title: A global approach to the management of EMR (electronic medical records) of patients with HIV/AIDS in sub-Saharan Africa: the experience of DREAM software.
abstract: BACKGROUND
  The DREAM Project operates within the framework of the national health systems of several sub-Saharan African countries and aims to introduce the essential components of an integrated strategy for the prevention and treatment of HIV/AIDS. The project is intended to serve as a model for a wide-ranging scale-up in the response to the epidemic. This paper aims to show DREAM's challenges and the solutions adopted. One of the solutions is the efficient management of the clinical data regarding the treatment of the patients and epidemiological analyses.
  
  
  METHODS
  Specific software for the management of the patients' EMR has been created within the DREAM programme in order to deal with the challenges deriving from the context in which DREAM operates. Setting up a computer infrastructure in health centres, providing a power supply, as well as managing the data and the project resources efficiently and reliably, are some of the questions that have been analysed in this study.
  
  
  RESULTS
  Over the years this software has proved that it is able to respond to the need for efficient management of the clinical data and organization of the health centres. Today it is used in 10 countries in sub-Saharan Africa by thousands of professionals and by now it has reached its fourth version. The medical files of over 73,000 assisted patients are managed by this software and the data collected with it have become essential for the epidemiological research that is carried out to improve the effectiveness of the therapy.
  
  
  CONCLUSIONS
  Sub-Saharan Africa is the region hardest hit by HIV and AIDS in the world. However, the resources and responses adopted so far, to confront the epidemic, have at times been rather minimalist. The DREAM project has faced the battle against the epidemic by equipping itself with qualitative standards comparable to Western ones. The experience of DREAM has revealed that it is indeed possible to guarantee levels of excellence in developing countries, also in the sphere of ICT (Information and Communication Technology), thus making the intervention even more effective and contributing to bridging the digital divide.
authors.affiliation: Dipartimento di Fisica, Sezione Informatica, Università degli studi di Messina, Messina, Italy. a.nucita@gmail.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Nucita
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Bernava
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Bartolo
authors.forename: Fabio Di Pane
authors.initials: FD
authors.lastname: Masi
authors.forename: Pietro
authors.initials: P
authors.lastname: Giglio
authors.forename: Marco
authors.initials: M
authors.lastname: Peroni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pizzimenti
authors.forename: Leonardo
authors.initials: L
authors.lastname: Palombi
mesh_terms: D017954:Africa South of the Sahara; D003199:Computer Systems; D006679:HIV Seropositivity; D006801:Humans; D007391:International Cooperation; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D012984:Software