What is SmartCare?
SmartCare is an Electronic Health Record (EHR) system that was originally developed in the nation of Zambia for Zambians by Zambians and by their international partners.
Complementing, and integral to the electronic part of the system, is a set of standard MOH paper clinical forms which are used in situations where it is not possible for clinicians to directly use the electronic SmartCare system. This is discussed in more detail in the clinical mode section of this manual.
Since the health reforms of the late 1990's, Zambia has been improving its health information systems. One of the early milestones of the health reforms was the creation of a health management information system (HMIS) that was paper based at health facility level (patient level) and automated at district level (in aggregate form). In late 2003, efforts were initiated to extend the Ministry of health’s information system capacity, aimed at strengthening the patient level information system so that it could be better used to povide continuity of care to patients / clients, by enabling clients to carry their medical health record in electronic form (EHR). This system is presently called SmartCare.
The development of the SmartCare system has been a modular approach, with well care (MCH and VCT) and HIV (ART and PMTCT) services being the initial modules. Key development stages were:
Concept formation regarding complete patient level data systems and life long electronic health records
Consensus Building and Start of Software Development for the initial ANC module of the Continuity of Care system, with software development support from the Centers for Disease Control and Prevention.
Release of version 1.0:
- Piloting and refinement (in Kafue district)
Release of version 2.0:
- First use of smartcards as electronic health records for continuity of care in Zambia
Release of version 3.15 including:
- Integration of the Lusaka DHMT/CIDRZ ART Patient Tracking system (PTS), and called the Continuity of Care and Patient Tracking System (CCPTS) temporarily.
- Identification of the system as a national standard by MOH
- Revision of the system’s name, from CCPTS to SmartCare
Release of version 3.2 including:
- Full prescription and dispensation data capture; Lab results; Delivery services
- Addition of Role Based Security for all users
- Secure reporting, and other data security and confidentiality protection features and protocols
Release of version 4.0 including:
- Paediatric HIV; Postnatal services; Provider tracking; Mapping & GIS;
- Patient Charts (initial versions); new Registration structure; new Clinician-in-Charge role;
- New Site Configuration lock-down; improved Login Security; new CPU type Smartcard
- Compatibility with new HMIS (DHIS); updated Reporting Framework & faster reports;
- New primary storage 20x more compact; 13x faster merges with de-identification above district
The development of the SmartCare system has been a collaborative effort including cooperating partners, and based on existing Ministry of Health data elements, protocols and regulations.
It is intended that the SmartCare system will improve patient care, and also, data accuracy & reliability.