The Kibera Medical Records Initiative (KMRI) is a program designed to promote the responsible and secure use of electronic and mobile health programs first in the Kibera slum and then at a national level throughout Kenya. The first objective of the project was to validate that a cloud-based Electronic Medical Record (EMR) application could be developed for and deployed in Kibera, the second largest slum in Africa and a community of nearly one million people. This validation was completed in 2015 and scale-up of the OpenMRS platform was approved by the Kenyan Ministry of Health for a national deployment.
During the initial evidence gathering phase of developing a model of sustainability to address the health record needs of vulnerable communities, ICChange identified several other EMR software solutions in use throughout Kenya that focused on disease surveillance, acute or hospital-centric care, pharmacy and drug management, or patient registration. Through this analysis, ICChange and its partners recognized that there was a definite need for a centralized electronic health platform that starts in a primary care context and can enable the mobility of patients between healthcare providers through the secure sharing and availability of a health record database between facilities.
Choosing an open source platform already in use in Kenya prevented duplication of efforts and further confusion in the EMR community and allows the KMRI team to contribute software and code back to the OpenMRS community that can be reused and reconfigured for EMR deployments worldwide. To date there have been several major releases of the KMRI EMR that have added primary care patient registration, disease codification, drug prescribing and inventory, cashier functionality, GIS disease surveillance, DHIS2 reporting output, and lab capabilities to the software.
With the successful pilot, production deployment, and open source availability of a primary care EMR now complete, ICChange is working to take its competency in electronic and mobile health and expand services to target critical gaps in electronic health services that the private sector would not typically address. This has meant the creation of a social enterprise to manage this competency (Babyl Solutions) with several projects targeting trauma registries and community health worker based disease surveillance via SMS.