Electronic Medical Record (EMR) System Project
in Daeyang Luke Hospital

Data generated from the clinical care is crucial in various ways. Medical record is vital reference for decision making process on both diagnosis and treatment not to mention that efficient hospital management is impossible without cost and income data. However, most hospitals in developing countries suffer from lacking of those systems that enable them to collect data and to make use of the information. This problem was same at the Daeyang Luke Hospital (DLH) in Malawi, one of the most impoverished countries in Africa. Although the hospital has provided medical services to more than 90,000 people annually, the hospital was in desperate need the electronic medical record (EMR) system.

As the first software engineer and a project manager at the hospital, I initiated the project regarding the development of EMR system. Under the robust collaboration with Baobab Health Trust (Baobab), a local health informatics NGO that had been contributing to the Health Management Information System (HMIS) of the Ministry of Health in Malawi, I developed patient registration and billing module, which were most urgently needed to the hospital.

Previously, most documentation was carried on paper and filed to cabinet, and thus it was difficult to manage or use the information. However, the new registration and billing module enabled recording and retrieving medical history of patients effectively in a timely manner. By providing efficiency and accuracy, the system resolved not only patients’ long and painful waiting time, but also the hospital management team’s problems of estimating their annual budgets. Moreover, installing other parts of EMR in the hospital was planned.

Software engineering in a developing country was very challenging task. Under resource scarce circumstances, we started our work based on open-source software to make the task more attainable. We designed the database schema based on OpenMRS, the open source medical information system developed by Partners in Health (PIH). The software framework of the billing module was on other modules developed by Baobab Health Trust. The backbones of the system are Ruby on Rails, a web application development framework, and MySQL, a database management system.

Many thanks to Dongyong Lee, Gerald Douglas, Blessings Mhango, Ju Eun Kim, Paul Kim, Hong Kun Yoo, and team members of Daeyang Luke Hospital, Baobab Health Trust and Project BOM.