1. University of the Philippines Manila National Telehealth Center
mHealth in the
Philippines
Alvin B. Marcelo, MD

2. Goals for this Presentation
Provide examples of how we use mobile phones for health in the Philippines
Present results of our research on using mHealth for delivering care to remote underserved areas

3. State of (ill-) health: Why?
Philippines
90 million people
Growing at 2 million per year
7,107 islands
Maldistribution of doctors and nurses to urban areas and few/none in rural areas

4. Opportunity for mHealth
Philippines
Three wireless providers
75% penetration rate (with several having more than one line)
“the texting capital of the world with 2 BILLION text messages exchanged everyday”

5. OneHEALTH Program eMedicine (Telemedicine) eLearning for Health
eRecords (CHITS)

6. Telemedicine in the Philippines
6 years of experience and
collaborations with DOH-DTTBs
with research support from DOST
RESEARCH
SERVICE
DOST, 2008
CICT
2004
Our experience with IT started in 2004 when UP Manila and DOH received a grant from CICT to design and implement telemedicine services through the BuddyWorks Project.
Over the next 6 years, with additional support from various funders such as DOST, IDRC, USAID, and UNDP, we are now ready to translate our research into service and to align information technology within the Aquino Health Agenda.
DTTBs

7. How do we do Telemedicine?
We train health workers how to use the cellphone to effectively collaborate with doctors, specialists, and other health workers in their region.

8. TELEMEDICINE How it Works
Internal
Medicine
Doctor-to-
the-Barrio
Pediatrics
Radiology
NTSP
Central
4th, 5th, 6th class LGUs
Dermatology
Doctor-less
site
The transaction starts when a health worker encounters a case beyond his or her capacity to manage.
Using text or , the health worker describes the situation and sends it to NTSP Central where a triage nurse relays it to the appropriate domain expert.
The domain expert may opt to respond by text, or voice call as is necessary.
This exchange can occur once or as frequent as is needed until a case is deemed resolved.
And all transactions are recorded at NTSP Central for documentation purposes.
Ophtha
*** Ethical, legal, and social framework
for the practice of telemedicine
Others
PGH and DOH regional hospitals

9. TELEMEDICINE How it Works
We built a network of doctors.
We defined guidelines and protocols.
We trained the network.
We use SMS, MMS, voice and .
The transaction starts when a health worker encounters a case beyond his or her capacity to manage.
Using text or , the health worker describes the situation and sends it to NTSP Central where a triage nurse relays it to the appropriate domain expert.
The domain expert may opt to respond by text, or voice call as is necessary.
This exchange can occur once or as frequent as is needed until a case is deemed resolved.
And all transactions are recorded at NTSP Central for documentation purposes.
PGH and DOH regional hospitals

10. Stories of Telemedicine

11. Skin Diseases among Tribesmen
A young doctor with a cellphone saw a unique skin problem among the tribesmen
Using his cellphone camera (with patient consent), he referred the case to Manila
Dermatologist recognizes the problem as a rare skin disease and asks for more examinations
Young doctor complies and sends confirmatory images
Patients got treated appropriately and in a timely manner

17. Results
Telemedicine is possible in geographically isolated and disadvantaged areas (GIDA)
Telemedicine is fraught with ethical, social, and legal challenges (read: should only be done by trained health professionals and certified personnel). Protocols are important.
Telemedicine is expensive for few sites, but costs go down with more sites

18. NTSP National Telehealth Service Program
We are now in the process of finalizing a grant from the Government to offer the services on a national scale.

19. Thank you for listening