May 2, 2008

ICT can still do more for RP’s healthcare sector -- experts

Although the public and private sectors are using information and communications technology (ICT) on contrasting levels, both agree that innovative technologies could serve as a tool for bridging the country’s yawning health gap.

At the CyberPress Forum held recently at the iAcademy auditorium in Makati City, experts from the industry said ICT is transforming the way healthcare is provided in the country for both the underfunded public health facilities and state-of-the-art private medical centers and hospitals.

Dr. Alvin Marcelo, director of the National Telehealth Center in UP Manila, said "telemedicine" modalities such as text messaging, multimedia messaging system (MMS), voice over Internet protocol (VoIP) can help serve far-flung areas where the availability of doctors and health professionals is scarce.

Marcelo said 50 percent of Filipinos die without ever seeing a doctor in their lifetime. ICT, he said, could partly solve the problem.

Marcelo said the National Telehealth Center has been pushing for "the ethical, effective and efficient delivery of healthcare to underserved communities of the Philippines" using all available technology that is mostly based on open source platform.

The center, established by the University of the Philippines' board of regents in 1998 as an attached agency of the National Institutes of Health (NIH) and is based at the Philippine General Hospital (PGH), is also mandated to "design and develop IT-based solutions that will provide primary health care to local communities served,” he said.

He said the deployment of ICT is crucial at this time when the Philippines is caught between the "migration of health care workers to other countries and the severe lack of health care providers in many parts of the country because of the remoteness of the
underserved areas."

Marcelo said there has been a "disintegration of the health care system's public sector component because of devolution, which put local governments in charge of health care funding and personnel management."

ICT, he said, "can help reintegrate the system" by bringing together a network of doctors and healthcare workers in remote or underserved communities and linking them with doctors in urban areas who can help diagnose and treat provincial patients using mobile phones, the Internet and, in cases where the remote area also suffers a lack of electricity, radio communication.

In 2005, the Commission on ICT (CICT), through the E-Government fund, awarded a grant to the National TeleHealth Center so it could "design and develop ten telehealth and telementoring systems" in the provinces of Cagayan Valley, Capiz Province, Leyte and Iligan, where the UP Manila medical school has satellite facilities.

However, Marcelo admitted that the set-up initially failed to reach its goals of providing remote telemedicine to the selected areas. The system took off only after barrio doctors "shifted to SMS teleferrals" that make use of "simpler technology and have less need for tech support."

Under the National Telehealth Center, patient records are compiled and kept using open-source software, which Marcelo said is easy-to-use, customizable, and capable of generating standard reports for local, provincial and regional patients, including PhilHealth components.

The center also offers e-learning in the form of a collection of formal and non-formal courses such as masters of science in health informatics; geographic information systems for health leaders; e-health project management and; e-learning for community health. The modules are taught by distance learning using VoIP, cellular phone, radio, or whatever means is available.

For the side of the private sector, De Los Santos-STI MegaClinic administrative director Jose Ronaldo De Los Santos said that unlike government-run institutions, local private medical hospitals are globally competitive in terms of modern equipment.

He said this is what is needed to stay in the business since “never in the history of healthcare that IT has been as important as medical expertise and specialized medical equipment.”

Apart from looking towards utilizing ICT to exploit new opportunities such as medical transcription, De Los Santos said ICT is also becoming instrumental the country a medical tourism haven like Singapore and Thailand.

De Los Santos-STI MegaClinic is working to ensure that it is compliant with the United States' Healthcare Information Portability and Accountability (HIPAA) Act of 1996, "which is what we need to meet if we are to make the Philippines a medical tourism destination."

HIPAA calls for the digitization of patient data, which must be transcribed from doctors' dictated recordings and put in a text format that is accessible across all types of computer systems.

"We are now digitizing about 20 years' worth of medical records to the patients' financial records... We are going into a paperless setup where the patient is registered digitally in an (offsite) database," he said.

Doctors see patients at their clinic based on a "digital queuing system", which is linked a computer network that De Los Santos said allows doctors to simply "type his prescription into the computer and click on the tests he is prescribing for the patient, as well as (encode) the diagnosis. Our patients also get their lab results sooner, over the Internet, by email, "making diagnosis quicker and more efficient -- in many cases detecting diseases earlier so patients can seek less expensive and more timely treatment.

With this system, billing procedures are also faster and more accurate, he added. "The cashier will know what the patient needs to pay for thanks to the queue." Patients can also obtain copies of their data, including x-rays, cranial axial tomography (CAT) scans, magnetic resonance imaging (MRI) scans and other images that we can give the patients on optical discs such as CDs and DVDs.

De Los Santos said the megaclinic is working toward obtaining "optical character recognition technology to make every word (in a patient's medical records) a searchable record," meaning each word in the document acts like a hyperlink that automatically allows access to other cross-referenced data within the same set of records.

However, he said the constraint "is cost, though there is a need for such data mining capability so doctors will have better and quicker access to their patient records."

"All records - patients' data like digital images and financial records with our facility are stored off-site, so if something happens to the facility, records can be recovered," he added.

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