drbowen wrote on Monday, September 14, 2009:
Dear Dr. Bowen,
I am Kumara Mendis from the University of Sydney Australia (Deaptment of Rural Health). I am an academic general practitioner with special interest in medical informatics.
We have chosen your OpenEMR system as the starting point to build an EMR for Sri Lankan primary care doctors.
This initiative is a pilot phase for a broader EMR system for medium developed countries especially from the Asia-Pacific region. Very few EMR’s specifically address context and issues of medium-developed countries.
Most of these countries have the basic ICT infrastructure and the primary care/General/Family Practice processes and facilities already in place in their countries but do not have reliable software to use in real-time practice. Furthermore the context of practice and fee structure is also completely different to the developed country gate-keeper model of primary care.
Sri Lanka is a medium developed country according to the WHO Human Development Index, ranking 99th out of 170 country list. Currently coming out of a two decade of terrorism it has maintained a life expectancy at birth of more than 72 years even after spending sometime more than 10% of the GDP for the War! It has very strong preventative healthcare system and curative care is delivered by both public and private sectors. The Family/General practice is a fee-for service system by the private practitioners.
We hope to pilot a EMR system for primary care in and we have chosen OpenEMR system as the starting point.
Can we ask from you about some fundamental changes that we propose to do and how best to go about this.
Codes
1) ICPC2 as a preliminary coding system for reason for encounter, process of care and problem definition (and Problem List – issues).
2) For increase granularity we propose to use a cross map of ICPC2-ICD10
3) For drug codes we are using a Generic, Brand, ATC code list unique to Sri Lankan (SL National Drug Index).
We hope to maintain Sri Lankan National Drug list with in the OpenEMR database and we will be modifying the Rx interface to find the drugs easily.
Interface
We propose to build on the SOAP form as clinical note maker along with the added ability code using ICPC2 for Subjective (Reason for Encounter), Objective (Process of Care) and Assessment (Problem Definition).
We will maintain the Encounter – Episode relationship as it is.
Is there any possibility to include the changes we are doing in to the source code distributed, so that we don’t have to do the changes again during upgrading to new versions?
Your advice and suggestions will be much appreciated.
I am copying this to our chief programmer Hiran Perera.
Best regards
Kumara
kmendis at med . usyd . edu . au
Hiran Perera
mhrperera at gmail . com