Johannesburg - Just a year ago, more than 600 patients at Helen Joseph Hospital’s Themba Lethu Clinic would line the corridors daily waiting to get their antiretroviral treatment.
Queues would start forming as early as 4am outside the clinic, with patients from as far as Ekurhuleni hoping to beat the long waiting times.
But, even when doors eventually opened at 6am and patients were gradually brought in, the average waiting time at the country’s second largest HIV treatment facility for any one patient would be anything between three- to four-and-a-half hours.
Today patient waiting times have dropped to 30 minutes and the numbers of people coming in to the clinic have dropped by almost 200.
How did this clinic with more than 17 000 patients in HIV clinic care achieve this?
In October last year, NGO Right to Care implemented a pilot project that created the first robotically automated pharmacy in a public health facility in the country.
The Rowa automation unit – made up of a dispensing, loading and storage system for medicines – can store up to 12 000 medicines. Loading can be done automatically by filling a bin fed by a conveyor belt.
Barcode scanning technology ensures accurate loading. Within 15 seconds, a typical prescription can be picked and its label printed.
“Doctors write electronic scripts, which are linked to the pharmacy’s patient management system. The patient brings their script to the pharmacist, the pharmacist then checks if the medicine prescribed is safe for the patient according to their history, so that if the doctor prescribed something incorrectly the system will pick it up.
“They validate that on the system and once the pharmacist hits print, the machine finds the medication,” said Kurt Firnhaber, Right to Care’s chief operations officer.
And, in less than two minutes, a patient’s prescription can be in their hands.
“We used to open at 7.30am and close at 8pm because of the high volumes of patients, and even then we wouldn’t be done with all the patients. Now we still open at the same time, but are closed by 3pm because patients are attended to quicker,” regional pharmacy manger Robert Setshedi said.
With the long waiting times, “opportunities” cropped up for less scrupulous staff, Firnhaber admitted.
“Staff would take some drugs home and sell or give them to friends and family. Or patients used to pay R20 to jump queues. Robert (Setshedi) spoke of scenarios where people would rent out babies or steal wheelchairs – all this to get through the queues,” he added.
In the past there were 13 pharmacists, now there are six – the rest attend to patients in the wards.
Dr Shabir Banoo, the pharmacy supply programme manager, said although there was less staff, they saw more patients daily.
When The Star arrived at the clinic earlier this week at 7am, there were more than 20 patients waiting for treatment. By 8.20am, there were three.
Francis Nkosi, 43 – who has been receiving treatment at the clinic since 2007 – said there had been a marked change.
“I used to get here at 2am because I live in Soweto. But even then, I’d get here and there’d already be 50 people in line. Now everything is quicker than before… I came here today at 7am and I am out now and it’s 8am,” she said.
Another patient, who asked not to be named, echoed Nkosi’s sentiments. “I used to come here very early and leave at midday, but now I’d be lying if I said I still have to wait a long time,” she said.
On Thursday, Right to Care won first place at this year’s iCMG Conference of Enterprise & Architecture in Bangalore, India, for the automated pharmacy system in the category “Best Enterprise & IT Architecture in Government/Defence/Public Sector”.
Firnhaber said: “Next year we plan to roll out the system to three pilot sites in Tshwane. This isn’t just an HIV solution, it’s a chronic medication solution.” - The Star