Figures & Tables
Figures
- FIGURE 1
General Architecture of the MediCapt App
The screen on the left shows the home screen; the middle screen is the main menu that allows users to complete a new sexual violence form, browse saved forms, and sync their data when connected to the Internet; and the screen on the right shows an example of data-entry fields.
- FIGURE 2
Flow of Sexual Violence Evidence Using the MediCapt App
Abbreviation: API, application programming interface.
Congolese clinicians at Panzi Hospital in the Democratic Republic of the Congo participate in the collaborative design process of MediCapt.
- FIGURE 3
Pictogram Feature in the MediCapt App to Document Location and Type of Injuries
Left: The provider can show the location of the patient's injuries on a pictogram, shown with red dots.
Right: The provider can also include additional clinical data (e.g., type, size, and depth) about a specific injury.
Documentation of sexual violence cases in the Democratic Republic of the Congo commonly entails use of several paper forms, including general ledgers, patient charts, and carnets.
Tables
- TABLE 1.
MediCapt Development Process Compared With Principles for Digital Development Benchmarks
Principles for Digital Development16 MediCapt Development Process Design with the user Develop context-appropriate solutions informed by user needs ✓ Include all user groups in planning, development, implementation, and assessment ✓ Develop projects in incremental and iterative manner ✓ Design solutions that learn from and enhance existing workflows, and plan for organizational adaptation ✓ Ensure solutions are sensitive to, and useful for, the most marginalized populations: women, children, those with disabilities, and those affected by conflict and disaster ✓ Understand the ecosystem Participate in networks and communities of like-minded practitioners ✓ Align existing technological, legal, and regulatory policies ✓ Design for scale Design for scale from the start, and assess and mitigate dependencies that might limit ability to scale ✓ Employ a systems approach to design, considering implications of design beyond an immediate project ✓ Be replicable and customizable in other countries and contexts Planned Demonstrate impact before scaling a solution In process Analyze all technology choices through the lens of national and regional scale ✓ Factor in partnerships from the beginning, and start early negotiations ✓ Build for sustainability Plan for sustainability from the start, including planning for long-term financial health In process Utilize and invest in local communities and developers by default, and help catalyze their growth Not done Engage with local governments to ensure integration into national strategy, and identify high-level government advocates ✓ Be data driven Design projects so that impact can be measured at discrete milestones with a focus on outcomes rather than outputs In process Evaluation innovative solutions and areas where there are gaps in data and evidence ✓ Use real-time information to monitor and inform management decisions at all levels Planned for future When possible, leverage data as a by-product of user actions and transactions for assessment Planned for future Use open data, open standards, open source, open innovation Adopt and expand existing open standards Partially done Open data and functionalities, and expose them in documented APIs ✓ Invest in software as a public good ✓ Develop software to be open source by default with the code made available in public repositories and supported through developer communities Planned for future Reuse and improve Use, modify, and extend existing tools, platforms, and frameworks when possible ✓ Develop in modular ways favoring approaches that are interoperable over those that are monolithic by design ✓ Address privacy and security Assess and mitigate risks to the security of users and their data ✓ Consider the context and needs for privacy of personally identifiable information when designing solutions and mitigate accordingly ✓ Ensure equity and fairness in co-creation, and protect the best interests of the end-users ✓ Be collaborative Engage diverse expertise across disciplines and industries at all stages ✓ Work across sector silos to create coordinated and more holistic approaches In progress Document work, results, processes, and best practices, and share them widely ✓ Publish materials under a creative commons license by default, with strong rationale if another licensing approach is taken ✓ Abbreviation: API, application programming interface.
- TABLE 2.
Barriers to Integrating MediCapt Sexual Violence Documentation App Into Existing Workflows Reported by Key Informants (N=9)
Type of Barrier Examples Infrastructural Frequent periods with no electricity
No Wi-Fi availability during electricity stoppage time
Lack of clarity regarding data storage, cloud location, and capacity
Limited or no availability of printers and copiers and their associated supplies
Systemic and organizational Questions regarding organizational support of project (at hospital, district, regional, and national levels)
Long-standing workflow practices that promote redundancy and inefficiency (need for multiple copies including the patient chart, carnet, and Standard Sexual Violence form)
Need to train multiple clinicians in using app and allowing clinicians time off for training
Limited or no availability of electronic medical record system or links to hospital archives
Personal behavior Educational barriers for technology use (minimal)
Personal leadership attributes that affect workflow within health care facility
Presence of and ability to negotiate perceived jealously and peer resentment
Degree of willingness to try new things
Degree of willingness to invest more time initially in learning and using app
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