‍Background: Not Just a Big Donor Technology

While Ozone is primarily a framework and ecosystem designed to scale digital health strategies for large donors, governments, and public health infrastructures, its versatility also makes it accessible to (much) smaller organizations. The Lake Clinic-Cambodia (TLC) is a prime example of how even small-scale operations can leverage Ozone effectively.

Challenge: Digitizing the Cambodian Last Mile with Modest USAID Funding

TLC operates in some of Cambodia’s most underserved and remote regions, providing healthcare to floating and rural communities of the lake Tonlé Sap with minimal infrastructure. The challenges of digitization were compounded by modest funding from USAID, requiring a cost-effective approach that should deliver value without overburdening the organization.

TLC needed to transition from paper-based processes to a scalable digital system while addressing the connectivity challenges of the lake Tonlé Sap. The solution also had to accommodate TLC’s unique mobile clinic workflows, meet the Ministry of Health’s HC1 reporting requirements, and lay the foundation for a system that could last—all under the constraints of limited financial and technical resources.

These challenges required careful prioritization, phased implementation, and innovative use of open-source tools.

Solution: From a Fragile USAID Pilot to a Resilient, Evolving Ozone HIS

TLC’s digitization journey began in mid-2017 with modest USAID funding, starting with a customized implementation of Bahmni. The focus was on Bahmni EMR and its offline app, Bahmni Connect, designed to address connectivity challenges in two villages where TLC conducts outreach. As 4G coverage expanded, Bahmni Connect was gradually phased out entirely.

This project achieved significant technological milestones with very limited funding thanks to exceptional technical execution, including the

• First Dockerized deployment of Bahmni and
• The modernization of OpenMRS’ configurability layer through the creation of the Initializer module.

Tailored configurations enabled TLC to meet the specific needs of its mobile clinics, while custom Bahmni Reports fulfilled Cambodia Ministry of Health’s HC1 reporting requirements.As the Ozone ecosystem matured, TLC’s system seamlessly transitioned into an Ozone distribution as part of its maintenance service plan. It retained an up-to-date Bahmni EMR as the EMR app and Ozone Analytics with Apache Superset for real-time reporting. This evolution demonstrated that, despite originating in late 2017, TLC’s system remained fully upgradable due to continuous maintenance and monitoring over the years.

‍Take-away: Exceptional Execution Drives Sustainable Success with Ozone

‍The success of TLC’s digital health journey underscores that, in rare cases, even with modest funding and significant constraints, it is possible to achieve impactful and sustainable results when the technical implementation is exceptional. The meticulous design, execution, and evolution of TLC’s system maximized every resource, ensuring the solution met immediate needs while remaining adaptable for future challenges.