Tech & Health

January 26, 2022

Smartphone app supports EHR efforts in low-income countries

A smartphone app developed at Vanderbilt is assisting health care efforts in low- and middle-income countries.

To assist health care in low- and middle-income countries (LMICs), Martin Were, MD, MS, associate professor of Biomedical Informatics at Vanderbilt University Medical Center and a member of the Vanderbilt Institute for Global Health, devised a smartphone application called mUzima. Uzima is Swahili for life and mUzima’s slogan is “mobile for life.”

Vanderbilt’s Martin Were, MD, MS

Running on Google’s Android smartphone operating system, the open-source application is designed to work seamlessly with the most widely adopted electronic health record (EHR) system in LMICs, OpenMRS, used in parts of Africa, Asia and Latin America.

In a recent paper in the Journal of Medical Internet Research, Were and colleagues recount the mobile application’s growth and continuing geographic spread. By 2017, some clinics in Kenya, where Were is from, had begun using mUzima for chronic disease management; that year, the application received a boost when the Kenyan Ministry of Health, with assistance from the U.S. Centers for Disease Control and Prevention, adopted mUzima to support HIV testing services across the country. The authors report that the application has since been implemented nationally in Kenya, is widely used in Rwanda, and is gaining scale in Uganda and Mozambique. They also note that, as it has gained in popularity, mUzima has acquired an active community of developers and adopters from around the world.

The application is a work horse, allowing providers who work remotely to access historical patient data, collect new data, view media, leverage decision support, conduct store-and-forward teleconsultations and geolocate clients. As detailed in the report, use cases stretch from COVID-19 and cancer to HIV and other chronic diseases.

“We believe mUzima’s development and spread points the way forward for health IT in resource-limited settings,” Were said. “Over reliance on standalone system installations at health care facilities in these countries threatens to widen the digital divide, leaving behind areas with inadequate electrical and network infrastructure. Our application’s ability to work both online and offline allows for its use in settings with very limited infrastructure. mUzima’s continued growth shows that open-source mobile information technology has a vital role to play in serving health care needs in these countries.”

Ongoing development of mUzima includes, among other things, a new user interface and adoption of the FHIR (Fast Healthcare Interoperability Resources) data standard.

In reporting the development of mUzima, Were and colleagues take into account various guidelines and principles developed by the World Health Organization for assessment of mobile health technology. “This is one of the few descriptions of a robust mobile extension of a widely used EHR system in LMICs,” the authors write.

In addition to his work at VUMC, Were serves as a health information system technical advisor for Mozambique. He previously served as founding director of the Institute of Biomedical Informatics at Kenya’s Moi University, and as chair of the Education Working Group for the Pan-African Health Informatics Association.

Joining Were for the report are members of the mUzima development team from Moi University and the Digital Impact Alliance in Washington, D.C.