Case Study: iDART, A Pharmacy System for Antiretroviral Dispensing
iDART was designed with the following constraints in mind (after Rivett & Tapson, 2009):
For this reason, iDART evolved to support a small number of basic tasks, including routine dispensing and capture of basic patient and prescription data.
The initial iDART prototype was developed in 2004 for a pilot site of DTHC, the Gugulethu Community Clinic in a township near Cape Town.
This atmosphere of social activism, coupled with the notion of having to prove to government that it was possible to provide treatment even in resource-constrained rural areas, was one of the unforeseen enablers of iDART. Since iDART collaborated with DTHC, other research institutions, such as the Medical Research Council of South Africa (MRC), the Reproductive Health Research Unit (RHRU), and the Paediatric Health Research Unit (PHRU) at the University of the Witwatersrand, were aware of the system and its early success.
The first funding for iDART came from the Elton John Foundation and was focused on equipping four sites in rural South Africa with iDART.
iDART became part of the rollout as a consequence of early involvement with research sites.
Broadreach Healthcare, a private company with responsibility for IT systems at several clinics in KwaZulu-Natal, downloaded iDART from Cell-Life's website and proceeded to implement it themselves (Cell-Life was still involved, but mostly in technical training).
This process became a particular strength of iDART, particularly in the early days.
Constantly responding to user requests for changes to iDART became particularly difficult once the exploratory orientation of the initial research project became secondary to considerations of scale.
In the case of iDART, Rivett and Tapson (2009) describe multi-stakeholder collaboration in the implementation community: