E-health systems for management of MDR-TB in resource-poor environments: a decade of experience and recommendations for future work.

INTRODUCTION Multi drug resistant TB MDR TB is a complex infectious disease that is a growing threat to global health It requires lengthy treatment with multiple drugs and specialized laboratory testing To effectively scale up treatment to thousands of patients requires good information systems to support clinical care reporting drug forecasting supply chain management and monitoring METHODS Over the last decade we have developed the PIH EMR electronic medical record system and subsequently OpenMRS TB to support the treatment of MDR TB in Peru Haiti Pakistan and other resource poor environments RESULTS We describe here the experience with implementing these systems and evaluating many aspects of their performance and review other systems for MDR TB management CONCLUSIONS We recommend a new approach to information systems to address the barriers to scale up MDR TB treatment particularly access to the appropriate drugs and lab data We propose moving away from fragmented vertical systems to focus on common platforms addressing all stages of TB care support for open data standards and interoperability care for a wide range of diseases including HIV integration with mHealth applications and ability to function in resource poor environments