A Novel Mobile Health Software Platform to Improve Emergency Medical Systems: 912Rwanda.

Emergency care is essential to health systems, yet many low- and middle-income countries (LMICs) lack well-organised pre-hospital systems. The Ministry of Health of Rwanda created an emergency medical system in the capital city of Kigali in 2007, which is led by the Service d'Aide Médicale Urgente (SAMU) ambulance team. Based on a long-standing collaboration with SAMU, we developed, tested and implemented 912Rwanda, a mobile health software platform to integrate and improve communication between callers, dispatch staff, ambulance teams, and receiving facilities. We evaluated the reliability, fidelity, and usability of the 912Rwanda platform over 15 months since its full implementation in December 2023 during which the platform has been used in 9,293 completed incidents, with > 97% reliability and 99.99% uptime. Usability improved across all domains, including ease of use, effort, and demand, as measured by two scales. Our experience provides a robust and scalable example of mobile health technologies for LMICs as they develop essential emergency infrastructure in their settings.