Open source challenges for hospital information system (HIS) in developing countries: a pilot project in Mali

Cheick-Oumar Bagayoko,Saad Chaacho,Marius Fieschi,Jean-Charles Dufour,Omar Bouhaddou

doi:10.1186/1472-6947-10-22

Cheick-Oumar Bagayoko, Saad Chaacho + Show 3 more

Open Access

https://doi.org/10.1186/1472-6947-10-22

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Abstract

BackgroundWe are currently witnessing a significant increase in use of Open Source tools in the field of health. Our study aims to research the potential of these software packages for developing countries. Our experiment was conducted at the Centre Hospitalier Mere Enfant in Mali.MethodsAfter reviewing several Open Source tools in the field of hospital information systems, Mediboard software was chosen for our study. To ensure the completeness of Mediboard in relation to the functionality required for a hospital information system, its features were compared to those of a well-defined comprehensive record management tool set up at the University Hospital "La Timone" of Marseilles in France. It was then installed on two Linux servers: a first server for testing and validation of different modules, and a second one for the deployed full implementation. After several months of use, we have evaluated the usability aspects of the system including feedback from end-users through a questionnaire.ResultsInitial results showed the potential of Open Source in the field of health IT for developing countries like Mali.Five main modules have been fully implemented: patient administrative and medical records management of hospital activities, tracking of practitioners' activities, infrastructure management and the billing system. This last component of the system has been fully developed by the local Mali team.The evaluation showed that the system is broadly accepted by all the users who participated in the study. 77% of the participants found the system useful; 85% found it easy; 100% of them believe the system increases the reliability of data. The same proportion encourages the continuation of the experiment and its expansion throughout the hospital.ConclusionsIn light of the results, we can conclude that the objective of our study was reached. However, it is important to take into account the recommendations and the challenges discussed here to avoid several potential pitfalls specific to the context of Africa.Our future work will target the full integration of the billing module in Mediboard and an expanded implementation throughout the hospital.

Highlights

We will try to understand the opportunity of the Open Source movement in healthcare In particular; we report our experience with the use of Mediboard Open Source health information systems (HIS) at the Hospital Mère-Enfant le “luxembourg” in Mali
We focus our remarks on hospital information systems that represent a clear and pressing need for developing countries, even if other applications, such as systems to aid in decision-making, to support HIV/ AIDS care (i.e, OpenMRS, http://openmrs.org/wiki/ OpenMRS), public health reporting, or clinical research are not of lesser importance
The compatibility rate is approximately 89%. We recognize that these requirements are not specific to developing countries; given the lack of African specific requirements, they provide a useful basis to evaluate Open Source alternatives

Summary

Introduction

We are currently witnessing a significant increase in use of Open Source tools in the field of health. Our study aims to research the potential of these software packages for developing countries. The implementation of Clinical Information Systems (CIS) is key to the production of quality care, adequate management of rare resources and productivity. The implementation of information systems can succeed if two main conditions are met, and these both come with a financial burden:. (1) A rigorous and consistent organization of the actors and processes of care in which they are involved. Without this organizational approach any attempt to computerization is likely to fail. Organizational, and structural resources, the first condition appears to be available to everyone as long as the hospital management is informed, tenacious, thorough and methodical. Implementation of a CIS is based on the computerization of care processes as well as of support processes (administrative, accounting, logistics, etc.) to ensure coherence, feasibility and effectiveness of the clinical and business activities of the institution

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