BACKGROUND: In March 2015, an executive order allowed the creation of a localized, temporary syringe exchange program (SEP) in response to an outbreak of HIV in southeastern Indiana among people who inject drugs. On May 5, Indiana Senate Enrolled Act 461 allowed the establishment of localized SEPs statewide. A standardized method of data collection, storage, and assessment at state and local levels was necessary to consistently measure local program efficacy and assist with ongoing program evaluation. The Indiana State Department of Health (ISDH) SEP technical advisor created a spreadsheet Excel to track SEP participation and program elements. With the localized expansion of SEPs in Indiana, a more intricate data collection and evaluation system was needed.
METHODS: SEP technical advisors and ISDH Office of Technology and Compliance staff created a web-based application called Syringe Exchange Database to allow real-time collection and analysis in the field by computer or mobile device and by technical advisors at ISDH. The Syringe Exchange Database is housed on secure servers that also house other reporting and data management applications between local and state health departments. The Syringe Exchange Database was designed using Oracle Database C#.NET using RESTful API Webservices on .NET Framework 4.5 on the backend and HTML jQuery on the front end. Once a county has been approved to provide syringe access services, ISDH staff provides training and access to appropriate local SEP staff to the system. Data collection and evaluation is then conducted in real time alongside the provision of services with ongoing technical and program support provided by the ISDH SEP technical advisor.
RESULTS: The Syringe Exchange Database has provided counties with newly established and developing SEPs with accurate real time data for required evaluation and program planning that would otherwise be delayed. The system also allows ISDH SEP technical advisors to provide active technical guidance and support to SEPs as they establish themselves as community resources. The system also ensures active follow-up for referrals, HIV and hepatitis testing, vaccinations, and ancillary services.
CONCLUSIONS: The Syringe Exchange Database has been essential in the development and provision of SEP services in Indiana with substantial potential impact for use in well-established SEPs nationally and globally in the prevention of disease among people who inject drugs.