Development and Implementation of Stre@mline, a Locally Developed Electronic Health Platform in Uganda (Preprint)

Abstract

Introduction: Electronic healthcare records(EHR) are especially important in low-resource settings due to their potential to address unique challenges such as the high numbers of requiring long-term treatments who are lost to follow-up, the frequent shortages of essential drugs, poor maintenance and storage of records and inefficient clinical triaging. However, there is a lack of affordable solutions and many challenges in successfully implementing EHRs in low resource settings. Methods: Stre@mline is an EHR platform that has been locally developed by Ugandan clinicians and engineers in Southwestern Uganda. It is tailored to the specific context and the needs of low-resource hospitals. It operates without internet access, incorporates locally relevant standards and key patient safety features, has a medication inventory management component, has local technical support available, and is economically sustainable without funding from international donors. Results: Stre@mline is currently used by over 60 000 patients at 2 hospitals, with plans to expand across Uganda. User surveys from Kisiizi Hospital indicate that the vast majority of Stre@mline users find it is easy to use and helpful in increasing clinical efficiency as well as enhancing patient care. Discussions: The partnership of local clinicians and developers is crucial to the design and adoption of user-centered technologies tailored to the specific needs of low-resource settings. The EHR described here could serve as a model for the development of future appropriate technologies in developing countries.