[UPDATED] In COVID critical Bukidnon, no telemedicine services offered in health centers

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MALAYBALAY CITY (BukidnonNews.Net/12 September 2021) With increasing cases of COVID-19, no rural health unit (RHU) yet in the province has offered institutional telemedicine especially for indigent patients. 

Dr. Vincent Raguro, head of the Department of Health Office in Bukidnon, said so far no rural health unit in the province has been accredited to conduct telemedicine services. RHUs need to submit for accreditation with the Philippine Health Insurance Corporation (PhilHealth) to be able to offer the services, he added.

He said the RHUs needed the accreditation so that they can work with Philhealth for that service and be qualified to claim capitation to sustain their operations.

According to Phil Health, capitation is the scheme or form for the corporation to pay the RHU for specific services it provided.

Local RHUs like those of the cities of Malaybalay and Valencia, he added, have on-going applications for accreditation.

“Hopefully they will be able to obtain accreditation soon,” he added.

Dr. Efren D. Villahermosa Jr, president of the 350-member Bukidnon Medical Society (BMS), said that with the current strain in the health system due to the increasing number of COVID-19 cases, there is a need to institutionalize the use of virtual consultations or telemedicine, especially in the rural health units (RHUs).

He said in an interview with BukidnonNews.Net recently that the full occupancy of hospitals did not only bring trouble to the COVID-19 patients.

“The non-COVID case patients, especially the indigents with non-communicable disease, have really suffered because they hesitate to access the usual medical services for fear of being exposed to COVID-19,” he added.  

Dr. Villahermosa said with or without Philhealth benefits, local government units (LGUs) through the rural health unit should already do virtual consultation or telemedicine via the health centers.

In May 2021, the Department of Health (DOH), Department of Interior and Local Government (DILG) and PhilHealth issued a joint administrative order providing for guidelines on the implementation of telemedicine.

The guidelines, among others, provided that LGUs “shall lead and ensure the adoption and implementation of telemedicine services within their area based on the standards and guidelines provided by the order, provide the needed resources, investments, and support mechanisms to facilitate the institutionalization and seamless implementation of telemedicine services, and ensure proper complementation of efforts at the local level”.

Dr. Villahermosa said there is a need to limit face to face consultation and be able to cater to non-communicable diseases. With telemedicine, patients will not crowd in the waiting area where they might get infected from unexpected Covid patients. He said that through telemedicine, the RHUs can prescreen patients and find out who really needs face to face consultation.

The provincial government has recognized the problem of lack of access to health services.

In response to a query at the Bukidnon Sangguniang Panlalawigan on September 7, 2021, Dr. Gary Guido C. Tabios, Jr, Bukidnon Provincial Health Officer, said not all of those who died in their homes were due to COVID-19.

“Usa sa mga hinungdan matud pa ni Dr. Tabios nga kasagaran puno na ang mga hospital ug ang uban mahadlok nga magpa-admit gumikan kay mahadlok nga matakbuyan sa makamatay nga virus,” the Public Affairs Information and Assistance (PAIA) said in a press release posted in its social media account on September 9, 2021.

Most of those who died, he added, already had underlying co-morbidities or had previous illness, which worsened due to lack of medical equipment such as for those with high blood pressure, stroke, heart attack, diabetes and other illnesses.

The World Health Organization defines telemedicine as the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.

The local government, Dr. Villahermosa added, should invest in a platform for telemedicine and need not wait for the national government to initiate it so that indigent patients in their areas can still access health services even during the pandemic.

He cited the example of the Provincial Government of Cebu’s SugboMed and the Municipality of Liloan, Cebu’s GugMed Online Medical Consultation.

“As you can see Cebu is into telemedicine since the middle of last year,” he added, though he said he is unsure how the initiatives have progressed so far. In Cebu, the local governments worked with private firms providing information technology (IT) solutions.

Locally, Dr. Villahermosa said the LGUs can design telemedicine platforms via the rural health unit and the barangays. He added that doctors can be where they are and their indigent patients may proceed to the barangay hall, where a tele-medicine set up can be arranged. 

He said the BMS is willing to sit down with interested RHUs to arrange a group of select specialists who can serve the tele-medicine platform for free. But he said the set-up should be fairly arranged as their specialists will be there only to provide augmentation.  

Dr. Villahermosa stressed the need for the set up to be done as soon as possible to help address the problem of lack of access to health services by indigents and patients in general.

He said so far he knew of two hospitals in the province, both privately-owned, who have tele-medicine platforms with their patients. But he said the local government-ran health centers should offer it to indigent patients, too.

A physician serving in an RHU in the province said the number of non-COVID patients submitting themselves for face to face check-up has reduced.  The physician cited the cases of hypertension, diabetes, minor wounds, among others.

“Mas daghan sa text (SMS) and Messenger,” added the doctor. BukidnonNews.Net was unable to obtain permission to identify.  The doctor said though their RHU has no official teleconsultation set up, the physician caters to the service by personal initiative. The physician said it involves responding to patients via SMS, phone call or Messenger chat.  

BukidnonNews.Net tried but failed to get a response from the Provincial Health Office about the issue of setting up telemedicine platforms.

H.N, a mother of a four year old boy with pneumonia, said they hoped there was a tele-medicine service, which they could have availed during the time they were unsure about their condition. They had to go to a private hospital for face to face check-up. They later tested positive to COVID-19 but were allowed to go on home quarantine.  (BukidnonNews.Net)  

IN PHOTO: A staff of the Malaybalay City Health Office briefs residents who queued for vaccination at the Malaybalay City Covered Court in Brgy. 4. BukidnonNews.Net file photo    

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