OpenELIS: An “open source” program
When I-TECH and collaborators began to develop an electronic laboratory information system (LIS) for three central laboratories in Côte d’Ivoire, one of their first tasks was to decide what kind of computer program to use. The team had the option of paying to have a program created, buying an existing program, or using “open source” software.
Together with stakeholders, the group chose an open source program called OpenELIS. OpenELIS was originally developed by the Minnesota Public Health Laboratory and the Association of Public Health Laboratories (APHL) for use in the United States. Its developers chose to keep the code base for the program “open”: unlocked, changeable, and free for use. Because of this, a community of skilled programmers can manipulate the building blocks of OpenELIS, customize the program, and share their knowledge, making improvements as they go along.
I-TECH chose OpenELIS because of this adaptability, which allows it to respond to existing workflows and needs. The program promotes local ownership and provides opportunities for future modifications, which supports system longevity. With modification, the program can also be adapted to meet the unique needs of laboratories anywhere in the world.
A video demo is available online at http://vimeo.com/11559424
I-TECH has been working in Côte d’Ivoire since December of 2008 and currently supports two distinct projects: the development and implementation of electronic laboratory information systems for three central laboratories, and rapid scale up for HIV care and treatment services in the northeastern region of the country.
Electronic Laboratory Information Systems
In Côte d’Ivoire, as part of the President’s Emergency Plan for AIDS Relief (PEPFAR), I-TECH is collaborating with local stakeholders to implement an open-source electronic laboratory information system (LIS) at three central laboratories: the National Public Health Laboratory (LNSP); the Pasteur Institute (IPCI), which is acting as the national reference laboratory for TB; and Retro-CI, a US Centers for Disease Control and Prevention (CDC) laboratory in Côte d’Ivoire.
Electronic LISes receive, process, store, and report on data generated by medical laboratories, supporting the efficient and accurate management of patient health information. For example, LIS supports sample tracking as well as test-results entry, validation, and reporting. It also automates data transfer with other information systems, allowing for results to be viewed quickly and national-level disease surveillance and program monitoring to be done easily.
In 2009, I-TECH and CIRG conducted in-depth and structured assessments at Retro-CI, LNSP, and IPCI. The purpose was multifold: to document the unique workflows at each lab; define each one’s core set of functions (e.g., specimen processing, sample management, and test entry); identify what data and indicators need to be reported to outside stakeholders; and identify what information must flow between labs.
At an LIS stakeholder meeting, the team presented initial assessment findings as well as a proposal for laboratory business processes to include in first phase LIS implementations at each of the three central laboratories. The agreed-upon goal is to implement and maintain three streamlined, role-based, networked systems linking all aspects of the labs, including reception, data entry, various units (e.g., immunology, hematology, serology, virology), and supervision/validation).
The LIS software selected by stakeholders is OpenELIS—an open-source, enterprise laboratory information system that can be adapted to respond to changing laboratory needs. Because of its inherent flexibility, OpenELIS:
- can be adapted to country-specific contexts;
- easily interfaces with other electronic equipment and systems, such as laboratory analyzer machines and Côte d’Ivoire’s national patient medical record system;
- allows for local ownership and maintenance, which leads to system sustainability;
- is fully adaptable, to address evolving workflows, and can be scaled up or down; and
- provides automated reports for national-level disease surveillance and laboratory program monitoring and evaluation.
In addition to providing appropriate and locally-owned laboratory information systems, I-TECH views this work in Côte d’Ivoire as an important contribution to the global community of open-source developers. I-TECH’s Côte d’Ivoire-based colleagues are now members of this community, and it will offer a channel for ongoing collaboration and mutual support through the sharing of newly developed software code, lessons learned, and best practices.
Video DemonstrationA video demo showing the program in action with French narration is available online at http://vimeo.com/11559424
For More Information
I-TECH continues to make considerable progress with code base development for OpenELIS. Status updates and a live, French-language demonstration of OpenELIS can be accessed online at the following site: openelis.cirg.washington.edu/CDIOpenElis. To view the demonstration, log in with the username user and password userUSER!.
Rapid Scale-up for HIV Care and Treatment Services in Northeastern Côte d’Ivoire
I-TECH is working in northeastern Côte d’Ivoire in collaboration with Health Alliance International (HAI) to support the training component of a 5-year grant from the CDC through PEPFAR. The program aims to rapidly scale up and expand access to comprehensive HIV and AIDS care and treatment in Vallée du Bandama, Les Savanes, and Zanzan. I-TECH is working to build the capacity of national ministry of health staff and health care workers to provide high-quality service delivery.
In collaboration with Programme National de Prise En Charge (PNPEC), Côte d’Ivoire’s national program to support people living with HIV and AIDS, I-TECH provides technical assistance (TA) for the development of high-quality training programs for health care personnel of diverse disciplines in the northeastern region. Through onsite and remote TA from I-TECH’s Training Development Team, I-TECH is working to develop the capacity of HAI training staff based in Bouaké to envision, create, and implement health care worker training.
By preparing health care workers, these locally-based programs result in high-quality practice and improved patient outcomes. I-TECH’s multilevel training framework includes didactic training, workshop-based skills development, supervised practicum, clinical mentoring at the trainee’s professional worksite, and remote consultation to reinforce best clinical practices. Curricula content areas include antiretroviral therapy; confidential testing and counseling; HIV-related basic health care and support; TB prophylaxis and DOTS treatment (an internationally recognized standard for TB control); and prevention of mother-to-child transmission of HIV.