Department of Biostatistics, University of Washington, 1705 NE Pacific Street F-600, Seattle, WA, 98195, USA.
Last Mile Health, 205 Portland St #200, Boston, MA, 02114, USA.
BMC Med Inform Decis Mak. 2020 Feb 22;20(1):39. doi: 10.1186/s12911-020-1059-6.
Mobile phones and personal digital assistants have been used for data collection in developing world settings for over three decades, and have become increasingly common. However, the use of electronic data capture (EDC) through mobile phones is limited in many areas by inconsistent network connectivity and poor access to electricity, which thwart data transmission and device usage. This is the case in rural Liberia, where many health workers live and work in areas without any access to cellular connectivity or reliable power. Many existing EDC mobile software tools are built for occasionally-disconnected settings, allowing a user to collect data while out of range of a cell tower and transmit data to a central server when he/she regains a network connection. However, few tools exist that can be used indefinitely in fully-disconnected settings, where a user will never have access to the internet or a cell network. This led us to create and implement an EDC software tool that allows for completely offline data transfer and application updating.
We designed, pilot-tested, and scaled an open-source fork of Open Data Kit Collect (an Android application that can be used to create EDC systems) that allows for offline Bluetooth-based bidirectional data transfer, enabling a system in which permanently-offline users can collect data and receive application updates. We implemented this platform among a cohort of 317 community health workers and 28 supervisors in a remote area of rural Liberia with incomplete cellular connectivity and low access to power sources.
Running a fully-offline EDC program that completely bypasses the cellular network was found to be feasible; the system is still running, over 4 years after the initial pilot program. The users of this program can theoretically collect data offline for months or years, assuming they receive hardware support when needed. Fully-offline EDC has applications in settings where cellular network coverage is poor, as well as in disaster relief settings in which portions of the communications infrastructure may be temporarily nonfunctional.
移动电话和个人数字助理在过去三十年中已被用于发展中国家的数据集采，且其使用越来越普遍。然而，在许多地区，由于网络连接不稳定和电力供应不足，移动电话电子数据采集（EDC）的使用受到限制，这阻碍了数据传输和设备使用。利比里亚农村地区就是这种情况，许多卫生工作者生活和工作在没有任何蜂窝连接或可靠电力的地区。许多现有的 EDC 移动软件工具都是为偶尔断开连接的环境而构建的，允许用户在离开基站范围时收集数据，并在重新连接到网络时将数据传输到中央服务器。但是，很少有工具可以在完全断开连接的环境中无限期使用，在这种环境中，用户将永远无法访问互联网或蜂窝网络。这促使我们创建并实施了一种 EDC 软件工具，该工具允许完全离线的数据传输和应用程序更新。
我们设计、试点测试和扩展了开源的 Open Data Kit Collect（一种可用于创建 EDC 系统的 Android 应用程序）的分支，该分支允许基于蓝牙的双向离线数据传输，使永久性离线用户能够收集数据并接收应用程序更新。我们在利比里亚农村一个偏远地区的一个 317 名社区卫生工作者和 28 名主管人员的队列中实施了这个平台，该地区的蜂窝连接不完整，电力供应不足。
完全绕过蜂窝网络运行完全离线的 EDC 程序被证明是可行的；该系统在初始试点项目 4 年后仍在运行。只要在需要时提供硬件支持，该程序的用户可以在理论上离线收集数据数月甚至数年。完全离线的 EDC 在蜂窝网络覆盖不佳的环境中以及在通信基础设施的某些部分可能暂时无法正常运行的灾难救援环境中都有应用。
