MMDM OpenEMR — Offline-First Clinical Platform
Deployed 2026 · OngoingMedical Missionaries of Divine Mercy · Houston → Costa Rica · 2024–Present
Self-hosted EMR built to run a six-station volunteer clinic in a Costa Rican parish hall with no internet, no cloud, and no public DNS. Migrated off a corrupted XAMPP environment to a hardened Ubuntu / Apache / MariaDB / PHP stack with a private certificate authority, daily backups, and bilingual Spanish/English clinical forms. Deployed at the April 18–25, 2026 mission in Grano de Oro, Costa Rica; next field deployment 2027.
Clinical Stations
Patients in 40 hours
Users Trained
Operations Posture
Problem
Corrupted Windows XAMPP stack with Aria storage engine failure. Paper forms across six clinical stations. No backups, no encryption, no recovery path. Mission-critical with zero connectivity guarantee.
Solution
Clean rebuild on Ubuntu 22.04 + Apache + MariaDB 10.6 + PHP 8.1. Private CA for offline TLS. UFW-hardened LAN posture. Daily cron backups with 30-day rotation. VirtualBox snapshot recovery.
Impact
Replaced 20+ years of paper workflow with structured clinical data. HIPAA-aligned posture. Recoverable from hardware failure. Designed for volunteers to redeploy at any mission site without a network engineer present.
System Architecture
Toggle between the EMR application stack and the field network it runs on.
Patient Flow · 6 Stations · EMR-Tracked
Shipped
- ✓ Linux VM rebuild & XAMPP migration
- ✓ Private CA + hardened Apache TLS
- ✓ RBAC across 6 clinical stations
- ✓ Daily cron backups, 30-day rotation
- ✓ Implementation guide (canonical doc)
Roadmap → 2027 Field Deploy
- → Laredo, TX · Nov 4–10, 2026 — HIPAA pre-deployment test track
- → Costa Rica · April 17–24, 2027 — full clinical incorporation
- → Philippines · Feb 16–25, 2027 — first Asia-Pacific deployment
Guiding Principles
Offline-first
No cloud, no public DNS, no assumed internet. The system must work in a Costa Rican parish hall with nothing but a power strip.
HIPAA-aligned posture
Even though Costa Rica patients aren't covered by HIPAA, the same controls protect everyone.
Structured data over free text
Every paper form field becomes a queryable database column so the mission can produce real statistics.
Recoverable
Snapshots, daily backups, and a documented rebuild path mean a single hardware failure doesn't end the mission.