How Digital Solutions Improve Philippine Public Health

DOST’s Balik Scientist Dr. Arnulfo “AJ” Rosario, Jr. writes what made him delve into the world of public health informatics and improve the Philippine healthcare system with SeeYouDoc and Pivotal Peak.

The implementation of public health informatics in the Philippines needs much improvement. The reality striked me during my clinical years as a medical student back in the late ‘90s — that’s the time when I went to the hospital, from just reading books to actually being there with the patients.

Back then, everything was manual. On top of handling countless cases we had to painstakingly write down patient medical records and transcripts from doctors before typing it all down with a typewriter. But aside from these workflow issues that made lending service inefficient for us medical practitioners, we could see that the lack of technology and infrastructure needed to provide healthcare services really affected our patients more than anyone else.

For my first assist for a surgery in OB, I had to aid a cesarean section. When I was about to get the baby out, unfortunately, there was a brownout. It was dark at night and there were no generators or even emergency lights to help us out. Worse, there wasn’t an accessible phone that we can use to call others for assistance, so we ended up losing the baby.

The tragedy really told me that the healthcare system should improve — technology-wise including the communication process. It made me really want to contribute, sparking my dreams of going into public health to be part of the policy makers or be an innovator.

This passion is what ultimately led me to collaborate with leading eHealth startups in the country. As Co-Founder and Chief Medical Marketing Officer of SeeYouDoc Corp. as well as Pivotal Peak Digital Health Solutions, Inc (Pivotal Peak PH)’s President and Chief Executive Officer, now I’m working with a team of digital solutions pioneers to make an efficient healthcare system a reality.  

Finding opportunities for growth

But years before I could even begin working with the promising start-ups leading the change in the country, I first had to widen my outlook and develop my expertise in public health informatics. Luckily, an opportunity came when, while at an American Public Health Association conference in the US, I got invited to apply for a Public Health Informatics Fellowship program organized by the United States’ Centers for Disease Control and Prevention (CDC) in 2002.

Back then, public health informatics was a new field of study being developed. But what is public health informatics really about?  In an article included in  the Journal of Public Health Management and Practice published in 2000, Dr. William Yasnoff and Dr. Patrick O’Caroll defined it as “the systematic application of information and computer science and technology to public health practice, research, and learning.”

As public health informaticians, we are the mediator when it comes to improving the innovation systems of the medical field. Prior to having this kind of practice, previously there was only an IT guy and a doctor, but now, we are the bridge between the two. We learned critical competencies including project, information, and change management so that we could properly implement, evaluate, and apply the technology -- both hardware and software — so that they are fit with the local medical setting.

Proper implementation of digital solutions in our healthcare systems would lead to an overall improvement in our communications, workflow, and more importantly, service delivery. Studying all this in the US, I became the first Filipino public health informatician trained by the CDC. And through the Balik Scientist Program of the Department of Science and Technology (DOST), I am able to share these experiences I gained with CDC for implementation in our country.

Learning from experience

Through my work overseas, it became apparent that our countries faced similar issues. There, patients’ access to healthcare was also impeded by the fact that the country had a huge land area. Travelling across distances was a huge problem for them.

Similarly, we have about 7,107 islands and are separated by these islands. To go to a hospital or clinic, sometimes a patient needs to travel barefoot down from mountains or sail across seas.

In the US, the use of healthcare innovations like telemedicine systems helped solve the situation and link patients to clinics. We’d like to implement the same thing here by working with eHealth startups like SeeYouDoc dedicated to developing healthcare innovations for the Filipino people.

Developing digital solutions

Until recently, the use of telemedicine in the Philippines was limited. Before the pandemic, communication was only used by health workers on-site to refer a patient to another specialized professional. Sometimes, for more pressing cases, healthcare providers in remote areas would also use their phones or the internet to ask for help in diagnosis and treatment from another expert.

As tragic as it is, the pandemic pushed us to develop our healthcare systems and innovations further. Telemedicine has evolved, and now, patients can go and get medical help from a doctor in the comfort of their homes through apps like SeeYouDoc. In fact, SeeYouDoc has been pioneering in introducing telemedicine to DOH. The startup was at the forefront of getting volunteer doctors to use eHealth platforms to provide medical services to Filipinos who had found difficulties in securing check-ups due to heightened hospital restrictions.

Part of the Asian Institute of Management - Dado Banatao Incubator (AIM-DBI) THINCOHORT 2020-2021 Program, SeeYouDoc is a comprehensive marketplace, booking, and telehealth platform for Filipinos. Aside from making booking consultations more convenient for patients, SeeYouDoc is also doubling their efforts to make work and management easier for doctors, clinics, hospitals, and medical societies easier with apps like SeeYouDoc MD, SeeYouDoc MC, SeeYouDoc MH, and SeeYouDoc MC.

Breaking the barriers

We’re not that far behind in learning because now we have the internet and Filipinos that are being trained abroad willing to share their expertise here. However, a number of obstacles are hindering our efforts of implementing public health informatics in the Philippines.

Aside from taking into consideration the lack of funding and infrastructures to enforce these innovations, we also really need to customize our systems based on the needs, culture of the nation, and the laws of the land. Some of the projects really boils down on how the community or the population receives them. Things that you learn in another country might not be easily embraced by the community or the population, so you need to tweak what you learn a little bit.

Right now it’s still a challenge to have health professionals use the innovations. Millennials are born with the internet and cellphones, but some practitioners in the age range between 50 to 60 don’t embrace it.

It’s a learning curve so we need to properly teach the doctor. In SeeYouDoc, we take the time to provide demos for our partner doctors so they can seamlessly use the app to properly deliver their services. This change management is necessary, because once these skills are instilled in doctors, they can be champions for the technology and influence more to use it.

We never thought of those innovations when we were medical students, so it’s good that medical schools are starting to teach them as early as now. Last year, SeeYouDoc partnered with a leading medical school in the Philippines to provide their medical students an exclusive platform where they can learn and practice telemedicine. This way, our future doctors would be more well-equipped in incorporating digital solutions to their practice.

The future of public health informatics

While we’re taking steps to solve these issues, of course, we’re continuing through our plans of developing public health informatics here in the country. SeeYouDoc aims to be a digital healthcare ecosystem, a one-stop-shop that would enable you to access the medical services you need through your mobile phone. We’re also working on developing the SeeYouDoc app to be used for medical missions, aiding local and overseas non-profit organizations in providing medicines and other healthcare remotely.

Not to mention, SeeYouDoc is also working with Pivotal Peak. The University of the Philippines (UP) Manila’s spin-off digital health startup has the exclusive license of UP Manila to distribute the pioneering Electronic Medical Record (EMR) System called the Community Health Information Tracking System (CHITS). With this partnership, SeeYouDoc platforms will be upgraded with this innovative technology. Soon, this will allow doctors to store and share medical records to another specialist, wherever they may be across the country, to help the referral and treatment of their patients.

To aid in the development of the Universal Healthcare (UHC) vision of the Philippines, SeeYouDoc is also hoping to develop a Telemedicine Data Dashboard to monitor trends and performance of virtual consults in the country.

Finally, to foster a collaborative environment for our health professionals and innovators, it would be great if we can develop an academic consortium connecting medical schools across the country. There we can all share our ideas and experiences so that the future doctors will benefit from it.

It takes a lot of collaborative effort and dedication on the part of our innovators and healthcare professionals but once we overcome these challenges, the advancement of public health informatics in the Philippines will really push through.