Orthopaedic International Inc. Project Lead: Dr. Ramon Gustilo
An estimated 3-5% of the world’s population would require total knee replacement (TKR) every year. In the Philippines, very few are availing of it because it is not affordable. Only around 1,000 cases are done every year, when it should have been approximately 70,000. There are only few surgeons who are trained to do TKR, because the procedure is complex and would require specialist training which could last for at least a year.
The Axis Knee System is a total knee replacement system that is designed for a wide range of sizes. This world-class, FDA-approved product was conceptualized and developed by Filipino doctors and engineers, together with some consultants from Japan, China, and US, and is being manufactured locally in Orthopaedic International Inc.’s ISO 13485-certified plant in Cabuyao, Laguna. Its patented instrumentation and surgical technique allows even the general orthopaedic surgeon to perform the procedure accurately without the use of x-ray, after completing a training workshop that only lasts for five days. It is very affordable, as it costs 50% less than other knee implants in the market.
Product Development Stage
The product is already being sold in the Philippines since 2015. Patents for its instrumentation and surgical techniques were already granted in the US and EU. It is now open for international licensing.
In the UP Diliman infirmary, an annual physical exam means you go for the required tests from one department to another, falling in line for each test. Then you wait hours or days, going back to the same venues, for the results, before being finally ready for a doctor’s assessment of your general state of health.
The process is stressful and drawn out, but you’re more or less assured that all bases are covered. In a rural health facility, the situation is worse. All the equipment it will most likely have will be thermometers, stethoscopes, sphygmomanometers, weighing scales, and for expectant mothers, speculums.
The staff can tell you if you have fever, the state of your heartbeat, your blood pressure, your weight. If you’re expecting, they’ll tell you if the baby’s heartbeat is OK, and if you’re close to giving birth.
But don’t expect to get exact figures about a whole lot of other important things. They can only estimate the level of oxygen in your blood, which helps detect lung and cardiovascular problems. The staff will have difficulty measuring the fetus’s heart rate at critical times of the pregnancy and delivery, and the strength of a mother’s uterine contractions during labor and delivery, which indicates distress of the mother and the baby.
For such exact measurements, you would have to go to a better-equipped polyclinic in town, which is probably half a day’s travel away for most Filipinos.
That’s why the RxBox is a game-changer. It’s a life-saving invention of UP, in a box which combines several diagnostic devices for common medical problems, computerizing results, and electronically transmitting data.
Doctors, health workers, physicists, computer scientists, and electrical and electronics engineers helped put this box together. This handheld machine has a blood pressure monitor, a pulse oximeter, an electrocardiogram (ECG), a fetal heart monitor and a maternal tocometer with fetal movement marker, and a temperature sensor—all built around a touch-screen tablet. Because it’s modular, it can be integrated with more devices in the future.
The RxBox can make many measurements in one sitting and can transmit them as a mobile and Internet device. Where there might be no doctors present, the health worker can make the measurements and send the results via telemedicine to a doctor who can respond immediately on remote. The potentials for faster and cheaper health services are obvious.
The tablet stores and transmits not only diagnostic results, but electronic medical records as well. With CHITS or the Community Health Information Tracking System—another homegrown and prizewinning UP Manila technological breakthrough—health workers need not pore over paper files to get to patients’ medical records.
You give all public health facilities mobile or Internet access and this device, and public health recording goes automatic. For this purpose, the configuration of the CHITS data sets has been aligned with the datasets of the Department of Health (DOH) and the Philippine Health Insurance Corp. (PhilHealth). Organized mass-based data will improve public health policy and planning.
The tablet also has built-in data to help users make sense of measurements, which makes it useful as a medical training device.
Telehealth involves the patient being attended to by the health worker, the worker referring his or her case to doctors and institutions, and the encoding of data for public health information and planning, all using networked devices. Through the leadership of UP’s National Telehealth Center (NTHC), telehealth has been a pillar in the modernization of the country’s health care system since 2004. Foremost among its tools is the RxBox.
“When you think about telehealth and telemedicine, think about a long-running health program that is likewise research and service by the University. It’s continually being improved with technologies being tested with the people—frontline health workers—so that we can find the best ways to improve access to health care and achieve better equity in health,” says Dr. Portia Marcelo, lead RxBox investigator.
The RxBox was originally conceptualized for emergency cases at the Philippine General Hospital (PGH). The idea was for the first responders to be able to provide the hospital staff real-time information on the clinical status of the patient before he or she arrived at the hospital—alerting the staff to the personnel and equipment needed.
The RxBox prototype was conceptualized as early as 2007 by Dr. Alvin Marcelo, then NTHC director, and Dr. Luis Sison of the UP Diliman College of Engineering. It is one of the first “emerging disciplines” projects of UP to have reached national policy levels.
Beginning from scratch, the device, CHITS, and telehealth underwent several iterations or versions through the years. Deployment to 169 rural health units refined the RxBox to its current design.
The RxBox now enables the National Telehealth Service Program (NTSP) being directed by a National E-Health Steering Committee, which was formed as part of UP’s advocacy for governance of e-health initiatives in the country.
Led by the DOH and the Department of Science and Technology, with the Department of Information and Communications Technology, the Commission on Higher Education, PhilHealth, and UP Manila, the committee is bent on scaling up the deployment of RxBox under the NTSP.
“The RxBox 1,000 project has been launched and will deploy these technologies to a thousand of the country’s 3,500 towns. The poorest of the poor municipalities are our priority,” Dr. Portia Marcelo says.
With widespread use and confidence, bigger demand is expected. Making an industry out of the RxBox will no longer be far-fetched. The manufacture of a thousand units in one go, for full deployment early next year, will be proof of the viability of commercialization.
This could be the country’s gift of innovation for national industrialization, and health care in the world, according to Marcelo. And as a UP product, RxBox emerged out of UP’s mandate to serve the country’s poor and underserved masses, which is perhaps its greatest value added.
The Department of Health (DOH), through its AHEAD (Advancing Health through Evidence-Assisted Decisions) strategy, aims to inform the health sector’s global and national administrative and legislative policy agenda, create an equitable and enabling environment for health policy and systems researchers all over the country, and ensure the progressive realization of the envisioned research system.
With the continued commitment of DOH in training the next generation for health sector leaders, researchers, policy analysts, and program managers, they have partnered with the Department of Science and Technology - Philippine Council for Health Research Development (DOST-PCHRD) in order to implement the DOH Research Fellowship Program.
The program is a two-year intensive Health Policy and Systems Research Fellowship intended for early career professionals who are considering a career in research. A pre-fellowship or internship is being made available for highly qualified applicants who demonstrate interest in health policy and systems research in the context of research to policy translation. Graduates of the internship program may proceed to apply to the fellowship program.
To develop capacity of Health Policy and Systems Research Interns in the process of research to policy translation
Accomplishment report approved by the DOH supervisor every month
Back-to-Office report for all meetings/workshops attended
Technical report for all meetings/workshops organized
One brown bag session organized or facilitated every month
At least 5 memoranda every month
Station-dependent, in addition to #1:
At least 2 policy reviews every month; includes drafting policy issuances as maybe needed, if deployed to Health Policy Division
At least 2 program strategy, and performance/plan analysis and budget analysis every month, if deployed to Health Planning Division
At least 2 position papers every month, if deployed to the Legislative Liaison Division
Adhere to agency policies, procedures, and rules governing professional behaviour
Be punctual, and work the required number of hours: 8am to 5pm Monday to Friday
Notify their supervisor if they are unable to attend
Behave and dress appropriately to the particular workplace
Respect the confidentiality of the workplace, its clients and its employees.
If things are slow, take the initiative and volunteer for different tasks or other work.
Discuss any problems with their supervisor and, if necessary, with the Internship coordinator at the Health Policy Development and Planning Bureau
Other technical tasks as may be required
Bachelor’s degree, field of study must be on public health or any related area in the social and medical sciences; post-graduate degree is an advantage
At least one (1) year work experience, previous work experience in DOH is a plus factor
At least eight (8) hours of relevant training
A genuine interest in health policy issues
Excellent English-language writing skills and the ability to present information in a variety of formats and styles for difference audiences
Strong skills in planning, preparing and delivering remarks
Strong organizational and administrative skills; with keen attention to detail
Strong interpersonal skills and the ability to work well in a team with others
Ability to develop work plans, set deadlines, work well with minimal supervision, prioritize assignments, and organize multiple projects and duties simultaneously while meeting deadlines
Ability to work effectively as a member of a team, know when to act independently and when to consult for advice on decision-making
A willingness to carry out a wide range of activities, including both professional and logistical tasks
Strong computer skills with familiarity with Microsoft Office, email clients, Internet research, and social networking tools
Flexibility with respect to schedule, working hours, travel, and work assignments, including ability to work overtime or on weekends when necessary; reliable job attendance essential
Two years, non-renewable
For BS/BA degree holders: At least PHP 25,000.00 NETT
For MS/MA degree holders: At least PHP 30,000.00 NETT
PHILIPPINES Department of Science and Technology- Philippine Council for Health Research and Development (DOST- PCHRD)
Philippine applicants are advised to check with the Council regarding the eligibility and requirements. Interested applicants may visit the Department of Science and Technology- Philippine Council for Health Research and Development website for the Grants-in-Aid and Call guidelines (http://pchrd.dost.gov.ph).
Research proposals may be submitted by Filipino applicants with the following as Implementing Agencies: Research and Development Institutions (RDIs) CHED- accredited Higher Education Institutions (HEIs) State Colleges and Universities Private/ non- governmental organizations with proven track record in R&D
The submitted project proposals shall undergo the evaluation process of DOST- PCHRD. Approved projects will be funded by the DOST- PCHRD accordingly and are subject to PCHRD rules and monitoring.
The DOST – PCHRD shall finance the project expenditures as itemized in the approved line- item budget (LIB) following the DOST Grants-in-Aid guidelines. The grant will cover a maximum of PhP 5,000,000.00 provided that the Implementing Agency will contribute counterpart funding. The grant may cover partial or full cost of the project, both direct and indirect cost of the Maintenance and Other Operating Expenses (MOOE) under the General Appropriations Act (GAA) which shall include Personal Services (PS), Maintenance and Other Operating Expenses (MOOE) and Capital Outlay (CO) that are integral in the conduct of the study. All expenditure items in the LIB shall be in accordance with the Unified Account Code Structures (UACS), relevant provisions are as follows:
Covers the expenses incurred by the implementing institution in executing the project considered indispensable to its operations.
I. Personal Services Includes salaries, wages, honoraria, fees and other compensation to consultants and specialists who undertake specific activities requiring expertise and technical skills.
II. Maintenance and Other Operating Expenses Includes traveling expenses, communication expenses, repair and maintenance of facilities/ vehicles, transportation and delivery services, supplies and materials, utilities, training and scholarship expenses, representation expenses, professional expenses, and expenses on advertising, printing and binding, subscription and survey. III. Capital Outlay This includes all equipment necessary for the implementation of the project, which shall be enumerated in the proposed LIB. Equipment shall still be subject to the evaluation of DOST PCIEERD, this also includes infrastructure that are integral part of the project and are crucial in the attainment of the project’s objective
Cost used to cover the overhead expenses by the implementing institution in managing and monitoring the project. The administrative and project management cost shall fall under this account. Similar to Direct Cost, the Indirect Cost can be broken down according to specific item under PS and MOOE. The total indirect cost of the project shall not exceed 7.5% of the total PS and MOOE of the project.
Prior to the submission of a full blown proposal, applicants are requested to submit a capsule proposal through the email addresses indicated below. Two (2) hard copies should be mailed to the Department of Science and Technology- Philippine Council for Health Research and Development (DOST- PCHRD), 1st floor, Saliksik Building, General Santos Avenue, Bicutan, Taguig City 1631. All proposals are also required to be registered in the Project Management System (PMS: http://www.projects.pchrd.dost.gov.ph). The capsule proposal should not exceed five (5) pages and should include the workplan and line- item budget. Institutions with shortlisted capsule proposals will then be requested to submit a full blown proposal.
For more information, please contact:
JASTIP-Net aims to strengthen the Japan-ASEAN research collaboration network, widen and deepen the coverage of JASTIP within the ASEAN region, and seek new collaborations for developing capacities, fostering partnerships and growing new endeavors into mature research projects.
Interested Applicants must choose one out of four research themes listed below:
Partnership, Networking and Integrated Approach
Operational linkages among academic sector, government agencies, and private sectors in the ASEAN Member States and Japan.
Study a strategy/policy to apply STI collaboration at a country/regional level to social implementation for achieving SDGs in the ASEAN region.
Energy and Environment Joint Laboratory
Implementation Study of Renewable Energy in Southeast Asia
Bioresources and Biodiversity Joint Laboratory
Studies on biodiversity in the ASEAN region contributing to the improvement of identification, collection and/or information.
Sustainable utilization of bioresources for biorefinery, bioremediation, wood construction, food or medicine.
Plant improvement for agroforestry systems and carbon sequestration contributing to the mitigation of and/or adaptation to climate change.
Disaster Prevention Joint Laboratory
Innovative ideas on disaster prevention, mitigation and recovery technologies and policies peculiar to each ASEAN Member State.
How to cope with trans-boundary disasters in the ASEAN region such as tsunami, flood, drought and haze.
Understanding and quantitative evaluating disaster risks peculiar to the ASEAN Member States.
Deadline of applications for the first submission is on 21 July 2018, and the second submission is on 10 August 2018, 17:00 (Japanese Standard Time).