IQCare Case Study

As part of Futures’ Strategic Information responsibilities in the AIDSRelief Project, we recognized early on that clinics needed to gather data, create reports and query the data for continuous program improvement. Initially, clinics implemented various Access based solutions however as the number users and number of patients grew exponentially, the performance of Access could not meet the increased data input, and robust data integrity demands of the clinics. The lack of robust architecture and inherent limitations of Access was not meeting the clinics requirements for sustainability and scalability to handle increased data demand and use.

Solution

Data centric applications are all about gathering clean and accurate data and reporting on that data. Primarily, the focus is to help users avoid input errors and then provide comprehensive and flexible data capture and reporting capabilities which do not require programmers. There was no question about using a fully relational database as the back end. This kind of database checks to ensure that relationships between tables remain consistent and allows for automatic rollback if there is a problem with saving some of the data in a form. The next decision focused on the user interface. Entering data had to be keyboard as well as mouse driven and provide field level and cross form validation. Futures decided to use a web-based interface so that the application can easily be deployed in a networked configuration, effectively leveraging their hardware assets. The networked computers only require a web-browser such as Internet Explorer to access the application.

Futures also decided to use a software development method, which takes advantage of the multidisciplinary team environment and incorporated years of in-country HIV and ART experience. We leveraged the expert knowledge from the AIDSRelief M&E staff across seven different African countries, each in-country expert proactively providing new ideas for the product. We placed them as the key component; the pivotal driving force for innovative ideas and enhancements in IQCare . Ultimately having our local in-country ARV experts involvement early and often in the process , keeping them continuously involved in the entire Agile development process greatly helped to improve data use, sense of data ownership at the clinics.

Taking advantage of the experience of developing IT systems, the AIDSRelief team made a concerted effort to follow best practices for the software development and testing. A significant amount of time was allocated to gathering detailed requirements and performing usability testing of the data entry screens to ensure ease of use. The software was architected with a holistic vision, thinking about software maintainability, scalability and performance. Test planning and implementation were followed by the software development team as well as in the field.

Success

Although IQCare may seem to be fairly sophisticated software application to the end user it is easy to use and and requires a number of base components and configuration on the computer that runs the application. This means that Futures Field Staff and the staff at the clinics had to learn how to install the software and quickly identify technical problems. In preparation, the development team tested the application on different machines and with low memory and slow computers. Multiple training sessions were held and technical resources were sent into the field to work side-by-side with the Field Staff. Even so, unexpected computer configurations and computer types continued to be a challenge throughout the implementation process.