Introduction: Patients are required to share information with their doctors to facilitate correct diagnosis and determination of treatment, especially to avoid adverse drug interactions. However, most patients may refuse to divulge important information in cases of health problems such as psychiatric behavior and HIV status as their disclosure may lead to social stigma and discrimination. Despite efforts to fully implement and adopt Electronic Health Records System, there is limited attention to fully secure patients‟ details. Issues of privacy and confidentiality still remain a major concern at health facilities mainly in developing countries like Uganda. This study aimed to develop an encryption and decryption tool for privacy and confidentiality of patients‟ data stored in the Electronic Health Records Systems. Methods: The study used a design science research approach that adopted qualitative methods; Key Informant Interviews and Document review for data collection. The study was conducted at 2 study sites; Mukono district hospital (HC IV) and Doctor's Medical Hospital - Kampala. Participants were both health workers and Hospital Administrator working with the electronic health record at the respective health facilities. Data Flow Diagrams were used to design the desired artefact while development of the encryption and decryption tool, we used Hypertext Pre-Processor(PHP) time platform, which is an object-oriented programming language and is a block component that is made up of Cascade Style Sheet (CSS) and HTML(hypertext markup language ) embedded in PHP for it to be fully functional and be able to connect to and run on the server where most of the records and details of the activities are stored in the database. Results: This study was conducted between February and March 2021 and a total of fifteen (15) respondents were interviewed. The respondents pointed at various current mechanisms for privacy and confidentiality that included; user credentials, segregation of roles, training of users etc. while their challenges with adherence to privacy and confidentially such as loopholes with the existing mechanisms like a system taking long to log off when not being used, sharing of passwords, loss of passwords, not changing password after a period of time and hence a need for a second layer of security such as encryption and decryption tool. Conclusion/Recommendation: Inclusion of encryption and decryption features are very vital to enhance health facilities‟ capacity and measures for establishing privacy and confidentiality of patients‟ data. This will certainly limit unauthorized persons including hackers from accessing and utilizing patients‟ data as well as helping health information officers to keep track of log in history. The Ministry of Health, Uganda and implementers of EHR should adopt the encryption and decryption tool for use at the health facilities as second layer of security to ensure privacy and confidentiality of patients‟ data.

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