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Telehealth as a tool to achieve universal health care

When Republic Act No. 11223, or the Universal Health Care (UHC) Law, was enacted in 2019, it paved the way for the automatic enrollment of all Filipino citizens in the National Health Insurance Program under the Philippine Health Insurance Corporation (PhilHealth), granting eligibility to health benefits packages.

It meant that Filipinos are now eligible for preventive, promotive, curative, rehabilitative, and palliative care, and PhilHealth will have expanded coverage to include free consultation fees, laboratory tests, and other diagnostic services.

However, as the implementation of the law was underway, the Covid-19 pandemic happened and it revealed the vulnerability of our health care system, most especially the lack of public health facilities and medical professionals.

According to the Department of Health (DOH), the doctor-to-population ratio in the Philippines in 2022 was at one physician serving about 26,000 people. Aside from being far from ideal, what is more concerning is the disparity among regions. In the National Capital Region (NCR), the population-to-doctor ratio was at one physician serving about 15,300 people. But in Region 11, which has the highest doctor-to-population ratio, it was at 40,680 people for every one physician.

In terms of medical facilities, this imbalance is also very evident. 

As of Dec. 31, 2022, there were 119 level-3 accredited hospitals by PhilHealth in the country, 59 of which are within Metro Manila, while the rest are in different regions. In Regions 8, 9 and 12, they only have one level-3 hospital each. Level-3 or tertiary hospitals are those that can provide all kinds of health services.


Promotive and preventive care 

It will take several years before we can fill in the gaps in medical infrastructure and manpower. Thus, it is essential that we put equal focus on promotive and preventive care, and use digital tools to maximize our manpower and resources. This way we can also lessen the pressure on our hospitals and prevent health worker strains.

Utilizing digital infrastructure such as telehealth can greatly improve healthcare access for the country’s underserved populations.

In India, the Apollo Telemedicine Networking Foundation, the oldest and largest multi-specialty telemedicine network, uses a combination of teleconsultations, remote diagnostics, and health education to provide healthcare services in remote areas.

In Africa, various projects use mobile health units equipped with telemedicine capabilities to provide healthcare services in remote regions.

Here in the Philippines, the DOH has launched telemedicine services to provide consultations and follow-up care to remote areas. These services have been crucial during the Covid-19 pandemic, ensuring continuity of care while minimizing physical contact.

The Department of Science and Technology (DOST) has been distributing the RxBox in rural health units across the country, particularly in identified Geographically Isolated and Disadvantaged Areas (GIDAs). 

The RxBox is a biomedical device capable of measuring a patient’s vital signs, such as temperature, blood pressure, heart rate, oxygen saturation, uterine contractions, and electrocardiogram readings. Through this device, patients can easily monitor their health and share this information with their healthcare provider, enabling prompt medical interventions and reducing the need for in-person visits.

In order to further develop, promote and advance the use of telehealth in the Philippines,  government policies must be present, and all the components necessary to make this work must be put in place.

High-speed internet and mobile connectivity are very crucial for the effectiveness of telehealth services. The availability of video conferencing tools, online portals, and mobile health applications will enable virtual consultations and patient management; but this also means that both patients and healthcare providers must know how to use these devices.

Other tools that can maximize the effectiveness of telehealth are remote monitoring devices such as smartwatches, fitness bands, digital thermometers, pacemakers; as well as health information systems such as digital databases and cloud storage solutions to allow healthcare providers better access to patient records, diagnostic images, and test results.

We also look forward to the passage of legislation that will provide a policy framework, dictate the direction, and regulate the practice of telehealth in the country.

Digital technology, particularly telehealth, is already giving us an opportunity to bridge the gaps in our healthcare systems, especially in the countryside. We only need to push harder and double our efforts to leverage this technology to make our healthcare services become more accessible, cost-effective, and timely for rural and underserved populations.

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