<s>
The	O
Zambia	O
Electronic	O
Perinatal	O
Record	O
System	O
(	O
ZEPRS	B-Application
)	O
is	O
an	O
Electronic	B-Application
Medical	I-Application
Record	I-Application
(	O
EMR	O
)	O
system	O
used	O
by	O
public	O
obstetric	O
clinics	O
and	O
a	O
hospital	O
(	O
the	O
University	O
Teaching	O
Hospital	O
)	O
in	O
Lusaka	O
,	O
Zambia	O
.	O
</s>
<s>
ZEPRS	B-Application
was	O
designed	O
to	O
improve	O
maternal	O
and	O
perinatal	O
outcomes	O
by	O
:	O
</s>
<s>
ZEPRS	B-Application
achieves	O
these	O
objectives	O
by	O
providing	O
the	O
following	O
:	O
</s>
<s>
ZEPRS	B-Application
components	O
include	O
a	O
voice	O
and	O
data	O
wireless	O
network	O
that	O
interconnects	O
facilities	O
;	O
wired	O
and	O
wireless	O
networks	O
within	O
facilities	O
;	O
a	O
data	O
center	O
managed	O
by	O
CIDRZ	O
;	O
and	O
an	O
electronic	O
perinatal	O
record	O
system	O
with	O
integrated	O
patient	O
referral	O
system	O
.	O
</s>
<s>
ZEPRS	B-Application
uses	O
a	O
tabbed	O
user	O
interface	O
and	O
role-based	O
access	O
control	O
system	O
to	O
enable	O
several	O
clinicians	O
to	O
share	O
the	O
same	O
computer	O
to	O
retrieve	O
and	O
enter	O
data	O
for	O
different	O
patients	O
.	O
</s>
<s>
ZEPRS	B-Application
has	O
been	O
developed	O
using	O
the	O
Java	B-Language
programming	I-Language
language	I-Language
.	O
</s>
<s>
Other	O
technologies	O
used	O
include	O
AJAX	B-General_Concept
,	O
Quartz	O
,	O
MySQL	B-Application
,	O
and	O
others	O
.	O
</s>
<s>
ZEPRS	B-Application
has	O
its	O
own	O
content	O
management	O
system	O
called	O
DynaSite	O
,	O
that	O
makes	O
it	O
easy	O
to	O
add	O
forms	O
,	O
fields	O
,	O
form	O
flows	O
,	O
and	O
business	O
rules	O
without	O
programming	O
.	O
</s>
<s>
RTI	O
has	O
developed	O
a	O
locally	O
installable	O
version	O
of	O
the	O
software	O
using	O
the	O
Eclipse	B-Application
Rich	B-Architecture
Client	I-Architecture
Platform	I-Architecture
(	O
RCP	O
)	O
and	O
the	O
Apache	B-Language
Derby	I-Language
embedded	O
database	O
.	O
</s>
<s>
This	O
version	O
uses	O
the	O
free	O
and	O
open	B-Application
source	I-Application
Zcore	O
platform	O
,	O
which	O
uses	O
an	O
implementation	O
of	O
RSS	O
to	O
transmit	O
data	O
over	O
intermittent	O
networks	O
,	O
such	O
as	O
mobile	O
phone	O
networks	O
.	O
</s>
<s>
Before	O
the	O
end	O
of	O
2003	O
RTI	O
had	O
worked	O
with	O
Comsol	O
to	O
add	O
Voice	B-Application
over	I-Application
Internet	I-Application
Protocol	I-Application
(	O
VoIP	B-Application
)	O
to	O
provide	O
voice	O
communication	O
between	O
facilities	O
,	O
and	O
had	O
extended	O
the	O
network	O
to	O
connect	O
multiple	O
buildings	O
in	O
clinic	O
compounds	O
and	O
to	O
multiple	O
wards	O
of	O
the	O
University	O
Teaching	O
Hospital	O
.	O
</s>
<s>
Three	O
to	O
nine	O
networked	O
PCs	B-Device
and	O
one	O
laser	O
printer	O
were	O
installed	O
in	O
each	O
clinic	O
,	O
as	O
well	O
as	O
additional	O
PCs	B-Device
and	O
printers	O
in	O
the	O
University	O
Teaching	O
Hospital	O
and	O
administrative	O
offices	O
.	O
</s>
<s>
The	O
ZEPRS	B-Application
data	O
center	O
was	O
installed	O
at	O
CIDRZ	O
,	O
which	O
housed	O
the	O
combined	O
ZEPRS	B-Application
technical	O
support	O
team	O
.	O
</s>
<s>
Standard	O
clinical	O
protocol	O
reference	O
works	O
and	O
email	O
were	O
made	O
available	O
to	O
clinicians	O
electronically	O
over	O
the	O
ZEPRS	B-Application
network	O
.	O
</s>
<s>
By	O
early	O
May	O
2004	O
RTI	O
had	O
completed	O
an	O
open	B-Application
source	I-Application
electronic	O
patient	O
referral	O
system	O
.	O
</s>
<s>
Also	O
in	O
May	O
2004	O
,	O
CIDRZ	O
asked	O
RTI	O
whether	O
the	O
ZEPRS	B-Application
software	O
could	O
be	O
adapted	O
to	O
help	O
in	O
managing	O
antiretroviral	O
therapy	O
(	O
ART	O
)	O
to	O
treat	O
patients	O
infected	O
with	O
the	O
Human	O
immunodeficiency	O
virus	O
(	O
HIV	O
)	O
.	O
</s>
<s>
ZEPRS	B-Application
was	O
launched	O
into	O
production	O
use	O
in	O
two	O
clinics	O
in	O
February	O
2006	O
.	O
</s>
<s>
Since	O
roll	O
out	O
was	O
completed	O
in	O
August	O
2007	O
,	O
ZEPRS	B-Application
has	O
been	O
used	O
by	O
24	O
public	O
obstetrics	O
clinics	O
,	O
as	O
well	O
as	O
six	O
wards	O
(	O
blocks	O
A-D	O
,	O
adult	O
ARV	O
ward	O
,	O
and	O
pediatric	O
ARV	O
ward	O
)	O
within	O
the	O
University	O
Teaching	O
Hospital	O
in	O
Lusaka	O
.	O
</s>
<s>
The	O
ZEPRS	B-Application
patient	O
record	O
database	O
has	O
been	O
used	O
since	O
February	O
2006	O
for	O
routine	O
health	O
surveillance	O
,	O
monitoring	O
,	O
and	O
supervision	O
of	O
health	O
care	O
.	O
</s>
<s>
A	O
2006	O
study	O
cited	O
the	O
use	O
of	O
a	O
ZEPRS-based	O
patient	O
record	O
system	O
as	O
one	O
of	O
four	O
key	O
factors	O
in	O
the	O
successful	O
rapid	O
scale-up	O
of	O
antiretroviral	O
therapy	O
at	O
primary	O
care	O
sites	O
in	O
Zambia	O
.	O
</s>
<s>
By	O
September	O
2011	O
ZEPRS	B-Application
contained	O
medical	O
records	O
for	O
more	O
than	O
510,000	O
patients	O
and	O
ZEPRS	B-Application
had	O
been	O
used	O
to	O
manage	O
multiple	O
pregnancies	O
for	O
more	O
than	O
20,000	O
mothers	O
.	O
</s>
<s>
Clinicians	O
in	O
25	O
facilities	O
have	O
used	O
ZEPRS	B-Application
to	O
manage	O
perinatal	O
care	O
during	O
more	O
than	O
7.7	O
million	O
patient	O
encounters	O
with	O
more	O
than	O
770,000	O
patients	O
and	O
during	O
more	O
than	O
335,000	O
deliveries	O
.	O
</s>
<s>
Information	O
regarding	O
the	O
impact	O
of	O
ZEPRS	B-Application
on	O
the	O
quality	O
of	O
health	O
care	O
and	O
health	O
outcomes	O
can	O
be	O
obtained	O
by	O
contacting	O
the	O
Center	O
for	O
Infectious	O
Disease	O
Research	O
in	O
Zambia	O
or	O
the	O
Zambian	O
Central	O
Board	O
of	O
Health	O
.	O
</s>
<s>
Since	O
ZEPRS	B-Application
was	O
launched	O
in	O
February	O
2006	O
it	O
has	O
been	O
continually	O
refined	O
and	O
enhanced	O
based	O
on	O
input	O
from	O
clinicians	O
and	O
emerging	O
needs	O
.	O
</s>
<s>
In	O
2008	O
RTI	O
worked	O
with	O
CIDRZ	O
to	O
implement	O
an	O
interface	O
with	O
the	O
Laboratory	B-Application
Information	I-Application
Management	I-Application
System	I-Application
(	O
LMIS	O
)	O
at	O
Kalingalinga	O
Clinic	O
,	O
enabling	O
lab	O
test	O
results	O
such	O
as	O
CD4	O
counts	O
to	O
be	O
transferred	O
to	O
patient	O
records	O
automatically	O
twice	O
daily	O
.	O
</s>
<s>
This	O
version	O
is	O
based	O
on	O
the	O
free	O
and	O
open	B-Application
source	I-Application
Zcore	O
platform	O
,	O
which	O
can	O
transmit	O
data	O
automatically	O
over	O
intermittent	O
networks	O
,	O
such	O
as	O
mobile	O
phone	O
networks	O
.	O
</s>
<s>
The	O
Zcore	O
software	O
platform	O
that	O
emerged	O
from	O
ZEPRS	B-Application
has	O
been	O
used	O
for	O
managing	O
pharmaceutical	O
supplies	O
in	O
health	O
centers	O
in	O
Nairobi	O
,	O
Kenya	O
,	O
managing	O
malaria	O
indoor	O
residual	O
spraying	O
operations	O
in	O
Kenya	O
,	O
and	O
managing	O
medical	O
and	O
legal	O
care	O
for	O
rape	O
survivors	O
in	O
South	O
Africa	O
.	O
</s>
<s>
ZEPRS	B-Application
has	O
been	O
released	O
by	O
RTI	O
as	O
free	O
and	O
open	B-Application
source	I-Application
software	I-Application
under	O
the	O
Apache	B-Application
Software	I-Application
License	I-Application
(	O
Version	O
2.0	O
)	O
.	O
</s>
<s>
RTI	O
has	O
released	O
ZEPRS	B-Application
documentation	O
under	O
a	O
Creative	O
Commons	O
Attribution-NonCommercial-ShareAlike	O
2.5	O
License	O
.	O
</s>
