OpenHIMS2 — Open Health Information Management System

A free, open-source Health Information Management System built with Laravel 10 and MySQL. Designed for multi-clinic hospital networks, it supports patient registration, clinical workflows (Doctor → Nurse → Pharmacist), drug prescriptions, pharmacy stock management, medical terminology autocomplete, and a fully dynamic clinical page builder.

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Table of Contents

1. Features
2. Requirements
3. Installation
4. First-Time Setup (Admin)
   • 1. Create Institutions
   • 2. Create Units
   • 3. Create Unit Views
   • 4. Create Users & Assign Views
   • 5. Manage Drugs & Defaults
   • 6. Manage Terminology
5. Daily Clinical Use
   • Clerk Workflow
   • Doctor Workflow
   • Nurse Workflow
   • Pharmacist Workflow
6. Advanced: Custom Unit Templates
7. Advanced: Custom View Templates & Clinical Pages
8. Advanced: Custom Terminology Boxes
9. Advanced: Using Terminology in Blade Views
10. Database Schema
11. License

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Features

• Multi-clinic, multi-institution hierarchy
• Role-based access: Admin and Clinical staff
• Patient registration with duplicate detection (NIC / mobile)
• Queue management per clinic per day
• Doctor visit notes: complaints, history, examination, investigations, drugs, allergies, BP readings
• Pharmacist stock management with low-stock alerts and expiry tracking
• Prescription dispensing with audit trail
• Dynamic Unit Templates — add custom clinic types from the admin UI (no code changes)
• Dynamic View Templates — add custom clinical views from the admin UI; blade file auto-scaffolded with full developer guide
• Dynamic Terminology Boxes — add custom terminology categories from the admin UI; slug immediately usable in clinical pages
• Medical terminology autocomplete (19 built-in + unlimited custom categories)
• Drug name master list with dose/frequency defaults
• Clinic confirmation letters and monthly reports
• Fully local frontend (Bootstrap 5 + Bootstrap Icons, no CDN dependency)

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Requirements

Component	Version
PHP	8.1+
Laravel	10.x
MySQL / MariaDB	10.4+
Node.js	16+ (for npm install only)
Composer	2.x

Recommended: XAMPP (Apache + MySQL + PHP bundled).

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Installation

Option A — Fresh Laravel Install (Recommended)

# 1. Clone the repository
git clone https://github.com/your-org/openhims2.git
cd openhims2

# 2. Install PHP dependencies
composer install

# 3. Install frontend dependencies (Bootstrap + Icons)
npm install bootstrap bootstrap-icons

# 4. Copy Bootstrap to public/vendor/ (no Vite build needed)
php artisan app:publish-assets

# 5. Create your environment file
cp .env.example .env
php artisan key:generate

# 6. Configure your database in .env
#    DB_DATABASE=phims
#    DB_USERNAME=root
#    DB_PASSWORD=

# 7. Run migrations and seed default data
php artisan migrate:fresh --seed

# 8. Start the development server
php artisan serve
# → http://127.0.0.1:8000

Option B — Using XAMPP (Windows)

# Place project in H:\xampp\htdocs\openhims2
# Access via: http://localhost/openhims2/public

# In .env set:
# DB_HOST=127.0.0.1
# DB_DATABASE=phims
# DB_USERNAME=root
# DB_PASSWORD=

composer install
npm install bootstrap bootstrap-icons
php artisan app:publish-assets
php artisan migrate:fresh --seed

Option C — Import from database.sql

The database.sql file in this repository contains the full schema, system seed data, and demo data.

# 1. Create database
mysql -u root -p -e "CREATE DATABASE phims CHARACTER SET utf8mb4 COLLATE utf8mb4_unicode_ci;"

# 2. Import schema + seed data
mysql -u root -p phims < database.sql

# 3. Create the admin user
php artisan db:seed --class=AdminSeeder

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First-Time Setup (Admin)

After installation, log in at / with:

Email:    admin@phims.lk
Password: password

Change this password immediately via Admin → Profile.

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1. Create Institutions

Admin → Institution Hierarchy

Institutions represent your physical locations. They support a parent-child hierarchy:

National Department of Health       ← top-level institution
  └─ Northern Regional Authority    ← child
       └─ St. George's Hospital     ← leaf (where units live)

Fields:

• Name — full institution name

• Code — short identifier (e.g., GMC-AKR)

• Parent Institution — leave blank for top-level

• Email, phone, address (optional)

  

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2. Create Units

Admin → Unit Management

A Unit is a physical clinic room/ward within an institution. Each unit is typed by a Unit Template (e.g., GMC, DC, GP).

Fields:

• Unit Name — e.g., City General Clinic
• Unit Number — optional identifier
• Institution — which institution this unit belongs to
• Unit Template — the clinic type

Unit Template	Code	Typical use
General Medical Clinic	GMC	OPD / clinic consultations
Dental Clinic	DC	Dental consultations
General Inward	GI	Ward/inpatient
General Pharmacy	GP	Pharmacy dispensing
Office	OFFICE	Admin / staff

Custom unit templates (created via Admin → Unit Templates) also appear here.

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3. Create Unit Views

Admin → View Management

A Unit View is an instance of a role-view at a specific unit.

Steps:

1. Select the Unit
2. Select the View Template (role-based view for that unit type)
3. Give it a name (e.g., City General Clinic — Doctor)
4. Save

Available built-in View Templates per Unit Template:

Unit Template	Available View Templates
GMC	Doctor View, Clerk View, Nurse View
DC	Doctor View, Clerk View, Nurse View
GI	Doctor View, Clerk View, Nurse View
GP	Doctor View, Pharmacist View, Clerk View
OFFICE	Doctor View, Nurse View, Clerk View

Custom view templates (created via Admin → View Templates) also appear here.

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4. Create Users & Assign Views

Admin → User Management

Fields:

• Name, Email, Password — login credentials
• Role — admin (full admin access) or user (clinical access)
• Institution — the user's home institution
• Units — which physical units this user can access
• Views — which Unit Views this user can see (determines the clinical pages shown at login)

Important: A clinical user must have at least one View assigned to log in.

Login behavior:

• 1 view → lands directly on that view's clinical page
• Multiple views → presented with a selection screen
• Admin role → always goes to /admin/dashboard

The form is AJAX-driven: selecting an Institution auto-loads its Units; selecting Units auto-loads available Views.

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5. Manage Drugs & Defaults

Admin → Drug Management

Adding Drug Names

Click Add Drug and type the drug name (e.g., Metformin 500mg).

Setting Drug Defaults

Click Set Default to pre-fill prescribing defaults:

Field	Options
Type	Oral, S/C, IM, IV, S/L, Syrup, MDI, DPI, Suppository, LA
Dose	Numeric value
Unit	mg, g, mcg, ml, tabs, item
Frequency	mane, nocte, bd, tds, daily, EOD, SOS
Duration	Number of days

When a doctor searches for this drug, these defaults auto-fill the prescription form.

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6. Manage Terminology

Admin → Terminology

Terminology terms provide autocomplete suggestions in clinical forms. Terms are grouped into boxes (categories).

Built-in boxes (19 system boxes, protected)

Slug	Display Name
presenting_complaints	Presenting Complaints
complaint_durations	Complaint Durations
past_medical_history	Past Medical History
past_surgical_history	Past Surgical History
social_history	Social History
menstrual_history	Menstrual History
investigations	Investigations
general_looking	General Looking
cardiology_findings	Cardiology Examination Findings
respiratory_findings	Respiratory Examination Findings
abdominal_findings	Abdominal Examination Findings
neurological_findings	Neurological Examination
dermatological_findings	Dermatological Findings
differential_diagnosis	Differential Diagnosis
working_diagnosis	Working Diagnosis
diabetes_instructions	Diabetes Instructions
hypertension_instructions	Hypertension Instructions
dyslipidemia_instructions	Dyslipidemia Instructions
general_instructions	General Instructions

Adding terms

Type in the "Add new term…" box within any category card and click Save. Terms appear instantly via AJAX.

Adding custom terminology boxes

Click Add Custom Box (top-right) → enter a name (slug is auto-generated) → Create Box. Your new box appears immediately with its slug displayed. See Advanced: Custom Terminology Boxes for how to wire it into a clinical page.

Implementation Guide

Click Implementation Guide (top-right) for ready-to-copy code snippets showing how to embed any terminology box in a clinical blade file.

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Daily Clinical Use

Clerk Workflow

1. Register a new patient: Click Register Patient → fill in Name, DOB/Age, Gender, NIC, Mobile, Address → Save.

2. Add patient to queue: Click Add to Queue → select visit category:

   • OPD — general outpatient (OPD number, height, weight, BP)
   • New Clinic Visit — first attendance (clinic number assigned)
   • Recurrent Clinic Visit — follow-up
   • Urgent — priority case

3. Monitor queue: All patients waiting, in-progress, and visited today.

4. Reset queue: At end of day to start fresh the next morning.

   

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Doctor Workflow

1. Select a patient from queue → opens the visit form.

2. Presenting Complaints — with durations, using terminology autocomplete.

3. History — past medical, surgical, social, menstrual — all with autocomplete.

4. Examination — general, cardiovascular, respiratory, abdominal, neurological, dermatological.

5. Investigations — name + result (e.g., FBS: 6.2 mmol/L).

6. Blood Pressure — one or more readings.

7. Allergies — persists across all visits.

8. Diagnoses — differential and working diagnosis.

9. Drugs — search → defaults auto-fill → adjust if needed. Full audit log of changes.

10. Management Instructions — free-text plus instruction bundles.

11. End Visit — marks patient visited; moves to pharmacist queue.

    

    

    

    

    

    

    

    

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Nurse Workflow

Read-access summary view. Nurses can:

• View the patient list for the day
• Open patient history (all past visits)
• View visit summaries (notes, drugs, BP, investigations)

The nurse view does not modify clinical data.

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Pharmacist Workflow

Dispensing

1. Queue shows patients with visited status
2. Click patient → view full prescription
3. For each drug: click Dispense → select stock item → enter quantity
4. Mark visit as Dispensed when complete

Stock Management

• Add Stock: drug name, initial quantity, expiry date, low-stock threshold

• Restock: add quantity to existing stock (logged)

• Mark Out of Stock: toggle manually

• Alerts panel: drugs expiring ≤30 days, below threshold, or out of stock

  

  

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Advanced: Custom Unit Templates

Unit Templates define clinic types. The 5 built-in templates (GMC, DC, GI, GP, OFFICE) are system-protected and cannot be deleted. You can add your own.

Via Admin UI (recommended)

1. Go to Admin → Unit Templates
2. Click Add Unit Template
3. Enter a name (e.g., Rehabilitation Hub) and a code (e.g., RH) — the code is auto-uppercased
4. Save

The new template appears immediately in Unit Management when creating units.

Via Seeder (for deployments / fresh install)

Add to database/seeders/UnitTemplateSeeder.php:

UnitTemplate::firstOrCreate(['code' => 'RH'], [
    'name'      => 'Rehabilitation Hub',
    'code'      => 'RH',
    'is_system' => true,   // set true if you want it protected from UI deletion
]);

php artisan db:seed --class=UnitTemplateSeeder

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Advanced: Custom View Templates & Clinical Pages

View Templates define role-based views for a Unit Template. Each template has a blade_path that points to a Blade file.

Via Admin UI (recommended)

1. Go to Admin → View Templates
2. Click Add View Template (or the + Add View button on a specific unit template row)
3. Fill in:
   • Unit Template — which clinic type this view belongs to
   • View Template Name — e.g., RH - Physio View
   • Code — auto-generated slug (e.g., rh-physio)
   • Blade Path — dot-notation path (e.g., clinical.rh.physio) — auto-suggested from the name
4. Save

What happens automatically:

• The view template record is created in the database
• The blade file is created at resources/views/clinical/rh/physio.blade.php
• The blade file contains a full Developer Starter Guide (tabbed UI with 6 sections — see below)

After creating the view template:

• Go to Admin → View Management and create a Unit View linking a unit to the new template
• Assign the Unit View to a user
• The user can now log in and reach the new clinical page

Via Seeder (for deployments)

$rhTemplate = UnitTemplate::where('code', 'RH')->first();

ViewTemplate::firstOrCreate(['code' => 'rh-physio'], [
    'name'             => 'RH - Physio View',
    'code'             => 'rh-physio',
    'blade_path'       => 'clinical.rh.physio',
    'unit_template_id' => $rhTemplate->id,
    'is_system'        => false,
]);

The Developer Starter Guide

When a clinical user visits a newly-created view, they see a Developer Starter Guide — a full-page tabbed interface embedded in the blade file itself. The guide includes:

Tab	Contents
Getting Started	4-step instructions, live context values, working live examples
Starter Template	Copy-paste ready blank clinical page with syntax highlighting
Components	Snippets for alerts, cards, tables, forms, modals — with live preview
Search Boxes	Live terminology and drug autocomplete demos with copyable code
Variables	All PHP variables available in the view, with live rendered values
Backend	How to add routes and a controller for this page

All code blocks have copy-to-clipboard buttons.

To replace the guide with a real page, open the blade file in your editor and replace its content. The file path is shown prominently in the guide banner.

Variables available in every clinical view

ClinicalDashboardController::show() injects these into every view:

$unitView       // UnitView model — the specific view instance the user selected
$unit           // Unit model — has ->name, ->institution, ->unitTemplate
$viewTemplate   // ViewTemplate model — has ->name, ->code, ->blade_path
$pageTitle      // String: "View Name — Unit Name"
auth()->user()  // The currently authenticated User model

Minimal blade file skeleton

@extends('layouts.clinical')
@section('title', $pageTitle)

@push('styles')
<style>
    /* page-specific CSS */
</style>
@endpush

@section('content')

<div class="mb-4 d-flex align-items-start justify-content-between">
    <div>
        <h4 class="fw-bold mb-1">{{ $pageTitle }}</h4>
        <p class="text-muted small mb-0">
            {{ $unit->name }} &middot; {{ $unit->institution->name ?? '' }}
        </p>
    </div>
</div>

<div class="card border-0 shadow-sm">
    <div class="card-body p-4">
        <!-- your clinical content -->
    </div>
</div>

@endsection

@push('scripts')
<script>
    // page-specific JS
    const CSRF = document.querySelector('meta[name="csrf-token"]').content;
</script>
@endpush

Adding backend routes for a clinical page

Place new routes before the /{unitView} catch-all at the bottom of the clinical group in routes/web.php:

use App\Http\Controllers\Clinical\MyPageController;

Route::get('/{unitView}/my-page',  [MyPageController::class, 'index'])->name('clinical.my-page');
Route::post('/{unitView}/my-page', [MyPageController::class, 'store'])->name('clinical.my-page.store');

php artisan make:controller Clinical/MyPageController

Controller boilerplate:

namespace App\Http\Controllers\Clinical;

use App\Http\Controllers\Controller;
use App\Models\UnitView;
use Illuminate\Http\Request;

class MyPageController extends Controller
{
    public function index(UnitView $unitView)
    {
        $unit         = $unitView->unit->load('institution', 'unitTemplate');
        $viewTemplate = $unitView->viewTemplate;
        $pageTitle    = $viewTemplate->name . ' — ' . $unit->name;
        $items        = MyModel::where('unit_id', $unit->id)->latest()->get();

        return view('clinical.my.page', compact('unitView', 'unit', 'viewTemplate', 'pageTitle', 'items'));
    }

    public function store(Request $request, UnitView $unitView)
    {
        $data = $request->validate(['notes' => 'required|string']);
        MyModel::create($data + ['unit_id' => $unitView->unit_id]);
        return back()->with('success', 'Saved.');
    }
}

---

Advanced: Custom Terminology Boxes

Terminology boxes are named categories of terms. You can add unlimited custom boxes alongside the 19 built-in system boxes.

Via Admin UI (recommended)

1. Go to Admin → Terminology
2. Click Add Custom Box (top-right)
3. Enter:
   • Box Name — displayed as the section heading (e.g., Orthopaedic Findings)
   • Slug — auto-generated from the name (e.g., orthopaedic_findings); this is the value you use as data-category in HTML
   • Description — optional note about what the box is for
4. Save

The new box appears at the bottom of the terminology management page. Add terms to it immediately.

Deleting a custom box

A custom box can only be deleted when it has no terms. Delete all terms first, then use the trash icon in the box header.

System boxes (the original 19) are protected and cannot be deleted.

Using the slug in a clinical page

Once you have a custom box with slug orthopaedic_findings, add this HTML to any clinical blade file:

<input type="text"
       class="form-control terminology-search"
       data-category="orthopaedic_findings"
       name="ortho_findings"
       placeholder="Type a finding...">

The autocomplete is wired up automatically — no JavaScript needed.

The Implementation Guide button at the top-right of the Terminology Management page shows all slugs with copy buttons and ready-to-paste code examples.

Via Seeder (for deployments)

use App\Models\TerminologyCategory;
use App\Models\TerminologyTerm;

TerminologyCategory::firstOrCreate(['slug' => 'orthopaedic_findings'], [
    'name'        => 'Orthopaedic Findings',
    'slug'        => 'orthopaedic_findings',
    'description' => 'Musculoskeletal examination findings',
    'is_system'   => false,
    'sort_order'  => 100,
]);

$terms = ['Normal range of motion', 'Limited flexion', 'Joint effusion', 'Crepitus'];
foreach ($terms as $term) {
    TerminologyTerm::firstOrCreate([
        'category' => 'orthopaedic_findings',
        'term'     => $term,
    ]);
}

---

Advanced: Using Terminology in Blade Views

Simple autocomplete input

<!-- Search across all terms in a category -->
<input type="text"
       class="form-control terminology-search"
       data-category="presenting_complaints"
       name="complaint"
       placeholder="Start typing...">

The terminology-search class is wired globally by the clinical layout. Multiple inputs on the same page all work independently.

AJAX call from JavaScript

fetch(`/terminology/search?category=presenting_complaints&q=${encodeURIComponent(query)}`)
    .then(r => r.json())
    .then(terms => {
        // terms = ["Headache", "Chest pain", "Fever", ...]
    });

Search endpoint reference

GET /terminology/search?category={slug}&q={query}

Auth:     Any authenticated user (admin or clinical)
Params:   category — required, must be a valid slug
          q        — optional search string (partial match)
Response: JSON array of strings e.g. ["Headache", "Chest pain"]

Tag-input pattern (multiple selections)

This is the pattern used in the GMC Doctor view for multi-select terminology fields:

<div class="position-relative">
    <input type="text"
           class="form-control terminology-ac"
           data-category="presenting_complaints"
           placeholder="Type to search..."
           autocomplete="off">
    <ul class="list-group position-absolute w-100 shadow-sm"
        id="complaints-suggestions"
        style="display:none; max-height:200px; overflow-y:auto; z-index:10;"></ul>
</div>
<div id="complaints-tags" class="d-flex flex-wrap gap-1 mt-2"></div>
<input type="hidden" name="presenting_complaints" id="complaints-hidden" value="[]">

document.querySelectorAll('.terminology-ac').forEach(input => {
    const category    = input.dataset.category;
    const suggestBox  = document.getElementById(category + '-suggestions');
    const tagsBox     = document.getElementById(category + '-tags');
    const hiddenField = document.getElementById(category + '-hidden');
    let selected      = JSON.parse(hiddenField.value || '[]');

    function renderTags() {
        tagsBox.innerHTML = selected.map((t, i) =>
            `<span class="badge bg-primary d-flex align-items-center gap-1">
                ${t}
                <button type="button" class="btn-close btn-close-white btn-sm"
                        data-index="${i}" style="font-size:.6rem;"></button>
            </span>`
        ).join('');
        hiddenField.value = JSON.stringify(selected);
        tagsBox.querySelectorAll('.btn-close').forEach(btn => {
            btn.addEventListener('click', () => {
                selected.splice(parseInt(btn.dataset.index), 1);
                renderTags();
            });
        });
    }

    let timer;
    input.addEventListener('input', function () {
        clearTimeout(timer);
        const q = this.value.trim();
        if (!q) { suggestBox.style.display = 'none'; return; }

        timer = setTimeout(() => {
            fetch(`/terminology/search?category=${category}&q=${encodeURIComponent(q)}`)
                .then(r => r.json())
                .then(terms => {
                    suggestBox.innerHTML = terms
                        .filter(t => !selected.includes(t))
                        .map(t => `<li class="list-group-item list-group-item-action py-1 px-2"
                                       style="cursor:pointer">${t}</li>`)
                        .join('') || '<li class="list-group-item py-1 px-2 text-muted">No results</li>';
                    suggestBox.style.display = 'block';
                    suggestBox.querySelectorAll('li:not(.text-muted)').forEach(li => {
                        li.addEventListener('click', () => {
                            selected.push(li.textContent.trim());
                            renderTags();
                            input.value = '';
                            suggestBox.style.display = 'none';
                        });
                    });
                });
        }, 200);
    });

    document.addEventListener('click', e => {
        if (!input.contains(e.target) && !suggestBox.contains(e.target))
            suggestBox.style.display = 'none';
    });

    renderTags();
});

Saving multi-select terminology in a controller

The hidden input submits a JSON string. Cast the field to array in the model:

// app/Models/VisitNote.php
protected $casts = [
    'presenting_complaints' => 'array',
    // add your custom field here:
    'orthopaedic_findings'  => 'array',
];

// In your controller store() / update():
$visit->note()->updateOrCreate(
    ['visit_id' => $visit->id],
    ['orthopaedic_findings' => $request->input('orthopaedic_findings', [])]
);

{{-- Reading in blade --}}
@foreach($visit->note->orthopaedic_findings ?? [] as $finding)
    <span class="badge bg-light text-dark border">{{ $finding }}</span>
@endforeach

Adding a new JSON column to visit_notes

php artisan make:migration add_orthopaedic_findings_to_visit_notes_table

// In the migration up():
$table->json('orthopaedic_findings')->nullable()->after('dermatological_findings');

php artisan migrate

Then add 'orthopaedic_findings' to $fillable and $casts in app/Models/VisitNote.php.

---

Database Schema

The file database.sql contains the complete schema, system seed data (unit/view/terminology templates), and demo patient data.

Quick import

mysql -u root -p -e "CREATE DATABASE phims CHARACTER SET utf8mb4 COLLATE utf8mb4_unicode_ci;"
mysql -u root -p phims < database.sql
php artisan db:seed --class=AdminSeeder

Core table relationships

institutions (id, name, parent_id, code, email, phone, address)
    └── units (id, name, unit_number, institution_id, unit_template_id)
            └── unit_views (id, name, unit_id, view_template_id)
                    └── [pivot] user_views (user_id, unit_view_id)

unit_templates (id, name, code, is_system)
    └── view_templates (id, name, code, blade_path, unit_template_id, is_system)

users (id, name, email, role, institution_id, ...)
    ├── [pivot] user_units (user_id, unit_id)
    └── [pivot] user_views (user_id, unit_view_id)

terminology_categories (id, name, slug, description, is_system, sort_order)
    └── terminology_terms (id, category [→slug], term)

patients (id, name, dob, nic, mobile, phn, address)
    ├── patient_allergies (id, patient_id, allergen)
    └── clinic_visits (id, patient_id, unit_id, visit_date, category, status, ...)
            ├── visit_notes (id, visit_id, presenting_complaints JSON, ...)
            ├── blood_pressure_readings (id, visit_id, systolic, diastolic)
            ├── investigations (id, visit_id, name, value)
            ├── visit_drugs (id, visit_id, type, name, dose, frequency, duration)
            │       └── prescription_dispensings (id, visit_drug_id, stock_id, qty)
            └── visit_drug_changes (id, visit_id, action, old_values, new_values)

drug_names (id, name)
    └── drug_name_defaults (id, drug_name_id, type, dose, unit, frequency, duration)

pharmacy_stock (id, unit_view_id, drug_name, remaining, expiry_date, threshold)
    └── pharmacy_restock_logs (id, stock_id, action, amount, performed_by)

is_system flag

unit_templates, view_templates, and terminology_categories all have an is_system boolean column.

is_system	Meaning
true	Seeded by the system; protected from deletion in the admin UI
false	Created via the admin UI; can be deleted when no longer in use

Visit categories

Value	Description
opd	General OPD visit
new_clinic_visit	First clinic attendance
recurrent_clinic_visit	Follow-up clinic visit
urgent	Urgent / priority case

Visit statuses

Value	Meaning
waiting	In queue, not yet seen
in_progress	Currently with doctor
visited	Doctor done, awaiting pharmacy
dispensed	Pharmacy dispensed
cancelled	Removed from queue

---

License

OpenHIMS2 is open-source software licensed under the MIT License.

---

Contributing

Pull requests are welcome. For major changes, please open an issue first to discuss what you would like to change.

When contributing a new clinical view template:

1. Use Admin → View Templates to create it (blade file is auto-scaffolded)
2. Replace the developer guide content in the blade file with your clinical page
3. Optionally add it to ViewTemplateSeeder.php for reproducible deployments
4. Update this README with the new template details