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Electronic records for Community Outreach

By Usman Raza Moderator Emeritus | 04 May, 2016

Hi everyone,

I wanted to ask if someone can point out resources related to electronic records for outreach activities for a chronic disease e.g. conducting health education sessions, identifying and screening suspect cases of the disease, registering people at risk in a database, referring them to relevant health services etc.

If someone can point out an open source solution already available, that would be great help.




David Cawthorpe Replied at 11:51 AM, 4 May 2016

E-record implies a way of storing information.

This low cost ($3US) ipad application is made for remote data entry.

Can track any treatment for any disease in RCT format (if required).

Provides for e-transmission of anonymous data for integration when access is available.

Does not use a 'cloud' and therefore protects privacy.

Was published in the WHO compendium of emerging technologies.

All info available below:


Attached resource:

Gordon Cressman Replied at 1:09 PM, 5 May 2016

Another alternative is Coconut, a free and open source platform developed by my team at RTI International. Example applications include the Mutare Coconut Clinic system used by CeSHHAR in Zimbabwe (https://docs.coconutclinic.org), and Coconut Surveillance, which has been used by the Zanzibar Malaria Elimination Program for more than three years (https://stories.usaid.gov/zanzibars-malaria-hunter/). Please feel free to contact me for further information.


Gordon M. Cressman
Senior Program Director | Research Computing Division | RTI International
Email: | Office: +1 919 541-6363 | Mobile: +1 919 271-7003 | Skype: gmcressman

Lee Weeks Replied at 2:55 PM, 5 May 2016

Dear Gordon,

I am currently researching an MRS or ER system that would work for my organization. We work in mostly rural areas in various African countries, thus having limited internet capabilities. I am looking for a system that can function from a server without dependence on the web, but able to sync to a cloud once back in wifi capability. Would your system work or do you know of such a system?

We have a patient flow of 8-12 thousand in 6 days, we are a mobile clinic.

Thank you.

A/Prof. Terry HANNAN Moderator Replied at 5:43 PM, 5 May 2016

Lee, go to www.openmrs.org or OpenMRS Talk. Register on OpenMRS talk and ask the same question and support will be rapid. Terry

Lee Weeks Replied at 6:11 PM, 5 May 2016


Steven Wanyee Macharia Replied at 11:10 PM, 5 May 2016


We have customized OpenMRS in Kenya (the cradle of OpenMRS) and implemented
at scale. For one of the customizations for Ministry of Health, the OpenMRS
customization we called KenyaEMR runs at each of the >300 health
facilities on a desktop computer.

I'll be happy to provide you more info.


Gani Alabi Replied at 9:31 AM, 6 May 2016

Hi Steven. Can you please provide detailed information about it. Thank you so much in advance.

Andrew Sideman Replied at 9:52 AM, 6 May 2016

You might also look at using free and open source CommCare (https://www.commcarehq.org/home/). FHI 360 has had excellent results using CommCare as a case management / referral application. Dimagi doesn't claim that it's an EMR, but it would certainly work in the outreach use case described in Usman's initial RFI. Not sure if it is robust enough for Lee's, but worth exploring.

Gordon Cressman Replied at 10:35 AM, 6 May 2016


Yes, all Coconut-based applications, including Mutare Coconut Clinic, function offline on mobile devices and synchronize with a shared cloud or privately hosted database when connectivity is present. It can synchronize automatically in the background or synchronize on user command. Coconut excels as a mobile case management and decision support system due to its robust bidirectional data synchronization. It also encrypts data on mobile devices automatically, as well as during data transmission. However, Mutare Coconut Clinic is a specialized EMR designed specifically to meet the needs of CeSHHAR's Sisters with a Voice program in Zimbabwe.

OpenMRS is a very complete open source standards-based EMR platform with broad community support and continued active development. It is built on a nearly the same technology stack as ZEPRS and DHIS2. It is highly customizable and has been proven at scale. I endorse Terry's and Steven's suggestion to look at openmrs.org.

Lee Weeks Replied at 11:34 AM, 6 May 2016

Hi Steven,

Thank you for the response. I would be grateful for more information concerning your system. Just a few questions.

1. How is the information secured?

2. Can it sync with other computers or tablets without internet on site?

3. Can it handle large rapid patient flow?

Usman Raza Moderator Emeritus Replied at 1:50 PM, 8 May 2016

Thanks all for the great suggestions.

@ David: TRACT is a great tool for RCTs; we're looking for something
simpler than this. But thanks for pointing out.

@ Gordon: CoconutClinic looks like a good model. I am wondering if it would
be easily modifiable for another disease (or group of chronic diseases like
diabetes + hypertension etc.)?

@ Andrew: Yes I'm well aware of CommCare, and it is one of the options
we're looking at.

Another friend also suggested OpenSRP (SmartRegister.org), which I am
posting here for the benefit of others.

David Cawthorpe Replied at 2:04 PM, 8 May 2016

Tract does not have to be an rct
Can simply be an e record that tracks changes

Joaquin Blaya, PhD Moderator Replied at 8:35 AM, 9 May 2016

We created a diabetes and hypertension management system by connecting
OpenMRS to Verboice (verboice.instedd.org), so that OpenMRS kep the
patient's data and was made automated calls through Verboice about once a
week to keep up to date with patients. It's not available as a solution
that you can just take and use, but if you're interested I could show you
where the modules are. It'll definitely take programmers to figure out how
to do it.

Emmanuel Benyeogor Replied at 10:51 AM, 9 May 2016

I am interested.

Have a working knowledge of programming.

Gordon Cressman Replied at 6:44 PM, 10 May 2016

Hi Uzman:

We built Coconut Surveillance for malaria elimination using Coconut. It has been used at scale successfully for more than three years by the Zanzibar Malaria Elimination Program to prevent malaria resurgence. We are working on the next generation of this system with them now. With its plug in architecture, we have developed a prototype for Ebola. The same platform could work well for Dengue, Yellow Fever, and other diseases.

A/Prof. Terry HANNAN Moderator Replied at 7:30 PM, 10 May 2016

Dear Gordon, these are interesting comments. If you are able to try and access the presentations from MEDINFO by Andy Kanter, Jonathan Teich and Chris Seegbrets on how OpenMRS was adapted to the Ebola crisis in real time-lessons learnt! I have the slide sets but the presenters need to be contacted re obtaining access. This is a chance for collaboration. Terry

Usman Raza Moderator Emeritus Replied at 6:53 AM, 18 May 2016

Thanks Joaquin, Emmanuel and Gordon.

At the moment we're looking for a very lightweight and quick solution, but
thanks a bunch for pointing out these great resources.

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