The purported advantages of EMR implementation in urban slums are widely promoted. Increasingly capable health information systems could facilitate communication, help coordinate care, and improve the continuity of care in disadvantaged communities like Kibera. However, available systems may not have the ability to simplify care or improve efficiency where funding and human resources are scarce, infrastructure is unreliable and health data demands are opportunistic, not strategic. This study described perceptions of local EMR stakeholders in two urban slum clinics. They shared many observations that may be important for other EMR initiatives to heed, and worried most about the sustainability of EMR initiatives in like communities. The future for EMR use in urban slums is promising. Innovative new technologies, such as mobile applications and point-of-care laboratory tests, could extend the reach of EMRs where infrastructure is wanting. New cloud-based EMR ecosystems, where data is collected and stored centrally could leverage cell phone networks to promote more health information sharing, coordination of care and ultimately better outcomes for vulnerable populations.Summary pointsWhat was already known on the topic?•Rapid urbanization is associated with growth in the number and size of urban slums and an associated rise in the burden of disease, further worsening an already fragmented and inefficient health care system.
