OpenMRS represents a collaborative effort to develop an open-source EMR for developing countries in the fight against HIV/AIDS, multi-drug resistant tuberculosis, malaria, and related health crises. Open Medical Record System (OpenMRS) formed in 2004 as a open source medical record system framework for developing countries — a tide which rises all ships.
OpenMRS is a multi-institution, nonprofit collaborative led by Regenstrief Institute, Inc., a world-renowned leader in medical informatics research, and Partners In Health , a Boston-based philanthropic organization with a focus on improving the lives of underprivileged people worldwide through health care service and advocacy. These teams nurture a growing worldwide network of individuals and organizations all focused on creating medical record systems and a corresponding implementation network to allow system development self reliance within resource constrained environments.
To date, OpenMRS has been implemented in several African countries, including South Africa, Kenya, Nigeria, Rwanda, Lesotho, Zimbabwe, Mozambique, Uganda, and Tanzania. This work is supported in part by organizations such as the World Health Organization (WHO), the Centers for Disease Control (CDC), The Rockefeller Foundation, and the President's Emergency Plan for AIDS Relief (PEPFAR).
The origin of OpenMRS began through a partnership with "Indiana University School of Medicine and Moi University in Kenya" in the 1990s. With time, the original goals of using this program to train Kenyan students in health care shifted due to an HIV/AIDS epidemic. The "Academic Model for Prevention and Treatment of HIV/AIDS (AMPATH)" was created in order to record and monitor patients with HIV/AIDS. The large influx of records in the system became such a great concern for the program, which indicated personnel had to step in and restructure the system. 
OpenMRS is an application which enables design of a customized medical records system with no programming knowledge (although medical and systems analysis knowledge is required). It is a common framework upon which medical informatics efforts in developing countries can be built. The system is based on a conceptual table structure which is not dependent on the actual types of medical information required to be collected or on particular data collection forms and so can be customized for different uses.
OpenMRS is based on the principle that information should be stored in a way which makes it easy to summarize and analyze, i.e. minimal use of free text and maximum use of coded information. At its core is a concept dictionary which stores all diagnosis, tests, procedures, drugs and other general questions and potential answers. OpenMRS is a client-server application which means it is designed to work in an environment where many client computers access the same information on a server.
OpenMRS is for people that need to implement a medical records system. It is both just a library of API calls and a database and a default implementation of those API calls in the form of a web application.
OpenMRS is a free, open-source program. All of the resources needed are open source and freely available.
Aside from the default features that OpenMRS has, additional plugins are available to extend its functionality. Current features are :
- Central concept dictionary: Definitions of all data (both questions and answers) are defined in a centralized dictionary, allowing for robust, coded data
- Security: User authentication
- Privilege-based access: User roles and permission system
- Patient repository: Creation and maintenance of patient data, including demographics, clinical observations, encounter data, orders, etc.
- Multiple identifiers per patient: A single patient may have multiple medical record numbers
- Data entry: With the FormEntry module, clients with InfoPath (included in Microsoft Office 2003 and later) can design and enter data using flexible, electronic forms. With the HTML FormEntry module, forms can be created with customized HTML and run directly within the web application.
- Data export: Data can be exported into a spreadsheet format for use in other tools (Excel, Access, etc.)
- Standards support: HL7 engine for data import
- Modular architecture: An OpenMRS Module can extend and add any type of functionality to the existing API and webapp.
- Patient workflows: An embedded patient workflow service allows patient to be put into programs (studies, treatment programs, etc.) and tracked through various states.
- Cohort management: The cohort builder allows you to create groups of patients for data exports, reporting, etc.
- Relationships: Relationships between any two people (patients, relatives, caretakers, etc.)
- Patient merging: Merging duplicate patients
- Localization / internationalization: Multiple language support and the possibility to extend to other languages with full UTF-8 support.
- Support for complex data: Radiology images, sound files, etc. can be stored as “complex” observations
- Reporting tools: Flexible reporting tools
- Person attributes: The attributes of a person can be extended to meet local needs
OpenMRS is developed under open source standards and under specific data model. It runs under Apache Tomcat platform using Java and the MySQL databse engine. The OpenMRS data model borrows heavily from the Regenstrief model, which has over a 30-year history of proven scalability and is also based on a concept dictionary. The API (application programming interface) provides a programmatic wrapper around the data model, allowing developers to program against more simplified method calls rather than having to understand the intricacies of the data model. The Web Application includes web front-ends and modules that extend the core functions — these are the user interfaces and applications themselves built upon the lower levels. OpenMRS is also a community of developers, implementers, and users working toward a shared and open foundation for managing health information in developing countries.
The implementation of OpenMRS has been successful in various Latin American, African, and Asian developing countries. Through specific tailored programs, patient records are more easily exchanged within the community to improve overall quality of life. Below are several of the recorded projects that have shown positive results with the help of OpenMRS:
- PIH-EMR Peru: Currently the project headed in the developing country of Peru includes over 25,000 patients on record. Since one of the main diseases focused on OpenMRS is MDR-TB, this EMR has the ability to collect patient information to monitor them from the beginning treatment, until the final patient outcomes. A very useful tool in the program is the use of PDAs with the EMR. Information entered into the PDA of health personnel from various establishments can be taken and transferred into computers directly linked to the PIH-EMR. 
- IHVN OpenMRS Nigeria: The Institute of Human Virology, Nigeria (IHVN) developed openMRS based eMAR which was piloted in Nasarawa State, Nigeria. The EMRs are used at the facility level primary for capturing data for HIV-AIDS patients. They also use the EMRs to generate aggregate data that are reported to the national program. The EMR have been successfully deployed in 17 ART clinics and with plans to scale up to 41 as of 2014. 
- Regenstrief Institute - Indianna University, USA
- Millennium Villages Project, SAURI, Kenya. http://www.unmillenniumproject.org/mv/mv_closer.htm
- Experience in implementing the OpenMRS medical record system to support HIV treatment in Rwanda
- Implementation process guide
- OpenMRS Overview
- OpenMRS FAQ
- OpenMRS Wiki
- Regenstrief Institute, Inc.
- Partners In Health
- Review of "Enabling Better Interoperability for HealthCare: Lessons in Developing a Standards Based Application Programing Interface for Electronic Medical Record Systems"