Abstract

Background: Laboratory Information Management System (LIMS) is essential for improving data accuracy, workflow efficiency, and clinical decision-making. Uganda drafted a modular national LIMS strategy in 2017 to strengthen laboratory services; however, evidence on progress of system performance and user experience remains limited. This study evaluates LIMS performance, user satisfaction, organizational impact, and compliance with data protection regulations. Methods: A cross-sectional study was conducted between August and September 2024 across 42 health facilities in Uganda, purposively selected by region, level of care, and LIMS implementation status. A semi-structured digital questionnaire, informed by the DeLone and McLean Information Systems Success Model, was administered via Kobo collect. The instrument assessed system and information quality, user satisfaction, organizational impact, and compliance with the Uganda Data Protection and Privacy Act 2019. Data were analyzed using STATA 12.0 and Microsoft Excel, with descriptive statistics summarized across all variables. Results: A total of 114 respondents participated, predominantly laboratory personnel, across National Referral Hospitals (n=6), Regional Referral Hospitals (n=16), General Hospitals (n=11), and Health Centre IVs (n=9). Awareness of LIMS was high (>80%), with near-universal access to core modules; however, access to specialized systems remained limited, including Lab Results SMS (38%) and HIV Drug Resistance Dashboard (45%). System reliability was high (≥80%) for most modules, but infrastructure challenges particularly power outages (32%) and network failures (29%) significantly affected system availability. Integration was limited, with only 34% of laboratory analyzers interfaced and EMR(Electronic Medical Records) LIMS integration reported in 19% of facilities. LIMS use was associated with improved data utilization (85%) and enhanced communication and collaboration (97.6%). However, gaps in data governance were observed, including absence of Information and Communication Technology (ICT) data safety Standard Operating Procedures (SOPs) in 35% of facilities, credential sharing (33%), and use of personal email for transmission (35.7%) Conclusion: LIMS implementation in Uganda has achieved substantial progress, particularly in the widespread adoption of core systems, high levels of system reliability, and notable improvements in data use and communication across facilities. However, important gaps remain, including infrastructure-related disruptions, limited interoperability with analyzers and EMRs, uneven access across facility levels, and inconsistencies in data governance practices. Addressing these areas presents a clear opportunity to enhance system performance.