DESIGN AND IMPLEMENTATION OF A PUBLIC SECTOR ELECTRONIC HEALTH RECORD IN RURAL NEPAL

Globally, electronic health records form a central component of modern healthcare systems infrastructure. They are essential for effective impact evaluation, longitudinal care provision, tracking of patients, quality improvement, and efficient and accountable financial management. Yet the vast majority of electronic health records have been designed for resource-rich environments and are overly complex, costly, and difficult to maintain. Here, we describe the design and implementation of an OpenMRS-based electronic health record at a public sector district hospital in rural Nepal. We designed the system with the following product goals: optimization for longitudinal care; integration across sites of care; simplicity of user interface with a focus on mid-level practitioners; compatibility with the national healthcare information reporting system; and reliability to both electrical and internet disruptions. We aim to scale this electronic health record within the district and then develop it as a national model across Nepal’s public sector healthcare system.