Innovation In A Time of Crisis :
Mozambique ’ s Laboratory Information Systems
By Sofia Viegas , PhD , director , National Public Health Laboratories , Instituto Nacional de Saúde ; Solon Kidane , senior laboratory manager , APHL Mozambique ; Reshma Kakkar , MA , informatics manager , Global Health and Palmira Mangae , specialist , Global Health
pandemic has pushed public health professionals around the world to innovate and implement new ways of delivering care . Faced with managing large volumes of testing and limited resources , APHL , in collaboration with the Mozambique Ministry of Health
( MISAU ) and Instituto Nacional de Saúde
( INS ), got creative and repurposed the previously implemented laboratory information systems ( LIS ) to support COVID-19 testing .
While the LIS was originally deployed to support the needs of HIV care and treatment , modifications enabled them to be used to manage laboratory data needs of the COVID-19 pandemic , from data and sample tracking from points of collection to testing laboratories . In addition , the systems provided management of COVID-19 laboratory data at the national level , daily caseload reporting to MISAU , and results authentication by the Mozambique government for purposes of travel . The collaboration between APHL , MISAU and INS , while strategizing a rapid and innovative response , also supported the need for data privacy and confidentiality — areas of particular concern with COVID-19 data .
Some specific and successful activities carried out through this collaboration include :
• Enhancing the national laboratory data repository , a trusted resource for MISAU and INS thanks to a successful track record demonstrating secure storage and reporting of laboratory data
• Use of one data source ( i . e ., the laboratory data repository ) for all reporting including the critical COVID-19 daily standardized summary report that required synthesis of data from disparate data sets
• Submission of this daily report in electronic format to local and regional authorities
• Minimal human intervention for report generation from the laboratory data repository , resulting in not only a sustainable process requiring fewer resources , but also reducing number of staff requesting access to data thus improving data security
• Reports that can be used by local and regional authorities for public health surveillance , contact tracing and to make informed COVID-19 response decisions
• Initiation and rollout of a secure short message service ( SMS ) alert system for communicating negative COVID-19 test results to patients across the country while maintaining data privacy
• Development and deployment of an application to collect COVID-19 test data from private laboratories and merge these data into the national laboratory data repository
• Designing a solution to authenticate COVID-19 test results to determine an individual ’ s ability to cross Mozambique ’ s borders into any of the six neighboring countries . Using a secure mobile app from the LIS provider , APHL built capability to authenticate the results of a COVID-19 test based on scanning a barcode printed on a traveler ’ s printed test result . No personal identifiable data is displayed on the app and no data are stored locally .
With these tools in place , public health officials with authorized access are able to securely monitor the nation ’ s testing capacity , inform public health policy and practice and ensure validity of test results . Both the LIS and the national laboratory data repository that are maintained and managed by APHL for MISAU are seen as a key reason for the successful utilization of data in guiding the COVID-19 response . These powerful tools have demonstrated they can be used to serve Mozambique for routine testing and sample management , as well as act as a gateway to stand up a national response for emergency and unprecedented public health threats . n