When you’re working to halt a health crisis, trusting your data is vital. Senior Database Scientist Colin Newell works in a desperate region of South Africa where one-fifth of the general population and more than half the young adults are infected. As such, he is leveraging Laserfiche to build a new database that could help stem the spread of HIV/AIDS.
“HIV is a global problem and we are just one research center in a worldwide effort to learn more about the disease,” says Newell. “But HIV infections rates here are higher than anywhere else. It’s possible that what we learn here about the transmission of the disease here may help slow the spread of the disease elsewhere in the world.”
Over a decade of detailed field research, Newell and his colleagues at the Africa Centre for Health and Population Studies in KwaZulu-Natal have painted what may be the pandemic’s most deeply detailed portrait.
According to avert.org, as of 2010, there were 22.9 million people living with HIV in Sub-Saharan Africa, increasing from an estimated 22.5 million people, including 2.3 million children, a year earlier. The organization reports that the increase in people living with HIV could be partly due to a decrease in AIDS-related deaths in the region. There were 1.2 million deaths due to AIDS in 2010 compared to 1.3 million in 2009. Almost 90 percent of the 16.6 million children orphaned by AIDS live in sub-Saharan Africa, according to Avert.
During the time the Centre staff has been working in Africa, they have painstakingly transcribed millions of pages of field surveys into a computer file—with the hard copies then stored in a warehouse a few hours’ drive, or a day’s walk, from the office.
Whenever data errors or discrepancies arose in the computer file, staff members were dispatched to the warehouse to rifle through filing cabinets in search of the originals. “When you’re gathering data in communities where running water is a luxury, unemployment is 75% and 40% of households cook with wood, errors are a daily fact of life,” says Newell.
“You have to understand that in South Africa we’re in a time-rich, cash-poor society, and very often it’s much more economical to employ more people rather than employ a high tech solution,” he explains. “We’re about 10 kilometers away from the next Internet user. If anything goes wrong, spare parts and tech guides coming to fix things is a very difficult job, so for many things we tend to go toward the low-tech solution, at the expense of making more mistakes.”
That doesn’t mean there isn’t room for any technology at the Centre. It just means that any technologies embraced must be effective, easy to use and, above all, reliable.
Since 2000 the Centre has been conducting deeply detailed demographic surveillance of 90,000 people in 12,000 South African homesteads, visiting each one twice annually to gather information. Every round of visits produces about 600,000 pages.
Until recently, the Centre’s technology was limited to the one computer file used to catalogue an endless stream of documents coming in from field researchers. But imagine what happens, an all too real possibility, when the computer malfunctions. The Centre IT’s staff came up with a solution: using Laserfiche to store an unlimited number of digitized documents and retrieve any one instantly through a barcode connected to its 13-digit survey subject identification.
Eighteen months later, half of the 15 million survey forms have been scanned into images stored in a new database connected via the barcode information to the old database.
“Now we can easily go back and resolve discrepancies instantly,” explains Newell. “We can see where transcriptionists might have misread a date scribbled by field workers and that clarification can lead to other vital pieces of information falling into place.”
Africa Centre may even be setting a trend not just for this beleaguered part of the world but for its many peer organizations, says Christian Kyony, head of IT at the Centre. According to Kyony, there are 45 similar outposts across the world, generating 10 to 20 million pages of field surveys annually.
“Those organizations all have the same challenge,” says Kyony. “How to keep information archived in the source document and how to easily access the information in the source document. Our office is the first office to employ this technology.”
Kyony estimates that using Laserfiche has allowed Africa Centre to reduce overall operational expenses by 10 percent. But those savings could be dramatically higher for organizations in other, more advanced areas of the world, says Sheldon Halgreen of Nashua, SA, which sold and installed Laserfiche at Africa Centre.
Halgreen is talking to medical researchers elsewhere in Africa about using electronic forms on computer tablets to monitor patient health in field research. Such forms allow all the data gathered in the field to be stored as text along with the images, enhancing the value of the forms for medical research while greatly reducing the transcription costs of manually inputting all the information. Moreover, where wireless internet access exists, the information from field research can be downloaded automatically, allowing researchers and doctors to get new information in real time.
“Africa Centre is seeing great results from the software,” Halgreen says. “This software can improve the quality of health care on a global scale, while saving healthcare organizations a great deal of money.”
Newell understands well the potential advantages to applying such technology to the patients in the communities the Centre surveys. However many other things must change in KwaZulu Natal before he can take full advantage of the technology.
“The end goal is not just research but also tracking the success of ATR therapies now being administered to thousands of people in all sorts of living conditions,” Newell explains. “Armed with that information, we can better contain the spread of this disease under all conditions. As a center, we’re quite proud of what we do and we’ve managed to keep quite a number of people alive who otherwise might have been dead.”
In the meantime, he’s cleaning up 12 years of research at a pace he never imagined possible just two years ago.
“It’s a big advantage just having clean data,” he says.
*An edited version of this story appeared on TMCnet’s HealthTechZone.