Work · Case 02

LAMISPlus — national HIV/AIDS EMR

Backend work on the electronic medical record Nigeria's national HIV/AIDS programme runs on.

headline metric: production at national scale

01 — Problem

What was going wrong

A national treatment programme needs one record per patient that every facility can read, that keeps working where the network does not, and that never leaks a patient's identity. The failure modes are not aesthetic: a duplicated patient record splits a treatment history, and a sync that silently drops a visit means somebody's regimen is wrong at the next appointment.

02 — Approach

The decision that resolved it

Treat correctness at the boundary as the whole job. Every write is validated against the programme's reporting definitions before it is accepted rather than cleaned up afterwards, because a record that reaches the database wrong has already been read by someone. The modular Spring service split keeps clinical modules independent, so a change to one programme area cannot quietly alter another's numbers.

The reason this case sits second rather than first is that it proves a different thing from the capstone. The capstone argues about design. This one is the evidence that the design habits survive contact with production — a system real clinicians open every day, where being wrong has a cost that is not measured in engineering time.

04 — What I shipped

What exists now

  • Backend modules in Java and Spring Boot against the shared patient record, built so each clinical area can change without touching the others.
  • Validation at the write boundary, matched to the national reporting definitions, so bad data is refused at the door rather than reconciled later.
  • Facility-level deployment and support work — installs, upgrades and the unglamorous debugging that keeps a record system usable in the places it is actually used.

05 — Result

What changed

Scope
National programme
LAMISPlus is the electronic medical record used by Nigeria's national HIV/AIDS treatment programme, deployed across participating facilities.
Data handling
No PII off-site
Every screenshot and demo of this work uses dummy records only. Patient data does not leave the facility deployment, and none of it appears here.

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