Through a wholly owned subsidiary, Right to Care Health Services (Pty) Ltd, Right to Care provides HIV care and management services to private companies. The services include provision of a 24-hour medical call centre, case management, counselling and adherence management of patients, and comprehensive data management and reporting.
Three private programmes are in operation. The largest programme is Direct Aids Intervention (DAI). DAI has 23 medium to large clients. They include Telkom, Massmart, Investec, Vodacom, and Alexander Forbes.
Right to Care also operate programmes for clients Oprah Winfrey Foundation and Housing for HIV Foundation.
Across the full client base, over 83 000 employees are eligible for programme enrolment.
Right to Care provides HIV-management programmes that are tailor-made for the client company and that integrate into the client’s medical aid and on-site health services. This ensures a streamlined transition from HIV counselling and testing (HCT) to treatment.
Right to Care’s motto is, “Testing for Treatment”. Therefore, the effective transition into care is vital. Right to Care ensures co-operation with the client’s medical aid so that the HIV test is directly linked to the managed care of the HIV-positive individual. Right to Care has a team of dedicated medical professionals who provide on-site HCT. In the 2009 financial year, over 200 000 tests were performed.

24h call centre

We provide a toll-free 24-hour medical call centre of the highest professional and ethical standards. We employ only qualified professional nurses with more than 10 years’ experience. They are representative of all South African cultural and language groups.
We provide support to the employee’s household on all health-related issues, but focused on HIV. Any employee or household or family member is free to call the call centre for medical and counselling advice, 24 hours a day, seven days a week. The call centre provides support for inbound and outgoing calls. Employees that are registered on the programme receive regular calls from our case managers to track their progress and monitor problems.

Clinical management and care

Our HIV management programme provides an outgoing call service from the medical call centre to ensure drug adherence, early identification of problems (such as drug resistance), ongoing support, and patient education. The outbound service also ensures that the social and psychological needs of the patients are addressed. This service is provided by an allocated case manager, who is a registered professional nurse with specialised training.
All cases are managed on a proactive basis with regular viral load tests, full blood counts, liver function tests, CD4 counts, and other investigations as required. Cases are managed by clinical HIV specialists on our data portal, TherapyEdge™. Through our links with the laboratories, all data and results of investigations are immediately available on TherapyEdge™ and can be used to manage calls made to the medical call centre.
Our programmes provide for the provision of pre-HAART supplements in the form of vitamins, minerals and additives which boost the immune system and delay the initiation of the patient on ART.
We provide ART in line with World Health Organisation protocols and those of the Southern African HIV Clinician Society. Our protocols are also aligned with the guidelines of the South African national Department of Health.
Drugs are delivered on a three-monthly basis through a courier pharmacy system, having been packaged by RightMed Pharmacy.

Adherence counselling and incentives

We provide clinical psychological counselling through our partnership with Employee Assistance Programmes (EAP). The EAP provides telephonic (24 hour) and face-to-face counselling for HIV-positive employees. We provide a direct link to EAP’s call centre from our call centre and the employee only has to use one toll-free number.

HCT

We offer on-site and off-site HCT services. For on-site testing, we take mobile clinics, gazebos, marquees to the workplace. We also use facilities provided by the employer such as training and meeting rooms.
Off-site HCT services are provided to employees as an alternative to testing in the workplace since employees are not always able or willing to test at work.
The required pre-and post-test counselling is done for every individual. Post-test counselling is done by the same nurse counsellor who performed the HIV test, and a psychologist is on stand-by to provide crisis support.
Rapid HIV finger prick test kits are used. If the Rapid test is positive, it is followed by another rapid test from a different manufacturer to provide confirmation before the employee is informed of the results.
All information is managed via a portable HCT module that records the HCT session with each patient and keeps a paperless record. We use fingerprint technology for the consent. Since all information resides in the HCT server, reporting is accurate and instant.
We give the employer no access to data on individuals but report consolidated results.

Communication and awareness

Our education and awareness programmes are rolled out to suit the needs of the client. Typical elements include: employee eligibility card and brochure; posters for HCT events or wellness days; management training; training for shop stewards and safety, health and environment officials; employee information sessions; and access to a Web site with HIV information.

Data management and reporting

We provide monthly participation reports to clients. They list, for example, numbers of incoming and outgoing calls, nature of the calls, and numbers of employees registered, tested and on treatment.
Quarterly reports are more expansive and include: HIV/AIDS stages of employees that are registered (CD4 count and viral loads) and financial reports. Annual reports are provided which include the 12-month outcome and achievement of the programme; detailed report on testing prevalence and uptake of HCT by region, division, age, and gender; annual financial report; absenteeism analysis detailing the success with regards to implementation of the programme; cost-benefit analysis; and an actuarial analysis of current prevalence and future scenarios and risks.