Bahmni Connect +

- Bahmni Team Thoughtworks

No Network connectivity:● Without Bahmni Connect: A health worker, usually active on the field and does not

have access to the internet. They would record patient details/observations for patients on paper and enter it in Bahmni once they are back in the hospital at the end of the day.

● With Bahmni Connect: A health worker can directly enter the observations in the offline app and sync it to the server at the end of the day when there is network.

How does it help?● Data entry is a time taking process. Entering a day’s worth data at the end of the day is

a huge task.● The more the number of hops before data is entered in the system the more error

prone it is. ● Avoids loss of paper records - during the transition of paper records from hospital to

remote area, many times they get lost. ● With paper records, a lot of times duplicate records get created as it is difficult to

search. An offline app helps in search and prevents creation of duplicate records.● Doctors usually start a treatment in hospital but do follow ups in a sub centre. If the

paper record is not available, doctor at the subcenter will not know the details of the treatment going on.

● Entering the data in Connect app (offline) will help them identify the missing (mandatory) information/ erroneous information at the field itself.

● Syncing the Connect app to server ensures that the latest information is present in the Connect app as well as at the main hospital.

Current Features:●Works Offline.●Patient Registration●View the following information on patient

dashboard○Observations○Visits○Treatments○Lab orders○Diagnosis

●Record observations●Push to/ pull from (sync) server

Offline Support through Apps

● Chrome Extension (Bahmni.tar.gz) : Web worker, Indexed DB, Lovefield

With discontinuity of Chrome’s support for Chrome AppsEvaluating options:● Electron● Progressive Web apps (Service workers)

Offline Support through Apps● Android App (Bahmni.apk)

Ionic provides all the functionality that can be found in native mobile development SDKs.Crosswalk

Home Page With Sync button:

Sync Mechanisms

●Initial Sync : App is unusable.●Background Sync : Uses Web workers. Scheduled

at periodic intervals. App is usable.●Manually trigger sync.

Initial Sync:

Background Sync/ Manual Trigger

App Pull

App Pull

●Meta data: Synced to all devices○Configs○Global properties○Reference data○Concepts

●Transactional Data: Synced based on login location○Patient Profiles○Encounters( observations, orders ….)

App Push

Hustle : A javascript queuing and messaging library built on top of IndexedDB.

Sync Strategy● As the number of patients, their encounters, observations would be usually very high, the

storage space on the tab would be a constraint.● Data is usually pulled based on the login location used during login.● For example if a person has logged in for login location 1, data relevant for location 1 is

only pulled.● The way data is mapped to a login location is based on a strategy. The strategy is a java

class which just evaluate the filter for each event.● Strategy is customizable and pluggable.● Out of the box there are 2 strategies

○ LocationBasedOfflineSyncStrategy: Based on the patient address filled in registration form the filter is evaluated.

■ Eg: If a community health worker logs in from “Kampala” , all patient whose address is Kampala would be synced. It uses address hierarchy to map patients to login location

○ IDBasedOfflineSyncStrategy : Based on the patient identifier a patient is mapped to a login location.

■ For eg: Primary identifier has a prefix which represents the village they belong to.

Strategy can be customised and can be plugged in as a global property in OpenMRS

Sync Strategy:

Note: Metadata (configs/global properties/concepts) would be synced to all locations irrespective of login location.

Data Flow:

Components on server side

●Event log Service○Polls Events Records table for new events ○Creates events in event_log with filter for each

event ●Bahmni Offline Sync OMOD

○Loads the strategy configured in global properties

○For every event in event records it evaluates the filter based on the strategy and gives it to Event log service

Demo...