ArticleJournal of the American Medical Informatics Association : JAMIA
Evaluating a scalable model for implementing electronic health records in resource-limited settings.
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Routine Health Information System (RHIS) improvements for strengthened health system management.The Cochrane database of systematic reviews · 2020Pooled it
- Quantitative measures of health policy implementation determinants and outcomes: a systematic review.Implementation science : IS · 2020Pooled it
- Beyond urban bias: A circulation-based model for equitable medical workforce distribution.Dialogues in health · 2026Article
- Bridging crisis recovery and long-term transformation of the health system in Lebanon: evidence from key informant interviews and global lessons.BMC health services research · 2026Article
- Associations between in-home environmental exposures and lung function in a safety net population of children with asthma using electronic health records and geospatial data.Annals of epidemiology · 2025Article
- Contextual Barriers to Implementing Open-Source Electronic Health Record Systems for Low- and Lower-Middle-Income Countries: Scoping Review.Journal of medical Internet research · 2024Article
- Feasibility, usability and acceptability of a novel digital hybrid-system for reporting of routine maternal health information in Southern Tanzania: A mixed-methods study.PLOS global public health · 2023Article
- mUzima Mobile Electronic Health Record (EHR) System: Development and Implementation at Scale.Journal of medical Internet research · 2021Article
- Exploring the effectiveness of telehealth interventions for diagnosis, contact tracing and care of Corona Virus Disease of 2019 (COVID19) patients in sub Saharan Africa: a rapid review.Health and technology · 2021Article
- A prospective risk assessment of the implementation of a schistosomiasis preventive mass drug administration for children aged five years and below in the uMkhanyakude district of KwaZulu-Natal.BMC health services research · 2019Article
- Overcoming limitations of tuberculosis information systems: researcher and clinician perspectives.Public health action · 2019Article
- A Locally Developed Electronic Health Platform in Uganda: Development and Implementation of Stre@mline.JMIR formative research · 2018Article
- Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review.African journal of primary health care & family medicine · 2017Review
- User experience analysis of e-TB Manager, a nationwide electronic tuberculosis recording and reporting system in Ukraine.ERJ open research · 2017Article
- Scaling-up health information systems to improve HIV treatment: An assessment of initial patient monitoring systems in Mozambique.International journal of medical informatics · 2017Article
- Benefits and challenges of EMR implementations in low resource settings: a state-of-the-art review.BMC medical informatics and decision making · 2016Review
- Implementation of a Cloud-Based Electronic Medical Record to Reduce Gaps in the HIV Treatment Continuum in Rural Kenya.PloS one · 2015Article
- A clinical decision support system for integrating tuberculosis and HIV care in Kenya: a human-centered design approach.PloS one · 2014Article
- Where is information quality lost at clinical level? A mixed-method study on information systems and data quality in three urban Kenyan ANC clinics.Global health action · 2013Article
- Developing open source, self-contained disease surveillance software applications for use in resource-limited settings.BMC medical informatics and decision making · 2012Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
Current models for implementing electronic health records (EHRs) in resource-limited settings may not be scalable because they fail to address human-resource and cost constraints. This paper describes an implementation model which relies on shared responsibility between local sites and an external three-pronged support infrastructure consisting of: (1) a national technical expertise center, (2) an implementer's community, and (3) a developer's community. This model was used to implement an open-source EHR in three Ugandan HIV-clinics. Pre-post time-motion study at one site revealed that Primary Care Providers spent a third less time in direct and indirect care of patients (p<0.001) and 40% more time on personal activities (p=0.09) after EHRs implementation. Time spent by previously enrolled patients with non-clinician staff fell by half (p=0.004) and with pharmacy by 63% (p<0.001). Surveyed providers were highly satisfied with the EHRs and its support infrastructure. This model offers a viable approach for broadly implementing EHRs in resource-limited settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.