Connecting patients, docs in faraway places

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Saturday, May 10, 2014

MARIO, now 68, lives in a remote barangay in Bansalan, Davao del Sur. He said that he had never been to a hospital when he was still younger. But lately, he has a hard time seeing things. Since he could not move well, as he used to do, he gained weight.

He would never know what he is suffering from had it not been for a medical mission conducted in their area. His younger brother helped him to join the other residents. One of the doctors examined him closely. He was told that the reason his vision was waning was due to diabetes.
Mario was still lucky. He found out what disease struck him. But others living in far-flung areas don’t have such blessing. In fact, 60% of the 94 million Filipinos today die without seeing a doctor.

The reasons for such high rate: lack of medicines and other life-saving technology, improper distribution of health workers, geographic isolation (particularly those in the islands or without electricity), and commercialized medicine (expensive and out of reach of the poor people).


So, how can these deprived people be helped? To think of, the government launched the KalusugangPangkalahatan or Universal Health Care (UHC). “Inspite of the gains of the health sector,” said a statement released by National TeleHealth Center (NTHC) during Regional Forum on eHealth in Marco Polo, “the challenge of delivering improved health care services remains.”

One of the constraints identified is “the availability of, access and equity of access to, health professionals and health facilities,” adding that “90% of specialists and 60% of tertiary hospitals are in urban areas.”

Another constraint is “the archipelagic nature of the country where there are many geographically isolated and disadvantaged areas.”

One possible solution: maximizing the established benefits of information and communications technology (ICT) in health care. Doing so will “enable communication and connect patients, health technology, and health providers.”

Thus, the idea of RxBox came into existence. Touted to be “one of the most important tools generated by the research community,” RxBox is a multi-component program designed to provide better access to life-saving health care service in isolated and disadvantaged communities in the country. It is among the efforts of the Department of Science and Technology (DOST) for so-called “Smarter Philippines.”

The NTHC is targeting about 140 sites by the end of the year from the current 21 sites. It wants to have an additional 1,000 more units to be rolled out by 2015.

“We want the device to be placed in areas where doctors are hard to find and traveling to the cities is a big problem,” said Dr. Kristine Mae P. Magtubo, a resident doctor at the NTHC, which is based at the University of the Philippines in Manila.

The RxBox is a product of NTHC’s collaboration with the Electronics and Electrical Engineering Institute of the UP Diliman and the DOST’s Advanced Science and Technology Institute. Funding the project is the Philippine Council for Health Research and Development of the DOST. An RxBox unit costs around P100,000. But should it be multi-produced, the cost can be lowered to P80,000.

Different sensors

According to Dr. Magtubo, the RxBox has a sensor that can measure the patient’s blood pressure to detect cardiovascular problems, especially hypertension. It also has an electrocardiogram (ECG) which can monitor the heart’s movement. “This is helpful for people with acute and chronic heart problems,” she said.

Another sensor is the pulse oxymeter, which can measure the level of oxygen in the patient’s blood. “This sensor can help detect lung and cardiovascular problems,” Dr. Magtubo claims.

There is also a fetal heart monitor (that measures the baby’s heart rate while in the womb and can help detect fetal distress at critical times of the pregnancy and delivery) and maternal locometer (which measures the strength of contraction of the mother’s uterus especially during delivery).

Through the Rxbox, patients in far-flung areas may receive advice from doctors and health workers situated elsewhere.

“The RxBox can capture medical signs with its built-in sensors, save the data in an electronic medical record (using the Community Health Information Tracking System or CHITS), and transmit the information via internet to clinical specialists in the Philippine General Hospital,” Dr. Magtubo explained.

TV White Space

When the DOST’S Information and Communications Technology Office (ICTO) heard of the RxBox project, they saw a golden opportunity to link the RxBox to one of their flagship projects: TV White Space (TVWS). It refers to the vacant frequencies located between broadcast television channels in the VHF and UHF range; it is located between 54 MHZ and 806 MHZ.

“Currently available TVWS equipment can deliver up to 6 Mbps of data throughput at a maximum range of 10 kilometers,” explained ICTO in a fact sheet. “TVWS long range means that less base stations are required to provide coverage for a given area compared to existing wireless technologies.

“TVWS is an extremely cost effective means for internet/data delivery and quick deployment,” ICTO added. It has proven its worth during the post Disaster Internet Connection implementation in the stricken areas of Bohol earthquake and typhoon Yolanda.

Bettina Quimson, Assistant Secretary for Society in the DOST-ICTO said the department is still not implementing TVWS in full blast yet. “We're actually rolling this out slowly,” she pointed out. “It’s a new technology and there are some policies that need to be addressed specific to this because we’re using the unused spectrum of the broadcasters on TV and TV White space.”

Published in the Sun.Star Davao newspaper on May 11, 2014.


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