Digital health for Tuberculosis control: findings from the piloting of an electronic medical record in Luanda (Angola)

Digital health, like the use of electronic medical records (EMR), has been highlighted as a potential avenue to improve Tuberculosis (TB) surveillance and treatment outcomes. In Angola this technology remains largely untapped within TB health services, despite TB is a huge public health burden. A previous study described the development of a TB EMR system, and the current study fostered the piloting of the TB EMR system in three health facilities of Luanda from January 2022 to February 2023. To assess the adequacy of the EMR system (accuracy and completeness) comparison of paper-based medical records and EMRs was performed. Secondly, to assess the user-friendliness of the EMR system 24 semi-structured interviews were conducted with the personnel of the health facilities. Finally, to assess the sustainability of the EMR system semi-structured interviews were performed with the same personnel and 8 managerial staff and representatives of Angolan Institutions. From the study it emerged that the TB EMR system allowed to reduce errors, time, the lack of patient information, and the EMR system users described it as easy to use with adequate training. Regarding the sustainability of the system, its continuity and scalability seem feasible if proper financial support is granted. Continuity to this phase of digitalization of the TB data and information reported in the paper-based clinical record should be supported to gradually move to a transition to the use of the EMR system alone (electronic-first approach), if adequate and continuous training is provided.