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

Martin Chieng Were1, Simon Savai2, Benard Mokaya2

  • 1Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States.

Journal of Medical Internet Research
|December 14, 2021
PubMed
Summary

Mobile health (mHealth) applications like mUzima extend electronic health record (EHR) systems in low- and middle-income countries (LMICs). This approach overcomes data silos and improves healthcare access and quality, addressing the digital divide.

Keywords:
developing countriesdigital dividedigital healthelectronic medical recordsglobal healthmobile health

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Area of Science:

  • Digital Health
  • Health Informatics
  • Mobile Health (mHealth)

Background:

  • Electronic health record (EHR) systems in low- and middle-income countries (LMICs) are often standalone, exacerbating the digital divide due to poor infrastructure.
  • Existing mobile health (mHealth) solutions frequently create data silos, failing to integrate with scaled national EHR systems.
  • There is a critical need for mHealth applications that effectively extend EHR capabilities to improve healthcare access and quality in resource-limited settings.

Purpose of the Study:

  • To report on the development and scaled implementation of mUzima, an mHealth extension for OpenMRS, the most widely deployed EHR system in LMICs.
  • To showcase how mUzima's architecture, features, and functionalities can be adapted for broader use in similar contexts.

Main Methods:

  • The mUzima application was developed following the "Guidelines for reporting of health interventions using mobile phones: mobile (mHealth) evidence reporting assessment (mERA)" checklist.
  • The World Health Organization (WHO) Principles for Digital Development framework was used as a secondary guiding framework.
  • Details on mUzima's architecture, core features, functionalities, and implementation status are provided.

Main Results:

  • mUzima is an open-source, configurable Android application with features including offline data management, deduplication, security, and teleconsultation.
  • It enables remote providers using basic smartphones to access patient data, collect new information, and utilize decision support tools.
  • mUzima has achieved national scale in Kenya, is widely used in Rwanda, and is expanding in Uganda and Mozambique, supporting various disease management programs.

Conclusions:

  • mHealth applications that extend EHR systems, rather than operating in silos, are crucial for resource-limited settings with developing health information exchange infrastructure.
  • mUzima exemplifies a successful, scalable model for extending EHR reach across multiple countries and diverse care domains.
  • The widespread adoption and recognition of mUzima highlight its potential as a digital global public good.