Lab Matters Summer 2020 | Page 23

GLOBAL HEALTH Telling the COVID-19 Data Story on a Global Scale By Reshma Kakkar, manager, Informatics, Global Health; Solon Kidane, senior laboratory technical manager, Mozambique, Global Health; Rufus Nyaga, informatics technical manager, Kenya, Global Health; Clement Phiri, senior technical advisor, Zambia, Global Health; Kasimona Sichela, developer/data manager, Zambia, Global Health; and Elias Munshya, laboratory information systems support officer, Zambia, Global Health The COVID-19 pandemic has created a challenging data management environment for public health, hospital, clinical and private laboratories due to the large volume of specimens requiring testing within a short timeframe, the associated epidemiology data that have to be managed and reported, and involvement of multiple stakeholders with differing objectives. A successful public health response is dependent on timely and accurate laboratory results for confirming cases and enabling contact tracing. And a country-specific yet consistent laboratory data management strategy is vital. The significance of this strategy cannot be overstated: preventing multiple ad hoc databases, duplication of cases and lack of linkage between laboratory results and epidemiological and/or clinical data is critical to ensure a timely response. Policy directions, new cases and technology for conducting tests and reporting, as well as case based surveillance and incident management are rapidly evolving. APHL’s previous innovative data management approaches in several countries under the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and Global Health Security Agenda (GHSA) have served to jump-start the response efforts for managing and reporting laboratory data for the pandemic. APHL has not only built upon existing human resource and infrastructure capacity but also the trust and partnerships established with respective Ministries of Health in Asia and Africa over the past decade. Established tools have proven to be critical in rapidly responding to the data management needs of the pandemic, such as: • A central laboratory data repository to receive and record laboratory data submitted from a variety of data sources • Interfacing of the testing analyzer to allow automated capture of large volumes of result data • Remote test orders to decrease data entry workload at the testing laboratory, speed processing and testing of the specimen and provide rapid and accurate communication of test results to health facilities • Integration with external systems requiring laboratory data. Actions taken by APHL to strengthen data management and reporting include: • Standardized system/data collection tools at the laboratory or testing site were rapidly deployed • Use of tools that staff on site at national and/or sub national levels were familiar with requiring minimal training • Remote access to be able to troubleshoot and provide support • Automation of individual test result alerts and standard summary reports • Developing solution to enable integration of laboratory data with case-based surveillance system in use in the country. APHL staff are continuing to work with country governments to define a consistent laboratory data management strategy with a focus on: • Establishing a working group co-chaired by surveillance/ epidemiology and laboratory departments to: • Define minimum critical data elements and/or fields to be captured by laboratories including test methods and protocols • Map workflow process to establish the sample path from sample collection to results release and identify points for capturing critical data elements • Develop guidelines for review of authorized users of laboratory and patient information captured in laboratory and epidemiology/ surveillance data systems • Data sharing agreements between laboratory data systems and central laboratory data repository or epidemiology/surveillance database electronically • Establish or revise national privacy rules protecting individually identifiable information. • Develop data use agreements and policies. • Partnering with a country’s national laboratory director on developing a strategic plan for: • Rapid assessment of current laboratory data management systems at all levels of laboratories • Identification of health centers and/ or specimen collection sites to be connected to the testing laboratory • Determination of any electronic specimen referral methods or systems available for remote test orders and results receipt • Implementation plans, timelines and estimated expenses with options for financial support for the above activities. • PublicHealthLabs @APHL APHL.org Summer 2020 LAB MATTERS 21