Computer-based ARV Dispensing

Pharmacies, as specialized services with specialized staff, are often the limiting factor for the delivery of health care in low-resource settings. I work with a small clinic in South Africa that has more than 1,300 patients on ARV treatment. We’ve worked with an NGO Cell Life to bring in a computer-based ARV dispensing system, iDART, to speed dispensing and decrease clerical work. Simple solutions to help pharmacies such as pre-packaging drugs, dispensing two months supply to stable patients, and easy to use registers can make a big difference, however as clinics grow, there comes a point when a computer system will keep the clinic ahead of the crush.

Here are a couple of systems that we’ve come across for dispensing at the clinic level with some key attributes. We’re not exactly clear which will work the best and would love input if you have used these, or know of others.

* Cell Life, iDart – Built for ARV dispensing, iDART incorporates the ARV start date, treatment supporter contact info, and defaulter tracing. Reports cover the necessary requirements for government (stock dispensed, etc.), and will soon allow for easy PEPFAR reporting. Bottle labels print with a click of a button speeding the consultation. The system can be used for dispensing directly to the patient or to keep track of drugs that have been packaged for individual patients at a central pharmacy and then distributed at local clinics. The system is Open Source, but no outside developer base exists as far as I know.  It is downloadable at their site.

* ProPharm – Built for retail dispensing ProPharm has a large customer base and fast and easy customer support (a key need when computer skills are lacking). The system is more complicated than iDART but can be modified to include ARV specific dispensing information. An NGO manages thousands of patients on numerous studies with this, and, as far as I know, likes the system. I don’t think, however, that they are using it at the clinic level. The learning curve is steeper given greater complexity and features that are not used in public sector dispensing. It’s a proprietary system.