OpenMRS is an open-source medical record system framework developed specifically for resource constrained countries battling with HIV AIDS to scale up the existing information management infrastructure. To transition from paper systems to electronic systems poses challenges to the traditional workflow of health service providers. Electronic systems pose new challenges such as privacy of patient records, integrity of medical record content, and maintaining continuity of care. It is important, therefore, to document these challenges and provide a conceptual framework of integrating electronic systems into day-to-day patient care and evaluating the possible benefits of such systems. Investments into these systems must be evaluated to measure the benefits of such technologies to patient care, public health systems, and outcomes research.