1. The ABCs of Telemedicine Alvin B. Marcelo, MD UP Manila National Telehealth Center

3. Current definition

4. The Philippine healthcare situation

8. 1954: Teleradiology

9. 1959: Telepsychiatry

10. 1970s: NASA

13. Transmission of still images

14. eHealth including patient portals

15. Remote monitoring of vital signs

16. Continuing medical education

17. Nursing call centers American Telemedicine Association, 2010

19. Patient consultations

20. Remote patient monitoring

21. Medical education

22. Consumer medical and health information services

24. Point-to-point connections

25. Primary or specialty-care to home connections

26. Home to monitoring centers

27. Web-based eHealth patient service sites

29. Many areas with no access to doctors

30. Traveling for simple consults not cost-effective

31. Bottomline: no access to primary care practitioners/specialists until conditions become severe

33. eLearning

34. eMedicine

36. Held e-Learning sessions in several provinces (Capiz, Nueva Vizcaya, Quezon, Bicol, Batanes, Cebu)‏

37. eLearning for Health

38. eLearning for Health

40. Telemedicine at UP Manila

42. SMS, MMS, Email telemedicine

43. Facilitated Referrals

44. DOST Telemedicine Project

46. Ten sites in four provinces (portal, computers, workstations, training, fast Internet) ‏

47. After two years – 8 referrals only

49. Provincial Health Office

50. Cagayan State University

53. Roxas Memorial Provincial Hospital

54. Sigma Municipal Health Office

56. Mindanao State University - Gregorio T. Lluch Memorial Hospital

57. CHITS

58. After enhancement Doctors-to-the-barrios 2008: n = 58 2009: n = 124

62. SMS Telemedicine 3 day old male, home delivered by untrained hilot with CC of fever for one day duration. PE patient is febrile (38.5C), irritable and with poor suck (as observed). im referring this to the hospital for neonatal sepsis. the weather here is so bad ... they could not yet travel by the sea. i do not have IV meds so i just prescrived co-amoxiclav and paracetamol per orem as temporary management.

63. SMS Telemedicine please avoid co-amoxiclav coz it might cause hepatotoxicity; short of bringing the patient to the hospital, you may give ampicillin 100 mg/k/day IM q12. if ampicillin is unavailable, you may give cefalexin 100 mg/k/day q8 oral

64. TeleDermatology

65. TeleOphthalmology REFER LOR 55 Female suddenly lost sight after 'hitting a spider' she felt on her eye.

67. TeleRadiology

68. TelePsychiatry

69. Facilitated Referral

73. Use appropriate technology BuddyWorks Lessons

74. Web-based Telemedicine

77. RxBox – telemedicine device

78. TRIAGE – central coordinating system

79. EXPERT – transaction system for poisoning

80. RxBox

81. Expert Interface

83. Provincial Health Office (PHO) ‏

84. Center for Health Development – Department of Health (CHD-DOH) ‏

85. Philippine Health Insurance Corporation (PHIC) ‏

86. UP Manila – National Telehealth Center (UPM-NThC) ‏

87. Congressional Commission on Science and Technology and Engineering (COMSTE) ‏

88. The ABCs of Telemedicine

90. There should be pre-existing relationship between the two parties (or at least the facilitation of an accepted 'broker')

92. Must be acceptable to both parties

93. Must be appropriate (don't expect fast Internet in remote areas of the country)

95. Preparing connection

96. Maintaining connection

97. Exchanging information between two parties

98. Post-conference documentation

100. B bridge – use most appropriate connection

101. C control – follow guidelines and document