Digital health for Tuberculosis control - findings from the piloting of an electronic medical record in Luanda (Angola)

Sep 30, 2026

Digital health using electronic medical records (EMR) is investigated for strengthening tuberculosis (TB) surveillance and care outcomes in Angola, where EMR adoption in TB services remains limited despite TB being a major public health burden. The study piloted an aTB EMR system in three Luanda health facilities from January 2022 to February 2023. It evaluated EMR adequacy via comparisons with paper records, usability through semistructured interviews, and sustainability through interviews with staff and managerial stakeholders.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Background

Global and local TB burden context

Rationale for EMR in TB services

Robbiati etal. BMC Medical Informatics and Decision Making (2026) 26:4 [https://doi.org/10.1186/s12911-025-03270-7](https://doi.org/10.1186/s12911-025-03270-7) BMC Medical Informatics and Decision Making RESEARCH Open Access Digital health for Tuberculosis control: findings from the piloting of an electronic medical record in Luanda (Angola) Claudia Robbiati 1,2*, Maria Elena Tosti 1, Joaquim Tomas3, Giulia Natali3, Luca De Simeis3, Nsuka Da Silva3, Florentino Ferraz Joaquim3, Daniel Tulomba3, Neusa Lazary4, Janet Adão5, Fabio Manenti6 and Maria Grazia Dente 1 Abstract Background Digital health, like the use of electronic medical records (EMR), has been highlighted as a potential avenue to improve Tuberculosis (TB) surveillance and treatment outcomes. In Angola this technology remains largely untapped within TB health services, despite TB is a huge public health burden. A previous study described the development of aTB EMR system, and the current study fostered the piloting oftheTB EMR system in three health facilities of Luanda from January 2022 to February 2023. Methods To assess the adequacy of the EMR system (accuracy and completeness) comparison of paper-based medical records and EMRs was performed. Secondly, to assess the user-friendliness of the EMR system 24 semistructured interviews were conducted with the personnel of the health facilities. Finally, to assess the sustainability of the EMR system semi-structured interviews were performed with the same personnel and 8 managerial staff and representatives of Angolan Institutions. Results From the study it emerged that the TB EMR system allowed to reduce errors, time, the lack of patient information, and the EMR system users described it as easy to use with adequate training. Regarding the sustainability of the system, its continuity and scalability seem feasible if proper financial support is granted. Conclusion Continuity to this phase of digital ization of the TB data and information reported in the paper-based clinical record should be supported to gradually move to a transition to the use of the EMR system alone (electronicfirst approach), if adequate and continuous training is provided. Keywords Electronic medical records, Tuberculosis, Angola *Correspondence: Claudia Robbiati [claudia. robbiati@iss.it](claudia. robbiati@iss.it) 1National Center for Global Health, Italian National Institute of Health,(Istituto Superiore di Sanità), Rome, Italy 2Public Health and Infectious Diseases Department, Sapienza University of Rome, Rome, Italy 3Doctors with Africa CUAMM, Luanda, Angola 4Public Health Department, Bureau of Public Health of Luanda (Gabinete Provincial de Saúde de Luanda), Luanda, Angola 5Direction, Anti-Tubercolosis Dispensary of Luanda (Dispensário Antituberculose de Luanda), Luanda, Angola 6Doctors with Africa CUAMM, Padua, Italy © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Robbiati et al. BMC Med

FAQs

What was the purpose of piloting the TB EMR system in Luanda?

To test how effectively the electronic medical record could support TB surveillance and treatment processes in three health facilities in Luanda, where EMR use in TB services was limited.

How was the EMR system evaluated in the study?

Adequacy was assessed by comparing paper-based records with EMRs for accuracy and completeness. User-friendliness was assessed through 24 semistructured interviews, and sustainability through additional semistructured interviews with staff and managerial representatives.

What benefits and sustainability factors were reported?

The TB EMR system reduced errors and time and addressed missing patient information, and users described it as easy to use with appropriate training. Continuity and scalability were viewed as feasible with proper financial support and adequate continuous training.

Sep 30, 2026

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