PC in Africa - The OCEMR Story

Extremely Late Update

2011-12-01T09:44:00.001-08:00

  It's coming up on one year since our team flew to Uganda to computerize the Engeye Health Clinic's medical records. A lot has happened since then. Our server's motherboard failed in the summer and we ran the system off of one of the netbooks for a few months. Kathy and Joe moved to Uganda in September for an extended stay to help out and brought a replacement server. While we did loose some data due to the hardware failure, most historical data was safely backed up off-site and easily restored when the system was replaced.

  Since this Blog serves as the main news site for the OCEMR software project and our involvement with the Engeye organization, We're going to be working on some stories about what has happened over the past year and where we are going from here.

  You can support the efforts of the Engeye Health Clinic by making a donation online today. Thanks for reading this update and stay tuned for more stories over the coming weeks.

Software Project Open Sourced!

2011-01-27T10:07:00.000-08:00

As originally planned, I've licensed the source code for this project under the GPLv3 and released it to the world:

OCEMR Project Home Page

Some more work will need to be done to generalize the code, document the installation, and package the software to make it easier to setup and use. I am currently looking at the software roadmap and plan to include the above in an upcoming v1.0 release.

Some Photos

2011-01-18T06:23:00.000-08:00

Here are some select photos from our trip:

Click here for the complete Photo Album.

Back in the States.

2011-01-15T16:30:00.001-08:00

After white water rafting the headwaters of the nile all day friday, we flew to Amsterdam and walked around downtown for an hour Saturday morning. We flew back across the pond, battled US customs, and are awaiting for our flight from Minneapolis to Chicago. Sick of airplanes but excited to be so close..

Changed Ears

2011-01-13T03:20:00.000-08:00

We are leaving the Engeye clinc in less than two hours. I am in denial. I think we all wish we had more time, but such is life. The system is successfully in place. Dr. Kathy and Dr.Joe did their very best in training the staff, organizing the pharmacy, treating the patients, basically helping out in every way they could. Philip created an amazing system that I know he is proud to have his name on. I still think he is a genius! As for me, I finished the OCEMR manual and put a copy at each station in the clinic. If any questions come up, more than likely, an answer will be in the manual. This has been the experience of a life time.

It's your last night in Africa

Every step you take, you should

The road always finds a place

As you hoped, it would

The fairies changed your ears to hear

and whispered to your skin

It's your last night in Africa

Webale

forever

within

Winding down our on-site time

2011-01-13T02:38:00.000-08:00

Today we printed out a few copies of the manuals and other documentation we wanted to leave in hard copy. The system was up and running for a second day without problem, let's hope that the trend continues. Our plan is to head out to Kampala this afternoon, whitewater raft the Nile tomorrow and then get on an airplane tomorrow night after midnight to head home. We may not find the Internet again before Holland or the states, so I leave you with this...

While we will be working on the software and the process into the future, our time on-site is drawing to a close. Last summer, around a campfire, in northern Minnesota, Joe asked me what I thought about designing an electronic medical records system for the clinic. With a lot of support from family and friends, we were able to pull off the logistics and make it out here. Almost halfway around the earth, about halfway in earths orbit around the sun later, we're packing up loose ends and getting ready to take the long road home to where we belong, or, I should say, where we come from.

Kickin' it in Kampala

2011-01-10T16:40:00.000-08:00

It is currently 1:37 a.m. in Ddegeya. Phil and I are still awake and working. Joe is in the other room "working" or rather sleeping on the computer. Another long day at the clinic. We only have two more days to add the final touches to the system so I'm predicting more late nights.

Chicago feels like a dream away or like a past life. I miss everyone but somehow I don't want to leave and am dreading going back to the hustle and bustle of everyday life in the states. Time does not seem as rushed here and the weather, scenery, and people are all just amazing.

Side note: Joe is currently talking in his sleep! (hehe) something about a rattle snake and a jack! Oh yes, and he just fell off of his chair! Too funny!!!

We ventured to Kampala this weekend to clear our heads. The taxi ride there was incredibly uncomfortable. The bus was totally full and the taxi kept stopping to pick up more passengers, all the time I'm wondering where in the h are these people going to fit, but somehow they shuffled us around and cramped us in like clowns.

Once we arrived in Kampala we hit all the computer stores possible. We finally found at least some of supplies we needed. However, the UPS with a usb connection was almost impossible to find. After all the exciting electronics shopping, we hit the craft market and picked up some cool souvenirs! I am terrible at haggling so I found out.

With the market behind us, we walked to Hendi, an Indian restaurant with amazing food! We ordered five main dishes and three kinds of Naan. Yummy! Unfortunately, the next day we all paid for that meal... From Hendi we hiked through the city at night all the way to the Back Packers hostel on the other side of town. It was quite a hike but it was so cool to travel through the city at night. The roads are dangerous though and I think I only saw two traffic lights. There are definitely no Pedestrian cross-walks. It's pretty much cross at your own risk, which made it more exciting in my opinion.

Once we arrived at the hostel we had a great room, a hot shower, and some drinks. Phil and I stayed up with the bartenders for a while. We met a guy named Martin from Poland who will be living in Kampala for six months but hardly speaks English. Freddie, the other bartender is a native of Uganda but is planning on traveling to Mexico to volunteer to educate the poor. All in all, our trip to Kampala was a blast!

Things are running smoother with the system and hopefully will continue that way. In my last blog, I failed to mention another very important and unexpected person, Sarah . Sarah has been in Ddegeya for about six months now. She is originally from New York but decided after graduating that she wanted to teach in Africa. The school she teaches at is currently on holiday so she has been available to help us train the staff and teach us about the culture. She is like the rock star of Ddegeya, everywhere she goes people call her name! We are all so fortunate to have her help and her friendship, another truly amazing woman!

Sula Balungie
Sleep Well
Quell all the worry
Be still

P.S. I smell.

We Have Liftoff!

2011-01-10T14:25:00.000-08:00

Good News, we've got a stable system and we're finalizing documentation and process! Today went off almost totally without our intervention.

The database has undergone some revamping and now looks like this:

Amazing, huh?

Back at the Clinic

2011-01-09T13:02:00.000-08:00

Well, our trip to Kampala was a success. We picked up some electronics we needed and hiked around the city.

We made it back to the clinic early this afternoon and got back to work on the infrastructure and software. Tomorrow we open for business again and see more patients.

Break Time

2011-01-08T00:21:00.000-08:00

Well, after over a week of late nights and early mornings, the system is up and jogging at a fare pace. The staff here saw 70 patients yesterday with no major problems. In fact, We've got 3 full days of data.

This weekend we're gonna take an overnight back in Kampala to rest our brains, see some sights and unwind.

See you soon!

QWERTY

2011-01-05T14:22:00.000-08:00

Today was a very long day. We've spent the last week slowly introducing the system to the staff. There are so many patients everyday, incorporating a new system on top of the already twelve hour day is quite a challenge. Treatment is slow with only three nurses treating 50-70 patients a day, so you can imagine how integrating this system would slow things down even more. Nonetheless, the staff is incredible. Everyone seems really enthusiastic about using the system.

The two most exciting aspects of the system (it's all exciting) but most noticeable to me today is how the system eliminates the redundant and time consuming task of entering all the patient information into a spreadsheet. Phil created an automatic tally system for all daily and monthly reports so now all John has to do is click print!

The system also allows Resty, the pharmacist on staff, to start filling a patient's prescription before the patient is out of the exam room. All she has to do is look up the med queue, and by the time the patient comes to her she is just about finished dispensing the medication. I can't stress enough how these details effect the overall efficiency of the clinic. Many patients wait all day. It's not your typical 20 minute wait.

The staff is extremely dedicated to the patients. Rosie and Tushabi have been working hard and are eager to start using the system. Rosie was thrilled that she will now be able to look up a patient's history. I was working in parallel with Rosie yesterday (typing the info she was writing in the notebook) but Rosie wanted to jump right in and start using the system. Rita, another clinician at Engeye is very good at navigating the system.

I think the biggest challenge in switching to a computerized system is the typing aspect of the program. Otherwise, Philip has created a straight forward system and the staff seems to be able to navigate it very well. As for the typing, practice makes perfect.

This morning before the clinic opened, John Kalule, the co-founder who manages the clinic went around entering all of the patient's into the database. So, by the time the clinicians started the visit the system displayed the patients' charts. This allowed the clinicians to start the exam right away without having to write down the patient name, age, or village. The clinician could also check the reason for the visit before the patient entered the room.

A bit of a side note: John is an all out wonderful man. Since working with him it is obvious that he cares deeply about all the patients. He makes all the patients laugh and, of course, the staff.

As for the four of us, we are all doing well. We are tired as is the entire staff but we are all making a lot of progress. I am proud to be a part of this effort.
Oh yes, one last side note: our friend Dora likes using my camera phone to take pictures and she seems to have some natural talent! Pictures to follow!

We love you all

Pray if you pray

Wish if you wish

or eat pasta for us

either way

love, us

Did someone say chocolate?

2010-12-31T08:22:00.000-08:00

O-liotia (Hello, how are you?)

Staging Network

Phil has been hard at work trying to get a speedy and reliable internet connection which isn't all that easy considering we are in rural Africa. Less than an hour ago, he seems to have figured it out. He's a genius! It's quite impressive to see someone so focused for hours and hours at a time. I have been right next to him continuing to work on the reference manual. The more he develops, the more I document.

We have three hearty meals a day here. A hired cook prepares meals for us everyday. The African sun is quite powerful and anyone who knows me knows my skin just loves that... I've never craved chocolate so much in my life. Thank God for Joe. He had chocolate!

Walking through local farms

Joe has been going to town everyday on the motorcycle. A good forty miles on a small dirt bike to ensure the clinic has enough medication in stock and Phil has the right adaptors/voltage regulators and whatever else he may need to get the system up and running. He and Kathy are donating a lot of their resources and love to this clinic. I've never seen Joe so happy! He took us for a walk around the village today and every child we saw (no joke) kept yelling Joe! Joe! They all seem to know him.

There were two little girls hanging out in the kitchen area all day today (the cook's nieces) Maxi, one of the girls does not stop smiling and staring. Just wanted to pick her up and snuggle her. The other little girl (don't know name) is afraid of white people (Mazoongu). If we try to look at her she starts crying. Kathy thinks it's hilarious! It is.

Clinic sign at main road

Dr. Kathy has been treating patients in the clinic for two long days. She is learning from the staff how everything runs. This is useful information for Phil while he is developing the system. She has recently diagnosed a pregnant woman with Malaria and a patient with Typhoid Fever which is something a practicing doctor in the U.S. would probably never diagnose.

Tonight is New Year's eve and we plan to celebrate! Happy New Year indeed! Love you all (sorry for any errors, grammar, etc hehehehe) PCJK

Uganda's Great Crested Crane

We are safe in Ddegeye!

2010-12-29T23:36:00.000-08:00

We arrived in Ddegeye yesterday evening after a very long flight and a six hour bus ride from Kampala. We are safe and healthy and were greeted with lots of hugs. Africa is absolutely beautiful and all the children run up to us smiling and waving. This is our first full day at the clinic and we are working on getting all of the computers hooked up. The clinic is very busy and sees more than sixty patients a day. The clinic opens at eight in the morning but most of the patients have been waiting since six a.m. We hope to make a difference and will continue to do our best. Mucho Love from all of us to all of you, PCJK

Packing

2010-12-27T09:49:00.001-08:00

We're off.

2010-12-22T14:47:00.000-08:00

On the 3rd day of Christmas my true love gave to me, a program in a software tree...

Staging Network

2010-12-20T01:07:00.000-08:00

We have hardware setup in a staging network stateside. Running off 3g tether on my cellphone. Much of the infrastructure is in place.

Not much time left before we take off and so much coding yet to do. We may have to work through Christmas.

Started working on the Software

2010-10-04T09:51:00.000-07:00

Over the weekend I put in about 20 hours of actual coding and got a good start on the framework and website. The software will be released, opensource, and is called OCEMR (Open Clinic Electronic Medical Records.)

Here's a graphical map of the Database structure:

And a screenshot of the new interface.