Design and implementation of a basic laboratory information system for resource-limited settings
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Basic Laboratory Information System (BLIS) is a joint initiative of C4G @ Georgia Tech, the Centers for Disease Control and Prevention (CDC) and Ministries of Health in several countries in Africa. The vast majority of health laboratories in Africa, engaged in routinely testing samples drawn from patients (for HIV, malaria etc.), have been using non-standardized paper logs and manual entries for keeping track of patients, test samples and results. Besides the obvious burden of tedious record-keeping, these methods increase the chances of errors due to transcription and mismatches, making it difficult to track patient history or view critical population-wide data. In 2008, PEPFAR (the United States President's Emergency Plan for AIDS Relief) together with the CDC was reauthorized with a $48 billion budget over five years to combat HIV/AIDS, tuberculosis, and malaria. The focus of PEPFAR has shifted from rapid scale-up to the quality and reliability of the clinical health programs and having an effective laboratory management system is one of its goals. C4G BLIS is a robust, customizable and easy-to-use system that keeps track of patients, samples, results, lab workflow and reports. It is meant to be an effective and sustainable enhancement to manual logs and paper-based approaches. The system is designed to work in resource-constrained laboratories with limited IT equipment and across sites with good, intermittent or no internet availability. With varied practices, workflow and terminology being followed across laboratories in various African countries, the system has been developed to enable each laboratory or country to customize and configure the system in a way that suits them best. We describe various aspects of BLIS including its flexible database schema design, configurable reports and language settings, end-user customizability and development model for rapid incorporation of user feedback. Through BLIS, we aim to demonstrate a sustainable ICT solution brought about by the early and constant involvement of the target laboratory staff and technicians, identifying their short- and long-term needs, and ensuring that the system can match these needs. We will present preliminary evaluation results from laboratories in Cameroon, Ghana, Tanzania and Uganda.