12th PNHRS week to highlight equity in health

Information and Communication Technology (ICT) has been already implemented in different industries here in the Philippines specifically in the field of Health and Medicine. According to the column of Helen Flores in Philippine Star posted in 2011, Science Secretary Mario Montejo said that “The Government spent almost 30 Million Annually for National Telehealth Service Program that aims to deliver health services through information and communications technology in remote communities”. The program is also called as the eHealth Technology which includes the portable device “RxBox” to over 1,600 poorest municipalities in the country. RxBox is a portable innovation funded by the DOST’s Philippine Council on Health Research and Development (PCHRD) and developed by researchers at the Electrical and Electronics Engineering Institute, and the U.P. National Institute of Physics from the University of the Philippines in Diliman, and the National Telehealth Center. In August 2015, the National Telehealth Center joined the science and technology (S&T) community in celebrating the “2015 National Science and Technology Week” and RxBox was the featured Technology.The main objectives of the RxBox research program is to develop a locally manufactured device with the medical-grade telemedicine device to help Rural Health Units/Local Health Center in rural areas or communities with the a Designed to provide better access to life-saving health care services in isolated and disadvantaged communities nationwide. The device can reduce the overall cost of healthcare by enabling health workers to diagnose, monitor and treat patients within the rural health facility. The research program is divided into three projects: Community Health Information Tracking System (CHITS) and eTriage integration into commercial biometric device, eNAI: Electronic Neonatal Assistive Intervention and the Field Testing and telemedicine device.

The Community Health Information Tracking System (CHITS) and eTriage integration into commercial biometric device is aim to integrate an electronic medical record. The eNAI: Electronic Neonatal Assistive Intervention is developed by the Electrical and Electronics Engineering Institute (EEEI) of the University of the Philippines Diliman with the following sensors included: Blood Pressure Monitor, Pulse Oxymeter, ECG, Fetal heart monitor, Maternal tocometer and Slots for future modules and lastly the Field Testing and telemedicine device with the aim determine the usability, ease of use and workflow integration of the RxBox.

eHealth System

The ICT used for health or also called as the eHealth System was started in the early 1988 as the DOH has learned from the results of experimentation and early adoption phase of developing software for Field Health Services and Information System, and has continuously developed or built other application or information systems. The use of ICTs in the DOH has remarkably supported and improved some of the functions of the Department. The ehealth vision is “By the year 2020 the Philippines will enable widespread access to health care services, health information, and securely share and exchange patient’s information in support to a safer, quality health care, more equitable and responsive health system for all the Filipino people by transforming the way information is used to plan, manage, deliver and monitor health services”. eHealth has proven to provide improvements in health care delivery and is at the core of responsive health system.
eHealth will improve the quality and safety of the health system through the following:

1. Empowerment of health consumers to better manage their health records
2. Availability of information like single view of the patients’ information at the point of care
3. Decision support tools and knowledge based information thereby reducing medical errors
4. Improved treatment and monitoring
5. Availability of information for efficient and effective surveillance and monitoring of diseases and management of health
   The eHealth will also support a more equitable health system through presence of information about the availability, location, expertise and services of health care providers and it will provide a more responsive health system. The DOST has the following projects for smarter healthcare:
6. RxBox: Connecting medics - a medical device which enables health workers in remote communities to consult with medical experts in urban areas, thus providing better access to life-saving healthcare services in isolated and disadvantaged communities nationwide.
7. e-TABLET: Managing medical records - is a tablet-based electronic medical record system.
8. PHIE: Centralized medical records - provide centralized database of health and medical records nationwide, allowing a patient to retrieve his medical records from anywhere in the country.
9. Enhancing eHealth via TVWS connectivity - DOST-ICTO is tapping into the potential of TV White Spaces (TVWS) or unused frequencies between broadcast TV channels, to provide an extremely cost effective means for internet connectivity and data delivery in areas underserved by telecommunications companies.

RxBox Device

RxBox Device or simply known as “RxBox” is a telemedicine device capable of capturing medical signals through built-in medical sensors, storing data in an electronic medical record (Community Health Information Tracking System – CHITS), and transmitting health information via internet. It is one of the DOST’s efforts of “Smarter Philippines” and the ICT’s innovation designed to support the DOH’s call for Kalusugang Pangkalahatan or Universal Health Care. This is funded by the DOST’s Philippine Council on Health Research and Development (PCHRD) and developed by researchers at the Electrical and Electronics Engineering Institute, and the U.P. National Institute of Physics from the University of the Philippines in Diliman, and the National Telehealtg Center. The RxBox can reduce the overall cost of healthcare by enabling health workers to diagnose, monitor and treat patients within the rural health facility. RxBox can do the following medical services:

1. Blood pressure monitor – measures the patient’s blood pressure to detect cardiovascular (heart and blood vessels) problems especially hypertension, a disease which can also worsen other chronic lifestyle disease conditions.
2. Pulse oximeter – measures the level of oxygen in the patient’s blood and can help detect lung and cardiovascular problems.
3. Electrocardiogram (ECG) – monitors the heart’s movement to pump blood throughout the body, helpful for those with acute and chronic heart problems, including pregnant mothers with cardiovascular problems.
4. Fetal heart monitor – measures the baby’s heart rate while in the womb, helping detect fetal distress at critical times of the pregnancy and delivery.
5. Maternal tocometer – measures the strength of a mother’s uterine contractions during labor and delivery, enabling early detection of distress to the mother and/or the baby.
6. Temperature sensor – measures a patient’s body temperature. It can help detect fever, a common medical sign of infection and other disease conditions

Source: Jaudian, R.J. (2018, January). Trends, Issues and Strategies of Department of Health for Health Workers in Remote Communities. Retrieved from https://steemit.com/ehealt/@godlovermel25/2n5bv4-trends-issues-and-strategies-of-department-of-health-for-health-workers-in-remote-communities

Axis Knee System 

Confidence in every step

Technology Generator

Orthopaedic International Inc. 
Project Lead: Dr. Ramon Gustilo

The Problem

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 Solution

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.

Contact Person:

Mr. Jude Sasing
President, Orthopaedic International Inc. 
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Source: http://www.pchrd.dost.gov.ph/index.php/programs-and-services/create-article/6349-axis-knee-system-confidence-in-every-step

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.

      RxBox Program in Cabucgayan, Biliran in the Philippines (Photo from telehealth.ph)

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.

Source//: Lontoc, F. ( 2017, September 05). Unboxing the RxBox. Retrieved from https://www.up.edu.ph/index.php/unboxing-the-rxbox/ 

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.

Objective:

To develop capacity of Health Policy and Systems Research Interns in the process of research to policy translation

Deliverables:

1. Standard deliverables
   • 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
2. 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

Responsibilities

1. Adhere to agency policies, procedures, and rules governing professional behaviour
2. Be punctual, and work the required number of hours: 8am to 5pm Monday to Friday
3. Notify their supervisor if they are unable to attend
4. Behave and dress appropriately to the particular workplace
5. Respect the confidentiality of the workplace, its clients and its employees.
6. If things are slow, take the initiative and volunteer for different tasks or other work.
7. Discuss any problems with their supervisor and, if necessary, with the Internship coordinator at the Health Policy Development and Planning Bureau
8. Other technical tasks as may be required

Minimum Qualifications:

1. 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
2. At least one (1) year work experience, previous work experience in DOH is a plus factor
3. At least eight (8) hours of relevant training

Requirements:

1. A genuine interest in health policy issues 
2. Excellent English-language writing skills and the ability to present information in a variety of formats and styles for difference audiences
3. Strong skills in planning, preparing and delivering remarks
4. Strong organizational and administrative skills; with keen attention to detail
5. Strong interpersonal skills and the ability to work well in a team with others
6. Ability to develop work plans, set deadlines, work well with minimal supervision, prioritize assignments, and organize multiple projects and duties simultaneously while meeting deadlines
7. Ability to work effectively as a member of a team, know when to act independently and when to consult for advice on decision-making
8. A willingness to carry out a wide range of activities, including both professional and logistical tasks
9. Strong computer skills with familiarity with Microsoft Office, email clients, Internet research, and social networking tools
10. 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

Duration:

Two years, non-renewable

Compensation/Stipend:

For BS/BA degree holders: At least PHP 25,000.00 NETT

            For MS/MA degree holders: At least PHP 30,000.00 NETT

Expression of Interest:

Qualified applicants may file their application together with the following documents at This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it. orThis email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it.:

1. Cover letter addressed to:

KENNETH G. RONQUILLO, MD, MPHM, CESO III

Director IV

Health Policy Development and Planning Bureau

Department of Health

2. Curriculum Vitae

Deadline of submission is on or before July 14, 2018. 

For queries, contact Ms. Juanita R. Valeza at 651-7800 local 1326/1328 or Ms. Ian Hannah C. Gozun at (02) 837-7537 local 2117.

Source: http://pchrd.dost.gov.ph/index.php/news/6382-call-for-applications-doh-health-policy-planning-and-research-plpr-interns