Background

For over twenty years, Holy Name Medical Center has supported Hôpital Sacré-Coeur (HSC) in Haiti, and more recently through its charitable foundation, Haiti Health Promise. This long-standing commitment extends to the development of HSC's digital transformation. Holy Name’s own expertise in developing its EHR uniquely positions it to guide HSC’s HMIS journey. Recognizing that an effective EHR implementation requires a long-term commitment, Holy Name brings the resilience, dedication, and experience needed to meaningfully transform healthcare delivery at HSC and beyond in Haiti for the long run.

Challenge: Taking Careful Steps Toward a Sustainable HMIS

Hôpital Sacré Coeur (HSC) faced numerous challenges in its journey toward a modern HMIS. These included transitioning from paper records to a digitized system, carefully rolling out features across the hospital, and prioritizing, initially at least, ERP needs like financial visibility and inventory management over clinical aspects of the system. Compounding these technical challenges, Haiti's poverty and political instability made implementing such a project exceptionally difficult. Additionally, the goal was to create a reusable HMIS framework for other facilities in Haiti, ensuring long-term scalability and impact.

Solution: Adaptive Processes from Bahmni HMIS to Ozone Haiti

The solution combined adaptive change processes with an evolving technological framework. Starting in mid-2018, HSC’s HMIS was introduced in carefully managed phases. The initial production deployment in Spring 2022, delayed by the Covid-19 pandemic and several episodes of unrest in Haiti, focused on deploying an ERP system for pharmacy stock management and patient billing, alongside basic EMR functionality. This included patient registration for all patients and a medical record system for the Pediatrics department. The system ran in this configuration for about six months to stabilize operations and refine workflows.

Following this foundational stage, the EMR was progressively expanded to other departments, at a pace of about one department per month. This phased rollout brought general clinic, Obstetrics, Gynecology, Surgery, Internal Medicine, Emergency, Dental, Cardiology, and finally Maternity and Inpatient Wards into the system.

Initially, the system was based on Bahmni HMIS, featuring Bahmni EMR and Odoo and was branded as ‘Bahmni Haiti’. As the Ozone ecosystem emerged, this distribution evolved into an Ozone distribution, incorporating:

• Bahmni EMR as the EMR app
• Odoo for ERP functionalities
• SENAITE as the LIMS app
• Ozone Analytics with Superset for advanced data visualization

As part of ongoing improvements, the EMR app is now transitioning from Bahmni EMR to OpenMRS 3.0, and the overall solution has been rebranded as Ozone Haiti—a comprehensive, scalable HMIS distribution tailored for HSC and adaptable for broader use across Haiti.

‍Take-away: Ozone Haiti, Built to Last

‍Holy Name Medical Center’s success at HSC stemmed from recognizing from the onset that building a sustainable HMIS is a long-term endeavor. This approach stands in stark contrast to the short-sightedness often seen in digital health projects, where ambitious goals are paired with unrealistic timelines. Despite being led by prominent organizations or ministries, such projects frequently overlook the complexity of implementation and the need for gradual, thoughtful adoption.

Holy Name’s approach serves as a much-needed example of how long-term vision and commitment are essential for achieving meaningful, lasting impact in digital health. By progressively introducing features and carefully building capacity in Milot, they established a solid foundation for a system that evolves while remaining actively maintained and monitored.

Taking a progressive approach allowed for gradual training and onboarding of staff, starting with the most motivated people and departments first. This strategy helped build internal champions for the system and address adoption challenges by fostering buy-in from within the hospital. Over time, the approach created a strong foundation for system-wide acceptance and usage, making the transition to a new HIS more manageable. Finally, Ozone, as a versatile and evolving framework aligned with global health needs, provided the tools that ensured HSC’s HMIS is built to last.