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The SmartCare electronic health record system (EHR) has been developed and deployed by the Zambia Ministry of Health (MoH) in collaboration with the Centers for Disease Control and Prevention (CDC) and many other implementing partners.

SmartCare is:

  • A fully integrated electronic health record system to provide continuity of care
  • A clinical management information system at the facility and district (management/admin) level
  • A key component in 'one National M&E system'

System innovations[edit]

Distributed database system
Given resource constraints in developing countries such as Zambia where electricity is still not available in some parts of the nation, having Internet access throughout the nation will take many more year. SmartCare data is held at each facility in a distributed design; unlike centralized designs of most systems. Internet is not essential, merely an added benefit.
Care Card
SmartCare uses client carried care cards or staff carried flash drives for a lower-tech connectivity solution[buzzword] that works today. An individual's health information is stored on a very compressed, secure care card to maintain continuity of care between visits, health services and health facilities. The individual's health record is also stored on the health facility installation database for backup and generation of facility level and health management information system reports.
Making the data capture task bearable can be the most challenging part of EHR design. SmartCare extends a successful Malawi idea, where touchscreen data entry by existing staff lowers this barrier. The software works well with a touch screen monitor enabling the clinician to view and record patient data. This tool, in combination with client specific data, can provide decision support for over-extended clinicians, and clinician assistants. Clinicians can ‘read and touch’ to enter data; no typing is required. See the image at top for example screen with touch screen technology enabled.
GIS data visualization
Aggregate health data stored at health facilities can be visualized in GIS maps. This includes live patient data as well as static data from health surveys.

Deployment status in Zambia[edit]

  • Ministry of Health, Zambia has deployed SmartCare in > 800 facilities (clinical and district/provincial/national levels), in 94 districts (mid-2014); patient enrollment >200,000
  • Partners are supporting deployment in government and private facilities (for instance: ZPCT >44, CIDRZ >56, AIDSRelief >12), but government deployment & enrollment rates are increasing most rapidly

Future plans[edit]

  • Capacity building and systems strengthening by developing SmartCare
  • Completion of ambulatory service modules e.g. OPD, family planning, and children’s clinic
  • Systems integrations with other health record systems in Zambia ex: ZEPRS
  • Integration of drug stock management system


In addition to Zambia, SmartCare is also being used in Ethiopia and South Africa.[1] However, as of 2012, it was only available for use by partner organizations.[2]

Electronic Health Record System called SmartCare-Ethiopia. As of December 2007, the system is being piloted in one of the hospitals.
Zambian National Blood Transfusion Service
Blood donor data collection and reporting system called the SmartDonor module. The system is being piloted at the national blood transfusion centre headquarters, as of January 2009, and plans to deploy to the nine provincial transfusion centres are underway.

Related systems[edit]


  1. ^ Tilahun, Binyam; Fritz, Fleur (April 2015). "Comprehensive Evaluation of Electronic Medical Record System Use and User Satisfaction at Five Low-Resource Setting Hospitals in Ethiopia". JMIR Medical Informatics. 3 (2): e22. doi:10.2196/medinform.4106. PMC 4460264. PMID 26007237. open access
  2. ^ Millard, Peter S.; Bru, Juan; Berger, Christopher A. (4 July 2012). "Open-source point-of-care electronic medical records for use in resource-limited settings: systematic review and questionnaire surveys". BMJ Open. 2 (4): e000690. doi:10.1136/bmjopen-2011-000690. PMC 3391372. PMID 22763661. open access
  • Hubschman T, Mweetwa V, Fusco H, Muneene D, Chi B, Levy J, Sinkala M, Shields M, Phiri J, Stringer J (May 22–27, 2005). Electronic patient tracking supports rapid expansion of HIV care and treatment in Lusaka, Zambia. President's Emergency Plan for AIDS Relief 2nd Annual Meeting, “Supporting National Strategies: Building on Success”. Addis Ababa, Ethiopia.

Further reading[edit]