Adapting REDCap for COVID-19 Laboratory Data Management in Botswana - Experiences, Lessons and Challenges

Abstract

Abstract Background The COVID-19 pandemic brought challenges requiring timely health data sharing to inform decision making on appropriate interventions at a national level. To streamline the collection and integration of data, we designed and piloted a workflow utilizing the REDCap platform. Our approach focused on establishing efficient COVID-19 data flows within a national public health laboratory, enabling seamless integration with the national district health information management system (DHIS2). This integration facilitated an automated centralized reporting of COVID-19 results at the Ministry of Health. This paper reports the experiences, challenges and lessons learnt while designing, adapting, and implementing REDCap to support COVID-19 data management at the National Health Lab in Botswana. Methods A participatory design approach was adopted to guide the design, customization, and implementation of the REDCap platform in support of COVID-19 data management at the NHL. Twenty-nine NHL and four Ministry of Health personnel participated in the study, effective from 02 March 2020 to 30 June 2020. Participants’ requirements for an ideal COVID-19 data management system were established. NVivo 11 software supported thematic analysis of the challenges and resolutions identified during this study. These were categorized according to four themes of Infrastructure, Capacity Development, Platform constraints, and Interoperability. Results Overall, REDCap supported a majority of perceived technical and non-technical requirements for an ideal COVID-19 data management system at the NHL. Although some implementation challenges were identified, each had mitigation strategies such as procurement of mobile internet routers, engagement of senior management to resolve conflicting policies, continuous REDCap training, and the development of a third-party web application to enhance REDCap’s capabilities. Lessons learnt informed next steps and further refinement of the REDCap platform. Conclusion Implementation of REDCap at the NHL to streamline COVID-19 data collection and integration with national systems was feasible despite its emergency implementation during the pandemic. By piloting and implementing the REDCap workflow at a national public health laboratory, we demonstrated feasibility for centralized reporting of COVID-19 cases, enabling timely and informed decision-making at the national level. Challenges faced presented lessons learnt to inform sustainable implementation of digital health innovations in a resource-constrained environment.