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Right to Care - PDU's

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by

Marileen Schutte

on 27 November 2014

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Transcript of Right to Care - PDU's

Right ePharmacy is
working directly with the South African Pharmacy Council
in advancing pharmacy regulations to accommodate
automation
. The Council has agreed to participate in this pilot to develop
appropriate regulations
to ensure
safe and effective scale up of this technology
.
Right ePharmacy has also been working with
SITA
to ensure the Cloud technology that drives this solutions is
in-line with the technology requirements and safety of information.
Right ePharmacy is working on
two different
, but complimentary strategies with pharmacy automation and supply chain management.
Pharmacy Dispensing Units (PDU's)
An Out-of-Pharmacy approach where
stable, chronic patients
can receive their medicines
12 hours per day
,
seven days per week
, outside of health facilities at a registered PDU pharmacy in centrally located shopping areas.
This approach will
substantially reduce patient waiting times,
which is the number one complaint that is leveled about public sector health service delivery. This pilot will include
in-pharmacy automation
and
out-of pharmacy automation.

This will be completed at:
Steve Biko Academic
(14,000 patients)
Chris Hani Baragwanath
(22,000 patients)

Night time remote dispensing meets new 24hours requirements
Stable, chronic patients (80,000 patients) will access medicines from
1
of
4
sites, through the use of
remote Pharmacy Dispensing Units (PDU's)
in the surrounding sub-district of Baragwanath, covering
SOWETO region D
.
These two strategies will be implemented in-line with the
NHI
approach of
a cost per script model.
Following year one of the pilot, the DoH will absorb the project costs for the years to follow. This is structured through a
Service Level Agreement
between the DoH and Right ePharmacy.
The full cost of implementing this solution in year one will be covered by
donor
and
private
funds.
This will allow
donor funds
to be leveraged in supporting future sustainable services for automation.
Right ePharmacy’s approach for pharmacy automation is in support of the government’s strategy for job creation and job security.
This is accomplished in
2
areas
Nr.1 Job Security for the Patient
Leaving home 04:00 to hospital
on a work day
Taxi to the hospital
R30.00
07:30
10:30
13:30
15:30
1 FULL DAY SPENT

Lost a day of wadge - R150.00
Frustrated employee
Taxi to go home
R30.00
SUMMARY
Taxi to work R 30.00
Day lost of work R150.00
Taxi back home R 30.00


R210.00
Never arrived a work.

Unhappy employer.
Miss a day of work
Costly & Time consuming
Jeopardizes current employment
Compromises future employability
In-Pharmacy Solution:
Leaving home 06:00 to hospital
on a work day
Taxi to the
hospital
R30.00
07:30
08:00
Patient left within 30min of arrival.
At work by 09:00.

Happy employer.
Taxi to work
R30.00
Chris Hani
Steve Biko
Reduced Script cost
R48.00
R53.00
Waiting time reduce from 4 hrs to less than 30 min.

Government cost saving of 30% per script

Monthly cost savings to chronic patients in the Soweto region D could be upwards of R14,300,000 per month in lost wages and expenses.
Nr.2 Job Security for the Pharmacy Staff
Current DoH staff will be transferred
to run the six facilities in the pilot at Steve Biko and Chris Hani hospitals. This will
create job security
for Pharmacy Staff in current health facilities.
Staff would be offered positions and have
opportunities in three different areas
within the Right ePharmacy.
Staff that would be transferred from the DoH to Right ePharmacy would be
transitioned through a section 189 transfer
.
Staff that would not transfer to Right ePharmacy would
fill current vacant positions within their current facility
as well surrounding DoH health facilities.
New job opportunities
in expanded services like Logistics Manager, Call Center Agents, etc.
Right to ePharmacy opportunities:
1) In-pharmacy facilities (Steve Biko and Baragwanath).
2) PDU sites at surround shopping areas in the same
community (a total of four sites).
3) The Right Health Pharmacy call center.
4) Current vacant positions within the DoH system.
Current DoH Staff at
Baragwanath and Steve Biko
DoH Vacancies
In- Pharmacy Automation
PDU Sites
Call Centre
Right ePharmacy is continuing to engage the
South African Pharmacy Council (SAPC)
in addressing the regulatory issues for pharmacy automation. In this regard, support has been provided to the SAPC in developing the minimum standards, which were published for comment in December 2013 (Board Notice 272) and are currently being finalized.
From discussions with the SAPC, there is support for conducting a
pilot evaluation of remote Units
in order to demonstrate “proof of concept” and facilitate the development of minimum standards for the use of this technology.
"An assessment of both
Baragwanath
and
Steve Biko
pharmacies has been completed by Right to Care which evaluates the current challenges in these facilities."
Challenges at Chris Hani Baragwanath hospital:
Long queues for patients to get triaged at the pharmacy exacerbate the waiting times.
Ineffective stock control systems result in medication errors and a high volume of expired stock.
Responsibilities outside of the main pharmacy are neglected with the high patient burden demands of a high volume pharmacy.
Significant resource is needed for manual re-packing of medicines.
Patient counseling suffers as a result of overburdened staff.
Challenges at Steve Biko hospital:
High number of items per script results in longer waiting times.
The waiting room is not sufficient to handle the volume of patients. This leads to congestion of the main passage.
Manual systems in the dispensary results in poor stock control and medication errors.
This approach will have
pick-up points in the sub-district
that will be placed at
central shopping centers
, where patients currently visit on a regular basis. A
patient survey
is currently being conducted at PHC facilities
SOWETO, sub-district D
, to assess the shopping facilities that they frequent.
With
PDU's at central pick-up points
, all monthly medicines will be collected at one of four sites.
New patients will be register into the Cloud, with the following information:
Patient photo
Record of RSA ID book barcode
Demographics
Contact details
4 digit pin code

Their first script will be captured, they will receive training and receive their first medicines through the PDU.
This registration process will take up to eight minutes
.
8 System
Advantages

12 hour, 7 days a week availability for patients to collect medicines.

Quick patient collection process (3.5 minutes) reducing patient queues.

Centralized data allows patients to collect at any of the PDU's, and not more than once a month.
PDU sites will have a responsible Pharmacist.

Integrated data system between In-Pharmacy and Out-of-Pharmacy for reporting and accountability.
All patients will receive automated communication through SMS reminders and follow-up calls for missed visits.

Stock control management will meet the highest standards to eliminate stock loss and eliminate expired stock.
Right ePharmacy will be proposing to the Gauteng DoH to provide an
innovative and patient integrated PDU project
for the City of Johannesburg, Region D in Soweto as well as
in-pharmacy dispensing
at the Baragwanath Hospital.

A PDU integrated with the
Cloud
with
centralized scripting data
is a
first
in South Africa and the world.

The PDU's are projected to be placed in the following regions, based on the chronic patient mapping:
Current Project:
Themba Lethu Clinic in St. Helen Joseph Hospital

Project Results:
Read more on PAGE 2 regarding
The Project
to solve these challenges...
The aim is to increase the quality of pharmacy services through the demonstration of pharmacy automation in to large hospitals.
Prominent Benefits

Improves quality patient care.

Shorter waiting times.

Reduced dispensing errors.

Increased consultation time.

Increased availability of services.

Improved stock management.

Lowering cost of services (DoH).
Donor Contributions thus far:
GIZ
MACH4 Germany
RTC
USAID

Total Funding:
R 13 320 000
R 7 622 000
R 7 000 000
R 29 200 857

R 57 142 857
This Funding Covers:
All staff costs.
Prorated amount for infrastructure & capital.
Project management.
Cloud Solution.
IT connectivity.
Call center support.
Current In-Pharmacy Reality:
Current Script cost
Chris Hani
Steve Biko
R64.00
R73.00
Leaving home 07:00 to local Clinic on a work day
Never arrived a work.

Unhappy employer.
Out-Of-Pharmacy Solution:
Leaving home on a Saturday /Public Holiday / after hours.

Happy employer.
Current Out-Of-Pharmacy Reality:
Script cost
PDU's at shopping centers
R39.25
07:30
09:00 - Clinic opens
11:30
12:30
HALF A DAY SPENT

Lost a day of wadge - R150.00
Frustrated employee
Patient won't go back to work for the day
SUMMARY

Day lost of work R150.00



R150.00
Miss a day of work
Costly & Time consuming
Jeopardizes current employment
Compromises future employability
Right ePharmacy, through donor support from GIZ, USAID, MACH4 Germany and Right to Care, will demonstrate significant
improvements in service delivery
for collection of chronic medicines, through a reduction in waiting times by a minimum of 60%, a reduction in cost for the Department of Health to provide pharmaceutical services by 25% and reduction in patients missing employment to collect medicines by 30%. This project will demonstrate dramatic increases in patients' adherence to chronic medicines.
Gets medicine while out shopping.
In-Pharmacy Automation
of pharmacies where the
dispensing of all medicines runs through an automation system
.
Full transcript