Development and national scale implementation of an open-source electronic laboratory information system (OpenELIS) in Côte d’Ivoire: Sustainability lessons from the first 13 years

•Factors for scaling and sustaining an eLIS in LMICs have not been previously described in the literature.•Successful adoption, scaling, and sustainment of OpenELIS in Côte d'Ivoire relied on early collaboration with partners, regulatory agencies, and technical experts into every step of the design, implementation, and evaluation phases.•Entities planning to nationally scale an eLIS should plan for 1) workforce development in both end users and system administrators; 2) financial sustainability; and 3) institutionalization of government ownership and technical leadership.•An open-source eLIS can increase accuracy and timeliness of clinical laboratory data supporting diagnostic testing and monitoring in a resource limited setting such as Cote d’Ivoire.