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.
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.
(For a demonstration of OpenELIS, please see the link provided below under ‘Video Demonstration’.)
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 and collaborators are now members of this community (which keeps on growing), 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.
Hawa Camara, MPH
Technical Officer: Program Management
International Training and Education Center for Health (I-TECH)
University of Washington
901 Boren Avenue, Suite 1100
Seattle, WA 98104-3508 USA
I-TECH has been working in Côte d’Ivoire since December of 2008 and its primary project is the development and implementation of electronic laboratory information systems in a myriad of central and regional laboratories.
Electronic Laboratory Information Systems
In Côte d’Ivoire, as part of the President’s Emergency Plan for AIDS Relief (PEPFAR), I-TECH has been 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 and has been expanding the program to several regional laboratories around the country.
An eLIS receives, processes, stores, and reports 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 quicker turnaround time in viewing results and for national-level disease surveillance and program monitoring to be done easily.
In 2009, I-TECH and CIRG (the Clinical Informatics Research Group at the University of Washington) 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 the first phase of 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.
Since the project’s inception, OpenELIS has been implemented in the three main central laboratories as well as three regional laboratories, including:
Central Laboratories at the:
- Retro-CI, Centers for Disease Control and Prevention (CDC) Laboratory in Abidjan, Cote d’Ivoire;
- IPCI, Institut Pasteur Cote d’Ivoire (Pasteur Institute), and;
- LNSP, Laboratoire National de Sante Publique (National Public Health Laboratory).
Regional Laboratories at the :
- Centre Hospitalier Regional (CHR) de Yamoussoukro (Yamoussoukro Regional Health Center);
- Centre Hospitalier Regional (CHR) de Korhogo (Korhogo Regional Health Center), and;
- Centre Hospitalier Regional (CHR) d’Abengourou (Abengourou Regional Health Center).
In early 2015, the implementation of OpenELIS will expand to the following additional five national and regional laboratories:
- CePReF, Centre de Prise en charge, de Recherche et de Formation (Center for HIV Care, Research and Training)
- Centre Hospitalier Universitaire (CHU) de Yopougon (Yopougon University Health Center)
- Centre Hospitalier Universitaire (CHU) de Bouaké (Bouaké University Health Center)
- Centre Hospitalier Regional (CHR) de Man (Man Regional Health Center), and;
- Centre Hospitalier Regional (CHR) de San Pedro (San Pedro Regional Health Center).
I-TECH works collaboratively with its different local partners to continuously adapt the system to the needs of their distinct laboratory functions. I-TECH’s goal is to continue improving the system while building local capacity of main stakeholders in order to ensure the sustainability of the system in country.
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. For more information, please access the following site: https://sites.google.com/site/openelisglobal/global-implementation.