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Web-Based Tools to Maximize a National Investment in the GeneXpert Jeff Takle, Dir. of Associates 2 nd African Regional Training Workshop.

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Presentation on theme: "Web-Based Tools to Maximize a National Investment in the GeneXpert Jeff Takle, Dir. of Associates 2 nd African Regional Training Workshop."— Presentation transcript:

1 Web-Based Tools to Maximize a National Investment in the GeneXpert Jeff Takle, Dir. of Associates 2 nd African Regional Training Workshop on Xpert MTB/RIF July 24, 2013 Rapid diagnosis must lead to the rapid initiation of an appropriate treatment

2 Abt Associates USB modem, Wifi, Mobile phone, Manual upload How Does it Work? eTB Manager or M&E tools Targeted alert messages Electronic patient records Web database

3 Abt Associates GxAlert –Open source, dev in 2012 by Abt Associates –Incorporates diagnostics for TB and flu (GeneXpert) and HIV (PIMA) –Active in India and Nigeria; early stage in 5 countries TBGxMonitor –Developed in 2011 by Univ. of Witwatersand in South Africa –Active in South Africa; early stage in 13 countries XpertSMS –Open source, dev in 2011 by IRD Pakistan –Active in Pakistan, Nepal, Kenya, Zimbabwe; early stage in 5 countries RemoteXpert –Being developed by Cepheid, estimated launch December 2013 –Pilot tested in South Africa There Are Four Stable, Scaling-up Data Services Around the GeneXpert

4 Abt Associates Providers Cartridge expirations Stockout management Utilization vs. disease load Deployment planning Procurement, warranty, and service planning GxAlert What Does Each Software Do? MOH Case+Population level Management Indicator reporting MDR treatment Drug demand / supply Integration into existing National Health Information Systems (eTB*) MOH messaging Clinic / lab messaging Patient messaging GxAlert XpertSMS Labs External Quality Assurance (EQA) Instrument Verification Pre-analytical, analytical and post-analytical evaluation Errors and error rate (by user, module, and machine) TBGxMonitor RemoteXpert*

5 Abt Associates A Look Inside…GxAlert

6 Abt Associates HIV Devices (PIMA) Can Report Directly into GxAlert

7 Abt Associates Tracking Co-Infection Indicators at the Patient Level

8 Abt Associates MOH Can Forecast Cartridge Needs By Observing Consumption Trends Avg. # tests/yr per device 438 Avg. Utilization per device 18% Est. Overpurchase in Year 1 -$103,114

9 Abt Associates MOH Can Identify Malfunctions Earlier and Reduce Patient Re-visits A serious outlier Error Codes Number of Error Results, by Module Possible alert threshold

10 Abt Associates MOH Can Set Thresholds for Errors: Above = Alert to Supervisor Opportunity to identify best practices Focus attention where needed most Possible alert threshold

11 Abt Associates A Look Inside…XpertSMS

12 Abt Associates A Look Inside…XpertSMS

13 Abt Associates A Look Inside…TBGxMonitor

14 Abt Associates Each is Relatively Inexpensive to Bring to National Scale GxAlert ~$25,000 Yr1 to roll out nationwide and tech support existing software; Yr2 ~$10,000 XpertSMS ~$25,000 Yr1 to roll out nationwide and tech support existing software; Yr2 ~$10,000 TBGxMonitor available to complement NHLS/Wits DCS EQA program. Independent use cost TBD. Cepheids RemoteXpert, cost TBD, Dec 2013 Each of these software is capable of being connected with the others so installing a mix of software is possible

15 Abt Associates Ways To Extend This Capability Connect to an EMR (OpenMRS) Connect to an M&E system Connect to a case management tool (eTB Manager) Connect to drug logistics program Connect other diagnostic devices (Hain, MGIT, PIMA) Automate portions of your indicator reporting

16 Abt Associates Challenges Stable nationwide connectivity Security Stakeholder coordination

17 Abt Associates Why Include These Tools in Your GeneXpert Implementation? 1.Patient benefits: start treatment faster, reduce spread of drug resistant disease, recover sooner 2.Identify and track population drug resistance patterns of TB cases 3.Shorten diagnostic response time from months to minutes, getting patients into treatment faster 4.Reduce waste and avoid stockouts through real-time forecasts 5.Dramatically improve data quality 6.Measure program adherence to the TB treatment protocols

18 Abt Associates Acknowledgements MSH KNCV Nigeria NTP India private sector labs CHAI IRD Pakistan NHLS South Africa USAID CDC

19 Better patient treatment Faster response to MDR-TB More efficient TB logistics Prepared by: Martha Benezet Jeff Takle Download slide


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