e-PC 101 : an electronic clinical decision support tool developed in South Africa for primary care in low-income and middle-income countries

► Primary Care 101 (PC101), now called PACK (Practical Approach to Care Kit), is an effective pointof-care clinical decision support tool for primary care in health systems in low-income and middle-income countries. ► Digital delivery of medical content has potential benefits for healthcare workers, patients and health systems. ► The development and implementation of electronic PC101 across four primary care clinics in South Africa has demonstrated its feasibility and has flagged challenges for its further development and scaling. AbSTrACT Health technology is increasingly recognised as a feasible method of addressing health needs in low and middleincome countries (LMICs). Primary Care 101, now known as PACK (Practical Approach to Care Kit), is a printed, algorithmic, checklist-based, comprehensive clinical decision support tool. It assists clinicians with delivering evidence-based medicine for common primary care presentations and conditions. These assessment and treatment guides have been adopted widely in primary care clinics across South Africa. This paper focuses on the process of designing, developing, and implementing a digital version of the clinical decision support tool for use on a tablet computer. Lessons learnt throughout its development and pilot implementation could apply to the creation of electronic health interventions and the digitisation of clinical tools in LMICs.