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. The KMRI EMR is based on the OpenMRS platform that is approved by the Ministry of Health as an EMR platform in Kenya and is developed around the Free and Open Source Software (FOSS) philosophy.
During the initial evidence gathering phase of developing a model of sustainability to address the health record needs of vulnerable communities, ICChange identifed 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 three major releases of the KMRI EMR that have added primary care patient registration, disease codification, drug prescribing and inventory, and cashier functionality to the software. A Geographic Information System (GIS) module that will enable location-aware medicine is targeted for a May 2015 release.
The growing vision for KMRI is that, as more and more clinics are added to the EMR network, access to quality longitudinal care for this vulnerable population will also increase. In addition, as new cutting-edge functionalities, such as GIS mapping capabilities, are developed for the KMRI software, enhanced care can be offered through other modalities, such as outbreak-targeted public health interventions and point-of-care diagnostic services.
Eventually, ICChange hopes that a sustainable KMRI clinic will serve as a model for implementation of similar EMR-based clinical networks in slums and densely population low-income communities worldwide.