Pharmacy automation reduces wait times

Automated pharmacy at SA’s busiest HIV clinic reduces wait times from 4 hours to 18 minutes


Johannesburg, November 28, 2013: South Africa’s busiest HIV clinic sees more than 750 patients a day with more than 17 000 patients on ARVs. In response to lengthy patient queues and overworked pharmacist staff, the first robotically automated pharmacy has been introduced in a public health facility in South Africa. This innovation addresses the concerns of patients needing HIV and other chronic medicines at the Right to Care’s Themba Lethu HIV Clinic at Johannesburg’s Helen Joseph Hospital.

Right to Care is South Africa’s leading HIV/Aids NGO. Funding for the initiative was provided by USAID.

The automation system demonstrates the latest technologies in pharmacy dispensing and Themba Lethu Clinic has seen patient waiting times in the pharmacy drop from over four hours to 18 minutes.  The system has also eliminated the loss of stock due to drug expiry which will save the Department of Health millions of Rands.

Doctors in the clinic write electronic scripts which then link directly into a patient management system in the pharmacy using cloud technology systems. Medicines are then automatically dispensed and are available for handover by pharmacy staff shortly after the patient arrives at the pharmacy.

The system holds all the medicine stock in a secure container and a robotic picking head is used to quickly dispense the medicines to the pharmacist.  It was not just a machine that was installed, but systems and processes for stock control management and pharmacy dispensing that are aligned to a new way of work flow and responsibility within the pharmacy. 

Dr Pappie Majuba, Right to Care’s Chief Medical Officer, comments, “Patients now receive their drugs very quickly, which leaves more time for patient counselling from the pharmacy staff. Picking errors and have been reduced to zero and patient care has improved.  Patients are now more compliant on their medicines as a result of not having to spend the whole day at the clinic.”

With increased efficiencies, the staff requirement to run the pharmacy has been drastically reduced, allowing for pharmacy personnel to be used for supportive functions in the wards and throughout the clinic.  The pharmacy used to close at 19h30, with staff working overtime.  Now the pharmacy sees all patients by 15h00. 

Kurt Firnhaber, COO of Right to Care adds, “Right to Care has received international recognition for one of the many innovations it is has developed in support of public health in South Africa.  We believe that through the advancements and innovation of automation in medicine dispensing there will be enormous benefits to the patients who access services through the Department of Health”.

Right to Care is also working with the National Health Insurance (NHI) to expand this innovation at a further three sites in Tshwane.

The next development which is not yet available anywhere in the world, includes the use of Pharmacy Dispensing Units (PDUs), developed by Right to Care Health Services which are like ATMs, that will deliver drugs to patients 24 hours a day, with support from Right to Care’s call centre pharmacy. Patients will be able to obtain drugs at PDUs simply by using their South African bar coded ID or health card.  This innovation also uses a cloud based pharmacy and data system that will manage these remote PDUs. 

The support of Liberty Life will play an important role in developing this approach to bringing medicines to people needing chronic medicines.  Right to Care is also working closely with the Department of Health, the Pharmacy Council and the National Health Insurance to advance this technology.

Right to Care won a major international award for its system that automates pharmacy systems in high volume treatment centres. It won the category of the Best Enterprise & IT Architecture in Government/Defence/Public Sector. The award, which was selected from projects submitted from 27 different countries, was presented in Bangalore, India at the iCMG Conference of Enterprise & IT Architecture 2013. Previous winners and finalists include many well known multi-national companies, IT specialist and governments from around the world.

See the system in operation on YouTube at http://bit.ly/1aVHVJs

 

 
About Right to Care

Right to Care is a non-profit organisation (Section 21) that supports and delivers prevention, care, and treatment services for HIV and associated diseases.
 

Through technical assistance, Right to Care supports the Department of Health at national level. Support at provincial level is provided primarily in five provinces: Gauteng, Mpumalanga, Northern Cape, Western Cape, and Free State. In addition, through direct service delivery, Right to Care treats patients for HIV, TB, cervical cancer, and sexually transmitted infections.
 

Support for clinical programmes is delivered through development of clinical best practices, research, training, mentoring, participation in technical committees, provision of facilities and equipment, and secondment of staff, among others services.

Funding and revenue

The chief funding and revenue streams are:

  • The President’s Emergency Plan for AIDS Relief (PEPFAR), managed by USAID
  • Global Fund
  • Private-sector donors
  • Revenue from the private sector for provision of employee wellness services (through Right to Care Health Services)

HIV care and treatment

Right to Care’s Adult HIV and Paediatric HIV programmes support the clinical care and treatment of individuals infected with HIV and associated diseases. Care and treatment is accessible through an integrated model that includes prevention, transition into care, treatment adherence, and nurse initiated and managed ARV treatment (NIMART). Loss-to-follow-up is minimised using innovative approaches, such as automated text messages and patient transfers with electronic records.
 

On-site and didactic training are provided to clinicians in the public and private sectors. In each province, centres of excellence are hubs for mentoring and training and for referrals of complicated cases.
 

In its first ten years of operation, Right to Care initiated over 230 000 patients on ARV therapy.

TB

Right to Care’s TB programme provides integrated TB/HIV services for both drug-sensitive and drug-resistant TB. Components of Right to Care’s TB strategy include use of the ‘‘3 Is’’: Intensified case finding; INH Preventative Therapy (IPT); and Infection control in health facilities.
 

TB symptom screening is done at all healthcare visits. Sputum induction facilities reduce by 10% the number of patients who cannot produce sputum, leading to improved testing rates.
 

Right to Care has spearheaded the use of the Cepheid GeneXpert MDR TB Rif for rapid diagnosis of TB and of drug resistance.
The diagnosis and management of Multidrug and Extensively Drug-Resistant TB is supported, in particular at Sizwe Tropical Diseases Hospital, Johannesburg. On an on-going basis, Right to Care collaborates in TB research studies.

Cervical cancer

At present, our most important weapon against cervical cancer is an effective screening and treatment programme to detect and remove early cervical dysplastic lesions. Right to Care trains medical officers to perform colposcopic biopsies and large loop electrical excisions (LLETZ). These cost-effective procedures have resulted in greatly improved access to treatment.
 

Mobile clinics take screening and treatment services, and other women’s health services, to remote areas.

Prevention

Right to Care’s prevention programmes include treatment as prevention, medical male circumcision (MMC), HIV counselling and testing (HCT), and prevention of mother-to-child transmission (PMTCT).
 

Right to Care advocates treatment as prevention. Among discordant couples, ARV therapy has been shown to reduce by 90% the rate of transmission from one partner to the other.
 

Annually Right to Care conducts over 300 000 HIV tests.
 

Through technical assistance and direct service delivery, Right to Care is supporting the DoH in the delivery of MMC services. MMC is offered as a comprehensive package of services that includes HCT, the provision of condoms, and education for behaviour change. MMC clinics are optimised for high-volumes.
 

Right to Care’s integrated PMTCT and Maternal & Child Health unit provides technical assistance for prevention for mothers, immunisations, reproductive health services, basic antenatal care, and PMTCT at supported sites.

Pharmacy supply chain management

Right to Care’s pharmacy programme supports the DoH at national, provincial, district, and facility levels. Programme staff members play an important role in the development of pharmaceutical policy. Right to Care supports the Medicines Control Council for the registration of medicines and for the regulation of clinical trials. Right to Care supports the site-level implementation of computerised pharmacy dispensing and information management systems. This includes integration of clinical data systems and pharmacy management systems.

Right to Care Health Services

Right to Care Health Services, a wholly owned subsidiary of Right to Care, offers organisations a comprehensive integrated wellness programme. The programme includes health and wellness screening, health risk assessments, management of chronic diseases, psychological counselling, legal and financial counselling, primary and occupational healthcare services, executive wellbeing, absenteeism, and incapacity and disability management. Clients are provided with comprehensive and integrated reports on all aspects of employee healthcare.

Training

Right to Care’s Training Department develops staff knowledge and skills in order to improve the capacity to provide quality HIV care, treatment, and support. Training courses covering a broad range of clinical subjects are offered to healthcare providers of supported sites. Didactic training is follow up with on-site mentoring.
 

Skills programmes are conducted for lay counsellors and for non-clinical staff.

Corporate governance

Right to Care is governed by a board of directors, of whom two-thirds are non-executive directors. The organisation complies with King III standards of corporate governance.
 

Right to Care consistently achieves unqualified audits from its auditing firm, Deloitte and Touche.

 

 
Our Vision & Mission

Our Vision

That every individual will have ready and affordable access to quality evidence-based medical services

Our Mission

To respond to public health needs by supporting and delivering innovative, quality healthcare solutions, based on the latest medical research and established best practices, for the prevention, treatment, and management of infectious and chronic diseases
 

 

 
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