Notice E0 Phase 1 Shelf Readiness

Notice E for promoting investments in digital health global goods

OpenMRS Quality Assurance for Interoperability

Two-sentence overview: 

OpenMRS aims to advance shelf-readiness by producing high-quality interoperable software and increasing trust in our system through rigorous, comprehensive, systematic quality assurance. By bringing together experienced community members and collaborating with other global goods communities, this investment will be used to 1) extend OpenMRS automated test portfolio, 2) address QA for OpenMRS interoperability testing, and 3) strengthen the adoption of the improved QA for community-wide utilization and conduct dissemination of a QA model to the broader global goods community.

Executive summary: 

Founded in 2004, OpenMRS is a high quality, open source, integrated electronic medical records platform (EMR) aimed at resource-constrained settings where structured patient record keeping systems can support improved care delivery and help achieve health equity. As OpenMRS continues its growth in over 5,500 health facilities in 60 countries to date, it increasingly is recognized as a de-facto EMR standard, supported by the OpenMRS community. 

At OpenMRS, we contend that a critical factor of shelf-readiness is a user being able to trust the product.  This trust is earned through rigorous, comprehensive, and systematic quality assurance testing and protocols; thus, quality assurance is an integral part of building shelf-ready, standalone, and interoperable OpenMRS technical products. With funding from Digital Square Notice C, the OpenMRS Quality Assurance (QA) Team was established to improve community quality assurance processes and tools. As a first step, our QA Team identified an initial set of priority test cases to automate with the OpenHIE testing framework. As a result, OpenMRS is the first global good trialing the adoption of the OpenHIE testing framework into a community QA process and tooling for OpenMRS products.

With additional funding, the OpenMRS QA team can a) expand the set of automated tests for full product release and system interoperability testing, b) participate in the generalizability of the OpenMRS test portfolio for standard EMR/EHR testing in the Instant OpenHIE ecosystem, and c) transition the QA process from emerging to established, community-owned and community-wide standard. Our consortium will achieve these objectives by fostering collaborative work between the OpenMRS QA Team and the larger OpenMRS community, including the FHIR Module Squad and OpenMRS implementers, OpenHIE subcommunities such as the LIS CoP and Client Registry CoP, and Instant OpenHIE representatives. The QA Team’s current scope of work and relationships with these stakeholders serves as a foundation for future collaboration.  The QA team recently explored an approach for integrating this process and tooling into the FHIR Squad project to support their work on EMR-LIS and EMR-SHR use cases. The OpenMRS QA team is well positioned to serve as an advocate and leader for how other global goods can adapt the model and tooling to their community and products, resulting in Shelf-Readiness improvements to the global goods domain as a whole.

Consortium Team: 

In 2019, UW CIRG and OpenMRS partnered to lead OpenMRS QA Team work as well as the OpenMRS FHIR Squad project. Our consortium team reflects our commitment to supporting the OpenMRS QA Team and FHIR Squad by continuing this partnership.

UW CIRG (University of Washington Clinical Informatics Research Group) is one of the premier global health informatics organizations, specifically working to advance digital health global goods and the communities supporting them.  CIRG has contributed substantially to multiple digital health communities, and led numerous large-scale informatics grants and programs around the world in partnership with global health funders and Ministries of Health. CIRG faculty member Jan Flowers serves as Chair of the Board of Directors of OpenMRS, a member of the Board of Directors for OpenELIS, and is the co-founder and project co-lead of the OpenHIE Laboratory Information Systems Community of Practice.  In addition, CIRG staff member Jennifer Antilla has served as the Director of Community for OpenMRS for nearly 2 years, successfully supporting the development of a new governance model that included the decentralization of decision making into small committees focused on specific aspects of the product, strategy, or operations of the community.  Ms. Flowers and Ms. Antilla have over a decade of experience working on OpenMRS and other global goods and HIS architectures in real-world LMIC implementations.  They have each led multiple national-level OpenMRS architecture, implementation, and interoperability projects, including in Kenya (KenyaEMR), Haiti (iSantePlus), Mozambique (eSaude), and Vietnam (eClinica).  Ms. Flowers has been the lead interoperability architect for Haiti, Kenya, Cote d’Ivoire, Mozambique, and Vietnam health programs.  Ms. Flowers and Ms. Antilla are the founders of the OpenMRS Quality Assurance team and is an ongoing required operational group and process within the community.

OpenMRS, Inc. OpenMRS is an open source EMR and community that functions as a consortium, with many organizations working in LMICs supporting the work of individual OpenMRS contributors. As such, the community seeks to engage and motivate both volunteers and supporting organizations to actively contribute to all aspects of the software development and implementation process.  OpenMRS is the home for the OpenMRS Quality Assurance team, with the expectation that this emerging team, led by the UW currently, will transition to a core operational component of the OpenMRS community long-term and will be funded under the OpenMRS core operational budget after that transition in the next few years once the QA process and adoption has been fully established.  The OpenMRS Quality Assurance team has led the first global good community pilot of the OpenHIE test management platform.  In addition, the QA Team has established a need for and disseminated lessons learned in how to manage the required culture change in a global good community to build and incorporate comprehensive proactive quality assurance program as part of a core aspect in software development.  This ultimately leads to increased trust and value in the products.

Geographic Reach: 

OpenMRS is utilized globally as the de facto EMR for resource-constrained environments, implemented in more than 5,500 facilities in over 64 countries and serving over 12.5 million patients. 

WHO Classification: 
Electronic medical record
Application Status: 
Approved - fully funded
Application Tags: 


Hi Jan,

Thank you for submitting a concept note for Notice E0. For the deliverables & schedule section in the concept note template attachment, please add an anticipated timeline to meet deliverables. Final concept notes are due May 22 at 5pm EDT.