OpenMRS Community Announces Malawi will be the Host Country for OMRS17

Roger A. MaduroOpenMRS Global Events Manager Christine Gichuki announced yesterday that Malawi has been chosen as the host country for the OpenMRS 2017 implemeters meeting (OMRS17). This is a major milestone for the OpenMRS project. OMRS16 was hosted by the government of Uganda last year. The conference was a major success as I decribed in a presentation at the recent OSEHRA 2017 meeting in Bethesda, Maryland. This will be the second OMRS meeting that is hosted the by a national goverment. The incredibly successful meeting in Uganda is described in this article.

Malawi is one of more than 30 nations across the world in the process of carring out large-scale public/private sector OpenMRS implementations. Malawi and a large number of other countries sought to host the 2017 meeting after seeing the extraordinary success, and impact of the 2016 meeting in Uganda. The Ugandan government hosted the 2016 OpenMRS Implementers meeting to bring the world’s leading OpenMRS experts to Uganda to meet and collaborate with Uganda’s OpenMRS community. The Ugandan government had already implemented OpenMRS in more than 500 clinics across the country and wanted to see if OpenMRS could become the national health IT platform.

The crucible of more than 400 OpenMRS implementers spending 10 days meeting, talking, and working together was such a success that before the end of the meeting, the government of Uganda officially announced the decision that OpenMRS was going to be the nation’s health IT platform. OMRS16 counted with official delegations from 26 countries.

Gichuki describes the selection process that led to Malawi being chosen as the next host of an OpenMRS meeting in her announcement:

After thorough review, deliberation, and feedback from the OpenMRS community I am happy to announce Malawi will be hosting this year’s OpenMRS Implementers’ Conference The Malawi team managed to pass through our vigorous selection process which included votes from the community and final review by the OpenMRS planning committee against the set criteria. Malawi has shown great interest in hosting this year’s conference which was clearly indicated in their detailed application, and they most closely meet the criteria for hosting this annual conference.

A large number of other countries applied. Gichuki thanked them for their applications, saying:

We’re overwhelmed with gratitude for all the countries that expressed interest in hosting this incredible event, and although your country wasn’t selected this year we hope your offer extends beyond 2017 as we’d like to consider you for next year. Thanks to all the members who took part in the application process and to all the community members who helped via their votes and council throughout the selection process.

Official dates for the conference have not been finalized, but it is expected that the implementers meeting will take place around December. 

Criteria for OpenMRS Implementers Meetings

There was such an outpouring of interest in hosting the 2017 meeting that the OpenMRS community had to develop a set of criteria. The criteria was announced by OpenMRS Project Leader Dr. Paul Biondich from the Regenstrief Institute in April of this year. The criteria were:

• Significant local OpenMRS community activity (ie, presence of regional community within country, hackathons, > longstanding community membership, etc)
• Country helps support long term strategic interests of the OpenMRS community
• Easy physical access (ie, good international airport, liberal visa policies, local transportation)
• Travel and hotel infrastructure suitable to host the meeting
• Safety and stability
• Commitment to OpenMRS as a network, regional, or country level platform for patient-level record keeping (ideally, this commitment would come directly from a country's MOH or top health leadership)
• Strong local hosting organization with an ability to engage local resources / sponsorship
• Underserved environment
• Willingness to host OpenMRS clinical site visits

Christine GichukiMalawi's Application

Malawi's application was submitted by Maganizo Monawe, Director of Planning and Policy Development responsible for the implementation of the national health strategy, monitoring and evaluation including health information systems for the government of Malawi.

Question: Please detail the local OpenMRS community activity (ie, presence of regional community within country, hackathons, longstanding community membership, etc) *

Monawe: Malawi currently uses OpenMRS as the core EMR platform for the management of the national HIV/ART management program. There are also integrated modules to covering other key areas such as OPD, Non Communicable diseases, Maternity, ANC. All sites across the country that are using the national EMR for managing the program use OpenMRS for about 10 years.

Several implementers use the OpenMRS platform for managing electronic patient data in Malawi with key implementers being Baobab Health Trust, Luke International, Partners in Health and Lighthouse Trust through a consortium of several organisations that are working towards increasing data use in Malawi. Most of the development work and implementation of EMR solutions using OpenMRS is mainly done by technical implementing partners which also provides an opportunity for use of organisational resources in improving the platform for the greater good of the OpenMRS community.

Question: Please explain how your country helps support long term strategic interests of the OpenMRS community. *

Monawe: Since most of the use and implementation of OpenMRS in Malawi is done by the Ministry of Health in collaboration with partner organizations and as such the system is wholly embraced by the government as the official data store for all national electronic patient level data, there are many opportunities available to provide direct support in the enhancement of the platform.

This is the case because with data having been collected for over 10 years using the platform, more efforts are currently being invested into making the data collected using the platform more accessible and easier to integrate at national level from multiple sources. Furthermore, all national clinical data concepts are currently being managed using OpenMRS as the platform for management.

With funding from the Bill and Melinda Gates foundation, further work on improving accessibility of data concepts to all players in the health industry at national level is currently underway which also demonstrates the level of trust and long term strategic role OpenMRS has on the community in Malawi both now and for future expansions that may be planned for. In addition, the Ministry of Health promotes use of Open Source software in developing health information systems in the country.

The effort that Malawi is making in strengthening data use based on its large dataset provides models to the larger OpenMRS community on how to improve OpenMRS or to use OpenMRS to enable decision making. Such efforts include leveraging the OpenMRS framework to implement a patient level system that not only provides data but also enables integration and support decision making through the patient workflow within the facility.

Maganizo MonaweQuestion: Please explain your commitment to OpenMRS as a network, regional, or country level platform for patient-level record keeping. *

Monawe: As was indicated in [previous questions], Malawi has been one of the biggest beneficiaries of the OpenMRS platform and contributions made by its community for over 10 years now and stands to continue benefitting from participation in this network in the foreseeable future.

The country also stands to benefit more as OpenMRS as a solution provides very relevant solutions to age-old problems that the community of health information system developers in Malawi have grappled with for a while now in that it brings pre-packaged solutions to several issues that keep coming up in cases where one has to develop a clinical electronic data solution.

Issues like the management of data concepts in a centralised way despite multiple ways of presenting the concepts while at the same time being able to group observations by the concepts despite variations at the point of data capture have been made easier to deal with through the use of OpenMRS which is a big plus to a country like Malawi.

The generic design of a typical clinical data management platform as is the case with OpenMRS also makes the development of new specific clinic modules much easier which can also be a challenge for low resource countries like Malawi if every time one had to build a full solution from scratch. Contributions from different players around the world also provide a sound platform that can easily be used locally.

Having witnessed how vibrant the OpenMRS community is and how mature the OpenMRS API and modular architecture have evolved, the implementers of the national EMR with support from the MoH are planning to extend usage of the OpenMRS platform to include integration of the API so that modules developed by the community can be available for use in the national EMR.

The Ministry of Health has also committed to use funding from Global Fund and Bill and Melinda Gates Foundation to extend modules of the OpenMRS-based national EMR into new programmes such as Tuberculosis. This is in addition to supporting the existing modules for ART, Outpatient, Non-Communicable diseases and Antenatal Care which heavily rely on OpenMRS.

Malawi will continue to share its experiences in patient level data using OpenMRS to the network through such forums as the conferences and through other publication channels. As such Malawi foresees its commitment to the network as strong. As a country we have been participating in the network for a long time and with the entrenchment of OpenMRS systems in patient management in the country there is hope that this commitment will continue into the future.

Question: Please explain your ability to engage local resources/sponsorship to support the cost of hosting such an event. *

Monawe: The organizing team is very capable in terms of raising local resources to support the cost of hosting the conference. First, the members of the organizing team will comprise time commitment from staff who are already working for institutions from the Ministry and those affliated to the implementation of OpenMRS systems. This means less strain on the cost of hosting.

Second, the members of the organizing team have experience mobilizing sponsors such as mobile service providers who are usually willing to participate at the meeting at the cost of advertizing themselves. We will engage local mobile service providers and other local companies to identify with the conference and sponsor the conference.

Third, there are institutions that are sponsoring EMR and other ICT developments. We will engage with them to support some components. Fourth, we will engage with local industries in the areas of health informatics or ICT technologies to setup exhibition stands at a cost. This is easy for the team to do as we have hosted annual health sector ICT innovation fairs for a number of years. In terms of engaging sponsors, the organizing team will comprise a comprehensive itemized budget. The sponsors will be asked to fund items on the list. This is most preferred by most sponsors rather than giving out the actual money.

Question: Something the OpenMRS developers greatly value is visiting implementing clinics of the country. Are you willing and able to host OpenMRS clinical site visits? Please explain. *

Monawe: The country is willing and able to host OpenMRS clincial site visits. Within 20 to 30 Kms of the conference center there are about 15 sites and about 10 sites within 15 kms that are active all day. The Ministry has often allowed partners to visit and learn from these sites. The accessibility to these sites is easy and there are adequate transportation providers who could ferry participants to these sites safely.

We would not expect these visits to take long as the distances are short but to cover for eventualities the organizing team will arrange to ensure that appropriate food and beverages are provided to each group. The organizing team will ensure that appropriate authorizations are obtained from all necessary offices to ensure that participants are not denied access to facilities for the site visits. The organizing team will also arrange local coordinators for each team so that participants are not stranded once they are at a site due to lack of guidance.

Question: Does your country have relatively easy access (ie, good international airport, liberal visa policies, local transportation)? and Please explain more about the airports, visa policies, and local transportation. *

Monawe: Yes...[and] The Capital City, Lilongwe, has an International Airport with major carriers like South African Airways, Ethiopian Airways and Kenya Airways making inbound and outbound ights every day. Lilongwe International Airport is within 20 minutes drive to the City Center, where Bingu International Conference Center, the proposed venue for the conference is based.

The airport and the City are connected through the M1 road which is the main road cutting across the Country. Within the area where Conference Center is located including the other satellite hotels, trac is minimal, even at pick hours. In terms of local transportation, participants have the option of using either public transport or private.

Private transport is certi趸ed by the hotels to protect participants and the prices are very reasonable. For any participants residing at any of the nearby hotels, the conference organizing team will organize regular private transport to be communiting between the Conference Center and the hotels so that participants will not have to hire. This transport will be certi趸ed.

Malawi has a very liberal visa policy. Nationals from all countries, including Israel, Pakistani are allowed visa entry into the country. For all foreign nationals requiring a visa to enter Malawi, there is provision to preprocess their Visa so that they make payment at the port of entry. What is required is for the foreign nationals to submit electronic copies of their passport photos. This way, the organizing committee will be able to process mass visa approvals with the immigration department. 

Question: We have a very large community, do you have the travel and hotel infrastructure suitable to host meeting for potentially hundreds of people? Please explain. *

Monawe: We propose the conference to take place at the Bingu International Conference Center. This place is a combination of a five star 350 room spacious President's Hotel and a conference center comprising multiple restaurants, conference rooms, meeting rooms of large capacity and an auditorium of 500 participants. Besides the breakaway rooms can in some sections be combined to create rooms of large capacity sitting more than 300 people at a time.

Within 100 meters of the conference center is another 150 four star hotel (Sunbird Capital Hotel) comprising multiple restaurants and spacious rooms and bars. Within 300 meters is another hotel, Golden Peacock Hotel offering Chinese cuisine. It has more than 300 rooms, a casino and multiple restaurants. BICC is located within the City Center and close to the Parliament Building. It is a very secure area offering participants to an opportunity to socialize after daily sessions. It is also very safe for participants to walk from the other hotels to the conference center even at night.

In terms of transportation, there is very good road network from the airport to the conference center and from the conference center to nearby places like other hotels, entertainment center and markets. There are certified transport providers both at the airport and within the hotel premises. It is also very easy for the organizing team to organize transportation for the participants at their own cost.

Question: Safety is important to us and we must ensure of good security throughout the conference. Please explain how we can ensure a safe conference for your guests. *

Monawe: Malawi is safe place without serious threats to the well being of visitors from outside the country. The conference center and the surrounding hotels are located within City Center, next to parliament buildings on one side, capital hill on the other side, and adjacent to the presidential drive leading to the state house. Because of this environment the conference center is a safe place. Not to mention that the whole city is safe for tourists and visitors. However, not to leave anything to chance the local organizing committee will arrange a security briefing covering how to prevent petty crime and other general security issues.

There are certificated transportation vehicles within hotel premises, we will work with the hotel to ensure there is adequate certified drivers in order to protect participants; We will arrange a briefing of alternative restaurants separate from those at the hotel, key entertainment places for nightlife within the vicinity of the conference area.  The organizing committee will also coordinate with Malawi Police Service to have a presence around the conference area to ensure that there is assurance of security or immediate attention should there be a security breach.

OpenMRS 2016 Group Photo in Kampala, Uganda