C4G BLIS: Health Care Delivery via Iterative Collaborative Design in Resource-constrained Settings.

Health care delivery in resource-constrained settings presents many challenges, including highly diverse workflows, lack of standardization in data collection and reporting, and scarcity along many dimensions such as infrastructure, income and education. Many attempts to introduce state-of-the-art standardized systems for electronic record keeping have met with limited success in these settings. We present the design, implementation and evaluation of C4G BLIS, a system that tracks patients, laboratory samples, test results, and generates customized reports and trends for patients, physicians and health officials. The system was designed and deployed based on two major principles: (1) an Iterative Cooperative Design (ICD) methodology (2) immediate and continuous benefits for day-to-day users of the system. C4G BLIS is currently in use in many large hospital laboratories in Africa, and we report on the experience and results from these deployments, including improved turn-around times, reduced error rates and user satisfaction.