Bahmni

Bahmni

Bahmni is an open source Hospital Information System (HIS) and Electronic Medical Record (EMR) product led by the Bahmni Coalition, a group of companies and non-profit organizations that provide leadership to Bahmni. It is a project of the OpenMRS Foundation. Bahmni’s mission is to provide sophisticated digital healthcare to improve patient care in low-resource settings. Bahmni aims to provide a high-quality, free, open source, comprehensive Health Information Management System (HIMS) solution that is comparable to the best tools available in high income countries. Bahmni combines and enhances existing open-source products into a single solution. It integrates:

• OpenMRS for electronic medical records and patient management
• OpenERP for inventory, billing, financial accounting
• OpenELIS for laboratory management
• Dcm4chee for DICOM and PACS

Bahmni improves healthcare delivery through efficient information management, so that decision-making is faster and more reliable across the organization; doctors are enabled to be more effective and accurate while providing care; administrators have the information they need real time. Bahmni is an easy to use, complete, open-source Hospital Information System (HIS) and Electronic Medical Record (EMR) under development since November 2012. Bahmni aims to meet the needs of hospitals in low resource environments by leveraging a tapestry of existing open-source products. The information that Bahmni makes accessible helps healthcare providers to improve efficiency and quality of patient care, reduce errors in clinical encounters and advocate for issues related to public health.

Approach

Bahmni integrates and builds on top of:

• OpenMRS for electronic medical records and patient management
• Odoo for inventory, billing, financial accounting
• dcm4chee for DICOM and PACS
• OpenELIS for laboratory management

The main features of Bahmni are as follows:

• Patient Registration: Register patients with their demographics, identification, contact, relationships & other details. Search patients. Print patient ID cards.
• Appointment Management: Schedule, manage patient appointments
• Clinical Services: Capture, maintain and access clinical records of patients. Create general and disease specific forms. Capture drug prescriptions and order lab, radiology, other investigations, or procedures. Use pre-created drug prescription templates.
• Laboratory Management: Manage patients' orders, samples, and tests. Get bird's eye view of the lab's workload. Send samples for referrals.
• Inpatient Management: Manage patient's admission, perform bed assignments, and track ward occupancy.
• PACS Integration: Create radiology orders, view DICOM images
• Telemedicine: Teleconsultation appointments, encounters
• Operation Theatre / Surgery scheduling
• Stock Management: Manage, track, reorder medicines and other supplies. Move and monitor stock levels.
• Billing, Accounting: Manage and maintain accurate records of all bills and financial transactions.
• Reporting: Perform operational, clinical, and public health reporting (Bahmni Mart)

Bahmni is:

• An Integrated Solution - Manage patient information across registration, point of care, investigations, and billing
• Intuitively Designed - Simple to use at the point of care, with minimal training required
• Flexible - Allows for unique workflows and processes based on each hospital's needs
• Modular - Choose parts of Bahmni and integrate them with existing systems
• Infrastructure Appropriate - Hosted and operated at the hospital site, requiring no dependence on the Internet
• Adaptable - Bahmni can be used on a variety of devices, including tablets and laptops

The primary users of Bahmni are clinicians - physicians, dentists, pharmacists, physician assistants, field health workers, nurses, hospital Staff - Front desk, receptionists, scribes, billing and administrative staff, Pharmacy and Store managers, medical Technicians - Lab technicians, radiographers, hospital Administrators: To see facility level reports for clinical and operational decisions. The end users of Bahmni are typically doctors, specialists, clinical and non-clinical staff at hospitals located in remote parts of the world, most of whom rarely use technology in their daily life. Bahmni was designed to be used by such users. Its configurable interface allows clinical users of different specialties to design forms to capture the data they need. Bahmni is also designed to be used by users in multiple languages.

Implementations

Bahmni has been in development since early 2013. It was piloted at the Jan Swasthya Sahyog (JSS) Hospital in Chhattisgarh, India in October 2013. It was introduced to the wider community at the OpenMRS conference in 2015. Since then, the adoption has been growing organically. In a short span of 9 years, Bahmni has been chosen for national-level rollout in Lesotho, Bangladesh, South Sudan, Cameroon and Tanzania by the ministries of health of these countries. The endTB project consortium, a group of well-respected global health organizations - Médecins Sans Frontières (MSF), Partners in Health (PIH) and Interactive Research and Development (IRD), chose Bahmni as the EMR for a large implementation trial for the new Tuberculosis (TB) drug regimen.

According to Bahmni's best estimate, thay have more than 500 known sites worldwide in over 50 countries using Bahmni. Over twenty million patient records have been managed via Bahmni. Bahmni was designed for use in low-resource settings. Currently, it is used predominantly in Low- and Middle-Income Countries (LMICs). Typical organizations that form Bahmni’s core user segments are: Large NGOs (e.g., MSF, Cure International), Country Ministries of Health (MoH) - for country-wide implementations, small and medium-sized for-profit and NGO hospitals and research institutes.

Bahmni is usually chosen as the EMR for healthcare institutions looking to digitize patient care because of the following advantages: It replaces much more inefficient paper records, its customizability (localization, calendar), integrations with other systems, strong reporting capabilities. Additionally, Bahmni is preferred over alternatives because it is easy to use, it is open source, and it has an active community behind it, including the much larger OpenMRS community. Less commonly, Bahmni also replaces existing EMR implementations.

At the urging of India’s National Health Authority (NHA), the Bahmni community is building Bahmni Lite, a lightweight version of Bahmni more suited to OPD settings in small clinics. Bahmni Lite will also be cloud-native to take advantage of increasing internet connectivity and allow clinics to use Bahmni in Software as a Service mode for as little as USD 20 a month. This will also reduce costs to implementers and allow for efficiencies of scale.

In 2021, Bahmni became the first (and to date, only) open source HMIS to be certified for all three milestones of India’s Ayushman Bharat Digital Mission (ABDM) network. It is being considered as a strong option for ABDM roll-out in multiple states in India and has already been piloted in the state of Bihar.

Bahmni has been recognized as a Digital Public Good by the Digital Public Goods Alliance (DPGA). It has also recently (September 2022) been listed in the United Nations Development Programme’s (UNDP) Digital X Solution Catalogue.

Resources

• Website: https://www.bahmni.org
• Source Code:https://github.com/bahmni
• Articles
  • List of Repositories for Development on Bahmni
  • Digitalising Nepal’s health sector: A country’s journey towards an interoperable digital health ecosystem:
  • Open-source electronic health record systems: A systematic review of most recent advances
  • Strengthening Strategic Information Activities in the Kingdom of Lesotho: Key Findings Report
  • Electronic Health Record Systems for Low-Resource Settings: Systematic Review
  • Design and implementation of an affordable, public sector electronic medical record in rural Nepal
  • Partnering With a Hospital for and by the Adivasis | Thoughtworks:
  • OpenMRS Cameroon