Paper to Field-Ready EMR

Medical Missionaries of Divine Mercy (MMDM) operated free clinics in Costa Rica and Laredo using only paper forms. Records were restricted to a single physical copy, and thermal autorefractor printouts routinely faded within months.

MMDM's 501(c)(3) status confirmed. First meeting with a Microsoft representative to assess how nonprofit licensing and cloud resources could support the mission's digital infrastructure.

A Microsoft subsidiary offered to configure cloud and networking infrastructure for $6,000. After reviewing scope with the MMDM president — a former Microsoft employee — the decision was made to build it in-house. Full cloud infrastructure stood up independently.

Secured a Microsoft nonprofit grant providing free access to the Azure portal and Copilot. Transitioned the organization away from passing USB drives by provisioning @mmdm.org Outlook and SharePoint accounts, establishing MMDM's first centralized cloud infrastructure.

Hardware specification presented to MMDM leadership. TP-Link Omada network gear, Lenovo tablets, and supporting equipment approved for procurement.

Full hardware order arrives: 8-port PoE+ switch, Gigabit VPN gateway, Wi-Fi 6 AX3000 access points (indoor and outdoor), Lenovo IdeaTabs for each station. First configuration and connectivity tests run against the existing Windows/XAMPP setup.

Consulted with Dr. Byrd, Head of Pediatrics and a veteran of 32 MMDM missions over 20 years. Outlined the clinical and operational requirements for integrating a pharmacy formulary into the OpenEMR deployment.

MariaDB system tables corrupt on the original Windows host. The SQL dump is intact. Decision: stop repairing, migrate to Ubuntu 22.04 LTS on a hardened VM. Clean import; fresh baseline established.

A private certificate authority provides LAN-only TLS without a public CA. Per-device trust installed once before each mission. All clinic traffic encrypted from day one.

Patient-creation flow breaks mid-clinic. Fallback build lacks required security updates. Decision: full OpenEMR reset in place during the mission. Rebuilt, confirmed working, no patient records lost.

First deployment: paper-primary with evening EMR entry across eleven stations. 39 missionaries and 13 local translators served a record 1,121 patients — including 151 during a one-day outreach to Bloriñak. Connectivity held at every fixed station. Network gaps in outdoor corridors and a switch capacity limit identified and logged. MMDM's 10th anniversary mission.

Volunteer survey drives form refinements. Recruiting program launches. Leadership deck and speaker script prepared for June 4 board meeting.

Board approval request, dental form authority introductions, HIPAA-aligned hybrid model endorsement, and recruiting-plan support on the agenda.

OpenEMR and the board-endorsed Power Apps direction both scrapped in favor of a purpose-built Node.js and SQLite system, designed offline-first for mission conditions rather than adapted to them.

Dr. Byrd answered the Medical station's open questions on June 10, shaping the form's skeleton build. On June 25 he reviewed that build and specified what else needs to be added, ahead of the June 30 board demo.

Custom system demoed live across all five stations. Proposal: a clinic.mmdm.org review subdomain so leadership can track the build remotely.

clinic.mmdm.org comes online via Render — auto-deploys from main, safety-interlocked against real patient data. Leads can now review forms remotely while development continues out-of-state.

Primary full deployment: HIPAA-aligned, US jurisdiction, pharmacist on-site with e-prescribing to local pharmacies. Catholic Charities intake handoff, cross-street network bridge, Laredo-specific form configuration.

Batangas, Philippines. First international deployment outside of the Western Hemisphere. Scope and form configuration for this mission are being determined.

Annual return to the Cabécar community in Grano de Oro. Full digital-primary deployment target if Laredo trial is successful.