BMTPlus - Information Management Solution for Bone Marrow Transplant

BMTPlus is the first dedicated software platform for complete management of Hematopoietic Stem Cell Transplantation. It is particularly designed for both start up and established transplant centers participating in network collaborations and willing to implement quality assurance programs according to FACT/JACIE standards.
BMTPlus enables comprehensive data recording, analyzing and reporting for all stages of BMT including enrolment, preparation and follow-up. While providing a in-house Eletronic Medical Record (EMR) system specifically designed for BMT patients, it facilitates data reporting to international transplant organizations such as the Center for International Blood and Marrow Transplant Research (CIBMTR) or the European Group for Blood and Marrow Transplantation (EBMT).
BMTPlus provides professional development tools, core competency assessments and monitoring as well as medical error management.
Drugs and consumable supplies inventory, equipment maintenance management as well as patient-specific and general BMT cost tracking are provided through a single interface.
BMTPlus has been developed in collaboration with the Cure2Children Foundation, a non-profit organization promoting global access to cure for children with cancer and blood disorders.

Problem Statement

The legacy system existed as a simple database system which allowed for recording of patient related data and simple display. The idea was to initially migrate the application data into a CMS based system that would make basic features related to data entry, notifications, centre specific visibility seamless. The focus was also speed as migration from a simple database to advanced CMS system could lead to site being slow.


We proposed Drupal due to its robustness and its ability to extend using modules. Migration API helped us a great deal in ensuring successful migration. We worked on several caching mechanisms, finally zeroing on APC caching as it was a simple installation and configuration and provided great speed benefit. We started plugging in various features once the normal operation of work became seamless. Features like Document Management, Inventory, Quality Assurance System, Incidence Management, Outcome Analysis, Competence Management, Support desk, Event Management, Todos, Forum were added in iterations to make the system truly comprehensive. 

As of February 2014, over 2400 patients have been registered and 112 BMTs have been performed with outcomes comparable to international standards, but at a fraction of the cost. The tool contributes to local healthcare strengthening and competitiveness thereby minimizing medical emigration. 

Scientific Papers and Presentations


Clinical Management:

  • Enrolment : Enables capturing enrolment data, general medical evaluation, disease-specific summary, notes, socio-economic profile etc.
  • Selection: Tracks the process of identifying and screening potential donors.
  • Preparation: Enables and tracks the process of scheduling, conditioning and preparing patient for transplant.
  • Transplant: Daily clinical forms allow monitoring through pre and post-transplant phases including vital signs, lab reports, transfusions, medications, complications, nursing notes, as well as, consultant's notes. 

Outcome Analysis

A clinical form with tabular display of essential daily parameters (weight, maximal temperature, blood counts, liver and renal function tests) to be monitored during the critical phase of BMT enabled at-a-glance clinical assessment. The system also offers charts plotting height and weight z-scores based on 'The WHO Child Growth Standards', which is very relevant for both pre-transplant and follow up assessments. Enables consultants and other professionals, including multidisciplinary experts who may not be available locally, from various collaborating centers to share knowledge and provide general as well as patient-specific advice.

Notifications and Alerts

  • Generates statuses related to relevant parameters such as lack of critical pre-BMT tests, requirement for an evaluation within a defined time from BMT or relevant alerts, e.g. allergies, hepatitis or HIV positivity.
  • The system warns of any critical enrolment data missing, tracks BMT preparation status, monitors post-transplant critical parameters and highlights any abnormalities including missed labs.
  • Follow-up height and weight according to standard growth curves is monitored.
  • Each time there is a change the concerned individuals are immediately notified by email.
  • Periodic emails are sent to the concerned individuals indicating the status of the patient on all parameters that need attention.

Quality Management

  • The tool enables development, implementation and assessment of quality system in accordance with FACT-JACIE. It systematically highlights the areas where progress is being made and opportunities for improvement.
  • Enables status tracking of the organisation on the compliance to each standard listed in the accreditation checklist
  • Automatic triggers for standards that need to be re-evaluated
  • Enables distribution of responsibility and accountability for maintaining a quality assurance scheme.
  • Provides both high and low level view of areas that need attention on a real time basis.


  • Records personnel’s name and employment related information
  • Job descriptions for all personnel including their responsibilities, authorities, and position requirements (e.g. degrees, skills, experience, training) - periodic review of same.
  • Periodic competency evaluation target critical job functions
  • Mechanism to document and to provide opportunities for continuing education related to job position

Inventory and Costs

  • Tracking, monitoring and storage of materials and reagents
  • Automatic alerts when stocks reach configurable reorder level
  • Enables tracking and prevention of expiry
  • Provides insight into patient wise, vendor wise, date wise and item-wise costs
  • Provides option to maintain multiple store locations
  • Supplier details, agreement and service history.
  • Invoice generation

Private, Confidential and Reliable

  • The electronic records offer accuracy, integrity, identity, and confidentiality.
  • Fast retrieval and review of critical information for emergency intervention.
  • Limited access to only authorised program personnel based upon user and role specific permissions.
  • Multi level back-up and option to restore old records. (Backup at remote servers included)
  • Enables change tracking and records identity of users making changes
  • In-built support desk and in-line system documentation
  • Designed for minimise faults by using submission validation, preview etc.


  • The platform can operate in a stand-alone or a multi center mode.
  • Multi-center mode allows for usage of common protocols, procedures, quality management systems, and review of clinical results and regular interaction.
  • Allows for involvement of remote professionals for consultation and monitoring.

Why Drupal?

Migration from a simpler database system to a comprehensive system was the idea. However we were not sure on how the system would ultimately shape as. Migrate API provided a seamless method for data migration. We were not sure on the iteration of changes required for building a truly comprehensive solution. We chose Drupal because it allowed faster prototyping through Content Type, Entities and Views. Additional features and scaling could be easily managed via contributed modules.

Key Modules

Organic Groups
Field Collection
Custom Formatters
Entity Reference
Messaging and Notifications
Menu Icons
Menu Badges
Node Clone
Entity Cache
Computed Field
Apache Solr Search

Why these modules/theme/distribution were chosen

Migrate: Migration of the legacy system into Drupal.
Organic Groups: The system originally was created for one centre only. When integration with other centres was required, Organic Groups made it a cakewalk. 
APC: Faster Caching mechanism. 
Rules: All custom operations that required handling for a specific event was managed using Rules. 
Custom Formatters: Heavily used. Formatting for age and numeric manipulations.
Support: Support Desk within site
Signup: Signup for events
Panels: Patient Page. Used for displaying all relevant patient related information on a single page.
Quicktabs: Arranging list of patient related reports in tabs and using ajax to load them upon request.
Highcharts: Interactive charts of high quality used for displaying WHO based Growth Charts, Hemoglobin trends and various others.
Print: Various printable form templates to be automatically generated.
Adaptive Theme: Themeing and subthemeing