Cooking up an open source EMR for developing countries: OpenMRS – a recipe for successful collaboration

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Cooking Up An Open Source EMR For Developing Countries: OpenMRS – A Recipe For Successful Collaboration

This is a review of Mamlin, Biondich, Wolfe, Fraser, Jazayeri, Allen, Miranda and Tienrney (2006) article, Cooking up an open source EMR for developing countries: OpenMRS-A recipe for successful collaboration. [1]

Research Question

The purpose of this study is to create an OpenMRS that is amenable to the needs of developing countries.


The majority of persons infected with HIV/AIDS live in developing countries. The authors believe an OpenMRS system will serve these countries in managing the pandemic. The success of an OpenMRS is dependent on coordination, scalability, and flexibility of the information system. The paper reports the project’s progress, lesson learned, and future direction.


A data repository model with enterprise-quality was developed based in information gathered over 30-years of Regenstrief Medical Record system research. The OpenMRS primarily transmits data using HL7 standards promoting re-usability and interoperability. The system is also capably of mapping to LOINC, ICD-10, and CPT. The project allowed providers to download the plaftform from the studies website with no up-front cost. The website also helped develop a collaborative community.


The project resulted in 9 key lessons.

  • The first lesson is collaboration. The best model occurs within a shared platform.
  • The second lesson is scalability. The infrastructure must be able to handle hundreds of thousands or millions of patients.
  • The third lesson requires a system that is flexible enough to support HIV centered care, as well as, general medical care.
  • The fourth key lesson if the need for rapid form design to meet continuous user demands.
  • The fifth key is providing useful feedback to clinicians and caregivers.
  • The sixth key is maximizing the use of standards.
  • The seventh key is the support of on-going high-quality research.
  • The eight lesson is the need support the web-based system, even when users have intermittent internet connections. *The ninths lesson is to maintaining the system at low cost. Ideally the system will be free to all providers.


The OpenMRS was implemented in Eldoret, Kenya with successful outcomes. Due to the continued need for development of an OpenMRS, there are plans to implement a system in Tanzania, Uganda, and South Africa. Implementing an OpenMRS will maximize the providers’ workflow by building and customizing multiple application accessing data that serves different users and various work environments.


There is a great need for a low cost internationally available Health Information System. Pandemics such as HIV/AIDS are on the rise and managing healthcare in countries with limited resources is challenging. This study demonstrates that it is possible to adopt and successfully implement a free OpenMRS in developing countries. The future of OpenMRSs is dependent upon its continued success in a variety of environments. The implementation of an OpenMRS in Tanzania, Uganda, and South Africa will help shape the continued development OpenMRS’s and provide set of guidelines for international success.

Related Links

  1. Leveraging of Open EMR Architecture for Clinical Trial Accrual
  2. Open_source_EMR_software:_Profiling,_insights,_and_hands-on_analysis
  3. Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS
  4. The_OpenMRS_System:_Collaborating_Toward_an_Open_Source_EMR_for_Developing_Countries
  5. Open_Source_Handheld-Based_EMR_for_Paramedics_Working_in_Rural_Areas
  6. top-7-free-open-source-emr-software-products


  1. Mamlin, B. W., Biondich, P. G., Wolfe, B. A., Fraser, H., Jazayeri, D., Allen, C., Miranda, J., & Tienrney, W. M. (2006). Cooking up an open source EMR for developing countries: OpenMRS-A recipe for successful collaboration. AMIA Symposium Proceedings, 529-53.