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DELIVER Annual Technical Meeting Key Bridge Marriott - June 2005

DELIVER Annual Technical Meeting Key Bridge Marriott - June 2005. S ecure T echnology A dvancing T reatment. Application of Biometrics / SmartCard Technology for A nti- R etroviral T herapy (ART) in South Africa. John Wilson & Rovaro Bayard JSI South Africa.

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DELIVER Annual Technical Meeting Key Bridge Marriott - June 2005

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  1. DELIVER Annual Technical Meeting Key Bridge Marriott - June 2005

  2. Secure Technology Advancing Treatment Application of Biometrics / SmartCard Technology for Anti-Retroviral Therapy (ART) inSouth Africa John Wilson & Rovaro Bayard JSI South Africa

  3. JSI requested by NDOH Chief Director to survey what systems are available in South Africa that can help with the ARV roll-out, especially in terms of Logistics, Patient Information Systems and Program Monitoring THE OPERATIONAL PLAN FOR COMPREHENSIVE HIV AND AIDS CARE, MANAGEMENT AND TREATMENT FOR SOUTH AFRICA – November 2003

  4. CRITICAL REQUIREMENTS: • Must be ‘attractive’ to clinicians and healthcare workers • Capable of tracking drug distribution to end user • Will generate NDOH / Emergency Plan indicators (2-7-10) • Confidentiality • Authentication / Verification • Data Security • Responsive to the very high mobilityof South Africans • Can operate in an off-line environment (community outreach)

  5. FINDINGS: • Of the 9 systems reviewed that are currently in use in 6 Provinces of South Africa only 1 system is sufficiently responsive to the mobility issue, and can operate off-line in community outreach settings NET1 Biometrics / Smart Card system used for dispensing more than 4 million pensions and social grants in 6 Provinces (began 1999), which seemed to have applicability in an ART setting

  6. NET1 “UEPS” system for pension payout • More than 4 million pensions & social grants dispensed using SmartCard/ Biometrics in 6 South African Provinces since 1999; • This indicated potential applicability to ART in overcoming challenges. Pensioners receiving payouts from mobile unit

  7. STAT™ System Development Phase 1: Conceptual Framework Phase 2: Proof of Concept Phase 3: Systems Development in Clinical ART Settings Phase 4: “Live” Implementation in Diverse Field-Test Sites

  8. JSI Partners Developing Biometric / Smartcard Solution for Patient Information and Drug Stock Control System

  9. Phase 1: Conceptual Framework - Timeframe 4months

  10. Phase 1: Conceptual Framework (2) – additional 2 months

  11. STAT™ System Development Phase 1: Conceptual Framework Phase 2: Proof of Concept Phase 3: Systems Development in Clinical ART Settings Phase 4: “Live” Implementation in Diverse Field-Test Sites

  12. Phase 2: Proof of Concept – plus five months. Patient Database Development & card to card data transferability – the “Boardroom Demo” Prototype Smartcard readers Fingerprint scanner POS device

  13. STAT™ System Development Phase 1: Conceptual Framework Phase 2: Proof of Concept Phase 3: Systems Development in Clinical ART Settings Phase 4: “Live” Implementation in Diverse Field-Test Sites

  14. Systems Development in Clinical Community Outreach Setting

  15. STAT™ System Development Phase 1: Conceptual Framework Phase 2: Proof of Concept Phase 3: Systems Development in Clinical ART Settings Phase 4: “Live” Implementation in Diverse Field-Test Sites

  16. Patient Registration On “Live” system

  17. STAT™ System for ART • Based on existing RSA Biometrics and Smartcard technology • ART patients retain their cards • Healthcare workers have their own cards • Cards hold 64Kb of data in 255 data wallets.

  18. Provider can print prescription, sign and store in patient folder Patient’s STAT™ Card Provider enters codes for drugs prescribed, gives drugs to patient and returns STAT™ Card • Coded data entry: • Symptoms • Weight • Lab results • Prescription Provider’s STAT™ Card How STAT works in practice:Patient ART Center Visit/Home Visit Script Rx Alternatively, if pharmacy available…

  19. OPTIONAL: Patient gives prescription to pharmacist Patient’s STAT™ Card Script Rx Rx Rx Pharmacist gives drugs to patient, returns Patient’s STAT™ card Pharmacist dispenses drugs as prescribed and recorded on patient card Pharmacist’sSTAT™ Card ARVs Dispensed in Pharmacy

  20. Providers’ & Pharmacists’STAT™ Cards Data Batch Upload to STAT Reporting Database Data from Net 1 FTP’d to JSI STAT™ Reporting database server Encrypted Data on Service Provider STAT™ cards uploaded to Net1 Switch by dialup or broadband at end of day

  21. Patients can use their card at any STAT™ ART center; Ideal for home visits - Battery operated and portable STAT™ system functions off-line, with upload of data to central database at end of day; JSI STAT™ central database runs on Microsoft SQL relational database, hosted on a MS-SQL Server incorporating SQL Reporting Services; Able to accurately record facility-level ARV inventory. Features of the STAT™ System

  22. Only the owner or proxy in exceptional circumstances of the STAT™ card can use it to obtain treatment; = without X • Patients cannot receive more than the appropriate amount of drugs in any month; • Potential ARV leakage at ART centers minimized due to higher level of accountability through use of provider STAT™ cards.

  23. Electricity/phone line available availability: Since card readers powered by rechargeable batteries, no electricity required during home visiting; Battery pack allows estimated 320 patient interactions on single charge; Patient visits at ART centers can continue during power outages; No need for constant online connection – dialup and upload at end of day only.

  24. ARV inventory control, security, & data management: Incoming drugs entered on pharmacist’s STAT™ card and deducted from inventory on hand as drugs dispensed to patients; ARV stock status uploaded daily to national STAT™ database; Precise consumption data generated to enable accurate forecasting; Supervisors can check physical inventories against up-to-date stock status data.

  25. Verifying Private Provider Billing: Private practitioners can claim payment made through data uploaded through Net 1 switch; Eliminates need for paper billing.

  26. STAT™ Implementation (FY 04 PEPFAR COP) • Currently live field testing in Hospital, Static Clinic & Community outreach environments ( Target 2500 on ART, 4000 on Care and Support) • Uplink to STAT™ central database went live April 8, 2005

  27. Planned Implementation of STAT per FY 05 COP • By end FY 05 funding, 5,700 patients on ARV's plus 38,000 patients on care and support utilizing STAT™ in 23 CRS/SACBC sites in 8 of 9 provinces • In addition, as appropriate, public sector sites in provinces (so far 4 provincial sites • Testing of STAT Drug Inventory Module • Development of TB, Pediatric, and Nutrition modules

  28. SmartCard/Biometrics Readers • Portable, rechargeable battery operated card readers; • Patient and provider cards inserted in card reader; • Built-in fingerprint scanner; • LED screen to guide provider through treatment protocol; • Numeric keypad for data entry.

  29. } • Potential New Partners? • Broadreach • Aid for Aids • Absolute Recovery for Kids (ARK) Private GP Service Providers Billing / Verification potential!! • Malawi (Malswitch Reserve Bank) • Nigeria (FHI?)

  30. ADVERTISEMENT LOGO Long Term Vision ?? • The Patient-Retained • Record System of Choice? • Reduced Shrinkage in Supply Chain Management Systems ??

  31. Thank you !

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