Notice F2: Shelf readiness with a focus on building local capacity and new teams.

Adding Bahmni support for metadata registry for terminologies

Two-sentence Overview: 

The goal is to standardize metadata management terminologies for Bahmni and integrate with registries. This will be achieved by leveraging OCL support for the OpenMRS module. 

Executive Summary: 

Bahmni is an easy to use, complete, open-source Hospital Information System (HIS) and Electronic Medical Record (EMR) that has been built in the Global South to meet the needs of low resource environments. Bahmni is a distribution of the OpenMRS medical record platform, with a user interface built from the ground up. It also supports Odoo (formerly OpenERP), OpenELIS, and dcm4chee, providing an integrated robust solution that manages patient information in a flexible fashion through the care cycle, including registration, various points-of-care, investigations, lab orders and results management, PACS and billing.    

 BeeHyv is currently planning to leverage OCL to manage various installations of Bahmni centrally using OpenMRS OCL for the state of Bihar, India. This project is supported by Bill & Melinda Gates Foundation It involves Setting up common terminology (metadata) registry to manage all hospital's metadata centrally.  We plan to extend it to support concepts and sets which are not handled by OCL of OpenMRS like "Diagnosis Set of Sets", "Dosing", "Disposition" . BeeHyv will use this to facilitate the resources needed towards shipping the proposed solution to the community. This will generally cover the development and administrative costs related to the project.  

BeeHyv has been the preferred technology partner in low resource settings for several path-breaking ICT4D programs for non-profits, donor organizations and universities.  Our expertise in open-source spans across MOTECH, DHIS2, openMRS (Bahmni), Community Health Toolkit (CHT) of Medic, Connect for Life (CfL) of Janssen, ODK, Apache Superset and Clickhouse. Our past experiences including implementing FHIR integration with OpenIMIS would ensure that the set goals of the proposed solution are met.   

 OpenHIE Architecture & Standards - Documents - OpenHIE Wiki (ohie.org) 

Consortium team: 

The Bahmni project was started by Thoughtworks in January 2013, and in January 2018 Bahmni coalition was formed to own the Bahmni project. At present, the Bahmni Coalition includes 11 organizations, including BeeHyv.    

BeeHyv will undertake the development activities and will work closely with of Bahmni coalition and other relevant communities to achieve the project goals

Project Description: 

Problem statement:  

 Currently, Bahmni can be installed and configured for a hospital one at a time. So, even if three districts use the same metadata, there is no way to configure metadata centrally and import it in all bahmni installations. Bahmni will need some features that allow for centralised Master Data Management. This will ensure that a change is made at one place and propagated to all Bahmni instances. It will also ensure standardisation of implementations -- for instance Concepts, Form Definitions, Drug Lists, etc. 

 Technical approach: 

We plan to set up a common terminology (metadata) registry to manage all hospital's metadata centrally. This will be achieved as follows: 

Task 1: Modify client module to provide the ability to manage multiple sources. This would be required otherwise bahmni will be bound to import all terminologies under a single collection.  

The possible implementation solutions are :- 

  • The OCL client module lacks the ability to manage multiple sources. For example in case of drug databases, India is coming with its own drug database. In addition to that we need to preferably use SNOMED-CT, LOINC and classification ICD10 for ICD11 for drug databases. Establishing a terminology management group is going to be the key. 

  • Another possible solution would be to modify client module sync and take care of pulling duplicates from different sources. 

Task 2: Configure implementation to sync delta of terminologies from previously synced sources. This would require modification of the client module. 

Task 3: To extend OCL client module to support concepts and sets which are not handled by OCL of OpenMRS:  

Current Bahmni clubs various Diagnosis concepts under various Diagnosis concept sets which inturn is grouped under a set named  "Diagnosis Set of Sets". Such a classification is not available in OCL. So, OCL clients need to be modified to provide capability to group above mentioned concepts and sets based on predefined heuristics while importing data from OCL to Bahmni. 

Monitoring and Evaluation approach: 

We propose to follow the Agile development model with 2-week sprints, with daily stand-ups. A project management tool like Trello or JIRA would be used to assign work to the team and track progress. A status report will be published to the Digital Square team before the monthly sync-up (proposed) to set the agenda for the call. It will contain the following information:  

  • Activities completed during the reporting period / planned during the reporting period but not completed (Slipped activities will be reported in bold).  

  • Activities scheduled for the next reporting period.  

  • Blockers, dependencies, and queries.  

  • Cumulative progress report for the sprint.  

The diagram given below explains the model at a very high level.  

Project Deliverables 

BeeHyv will provide the following deliverables:  Code and Documentation detailing the tasks accomplished to achieve the codes. 

 The status and outputs of the deliverables will be provided in the following reports 

1. Regular Status reports - These reports will document updates of the activity plans to be submitted regularly at agreed-upon intervals.  

2. Interim report - This report will have a summary of the project and a brief description of the progress at an agreed-upon interval through the project execution. 

3. Final project report - This report will provide a detailed description of the final results of the project and will be presented during the closure of the project. 

 Project Gantt Chart 

  

Risk Mitigation: 

It is critical that the scenarios for all implementations are considered while designing the solution and any failure in this regard will lead to adoption risks. To mitigate this risk, we plan to have periodic discussions with the Bahmni coalition and incorporate their inputs into the solution development process. 

Application Status: 
Pending Review & Investment

Comments

Thank you for the application. For the full technical application, in addition to general recommendations per the email, please:

  • Expand more on plans for the reuse potential for this work, as it is unclear how much of this is being done custom, and ensure it is clear that this is not specifically about meeting the needs of an implementation (see the list of "out-of-scope" activities for this notice cycle).
  • Ensure application reflects that there is alignment with recent/upcoming OCL work to protect against duplication of effort or conflicts (e.g., value set work, the IHE Sharing Valuesets Codes and Maps profile, OCL "collection of collections", etc.). Would like to see technical proposal citing engagement with OCL team with a plan for ongoing collaboration with them and other OHIE/OpenMRS terminology-related communities.