Digitizing HIV care in Uganda: Patient and provider perspectives on the AmFine patient portal

In resource-limited settings like Uganda, managing HIV care through conventional paper-based systems poses challenges such as inefficiencies in clinical workflows and limited patient engagement. The AmFine patient portal and mobile application was developed to digitize the paper-based "blue card" system and enhance patient-provider communication.

To explore the lived experiences of patients and healthcare providers in using the AmFine patient portal and mobile application at the immune suppressive syndrome (ISS) Clinic of Mbarara Regional Referral Hospital, focusing on usability, motivation for use, challenges and suggestions for improvement.

We conducted face-to-face in-depth interviews with 25 participants (21 patients and 4 healthcare providers) at the ISS Clinic of Mbarara Regional Referral Hospital between April 2023 and May 2023. Interviews were audio-recorded, transcribed verbatim, and analyzed using codebook thematic analysis guided by Braun and Clarke's approach. Coding was conducted in NVivo 12, and themes were developed inductively to explore participant experiences, perceived usability, and challenges of the AmFine patient portal and mobile application.

The AmFine patient portal and mobile application was positively perceived as enhancing communication and convenience. Patients appreciated the ability to send messages to providers without traveling to the clinic, fostering privacy and reducing stigma. Providers valued streamlined patient management and communication. Challenges included limited technological literacy among some patients, intermittent internet connectivity, and data costs. Suggestions for improvement included enhancing offline functionality, diversifying language options, and providing more detailed training sessions.

The AmFine patient portal and mobile application demonstrated potential to improve HIV care delivery and patient engagement in a resource-limited setting. Addressing identified challenges can optimize system usability and adoption.