Software Futures has delivered a Web interface for the Aid for Aids (AfA) Disease Management Programme of Pharmaceutical Benefit Management (PBM). The interface enables doctors in Botswana to access the system as part of Debswana Diamond Company's HIV/Aids programme. The project was undertaken by Software Futures' Cape Town branch.
PBM is the managed care subsidiary of Medscheme, the healthcare fund and medical aid schemes administrator. Its groundbreaking AfA programme is the only disease management programme allowing an independent organisation to manage the disease independently of a pharmaceutical manufacturer.
Debswana is the world's leading diamond producer by value. It is owned in equal shares by the government of the Republic of Botswana and De Beers Centenary AG, and employs 6 000 people. Diamond revenues account for 80% of Botswana's export earnings and half of its government revenues.
In May 2001, Debswana hit the headlines when it announced it was funding 90% of the cost of providing anti-retroviral drug therapy (ART) to employees who were HIV-positive or living with Aids, and their spouses. It contracted PBM to manage the project via the AfA programme.
Debswana's decision to subsidise ART was taken against the backdrop of an alarming increase in the percentage of staff deaths attributed to Aids-related illnesses, in a country where one in three of the economically active population is testing positive for HIV.
ART's effectiveness depends on tight monitoring by doctors and adherence to therapy by patients. A condition of the contract, therefore, was that doctors in Botswana could access the AfA Clinical Management Programme via the Internet "Although we already offered intranet access, we were faced with an urgent requirement for an Internet interface," says Karen van Huyssteen, GM, Rondebosch Operations of Medscheme Integrated Care Division. "We outsourced the Web development to save time and development resources. This enabled our internal IT staff to concentrate on modifications to the database."
A Software Futures team of four worked closely with PBM's IT staff on an almost 24-hour basis to deliver the interface on time.
The Web interface allows doctors to apply for the go-ahead to begin treatment for an HIV positive or Aids patient by completion of an online interactive application form. The form provides for the input of medical and Aids tests results, plus demographic information.
Doctors can select appropriate medication from PBM's Oracle database and submit a treatment plan into the workflow process at PBM for approval by AfA clinical staff. Once AfA clinical staff members have assessed the treatment plan, they either approve or offer an alternative treatment plan. This is then e-mailed to the doctor. The doctor initiates treatment, constantly updating the system during subsequent patient consultations. The system incorporates security levels with specified levels of access for different users.
In addition, Software Futures provided an online technology-based training solution as part of the application's help function.
"Software Futures was able to provide us with the expertise that we did not have on site," says Van Huyssteen. "The successful roll-out of the project has resulted in the Internet functionality being extended to other PBM AfA client companies, and to doctors working in other countries such as Swaziland, Malawi and Zambia."
"This project was a success largely due to the close co-operation between PBM and Software Futures," says Sean O'Connell, business unit leader at Software Futures. "It reflects Software Futures' ability to act quickly and flexibly to meet our customers' requirements. Our iterative development process eliminates risk while ensuring a successful outcome."
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