Evaluation of Redcap As a Surveillance System for Tennessee Travelers and Contacts with Epidemiologic Risk Factors for Ebola Virus Disease

BACKGROUND:   The Research Electronic Data Capture (REDCap) application, developed at Vanderbilt University, was selected for the development of an Ebola Virus Disease surveillance system for Tennessee travelers and contacts of suspected or confirmed cases.   Following the fungal meningitis outbreak in 2012, the Tennessee Department of Health (TDH) identified the need for a comprehensive and flexible data collection and management system for outbreaks.   REDCap was identified as an effective tool, and a model database was developed based on MERS-CoV.   The Ebola-Symptom Monitoring Database was then developed according to guidance provided by the Centers for Disease Control and Prevention (CDC), using the model database framework.               

METHODS:   TDH reviewed the MERS-CoV model database in REDCap, EpiInfo Viral Hemorrhagic Fever application utilized in country by the CDC field staff, and the Tennessee Countermeasure Response Network (TNCRN) as potential surveillance systems for EVD.   The systems were evaluated with regard to data security for protected health information (PHI), user controls for data access to records and forms, data collection and transmission procedures, and data sharing capabilities for situational awareness of public health partners.   In addition, the systems were evaluated for the ability to collect ongoing information about traveler and contact wellness, referred to as symptom monitoring.

RESULTS:   The REDCap application was selected as best meeting the needs of the statewide public health system for EVD based on the evaluation criteria.   REDCap is HIPAA compliant to protect PHI, and also allows for user controls using data access groups (such as by a public health region) to group records and user profiles to limit access to certain forms or tasks.   The system is web-based, allowing for real-time data entry, thereby eliminating data capture and reporting delays.   Basic reports can be developed within the system to provide line lists, and basic tabular and visual descriptive statistics.   These reports can be made available to specific users based on the user controls, and therefore facilitate protection of the data and prompt situational awareness.   As of December 19, 2014, the Ebola – Symptom Monitoring Database has successfully captured the demographics and risk assessment for 26 persons.   Twelve persons have completed 21-day monitoring, and monitoring is ongoing for the remaining 14 persons.

CONCLUSIONS:   The REDCap application has proved a flexible system for EVD surveillance, evolving with the CDC guidance and facilitating communications between the state and local public health departments.