Published On: Mon, Sep 10th, 2018

Electronic pharmacy tackles South Africa health sector crises

Alexandra Plaza PDU Managere Taffy Chinamhora, Photo by Savious Kwinika, CAJ News

Alexandra Plaza PDU Managere Taffy Chinamhora, Photo by Savious Kwinika, CAJ News

JOHANNESBURG – THE introduction of the electronic-pharmacy (e-pharmacy) innovation, which is driven by the artificial intelligence (AI) modern technology, is set to enhance health services delivery particularly in South Africa’s poverty stricken townships.

This is anticipated to eventually eliminate long hours spent in queues to receive medicines and the struggle by health workers to locate paper files of patients. It is filling the gap created by some health workers who have been accused of arriving late for work or dismissing before time.

The impact of the e-pharmacy solution, as low-income earners benefit, puts paid to claims AI was a negative phenomenon in that it would lead to a loss of jobs in a country which is struggling with unemployment rate of 28 percent, or about 7,2 million jobless people.

Patients suffering from chronic ailments, especially the ones living with HIV/AIDS, who usually go to work early morning and knock-off duty late would find the e-pharmacy functional and ready to serve them accurately.

South Africa has the highest number of people in the world living with the condition.

A majority living with HIV/AIDS have welcomed the e-pharmacy’s introduction in Alexandra, north of Johannesburg.

The Alexandra Plaza’s e-pharmacy is widely known as Pharmacy Dispensing Unit (PDU).

The ambitious Right ePharmacy has rolled out the facility jointly with the provincial and national health ministry. The Gauteng provincial government is financing the implementation of the pilot project. The innovation driven by AI comes from a company called Right to Care (RTC).

Key collaborations and strategic partnerships are with national and international stakeholders such as the Gauteng Provincial Health Department, RTC, United States Agency for International Development
(USAID), German Development Cooperation (GIZ).

Belinda Strydom, the Pharmacy Program Manager at Right ePharmacy, said the PDU was an ATM-type South African innovation was developed for accurate dispensing, counselling and collection of medication.

The PDU provides an innovative and unconventional alternative for the delivery of pharmaceutical services to public sector patients.

“The technology was developed with the aim of addressing some of the challenges compromising access to medicine in the resource-constrained public healthcare environment,” Strydom said.

The first PDU site at the Alexandra Plaza was started in May 2017 with subsequent sites opening in January and July this year (2018).

“The current four PDU sites form part of a pilot for this technology in Gauteng,” she said in response to enquiries by CAJ News.

“PDUs are only registered for the benefit of public health patients currently therefore further deployment of the technology depends on the National Department of Health,” Strydom said.

She said PDU sites were located at central and accessible community-based shopping centres and close to transport routes.

There are extended pharmacy operating hours, including weekends and public holidays – averaging 80 hours/month compared to surrounding primary healthcare clinics.

PDU pharmacies can operate 24 hours a day. There are short waiting times with robotic medicine dispensing – the average dispensing time is three minutes.

There are fewer chronic medicine collection clinic visits for patients due to the multi-month dispensing process.

“Patients don’t lose out on personal, face-to-face interaction, communication and counselling,” Strydom said.

Strydom said PDUs offered secure storage and easy retrieval of patient demographic and dispensing information or data.

She said other advantages such as remote, professional facilitation of dispensing of medicines and counselling were greatly helping to overcome barriers to medicine adherences such as language, literacy and education.

Personalised medicine labels are automatically applied.

The new healthcare innovation has enhanced communication through prescription collection reminder SMS, dispensing confirmation receipts with next collection dates, other health promotions communication per SMS supported by a toll-free tele-pharmacy care line.

There is also early identification of late collections and prompt follow up calls and tracing activities as well as stock usage reports for accurate stock management and ordering.

Strydom said her company always looked for knowledgeable personnel in their respective fields of pharmacy.

“Essentially, Good Pharmacy Practice applies to all operations which forms a crucial part of initial training for pharmaceutical staff,” she said.

“The additional technology-specific skills for our automated sites are trained as part of an in-service training program where staff get hands-on experience with the technology are assessed for competency and additional training needs.”

Staff are re-evaluated from time to time to identify additional training needs and to ensure that staff are always equipped with the knowledge they need.

“The current pilot of four sites is focused on providing services to patients in that immediate area. Expanding to more patients can happen through opening additional sites to provide the service in different areas,” Strydom said.

In the wake of fears technology would lead to job losses, she does not foresee with South Africa’s militant workers unions.

In fact, she said, the country was facing a shortage of pharmacists and AI was addressing that.

“There is a real shortage of pharmacy staff in the South African primary healthcare sector,” Strydom lamented.

She the technology would assist pharmacists focus on the care of the patient, which includes counselling appropriate and safe use of medicine, side-effect aversion, lifestyle modification and disease prevention.

“PDUs and pharmacy automation create jobs and offer the pharmacy professional additional and diversified career opportunities in a new niche market – tele-pharmacy,” Strydom said.

She also highlighted were new other applications such as Medication Adherence Apps, which are used for clinic and lab integration, Paperless Clinic, Pharmacy Automation and TB Diagnostics.

Strydom used the example of Themba Lethu Clinic in Johannesburg, where there is an end-to-end solution that allows clinicians to keep a fully electronic patient record.

“This system is integrated with the National Health Laboratory Services and pulls in the latest blood results for patients directly into the system,” she said.

She said clinicians would do electronic input for prescriptions which communicated directly to the pharmacy.

She says the pharmacist reviews the script electronically which then communicates to the dispensing robot the products to be picked.

“This fully automated process does away with the need for paper-based files since a full audit is available of the patient process from clinician to pharmacy,” Strydom said.

She said the main advantages of implementing paperless clinic and pharmacy automation provided a very secure way of handling patients’ information.

Strydom indicated all records were backed-up and security protocols were in place to ensure that all transactions were auditable.

“Pharmacy automation provides a technological solution to reduce picking errors, increase stock control, reduce patient waiting times and ensure accurate reporting on stock movement and patient requirements,” Strydom added.

An SMS reminder is sent two days prior to the next collection date.

The patient can proceed straight to a PDU and follow a five-step dispensing and collection process.

The patient can collect their prescriptions from the PDU until the repeats on the prescription runs out. Patients are then notified to return to their referral clinic for a follow up clinical visit and issuing of a new repeat prescription.

“The cycle then repeats,” Strydom said.

Behind the scenes is a robotic technology of the PDU that receives a patient or remote pharmacist instruction via the cloud-based electronic dispensing software.

A barcode product identification directs the robot to select the correct medicine type, strength, quantity and pack size.

Once selected, the medicine is automatically labelled with the patient’s personal information and sent to the medicine collection box at the front of the PDU for the patient to collect.

A prescription receipt is printed with the prescription number, items dispensed, date and time of dispense as well as the next collection date.
– CAJ News

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