Data Management
As testing is decentralized to lower levels of healthcare facilities within Cameroon, it is important that systems are developed to monitor the data generated by this new method of testing. Data management system will be developed at the site and national level. Data management systems will, therefore, be put in place at the following levels:
Site Level Data Management: To ensure that POC testing achieves its intended purpose of accelerating eligible patients into care and treatment, systems will be developed to ensure effective management of patient testing data at the site level. These systems will dictate how POC results flow from the healthcare worker who performs POC testing to the patient and how results are recorded into health facility logbooks and the patient’s file. Careful attention must be taken to ensure that every POC test result is received by the patient and provided to a clinician in a timely manner so that clinical decisions can be made based on these results. The impact of POC testing on patient outcomes relies on effective data management systems to minimize opportunities for lost test results and accelerate the interpretation of results. Site level data management will be covered in both the TOT and the site operator training modules.
National and Regional Level Data Management: There is also need to develop systems for ensuring that data from POC testing at the site level feeds into the national and regional databases for testing. Unlike conventional testing that utilizes national specimen transportation networks for data flow from health facilities to the regional and central levels; all data for POC are based at the site level. Systems for data flow to the regional and central levels to ensure appropriate program management and monitoring of testing should be developed. These systems should be disseminated at the site level during training, and program managers at the regional and central levels should put SOPs in place to ensure complete and efficient data flow. These SOPs should specify how often data should be collected at both levels and entered into the regional and national databases and how quality control of the data should be conducted.
Mobile Technology Data Management: Because testing data will need to be collected from a larger number of testing sites over which MOPH Labs may not have direct oversight, using a paper-based system for collecting data may be a challenge. To address this issue, it is possible to use mobile technology to transmit and analyze the data that is stored automatically on each POC device. The operator can transmit testing data periodically (e.g. after each day of testing) to the regional and central databases, which can be linked to a national Laboratory Information System (LIS). This data can then be synthesized into reports to monitor the progress of the POC testing program. These reports will help inform areas such as supply chain (by measuring the number of tests conducted at each site), quality assurance (by assessing whether each site is running and passing its daily quality controls), and service and maintenance (by assessing whether each instrument is functional). Additionally, once the LIS is operational this system can be used to track individual patient data, such as a patient’s CD4 count history over time, and improve national HIV surveillance and monitoring of epidemiological trends. This system of data transmission should be implemented at the same time as the devices are distributed. MOPH will also work with other diagnostics suppliers to ensure that this functionality becomes standard with new technologies as they become available.