madiroglobalhealth/uvl-emr

OpenMRS 3 repository for Ubuntu Village of Life in Burundi - Madiro's HealthTech Challenge 2024

This project is part of Madiro's HealthTech Challenge 2024 connecting passionated people willing to engage in Global Goods for Digital Health with real-life needs and impactful opportunities.

This repository contains a distribution of OpenMRS 3 that will support UVL in its digitalization of clinical operations (patient registration, consultations, laboratory, pharmacy, reporting, billing, etc.). Implementing a Digital Public Good such as OpenMRS in a rural hospital in Burundi is key for improving patient care through better record-keeping and streamlined medical data management such as laboratory test results or drug prescriptions, ensuring that healthcare providers have accurate and up-to-date information.

Additionally, it facilitates efficient tracking of public health trends and resource allocation, which is essential for addressing the unique healthcare challenges in rural settings. For example, the financial support from the government for child care and maternal care is conditional to digitalization - contributing to the long term viability and independence of the hospital.

Users and teams

Quick Start using GitPod

You can run the project and contribute to it using GitPod in your browser or VSCode. This will allow you to easily run the project without installing dependencies on your local machine like Java SDK, Docker, etc.

Quick Start on localhost

Prerequisites

1. Install or update Git
2. Install or update JAVA SDK
3. Install or update Docker Compose (version ≥ 2.29)

Clone and Install

Clone the repository locally

git clone https://github.com/MadiroGlobalHealth/UVL-EMR.git

Open the cloned folder

cd UVL-EMR

Build UVL distro/version of OpenMRS 3

./scripts/mvnw clean package

Run and Open

Run UVL EMR (Mugamba polyclinic)

cd sites/mugamba/target/ozone-uvl-mugamba-1.0.0-SNAPSHOT/run/docker/scripts
./start-demo.sh

Open UVL EMR for end-users (OpenMRS 3) in your browser (the installation can take a few minutes)

open http://localhost/

Open the administration of UVL EMR in your browser

open http://localhost/openmrs/admin

Note that default admin user is admin and password is Admin123.

Maven configuration

In some cases, you might need to customize your Maven configuration file to build the project.

On Mac, you can edit those settings using: vi ~/.m2/settings.xml

Add the Maven Server config and API key in your Maven settings on your laptop:

  <servers>
    <server>
      <id>madiroglobalhealth-github-uvl-emr</id>
      <username>YOUR_GITHUB_USERNAME</username>
      <password>YOU_GITHUB_PASSWORD</password>
    </server>
  </servers>

Configuration hierarchy and inheritance

Hierarchy overview

── pom.xml - Aggredator / Orchestrator
      └── /distro/pom.xml - UVL-wide Config
      └── /countries - Country-specific Config
            └── /burundi/pom.xl
      └── /sites - Site-specific Config
            └── /mugamba/pom.xl

Contributing

Contributions are welcome! If you have any suggestions, improvements, or bug fixes, please feel free to open an issue or submit a pull request.

Acknowledgments

This project is made possible thanks to OpenMRS, OzoneHIS, and OpenConceptLab communities. Special thanks to the contributors who have contributed to the development of these tools.

                         

Resources

OpenMRS resources

Join the conversation

Slack, Calls, Forum, Conferences, JIRA, Wiki

Learn more

OpenMRS Academy, Youtube channel

Code

Official Github repositories for OpenMRS

Prerequisites

Git, Docker Compose, Maven

Demo to checkout and run locally here

UVL Burundi Challenge resources

Slack Channel for all participants to discuss the project

JIRA project to pick up and accomplish tasks

Contact

For any questions, please contact Michael Bontyes or reach out on the OpenMRS Slack.

Sign-up for the challenge

Enrollment are open until September 1st, 2024:
https://forms.gle/R1gTWSYYw1WWAErm7

License

This project is licensed under the MIT License. See the LICENSE file for more information.

uvl-emr's Issues

Test Initializer to add billable services in billing module

The billing domain has been added to the Initializer module:
https://github.com/mekomsolutions/openmrs-module-initializer/tree/main?tab=readme-ov-file#version-280

We can already test it out in preparation of receiving the validated billable services to add for the project.

Add missing diagnosis

Compare the list of diagnosis from the UVL requirements:
https://docs.google.com/spreadsheets/d/1ZyqsvdSMR5sJ5JOQN47TLaPucLZOtB5mofWwiooz42E/edit?gid=46706108#gid=46706108

And flag the ones already present in the list of diagnosis in UVL OpenMRS:
http://uvl.southafricanorth.cloudapp.azure.com/openmrs/dictionary/concept.htm?conceptId=1259

Then add the missing tests in OpenMRS using the "concepts" domain from Initializer. For example to create the concepts:
https://github.com/openmrs/openmrs-distro-referenceapplication/blob/main/distro/configuration/concepts/diagnosis_core-demo.csv

All concepts with the data class "Diagnosis" will automatically be visible in the diagnosis dropdown of the UI.

Add Ozone HIS and Madiro logo in the bottom of login page

Example:

Configure address hierarchy for Burundi

Requirements: https://docs.google.com/spreadsheets/d/1ZyqsvdSMR5sJ5JOQN47TLaPucLZOtB5mofWwiooz42E/edit?gid=478269595#gid=478269595

Structure:

1. Country (ex. Burundi)
2. Province (ex. Bururi)
3. Commune (ex. Mugamba)
4. Zone (ex. Kibezi)
5. Colline (ex. Mutobo)

Example of configuration files:
https://github.com/openmrs/openmrs-distro-referenceapplication/tree/main/distro/configuration/addresshierarchy

In UVL EMR, address hierarchy is configured at the country level like here:
https://github.com/MadiroGlobalHealth/UVL-EMR/tree/main/countries/burundi/configs/openmrs/initializer_config/addresshierarchy

Add service types in billing module

Add service types:

• Visit
• Procedure
• Drug
• Lab test

Services can be listed as answers in a coded concept with the UUID "21b8cf43-9f9f-4d02-9f4a-d710ece54261" using the Initialiser "Concept" domain.

Example (not the right UUID though):

Modify the Patient ID generator

Modify the Patient ID generator configuration for the prefix to be "UVL" instead of "IQ146":
https://github.com/MadiroGlobalHealth/UVL-EMR/blob/main/sites/mugamba/configs/openmrs/initializer_config/idgen/idgen_sequential.csv

Configure Locations

How to

• Locations are defined here in the requirements: https://docs.google.com/spreadsheets/d/1ZyqsvdSMR5sJ5JOQN47TLaPucLZOtB5mofWwiooz42E/edit?gid=0#gid=0

• Configuration can replace the one here: https://github.com/MadiroGlobalHealth/UVL-EMR/blob/main/sites/mugamba/configs/openmrs/initializer_config/locations/locations.csv

• Reload the OpenMRS backend to see changes

• The updated locations.csv file can be committed as a pull request on the repository

Acceptance criteria

• All locations are visible upon login like here:

Cloud Architecture Overview

Assuming:

• CD-CI coming from Github Actions (configurations, binaries, Ozone execution)
• Database using MariaDB from Azure OR Docker images depending on costs/added value
• Using K3s or K8s if avoiding using a full VM is possible
• Nightly backups of patient data and files
• Uptime and performance monitoring
• Enabling HTTPS

Configure appointment types

Modify page titles from "OpenMRS" to "UVL EMR"

UVL-1: Add "UVL" to Docker volumes and Containers

When running UVL-EMR today, it uses the default naming from Ozone for volumes and containers. For examples:

Volumes:

Containers

The objective of this ticket is to modify the Ozone build and Docker Compose files to add "UVL" to volumes and containers to clearly identify them as part of the UVL project.

Add missing Lab Tests

Compare the list of tests from the UVL requirements:
https://docs.google.com/spreadsheets/d/1ZyqsvdSMR5sJ5JOQN47TLaPucLZOtB5mofWwiooz42E/edit?gid=1036769692#gid=1036769692

And flag the ones already present in the list of Tests in UVL OpenMRS:
http://uvl.southafricanorth.cloudapp.azure.com/openmrs/dictionary/concept.htm?conceptId=1259

Then add the missing tests in OpenMRS using the "concepts" domain from Initializer. For example to create the concepts:
https://github.com/openmrs/openmrs-distro-referenceapplication/blob/main/distro/configuration/concepts/tests_core-demo.csv
Then add them as members to the concept "Tests Orderability" for them to be visible in the order test dropdown:
https://github.com/openmrs/openmrs-distro-referenceapplication/blob/main/distro/configuration/concepts/convsets-core_demo.csv

Error with FHIR Backend module

Upon login, this error will show up:

Create testing users by roles

Using a similar method than here with liquibase, create testing users for the different roles:
https://github.com/MSF-OCG/LIME-EMR/blob/main/sites/mosul/configs/openmrs/initializer_config/liquibase/liquibase.xml

Users and roles needed:

Role	Privileges	Test username	Test password	Is provider?
Registration Officer	Patient registration (NOT patient summary), View patient queues, Manage appointments	RegistrationOfficer	Admin123	No
Nurse	Same as above + patient summary (create/edit/delete)	Nurse	Admin123	Yes
Doctor	Same as above + patient summary (create/edit/delete)	Doctor	Admin123	Yes
Lab Technician	Only access to the Lab feature	LabTechnician	Admin123	No
Pharmacist	Only access to the Pharmacy and dispensing features	Pharmacist	Admin123	No
Cashier	Only access to the Billing feature	Cashier	Admin123	No

Add payment types in billing module

Add payement types:

• Cash
• Mobile money
• Insurance

Configuration can be done through frontend config json.

Configure patient registration

• Requirements: https://docs.google.com/spreadsheets/d/1ZyqsvdSMR5sJ5JOQN47TLaPucLZOtB5mofWwiooz42E/edit?gid=257555607#gid=257555607

The configuration of registration is split in different locations:

1. CONTENT -> using the initializer files like the person attributes AND the address hierarchy

• Configuration of the "Person attributes" (such as "phone number, profession, etc.): https://openmrs.atlassian.net/wiki/spaces/docs/pages/25471074/Managing+Person+Attribute+Types.
  Example file for UVL: https://github.com/MadiroGlobalHealth/UVL-EMR/blob/main/sites/mugamba/configs/openmrs/initializer_config/personattributetypes/personattributetypes_core-demo.csv

• Configuration of the address hierarchy: https://openmrs.atlassian.net/wiki/spaces/Archives/pages/25475746.
  File examples in UVL: https://github.com/MadiroGlobalHealth/UVL-EMR/tree/main/countries/burundi/configs/openmrs/initializer_config/addresshierarchy

2. UI FIELDS -> using the frontend configuration file

• Configuration of the fields in the UI: https://o3-docs.openmrs.org/docs/configure-o3/configure-the-registration-app.
  File to edit for UVL: https://github.com/MadiroGlobalHealth/UVL-EMR/blob/main/sites/mugamba/configs/openmrs/frontend_config/uvl-mugamba-frontend-config.json

Display "Billing" in the sidebar navigation

Billing is a feature flag. Is there a way to leverage configs to enable that feature flag by default?

Once enabled, it should show up in the navigation.

Enable HTTPS for UVL-EMR

Enable HTTPS when visiting http://uvl.southafricanorth.cloudapp.azure.com/ though the Gateway container using LetsEncrypt automatically renewing or another free SSL option.

So the secured URL should be https://uvl.southafricanorth.cloudapp.azure.com

Add the Data Visualizer module from UgandaEMR

Using the frontend (and backend if needed) configuration files for modules, add the Data visualizer module: https://github.com/METS-Programme/esm-ugandaemr-data-visualizer/tree/main

Example:

UVL frontend modules config:
https://github.com/MadiroGlobalHealth/UVL-EMR/blob/main/distro/configs/openmrs/frontend_assembly/reference-application-spa-assemble-config.json

UVL backend modules config:

UVL-EMR/distro/pom.xml

Lines 29 to 40 in a8e776d

	<dependencies>
	<dependency>
	<groupId>org.openmrs.module</groupId>
	<artifactId>stockmanagement-omod</artifactId>
	<version>${stockmanagement.version}</version>
	</dependency>
	<dependency>
	<groupId>org.openmrs.module</groupId>
	<artifactId>billing-omod</artifactId>
	<version>${billing.version}</version>
	</dependency>
	</dependencies>