DTHC Pharmacy and Masiphumelele, Cape Town & Ocean View, Western Cape

The Desmond Tutu HIV Centre (DTHC) has been involved in dispensing ARV drugs to patients living in Masiphumelele since June 2004. Masiphumelele (meaning "We Will Succeed" in Xhosa) is an informal settlement situated in Ocean View, 40km south of Cape Town. A clinical study is under way to establish the HIV prevalence in this township, but current estimates have been high. One pharmacist works at the central pharmacy at DTHC, housed at the Medical School of the University of Cape Town, 30km from Masiphumelele. The pharmacist uses iDART to dispense monthly ARV drug supplies to patients visiting this remote ARV clinic. Two doctors, two nurses and two study coordinators work at this health care facility. In March 2005, the prototype system was installed and was used for 10 months.

Then, in January 2006, the first installation of the clinic application of iDART was successfully launched at Masiphumelele. In April 2006, 350 patients are actively being monitored on the system. All clinical staff is involved in the scanning in of pre-packaged drug supplies, and scanning out of these packages to patients. Accurate reports are now accessible to the staff working at Masiphumelele, and to the pharmacist working at DTHC.

DTHC Pharmacy and Hannan Crusaid Centre, Gugulethu, Western Cape

The Hannan Crusaid ARV Treatment Centre is situated in Gugulethu, 20 km outside of Cape Town, and was the first dedicated ART Centre in the Western Province. Today it actively serves more than 2000 HIV+ patients on ARV therapy. Initially, the pharmacist working at the central pharmacy at DTHC created monthly ARV packages for all patients at the Hannan Crusaid Centre, in the same way as patients from Masiphumelele. But, patient loads increased dramatically over the initial 12 months, resulting in dispensing moving to the pharmacy at the Hannan Crusaid Centre.

A major challenge in dispensing ARVs in South Africa is the lack of human resources. Patient loads at the Hannan Crusaid Centre are extremely high and staff work under high stress conditions. Presently, there is one pharmacist and 2 pharmacy assistants employed at this facility. It takes a considerable amount of time to pre-package a set of drugs for a large patient load. For this reason, we have modified iDART so that pharmacists can dispense directly to patients visiting the clinic.

Through out 2006, Cell-Life (in a partnership with eInnovation) have developed iDART 2.0. This updated version will be used at government clinics from early 2007 as the dispensing module for the electronic patient record system (eKapa). As the pilot site for this project, the Hannan Crusaid Centre recently had an installation of this version. In December 2006, the staff at this facility underwent training and are now using iDART 2.0 for their dispensing and managing of both patients and drug stock levels.

The Taung Treatment Centre, Bophirima District, North West Province

The Taung Treatment Centre is based at the Taung District Hospital and is the largest ART site in the North West province. In June 2006, iDART was successfully installed in this busy pharmacy who service over 1800 patients every month. Our two iDART users had little prior computing experience, but are now completely comfortable with the system and use it on a day to day basis. A number of new features were identified at this site, such as the identification through out the application of short cuts that if used, shorten the time it takes to dispense to a patient. The Taung Treatment Centre is the first (of five) ART sites in South Africa, that will receive the iDART system (both hardware and software) from Cell-Life free of charge. This donation is possible through a generous sponsorship from the Elton John Aids Foundation.

The Hillbrow Community Health Centre, Johannesburg, Gauteng

Cell-Life teamed up with the Reproductive Health Research Unit (RHRU) to expand the features and capabilities of iDART. In October 2006, Cell-Life installed the first release of this system at the Hillbrow CHC, and the pharmacist and pharmacy assistant started using iDART from that time. In December 2006, Cell-Life returned to Hillbrow to install the final version which incorporated all the required changes specific to their needs. Of particular interest at this site, was the identification of a number of new reports required by funders such as PEPFAR and local government.  This pharmacy actively serves over 1300 HIV+ patients receiving ARVs and iDART has been used to assist the monitoring of stock levels and patient tracking. 

The Galeshewe Day Hospital, Kimberley, Northern Cape

In March 2007, ARV pharmacists working at the Galeshewe Day Hospital used iDART for the first time to dispense ARV medication to their HIV+ patients. This is the second site identified for the Cell-Life project sponsored by the Elton John Aids Foundation. This site was also the first clinic to receive an iDART computer having the Ubuntu operating system (instead of the standard Windows). This is in line with governmental recommendations of using open-source software at government facilities. This choice of operating systems has resulted in Cell-Life spending less time supporting and maintaining the computers on which iDART is installed (e.g. virus and spyware attacks).

The Tshepong Wellness Centre, Klerksdorp, North West Province

In April 2007, the ARV pharmacy at the Tshepong Wellness Centre became the third Elton John Aids Foundation sponsored health care facility to receive the iDART system. In collaboration with the Klerksdorp Hospital, the Tshepong Wellness Centre is involved in a comprehensive down-referral system that is currently servicing over 6000 HIV+ patients. When iDART was introduced at this facility, a decision was made to manually enter every new patient onto the system (in previous implementations, we had used the import functionality of iDART). To assist with the initial couple of months of patient capturing, a second computer was loaned to the facility. This was the first time that two interconnected PCs were using iDART, accessing the same database. This is a great step forward, especially when looking at the suitability of iDART for larger facilities (such as government hospitals). After only two months of operations, iDART users at this facility have seen a reduction of up to two hours in the amount of time they spend at their place of work! This is a remarkable, quantifiable achievement highlighting the effectiveness of the iDART system in busy public health care pharmacies.