Technical Journal

Building in Public

Dated entries from the MMDM OpenEMR project — from the initial Linux migration through the Costa Rica field trial and toward Laredo. Filter by topic or read in order.

Slide deck open on a laptop showing the MMDM EMR project overview
Lessons

Leadership Briefing: Making the Case for a Digital-First Mission

The June 4 leadership meeting is the first formal ask to the board: approval, introductions, and endorsement of the HIPAA-aligned hybrid model. What is being presented and why it matters.

Chart showing post-mission survey response breakdown by station
LessonsForms

Post-Mission Survey Analysis: Volunteer Feedback Drives the Redesign

38 surveys sent, 14 responses. What station leads said about the forms, the workflow, and what to keep versus change before Laredo.

Volunteers collaborating at a laptop during the mission evening session
Recruiting

Building the Tech Ops Team: Recruiting for a Volunteer Mission

One person cannot sustain a mission tech operation indefinitely. Here is the role model, the recruiting approach, and why a skill-based questionnaire beats a resume call.

In discussion with MMDM president Roberto Orlandi on solutions to the initial patient bug.
FeaturedField DeploymentLessons

On-Mission Reset: Rebuild Beats Patch

When the patient-creation flow broke live in the field, the call was to reset OpenEMR in place rather than run an insecure fallback. What that decision looked like under pressure.

Andrew testing tablet connectivity outside the clinic building in Grano de Oro, Costa Rica, with patients in the background
Field Deployment

Costa Rica Field Trial: What the Network Taught Us

39 missionaries. 13 local translators. 11 stations. 1,121 patients in a single week — a record for MMDM's 10th anniversary Costa Rica mission. What the first full field trial looked like on the ground.

Side-by-side comparison of paper registration form and digital OpenEMR equivalent
Forms

Form Design as Clinical Workflow: Building Station-Specific LBFs

Paper forms are the canonical spec. Every deviation from them requires a station lead to justify it. Here is how that discipline shaped six custom forms across five clinical stations.

Diagram showing private CA trust chain on a local area network
SecurityInfrastructure

Building an Offline PKI: Private CA and HTTPS Without the Cloud

A clinic LAN with no internet access still needs encrypted transport. Here is how a private certificate authority provides real TLS trust across every station device without touching a public CA.

Terminal window showing Ubuntu server setup commands
Infrastructure

From XAMPP to Ubuntu: Migrating a Corrupted EMR to Linux

MariaDB system tables corrupted on the Windows host. The SQL dump was intact. The decision to stop repairing and start over turned a crisis into a clean foundation.

Andrew at a table surrounded by TP-Link networking gear and Lenovo tablets, running first configuration tests
InfrastructureField Deployment

The Hardware Arrives: TP-Link, Lenovo, and the First Real Test

The Bill of Materials was approved. The boxes arrived. The first time all the hardware was in one place and connected — a TP-Link Omada network talking to a Windows XAMPP setup that would soon be replaced.

Video call with Valeo Networks team discussing infrastructure options
InfrastructureLessons

Build vs. Buy: How We Saved $6,000 and Gained Full Ownership

A Microsoft subsidiary quoted $6,000 to configure our cloud and network infrastructure. We politely declined — and built it ourselves.

Video call with Microsoft representative discussing nonprofit cloud resources
Infrastructure

Nonprofit Infrastructure Foundations: Starting with Microsoft

Before any server was configured, the project started with a question: what resources does a 501(c)(3) have access to, and how do we use them?