Benefits outweigh challenges of implementing electronic health records in ART clinics in Malawi

August 10, 2010

In this week's PLoS Medicine Magazine, Gerry Douglas and colleagues describe their experience scaling up electronic medical records (EMRs) in six antiretroviral treatment (ART) sites in Malawi. The need for electronic records was clear. By December 2009, 46 of the ART clinics in Malawi had each registered more than 2,000 patients, which meant that nurses and medical record clerks were taking up to five days to prepare quarterly cohort reports, sometimes closing the clinic in order to complete this task. This often lead to risk of the completeness and accuracy of primary outcome data being compromised, say the authors in describing the rationale for their project.

Despite the challenges faced in implementing EMRs, the authors say that "the experience gained, and infrastructure built, through successful deployment of the ART EMR will facilitate further rollout to other high-burden ART sites in Malawi. We also see great potential for its adaptation and use for other chronic diseases such as tuberculosis, diabetes mellitus, and hypertension, preparing a foundation for a comprehensive electronic health record system."
Funding: We thank the Centers for Disease Control (CDC) and Prevention, Global AIDS Program, an anonymous donor, and the Open Society Initiative for Southern Africa (OSISA) for supporting the development and scale-up of the ART EMR in Malawi. The funders played no role in the decision to submit the article or in its preparation.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Douglas GP, Gadabu OJ, Joukes S, Mumba S, McKay MV, et al. (2010) Using Touchscreen Electronic Medical Record Systems to Support and Monitor National Scale-Up of Antiretroviral Therapy in Malawi. PLoS Med 7 (8): e1000319. doi:10.1371/journal.pmed.1000319



Gerald Douglas
Baobab Health Trust
Medical Informatics


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