OpenELIS Global

Laboratory information system for low-and-middle-income country public health laboratories.

Past and Current Partners

UNDP Singapore Global Centre, Digital Square, PEPFAR, The US Centers for Disease Control and Prevention, Bahmni

Active Countries

Ivory Coast, Mauritius, Haiti, Vietnam, Cote d'lovire, and in 14 countries with Bahmni

Thematic area(s)

Health

Technology

Open Source, Digital Public Good

Organisation Name

I-TECH DIGI University of Washington

The Problem

The recent emergence of the COVID-19 pandemic has highlighted the importance of strong laboratory systems for detecting outbreaks of infectious diseases, as well as for other personal and population health purposes such as monitoring HIV viral load suppression among patients receiving antiretroviral treatment, or measuring pathogen resistance to antibiotics. While laboratory information systems (LIS) are critical to clinical care and public health efforts, their reach and effectiveness can be amplified via automated data exchange with other health information systems.

The Solution

In June 2019, with support from Digital Square, the Digital Initiatives Group at I-TECH (DIGI) of the University of Washington began a project to address the need for a standards-based interoperability protocol for clinical lab test ordering and result reporting in resource-limited settings. Drawing on experience as developers, implementers, and contributors of the Open Enterprise Laboratory Information System (OpenELIS) and Open Medical Record System (OpenMRS), the DIGI team led efforts to design and build a solution using Fast Healthcare Interoperability Resources (FHIR), an emerging standard for interoperability. OpenELIS Global's mission is to strengthen clinical and public health laboratories and improve health for all by providing an advanced, standards-based laboratory information system that can be leveraged by health programs worldwide. The OpenELIS Global software is an open enterprise-level laboratory information system built on open-source web-based technologies that have been tailored for low-and-middle-income country public health laboratories.

How it works?

Step 1: Partnering with appropriate government agencies, key partners, and stakeholders to perform a needs assessment and create a strategic plan for national lab information.
Step 2: A lab HIS technical working group (TWG) is formed and reviews the needs, performs a GAP analysis and creates a deployment and software development roadmap and timeline.
Step 3: The TWG convenes workshops for the support and deployment teams, and begins training trainers.
Step 4: TWG and key technical teams set up the national infrastructure. TWG begins working on defining key data outputs.
Step 5: User acceptance testing and piloting in a small group of labs. Followed by an analysis and assessment of the pilot performance.
Step 6: Scaling up, ongoing maintenance, and upgrades with new functionality and interfaces to clinical analyzers.

Bridging the digital divide

OpenELIS Global is designed and built by a global community of laboratory experts, implementers, informaticists, and developers. We work closely with key partners and stakeholders to ensure our roadmap and design decisions are addressing local needs. OpenELIS is used most commonly in limited-resource environments, and extra concern is focused on ensuring no barriers exist for settings with limited digital capacity and low/no connectivity settings with intermittent power. OpenELIS includes secure results reporting to patients and caretakers, helping mitigate the challenge of digitally limited ecosystems that prevent the timely reporting of results to clinicians for patients.

Impact and highlights

Ivory Coast: used in 122 labs at all levels (from general hospitals to national reference laboratories).
Mauritius: processed more than 500,000 COVID tests and supported the labs to scale during a surge where labs reached more than 4000% of normal demand. OpenELIS also powers the border health monitoring system, which processes thousands of passengers tested per day, and provides data for additional systems to support follow-ups and screenings for COVID and other communicable diseases by health offices throughout Mauritius.
Haiti: OpenELIS is implemented in 40 clinic-based laboratories and interoperable with the electronic medical records system and national health information exchange.

Plans for expansion

Currently in contact with a number of different countries (Rwanda and Malawi amongst others). Further expansion is planned in Haiti (currently working with the Ministry of Health and CHARESS).

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