OpenELIS- International: An Adaptable, Open-Source Laboratory Information System Expanded for Global Standards Interoperability and Implementation in Resource Limited Settings

OpenELIS is an open-source electronic laboratory information system (LIS) first developed for public health laboratories in the USA.  OpenELIS supports many standard laboratory business processes, as defined by the Association of Public Health Laboratories (APHL).  The International Training and Education Center on HIV (I-TECH) drew upon the OpenELIS codebase for use in Haiti.  Open-source information systems (e.g. OpenELIS) offer promise in resource-limited settings because: they offer flexibility to adapt to country-specific contexts; permit facile integration with other electronic tools; promote a community with interest in sharing solutions to common problems; and support system longevity and expansion, and more easily address evolving needs.
I-TECH provides technical assistance to the Ministry of Health, CDC, and other stakeholders in strengthening key clinical and reference laboratories in Haiti. A MOH Working Group (LISWG) identifiedLIS system requirements in Haiti, selected an appropriate system after evaluating commercial and non-commercial LIS options, and informs system implementation.  The group reviewed the responses and selected OpenELIS based upon the strengths of its existing codebase and the promise of the open-source approach.  I-TECH initiated an iterative process to modify OpenELIS to meet Haiti-specific requirements.  
The process of adapting OpenELIS for Haiti has demonstrated the value of this open-source approach.  I-TECH leveraged most of the OpenELIS database design, but customized the business logic and user interface to match Haiti’s standardized paper-based laboratory tools.  Other Haiti-specific adaptations addressed characteristics for uniquely identifying patients (name, geographic location), assignment of accession numbers to take into account inconsistent supply chain reliability, and context-specific meaning of laboratory orders.  These enhancements, and others, such as extension of localization for full French-language implementation, are shared with the broader OpenELIS community, and I-TECH maintains a blog on OpenELIS in Haiti (http://haitilis.wordpress.com/).