IMPLEMENTION OF AN ELECTRONIC ART REGISTER:

FREE STATE PROVINCE

Presenter: Mr. F. Nkomo (FSDoH)

Background

• Since the inception of ART programme in the Free

State Department of Health (FSDoH), services were

monitored through non-standardised excel spread

sheets and this could not support the process of

quantifying the impact of the programme in the

province

Background - Non-standardised Tools

Background

• In 2012, FSDoH implemented a standardised ART register

for monitoring ART services

• This new register was implemented in line with the

National Department of Health guideline

– It was mandatory for all facilities managing 500 or more patients

to implement the electronic ART register

– Other facilities had to implement the paper ART register

– This was to improve monitoring of services and data quality

Aim & Methods Aim:

• The aim of the study is to describe the implementation of ART electronic register

Method:

• Consultative meetings to facilitate buy-in were conducted in the facilities

• Facility assessments were conducted, and all facilities with 500 or more patients

were provided with all the required equipment and training in preparation for the

implementation of the electronic register

• Facilities had to back-capture all the information from patient files as from the

date of initiation

• Implementation were monitored in phases, from 0 - 6

ELECTRONIC REGISTER MONITORING PHASES

Phase 0 Preparation for electronic ART register (Buy-in meeting with facility managers, Filing, orientation, process flow etc.)

Phase 1 Installation and training

Phase 2 Back capturing

Phase 3 Back capturing with live capturing

Phase 4 Live capturing (back capturing complete) and data cleaning in progress

Phase 5 Data signoff by DIT/PIT after completion of data clean up and baseline audit

Phase 6 - completed

Live site and site able to produce Monthly and Quarterly reports

ILLUSTRATION OF TRANSITION OF ART RECORDING SYSTEM

Paper Register

Electronic Register

Results

2012 2013 2014 2015

Total Implemented

145 205 214 228

Phase 0-5 94 117 56 15

Phase 6

51 88 157 213

PERCENTAGE OF PHASE 6 FACILITIES ACROSS THE FREE STATE PROVINCE

BY END OF 2015

100%

91%

85%

91%

100%

Results of Implementation

0

10000

20000

30000

40000

50000

60000

2012 2013 2014 2015

Nu

mb

er

Total ART Patients Remaining in Care In the Free State per District

fs Fezile Dabi District Municipality

fs Lejweleputswa District Municipality

fs Mangaung Metropolitan Municipality

fs Thabo Mofutsanyana DistrictMunicipality

fs Xhariep District Municipality

Number of ART Patients Remaining in Care Free State 2012 - 2015

0

20000

40000

60000

80000

100000

120000

140000

160000

180000

200000

2012 2013 2014 2015

adult remaining onart tot

child remaining arttot

Male and Female Clients Started on ART 2004 – 2015

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Adult naïve male start

Adult naïve female start (IncludingFemale pregnant at ART Start)

Male and Female Clients Started

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Adult naïve male start

Adult naïve female start

Female pregnant ART start

Challenges

• Computer Theft

• Non-functional anti-virus or none

• Lack of back-up systems

• Shortage of data capturers

• Recording of patient information in the clinical stationery

• Regressing facilities (Facilities which were on phase 6, but regressed to back-capturing phase)

Conclusion

• The implementation of the electronic register and collecting the most essential variables, timely and accurate reporting and monitoring of ART services is possible even in difficulty and resource constraint environments.

Acknowledgements

• Dr. P. Chikobvu (FSDoH)

• Me. Tsibolane (FSDoH)

• Me. K.M. Setlogelo(FSDoH)

• Mr. R.A. Khajoane (FSDoH)

• Me. M.R. Nophale (FDoH)

• Mr. T.L. Makhoba (FSDoH)

THANK YOU!