Hospital OS: An Open Source EMR System based in Thailand


As hospitals and clinics around the world seek to stay abreast of new technologies, some health centers are deprived of even the most basic ICT systems. In rural Thailand, this is especially the case. With their high licensing fees andskilled labor requirements, electronic medical record (EMR) systems are out of reach for many Thai health providers, resulting in less-than-efficient health services and poor interoperability between hospitals and clinics. EMR systems are essential to allowing health centers to store, retrieve, manage, and share patient medical records.

In 2002, a research effort entitled “Hospital OS”set out to address this problem. Comprising of 5 researchers and leveraging $62,000 in grants, the team developed an Open Source system that would eventually revolutionize the operations of small rural hospitals in Thailand. The research goals defined in their grants required them to equip 700 hospitals with an EMR system, given that the centers had no IT staff, no budgets for high-end computers, and no consistent workflow that could be streamlined through one single software application. In order to accomplish this herculean task, they set forth the following strategies: 1) Create the community, 2) Create the “peopleware”, and 3) Create the software.

The first goal was to unite the hospital community by centralizing information about the research effort on the Hospital OS website: http://hospital-os.com. In addition to allowing participants to download the software, the website kept them informed about new process workflows and allowed them to submit requirements, ask questions, and report bugs or issues. The next goal was to create the “peopleware” – or support staff. To address a fundamental lack of medical and technical personnel, the Hospital OS team offered long-distance training to non-IT staff who volunteered to act as administrators of the system. Training took place over the telephone, online, and through training courses, and resulted in administrators co-operating with one another to solve problems in each others’ hospitals. The final goal was to create the software. The technology aimed to improve hospital productivity and to decrease patient risk. Efficiency was obtained by simplifying the hospital workflow as much as possible, and by allowing hospitals to exchange information digitally by operating as paperless organizations. Through the complete digitization and collection of patient medical history, personal records, and e-prescriptions, Hospital OS minimized errors stemming from handwritten documents and ensured patient safety.

Today, Hospital OS is deployed in over 500 hospitals and clinics across Thailand and housesthe medical records of over five million patients. Its founder, Dr. Kongkiat Kespechara, continues to find innovative ways to improve the lives of many. His mobile app, iPenSook, leverages the centralized Hospital OS database to deliver medical record data directly to a patient’s mobile phone. He is also working with data scientists and analysts to predict disease trends and health patterns in order to inform decision-making within the Thai government. When once asked about the future of Hospital OS, Dr. Kongkiat said: “We hope to see a better quality of life in every community. Hospital OS is developed as a medium to bring these people together and create a truly sustainable community of learning and sharing. As time goes by, people join and leave, softwares come and go, but this community will last.”

2 comments:

  1. Great post Tim!
    Also recommend that you check out OpenMRS..which is essentially an open source electronic platform for the hospitals:
    http://openmrs.org

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  2. "We hope to see a better quality of life in every community. Hospital OS is developed as a medium to bring these people together and create a truly sustainable community of learning and sharing. As time goes by, people join and leave, softwares come and go, but this community will last.” This quote is absolute gold. It is so true that having an active open source community helps the idea thrive and live even as softwares and technologies get outdated. A lot of ICTD projects that run the risk of extinction, could have been saved if there was an active online community trying to save it.

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