ZEPRS

The Zambia Electronic Perinatal Record System (ZEPRS) is an Electronic Medical Record (EMR) system used by public obstetric clinics and a hospital (the University Teaching Hospital) in Lusaka, Zambia to improve patient care. The University of Alabama Birmingham (UAB) Center for Research in Women's Health (CRWH), RTI, and the Center for Infectious Disease Research in Zambia (CIDRZ) developed ZEPRS with local medical expertise and project engagement from the Lusaka Urban Health District, Central Board of Health and funding support from the Bill & Melinda Gates Foundation.

ZEPRS has been designed to improve maternal and perinatal outcomes by:

1. Improving perinatal care to women and postnatal care to neonates by:
   • Promoting adherence to good standard of care practices
   • Identifying and document potential medical/obstetrical problems so that effective therapies can be administered
   • Improving communication and referrals among providers
   • Enhancing monitoring and evaluation of outcomes, clinics, and providers
2. Improving efficiency, completeness, accuracy of documentation and reporting

ZEPRS achieves these objectives by providing the following major components:

• An electronic patient record system with patient record database shared among facilities
• A system that guides clinicians through the Zambian standard of care
• Intelligent rules that alert clinicians to problems and recommend patient referral when appropriate
• Standard & ad hoc reporting for supportive supervision, surveillance, and analysis
• An electronic-first system used by clinicians during the course of patient care
• An electronic referral system to improve the efficiency and effectiveness of referrals

In 2009 an average of nearly 10,000 new antenatal patients were registered in the system each month. Clinicians in 25 facilities have used ZEPRS during more than 3,400,000 patient encounters. By January 2010 ZEPRS contained medical records for nearly 340,000 patients.