Development of an integrated database and data collation system for monitoring and evaluating the public sector antiretroviral treatment (ART) in the Free State province, South Africa
Date
2006
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International AIDS Society (IAS), Geneva, CH
Abstract
ISSUES: Paper-based structured clinical records are widely used for monitoring and evaluating the
public sector HIV antiretroviral (ART) treatment program in South Africa. Computerized systems are
sometimes used for operational data capture but are usually limited to individual clinics and hospitals.
Important information also exists in other databases. A requirement exists to collate information into
electronic format and integrate data from a variety of sources to facilitate reporting and quality controls.
DESCRIPTION: Handheld computers (PDA's) were used to collate data from paper records at urban
and rural sites during the first nine months of the ART roll-out program in the Free State province of
South Africa. Thereafter a commercial online computer system (Meditech) was implemented. A
Microsoft SQL Server 2000 database server was used to deploy the information into a relational and
dimensional format using Microsoft Data Transformation Services. External laboratory and resistance
data were integrated as well. After 18 months 19013 patients were registered on the system, of which
2743 were ART patients. A total of 143751 forms have been captured with a median of 4 forms/non-
ARV patient and 26 forms/ARV patient. Six quality categories with a total of 32 quality routines were
implemented. The system has also been used to compile quarterly reports and national indicators. LESSONS LEARNED: PDAs compare favourably with online systems for data collection from remote
rural and urban sites and are useful where online systems or connectivity are lacking. Dimensional data
modelling and data warehousing techniques are fundamental for creating databases that are optimized
for querying, aggregated reporting, longitudinal analysis and research.
RECOMMENDATIONS: Data quality remains the most challenging aspect of information systems for
monitoring and evaluation. The next phase will be to feed information back to the health care workers
and patients to give them the benefit of information systems and to encourage better input data quality.
Description
Meeting: 16th International AIDS Conference, Toronto, Canada, August 13 - 18, 2006
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Keywords
MEDICAL RECORDS, DATABASES, COMPUTERIZED SYSTEMS, INFORMATION TECHNOLOGY, DATA COLLECTION, PDA, ANTIRETROVIRAL TREATMENT, AIDS, DISEASE CONTROL, FREE STATE, SOUTH AFRICA