“To say it was a deeply planned activity would be dishonest”, Paul Biondich tells me over the phone. I've dragged him out of a conference call with Kenya to discuss OpenMRS, an open source electronic medical record system platform. If he minds, it doesn't show: he talks rapidly and enthusiastically about the project. Paul, co-founder and president of OpenMRS, has a clinical background in paediatrics: he also works as the Director of the WHO Collaborating Centre in Health Informatics, and helps coordinate informatics activities in a large health systems strengthening activity in western Kenya called AMPATH. It was during a visit there that the idea for OpenMRS was generated: he saw “very finite resources, but a developing health system”. What was needed, he realised, was a record system that was easy to use, adaptable, and based around the needs of clinicians on the ground.
What is open source? In brief, it means that instead of software being developed by one company, delivered “shrink wrapped” and protected by copyright, it is free and open to further development by the user. To some, it is a philosophy—almost a religion—to others, it is simply a practical way to get things done. Paul is definitely in the latter camp. Initially tentative about open source, he grew to see its advantages after discussion with colleagues working with health-care systems in other developing countries. He realised that whilst for any one individual to create a whole system would not be possible, inviting collaboration between individuals across the globe could deliver a free, sustainable system. The philosophy, he says, is to “build the hardware store, rather than the whole house directly”. The latest version of OpenMRS was developed by around 50 contributors worldwide, a mixture of philanthropic individuals and corporations. At the user end, he says, everything is free. All OpenMRS asks is that if you have the answer to a question posted by other users, you respond to it. Unsurprisingly, over 40 countries have implemented it at one level or another, from individual clinics to whole nations.
I investigated further with the demo version of OpenMRS, available on the website. I found it simple, clean, and easy to use. It feels like a system that has been carefully honed and refined by user feedback. Paul points out that pluggable modules are also being developed that can build on its basic functionality. The site is well worth a visit from anyone interested in global health: OpenMRS is one of the unsung heroes of the movement.
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