Introducing the REDCap Mobile App – an Offline Data Collection Tool Yasmeen Hafeez, Debra Veryser, Robert Spain, Daniel McLaren Department of Public Health Sciences Henry Ford Health System, Detroit, Michigan Introduction Mobile App Concepts Security Features The REDCap system provides online users with the ability to create and manage surveys and databases quickly and securely to facilitate data collection. The REDCap Mobile App adds a new dimension to the system’s versatility by providing users with a tool for offline data collection, particularly in environments with poor or no internet connectivity. With REDCap and the REDCap Mobile App, users have new options for electronic data capture for studies that under previous circumstances would have dictated pen and paper. The app offers the feasibility to collect REDCap data in an offline environment and then sync the data back to the project on the REDCap server when internet access is available. Create and design your REDCap project on your REDCap server as you normally would. Grant Mobile App Rights to your mobile app users and have them request an API token. While online, set up the project in the app using the App Access Code or QR code provided in REDCap. The app will then download all of the data instruments, events, arms, form-event mapping, field validations, and calculations for the project. Once the project is downloaded, there is an option to download the existing records into the app. Begin data collection for both new and existing records. All data collection can be done offline – without internet access. Besides free text and structured data entry, pictures and video can be uploaded into designated fields. The data collected resides on the device and is only restricted by what the device’s hard drive will allow. Send data to the REDCap server securely. This will synchronize the mobile device’s data with the main REDCap project. New records are sent as a package; modified records have their values adjudicated against existing server values. This step must be done online. Once the data is synced to the REDCap server, it is fully integrated into your project. It can be viewed, edited, and exported for analysis as if it were entered online. The Clean & Reset Mobile Project (recommended) option can be used after successfully syncing the device’s data to the REDCap server. This will remove all data from the device and download any updated forms, events, or other project changes from the server. Data is transmitted securely to and from the REDCap server via SSL (https) if it is set up on the server. If SSL is not set up on the server, the REDCap Mobile App will alert the user when the project is downloaded. The REDCap data is encrypted on the mobile device’s hard drive using SQLCipher (public key/private key encryption). This prevents someone from accessing the data in the event that a device is lost or stolen. Deleting or regenerating a user’s project API token can be used to prevent the users from downloading or uploading data to the REDCap server from the app. This will also prevent the users from accessing the data on the app as soon as they are connected to the internet. In this way, the remote lockout feature provides yet another way for users to protect their data. The ‘Secure the Instrument’ feature in the app restricts access by a participant to a single form. Enabling this feature allows you to hand the device to a participant to enter information directly, but it locks the participant out of the rest of the REDCap app. The REDCap app user’s 6 digit pin is required to unlock the form. Similarly, the 6 digit pin is required to reenter the form if the participant minimizes the application or if a screen saver interrupts data entry. As of version 1.21.4 released on Sept 5th 2015, more security features have been added to the app. This includes an Admin account that can create user accounts in the app and grant or revoke user rights. With these new features, app users can now be limited to the minimum necessary activities needed to accomplish their work. When deploying the REDCap app, we strongly recommend evaluating the security features available in your chosen mobile device and implementing additional security features such as device encryption, unique logon IDs, and remote lockout and/or remote wipe capability to supplement the security features of the app. The REDCap Mobile App was launched in late May, 2015. The REDCap Mobile app is designed to fit the following scenarios: A REDCap project that needs data to be collected without any internet access available. collected in a location with sporadic internet access. The app works on iPhone 4 and up, iPad 2 and up and requires iOS 6.0 or later. It also works on Android phones and tablets and requires Android 4.3 and up. A login with a 6 digit pin is required to access the REDCap mobile app. Five login attempts are allowed before lockout, and a 15 minute lockout period is initiated. When the application is sent to the background or is cloaked with a screen saver, the pin is required again to access the application if a user is logged on. Similar login attempt rules and lockout rules apply when the user re- enters the application. Project logs for activity on the REDCap Mobile App are collected and stored on the device. These logs record data creation, modification, and uploads, as well as other activities. App Use at HFHS HFHS is among the first to implement the use of the REDCap Mobile App. Currently two pilot projects are using the app and the data collection is going smoothly. The first project is administering surveys at one of our HFHS hospitals. Although there is a wireless network available at the hospital, it is not available in all locations. The project requires collecting multiple inpatient surveys and calculating a risk assessment score for the patients. The REDCap Mobile App has been ideal for the project to collect the surveys, automatically (and reliably) calculate the risk score, refer the patient to the appropriate physician as needed, and upload the data when internet connectivity is available. Anecdotally, the project’s Research Coordinator has reported that most of the participants to date (all newly-admitted patients) have requested that the survey questions be read to them, rather than entering the data on the mobile device themselves. The second project is using the app to collect participant surveys at local Farmer’s Markets throughout the Detroit area. Since wireless connections are not available in these locations, the app is perfect for collecting the surveys and it eliminates the need for paper data collection and manual data entry into the REDCap database. In an informal survey, a small percentage of the study coordinators were not comfortable with using the technology and preferred paper forms to collect data, but the majority found the app very easy to use. In the unlikely event that an upload fails, an alternate option is available called ‘Emergency Data Dump’. This alternate mechanism sends data to the server as a CSV file that can be parsed manually. This should only be done in emergencies and it requires an online connection to the REDCap server. The user interface allows multiple individuals to access the app on a single device via a secure login. Teams with multiple mobile devices have the capability to collect data for one project, or multiple projects simultaneously. Conclusion We attribute the success of one of our pilot projects to the use of the REDCap mobile app. The project relies on capturing patient reported surveys in real time with sporadic internet access, and referring them to the appropriate physician based on a calculated score. We have found the app to be easy to learn and use, and it is popular with data collection staff. The app has been very reliable, and Vanderbilt staff are providing us with excellent support during this rollout phase. Limitations New project creation is not possible in the REDCap Mobile App. The REDCap mobile app runs in conjunction with the REDCap system. You must already have a REDCap user account and a project created on a REDCap server before being able to download the project to the app. The app cannot function or stand independently without a REDCap server. Reports, SQL lookup fields, randomization, and some other REDCap functions do not work in the app since these functions require online access to the REDCap server. Reference REDCap Support We have had excellent support on all Mobile App issues from the REDCap support team at Vanderbilt. They are very quick at trouble shooting and can push out new versions of the app immediately (pending approval by the App Store). http://projectredcap.org/app/security.pdf http://projectredcap.org/app/about.pdf https://www.icts.uiowa.edu/confluence/display/REDCapDocs/REDCap+Mobile+App