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Background The lack of unique patient identifiers is a challenge to patient care in developing countries. Probabilistic and deterministic matching approaches remain sub-optimal. However, affordable and scalable biometric solutions have not been rigorously evaluated in these settings. Methods We implemented and evaluated performance of an open-source facial recognition system, OpenFace, integrated within a nationally-endorsed electronic health record system in Western Kenya. Patients were first enrolled via facial images, and later match

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