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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 6, November/December 2015
AFRICA
229
Electronic register system: development and testing
We aimed to replace the paper-based data-collection forms with
electronic forms that could be deployed on inexpensive and
widely available mobile devices (e.g. phones and tablets), and
to associate these forms with a version of the WHF’s register
database that would automatically and continuously be updated
and readily accessible to multiple users simultaneously for
patient care, data analysis and reporting purposes, as illustrated
in Fig. 3.
We developed the electronic data-collection forms on the
CommCare platform,
17
an open-source, cloud-based software
platform for health programmes that supports the development
of customised data-capture tools using mobile devices. Our
lead programmer (JVD) had general software programming
experience only, with no prior expertise specific to CommCare.
To become acquainted with the platform, the CommCare online
training course was completed.
18
We then developed a number of
electronic data-collection forms by dividing the various sections
of the WHF data-collection form into smaller sub-forms,
16
as
illustrated in Table 1. This approach provides greater flexibility
for subsequently updating individual elements of the form and
tailoring them to local needs.
Once the forms were developed, we created data-extraction
jobs that export data from CommCare and map them to a
spreadsheet in Microsoft Excel, with a table structure and data
labels that are identical to the WHF database. We then created a
copy of the WHF database in Microsoft Access
®
2010 and used
the standard data import features of the program to ‘link’ the
database to the spreadsheet. Once established, subsequent data-
extraction jobs can overwrite the spreadsheet with new data,
which will automatically be visible in the WHF database.
We identified a number of minor technical issues for
which we implemented adjustments in our copy of the WHF
database, mainly to account for the different ways that data are
represented in Microsoft Access
®
versus CommCare, such as the
representation of missing values (‘ ’ or ‘–’), the representation
of binary values (‘yes/no’ or ‘true/false’) and the use of date
formats.
Fig. 2.
Data-collection form for the WHF patient register database, page 2.
Table 1. Overview of what forms are used to collect the
data elements in the WHF patient register database and the
eRegister. The data elements in the table refer to Figs 1 and 2.
WHF patient register
database
eRegister
Data elements
Data collected on the
following form
Data collected on the
following form
Personal details
Data-collection form Data-collection form
Secondary prophylaxis Data-collection form Data-collection form
Follow-up
appointments
Data-collection form Schedule follow-up
appointments
Diagnosis
Data-collection form Diagnosis
Cardiac surgery
Data-collection form Surgery
Review results
Data-collection form Review results
Benzathine penicillin
injection delivery
Data-collection form Benzathine penicillin
delivery
Death
Data-collection form Death
Notes
Data-collection form Data-collection form