Malawi has 1 million people who are HIV positive and just 150 doctors in the entire country. The Baobab Health Partnership has developed a patient management system that allows poorly qualified health care workers to provide top quality HIV treatment, and thus fill this human resource gap. To accomplish this, Baobab has crafted a unique touchscreen user interface that captures data in real time at the point of patient contact. Custom built touchscreen clinical workstations along with software developed in Ruby on Rails and client side javascript provide an interface with finger sized buttons and a workflow that is intuitive even for health care workers with no previous computer experience. The system has been developed entirely from open source tools, including usage of the OpenMRS data model and tools like ruby on rails, svn, firebug, and selenium for development. Furthermore, Baobab has released the javascript based touchscreen toolkit as open source software, which converts any web application into a touchscreen user interface. Baobab is currently piloting the system at three sites, and is working with the Malawi ministry of health to plan a national rollout to 60 high burden sites within the next year. The presentation will focus on the philosophy, benefits and challenges of real time patient management, along with a demonstration of the system and a 1 minute video showing the system in use in Malawi. - Mike McKay - Malawi