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The COVID-19 RDT application is available to be imported directly into CommCare project spaces for all users are an advanced plan and above. The application can be imported, along with all other free template applications, in this library: https://www.commcarehq.org/covid19. 


COVID-19 RDT Tracing Application Demo Video (please click image below)





About the COVID-19 RDT Tracking Application

Download the CommCare Application


The COVID-19 RDT Tracking application is available to be imported directly into all Advanced CommCare project spaces, along with all free COVID-19 template applications, in this library: https://www.commcarehq.org/covid19 


Application Version History

  • October 18, 2021: First Version Released

Application Overview

educ sample collection.png

The application, designed by FIND and Dimagi, supports health workers as they administer and record the results of COVID-19 antigen rapid diagnostic tests (RDTs). The application features workflows for patient registration, test initiation, and result capture. 

It also offers assistance to workers to ensure they are following testing protocol including: 

  • Built-in timers that inform users when a test is processing, when it is valid to read, and when it is too late to read the results based on the time the test was initiated. The tool supports managing multiple simultaneous timers to assist frontline workers running tests on multiple patients at once.

  • Visual job aids and instructions on how to administer different types of tests based on the manufacturer's instructions. 

The application facilitates collection of relevant testing point of care properties (e.g. test times, duration, image, results, etc.) including all those described in the ACT-A COVID Antigen RDT Data Model developed by FIND and the ACT-A. 

It is designed to be used as a standalone tool or as a modular template for questions, modules, and forms which can be incorporated into pre-existing applications to integrate support workflows for applying RDTs. Incorporating these forms will ensure that RDT data which is captured is compatible with the ACT-A Data model for reporting.

To support the RDT workflows, this CommCare application is integrated with the Rapid Diagnostics Toolkit, an Open Source Global Good which is downloadable from the Google Play Store for free, and offers support for RDTs across multiple diseases. CommCare is linked to the Rapid Diagnostics Toolkit via the Android App Callout feature, and the integration can be further customized as needed.


Application Details

This application was co-designed by FIND and Dimagi to support frontline health workers delivering COVID-19 rapid antigen tests. It supports the following workflows:

  • Patent Registration
  • Test Initiation
  • Test Result Capture


Test Delivery Workflow

   


Description of Forms in CommCare

The table below breaks down the the role of each form in the CommCare application:

RDT App Forms

Form Name

Form Purpose

Summary of Content

Register a New Patient

Used to register all patients to the app for testing

  • Basic demographic detail

Edit Patient Details

Used to update basic information that’s already been collected on patients

  • Basic demographic detail

Initiate New Test

Used to start a new test for a patient. This form calls out to the Rapid Diagnostics Toolkit so users can begin a test. Once a user has selected a test, the background timer will begin. 

  • Reason for testing

  • Symptoms

  • Test details including test type, specimen type, lot number and more

Capture Test Results

Used to capture the results of a test, ideally once test results are ready to be read. This form calls out to the Rapid Diagnostics Toolkit so users can easily capture an image of the RDT and enter detail on their interpretation of the test results.

This form has all fields specified in the ACT-A data model and can be used for easy reporting.

  • Test results

  • Additional notes on the test

Sample Logic

This form is not visible to users but it demonstrates logic of how certain fields can be referenced if organizations and custom user property features are utilized. 

For programs using these features, the nodes in the complex_logic folder can replace those with the same name in the Capture Test Result form. 

  • Sample logic to reference select properties using advanced CommCare features

Going Further: Utilizing Locations and Custom User Properties 

In the ‘Capture Test Results’ form, there are hidden values (administrator_id, facility_name, facility_id, and facility_address) which have been intentionally left blank. Implementers who want to follow the ACT-A COVID Antigen RDT Data Model have the option to allow users to fill these fields in manually (via free text questions posed to users) or they can utilize custom location and custom user data and pull them into forms automatically. 

Since we know these features are not ubiquitous across all CommCare projects, we left the fields blank in the ‘Capture Test Result’ form and have demonstrated the x-path expressions needed to reference the properties in the ‘Sample Logic’ form. Along with that step however, implementers will need to configure the user properties and custom location data in a manner on their own.

Custom User Data can be used to create and reference the administrator_id property. Customer User Data is a feature that enables you to store and reference information about your mobile workers. In order to reference administrator_id, you must begin by creating that as a custom user field, and then when creating mobile workers, you must assign them a value for that field. Once you’ve done so, you can copy the calculate condition on the administrator_id node in the ‘Sample Logic’ form into the same node in the ‘Capture Test Results’ form. You can read more about user property references here. 

To easily reference the facility_id and facility_address fields one must add each as custom location fields. To do this, implementers will need to create fields titled facility_id and facility_address as custom location fields and assign values to those fields for each location. Once you’ve done so, you can copy the calculate condition on the facility_id and facility_address nodes in the ‘Sample Logic’ form into the same nodes in the ‘Capture Test Results’ form. 

User Training

To support programs, Dimagi and FIND have developed an end user training guide for the template application. The training guide can be referenced here. The guide walks users through the process of downloading CommCare and the Rapid Diagnostics Toolkit, using CommCare, through the workflows of the template application. 

Data Dictionary and Case Types

The application supports the collection of all fields in the ACT-A COVID Antigen RDT Data Model. The fields and their purpose are described below.

ACT-A COVID Antigen RDT Data Model

Field

Form Purpose

Patient ID

Unique, system generated patient ID

Patient_First_Name

Patient's first or given name

Patient_Family_Name

Patient's last or family name

Patient_Birth_Date

Patient's date of birth capturing day, month and year of birth

Age

Estimated age in years of the patient, captured if patient_birth_date is unknown

Sex

Patient's biological sex at birth, either male or female

Contact_number

Number where patient may be reached

Address

Patient's address including street name, district/county, city and region

Session_ID

Unique, system generated case ID to capture instance of patient's visit; each patient could have multiple Case IDs

Administrator_ID

Unique ID of the health worker or practitioner who is conducting the test

Administrator_Name

Name of the health worker or practitioner who is conducting the test

Test_ID

Unique, system generated instance of a test; each Case_ID could have multiple test numbers

Test_Location

Geocodes of where test is being conducted, collected from device

Test_Reason

Indicates reason for performing test

Symptoms

Details of symptoms patient is exhibiting

Days_Since_Symptoms_Began

Duration for which symptoms have persisted

Specimen_Type

Indicates how biological sample was collected

RDT_Name

Device/RDT test model name as assigned by the manufacturer

Syndrome_Test_Type

Indicates type of test being conducted / what the RDT is testing for - HIDDEN Field - Pre-populated - (COVID-19)

RDT_LOINC_Code

HIDDEN Field - Pre-populated - (94558-4)

RDT_LOINC_Long_Common_Name

HIDDEN Field - (“SARS-CoV-2 (COVID-19) Ag [Presence] in Respiratory specimen by Rapid immunoassay”)

RDT_Lot

Lot or batch number to which the individual device belongs

RDT_Expiry_Date

Expiry date of the device with respect to the lot number

RDT_Expired

Message Popup Screen/Message only - No data to be filled

RDT_Start_Time

Time at which test was begun

RDT_End_Time

Time at which the result was read

RDT_Result

Final observation as evidenced by the test result

Image_of_RDT

Image of the RDT device that clearly shows test result from which the result can be inferred

Repeat_Test

Indicates whether the test being conducted immediately follows another, in the event of a failed or inconclusive test

Repeat_Test_Reason

Indicates reason for repeating test

Repeat_Test_Reason_Other

Allows user to capture additional details for test being repeated

Facility_ID

Unique ID assigned to the testing facility

Facility_Name

Name by which the facility is locally identified

Facility_Address

Address of the facility capturing district/county, city, region

Test_Setting

Type of facility where the test is being performed

Additional_Notes

Any other information of relevance - open field


Like many CommCare applications, this template application uses case management to keep track of progress of various points of interest. To learn more about case types and relationships please review your application’s case summary.

This application makes use of two case types: patient and test. The patient case holds information on the patient including demographic details and most recent test information, while the test case, a child case of the patient case, holds information about a given test. A patient case may have many child test cases associated with it.

Rapid Diagnostics Toolkit Overview & Test Types Supported

The Rapid Diagnostics Toolkit is intended to provide community health workers with efficient and effective tools to support their application and processing of tests at the point of care

The Rapid Diagnostics Toolkit:

  • Provides digital job aids to guide health workers in accurately administering RDTs

  • Captures metadata to provide visibility into how RDTs are being applied, and whether best practices are being followed

  • Automates data collection and eliminates key sources of errors

  • Enables high-level supervision of health workers’ RDT administration

Currently, the tool is designed to be directly downloaded from the Google Play Store where the latest version will be available. 

In addition to support for COVID-19 tests the toolkit also supports RDT’s for other diseases, notably Malaria, which may be of use in other applications as well. Some RDT’s in the toolkit support additional features, such as validation that a picture taken of an RDT is clear and automated interpretation of the test results, but those features are not yet available for supported COVID-19 RDT’s.


Currently Supported COVID-19 RDTs

Below is a list of the COVID-19 Antigen RDTs that the Rapid Diagnostic Toolkit currently hosts. Users can view the associated instructions, use the timer functionality within the Rapid Diagnostics Toolkit, photograph the RDT, and enter their interpretation.

Supported RDT

Specifications Link

Sure Status COVID-19 Antigen Card Test

Link

SD Standard Q COVID-19 Ag Test

Link

(Nasopharyngeal) Panbio COVID-19 Ag Rapid Test Device

Link

(Nasal) Panbio COVID-19 Ag Rapid Test Device

Link

Going Further

The Rapid Diagnostics Toolkit can be further customized for your program, building off of the example from the template app, either to support COVID-19 or other types of diagnostic testing. 

Our help site contains additional documentation outlining some of the options available for customizing the toolkit. You can also ask questions on the CommCare Forum about different options as well.


Cloudworks Data Backend


Programs which are managing RDT programs at scale may benefit from integrating an additional technical component available through the Cloudworks Data Backend. Cloudworks is an Open Source web service which supports capturing and reporting more extensive metadata as part of the Rapid Diagnostics Toolkit sessions, including full resolution images of RDT’s and detailed traces of usage to improve delivery.


The Cloudworks data backend can be hosted independently from its Open Source codebase. Our team is also seeking participants who are interested in participating in a closed beta of the toolkit which is hosted as a service. If you are interested in enrolling in the beta, please reach out to cloudworks-support@dimagi.com. 

You can find docs about connecting the backend from the help wiki.

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