%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 2
%N 2
%P e20
%T A Locally Developed Electronic Health Platform in Uganda: Development and Implementation of Stre@mline
%A Liang,Li
%A Wiens,Matthew O
%A Lubega,Phaisal
%A Spillman,Ian
%A Mugisha,Samuel
%+ Innovation Streams Limited, Plot 76/78 High Street, Mbarara La Grand Mall Room L2-03, Mbarara, PO Box 1340, Uganda, 256 704899935, samuel.gisha@gmail.com
%K electronic health record
%K locally developed technology
%K appropriate technology
%K eHealth in low-resource settings
%D 2018
%7 24.9.2018
%9 Original Paper
%J JMIR Formativ Res
%G English
%X Background: Electronic health records (EHRs) are especially important in low-resource settings due to their potential to address unique challenges such as a high number of patients 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 and practical EHR solutions. 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 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. Stre@mline is currently used by over 60,000 patients at 2 hospitals, with plans to expand across Uganda. Objective: The purpose of this article is to describe the key opportunities and challenges in EHR development in sub-Saharan Africa and to summarize the development and implementation of a “Made-for-Africa” EHR, Stre@mline, and how it has led to improved care for over 60,000 vulnerable patients in a rural region of Southwestern Uganda. Methods: A quantitative user survey consisting of a set of 33 questions on usability and performance was conducted at Kisiizi Hospital. Users responded to each question through a Likert scale with the values of strongly disagree, disagree, agree, and strongly agree. Through purposive sampling, 30 users were identified and 28 users completed the survey. Results: We found that users were generally very satisfied with the ease of use of Stre@mline, with 96% (27/28) finding it easy to learn and 100% (28/28) finding it easy to use. Users found that Stre@mline was helpful in improving both clinical efficiency and 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 technologies suitable for developing countries. 
%M 30684419
%R 10.2196/formative.9658
%U http://formative.jmir.org/2018/2/e20/
%U https://doi.org/10.2196/formative.9658
%U http://www.ncbi.nlm.nih.gov/pubmed/30684419