Support strategies for the adoption of electronic data capture systems for biomedical research and clinical service delivery records in heterogeneous, research intensive organizations in resource constrained environments

Maré, Irma Adele
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Electronic data capture (EDC) systems in the health domain offer benefits like efficient management, aggregation and secondary use of data, real-time validation and quality control, improved data provenance, advanced analytics, precision medicine and bedside clinical decision support. Like any technology implementation, user acceptance and adoption of an EDC system can be a critical obstacle post initial deployment. We used the implementation of the electronic data capture system REDCap at the Wits FHS as a case study to evaluate adoption support strategies for EDC technology implementation in research intensive and resource constrained health environments. Firstly, we performed an inductive thematic analysis of interview transcripts with key informants at the Wits FHS to identify what the main perceived drivers, barriers and enablers of EDC adoption were in our environment. Secondly, we performed a retrospective analysis of the growth, usage patterns, research outputs and support strategies related to REDCap at the Wits FHS between 2013-2021. Barriers to EDC adoption included fear of change, effort/benefit imbalance and lack of infrastructure and skills. Despite this, adoption of REDCap at Wits FHS spread rapidly to multiple different schools, and increased annually. This was facilitated by offering a system that was dependable, secure, user friendly and configurable, as well as support strategies like dedicated go-to technical officer, training workshops and regular academic meetings. Ongoing challenges include the lack of capacity from clinical staff, development and retention of informatics skills, access to reliable networking infrastructure and the integration of data systems and policies between government and university.
A dissertation submitted in fulfilment of the requirements for the degree of Master of Science in Medicine (Biomedical Informatics and Translational Medicine) to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2022