LUSAKA, Zambia — Just as any good community healthcare manager should, Ignicious Bulongo has his eyes peeled for disease outbreaks from his post at the Ng'ombe Integrated HIV/TB Clinic, located in the Zambian capital.

The facility provides primary care to nearly 50,000 people, many of whom, Bulongo says, live in poverty, employed as domestic workers and bus drivers. Environmental and sanitation conditions are less than ideal, so catching disease outbreaks early on is crucial for protecting the community's health.

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The 2010 introduction of the SmartCare system, an electronic health record system developed by Zambia's Ministry of Health and the U.S. Center for Disease Control, has helped make Bulongo's job easier. Instead of holding patients accountable for paper "exercise books" documenting their medical histories, the details of individuals' diagnoses and treatments can now be stored on a smart card they hold in their wallets, as well as locally at their health clinic and in the larger SmartCare network.

"The SmartCare card came in because we had a challenge," Bulongo says. "Patients would go home and didn't care what happened to their exercise books."

The advantages of the digital system expand beyond its portability: Computerizing the communities' medical records helps Bulongo and other clinicians like him to catch disease outbreaks and medical trends earlier than ever before.

"If there's any outbreak, we'll catch it. The system will show if we see six cases of the measles within one day in people coming from the same area," Bulongo says, noting a recent bilharzia outbreak the clinic found with the help of the electronic system.

Bulongo says he constantly monitors reports from the system, and will be the first to know when an outbreak occurs.

The computer program was designed to be intuitive for clinicians without extensive computer experience or exposure. The system uses a touchscreen to reduce the learning curve and enable easy use by all health workers. With its two-hour backup battery, the system was designed for use in regions with unreliable power and limited telecommunication infrastructure.

"Often when you try to find a patient's history, the files are missing," Bulongo says. "The SmartCare system has helped us get rid of the headache."

The Ng'ombe clinic is just one of many to adopt the SmartCare system. Anti-retroviral clinics across all 10 provinces of Zambia, as well as in Ethiopia and South Africa, have adopted the e-care solution. The breadth of the SmartCare network is another one of its strengths — migrant patients no longer need to be held accountable for remembering their own health records. The smart card they carry in their wallets, which hooks up to the SmartCare network, will inform any clinician of their medical histories.

However, the SmartCare system, Bulongo admits, is not without its flaws. The system doesn't yet cater perfectly to local disease conditions.

"We're working with a developer to make the system more unique to our area, because we know, for example, which seasons we have which diseases," he says.

Though leagues behind in many other ways, Zambia's healthcare system has the electronic data edge over the West.

When U.S. Secretary of State Hillary Clinton saw the SmartCare system during a 2011 official visit, she said, "I might need to send some people here to see how it is done."

Two years later, Zambia maintains this innovative healthcare lead.

Zoe Fox is reporting on HIV/AIDS, TB, and malaria in Zambia with the International Reporting Project (IRP).

Image: Zoe Fox, Mashable