A cluster randomized trial in rural Lesotho tested care for uncontrolled hypertension led by lay community health workers with a mobile decision support tool.[1][2] A study compared this approach with referring patients to health facilities.[1] Trained lay people tested more than 6,600 people for high blood pressure over a five-month period.[2] They identified over 1,200 individuals with hypertension, of which over 500 had medically problematic levels.[2] About half of hypertensive patients received antihypertensive treatment prescribed by lay people according to clear protocols and with digital decision support.[2] This model improved blood pressure control better than the standard facility recommendation.[1][2] The study showed how to shift tasks to laypersons with targeted training, supervision and digital support in areas with a shortage of experts.[2] The results support integration into Lesotho's existing health system.[2]