Telemedicine - A Legacy
I was into telemedicine or telehealth activities (see definitions below) as early as 1990 in my Zamboanga telemedicine projects. Because of this, I like to think that I am one of the pioneers in telemedicine in the Philippines.
I use telemedicine mainly for teaching surgeons, physicians, medical students, hospital administrators, and the public. Topics include general surgery, general medicine, hospital administrations, hospital disaster preparedness programs, how to live life, etc.
My telemedicine activities have one central goal: Education for Health Development in the Philippines.
I have used and still use up to now email groups of yahoo then gmail for telemedicine.
I have also used the free websites - Tripod.com (not using it anymore after 2008 - but some of my posts are still in the Net); Google Sites; Wordpress.com; YouTube; Slideshare; and Scribd.
In June 16, 2011, I started using Facebook for my telemedicine activities. Aside from teaching the public, I allow selective online medical consultations, in Facebook and in my emails.
Being one of the pioneers of telemedicine or telehealth in the Philippines and with a lot of experiences (see the Net and am still into it up to now - 2018), I like to consider telemedicine or telehealth as a legacy I leave and will leave behind - Telemedicine or Telehealth for Education for Health Development in the Philippines.
Websites
The websites that I created in Tripod.com from 1990 to 2008. (I think I stopped using Tripod.com after 2008. After 2008, I started using Google Sites and Wordpress.com)
Total of 36
2010 - websites created.
Documents show that I shifted from Tripod.com to Google Sites and Wordpress.com (doing this up to the present - 2018). I probably stopped creating a websites in 2009 as I don't have records.
2011 websites created.
Total of 72 as of 2011
I stopped tracking the number of websites that I have created as of 2014. Total websites, though, as of end of 2013 - 207.
Aside from Tripod.com, Google Sites and Wordpress.com, I also posted in YouTube, Slideshare, Scribd and Facebook (up to the present - 2018). Click on the following links to get some detailed info and statistics.
EMAIL GROUPS FOR INTERNAL COMMUNICATION AND KNOWLEDGE MANAGEMENT SYSTEM
I created 3 email groups in 3 institutions, namely for staff of the Department of Surgery of Ospital ng Maynila Medical Center; staff of the GSI Division of the Department of Surgery in Philippine General Hospital; and the Senior Management Team of Manila Doctors Hospital.
OMMC SURGERY EGROUP
I established the OMMC Surgery Egroup in 2002 as a means for internal communication and knowledge management system. It is still on even after my retirement in January 31, 2014.
https://rojosonommcsurgeryfilesandnotes.wordpress.com/2017/02/05/ommc-surgery-egroup-still-on/
GSI EGROUP
In 2006, I established the UP-PGH GS1 Yahoo Egroup.
I am happy to see that it is still functioning despite the dwindling subscription of the new rotating residents and fellows since about 5 years ago. (from a post in 2015).
The latest conversations that we had and which I appreciated, came from Bong Layug, a GS1 Head and Neck Surgical Oncology Fellowship graduate in 1992. I copied below the conversations to show that the GS1 Egroup is an important tool and venue for
1. Continuing medical- surgical education
2. Sharing of information
3. Exchange of ideas
4. Teaching and learning
https://rojosonuppghgs1filesandnotes.wordpress.com/2015/07/29/up-pgh-gs1-egroup-yahoo-group/
MANILA DOCTORS HOSPITAL SENIOR MANAGEMENT TEAM EGROUP
I created it in October 29, 2003 for internal communication and knowledge management system of the Senior Management Team of MDH.
https://rojosonfacebooknotes.wordpress.com/2012/09/18/mdh-smt-egroup-at-9th-year-what-now-2/
OTHER EGROUPS - MAINLY FOR MY ONLINE COLLABORATIVE AND INTERACTIVE LEARNING PROGRAMS
I have also created a lot of other egroups under my Online Collaborative and Interactive Learning (OCIL) Programs on Surgery, Hospital Administration, Hospital Disaster Preparedness Program, etc. Examples of egroups that I created are those for Ciudad Medical Zamboanga; for Salubris Medical Center; for Zamboanga City Medical Center; and for the Zuellig Family Foundations' Maternal Death Control Program in Zamboanga Peninsula.
OCIL - Online Collaborative and Interactive Learning
I officially started doing OCIL – Online Collaborative and Interactive Learning - informally when I started creating websites in 1990. This was reinforced by the establishment of egroups (earliest was 2002). However, the first formal and structured OCIL was done in 2010 (OCIL on Admitting Services in the Hospital Setting). [NOTE: The international Coursera courses started in 2012.]
What is an online collaborative and interactive learning (OCIL) program in a hospital setting?
• Learning program being conducted in a hospital
• conducted online, using either the Internet or intranet
• with learning being effected collaboratively with online interaction not only among the learner participants but also with the facilitator
• Online communication and interaction can be done through •emails (particularly group emails, such as the Yahoo egroups or Gmail group emails in the Internet or emails in the intranet of a hospital) •online real-time conference or chatting
• Lot of FREE information technologies in Internet that can be tapped for online collaborative and interactive learning Websites and webpages and blogs Facebook and Twitter
• Learning program in OCIL there must be a formulated and agreed upon learning curriculum or learning plan with specified objectives, contents, learning activities, and evaluation methods.
• The learning program can be on any topics as long as they are relevant to the activities of a hospital. It can be part of the continuing education program for the staff of the hospital or it can arise from a training need assessment of staff.
The OCIL can be applicable in any other setting (outside the hospital).
Facilitating Tools in Online Collaborative and Interactive Learning
Whenever I conduct Online Collaborative and Interactive Learning on any topic, I usually use the following facilitating tools (as of March 15, 2016):
Facebook Groups
Googlegroups
Google Sites
Cellphones
The FB Group is more for informal communication.
The Googlegroups is more for formal communication.
The cellphones will be used for urgent communication.
The Website is for formal communication and posting of “documented information.”
All the above shall be complementary to each other to achieve effective, efficient and closed-loop communication.
https://www.slideshare.net/rjoson/ocil-nandy-13nov19typo14mar7
DISTANCE EDUCATION IN GENERAL SURGERY IN ZAMBOANGA CITY MEDICAL CENTER
A distance education is considered a telehealth or telemedicine program.
From 1991 to 1997, I conducted a formal distance education in General Surgery in Zamboanga City Medical Center.
The details are contained in these links:
https://www.facebook.com/media/set/?set=a.959774160839309&type=1&l=25bf45e36e
https://www.facebook.com/media/set/?set=a.959334280883297&type=1&l=65fda6c349
TELECONFERENCING AND TELEVIDEOCONFERENCING IN MEDICINE
In March 1994, with the support of Dr. Art Pesigan, head of the Open University of UP Manila, I was conducting teleconferences using audio equipment with surgical resident-trainees of Zamboanga City Medical Center (formerly Zamboanga Regional Hospital) with me in Manila. Below is the abstract of a paper that I published in 1995.
Teleconference as a learning mode for surgical trainees based in Zamboanga City.
The University of the Philippines Manila Journal
June 1995 1(1):22-25
Teleconferencing is a form of distance education in which a conference is held between two parties who are not face-to-face with each other. This paper describes the authors experience with teleconferencing using audio equipment as a learning mode for surgical trainees based in Zamboanga City (ZC). Teleconferences were utilized in the authors General Surgery Course in ZC starting March 1994. The objectives were to evaluate the progress of students learning in the General Surgery course, to provide more teaching and learning activities, and to promote more frequent interactions between the ZC students and Metro Manila faculty. The design made use of active student learning and participatory activities, such as case discussion, panel discussion, and debate. At the end of five teleconferences held so far, the objectives were assessed to have been attained and teleconferencing will continue to be used to enhance the General Surgery Course of the author.
(see photo evidences in the link below)
In 2016, I started using Skype for televideoconferencing.
I did Teleconference Activities with various provincial groups of learners. I did not have to physically go to the provinces to conduct learning sessions as often as I should. I just stayed in my house in Metro Manila and conduct the distance education mode of learning to provincial learners. In 2016, through the Teleconference Activities, I taught hospital administration, quality management system, safety promotion and disaster preparedness program and public health (maternal and neonatal death control management system).
I started the 2016 Teleconference Activities with Zamboanga City Medical Center Maternal Death Control Management System Team in March 31, 2016 using Skype, followed by a series of teleconferences with the Team thereafter for the whole year of 2016. (see photo evidences in the link below)
I then did Teleconference Activities with staff of Salubris Medical Center in Nueva Vizcaya starting April 27, 2016 and continued them throughout the whole year of 2016 at practically once every 2-week interval. (see photo evidences in the link below)
Then, I facilitated the external auditing of the Zamboanga City Medical Center Neonatal Death Control Management System in May 25, 2016 together with Dr. Ramir Blanco and Dr. Luz Ayuza of Zuellig Family Foundation using Skype with Dr. Blanco, Dr. Ayuza and I in Metro Manila while the auditees were in Zamboanga City. (see photo evidences in the link below)
Then, I did Teleconference Activities with Zamboanga del Norte Medical Center Maternal Death Control Management System Team on June 9, 2016. (see photo evidences in the link below)
Then, I did Teleconference Activities with Zamboanga City Medical Center Earthquake Business Continuity Committee starting June 15, 2016 and continued them throughout the year ending with the Business Continuity Response Exercise in November 21, 2016. (see photo evidences in the link below)
Lastly, I facilitated the external auditing of the Zamboanga City Medical Center Maternal l Death Control Management System in November 23, 2016 together with Dr. Ramir Blanco of Zuellig Family Foundation using Skype with Dr. Blanco and I in Metro Manila while the auditees were in Zamboanga City. (see photo evidences in the link below)
I like to thank Dr. Arturo Pesigan for facilitating my telemedicine activities.
https://rojosonfacebooknotes.wordpress.com/category/teleconferences/
https://rojosonuppghgs1filesandnotes.wordpress.com/2017/12/15/telemedicine-activities-rojoson-1997/
TeleHealth and TeleMedicine
Commonly synonymous and used interchangeably
Telemedicine, a term coined in the 1970s, which literally means “healing at a distance”, signifies the use of ICT to improve patient outcomes by increasing access to care and medical information.
WHO definition in 2007 - “The delivery of health care services, where distance is a critical factor, by all health care professionals
using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities”
Some distinguish telemedicine from telehealth with the former restricted to service delivery by physicians only, and the latter signifying services provided by health professionals in general,
including nurses, pharmacists, and others. However, for the purpose of this report, telemedicine and telehealth are synonymous and used interchangeably.
Four elements are germane to telemedicine:
1. Its purpose is to provide clinical support.
2. It is intended to overcome geographical barriers, connecting users who are not in the
same physical location.
3. It involves the use of various types of ICT.
4. Its goal is to improve health outcomes.
ICT - Information and Communication Technology
ICT refers to technologies that provide access to information through telecommunications. It is similar to Information Technology (IT), but focuses primarily on communication technologies. This includes the Internet, wireless networks, cell phones, and other communication mediums.
http://www.who.int/goe/publications/goe_telemedicine_2010.pdf
https://www.aafp.org/media-center/kits/telemedicine-and-telehealth.html
What is telemedicine?
Telemedicine is the practice of medicine using technology to deliver care at a distance. A physician in one location uses a telecommunications infrastructure to deliver care to a patient at a distant site.
What is telehealth?
Telehealth refers broadly to electronic and telecommunications technologies and services used to provide care and services at-a-distance.
What’s the difference?
Telehealth is different from telemedicine in that it refers to a broader scope of remote health care services than telemedicine. Telemedicine refers specifically to remote clinical services, while telehealth can refer to remote non-clinical services.
References:
https://sites.google.com/site/rojosonwebsites/home
https://rojosonzcmcsurgerycourse.wordpress.com/
https://rojosonzcmcsurgerycourse.wordpress.com/category/evaluation-of-operative-skills/
https://rojosonuppghgs1filesandnotes.wordpress.com/2017/12/15/telemedicine-activities-rojoson-1997/
https://www.slideshare.net/rjoson/ocil-nandy-13nov19typo14mar7
https://www.slideshare.net/rjoson/phap-ocil-rj10nov12142123long
ROJ@18nov16