Figures & Tables
Figures
Screenshot of case reporting digital form co-created with Co-creation Hub and Lifebank in collaboration with the Nigerian Institute of Medical Research for the COVID-19 drive-through test center.
Tables
- TABLE 1.
Co-Creation Hub Research and Observations Conducted at Nigerian Institute of Medical Research on Data Collection and Data Integrity
Method When How Outcome Guided tour and observation February 2020 Before the first solution The NIMR team led 2 members of the CcHUB team on a guided tour of the facility, and their entire data collection process was observed. Identification of gaps and inconsistencies with the data collection and management process. Secondary research February 2020 At the inception of the new identified challenge (Improving the integrity of data collected) The team explored recent publications, news articles, and case studies that focused on health care data management to identify some common challenges, approaches, and theories. An understanding of the most important elements of data integrity in health care. Observation March 2020 During and after the secondary research The team (CcHub and Lifebank) spent more time at the NIMR facility to explore their data collection and management process. Identification of other inconsistencies with the data collection and management process. Process mapping April 2020 Before the drive-through COVID-19 test center A co-creation session was held with the NIMR team to brainstorm on developing the process of operation for the drive-through COVID-19 test center that was to be based within the NIMR facility. Process flow of the operations of the test center. Co-creation sessions April 2020 Before the drive-through COVID-19 test center A series of subsequent co-creation sessions were held with members of both the NIMR and Lifebank administrative team.
There were 5 virtual brainstorming sessions where participants co-created potential ideas for how to automate the process of the operation at the COVID-19 test center.Up to 20 automation feature ideas that addressed data quality, crowd management, ease of communication, and many other administrative issues. Survey and behavioral study August-September 2020 After the launch of the COVID-19 test center and the digital system The team conducted behavioral research in April to provide guidance for health administrators and policy makers on the factors that enhance the effective utilization of structures and platforms for service delivery. The study included 566 patients who had been invited for a COVID-19 test through the digital platform. Unpublished data
The findings also contributed to further development of the solution.Abbreviations: CcHub, Co-creation Hub; COVID-19, coronavirus disease; NIMR, Nigerian Institute of Medical Research.
- TABLE 2.
Characteristics of Data Integrity Considered as They Relate to the NIMR COVID-19 Test Center
Characteristics Definition Completeness Completeness refers to the availability of all relevant and required information. For example, a patient’s first and last name and address are required, but the middle initial and state or origin are optional. Data can be complete even if optional data are missing. Accuracy The degree to which data correctly describes the "real world" object or event being described. In the case of TB cases, the phone numbers provided did not reflect the patients’ phone numbers in the real world and as such were not accurate. Timeliness Timeliness considers how up-to-date the information is and how well it can be used for real-time reporting. The need to still transcribe data collected on paper forms at the point of registration creates a delay in real-time reporting. Validity Validity measures whether a value conforms to a preset standard, format, or syntax. Patient information like gender, weight, test results, etc. can easily be recorded with the wrong syntax. For example, recording weight in tons as opposed to pounds. Uniqueness Uniqueness is a measure of duplication of items in a data set. This measures how often 1 or more patients have had their data duplicated and listed as a separate entity. Security The protection of a patient’s data against unauthorized access or corruption is necessary to ensure data integrity. Specific patient data like test results and first line addresses are critical and need to be protected from authorized access. - TABLE 3.
Relevant Stakeholders Engaged in the Human-Centered Design Approach of a Digital System in Nigeria
Stakeholder Patients This included any suspected or high-risk persons who may be experiencing symptoms of the virus or may have been in contact with confirmed or probable cases and want to get tested or are required to get tested. Health Facilities and Test Center Administrators These were either specialized COVID-19 test centers or general health care facilities that have the capacity to run a significantly high number of tests daily to receive insights from other health care administrators that may benefit the solution focused on COVID-19. A key stakeholder in this category is NIMR, and in the case of this project, they provide all the necessary testing tools and infrastructure required to run the drive-through test center. NIMR personnel also served as the center administrators and lab managers. The role of the center administrators was to manage the drive-through system and oversee the collection of test samples. The lab managers were NIMR scientists responsible for running the tests, validating, and reporting results to the relevant authorities. Lifebank Health care technology and logistics company that is known for applying technology in solving health care problems.
Lifebank took on the role of digital platform administrators and managed activities such as contacting patients, sending invites, while also supervising the use of the platform by other stakeholders (NIMR and patients) during the design process. As delivery partners for the test center, it was essential to engage NIMR and Lifebank teams in the design process, particularly in brainstorming sessions and product testing to encourage their buy-in and drive equity.Government Institutions and Policy Makers Timely and accurate data is critical in aiding government institutions better make strategic and timely decisions regarding the pandemic. The NCDC is the country’s public health institute responsible for the preparedness, detection, and response to infectious disease outbreaks and public health emergencies. As Nigeria’s foremost public health institute, data on all tests conducted daily were reported to NCDC representatives on the ground. Insights gathered from this data helped to coordinate national public health responses and policy making. The NCDC personnel were indirectly engaged through our partnership with NIMR to understand the most important data types and formats to them. The Research Community and the General Public The importance of accurate, complete, and timely data for research in public health cannot be underestimated as the insight gathered by the research community contributes to the body of knowledge available for the general public and policy makers. The system strengthens the integrity of data collected and analyzed by researchers which will, in turn, ensure accurate insights and better understanding and management of the pandemic. Abbreviations: COVID-19, coronavirus disease; NCDC, Nigeria Center for Disease Control; NIMR, Nigerian Institute of Medical Research.
Characteristics Feature Result Completeness and consistency Form validation The platform has been able to achieve 100% completeness on all required fields. Accuracy Address validation 91% of all addresses (location) entered on the platform were validated. They all contain the state, local government area, and area details; and can be located on Google maps. Phone number validation and SMS communications The platform was able to validate and verify 100% of all phone numbers. Security and privacy Strict access control The platform has strict user access levels that allow us to ensure that only physicians and lab managers have access to test results. Data anonymization To protect the patient's privacy, their data are anonymized for users who do not require them. For example, those who run tests and upload results do not have access to the patients’ personal information. Timeliness Real-time data collection and delivery All data collected are made available on the dashboard in real-time with no delays. Validity Duplicate entries restriction At the launch of the system, the platform received 75% unique submissions.
However, after introducing the duplicate entry restriction feature in April 2020, this improved to 79% and by June 2020, we had up to 99% unique submissions.
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