A patient record system set up to improve health care and inform decision making in a Sub-Saharan African country needed improvement. Stakeholders, funders, and implementing partners tapped Vital Wave to independently evaluate the system’s overall performance in technical and non-technical areas, including governance, ownership, and operational issues. The firm was also tasked with providing strategic, actionable recommendations for systemic improvement. Vital Wave met with key stakeholders to understand their information needs and conducted field-based primary research with health workers and patients. The project provided a roadmap to help the local ministry of health, funders, and other partners collect better quality data and improve the management of programs in a variety of disease areas. The report also provided lessons and guidance to other countries attempting to deploy patient record systems.