What should health care look like?

I came across My Vision of Ideal Healthcare System by Abhinav Shashank on my Twitter feed last Christmas. I thought it was the perfect topic for the first #HealthXPH tweet chat for 2017!

Shashank enumerated 5 elements of an ideal healthcare system. Let me discuss these elements as I see it in Philippine healthcare.

Patients are the primary focus.

No one will argue that patients should actively be involved in deciding about their health. Low health literacy remains a barrier though as I have seen both in my clinic and on my Facebook page www.facebook.com/EndocrineWitch. The questions that readers post on my Facebook page reflect misconceptions about disease management. They also express confusion about what the doctor tells them and the information they get from others or online.

Information flow is streamlined.

This element refers to electronic health records. Much of healthcare in the Philippines is paper-based though there are some hospitals that have electronic health records. The national ehealth vision states –

By 2020, ehealth will enable widespread access to healthcare services, health information and securely share and exchange patient information in support of 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.

Establishment of the Philippine Health Information Exchange (PHIE) is underway. According to the Joint Administrative Order 2016-0001 by the Department of Health, Department of Science & Technology and the Philippine Health Insurance Corporation –

The PHIE is envisioned to become an integral component of the health care delivery system as part of health services available to all patients. It shall integrate and harmonize health data coming from different electronic medical record
systems and hospital information systems. It shall provide an infrastructure for data/ information sharing between health care providers, and support access to patients’ records across providers in all geographic areas of the country; thereby, improving efficiency and
reliability of communication among participating
health care providers. In general, its implementation shall promote public health, improve total patient care and better decision
making, while safeguarding the right to privacy
of every individual.

Innovation-driven healthcare improves outcomes and reduces costs.

Cost is always an important consideration for developing countries like the Philippines. It is not surprising that there are many working on using SMS for healthcare in the Texting Capital of the World.

My thesis student Aldren Gonzales won Best in Oral Presentation at the Ideas Positive National Youth Forum on Public Health last August 2016 for his paper, Design, Development and Formative Evaluation of iNANAY – an SMS-based Information Service for Maternal and Child Health Promotion in San Roque, Northern Samar.

Smartphone use is also rising in the Philippines from 40% in 2015 to a projected 70% in 2018. This will improve access to mobile apps for healthcare.

Ideas Positive of the Unilab Foundation recently announced the 15 youth team finalists who submitted innovative ideas for a #healthierPH. A team from UP Manila is developing an app for persons with hypertension.

Health insurance does not equal healthcare.

The 2017 government budget includes an allocation of P53.22 billion to fund universal healthcare for Filipinos through Philhealth, the national health insurance agency. Under the “No Balance Billing” of the Amended National Health Insurance Act, indigent patients will not have copay in government hospitals.

As an endocrinologist, I strive to keep my patients healthy enough so that they don’t need to be hospitalized. Outpatient medications and counseling by nutritionists are not reimbursed yet by Philhealth. So yes, I agree that health insurance does not equal healthcare.

Healthcare is affordable and equitable.

The Department of Health has pushed for Kalusugang Pangkalahatan (Universal Health Care). It is the –

provision to every Filipino of the highest possible quality of health care that is accessible, efficient, equitably distributed, adequately funded, fairly financed, and appropriately used by an informed and empowered public.

The three strategic thrusts of this program are:

1) Financial risk protection through expansion in enrollment and benefit delivery of the National Health Insurance Program (NHIP); 2) Improved access to quality hospitals and health care facilities; and 3) Attainment of health-related Millennium Development Goals (MDGs).

It is apt that we discuss our vision for an ideal healthcare system at the first #HealthXPH tweet chat for 2017 on Jan 7, 9 pm Philippine time. See you!

T1 What is your vision of an ideal healthcare system?

T2 What changes need to occur to attain your ideal healthcare system?

T3 How do you personally plan to contribute in achieving your ideal healthcare system in 2017?