Electronic data capture system (REDCap) for healthcare research and training in a resource-constrained environment: Adoption and growth at a South African institution (Preprint)

BACKGROUND Electronic data capture (EDC) in academic healthcare organizations provides an opportunity for the management, aggregation and secondary use of research and clinical data. It is especially important in resource constrained environments such as the South African public healthcare sector, where paper records are still the main form of clinical record-keeping. OBJECTIVE We describe the strategies followed by the Faculty of Health Sciences, University of the Witwatersrand (Wits FHS), during the period of 2013-2021 to overcome resistance and encourage adoption of the Research Electronic Data Capture (REDCap) system by academic and clinical staff. REDCap has found wide use in varying domains including clinical studies, research projects and administrative, financial and human resource applications. Given REDCap’s global footprint in more than 5 000 institutions worldwide and potential for future growth, the strategies followed by the Wits FHS to support users and encourage adoption may be of interest to others utilizing the system, particularly in resource-constrained setting. METHODS The strategies to support users and encourage adoption included: 1) Top-down organizational support; 2) Secure and reliable hosting infrastructure and systems administration 3) An enabling and accessible REDCap support team 4) Regular hands-on training workshops covering data collection instrument design and use of REDCap; 5) Annual local symposia to promote networking and awareness of all the latest software features and best practices for using them 6) Participation in REDCap Consortium activities; and 7) Regular and ongoing mentorship from members of Vanderbilt University Medical Center. RESULTS During the period 2013-2021, utilization of the REDCap EDC system by individuals in the Wits FHS increased from 129 active user accounts in 2013 to 3 447 active user accounts respectively in 2021. The number of REDCap projects numbered 149 in 2013 and increased to 12 865 in 2021. REDCap at Wits also supported various publications and research outputs including journal articles and postgraduate monographs. As of 2020, a total of 233 journal articles and 87 postgraduate monographs acknowledged the use of the Wits REDCap system. CONCLUSIONS By providing reliable infrastructure and accessible support resources, we were able to successfully implement and grow the REDCap electronic data capture system at the Wits FHS and its associated academic medical centers. We believe that the increase in use of REDCap was driven by offering a dependable, secure service with a strong end-user training and support model. This model may be applied by other academic and healthcare organizations in resource-constrained environments planning to implement EDC technology.