The Role of SmartCare Electronic Health Records System in the Delivery of Health Services: Case of First-Level Hospitals in Lusaka District, Zambia
Main Article Content
Abstract
The digitization of healthcare through Electronic Health Records (EHRs) has transformed medical service delivery globally thus leading to improved efficiency, data accuracy, and patient care. However, developing countries like Zambia face significant implementation challenges, including skills challnges, infrastructure gaps and policy limitations. This study examines the implementation of Zambia's SmartCare Electronic Health Record (EHR) system in first-level hospitals of Lusaka District, focusing on registry personnel's experiences, policy frameworks, service delivery impacts, and implementation challenges. The study employed a qualitative research design, exploiting a purposive sampling method to select 30 registry personnel across five hospitals in Lusaka. Data was collected from 25 registry personnel through in-depth interviews and analysed using thematic analysis. The findings reveal that all twenty-five participants emphasized that the SmartCare system was usefull, was user-friendly and its ability to streamline data capture and retrieval made work enjoyable and much easier. However, findings also revealed a concerning gap in policy awareness among registry staff, which potentially compromise data governance and system interoperability. The study further established that while SmartCare has significantly improved efficiency in patient record management, reducing paperwork and enhancing data accessibility, substantial barriers hinder its optimal utilization. Key challenges include system failures (reported by all participants), erratic power supply, inadequate training and therefore limited skills,, insufficient computer resources, and inconsistent distribution of SmartCare cards.
Article Details
How to Cite
NGOMA, Misozi et al.
The Role of SmartCare Electronic Health Records System in the Delivery of Health Services:.
Zambia Journal of Library & Information Science (ZAJLIS ), ISSN: 2708-2695, [S.l.], v. 9, n. 1, p. 21-33, june 2025.
ISSN 2708-2695.
Available at: <http://41.63.0.109/index.php/journal/article/view/168>. Date accessed: 30 june 2025.
doi: https://doi.org/10.53974/unza.zajlis.9.1.168.
Section
Records and Archives Management
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References
Achampong, E. K. (2012). The state of information and communication technology and health
informatics in Ghana. Online Journal of Public Health Informatics, 4(2), ojphi. v4i2.4191. https://doi.org/10.5210/ojphi.v4i2.4191. (Accessed on 13/1/2021).
AC06953431, A. (Ed.). (2008). Health informatics-Electronic health record communication-Part
1: Reference model. ISO
Adebayo, T.T. (2019). The Role of Health Information Officers in the Prevention and
Management of HIV/AIDS in the Three Tertiary Institutions in Southwestern Nigeria. Library Philosphy and Practice (e-journal), 3625.
Adedeji, P., Irinoye, O., Ikono, R., et al. (2018). Factors influencing the use of electronic health
records among nurses in a teaching hospital in Nigeria. Journal of Health Informatics in Developing Countries, 12.
Ali, S. K., Khan, H., Shah, J., & Nadeem Ahmed, K. (2023). An electronic health record system
implementation in a resource-limited country—lessons learned. Digital Health, 9, 20552076231203660. https://doi.org/10.1177/20552076231203660..
Alwan, K., Ayele, T. A., & Tilahun, B. (2015). Knowledge and utilization of computers among health professionals in a developing country: a cross-sectional study. JMIR human factors, 2(1), e4
Azamar-Alonso, A., Costa, A. P., Huebner, L. A., & Tarride, J. E. (2019). Electronic referral systems in health care: a scoping review. Clinico Economics and outcomes research: CEOR, 11, 325.
Bedeley, R. T. & Palvia P. (2014). Study of the Issues of E-Health Care in Developing Countries: The Case of Ghana. Twentieth Americas Conference on Information Systems, Savannah
Bwalya, T., & Akakandelwa, A. (2023). An assessment of government efforts towards the
implementation of an integrated electronic records management system in the Zambian public service. Zambia Journal of Library & Information Science, 7(2), 1-15.
Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E. et al. (2006). Systematic
Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care. Annals of Internal Medicine, 144, 742-752. https://doi.org/10.7326/0003-4819-144-10-200605160-00125
Chibawe, C. P., Essiet-Gibson, I., Mwansa, F. D., Jacenko, S., Rhee, C., & MacNeil, A. (2019).
Strengths, pitfalls, and lessons learned in implementing electronic collection of childhood vaccination data in Zambia: The SmartCare experience. International Journal of Medical Informatics, 129, 146-153. doi: 10.1016/j.ijmedinf.2019.06.006.
Clarke, K. E., Chibawe, C. P., Essiet-Gibson, I., Mwansa, F. D., Jacenko, S., Rhee, C., &
MacNeil, A. (2019). Strengths, pitfalls, and lessons learned in implementing electronic collection of childhood vaccination data in Zambia: The SmartCare experience. International Journal of Medical Informatics, 129, 146-153.
Global Digital Health Partnership. (2021). Advancing interoperability together globally.
Available at: https://www.healthit.gov/sites/default/files/page/2021-01/GDHP-Advancing%20Interoperability%20Together%20Globally.pdf. (Accessed on 10th February 2024).
Government of the Republic of Zambia. (2021). The Electronic Government Act, 2021. Lusaka,
Zambia: Government Printers.
Granlien, M. F., Hertzum, M., & Gudmundsen, J. (2008). The gap between actual and mandated use of electronic medication records three years after deployment. Studies in health technology and informatics, 136, 419. Available at https://person.hst.aau.dk/ska/MIE2008/ParalleSessions/PapersForDownloads/06.HIS&EHR/SHTI136-0419.pdf. (Accessed on 10th August 2022)
Gumede-Moyo, S., Todd, J., Bond, V., Mee, P., & Filteau, S. (2019). A qualitative inquiry into
implementing an electronic health record system (SmartCare) for prevention of mother-to-child transmission data in Zambia: A retrospective study. BMJ Open, 9(9), e030428.
Halubanza, S. K., Kunda, D., & Halubanza, B. (2022). A framework for an e-health system for
Zambian health centres that incorporate data mining reporting. In Proceedings of International Conference for ICT (ICICT)-Zambia (Vol. 4, No. 1, pp. 6-17).
Health Professions Council of Zambia (HPCZ). (2011). National health care standard for
Zambia: Class 'A' facilities (hospitals).
Health Professions Council of Zambia (HPCZ). (2016). Guidelines for good practice in the
health care profession: Generation and management of patient records. Available at: http://www.hpcz.org.zm/wp-content/uploads/2018/07/Generation-and-Management-of-Patients-Records.pdf. (Accessed on 12th March 2021).
International Standards Organisation (ISO). (2001). 15489-1: Information and documentation—
Records management part 1: General. Available at: http://www.iso.org. (Accessed on 17th February 2022).
International Records Management Trust (IRMT). (2009). Planning and managing an electronic
records management programme. London. Website: http://www.irmt.org. (Accessed on 12 March 2022).
Katurura, M. C., & Cilliers, L. (2018). Electronic health record system in the public health care
sector of South Africa: A systematic literature review. African Journal of Primary Health Care and Family Medicine, 10(1), e1–e8. doi:10.4102/phcfm. v10i1.1746.
Keakopa, S., Millar, L., O'Shea, G., Nordland, L. P., Suderman, J., Ardern, C., & Yusef, Z. M.
(2009). Understanding the context of electronic records management. Training in Electronic Records Management. International Records Management Trust.
Khumalo, N. (2017) The Need for the Establishment of E-records and eHealth Legislation and Policy Framework in the Health Sector in Zimbabwe. Library Philosophy and Practice (e-journal). 1662. https://digitalcommons.unl.edu/libphilprac/1662. Accessed on 02.02.2021
Kruse, G. R., Chapula, B. T., Ikeda, S., Nkhoma, M., Quiterio, N., Pankratz, D., & Reid, S. E.
(2009). Burnout and use of HIV services among health care workers in Lusaka District, Zambia: A cross-sectional study. Human Resources for Health, 7, 1-10. Available at: http://www.human-resources-health.com/content/7/1/55. (Accessed on 17th February 2025).
Latha, N. A., Murthy, B. R., & Sunitha, U. (2012). Electronic health record. International Journal of Engineering, 1(10), 25-27. International Journal of Engineering Research & Technology (IJERT) Vol. 1 Issue 10, December 2012
Liddy, C., Hogel, M., Blazkho, V., & Keely, E. (2015). The current state of electronic
consultation and electronic referral systems in Canada: an environmental scan. Global Telehealth 2015: Integrating Technology and Information for Better Healthcare, 75-83.
M’kulama, A., & Bwalya, T. (2024). Digital curation of records at the National Archives of Zambia. ESARBICA Journal: Journal of the Eastern and Southern Africa Regional Branch of the International Council on Archives, 43, 176-192.
Mahalli, A. E. (2015). Adoption and barriers to adoption of electronic health records by nurses in three governmental hospitals in Eastern Province, Saudi Arabia. Perspectives in health information management, 12(Fall).
Margam, R. (2023, July 30). The Importance of EHR in Revolutionizing Healthcare Delivery
and Financial Success. International Journal of Computer Trends and Technology, 71(7), 52–55. https://doi.org/10.14445/22312803/ijctt-v71i7p108.
Marutha, S.N (2011). Records Management in support of service delivery in the Public Health Sector of the Limpopo Province in South Africa. Dissertation (MLIS). University of South Africa. (Accessed on 4th February 2022).
Mengesha, T. (2011). Electronic solutions for Ethiopian health sector: Electronic medical record
(EMR) system.
Ministry of Health [MOH]. (2008). SmartCare Software User’s Manual. Lusaka: Ministry of
Health
Ministry of Health (2023). Zambia Health Facility Registry Standard Operating Procedures.
Lusaka: Ministry of Health. Available at: http://www.moh.gov.zm. (Accessed on 15th Nov. 2024).
Ministry of Health (2023). SmartCare Plus: Paper to Paperless in health facilities. Ndeke House,
Lusaka. Available at: http://www.moh.gov.zm. ((Accessed on 15th Nov. 2024).
Ministry of Health, Zambia (2017). Zambia National Health Strategic Plan 2017-2021. Lusaka,
Zambia: Government of the Republic of Zambia.
Mnjama, N. and Wamukoya, J. (2007), "E-government and Records Management: An Assessment Tool for E-records JOURNAL OF THE SOUTH AFRICAN SOCIETY OF ARCHIVISTS, VOL. 49, 2016 | SASA © 100. Readiness in Government", The Electronic Library, Vol. 25 No. 3, pp. 274-284. Available on https://doi.org/10.1108/02640470710754797. Accessed on 21st February 2022
Mutabazi, B. (2016). A case study to investigate the challenges of EMR implementation in four
district Hospitals in Rwanda (Doctoral dissertation, University of Rwanda).
Mutale, M. (2017). Health workers' experiences with the use of SmartCare for decision making
in selected health facilities in Mongu and Limulunga districts of Western Province, Zambia (Doctoral dissertation, The University of Zambia).
Mwanza, L. (2019). An assessment of the appropriateness of SmartCare electronic medical
record system in the delivery of HIV/AIDS services: A case study of six (6) health facilities in Lusaka district of Zambia (Doctoral dissertation, The University of Zambia).
Mweebo, K. (2014). Security of electronic health records in a resource-limited setting: The case
of SmartCare electronic health record in Zambia. Australian eHealth Informatics and Security Conference Conferences, Symposia and Campus Events. Cowan University, Perth: Western Australia. https://doi.org/10.4225/75/5798297631b47.
Mwiinga S. (2019) The E-health Systems in Zambia. Daily Nation Newspaper. Issued on 13th Sept 2019. Available in https://www.pressreader.com/zambia/daily-nation-newspaper/20190913/281668256675814. (Accessed on 14th March 2020)
National Archives of Australia (2014). Information and Records Management Policy. Available from: http://www.naa.gov.au/records-management/strategic-information/information-governance/key-documents/policy.aspx (Accessed on 4th February 2022).
Nawa, Doreen (2018) UTH medical records earmarked to enter digital era. Daily Mail issued on 7th January. Available at http://www.daily-mail.co.zm/tag/digital-era/. Accessed on 4th March 2020
Nengomasha, C. T. (2009). A study of electronic records management in the Namibian public service in the context of e-government (Doctoral dissertation, University of Namibia).
Ng’andu, D. and Haabazoka, L. (2024) A Study of the Effect of Health Records Digitalization on
Healthcare Facility Operational Efficiency. Open Journal of Business and Management, 12, 1135-1157. doi: 10.4236/ojbm.2024.122060.
Okello-Obura, C. (2011). Records and archives legal and policy frameworks in Uganda. Library
Philosophy and Practice (journal). Available at: https://digitalcommons.unl.edu/libphilprac/608. (Accessed on 2nd Feb 2021).
Pande, K. F. (2022). Investigating the implementation of SmartCare electronic health record
system project in Zambia using tenets of project management (Doctoral dissertation, The University of Zambia).
Ravindra, S. S., Chandra, R., & Dhenesh, V. S. (2015). A study of the management of electronic medical records in Fijian Hospitals. arXiv preprint arXiv:1507.03659. Available on https://doi.org/10.48550/arXiv.1507.03659. (Accessed on 10th August 2022).
SanJoaquin, M. A., Allain, T. J., Molyneux, M. E., Benjamin, L., Everett, D. B., Gadabu, O. & Heyderman, R. S. (2013). Surveillance Programme of IN-patients and Epidemiology (SPINE): implementation of an electronic data collection tool within a large hospital in Malawi. PLoS medicine, 10(3), e1001400
Shah, J. R., Murtaza, M. B., & Opara, E. (2014). Electronic health records: Challenges and
opportunities. Journal of International Technology and Information Management: Vol. 23: Iss. 3, Article 10. DOI: https://doi.org/10.58729/1941-6679.1082
Available at: https://scholarworks.lib.csusb.edu/jitim/vol23/iss3/10 . Accessed on 11th Nov 2023
Silvestre, E. (2018) How Electronic Health Records Strengthen the Health Systems of Low- and Middle-Income Countries: Learning from Eswatini and Mexico. Chapel Hill, NC: MEASURE Evaluation, University of North Carolina
SmartCare Zambia. (2024). About SmartCare. Retrieved from https://smartcarezambia.io
(Accessed on 16th February 2025)
Stephen, M and Frank, L. (2024). The Role of Electronic Health Records in Transforming
Healthcare Delivery and Financial Gains. Available at: https://www.researchgate.net/publication/377407661. (Accessed 16th Dec 2024)
Tsvuura, G. (2022). "Knowledge and skills for managing digital records at selected state
Universities in Zimbabwe", Journal of the South African Society of Archivists, Vol. 55 No. 1, pp. 110-123.
Thit, W. M., Thu, S. W. Y. M., Kaewkungwal, J., Soonthornworasiri, N., Theera-Ampornpunt,
N., Kijsanayotin, B., & Pan-Ngum, W. (2020). User acceptance of electronic medical record system: implementation at Marie Stopes International, Myanmar. Healthcare Informatics Research, 26(3), 185-192
Van Reisen, M. (2017). International cooperation in the digital era. Universiteit Leiden.
Waithera L, Muhia J, Songole R (2017) Impact of Electronic Medical Records on Healthcare
Delivery in Kisii Teaching and Referral Hospital. Med Clin Rev. Vol. 3 No. 4: 21.
World Health Organization (WHO) (2006). Medical records manual: a guide for developing
Countries. Manila: WHO Regional Office for the Western Pacific.
informatics in Ghana. Online Journal of Public Health Informatics, 4(2), ojphi. v4i2.4191. https://doi.org/10.5210/ojphi.v4i2.4191. (Accessed on 13/1/2021).
AC06953431, A. (Ed.). (2008). Health informatics-Electronic health record communication-Part
1: Reference model. ISO
Adebayo, T.T. (2019). The Role of Health Information Officers in the Prevention and
Management of HIV/AIDS in the Three Tertiary Institutions in Southwestern Nigeria. Library Philosphy and Practice (e-journal), 3625.
Adedeji, P., Irinoye, O., Ikono, R., et al. (2018). Factors influencing the use of electronic health
records among nurses in a teaching hospital in Nigeria. Journal of Health Informatics in Developing Countries, 12.
Ali, S. K., Khan, H., Shah, J., & Nadeem Ahmed, K. (2023). An electronic health record system
implementation in a resource-limited country—lessons learned. Digital Health, 9, 20552076231203660. https://doi.org/10.1177/20552076231203660..
Alwan, K., Ayele, T. A., & Tilahun, B. (2015). Knowledge and utilization of computers among health professionals in a developing country: a cross-sectional study. JMIR human factors, 2(1), e4
Azamar-Alonso, A., Costa, A. P., Huebner, L. A., & Tarride, J. E. (2019). Electronic referral systems in health care: a scoping review. Clinico Economics and outcomes research: CEOR, 11, 325.
Bedeley, R. T. & Palvia P. (2014). Study of the Issues of E-Health Care in Developing Countries: The Case of Ghana. Twentieth Americas Conference on Information Systems, Savannah
Bwalya, T., & Akakandelwa, A. (2023). An assessment of government efforts towards the
implementation of an integrated electronic records management system in the Zambian public service. Zambia Journal of Library & Information Science, 7(2), 1-15.
Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E. et al. (2006). Systematic
Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care. Annals of Internal Medicine, 144, 742-752. https://doi.org/10.7326/0003-4819-144-10-200605160-00125
Chibawe, C. P., Essiet-Gibson, I., Mwansa, F. D., Jacenko, S., Rhee, C., & MacNeil, A. (2019).
Strengths, pitfalls, and lessons learned in implementing electronic collection of childhood vaccination data in Zambia: The SmartCare experience. International Journal of Medical Informatics, 129, 146-153. doi: 10.1016/j.ijmedinf.2019.06.006.
Clarke, K. E., Chibawe, C. P., Essiet-Gibson, I., Mwansa, F. D., Jacenko, S., Rhee, C., &
MacNeil, A. (2019). Strengths, pitfalls, and lessons learned in implementing electronic collection of childhood vaccination data in Zambia: The SmartCare experience. International Journal of Medical Informatics, 129, 146-153.
Global Digital Health Partnership. (2021). Advancing interoperability together globally.
Available at: https://www.healthit.gov/sites/default/files/page/2021-01/GDHP-Advancing%20Interoperability%20Together%20Globally.pdf. (Accessed on 10th February 2024).
Government of the Republic of Zambia. (2021). The Electronic Government Act, 2021. Lusaka,
Zambia: Government Printers.
Granlien, M. F., Hertzum, M., & Gudmundsen, J. (2008). The gap between actual and mandated use of electronic medication records three years after deployment. Studies in health technology and informatics, 136, 419. Available at https://person.hst.aau.dk/ska/MIE2008/ParalleSessions/PapersForDownloads/06.HIS&EHR/SHTI136-0419.pdf. (Accessed on 10th August 2022)
Gumede-Moyo, S., Todd, J., Bond, V., Mee, P., & Filteau, S. (2019). A qualitative inquiry into
implementing an electronic health record system (SmartCare) for prevention of mother-to-child transmission data in Zambia: A retrospective study. BMJ Open, 9(9), e030428.
Halubanza, S. K., Kunda, D., & Halubanza, B. (2022). A framework for an e-health system for
Zambian health centres that incorporate data mining reporting. In Proceedings of International Conference for ICT (ICICT)-Zambia (Vol. 4, No. 1, pp. 6-17).
Health Professions Council of Zambia (HPCZ). (2011). National health care standard for
Zambia: Class 'A' facilities (hospitals).
Health Professions Council of Zambia (HPCZ). (2016). Guidelines for good practice in the
health care profession: Generation and management of patient records. Available at: http://www.hpcz.org.zm/wp-content/uploads/2018/07/Generation-and-Management-of-Patients-Records.pdf. (Accessed on 12th March 2021).
International Standards Organisation (ISO). (2001). 15489-1: Information and documentation—
Records management part 1: General. Available at: http://www.iso.org. (Accessed on 17th February 2022).
International Records Management Trust (IRMT). (2009). Planning and managing an electronic
records management programme. London. Website: http://www.irmt.org. (Accessed on 12 March 2022).
Katurura, M. C., & Cilliers, L. (2018). Electronic health record system in the public health care
sector of South Africa: A systematic literature review. African Journal of Primary Health Care and Family Medicine, 10(1), e1–e8. doi:10.4102/phcfm. v10i1.1746.
Keakopa, S., Millar, L., O'Shea, G., Nordland, L. P., Suderman, J., Ardern, C., & Yusef, Z. M.
(2009). Understanding the context of electronic records management. Training in Electronic Records Management. International Records Management Trust.
Khumalo, N. (2017) The Need for the Establishment of E-records and eHealth Legislation and Policy Framework in the Health Sector in Zimbabwe. Library Philosophy and Practice (e-journal). 1662. https://digitalcommons.unl.edu/libphilprac/1662. Accessed on 02.02.2021
Kruse, G. R., Chapula, B. T., Ikeda, S., Nkhoma, M., Quiterio, N., Pankratz, D., & Reid, S. E.
(2009). Burnout and use of HIV services among health care workers in Lusaka District, Zambia: A cross-sectional study. Human Resources for Health, 7, 1-10. Available at: http://www.human-resources-health.com/content/7/1/55. (Accessed on 17th February 2025).
Latha, N. A., Murthy, B. R., & Sunitha, U. (2012). Electronic health record. International Journal of Engineering, 1(10), 25-27. International Journal of Engineering Research & Technology (IJERT) Vol. 1 Issue 10, December 2012
Liddy, C., Hogel, M., Blazkho, V., & Keely, E. (2015). The current state of electronic
consultation and electronic referral systems in Canada: an environmental scan. Global Telehealth 2015: Integrating Technology and Information for Better Healthcare, 75-83.
M’kulama, A., & Bwalya, T. (2024). Digital curation of records at the National Archives of Zambia. ESARBICA Journal: Journal of the Eastern and Southern Africa Regional Branch of the International Council on Archives, 43, 176-192.
Mahalli, A. E. (2015). Adoption and barriers to adoption of electronic health records by nurses in three governmental hospitals in Eastern Province, Saudi Arabia. Perspectives in health information management, 12(Fall).
Margam, R. (2023, July 30). The Importance of EHR in Revolutionizing Healthcare Delivery
and Financial Success. International Journal of Computer Trends and Technology, 71(7), 52–55. https://doi.org/10.14445/22312803/ijctt-v71i7p108.
Marutha, S.N (2011). Records Management in support of service delivery in the Public Health Sector of the Limpopo Province in South Africa. Dissertation (MLIS). University of South Africa. (Accessed on 4th February 2022).
Mengesha, T. (2011). Electronic solutions for Ethiopian health sector: Electronic medical record
(EMR) system.
Ministry of Health [MOH]. (2008). SmartCare Software User’s Manual. Lusaka: Ministry of
Health
Ministry of Health (2023). Zambia Health Facility Registry Standard Operating Procedures.
Lusaka: Ministry of Health. Available at: http://www.moh.gov.zm. (Accessed on 15th Nov. 2024).
Ministry of Health (2023). SmartCare Plus: Paper to Paperless in health facilities. Ndeke House,
Lusaka. Available at: http://www.moh.gov.zm. ((Accessed on 15th Nov. 2024).
Ministry of Health, Zambia (2017). Zambia National Health Strategic Plan 2017-2021. Lusaka,
Zambia: Government of the Republic of Zambia.
Mnjama, N. and Wamukoya, J. (2007), "E-government and Records Management: An Assessment Tool for E-records JOURNAL OF THE SOUTH AFRICAN SOCIETY OF ARCHIVISTS, VOL. 49, 2016 | SASA © 100. Readiness in Government", The Electronic Library, Vol. 25 No. 3, pp. 274-284. Available on https://doi.org/10.1108/02640470710754797. Accessed on 21st February 2022
Mutabazi, B. (2016). A case study to investigate the challenges of EMR implementation in four
district Hospitals in Rwanda (Doctoral dissertation, University of Rwanda).
Mutale, M. (2017). Health workers' experiences with the use of SmartCare for decision making
in selected health facilities in Mongu and Limulunga districts of Western Province, Zambia (Doctoral dissertation, The University of Zambia).
Mwanza, L. (2019). An assessment of the appropriateness of SmartCare electronic medical
record system in the delivery of HIV/AIDS services: A case study of six (6) health facilities in Lusaka district of Zambia (Doctoral dissertation, The University of Zambia).
Mweebo, K. (2014). Security of electronic health records in a resource-limited setting: The case
of SmartCare electronic health record in Zambia. Australian eHealth Informatics and Security Conference Conferences, Symposia and Campus Events. Cowan University, Perth: Western Australia. https://doi.org/10.4225/75/5798297631b47.
Mwiinga S. (2019) The E-health Systems in Zambia. Daily Nation Newspaper. Issued on 13th Sept 2019. Available in https://www.pressreader.com/zambia/daily-nation-newspaper/20190913/281668256675814. (Accessed on 14th March 2020)
National Archives of Australia (2014). Information and Records Management Policy. Available from: http://www.naa.gov.au/records-management/strategic-information/information-governance/key-documents/policy.aspx (Accessed on 4th February 2022).
Nawa, Doreen (2018) UTH medical records earmarked to enter digital era. Daily Mail issued on 7th January. Available at http://www.daily-mail.co.zm/tag/digital-era/. Accessed on 4th March 2020
Nengomasha, C. T. (2009). A study of electronic records management in the Namibian public service in the context of e-government (Doctoral dissertation, University of Namibia).
Ng’andu, D. and Haabazoka, L. (2024) A Study of the Effect of Health Records Digitalization on
Healthcare Facility Operational Efficiency. Open Journal of Business and Management, 12, 1135-1157. doi: 10.4236/ojbm.2024.122060.
Okello-Obura, C. (2011). Records and archives legal and policy frameworks in Uganda. Library
Philosophy and Practice (journal). Available at: https://digitalcommons.unl.edu/libphilprac/608. (Accessed on 2nd Feb 2021).
Pande, K. F. (2022). Investigating the implementation of SmartCare electronic health record
system project in Zambia using tenets of project management (Doctoral dissertation, The University of Zambia).
Ravindra, S. S., Chandra, R., & Dhenesh, V. S. (2015). A study of the management of electronic medical records in Fijian Hospitals. arXiv preprint arXiv:1507.03659. Available on https://doi.org/10.48550/arXiv.1507.03659. (Accessed on 10th August 2022).
SanJoaquin, M. A., Allain, T. J., Molyneux, M. E., Benjamin, L., Everett, D. B., Gadabu, O. & Heyderman, R. S. (2013). Surveillance Programme of IN-patients and Epidemiology (SPINE): implementation of an electronic data collection tool within a large hospital in Malawi. PLoS medicine, 10(3), e1001400
Shah, J. R., Murtaza, M. B., & Opara, E. (2014). Electronic health records: Challenges and
opportunities. Journal of International Technology and Information Management: Vol. 23: Iss. 3, Article 10. DOI: https://doi.org/10.58729/1941-6679.1082
Available at: https://scholarworks.lib.csusb.edu/jitim/vol23/iss3/10 . Accessed on 11th Nov 2023
Silvestre, E. (2018) How Electronic Health Records Strengthen the Health Systems of Low- and Middle-Income Countries: Learning from Eswatini and Mexico. Chapel Hill, NC: MEASURE Evaluation, University of North Carolina
SmartCare Zambia. (2024). About SmartCare. Retrieved from https://smartcarezambia.io
(Accessed on 16th February 2025)
Stephen, M and Frank, L. (2024). The Role of Electronic Health Records in Transforming
Healthcare Delivery and Financial Gains. Available at: https://www.researchgate.net/publication/377407661. (Accessed 16th Dec 2024)
Tsvuura, G. (2022). "Knowledge and skills for managing digital records at selected state
Universities in Zimbabwe", Journal of the South African Society of Archivists, Vol. 55 No. 1, pp. 110-123.
Thit, W. M., Thu, S. W. Y. M., Kaewkungwal, J., Soonthornworasiri, N., Theera-Ampornpunt,
N., Kijsanayotin, B., & Pan-Ngum, W. (2020). User acceptance of electronic medical record system: implementation at Marie Stopes International, Myanmar. Healthcare Informatics Research, 26(3), 185-192
Van Reisen, M. (2017). International cooperation in the digital era. Universiteit Leiden.
Waithera L, Muhia J, Songole R (2017) Impact of Electronic Medical Records on Healthcare
Delivery in Kisii Teaching and Referral Hospital. Med Clin Rev. Vol. 3 No. 4: 21.
World Health Organization (WHO) (2006). Medical records manual: a guide for developing
Countries. Manila: WHO Regional Office for the Western Pacific.