Development, Implementation, and Evaluation of a Health Information System for a Rural Clinic in Pakistan: A Pilot Model for Low-Resource Settings

Abstract

Background: Health information systems (HIS) play a pivotal role in modern healthcare by improving patient outcomes, enhancing data management, and supporting public health initiatives. Despite these benefits, HIS adoption remains limited in rural areas of low- and middle-income countries (LMICs), where healthcare challenges are more pronounced. This study describes the development, implementation, and evaluation of a clinician led HIS model in a rural clinic in Sadwal Kalaan, Punjab, Pakistan. Methods and Materials: A structured four-step approach was used in developing, implementing and evaluating the HIS: 1) assessing the need for a HIS through interviews and focus group discussions with the clinic manager, physicians, and auxiliary healthcare staff; 2) designing a system tailored to the clinic’s context; 3) implementing a patient intake form designed using a survey questionnaire; and 4) evaluating adoption guided by iterative feedback from key stakeholders and impact on healthcare delivery. Results: The HIS was successfully integrated into the clinic’s workflow, facilitating patient follow-up by enabling retrieval of previous medical visits. Data was collected from 3,900 patient encounters on demographics, medical presentation, management, and overall patient satisfaction. Nearly all (99.8%) of respondents provided sufficient information regarding their condition and treatment. The system enhanced clinic operations by facilitating data-driven decision-making, optimizing resource allocation, and informing medication stock management. Despite initial resistance from staff regarding additional documentation workload, structured training and workflow adaptations ensured successful adoption. Conclusion: Overall, the findings demonstrate that implementing a clinician-led HIS in rural Pakistan is feasible and beneficial, offering scalability for similar settings in other LMICs.