1. Comprehensive training to support the national TB/HIV Information System (THIS) integration initiative
Change management processes to implement integrated TB and HIV data management in facilities, using TIER.Net

2. Welcome and introductions
Facilitators for training:
Riona Govender – NDoH M&E (NIT)
Nevilla Somnath – NDoH TB RIMES (NIT)
Barbara Franken – NDoH* (NIT)
Ipeleng Mojaki – NDoH* (NIT)
Moeketsi Finger – NDoH* (NIT)
Catherine White – NDOH* (NIT)
* Seconded from CHAI

3. Acknowledgements
NDoH appreciates the contributions into this complex initiative by:
NDoH TB, HIV and M&E teams.
Staff at the 11 Learning Implementation sites, and all (sub)district and provincial colleagues involved.
TIER.Net developers: UCT - Centre for Infectious Diseases Epidemiology and Research (CIDER).
Developers of interlinked systems: WAMTech (ETR.Net and EDRWeb), CSIR (HPRS), and HISP (DHIS).
CDC.
Clinton Health Access Initiative (CHAI).
BroadReach, Anova Health Institute, The Aurum Institute, TB/HIV Care Association, Stellenbosch Univ, VitalWave.

4. Welcome and acknowledgements
You, the participants! Thank you, re a leboga, enkosi, avuxeni, dankie, siyabonga for being here, in the midst of many other current demands on your time. Your commitment and effort will turn the TB/HIV integration strategy into an integration reality.

5. Welcome and acknowledgements
Let’s do some origami.
Participants from DoH, local authority, partners and special welcome to Correctional Services.
Round of introductions, or show of hands?

6. Ice breaker
Please express how you feel about TB / HIV Information Systems integration,
In one word,
Or, in one sentence,
Or, in a picture.
Then stick it on the wall.
3 minutes
Anonymous. But will ask for 5 volunteers to share with group.

7. Training objectives and approach
Training goals, objectives, overview, approach, pledge, and house rules

8. End goal of the training
To capacitate PITs and DITs and TKIs on implementing the national initiative to integrate THIS.
This includes rollout of the TB module for digitising the paper TB register in TIER.Net, and all related change management processes.
It is not just about the software!

9. Acronyms quiz Q. What does TIER stand for?
Three Interlinked Electronic Registers.
Q. What three registers does it refer to?
ART since TB rolling out now. MCH in the making.
Q. What do NIT, PIT and DIT stand for?
National / Provincial / District Implementation Team.
Q. What does TKI stand for?
TIER Key Implementer.
Q. What does THIS stand for?
TB / HIV Information Systems.
Q. What does digitising mean?
Capturing into an electronic system.
Q. Pronounciation of TIER is to rhyme with …...
Dear.

10. Objectives of the training
To capacitate participants to:
Be fully conversant with the TB module in TIER.Net,
Understand the associated change management processes to integrate data management for HIV and TB within facilities,
Support facilities to drive the digitisation of TB data in an effective and sustained manner,
Drive the integration of TB and HIV Information Systems at (sub)district level and above.

11. In other words, TKIs will learn to:
Adequately prepare districts and facilities for rollout
Implement
Oversee the initial transition
Maintain the integrated TB/HIV information system
Monitor

12. In other words, TKIs will learn to:
Adequately prepare districts and facilities for rollout
Includes: informational buy-in meetings, facility assessments with remedial action, adjusting the flow of patients/folders/data as per Ideal Clinic and Implementation Guide, and training facility staff on record-keeping, data entry, and data use.
Implement
Includes: upgrading facilities to TIER v1.10.
Oversee the initial transition
Includes: onsite handholding during back-capturing of all active TB patients, data audit, sign-off, and retiring of paper TB registers.

13. In other words, TKIs will learn to: (continued)
Maintain the integrated TB/HIV information system
Includes: regular (and documented) site visits and quarterly audits, to assess adherence to SOPs, quality of record-keeping and data entry, and optimal use of TIER reports and lists for the benefit of clinical patient management.
Monitor
Includes: ensuring timely flow of monthly and quarterly data into ETR.Net and DHIS, reporting on rollout progress to the next level, and analysing data to improve clinical governance and programme management.

14. Overview of the training
Key focus is TB/HIV integration.
In wake of Dr Pillay’s pronouncement at THIS kick-off meeting (7 March 2016), TKIs will also be orientated on:
Digitisation of HIV testing data in TIER.Net.
Digitisation of pre-ART data in TIER.Net (as not all patients take up UTT).
Data management in TIER.Net for patients in Adherence Clubs or CCMDD PuPs (i.c.w. increased drive to decongest facilities by decanting stable patients with chronic conditions).

15. Overview of the training (continued)
Training includes a refresher on the National vision for TB / HIV integration.
Training also covers many new functionalities in TIER.Net, e.g.
Viral Load Due report
Bulk capture of lab results
Interface with HPRS
Duplicate folder merge
Facility Management report
(Sub)District Management reports
Many other new reports and lists
Etc etc

16. Overview of the training (continued)
The components of the M&E system will be introduced in broad strokes.
E.g. the M&E SOP, support tools and documents, data flow and timelines.
Lastly, TKIs will be guided on how to carry this training forward – how to operationalise the rollout.

17. Next steps – team exercise for districts
Operationalising the rollout requires ongoing effort, detailed planning and team work.
District team exercise for this week: complete the handout (also on memory stick): “Next steps for initial rollout in minimum of 5% of eligible facilities before 31 March 2017.”
Submit via by Thursday evening.
Each district to present summary key points on Friday morning (strictly 2 minutes per district, verbal, no slides).

18. Next steps – team exercise for districts

19. Next steps – team exercise for districts

20. Next steps – team excercise for districts

21. Inclusion of Correctional Services in the training
Special welcome to Department of Correctional Services (DCS).
Acknowledged that historically DCS and DoH have worked largely in siloes.
Recent years DoH and DCS are addressing this gap:
Gradually increasing collaboration, and alignment of structures, systems and programmes, at all levels.
Recognition of partners’ valuable role in this.

22. Inclusion of Correctional Services in the training
In THIS initiative, in form of:
Inclusion of DCS in SOPs, guidance, training by NDoH,
Inclusion of DCS in PIT and DIT structures,
TIER.Net software being aligned to DCS needs,
Master Facility List being amended to include all Correctional Centres.
All the above still in fairly early stage of iterative development.
Hence training can give only very little overt guidance for rollout of TIER.Net in Correctional Centres at this stage.

23. Inclusion of Correctional Services in the training
Importance of having DCS and DoH in same training (and in PIT and DIT structures) is to have all cogs of public health system in one room.
Collaboration to be mainstreamed, become the ‘new normal’.
Break through the siloes – all TKIs must work as a team:
TKIs from DoH and partners are experienced in TIER implementation, and are thus expected to support DCS colleagues with rollout within Correctional Centres,
But they need to understand the operational differences between DoH and DCS, and work to support DCS’ needs.

24. Approach of the training
All sections on HIV and TB are couched within the framework of the cascades.
All sections are aligned with the prescripts of Ideal Clinic and ICDM / ICSM.
All sections describe the data source for capturing and the importance of proper clinical record-keeping.
All sections focus heavily on the reporting functionalities, and how to use those reports to improve clinical governance of patients.
Participants will do some practical exercises. However, this is limited, as this is NOT a data entry training.
Main focus is change management for integration.
All data in all training materials are dummy data.

25. Approach of the training
Audience is very diverse group:
Cadres from Programmes and M&E / Data / Info Mgt.
Provincial, district, sub-district levels.
Experienced TIER implementers and TIER newcomers.
What is basic knowledge for some is new terrain for others.
Training is based on assumption that all participants either already know the basics of the TB programme, HIV programme, and TIER.Net, or will upskill themselves within the coming weeks.
All TKI’s are expected to fulfil all TKI roles and responsibilities, not only in ‘their’ field.

26. Tools provided for upskilling yourself on TIER
On your memory sticks:
Training videos
User Guide
Slides
Today: sneak preview
On TIER.Net: Help functionality
On internet: Vula portal
In your area: your colleagues!!

27. Approach of the training roll-out
This is a training for implementers, not for spectators.
This is NOT a Master Training, or a Train-the-Trainer.
I.e. for TKIs, the do-ers who are direct stewards of the integration effort in facilities.
That is you, the
‘chosen ones’!

28. Participants’ commitment
District Management has selected you to be part of THIS initiative, and placed their trust in you to drive it. On Fri, you will be asked to sign a Pledge to commit yourself to fulfilling all your TKI duties, and rolling out accordingly in facilities in your (sub)district.

29. I, the undersigned, [name] hereby confirm that:
I have participated in the 5-day TB / HIV Information Systems (THIS) Integration Training, including TIER.Net.
I have thus been capacitated to be a TIER Key Implementer (TKI).
I pledge to complete my training by watching the training videos from .
I commit myself to make adequate time available to fulfill my roles and responsibilities as a TKI.
I commit myself to adhering to the prescripts of this training, the Implementation Guide TIER.Net TB Module, the integrated HIV/TB M&E SOP, and other national TIER.Net-related SOPs, support documents, and tools.
I commit myself to capacitating, mentoring and monitoring facility personnel in the geographic area for which I am responsible, to likewise adhere to the abovementioned prescripts.

30. I, the undersigned, [name] hereby confirm that:
I have participated in the 5-day TB / HIV Information Systems (THIS) Integration Training, including TIER.Net.
I have thus been capacitated to be a TIER Key Implementer (TKI).
I pledge to complete my training by watching the training videos from .
I commit myself to make adequate time available to fulfill my roles and responsibilities as a TKI.
I commit myself to adhering to the prescripts of this training, the Implementation Guide TIER.Net TB Module, the integrated HIV/TB M&E SOP, and other national TIER.Net-related SOPs, support documents, and tools.
I commit myself to capacitating, mentoring and monitoring facility personnel in the geographic area for which I am responsible, to likewise adhere to the abovementioned prescripts.
Without you, there will be no TB / HIV integration.

31. Certificate
You will also receive a Certificate, if you have attended all 5 days. Asikhulume
Managers of TKIs are requested to create an enabling environment where TKIs have sufficient protected time for their TKI duties.

32. Sustainability and ownership
This training aims to steer this major transition towards integrated TB/HIV data management in a manner that fosters sustainability, ownership and institutionalisation.
This training is expressly aimed at capacitating primarily DoH and DCS managers.
The implementation and maintenance of the M&E system is the responsibility of government officials.
It is therefore critical that the TB/HIV Integration is led by Province and District.

33. Sustainability and ownership (cont.)
Prov/District management must optimally use all resources to drive implementation and capacitation efforts.
Partners are part of those resources,
And have played major and invaluable role in TIER rollout since 2011.
HOWEVER….

34. Sustainability and ownership (cont.)
Partners have in most cases taken the lead with rollout.
DoH has mostly allowed and often even encouraged that.
TIER.Net often perceived as ‘partner system’, instead of the national system that it is.
25 districts no longer have partner support.
Partners will not be funded forever.
How sustainable is that?

35. Sustainability and ownership (cont.)
Prov/District management is to clearly map out roles and expectations (and limits) for partners, focusing on health system strengthening, not on parcelling out DoH work to partners.
Partners are to collaborate with the stewards (not be the stewards).
Partners who feel they are not being used effectively by Province/District are requested to inform their PEPFAR leads, who will then inform NDoH.
Asking others to do your work for you =
robbing yourself of an opportunity to empower yourself.

36. Questions? Discussion?

37. House Rules - TO BE ADOPTED
You are all here to be capacitated as TIER Key Implementers. Hence you are all here to learn, absorb, participate, ask questions, and engage.
You are expected to commit yourself to implementing what you will learn this week in facilities in your geographic area.
Ask questions, as and when they arise.
There are no dumb questions.
The facilitators may ‘park’ questions if it will be covered in another session, or is best answered by a facilitator who is not in the room, or is not relevant to the majority of the group.
Take notes for yourself.

38. House Rules - TO BE ADOPTED
Respect your facilitators and co-participants.
Be punctual; arrive on time, do not leave early, return promptly after breaks.
No side conversations.
Keep walking around to an absolute minimum.
Keep computers closed, except during pc-based exercises.
During pc exercises, do not get sucked into s etc.
Keep phones on silent.
Ideally, keep phones stowed away in your bag.
No answering of phone calls. (No, not even at a whisper.)
Wait for next break to attend to phone calls, s, etc.

39. House Rules - TO BE ADOPTED
Please sign Attendance Register every day.
If unable to attend on a certain day for a valid reason, please inform a facilitator at the registration table the previous day or next day.
STAY AWAKE! When dozing off, feel free to ask for an energiser. 
If you cannot read this on the screen, please find a seat in the front.
On Friday, please check out of your
accommodation BEFORE the training starts!

40. House rules
Any edits or additions to these house rules?
Can we adopt?

41. National TB / HIV Integration strategy and vision
Background, benefits, data flow mapping

42. Background to TB / HIV integration
In spite of high co-infection of TB and HIV – data remains separate.
Care increasingly integrated – however data has not supported this.
WHO-led 2013 evaluation of HIV, TB and PMTCT programmes recommended integrating information systems.
Independent systems review was done in 2014.
January NDoH decided to proceed with integrating TB and HIV data management in facilities.
7 March kick-off meeting to inform stakeholders of THIS integration initiative.
Integrated management supports HSS initiatives such as and EWI.

43. Benefits of TB/HIV integration
Problem: Fragmented data systems compromise patient management, and duplicate effort and resources to manage these systems.
Integrated system will support patient management:
Patient care is being integrated – and must be supported by integrated data management.
In-facility digitisation of TB data puts ownership of TB data back into the hands of facility staff.
Clinicians will have direct access to wide range of patient management reports – data can be used to improve care,
E.g. following up on tests due to be done, test results due back, patients due for treatment, defaulter tracing, outcome allocation, etc.

44. Benefits of TB/HIV integration
Integrated data flow: TB data will follow same flow as HIV data, from folder flow and clinical record-keeping, to capturing, to in- facility data usage, and reporting/exporting data to (sub)district.
Makes it easier for facilities and (sub)districts, and improves timeliness and completeness of reporting to DHIS.
Integrated SOP and guidance: sets foundation to improve data quality and ultimately patient outcomes, from facility-level up.
Rationalised support: streamlined processes for monitoring, maintenance, IT equipment and support, training, system upgrades / updates, etc.
Economy of scale – more efficient use of time by (sub)district teams.
From a process and system perspective – these are some of the benefits of integration

45. Benefits of TB/HIV integration
Inter-sectoral alignment: same system and processes will be used in non-DoH facilities, e.g. Correctional Centres.
Towards EMR: all change management processes that are implemented now, will benefit any future implementation of an Electronic Medical Record system.

46. Benefits of TB/HIV integration
So, we will be doing what we already do, but better.
Key point: putting ownership of TB data back into the hands of facility staff

47. National vision (future 2-3 years)
TB/HIV Programme Data
When TB Module fully rolled out, all TB & ART data will be captured in facilities, and flow up through TIER.Net and the DHIS.
HIV &TB patient information consolidated in 1 database.
All can draw reports via the Internet. If no connectivity, reports drawn directly from the TIER.Net on the PCs.
This is a step on the path to an electronic medical/ patient record (EMR).
National
Integrated HIV/TB Patient Database
Province
TIER
(sub)District
WebDHIS
TIER
Facility
FACILITY PC
with TIER.Net
FACILITY PC
with TIER.Net
FACILITY PC
with TIER.Net
TB & HIV data
from patient
folder
TB & HIV data
from patient
folder
TB & HIV data
from patient
folder

48. Interim data flow mapping
Paper TB facilities
Electronic HIV & TB facilities
Sites with EDR
National
EDR WEB
ETR
TIER
DHIS
Province
EDR WEB
ETR
TIER
DHIS
Export DR-TB data
(sub)District
Export DS-TB data
Export ART data
Export DS-TB data
EDR WEB
ETR
TIER
DHIS
Facility
It will take time (2-3 years?) to reach the national vision
In the interim, systems will run in parallel. This diagram illustrates that.
Point to in diagram:
On left: ETR remains in place while the TIER TB Module is being rolled out in your province – so things stay the same at facilities that have not yet implemented the TIER TB Module
On right: Facilities using TIER.Net for ART and DS- and DR-TB data will be inputting data from patient folders directly into TIER, then at sub-district TB data gets imported into ETR and EDR flows upwards as before
Emphasise importance of patient folder as source for electronic facilities
For ART data, things stay the same
The transition from paper to electronic data capturing at facility level will be slow and measured
During transition, each district will have a mixture of electronic TB register and paper TB register at their facilities
In the beginning most will be paper; after several years, most TB facilities will have digitised their TB data
ETR and EDR will remain TB reporting systems until TB Module in TIER.Net is universally implemented
Facilities implementing TB Module →
TB data will flow to (sub)district in same dispatch as ART data
(Sub)district level: TB data in TIER will be exported into ETR.Net and EDRWeb
DR-TB Register
TB Register
TB Register
TB Register
TIER
TIER
TIER
HIV, DS-TB &
DR-TB data
from patient
folder
HIV, DS-TB &
DR-TB data
from patient
folder
HIV, DS-TB &
DR-TB data
from patient
folder

49. Integration headlines - transition
Changes will be measured.
During transition, each district will have a mixture of electronic and paper TB registers at their facilities.
TIER.Net, ETR.Net and EDRWeb will run in parallel during transition.
Initially most will be paper; after a couple of years, most TB facilities will have digitised their TB data.
ETR and EDR will remain TB reporting systems for TB cohort outcomes data into DHIS, until TB Module in TIER.Net is universally implemented in a district.

50. Integration headlines
Debunking a myth:
THIS initiative is NOT about interlinking / interfacing TIER with ETR – i.e. maintaining two linked information systems.
THIS initiative is ultimately about replacing the paper TB register and ETR with TIER TB module at the facility level – i.e. having a single information system for TB and HIV at the facility.

51. Integration headlines - standardised clinical stationery
Standardised HIV and TB clinical stationery (TB Blue and Yellow card and HIV clinical stationery) as the source for:
Clinical patient management
And for data capture into M&E system, irrespective if facility is Tier 1, 2 or 3.
Tools for structured patient care – provide clinicians with a longitudinal view of patient history, allowing for continuity of patient care, and provides information for M&E.
Clinicians: responsible for accurately completing all patient assessment(s) findings.
Data clerks: responsible for transferring this data into the information system.

52. Integration headlines – integrated patient care
TB programme has historically often worked in a silo.
Prescripts on ICSM and Ideal Clinic have seen tremendous improvements in integrating patient services, including TB.
This also applies to data management – 1 patient, 1 folder, 1 folder number.
THIS initiative aligns with existing ICSM and IC prescripts.
End goal: improved clinical governance – better patient outcomes.

53. Integration headlines – DHMIS policy
TB treatment data will now follow DHMIS prescripts (previously only data for screening and presumptive TB followed DHMIS).
Standardisation of:
The flow of TB and HIV data into the DHIS
Timeframes of reporting monthly and cohort data
Responsibility for review and verification of data in DHIS
Note: TIER → ETR import does not allow double counting, including into DHIS.

55. Integration headlines – course correction
Some facility managers and (sub)district managers have not demonstrated ownership of the HIV programme, and not adequately engaged with associated data, i.e.
Not pulling / actioning missed appointment reports,
Inconsistent / incomplete / incorrect reporting on ART,
Not reviewing lists and reports to identify areas for improvement in patient care, etc.
Before rolling out the expanded functionalities of the system - need to ensure that facilities are fully utilising the existing functionalities of the system.
This compromises clinical patient care!

56. Integration headlines - SOP
Integrated TB / HIV M&E SOP (being finalised).
Purpose:
To provide standardised procedures for collecting and managing accurate and complete routine HIV/ART and TB data.
This includes facility-level generation of data, through to the flow of the data to the sub-district, district, province and the national levels.
To provide guidance to enhance the use of data at the facility level, and enhance reporting of information to the DHIS.
Compliance with SOP is poor in many facilities – needs to be resolved prior to rolling out new system.

57. Deferred use of TIER TB module for DR-TB
DR-TB functionality has been developed in software, but
at this stage, no overt guidance will be given on digitising DR-TB in TIER.Net.
Reasons:
Recent developments in EDRWeb -> export/import from TIER to EDR needs updating.
Rollout of MDR short course -> National is finalising algorithms, guidelines, definitions -> developers need to align software accordingly.
When the above has been completed, NDoH will compile guidance for digitising DR-TB in TIER.Net, and will inform provinces accordingly.

58. Timing of this training
Trainings were due to start ~Jul’16, but postponed due to:
Insufficient level of preparedness within provinces, districts, and facilities.
Solid catch-up in some areas, but ongoing challenges in other areas.
Interoperability challenges TIER.Net ↔ HPRS.
Resolved
Interoperability challenges TIER.Net ↔ ETR.Net, EDRWeb, and DHIS.
Most resolved. Updated at every upgrade of any system. Developers working on EDR link.

59. Questions?

60. TIER.Net v1.10 software upgrade / installation
Loading dummy dispatch
Selecting options
Activating TB module

61. Installation guidance for different scenarios
If TIER1.8 or higher, and SQL2008 on your pc → use upgrader to 1.10
If TIER 1.8 or higher and SQL2005 on pc → first upgrade to SQL2008 R2, then TIER upgrader to 1.10
If no TIER.Net on your pc → new install 1.10
If TIER.Net 1.5 on your pc → contact facilitators
Make sure to use correct handouts and files on memory stick.
Please do NOT jump ahead or skip steps. Follow instructions from facilitator.
Experienced TIER implementers – please assist newcomers!

62. Check what TIER.Net version is on your PC
Bottom right corner in TIER.Net screen
Update: Official version v released May 3. All facilities should use v1.10.5

63. Check what SQL Server version is on your pc
Start button in bottom left corner – All Programs.

64. Installation guidance for different scenarios
If TIER1.8 or higher, and SQL2008 on your pc → use upgrader to 1.10
If TIER 1.8 or higher and SQL2005 on pc → first upgrade to SQL2008 R2, then TIER upgrader to 1.10
If no TIER.Net on your pc → new install 1.10
If TIER.Net 1.5 on your pc → contact facilitators
Show of hands for each scenario above.
Check: can everyone log in as Administrator into your computer?

65. Installation guidance for TIER upgraders
If TIER1.8 or higher, and SQL2008 on your pc → use upgrader to 1.10
If TIER 1.8 or higher and SQL2005 on pc → first upgrade to SQL2008 R2, then TIER upgrader to 1.10
If no TIER.Net on your pc → new install 1.10
If TIER.Net 1.5 on your pc → contact facilitators
All other persons, please observe only.

66. Upgrading from 1.8.3 and above to 1.10
Follow steps in handout. Close your TIER.Net before upgrading. System may require you to re-do your TIER.Net passwords. Also in memory stick:

67. Installation guidance for SQL & TIER upgraders
If TIER1.8 or higher, and SQL2008 on your pc → use upgrader to 1.10
If TIER 1.8 or higher and SQL2005 on pc → first upgrade to SQL2008 R2, then TIER upgrader to 1.10
If no TIER.Net on your pc → new install 1.10
If TIER.Net 1.5 on your pc → contact facilitators
Experienced implementers who have already upgraded – please assist (not take over) where needed.
All other persons, please observe only.

68. Upgrading SQL Server from 2005 to 2008 R2
Follow steps in handout. Also in memory stick:

69. Upgrading from 1.8.3 and above to 1.10
Follow steps in handout. Also in memory stick:

70. Installation guidance for new TIER installers
If TIER1.8 or higher, and SQL2008 on your pc → use upgrader to 1.10
If TIER 1.8 or higher and SQL2005 on pc → first upgrade to SQL2008 R2, then TIER upgrader to 1.10
If no TIER.Net on your pc → new install 1.10
If TIER.Net 1.5 on your pc → contact facilitators
Experienced implementers who have already upgraded – please assist (not take over) where needed.
All other persons, please observe only.

71. Installing TIER.Net v1.10
Follow steps in handout. Also in memory stick:

72. Installation guidance for TIER upgraders
If TIER1.8 or higher, and SQL2008 on your pc → use upgrader to 1.10
If TIER 1.8 or higher and SQL2005 on pc → first upgrade to SQL2008 R2, then TIER upgrader to 1.10
If no TIER.Net on your pc → new install 1.10
If TIER.Net 1.5 on your pc → contact facilitators

73. Loading dispatch files in TIER.Net
Follow steps in handout.
Also in memory stick:
Remember to include Emaphupheni Clinic in Permissions for all your own user profiles.

74. Options for system settings
Follow steps in handout.
Also in memory stick:

75. Activating the TB module
Follow steps in handout.
After clicking OK, click Save.
Also in memory stick:

76. Activating TB module IMPORTANT:
Only activate the TB module in facilities where all steps as per the Implementation Guide and THIS Integration Training materials have been completed in full, and where appropriate plans and resources are in place for the on-going monitoring, support and oversight by TIER Key Implementers (TKIs) for the implementation and maintenance of all functionality.
Do upgrade other facilities to v1.10 to benefit from all the new functionalities / reports / lists etc.
But only activate the TB module for facilities properly prepared for THIS integration.

77. Questions?

78. Tools for TIER training and guidance
User Guide & Reports Manual
Slides
TIER.Net Help functionality
Vula portal
Videos

79. Tools provided for upskilling yourself on TIER
On your memory sticks:
Training videos
User Guide
Slides
On TIER.Net: Help functionality
On internet: Vula portal
In your area: your colleagues!!

80. Memory sticks For now – 1 memory stick provided per participant
April / May – 1 memory stick will be provided per each facility.
To be distributed via PIT – DIT – SDIT – TKIs.
Will have all finalised guidance documents, SOPs, and support tools.

81. Memory sticks

82. Slides for new TIER users

83. TIER User Guide and Reports Manual

84. Handout – Summary of reports

85. TIER.Net Help functionality
Practical: access TIER.Net Help now.

86. F

87. Vula portal
Practical: log in to Vula now at

88. Vula portal
Once you are loaded as a user by an administrator, you will receive an automated asking you to click on a link to activate your Vula account.
If you have not received this , and/or if you have not clicked to activate, you cannot log in.
Make sure that you have provided your correct address.

89. Vula portal

90. Vula portal

91. Vula portal
Folder with Resources contains all software, installation guidance, training documents, support tools, SOPs, etc.
Alert: many documents currently being updated. Always make sure that you are using the latest version of any document / tool.

92. Training videos Over 40 brief training videos have been created.
Familiarise yourself with all the videos, in the coming week(s).
Use the videos as part of the training for data clerks.

93. Training videos
Practical: access the videos now. Start with:

94. Tools provided for upskilling yourself on TIER
On your memory sticks:
Training videos
User Guide
Slides
On TIER.Net: Help functionality
On internet: Vula portal
In your area: your colleagues!!

95. Dummy data
When ‘playing around’ with TIER.Net to familiarise yourself, use dummy data in dispatch provided.
For Gauteng-based persons: use EC – Alfred Nzo – Maluti – Afsondering Clinic.
For persons based in any other province, use: GP – Ekurhuleni – East 1 - Emaphupheni Clinic.
This is to prevent any accidental inclusion of dummy data into the real data set.

96. Reporting software bugs and queries
Reporting software bugs, as well as requests / suggestions for improvements in the software:
Barbara Franken, with copy to relevant DIT and PIT members, and copy to
Queries on the software:
Start with looking in User Guide and TIER.Net Help function.
If unable to find clarity, ask TKIs at SDIT level.
If they are unable to reply, they must ask TKIs at DIT level.
If they are unable to reply, they must ask NIT members, with copy to

97. Questions

98. Sneak preview of TIER.Net

99. Contact details of NIT members
Nevilla Somnath – National TB Programme – RIMES – Riona Govender – NDoH M&E – Catherine White – M&E Technical Support to NDoH - Barbara Franken – Project Manager for THIS integration - Ipeleng Mojaki – TIER Implementation Associate - Moeketsi Finger – TIER Implementation Associate -