Right to Care's doctors and nurses, during patient examinations, capture clinical information directly onto a disease management database, TherapyEdge-HIV. The system displays data on both current and previous visits.
Real-time access to TherapyEdge has opened up the wealth of information and clinical decision support made available by this HIV clinical database and disease management tool. At the click of a mouse button, the user is able to retrieve graphical details of changes in CD4 count, viral load, and many other parameters that are used to monitor patient progress on antiviral treatment.
The doctor can rapidly access TherapyEval for treatment guidelines and drug information tailored to the individual patient. Moreover, using the Viroscore Suite, the doctor can select appropriate treatment for patients with resistant HIV strains.
Real-time statistics on patient numbers, bookings, loss to follow up, and other housekeeping information has greatly improved the administration of the clinic. The benefit of this has already been seen in the dramatic fall in numbers of patients lost to follow up. Furthermore, data quality has improved, as the system eliminates both the involvement of non-medical staff (data capturers) and of errors arising from illegible handwriting. Clinicians using the system live can check on the validity of data and call for corrections.
Added to this has been the increased use of clinical data from TherapyEdge for epidemiologic research, where errors encountered in data cleaning are corrected and fed back into the record.
While live TherapyEdge is a great advance, the hybrid system is in use at some sites. Data is recorded on paper forms and entered onto the system by data capturers. TherapyEdge-derived reports are available at these sites but they do not have the benefit of clinical support and the data review available to real-time users.
Another innovation piloted at Themba Lethu and made possible by live TherapyEdge is an SMS alert system for patients attending the clinic. Cellular telephone numbers are collected when the patient books out of the clinic. The patient is then sent reminders of scheduled visits and instructions on what to do if a visit is missed. This has significantly reduced the number of unscheduled visits and has improved the flow of patients in the clinic (by reducing minimising overcrowding caused by unscheduled appointments).