Kenya EMR

Follow the steps below

• Log into KenyaEMR using Admin
• Go to home
• Click ETL Admin
• Recreate Tables then Refresh Tables
• Re-run the report again

NB: If you end up with AJAX error, you may want to reset the kenyaemrChart entries on liquibasechangelog then restart tomcat.

This could be due to several reasons i.e.:

• Wrong URL entered on browser
• Network disconnection (LAN cable unplugged or cut)
• Wrong Network configurations at the terminal or server

Countercheck the above through elimination method and see if the issue has been resolved. Refresh your browser to confirm.

To upload data to the national Data warehouse you need a good internet connectivity. Make sure the internet connection is stable to complete upload.

• Log into mysql; mysql -uroot -p (Enter)
• Drop DWAPI database; drop database dwapi ; (Enter)
• Exit mysql ; exit(Enter)
• On the terminal typr ; sudo docker stop dwapi (Enter)
• Then type; sudo docker start -i dwapi (Enter) – Allow to run until it completes creating the tables
• Restart DWAPI; sudo docker restart dwapi (Enter)
• Refresh browser, configure dwapi end points correctly then reload data from EMR

• Open terminal and type sudo -i and press enter
• cd /var/lib/mysql/ and press enter.
• sudo rm -rf kenyaemr_datatools and press enter.
• sudo rm -rf kenyaemr_etl and press enter.
• Recreate tables manually.
• Restart tomcat9

Open terminal and install net-tools

• sudo apt install net-tools (Enter)
• ifconfig (Enter)

• Log into KenyaEMR and search for the patient whose visit you want to edit
• Click on the form you want to edit,
• Click on edit button at the bottom of the form
• Save after editing the details you wanted to change or update

KenyaEMR by design runs on Ubuntu environment. You can install it by following the instruction provided on:

Link:

You need to be able to install DWAPI app on Ubuntu for data transmission from KenyaEMR system. DWAPI is installed through a Docker container on Ubuntu. The following link gives you access to resources  on how to install DWAPI on Ubuntu 16.04LTS :

https://hub.docker.com/r/kenyahmis/dwapi

Steps to follow;

• Log in to KenyaEMR with administrator account and navigate Data Manager.
• Click on Merge Patients Records.
• Select the patients you want to merge then click on Merge Patients.
• Confirm that details are correct then click Merge then Okay

Open the terminal window (Ctr+Alt+T) and run the command below;

mysqldump -u root -p openmrs | gzip > openmrs_backup_facilityname_date.sql.gz

Press ENTER.

NB: You will access the database dump on your the home directory

Following an update on KenyaEMR, users are expected to update regimen line for all clients. This can be done either manually or by updating the regimen lines in bulk using a spreadsheet module.

The following guide provides a step-by-step guide on how to update missing regimen lines in bulk using the spreadsheet module

Link:

From time to time, you’ll need to upgrade your instance of KenyaEMR to respond to improvements and revisions on the HIV care or to fix some bugs that have been resolved. Here is the link to access an upgrade guide:

To address the need for increased performance in system start-up, general system stability and security, Users are advised to upgrade OpenMRS platform from v1.x to v2.x

The following guide provides a step-by-step guide on how to manually upgrade the OpenMRS platform

Key Population (KP) module has been integrated into KenyaEMR System as a module. This makes it convenient to access and document  client’s information on KP services without leaving KenyaEMR interface. It also makes it  possible to exchange KP data with various services within the system.

The following guide provides a walkthrough on how to use the KP module:

SOP

The following guide provides a step-by-step on how to configure automatic backup in KenyaEMR;

Obtain the correct openmrs backup tool  folder then open terminal and type the following;

• sudo cp -R openmrs-backup-tools/ /usr/share/
• cd /usr/share press enter
• sudo chown -R faciltyxx:facilityxx openmrs-backup-tools
• sudo chmod -R 755 openmrs-backup-tools
• sudo mkdir /var/backups/KenyaEMR/
• sudo chown -R facilityxx:facilityxx /var/backups/KenyaEMR/

Create a cron job to run the backup script on a daily basis by running crontab -e and select option 2. /bin/nano   [ENTER]

1. Add the line 00 11,16 * * * /usr/share/openmrs-backup-tools/openmrs_backup.sh
   Then press Ctrl+x and press y and enter to save
2. Confirm by typing cd /usr/share/openmrs-backup-tools [ENTER]

Then type  ./openmrs_backup.sh and press enter.

Steps to follow

1. Remove the existing mysql-5.6 package

sudo apt remove mysql-client mysql-server libmysqlclient-dev mysql-common

sudo apt-get purge mysql*

sudo apt-get autoremove

sudo apt-get autoclean

2.  Remove mysql,mysql-files and mysql-keyring  from  /var/lib     directory

cd /var/lib

sudo rm -rf mysql*

3. Install MySQL 5.6 on Ubuntu 20.04

sudo add-apt-repository ‘deb http://kr.archive.ubuntu.com/ubuntu xenial main’

OR:

sudo add-apt-repository ‘deb http://archive.ubuntu.com/ubuntu trusty universe’

Then do the following :

sudo apt update

sudo apt-get install mysql-server-5.6

sudo touch /var/run/mysqld/mysql.sock

sudo chown mysql:mysql /var/run/mysqld

sudo update-rc.d mysql defaults

sudo service mysql restart

• Restore KenyaEMR database
• Grant privileges
• Restart both MySQL and tomcat

The following guide provides a step-by-step on how to resolve openmrs error while login to KenyaEMR;

• Open terminal by hold Ctrl+Alt+T
• Type sudo service mysql restart

Type sudo service tomcat9 restart

When logging into KenyaEMR and you experience a red banner at the top of the screen notifying you to contact the system administrator use the following steps to resolve:

• Open the terminal and log into MySQL (mysql –uroot –p) and enter password.
• Select openmrs as the default database (use openmrs) and run the following:

                 set foreign_key_checks=0;

                            delete from location;

                            delete from location_identifier;

                            set foreign_key_checks=1;

Restart tomcat.

The following guide provides a step-by-step on how to resolve Ajax error while recreating tables;

• Log in to MySQL by typing mysql –uroot –p
• Enter correct MySQL password
• Choose database by typing use openmrs;
• Type call create_etl_tables();
• Type call sp_first_time_setup();
• Restart tomcat by typing sudo service tomcat9 restart

The following guide provides a step-by-step on how to resolve UI Framework Error while opening forms in KenyaEMR;

• Open terminal and log into mysql by typing mysql –uroot –p
• Enter correct MySQL password
• Select openmrs as the default database by typing use openmrs
• Obtain the latest version of KenyaEMR concept dump and source it into the openmrs database by typing: source /path_to concept_dump.sql;* 

* Is the actual path and file name to the backup file

A user may encounter a UI Framework error while running reports, this may be caused by lack of privileges to openmrs_user or missing some etl tables.

The following provides step-by-step guide;

• Log in to mysql by typing mysql –uroot –p
• Enter correct MySQL password
• Select database by typing use openmrs;
• Type call create_etl_tables();
• Type call sp_first_time_setup();
• Type grant all privileges on *.* to ‘openmrs_user’@’localhost’;
• Type flush privileges;

Restart tomcat by typing sudo service tomcat9 restart

There are various ways in which a user can update viral loads in KenyaEMR; Lab manifest option allows automatic pull of results from the lab to KenyaEMR and to individual patient records while mLab does the same via the interoperability layer. The Spreadsheet module allows a user to upload viral loads in bulk as downloaded from the VL/EID Website.

The spreadsheet module option offers a solution to sites with internet connectivity challenges or have no other option installed.

The following guide provides a step-by-step guide on how to upload viral loads using the spreadsheet module

Link:

Manual upgrade of OpenMRS platform is time consuming. To address this, a script to automatically upgrade platform has been developed to ease the process.

The below link provides access to the automated script: Link: OpenMRS2.x Platform Upgrade Using Auto Script Jul 2021

Operation Triple Zero (OTZ) is a program that support clinical care delivery and management of adolescents living with HIV. Here is how to use the module:

Link:

If you run a report and it throws an error then check the following;

• Clear report queue by running the following scripts;

Log into mysql using the terminal; mysql –uroot –p (Enter)  then enter password when prompted

delete from reporting_report_request; (Enter)

Exit (Enter)

Restart MySQL by typing  sudo service mysql restart (Enter)

Re-run the report

KenyaEMR might fail to launch due to several reasons. The most common one relates to a bean error which might display as follows:

User encounters an error message ” Error creating bean with name’MessageSourceServiceTarget’ defined in class path resource [applicationContext-service.xml].

To fix this error, you need to force a rebuilt of OpenMRS indexes as follows:

• Open terminal and type; cd /usr/share/tomcat6/.OpenMRS/lucene/indexes/ (press ENTER)
• Type sudo rm -rf * (press ENTER)
• Type cd (press ENTER)
• Type: sudo service tomcat6 restart (click ENTER)

Log in to KenyaEMR and rebuild search index on Developer panel as follows:

• Login into KenyaEMR  as Admin
• Click Home
• Click on Developer icon
• Click on  Legacy admin UI
• Under Maintenance, click Search Index
• On the Search Index page, click on Rebuild Search Index button.
• Wait for the process to complete.

Start of by performing the following procedure:

• Log into terminal and run the following command;
  • sudo service mysql restart
  • sudo service tomcat6 restart
• Then refresh browser

If there is no change in performance after the above procedure, you may want to check the size of memory allocation to JAVA HEAP SPACE  (sudo nano /etc/default/tomcat6)

The other place to check is the hardware specifications of your server. At a minimum, the specifications should be: (Speed = 3.6Ghz, RAM=8GB, HDD=500GB)

Lastly, you may want to check the MySQL  config file for further optimization as follows:

• sudo nano /etc/mysql/my.cnf

Confirm and fine-tune all the configurations  under InnoDb section

Log into terminal and run the following commands:

• sudo service mysql restart
• sudo service tomcat6 restart
• refresh browser

Follow the steps below to solve the problem

• Open terminal and log in to MySQL by typing; mysql –uroot –p then Press ENTER.
• Select database to be used by typing; use openmrs; then click ENTER.
• Type; call create_etl_tables(); then click ENTER.
• Type; call sp_first_time_setup(); then click on ENTER.

Type exit and close terminal. Refresh KenyaEMR

The error may appear like this:

Root Error – org.openmrs.framwork.UiFrameworkException:reportData is required

Follow the steps below to resolve the error;

• Log into mysql: mysql -uroot -ptest
• Type: use openmrs;
• Clear Chart entries from Liquibase: delete from liquibasechangelog where id like ‘%kenyaemrChart%’;
• Exit and restart tomcat: sudo service tomcat6 restart

• Open terminal and type; cd /var/lib/OpenMRS/lucene/indexes/ (Enter) – Ubuntu 20.04LTS

OR

• Type the following; cd /usr/share/tomcat6/.OpenMRS/lucene/indexes/ (Enter) – Ubuntu 16.04LTS
• Type; sudo rm -rf * (Enter)
• Restart tomcat
• Log in to kenyaEMR and rebuild search index on Developer module

Incase of variances in the TX_CURR / Current on ART reports, check the following.

• Enrolment form for TIs (completeness and accuracy) for missing clients
• Discontinuation form (completeness and accuracy) for missing clients
• Recreate ETL tables the re-run the reports
• Check patient dashboards for completeness and accurate data entry for missing clients
• Generate EMR Report for the specified period
• Download the current on ART Line list
• Using the DAR, list the unique patient number for all clients considered active for the specified period
• Using the compare tool, paste Unique numbers with more numbers on the first column and the one with less on second column (Compare tool has two columns one labelled EMR and paper)
• Once the data from both sources is pasted on Input worksheet, click on compare and the results will be populated on output worksheet
• Records listed on output on either of the columns indicates what’s in that source but missing in the other
• Using the output

Check the Green Card to confirm that the last visit was updated in EMR and the correct TCA documented

Generate Lost to follow-up report and confirm there is no active client listed

Generate list of clients transferred in and confirm that the correct effective dates are updated

NB: Here is a simple tool for performing the data comparisons across two dataset.  Compare