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REDESIGNING A BASIC LABORATORY INFORMATION SYSTEM FOR THE GLOBAL
SOUTH

1 1 1 1
Jung Wook Park ; Aditi Shah ; Rosa I. Arriaga ; Santosh Vempala
1 Georgia Institute of Technology

ABSTRACT experience and thus foster better decision making eventually
leading to better service to the patients [4].
Laboratory information systems (LIS) optimize information
storage and processing for clinics and hospitals. In the recent Users in the global south aspire to embrace mobile devices in
past, developers of LIS for the global south have worked under clinical settings [5]. Considering that most of the available
the assumption that computing environments will be very open source LIS are web applications, we might assume
limited. However, the computing resources in the area have that they can be easily accessed using any web-browser
been rapidly enriched. This has also changed the expectations across different types of platforms and devices. One might
that users have about the LIS interface and functionality. In consider that since most devices come with a pre-installed
this paper, we provide a case study of C4G BLIS that has been web browser, there should be no additional effort required by
in operation for nearly a decade in seven African countries. the end-user to access a LIS on their preferred device. This,
In two studies that included 51 participants from three African however, is not always the case.
countries, we redesigned the LIS to better suit the changing
technical landscape and user needs and evaluated the new Not having appropriate interfaces that are suited for a given
design. The study procedure, usability metrics and lessons task is not just an inconvenience, but in fact it makes medical
learned from our evaluation provide a model that other professionals less efficient and less productive. Past studies
researchers can use. The findings provide empirical insights have found that varying screen sizes and different interaction
that can benefit designers and developers of LIS in the global mechanisms require substantially different approaches for
south. The results also highlight the need for adding usability accessing information [6, 7]. For example, participants using
specifications for international standard organizations. a small screen (640 x 480) had to put twice the search effort
as compared to those with a large screen (1074 x 768) [6].
Keywords - ICT4D, C4G BLIS, Laboratory Information
System, User Interface, Usability Standard, Global South In this paper, we provide a case study of the redesign of an
open source LIS to meet the emerging demands of the LIS
communities. C4G BLIS has been operating in seven African
1. INTRODUCTION
countries for almost a decade [8]. During this time, there have
In the past, computing resources available to hospitals in the been great strides in the growth of technical infrastructures
global south were very limited. As an illustration, the largest of the region it serves. We provide the details of a user
teaching and research hospital, University College Hospital, study comparing task execution times between devices with
in Nigeria managed medical records through a paper-based large and small screen dimensions. Actual users of the latest
system for more than a million patients in 2008 [1]. In recent version of C4G BLIS in three African countries participated
times, however, there has been a proliferation of computing in this user study. The findings helped us identify areas of the
technologies through investments coming from internal as system requiring redesign to improve their usability. We then
well as global sources [2]. The access to information and validate the impact of these redesign attempts and present the
communication technologies has grown up rapidly across results.
hospitals in Africa; mobile phone-based health applications
are becoming available, and country-wide health information 2. BACKGROUND
systems are also becoming digitized [2].
LIS have become a common patients’ data management tool
As computing environments in the hospitals are advancing, in many countries, and there are more than ten open source
medical staff such as doctors, nurses, and lab technicians software programs (e.g., Open-LIMS, Baobab LIMS, Bika
are exploring newer avenues to leverage technology for more LIMS, ERPNext Healthcare, eLabFTW, and GNU LIMS) in
efficient treatment and diagnosis for patients [3]. Health this category in 2019. LIS is specialized to support a variety
care professionals are adopting the use of smartphones or of needs, from DNA/RNA processing information to human
tablets with an aim to transform many tasks of their clinical biobanking and more. It also has a variety of features. Bika
practice [4]. For example, the use of laboratory information LIMS, for example, provides a responsive user interface with
system (LIS) on portable devices like smartphones can make features for reporting, inventory managing, and cataloging
accessing of patient clinical records a significantly smoother [9]. Occhiolino (also known as GNU LIMS) provides an

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