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

BACKGROUND 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 OBJECTIVE To create a locally-developed electronic healthcare record system tailored to the specific context and needs of Ugandan hospitals. 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. CONCLUSIONS 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.