Computer nerds are not the image I normally conjure when someone mentions the words “community” or “teamwork.” However, my experiences at an implementer’s meeting for an open source software community last month strongly challenged this preconception. After spending several days with this passionate group of self-proclaimed geeks, I left awed by how their community had embodied open source ideology and enabled individuals across the globe to effectively work together towards sustainably meeting a common goal: improved health. 

The meeting I attended was for implementers of OpenMRS, an electronic medical records (EMR) package for use in the developing world. The open source nature of the software means that it’s developed in a public, collaborative manner and anybody can use it, change it, or improve it. A mechanism exists for those who partake in the latter two activities to contribute their new features back to the project thus benefitting all other users. This is a well-established model, - other great examples of open source projects are Mozilla Firefox, Open Office, Wordpress, and the Linux operating system.

To date, OpenMRS has been deployed in more than 50 countries and is managing medical information for more than a million patients. Organizations such as Partner’s In Health (PIH) have harnessed its power for efficiently managing the complex drug regimens required to treat HIV and tuberculosis in the most impoverished settings. Given the scale of treatment and scarcity of resources in these places, treatment would be virtually impossible without an EMR. The software has also streamlined meeting the exhaustive reporting requirements that keep the funding flowing for these treatments. It is a passion and compassion for improving the lives of others through solving these problems that drives the members of the OpenMRS community. From the physicians to the computer programmers, it was clear that this common purpose united each of the 80 meeting attendees and entire community.

The structure of the four-day meeting was representative of the community’s open-source roots and based on an unconference style. This means that instead of a predetermined schedule, participants collectively dictated the goals, the agenda, and constantly evaluated progress. Lengthily presentations were few, but idea sharing in the community-selected breakout sessions was plenty. Open Space Technology (also used by ROI), Birds of a Feather gatherings, and Lightening Talks were all employed to facilitate conversation. Not surprisingly, the community also utilized several innovative technologies such as Etherpad, which allowed for collaborative note taking as well as keeping an eye on other sessions in real-time. The collaborative nature of the meeting felt like an embodiment of the open-source mentality and was both engaging and productive. The underlying culture of collaboration also facilitated a tremendous amount of bi-directional teaching between newbies and veterans. Throughout the conference, it was clear that the open-source ideology overflowed from its traditional role in software engineering to create a unique, collaborative, and productive environment.

The meeting was hosted in Kigali, Rwanda and on the third day of the conference, participants had the opportunity to visit three large implementation sites in the surrounding area. The Rwandan government has chosen OpenMRS for the national medical record system and, in collaboration with PIH, the country has been investing in training OpenMRS programmers. The Rwandans thoroughly impressed everyone with their display of customized software modules that will soon be contributed to the greater community. It was absolutely incredible to see how OpenMRS is both improving the health of Rwandans citizens and also enabling them to contribute their work, with little extra effort, to meet the challenges of others around the world. To me, this is the definition of a sustainable project.

I wanted to attend the Kigali meeting to learn how I could merge my work developing a turnkey EMR (currently tracking more than 20,000 patients in Burundi) with OpenMRS. What makes my system unique is its technical simplicity which overcomes a major hurdle towards implementation in most small clinics. However, I wished to combine efforts because my system doesn’t allow for the same growth potential and lacks the vibrant support community offered by OpenMRS. With gratitude for the funding from the ROI Micro Grant, I am now on the way to accomplishing my goal. In addition to the important connections I made to begin collaborating, perhaps, more importantly, I received an invaluable education on how the open source framework can sustainably transform innovative ideas into action. I think this is a powerful and relevant concept for all the innovators in the ROI Community. For anybody interested in exploring it further, please be in touch and we’ll keep the conversation going.