HIV/AIDS Adult Case Report Form (ACRF) – There's an App for That?

BACKGROUND: Implementation of the Enhanced HIV/AIDS Reporting System (eHARS) dramatically improved the technology associated with HIV surveillance and data management, and advances in electronic laboratory reporting have improved the timeliness and completeness of case reporting.  However, the vast majority of case report forms continue to be completed on paper and manually entered into the database.  This process is subject to missing or inaccurate data.  We utilized open source technologies to develop web-enhanced forms for data collection in the field to standardize and streamline data collection activities.

METHODS: The form uses HTML technology to store, edit and display case data.  However, the webpage resides on the laptop computer and is not exposed to the internet.  Encryption of the laptop is required, as name, address, and other identifying information are stored in the files.  Because the application uses web-based technology, some form of Internet Information Service (IIS) is required to allow the pages to load, display, and function using the background programming code.  XAMPP is a free and open source cross-platform web server solution stack package, consisting mainly of the Apache HTTP Server, MySQL database, and interpreters for scripts written in the PHP and Perl programming languages.  Apache is typically used for web development, where programmers can write and test code without exposing data to the internet. 

RESULTS:   When launched, the page http://localhost/ehars/ehars_main.html displays the main menu of the application.  The ‘localhost’ address indicates that all activity remains on the local computer. From this page users can select the ACRF option to enter data for a new case report or choose from a list of open cases to modify/add data to an existing case report.  There is some basic logic included in the form (e.g. required fields and date verification), however the more complex calculations (e.g. lowest CD4 and exposure category) are left to the eHARS application.  When complete, the data can be exported to a PDF for printing and/or electronic storage, and a fully-formatted text file can be exported for importing to eHARS.

CONCLUSIONS:   The use of completely open source technologies means that the application has no overhead or maintenance costs.  The forms and outputs can be modified to address issues specific to local areas, and additional rules/restrictions can be applied to further standardize and streamline data collection activities.