EMR application can be used to support decision-making by health care professionals. Computerized guidelines can also offer benefits to help clinicians and patients make better decisions, thereby increasing the likelihood that health care decisions have a positive outcome on the patient.

Understanding data about public health

The data captured via an EMR system can be used to explore data used to create and monitor public health standards. For example, vaccination records stored in an EMR can provide a deep insight into the population of a state or country, and the health of those vaccinated people over time.

Serving as a record of patient care

Patient data recorded in an EMR system can serve as a historical record of patient care, and is usable both as a legal record as well as means of evaluating the quality of health care provided. For example, patient records in an EMR system that record health care activities at a certain location can be transferred to another location when that patient moves somewhere else. The information provided to the new physician can be re-used to assess a patient's health condition.

Challenges of maintaining EMR's

The need for standardized clinical terminology

Both variation of in terms used by health care professionals, and a general lack of standardization, have both had a significant impact on the meaningful use of health IT applications. For example, a clinician in one wing of the hospital might use the term "heart attack", while another in a different department might use the term "myocardial infarction" to refer to the same thing. This lack of standardization reduces the quality and usefulness of the data. The most common way to handle this problem is use of standardized medical terminology.

Data privacy, confidentiality and security issues

Given the significance of medical data, it is extremely important that confidentiality of patient records are ensured at all times, and that access to these records is strictly controlled and is only given to relevant users. For example, different types of EMR users may only require access to certain types of data or metadata, based on their roles in the health care facility.

Challenges related to data entry

It's necessary to ensure that entering data into an EMR is efficient and easy, so that providers are able to manage their time in a productive manner. If a health care professional is overworked or distracted, mistakes may occur that have adverse effects on a patient's health.

Integration of multiple health IT applications

Consistent with other efforts to ensure meaningful use of Health IT systems, data stored in the EMR system should be easily exchangeable to and from other medical applications. For example, the integration of separate health applications into a regional or national health Information Exchange (HIE) requires that an EMR is capable of easily exchanging data with these external systems.