Software Based Systems for ART Program and Patient Monitoring

USAID MEASURE Evaluation Situation We are working in an environment where capacity is weak in all areas. We have poor infrastructure in transport, communication, resources, human resources, training, health care skills, supplies, equipment, medications. We do know that without good information, the initiative will fail.

USAID MEASURE Evaluation AIDS AIDS is a multi-faceted disease that touches on all areas of health care and many areas of culture and society. AIDS is challenging since it will require continuous lifetime medical care and treatment.

USAID MEASURE Evaluation Principles: AIDS care integrated into country health system HIS is absolutely essential for the Initiative to work Must build local capacity for sustainability Keep it simple

USAID MEASURE Evaluation Plan: Plan for strengthening capacity of existing HIS We will need to build patient longitudinal medical records We will need to build ties with laboratory and logistics

USAID MEASURE Evaluation How: Need prototype systems that are 90% functional and can be easily customized to meet local needs  RHI register (DHIS)  PMTCT register  ART EMR

USAID MEASURE Evaluation Issues Architecture Disease Management Free open source model is the most “Development Friendly” Standards

USAID MEASURE Evaluation Client Server Networks

USAID MEASURE Evaluation Disease Management

USAID MEASURE Evaluation Data Standards Indicator definitions Data standards Data communication standards  Data flow

USAID MEASURE Evaluation Country / International Data Warehouse

USAID MEASURE Evaluation Sustainability Software systems require constant maintenance Imported systems suffer the same fate as other high tech equipment  It breaks and nobody knows how to fix it Must have open systems that can be maintained locally Must build local capacity to maintain the systems

USAID MEASURE Evaluation Software Inventory

USAID MEASURE Evaluation Key Criteria for ART Software Thin client - server Open source Basic ART data set Disease management

USAID MEASURE Evaluation The Envelope Please We do not have a winner. We are close. Next steps...

USAID MEASURE Evaluation Current Systems Proprietary Systems  TherapyEdge Systems Built on EpiInfo/Access CareWare Thin Client Server Open Source  OpenEMR, Care 2x

USAID MEASURE Evaluation Inventory Project Collaborative Workgroup Clearinghouse for information on:  software systems  implementation  customization  metadata Feedback on systems This is an open system - we want your feedback

USAID MEASURE Evaluation Future Work for the Inventory Logistics Systems  Information synergies with patient systems Laboratory Systems Innovative Technologies (smart cards, cell phones, PDAs, etc) Paper systems interface Metadata repository