As one could expect, these evaluations are an intensive process of collecting, organizing, cleaning, and analyzing data. The process happens over largely rural areas with vast distances between households and health service providers. In the video below, Population Council researchers, together Marie Stopes Uganda staff show how they are using ODK to streamline the evaluation of voucher programs. The work is funded by the Bill & Melinda Gates Foundation.

Find out more about RHVouchers at http://www.rhvouchers.org.

ODK Aggregate 1.0.6 now supports publishing of forms from Build. We've also added support do bulk delete submissions.

ODK Briefcase 1.0.2 and ODK Form Uploader 1.0.2 now work much better when accessing Aggregate through slow internet connections.

ODK Validate 1.6 fixes an issue where the same form would return different errors.

Again, you can find all the new versions at http://code.google.com/p/opendatakit/downloads/list.

The blog post notes that "the Dispensers for Safe Water (DSW) program at IPA (supported with a grant from the Bill & Melinda Gates Foundation) is improving water quality by providing a point-of-collection Chlorine Dispenser System in western Kenya. Treating drinking water with dilute chlorine solution can cut child diarrhea by 41%, but this fact alone doesn't guarantee impact. Using Open Data Kit, an open source set of data collection and management tools, DSW can significantly shorten the feedback loop from data collection to course-correction, allowing us to identify challenges with real-time data and address issues at a rapid pace. Surveys are built in Excel, uploaded to a server and downloaded to a low-cost smartphone.

The Chlorine Dispenser System is being scaled up in Kenya, and DSW is committed to applying rigorous evidence to programs. Having real-time data available for decision making helps take the guesswork out of safe water delivery by quickly focusing efforts where they are needed most. In this way, smartphones can help bring us one step closer to providing safe water for all."

It's always exciting to see ODK tools powering decision-making, so congrats to Jessica and the entire IPA team! Find out more about their work at http://www.poverty-action.org.

The data is being used for the Tendai Project, which according to Daniel Molokele of SARPAM, is "a practical intervention designed to ease the burden of the people by monitoring the situation at community level and disseminating information. The project aims to raise awareness of the challenges communities face in accessing essential medicines, provider pharmaceutical marketplace information through a regional info hub and contribute to improving access to medicines in the Southern African Development Community."

Adi explains that, "the first step is to collect evidence of systemic failings. It is easy to dismiss a stock-out, sub-standard medicine or poor service delivery as an exceptional event which doesn’t deserve further action. With a project such as Tendai, evidence of systemic failings can be gathered nationally and regionally. Armed with data civil society is able to engage with governments to identify the cause of these failings and suggest solutions. Researchers too may use this information to inform policy.

This is of course a simplistic example but there is a lot of value in understanding the nature of a problem before attempting to take action to correct it. Specifically with Tendai, we are hoping to encourage increased collaboration between governments and civil society to improve public health systems."

Browse all the data the project has collected at http://tendai.medicinesinfohub.net

There is some backwards compatibility with the old syntax but we encourage you to transition to using the new syntax documented here.

Additionally, we made some improvements to our error messages, but hopefully you never find out what they are.

If you find run into any problems, please post them to our issue tracker, or bring them up on our community mailing list.

And finally, here's a link to XLSForm: http://opendatakit.org/use/xlsform/

Home-Based Counseling and Testing with ODK Collect
AMPATH has an extensive home-based and counseling program where community health workers (CHWs) go house to house to identify and enroll persons in need of care (i.e., pregnant women not in antenatal care, orphaned children, persons at high risk for tuberculosis infection). The workers need mobile data collection to document socio-economic data (including GPS location of household) and to implement the counseling and testing protocol.

Before using ODK, AMPATH used Palm TX devices running Pendragon Forms. GPS information was collected using eTrex devices. Problems with this approach were outlined by Rajput et al. in their Evaluation of an Android-based mHealth System for Population Surveillance in Developing Countries (AMIA 2011) paper.

They write, "First, although costs were significantly lower than paper-based data collection methods the costs were still substantial. Second, the data collected could not be directly integrated into the electronic medical record system [OpenMRS] which was already in use at the AMPATH clinics -- integration required dedicated time by several experienced data managers. Third, the cable connection between the PDA and GPS devices was not always reliable, and GPS information had to occasionally be entered manually into the PDA devices. Fourth, the use of the proprietary Pendragon Forms Software on the PDA devices limited flexibility to incorporate some functionality into the data collection software –- some of these functionality included advanced barcode scanning and check-digit algorithms."

In late 2009, we provided an early version of ODK Collect to AMPATH (on an HTC Dream, the first Android device). We spent a week with them in Kenya piloting the system, and based on the available functionality, AMPATH decided to switch to Open Data Kit. Below is a picture of one of the CHWs scanning a patient barcode with the phone.

In early 2010, AMPATH finalized the HCT form, made minor changes to the user interface, acquired Android devices, and started to scale up. It is important to note that ODK's core developers were not involved at this stage.

Rajput et al. evaluated the ODK implementation at AMPATH a few months after and showed that "Users of the system felt it was easy to use, and facilitated their home visits. It is more cost effective than pen-and-paper alternatives. Additionally, electronic data collection facilitated earlier reporting. We have implemented a viable solution at scale for collecting electronic data during household visits."

More importantly, that study also found that for the 63,000 persons encountered, "the direct capture of electronic records greatly facilitated the expeditious performance of initial analyses and reports prior to the conclusion of the three year HCT program. Our work has highlighted ... most notably that only 28% of persons we are identifying as infected with HIV are presenting for follow-up care." AMPATH has acted on this data by launching programs to improve follow-up.

It has been almost two years since AMPATH started using ODK Collect. We recently touched base with the HCT program to see how their use of technology has scaled. Since early 2010, ODK has been used by a few hundred CHWs in over 650,000 patient encounters! The HCT program has a greater than 98% rate of acceptance into the homes it visits, and with the help of technology, has been able to lower mother-to-child transmission of HIV/AIDS to lower than 3%.

Mobile Clinical Decision Support with ODK Clinic
We have continued our collaboration with AMPATH, and this year, we focused on tools for clinicians. We have created a new version of ODK Clinic, an Android-based application that downloads patient data like demographics, disease history, lab results, and recent medications from OpenMRS (and the Clinical Summary Module). We re-designed the entire application from our early v1 release and added features to enable correction of serious mistakes in the patient record. We also added decision support so clinicians receive patient-specific reminders when the system notices that sub-standard care is being offered. All this in near real time and at the point of care -- a major improvement over AMPATH's existing paper-based summaries.

If, for example, the system notices a scheduled lab test is overdue or a patient's health indicators have dropped dramatically, a reminder is inserted into the patient's record and displayed to the clinician. ODK Clinic can also enforce compliance with the reminders and can help compliance by wirelessly printing lab order test requisitions complete with all necessary patient data. We detailed our findings designing the system in our Design of a Phone-Based Clinical Decision Support System for Resource-Limited Settings paper from ICTD 2012. The talk slides are available and a video demo of the system is below.

Since that paper was written, the system has been used with about 7,500 patients at two adult HIV clinics. We are still evaluating the results of that deployment in a controlled trial, but very early results seem to show that clinicians using ODK Clinic deliver a higher standard of care. Moreover, clinicians enjoy using the system! As a few told us, "[We] can't see a patient without this phone."

We believe that technology only magnifies existing human intent and capacity and so, sustainable improvements require organizations who are dedicated to the communities they serve. With HCT and within HIV clinics, ODK and OpenMRS have helped make health care providers more efficient and through that efficiency, magnified their impact. We believe this is one of the reasons why this work was featured as one of the mHealth Alliance and Rockefeller Foundation's Top 11 in 2011 Innovators Challenge.

Our work at AMPATH has been in deep collaboration with many people. We want to thank Martin Were, Nyoman Ribeka, Sam Mbugua, Zeshan Rajput for their help. We also thank all our colleagues at OpenMRS and Regenstrief for their support, and Abbott Fund and Google for funding much of this work. Finally, we thank the CHWs and clinicians for their participation in our research. It is their hard work that is making a difference in the lives of the underserved.

As part of those explorations, Chris found Open Data Kit and recruited School of Public Health (SPH) students Marion McNabb and Laura Khurana to train fellow BUSPH students on how to use ODK. The students have put some of the discussions they had, forms they created, and feedback they had online. If you are thinking about implementing ODK for a global health research project, it is a great to start.

Below is video with some of their thoughts on using ODK.

In October 2011, staff from EI and United Nations Environment Programme (UNEP) trained a group of agronomists and staff members from CSI on ODK. HRI reports that during "the week of the ORE ict4Ag training, the South Department experienced severe flooding as a result of heavy rains in the region. Anticipating widespread damage to personal property and infrastructure, UNEP asked ORE to undertake a rapid agricultural assessment to gauge the agriculture losses caused by the flooding. ORE agronomists were able to use their new phones and take advantage of their new ODK knowledge to undertake a rapid agricultural assessment."

Congratulations to the ORE team on their quick transition from training to field usage! Find out more about their work at http://haitiregeneration.org.

He notes, "my two main objectives with this paper were to explore the software and steps required for collecting GIS data with mobile devices (smartphones such as iPhone, Android, and Windows Mobile) and for displaying that collected data on the web. I accomplished this by attempting to develop a mobile GIS collection and display solution using each of the options currently available for building mobile apps.

The second part of the paper, detailed instructions, gives detailed step by step instructions on how to create GIS data collection and display solutions for each of the development options found to have the most potential. Each set of detailed instructions covers all of the steps needed by a user with no previous experience to install, configure, build, and deploy the solution."

Download the paper from Doug Browning's site.

Matt Berg writes, "We've incorporated the XLS2XForm library directly into formhub. This allows you to upload an xls into formhub and then be deployed directly to your phone. We also provide a nice excel/csv export that provides support for things like repeats and some very basic mapping visualizations. We are also working on incorporating the idea of form sharing (via xls files) into formhub. This is an idea we are really excited about."

formhub is Python/Django, open source and an absolute delight to use. Find out more in the "Data Gatherers of the World Unite" blog post and sign up for an account at http://formhub.org.

Thanks to the Modi Research Group for their many contributions to the ODK ecosystem and for making data collection a lot easier!