mUzima Mobile Electronic Health Record (EHR) System: Development and Implementation at Scale.

Background: The predominant implementation paradigm of electronic health record (EHR) systems in low- and middle-income countries (LMICs) relies on standalone system installations at facilities. This implementation approach exacerbates the digital divide, with facilities in areas with inadequate electrical and network infrastructure often left behind. Mobile health (mHealth) technologies have been implemented to extend the reach of digital health, but these systems largely add to the problem of siloed patient data, with few seamlessly interoperating with the EHR systems that are now scaled nationally in many LMICs.

Creating and Evaluating a Dynamic Study Randomization and Enrollment Tool within a Robust EHRs.

Randomized trials are difficult to perform in resource-limited settings. We developed a Randomization and Enrollment Tool (RET) within a live EHRs which automated enrollment, randomization, and data-collection in support of robust EHRs-based randomized interventions. We describe an observational assessment of RET which we piloted at three Kenyan HIV clinics for a decision support trial.