Enhancing Healthcare Records Management System in Nigeria with NMRS

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NMRS, powered by OpenMRS, is a tailored system supporting various HIV programs in Nigeria. With modules for patient and data management, the system operates in over 1000 facilities managing records of 750,000+ patients. SMS reminders and appointment lists aid in improving patient retention. Additionally, the system is evolving to include a Point of Care module for expanded disease area coverage.

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NigeriaMRS (NMRS) Powered by: OpenMRS NigeriaMRS (NMRS) Community - 2021

NigeriaMRS Overview NMRS is acronym for Nigeria Medical Records System An adaptation of the OpenMRS software to support HIV program in Nigeria Supported program areas - HTS, PMTCT, ART Modules include Patient management, Data management, Data quality assurance, Commodities management, Reporting and Systems management In use across over 1000 PEPFAR & GoN supported facilities in 21 states Manages records of over 750,000 patients currently on treatment

Retention (Patient Reminders) To achieve a sustainable implementation and in line with the need to optimize strategies for better retention of our clients, and in response to patient level issues that have contributed to IIT, the necessity for the use of SMS reminder systems came up. Patient phone numbers are linked to a service that handles appointment reminders, this reminders are coded messages in other to avoid stigma. This reminders help boost facility retention numbers overtime. These automated reminders deliver messages for Appointment Reminders, ARV Drug Pickups, Viral Load Test, Drug Adherence, etc.

Scheduled & Missed Appointment Lists Appointment lists facilitate both pre- emptive and early defaulter tracking to improve retention

Reference App Treatment Forms

Program Implementation Results Rivers Surge 12-month treatment status by gender: Patients who started treatment between Jan-Dec 2018 12-month treatment status by gender: Patients who started treatment between Jan-Dec 2019 70 100.0 90.4 59.1 57.3 85.5 90.0 60 80.0 50 Percentage (%) 70.0 Percentage (%) 40 60.0 50.0 30 25.3 24.7 40.0 18 15.7 20 30.0 10 20.0 11.7 7.3 10.0 0 2.8 2.4 0.0 Active LTFU Status Transferred Active LTFU Transferred Status Male Female Female Male

Point of Care Module Point of Care: Point of care system has also been implemented and set for full scale deployment this year which is part of our primary focus for 2021. The system is mainly focusing on HIV implementations but we have plans to scale-up to other disease areas which we have already started discussing with stakeholders.

National Data Repository (NDR) All HIV data from various NigeriaMRS implementation across the country by partners are mandated to provide daily reports to the National Data Repository. Presently collecting HIV data with plans to accommodate other disease areas.

Lab Information Management System (LIMS) The Lab Information Management System (LIMS) provides flexibility to hospital labs allowing them to send electronic manifests for Viral Load Samples to Registered PCR labs across states, and receive results electronically on the NMRS instance via an API end-point. . The LIMS also has a standalone functionality called Remote Sample Login (RSL) for sites without EMR.

Patient Biometric Service (PBS) The implementation and deployment of the biometric system can help prevent identity error, multiple client registration, reduce data deduplication, combat fraud, identity theft, and as well, improve the program's patient matching abilities when all HIV data are synced to a central database. This can help the Government of Nigeria improve its program to avoid interruption in treatment and improve retention. Deduplication is currently being done on the NMRS as well as centrally on the NDR.

NigeriaMRS For Community ART Pharmacy Community Pharmacy Medical Record System (CPMRS)

Community Pharmacy MRS Data Flow Community pharmacy Central Server Community pharmacy staff attending to patient and accessing the platform for documentation. HQ monitoring the CPMRS activities Hospital staff accessing the CPMRS platform to update their NigeriaMRS. State pharmacy staff accessing the CPMRS forDQA/CQI Community pharmacystaff accessing the platform 20

States, Hub Facilities & Community ART Pharmacies 4 STATES IN NIGERIA 59 HUB FACILITIES 137 COMMUNITY ART PHARMACIES As of 9th February,2021 23,379 PATIENTS CAPTURED 17