SmartCare is a US Center for Disease Control (CDC-Zambia) initiated nationally scalable Electronic Health Record System designed specifically for low resource, disconnected settings. SmartCare has the objective of improving the quality of health care (and health) by providing support o deliver “Continuity of Care” where existing paper systems are failing to preserve a longitudinal data view, and where clinics may often have no telecommunications.


Working collaboratively with the the Zambian Ministry of Health, the Center for Disease Control, the Elizabeth Glaiser Pediatric AIDS Foundation Center for Infectious Disease Research in Zambia (CIDRZ), Tulane University Technical Assistance Project Ethiopia (TUTAPE), and other groups, Dimagi is responsible for providing remote and in-country technical support and development on the SmartCare Platform. SmartCare supports longitudinal record-keeping for a variety of health verticals, including HIV/AIDS treatment, TB care, VCT, and antenatal care. It provides clinical decision support, touchscreen interaction, off-line data synchronization, and data portability via the use of smart cards. Additionally, the system provides complex data access through a large catalog of reports that includes HMIS reports, PEPFAR reports, early warning indicators, treatment failure lists, and individual patient summaries.

Our Role

Dimagi began working with the Center for Disease Control and Prevention in Zambia in 2004 to design a country-wide smart card based EMR and HMIS system. The objective of the project was to track patient information across rural and urban clinics in order to improve continuity of care for the patients and providers, as well as to strengthen the HMIS capacity of the country. SmartCare currently holds over 250,000 patient records, and is in 459 clinics in all 72 districts in Zambia, making it the largest system of its kind in Africa. Dimagi supports technology in SmartCare to allow partnering NGOs, health management officials, and providers to merge and access data in a secure and auditable manner, and allow data to be aggregated without the need for a central server or network connection. Dimagi participated on design and development of the software while growing and training local technical staff working for several organizations.

From Zambia to Ethiopia

Tulane University Technical Assistance Project Ethiopia (TUTAPE), with support from Dimagi, is currently implementing SmartCare in Ethiopia. Dimagi has supported TUTAPE through remote developer support, in-country training and development, and training Ethiopian developers in our Boston office. The Ethiopian version of SmartCare is in pilot stage and expected to be widely deployed in the upcoming year.

Key Features

SmartCare uses touch screen data entry (mouse and keyboard may also be used) to enable use of existing staff for capturing data, and it replaces the hand generated management reporting tally and register system to save labor. The ease of data entry makes the system a candidate for clinician user ‘E-First’ deployments, with the attendant real-time clinical decision support possibilities.

Dimagi has supported development work on the system since 2004 along with several development and implementation partners including:

  • Zambian Ministry of Health
  • United States Center for Disease Control, Zambia
  • Center for Infectious Disease Research in Zamia (CIDRZ)
  • Elizabeth Glaiser Pediatric AIDS Foundation
  • Tulane University Technical Assistance Project Ethiopia (TUTAPE)
  • Catholic Relief Services

Components of the system include:

  • One click PEPFAR and HMIS report genreation
  • ‘Circuit Rider’ merge capabilities for district, provincial, and national de-identified datasets
  • Secure Smart Card portable health records
  • Pharmacy Drug Dispensation module
  • HIV adult and Pediatric HIV modules
  • Dashboard patient view
  • Fully customizable role basd security