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GxAlert Papua New Guinea Case Study 072518

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GxAlert's use in Papua New Guinea for disease surveillance and response. Initially used for Tuberculosis response, device management and second-line drug forecasting and stockage.

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GxAlert Papua New Guinea Case Study 072518

  1. 1. THE CHALLENGE: PAPER-BASED SYSTEMS – INFRASTRUCTURE-CHALLENGED LANDSCAPES Healthcare workers in Papua New Guinea (PNG) relied on paper-based systems for tracking and communicating patient diagnostic data between provincial hospitals where GeneXpert instruments are located, to remote clinics where samples are collected and patients are located and to the National Department of Health staff. This involves sending a sample to a provincial hospital, documenting the diagnostic result on paper for the clinical TB team, locating the patient and connecting the patient to treatment if needed. The GeneXpert has been utilized to screen presumptive drug-resistant (DR) TB and most at risk population patients throughout PNG and most recently, as the initial diagnostic test for presumptive pulmonary tuberculosis cases. In this system, a symptomatic patient will generally wait for a diagnosis after returning home and is usually asked to return to the clinic in a week for their result. Patients often live far from a clinic and have limited transportation options. Yet the week or more that it can take between testing and providing a patient with diagnosis are critical, particularly in the case of DR-TB. In addition to the difficulty of identifying, informing and commencing DR-TB patients on appropriate treatment, PMDT clinics keep a minimal stock of second-line drugs (SLDs) onsite, as storage is often limited and to prevent expiration of SLDs, they are dispatched according to a notified rifampicin resistant (RR) TB case. Country Papua New Guinea Laboratories 24 Diseases TB, RR-TB Devices & Assays GeneXpert Funding Partner - DFAT (seed funding for two pilot sites) - TB Global Fund Grant (World Vision Principle recipient) Local Heroes Leads: Dr. Evelyn Lavu Ms. Jennifer Banamu Ms. Karen Johnson Team Members: Ms. May Keket Ms. Jennifer Dume FROM DATA TO IMPACT Implementation Summary CASE STUDY: SWAZILAND FROM DATA TO IMPACT Implementation summary Country Swaziland Laboratories 28 Diseases MTB, MDR TB Devices & Assays GeneXpert, MTB and MDR TB Funding Partner Global Fund Local Heroes: Lead: Themba Dlamini, Program Manager, NTP Dr. Welile Sikhondze, Technical Advisor and Research Coordinator, NTP Sindisiwe Dlamini, Chief Laboratory Technologist, SHLS Team Members: Doctor Busizwe Sibandze Drug Resistance Survey Laboratory Manager, NTP Tumiso Matumba Information Technology, National ICT Officer, NTP Thando Mabuza, Assistant ICT Officer, NTP Derrick Khumalo Principal Technologist & SHLS/NTP Laboratory Coordinator Sylvester Moyo Laboratory Information System Manager, CHAI Tufuma Zanamwe Laboratory Information System Manager, ICAP Pinky Kubheka Regional Laboratory Advisor, ICAP Justice Makuni Software Developer, HMIS THE CHALLENGE: MODERN DIAGNOSTICS AND TRAINED STAFF HAMPERED BY DISTANCE AND COMMUNICATION ISSUES The Swaziland NTP understood that despite having a fleet of new GeneXpert diagnostic devices and a skilled staff, they would not realize the full potential of these new devices without a robust device management platform. To maximize the use of GeneXperts, and eventually other diagnostics, the NTP needed to: • understand utilization; • figure out which errors were happening and why; • implement rapid response to diagnoses; • deploy targeted training resources efficiently; and, • manage a fleet of expensive devices over the long term. A robust device management connectivity platform could help realize the new technology’s promise. In addition to the immediate issues of improving time to treatment and system optimization, the Swaziland NTP wanted to take advantage of platform to: Manage inventory: • Optimizing procurement and utilization • Reducing wastage Manage devices: • Remotely, identify and fix device errors rapidly • Maintain devices and keep warranties up to date, and reduce costs over time Collect and analyze data, to: • understand disease trends and patterns • use custom fields to optimize laboratory processes and patient care • ensure data privacy and control • automate time-consuming reports Doctor Busizwe Sibandze installs GxAlert at the Raleigh Fitkin Memorial Hospital laboratory with supervision from Tumiso Matumba and SystemOne’s Max Strong. PAPUA NEW GUINEA: A CASE STUDY Wesey Girinde (in mask) and Jennifer Kopania Banamu at the Morobe GeneXpert installation
  2. 2. SOLUTION: Papua New Guinea first installed the GxAlert system in May 2015, and have been using the system for clinical and logistical work ever since. On the clinical side, the PNG team have been able to use GxAlert to dramatically reduce time-to-treatment. In one recent situation, within moments of a clinician receiving an SMS message with a patient’s test result, an ambulance was dispatched to the patient’s home and the patient was brought to the Provicial Hospital and immediately commenced on appropriate treatment. “In a total of 15 minutes the physician got the alert, arranged for an ambulance, and retrieved the patient to initiate treatment,”said Jennifer Banamu (Acting Officer-in-Charge TB Unit, Central Public Health Laboratory)“If it wasn’t for GxAlert, we wouldn’t have known until the hard copy result was dispatched to the TB clinic, and then we would have had to alert the physician and locate the patient.” PNG is initially focused on making use of the following GxAlert benefits: • Rapid case notifications for all positive results to all relevant healthcare officers • Inventory management and notifications to reduce stockouts and expiry • User-friendly calibration notifications to keep instruments maintained An Important GxAlert Benefit: The understanding of accurate diagnosis, and therefore drug requirements, in different regions provided by GxAlert impacts the timely dispatch of second-line drugs and the reduction of the commencement of appropriate treatment to the patient. National Area Medical Stores are now able to dispatch the required allocation of drugs to treatment facilities and ensure that fragile second-line drugs can remain safely stored at central facilities until required. MOVING FORWARD: As PNG anticipates the rollout of further GeneXpert instruments including expanding the use as the initial diagnostic test for presumptive pulmonary TB cases, the national TB program intends to expand its use of GxAlert notifications to all new and existing GeneXpert locations. Clinical teams are working with SystemOne on custom algorithms to utilize the tools and notifications that are most effective in the context of the country. The country also intends to use GxAlert with Hain LPA and BD MGIT instruments in the future. PNG is seeking additional funding to continue using GxAlert and to expand the program. @SystemOneCo SystemOne.id CASE STUDY: SWAZILAND FROM DATA TO IMPACT Implementation summary Country Swaziland Laboratories 28 Diseases MTB, MDR TB Devices & Assays GeneXpert, MTB and MDR TB Funding Partner Global Fund Local Heroes: Lead: Themba Dlamini, Program Manager, NTP Dr. Welile Sikhondze, Technical Advisor and Research Coordinator, NTP Sindisiwe Dlamini, Chief Laboratory Technologist, SHLS Team Members: Doctor Busizwe Sibandze Drug Resistance Survey Laboratory Manager, NTP Tumiso Matumba Information Technology, National ICT Officer, NTP Thando Mabuza, Assistant ICT Officer, NTP Derrick Khumalo Principal Technologist & SHLS/NTP Laboratory Coordinator Sylvester Moyo Laboratory Information System Manager, CHAI Tufuma Zanamwe Laboratory Information System Manager, ICAP Pinky Kubheka Regional Laboratory Advisor, ICAP Justice Makuni Software Developer, HMIS THE CHALLENGE: MODERN DIAGNOSTICS AND TRAINED STAFF HAMPERED BY DISTANCE AND COMMUNICATION ISSUES The Swaziland NTP understood that despite having a fleet of new GeneXpert diagnostic devices and a skilled staff, they would not realize the full potential of these new devices without a robust device management platform. To maximize the use of GeneXperts, and eventually other diagnostics, the NTP needed to: • understand utilization; • figure out which errors were happening and why; • implement rapid response to diagnoses; • deploy targeted training resources efficiently; and, • manage a fleet of expensive devices over the long term. A robust device management connectivity platform could help realize the new technology’s promise. In addition to the immediate issues of improving time to treatment and system optimization, the Swaziland NTP wanted to take advantage of platform to: Manage inventory: • Optimizing procurement and utilization • Reducing wastage Manage devices: • Remotely, identify and fix device errors rapidly • Maintain devices and keep warranties up to date, and reduce costs over time Collect and analyze data, to: • understand disease trends and patterns • use custom fields to optimize laboratory processes and patient care • ensure data privacy and control • automate time-consuming reports Doctor Busizwe Sibandze installs GxAlert at the Raleigh Fitkin Memorial Hospital laboratory with supervision from Tumiso Matumba and SystemOne’s Max Strong. PAPUA NEW GUINEA: A CASE STUDY Left to right: (front row) Dr Everlyn Lavu- Director CPHL, Jennifer Kopania Banamu Giggey Nidue and (back row) James Nanson, Roselyn Mano, May.V. Keket, Jennifer Dume at World TB Day 2018

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