‍Background: Essential Rural Health Services at Risk Without Digitization

Ubuntu Village of Life (UVL) is a rural hospital located in the highlands of Mugamba, Burundi. The facility serves a population with approximately 5,000 consultations per year and manages around 500 deliveries annually. As a critical healthcare provider in a remote area with few alternatives, UVL plays an essential role in ensuring maternal and child health services in the area.

In Burundi, the Ministry of Health has increasingly tied funding for maternal and under-5 care to digitalization requirements, creating an urgent need for even small rural facilities to implement electronic medical record systems. Without meeting these requirements, hospitals risk losing vital government support that sustains their most essential services.

Challenge: High Stakes, Low Capacity, No Time

UVL faced fundamental structural challenges in adopting digital health technology:

• Limited Technical Infrastructure: The hospital operated entirely on paper-based systems with minimal IT capacity and unreliable connectivity, making traditional EMR implementation nearly impossible.
  
  
• Resource Constraints: As a small rural facility, UVL lacked both the financial resources and technical expertise typically required for successful health information system deployments.
  
  
• Regulatory Compliance Pressure: Government funding for essential maternal and child health services had become conditional on digital reporting capabilities, creating an urgent timeline with serious consequences for non-compliance

These challenges directly threatened UVL's ability to maintain critical healthcare services in a region with few alternatives. Without digitalization, the facility risked losing funding that would effectively shut down maternal and child health programs serving the most vulnerable populations.

"Without digitizing our operations, we faced an existential threat to our most essential services. The traditional approach to EMR implementation would have been too complex, too costly, and too slow to meet our urgent compliance deadlines.", Dr. Alexis Nizigiyimana, MD, CEO of Ubuntu Village of Life.

Solution: Launching an Instant HIS with Ozone and OpenMRS 3

After evaluating available options, UVL decided to begin their digitization with Ozone to implement an "instant HIS" solution based on OpenMRS 3, addressing their three critical challenges and putting them on the right track for future expansions:

• Simplicity-First Architecture: Ozone's approach prioritized essential functionality that could work within UVL's limited technical infrastructure, providing an accessible starting point for digital transformation.
  
  
• Cost-Effective Implementation: The solution leveraging existing Digital Public Goods rather than custom development, dramatically reducing both initial implementation costs and long-term maintenance requirements.
  
  
• Rapid Deployment Strategy: A phased implementation starting with patient registration and core reporting capabilities ensured UVL could meet government requirements within the required timeline.
  
  
• Building Capacity: Choosing Ozone and its community of practices also put UVL in a better place to onboard new resources and develop digital capacity locally. Through a HealthTech Challenge organized in partnership, 20+ volunteers were able to quickly understand Ozone and deliver a workable version of the “UVL EMR” in only 3-months - as a milestone to train local staff on it in preparation of the adoption.

The implementation at UVL began with patient registration, OPD consultations, laboratory tests, pharmacy dispensing, billing, and basic reporting capabilities – the exact functionality needed to maintain funding eligibility while establishing the foundation for future expansion.

Through this use case, Ozone shows how it can deliver an integrated system that's accessible even to small rural facilities, addressing both immediate compliance needs and creating a pathway for sustainable digital growth.

Current Progress: From Registration to a Platform for Growth

The initial implementation phases have demonstrated Ozone's value in making complex systems more accessible:

• The patient registration module has been successfully deployed, establishing the foundation for all future digital health functions.
• Planning is underway to expand into Ozone's other ecosystem apps, including patient billing, inventory management, and analytics.
• The implementation follows Ozone's sustainability principle of "Don't build it" – relying on existing Digital Public Goods rather than creating custom solutions.
• Future integration with the national DHIS2 system will leverage Ozone's app-to-app interoperability layer and data visualization capabilities.
• Discussions have begun about connecting with community health worker systems.

‍Take-away: Ozone Makes EMR Adoption Feasible at the Last Mile

Even in these early implementation stages, UVL's experience offers insights into the benefits of Ozone:

• Ozone's "off-the-shelf, instant HIS" approach significantly simplified the deployment of OpenMRS 3, making digital health accessible even to facilities with minimal technical resources.
• The modular ecosystem of apps allowed UVL to implement only what was immediately needed while having a clear path for future expansion.
• Open standards and FHIR-based interoperability positioned the hospital for future integration with national health information systems.

UVL's ongoing implementation demonstrates that with Ozone's "Instant HIS" approach, even small rural facilities can begin meaningful digital transformation, creating more equitable healthcare systems that truly serve all communities.

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