The key lessons learned for a pre-implementation phase include the following:

• The need to establish a clear vision for SORMAS use cases
• The realization that any health system can successfully implement SORMAS if a proper needs assessment and context-appropriate planning is done
• An accurate and comprehensive resource needs estimation beyond the perceived “free” open-source software to account for cost of hardware and human resources
• A plan for sustainable financing beyond the pilot phase
• An institutional home for SORMAS within the health system as well as a coordinating mechanism for day-to-day implementation
• A clear plan for knowledge and skills transfer, especially where IT knowledge initially lies within a private-sector, nongovernment partner
• The provision of adequate country-specific data hosting server capacity In the pilot phase, it is imperative to be proactive about knowledge and skills transfer while having a strong learning and evaluation component to inform adjustments for the expansion.

The key lessons that span all phases from pre-implementation include the following:

• Needing to maintain political will and buy-in from high political offices to technical leadership through ongoing strong advocacy
• Adopting a multipronged approach to training that includes frontline workers and their managers and supervisors to ensure strong internal advocacy
• Leveraging the role of the SORMAS Foundation as a facilitator of the entire process through software curation, training and accreditation, implementation support, and community building.

As SORMAS continues to expand across countries, it will be valuable to continue learning from key implementation lessons in comparable contexts to help achieve the desired and ideal outcomes of a SORMAS deployment.