Hello Medplum team! Hope you're doing well - first off, thank you for the absolutely smashing job you've done with Medplum. I'm a doctor based in rural Pakistan (on the outskirts of a small city in Punjab), looking to use or develop a modern EHR for my small recently developed clinic. (I supervise a total of 4 doctors that rotate and sit at my clinic.) Medplum caught my eye early on - however, I only really have experience in graphic design and front end web design with SSG's such as Eleventy and CSS (aka Tailwind.) It's been a frustrating two weeks trying to develop an app based on Medplum or adapt one of the examples. To that end, I had a few questions. The only other option here is OpenEMR, which while fantastic has quite a bit of bloat and complexity - our receptionist wasn't able navigate and operate the OpenEMR system properly. So, here goes : 1) Would Medplum be feasible in an area with frequent connectivity issues? We do have a uninterrupted power backup and a small onsite baremetal server (dual core, 8gb ram) that we were hoping to host the backend on - in addition, we do have a dedicated 25mbps Ethernet line but it's prone to frequent disconnections and slow downs, especially in the evening. 2) Would a Medplum based system be feasible in Pakistan? Medplum (like most modern EHR's) seems to be mostly designed to cater to the US Healthcare sector - case in point, I wasn't able to add my country's own states in the patient-onboarding form in examples/medplum-provider. There's a lot of extraneous systems related to insurance and Social Security Numbers/demographics that are simply aren't at play here, and I'm worried if the Medplum system would work with those removed. 3) Is it possible to integrate a dispensary module with a patient module? The extent of the EHR for my clinic is probably just going to be patient onboarding from providers, patient records so we can provide continuity of care to the rural community, dispensary recording, management and prescription, and billing in the form of physical printed receipts (all in all a team of 3 will likely operate the system - the admin (me), a receptionist and a pharmacist.) There's a lot more questions I have, but for now, I thought I might as well enquire about the feasibility. Unfortunately, due to economies of scale, we can't afford a Medplum pro subscription or Enterprise solutions - Patients in a rural area such as mine often pay in cash and the typical appointment is only around $3 maximum, of which the clinic earns perhaps a third, and our daily inflow averages 10-15 patients thus far. (and increasing, albeit slowly! ) Thank you, best regards, and keep on rocking. -Swassie

Hi. If you’re mostly interested in forms and basic EHR you should be able to use it. You can add new valuesets with the specific codes from your country, importing those is fairly straightforward. I haven’t looked into Pakistan but I’m interested in solutions for colombia and Mexico For infrequent internet it would need additional coding on the front end. There are modern browser APIs for offline access where you basically save some actions in the browser memory and when it goes online again it resolves the transactions

Hey @Swassie , were you able to get started with this? I am happy to answer some more of these questions on a quick call if that would be easier