MMDM · Offline-First Clinical Platform
Deployed 2026 · OngoingMedical Missionaries of Divine Mercy · Houston → Costa Rica · 2024–Present
Purpose-built offline clinical platform for a six-clinic volunteer medical mission across a four-building parish campus in Costa Rica. Started as an OpenEMR rebuild on Linux; evolved into a custom Node.js / SQLite / React system designed from first principles around the mission's actual constraints: no internet, non-technical volunteers, and hundreds of patients in a single week.
Clinics
Patients · 40 hrs
Users Trained
Operations Posture
Problem
Corrupted Windows XAMPP stack with Aria storage engine failure. Paper forms across six clinics. No backups, no encryption, no recovery path. Mission-critical with zero connectivity guarantee.
Solution
Rebuilt as a purpose-built Node.js / SQLite / React application running as a single process on a dedicated Linux machine. SQLite replaces MariaDB: one file, no server to configure. React frontend served as static files. systemd auto-start with no manual steps after reboot. Hourly automated backups using SQLite's online backup API. All dependencies installed before the mission; zero internet required during operation.
Impact
Replaced 20+ years of paper workflow with structured clinical data. Five clinic forms co-designed with named clinic leads, touch-optimized for tablet use by first-day volunteers. Reboot-tested for autonomous operation in the field; recoverable from hardware failure with no network engineer present.
System Architecture
Toggle between the application stack and the field network it runs on.
Patient Flow · 6 Clinics · 10 Stations
Shipped
- ✓ Custom Node.js / SQLite / React system built and reboot-tested
- ✓ Five clinic forms co-designed with clinical leads (Registration, Triage, Medical, Vision, Dental)
- ✓ 96-drug Spanish formulary with Costa Rica naming conventions preserved
- ✓ Automated hourly SQLite backups, offline-safe
- ✓ Role-based access: admin, station lead, volunteer PIN tiers
- ✓ Live patient routing and station capacity state management
- ✓ Reporting screen: patients by clinic, vision inventory consumed, computed live from DB
Roadmap → 2027 Field Deploy
- → Laredo, TX · Nov 4–10, 2026: LAN setup and UX skeleton test. No patient data. HIPAA compliance is the open question before any real deployment.
- → 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.