June 2013 Contributor of the Month: Tobin Greensweig

Each month we select one of our many impressive volunteer OpenMRS contributors and highlight them here, to share their experiences and help others learn more about the others involved in the project. In June, community manager Michael Downey chats with Tobin Greensweig and learn more about his OpenMRS contributions and his work and studies in the Middle East. If you’d like to nominate a contributor for an upcoming month, check out more information about the program on the OpenMRS wiki. We look forward to hearing from you!

MD: Hi Tobin! Congratulations on being our June 2013 contributor of the month. I know you have a very interesting story to share with us this time, so why don’t you start by telling us a little about your background?

TG: Thanks! I’m a computer nerd who loves people and health. I grew up in California about one hour north of San Francisco and attended University of California, Santa Barbara where I studied mechanical engineering. After graduation I worked a few years as a Product Manager for an Internet startup before deciding to pursue a career in medicine. True to my interest in Global Health, I chose to study at the Medical School for International Health in Be’er Sheva, Israel which is where I live now. My program is collaboration with Columbia University and has a special emphasis on global health, development, and cross-cultural communication.

MD: It sounds like you’ve literally followed your passions half-way around the world! I guess your exposure to international travel and healthcare made a natural fit for getting involved with OpenMRS. When did you first hear about us, and how did you start getting involved?

TG: Yes, definitely. I first heard about OpenMRS while volunteering for the Village Health Works clinic in Burundi in 2009. One of my jobs there was to implement the clinic’s first EMR system – we were starting with a blank slate. After a lot of conversations, a trip out to Partners in Health’s site in Rwinkwavu, Rwanda, and thinking about all the things that “might make our new implementation fail”, we ultimately chose to build a custom Microsoft Access database instead of using OpenMRS. This was before the days of the OpenMRS standalone edition, and we didn’t think we could reliably support an implementation.

However, this didn’t mean that I forgot about OpenMRS! I had caught the curiosity bug and was especially impressed by the open source community and all the collaboration and sharing of resources made perfect sense to me. One of the things that really struck me was the inherent level of sustainability and opportunity that everyone gained by using and co-developing on a shared software platform. With the help of an ROI Microgrant, I managed to attend the 2011 Implementers Meeting in Kigali.

I think it was there that I made my first contribution to the community: a 5-minute lightning talk titled “Why Village Health Works chose NOT to use OpenMRS!” I think I probably ruffled a few feathers with that one, but the truth is I’d already been sold on OpenMRS and hoped that my newbie’s perspective might be a good catalyst for discussion. In retrospect, I definitely caught the wave at the right time – today I think that nearly every one of the bullet points I presented two years ago has been addressed!

MD: I remember that talk well, and it was really valuable to hear your experience as a newcomers, and to help us learn how to improve. It’s clear that your role as a medical student is highly related to your contributions to OpenMRS, but are there any other activities you’re working on in the Health IT field?

TG: About two years ago I co-founded MigrantHealth:IL, a small NGO addressing the health needs of refugees within the State of Israel. From day one, my co-founder Dr. Jonah Mink and I decided that we wanted our work to have a greater impact than just here in Israel – we wanted to share our growing knowledge base and solutions with the world. One of our inaugural projects was to help the Ministry of Health’s Refugee Clinic in Tel Aviv to implement an EMR.

Using OpenMRS was a no-brainer. It was a perfect software platform and had a built in way for us to share our work. From the start, I always tried my best to update the wiki to clarify the things I found unclear as a newcomer. I think we were one of the early users of OpenMRS at the point of care which meant we often needed new features. I did my best to communicate our needs through issues on JIRA, the mailing lists, and last year’s implementers meeting in the Philippines. We’ve always done our best to share even our hackiest (but usually practical) solutions for things like patient queues.

MD: OpenMRS got started in Africa and Central America, but is rapidly growing in your area of the world. Do you have any thoughts about what challenges lie ahead for both the software platform and our community as it grows and adapts to use in more parts of the world?

TG: I think the trend here in the Middle East and much of the rest of the world is the same: A focus is on efficiency and giving clinicians tools to make immediate and more informed decisions. It’s already started, but I believe that OpenMRS will be increasingly be used in point of care situations including mobile devices. This is opposed to the early implementations that were based on retrospective data entry by clerks and the output was often just reports. I think that part of point-of-care use will also be an expansion of the role of OpenMRS in the clinic and users will expect integration with appointments, queues, prescriptions, inventory, and medical imaging. I’m not saying much new here – actions speak louder than words. and the OpenMRS community’s investments in a new UI and other active conversations are addressing so much of this.

As the focus of OpenMRS broadens to address more of the workflow issues involved in healthcare, I think one of the community’s largest challenges is to continue developing and engage the ranks of non-developer contributors. We need everyone from community health workers, to business analysts, and UI designers writing the user stories that become tickets and ultimately good software!

MD: I couldn’t agree more, and we’re definitely working hard to help people of all backgrounds get involved. It sounds like you stay amazingly busy with school and your other projects. What are you doing with OpenMRS these days, and what’s happening out there that you find interesting?

TG: For the past year or so my main OpenMRS project has been working with Ben Gurion University of the Negev students Adam Lauz and Yonatan Grinberg to develop the Appointment and Scheduling module. We used the Tel Aviv clinic as a prototype and designed/developed the module with enormous help from the community. I think this project has been a really successful example of how a three-way partnership between a university, an implementation, and the community can hugely benefit each individual member. I’m interested in sharing our experience and trying to grow this model. Time seems to be my limiting factor these days … but there are lots of other projects that I’m interested in! To name a few, the new reference application, order entry, and pharmacy inventory management.

MD: You’ve been involved with OpenMRS for a few years now, and initially needed to look elsewhere to meet your needs, but stuck with us and continued to get more involved over time. What advice would you have for people just getting started looking at OpenMRS and want to contribute?

TG: Working with the community has been a life-changing experience. For me it’s as much about the software and what the community is actually accomplishing as it is about the underlying philosophy and how it’s all happening. I’m constantly inspired that every day there is a global exchange of ideas and active collaboration towards the common goal of improving the health of those who need it the most. What’s also inspiring is that this conversation isn’t just led by the usual suspect of doctors and public health experts, but by people from all backgrounds, including engineers and entrepreneurs. I feel a huge debt of gratitude to the community for making my ideas feel welcome and giving me a space to combine the things I love most – people, medicine, technology, and repairing the world.

For the newcomers, my best advice is not to be shy and introduce yourself via the mailing lists or IRC. There are always so many different projects happening all over the world that surely there will be a good fit! I’ve found that the individuals making up the community are also some of the most generous and approachable that I’ve ever met, and they’re happy to have help with their projects even if it means a bit of mentoring along the way.

MD: Tobin, thanks again for your time and sharing your insights, and congratulations!