Philippine Quality Healthcare: Excellence is the Standard

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A good number of those who have served in prestigious US hospitals have returned to the Philippines to cascade their knowledge to younger practitioners and to head the departments of the renowned medical hospitals and centers.

Philippine medical institutions aim for quality health care. They go through rigorous procedures using standards that are internationally acceptable.

They forge partnerships with external agencies, who themselves have to go through licensing and accreditation, to ensure that carrying out the task of delivery of quality healthcare is very thorough.

To accredit partners, a list of requirements is presented to the medical institutions to check their capability to deliver optimal healthcare on a consistent basis. Their record on improvement, experience and attainment of expertise are examined to ascertain their achievement levels.

On the local front, the Department of Health (DOH) is tasked to grant licenses to hospitals according to service capabilities on an annual basis. Specialized bureaus of the DOH check compliance with standards on personnel, equipment and physical environment. The Philippine Health Insurance Corporation (PHIC) accreditation enables participation in the National Health Insurance Program and claim reimbursements for health services rendered to eligible members.

Requirements for PHIC accreditation include DOH licensing for the part three years, acceptance of NHIP programs on quality assurance and utilization review and operation of Internal Quality Assurance Programs, Therapeutics committee and Infection Control Committee.

Accreditation by the Joint Commission International is recognized as a gold seal of service quality and patient safety. It is granted by the international affiliate of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the agency charged with accrediting US hospitals.

Recognition in the international arena is also provided via ISO 9001 Certification, an international quality management framework that is applied to hospitals as a whole or to component service units of institutions. ISO-certified Philippine hospitals include the Makati Medical Center and the National Kidney and Transplant Institute. Accreditation with the two groups is currently being sought by other Philippine medical institutions.

These processes by which medical institutions in the Philippines acquire good local and international standing and recognition were outlined by Dr. Alfredo Bengzon, former Philippine Secretary of Health and current President and Chief Executive Officer of The Medical City, in his presentation before the Public-Private Partnership Task Force on the Quality Healthcare in the Philippines.

On the part of the medical practitioners, licensing for doctors, nurses and other staff is provided by the Philippine Regulatory Commission while specialty certifications are provided by individual specialty societies.

A systematic approach to assess a medical doctor’s professional competence and conduct is through credentialing which includes a review of relevant academic training, experience, licensure, certification and registration to practice. Another method is through privileging which is the process by which a hospital determines what procedures may be performed and which conditions may be treated by each physician, based on his established qualifications.

These credentialing and privileging mechanisms ensure the continuing technical proficiency of and adherence to ethical standards by medical doctors, and thus, promotes the quality and safety of patient care.

Externally and internally-driven Quality Improvement (QI) programs prompt the improvement of the design, documentation, implementation and monitoring of hospital processes and their efficiency. QI programs are initiated by external regulatory agencies like the PHIC and through institutional collaboration with the Philippine Society for Quality in Healthcare (PSQua).

Within the medical organizations, the conduct of peer audits, sentinel event monitoring, the tracking of Hospital Quality Indicators and launch of Quality Circles are ways by which self-improvement are undertaken.

Among noteworthy developments as a result of tracking of Hospital Quality Indicators include the finding, from a sampling of Philippine hospitals, which infection rates are in the lower range or levels, per the International Nosocomial Infection Control Consortium (INICC).

From an INICC low of 1.7 to a high of 12.8, sample Philippine hospital scored a low of 1.9 in the monitor for Foley catheter-associated infection. From an INICC low of 7.8 to a high of 18.5, the studied hospital manifested a low 8.9 in blood stream infection. In ventilator-associated infection, with a low of 10.0 and a high of 52.7, the count for the model hospital was 13.2.

Presented side by side with the finding that death from infection is listed in the Top Three causes of deaths, these remarkable scores of sampled Philippine hospitals are undoubtedly excellent indicators of patient care and safety.

Patients are not left out in the process of achieving quality health care. As vital partners for growth and quality management, Patient Education Programs are carried out, empowering patients to demand quality service and safety. Feedback mechanisms through e-newsletters and web-based forums are new venues for active engagement of patients in the care process. Other forms used in Patient Rights Programs are individual counseling and group sessions.

The surge of managed care in the Philippines, with a count of 18 Health Maintenance Organizations (HMOs) since 1981, has also figured in the quest for quality health care. Awareness of hospitals of length-of-stay issues from HMOs and the Philhealth has upped the bar for efficiency in processes. It has also affected hospital compliance with documentary requirements for speedy claims processing.

All told, the current Philippine scene for the achievement, maintenance and continuous upgrading of quality health care is set. The recognition of the value of maintaining high marks in health care delivery and safety, with the onset of medical tourism, is providing a fresh drive for increased efficiency through focused and innovative schemes that address medical tourism requirements.

With quality health care and patient safety as vital elements for a growing medical tourism industry, the distinguished Filipino medical doctors and heads of institutions have nothing less than the best reasons to continue raising the bar in their respective fields.

Dr. Bengzon, who led his organization, The Medical City, to obtain the highly-coveted JCI accreditation is a multi-faceted leader. He is described as brilliant doctor, savvy manager, dedicated educator, courageous public servant and visionary leader. He is constantly driven by the quest for excellence and the passion for service.

A practicing neurologist, Dr. Bengzon completed his residency in Neuropsychiatry at the Philippine General Hospital and further honed his specialist expertise in several renowned medical training institutions, including the Freie Universitat Berlin in Germany, the University of Wisconsin in the U.S. and the Montreal Neurological Institute in Canada.

As Secretary of Health in the Cabinet of former President Corazon Aquino, he pursued the landmark Philippine National Drug Policy and associated Generics Drug Law. He earned in 1991 the prestigious international Ramon Magsaysay Award for Government Service.

Back as a private citizen, he was appointed Vice President for the Professional Schools and Social Development of the Ateneo and served as the Dean of the Ateneo Graduate School of Business (AGSB), a position he occupied up to June 2007. In 2007, Dr. Bengzon launched his latest enterprise – the Ateneo School of Medicine and Public Health (ASMPH), an institution that puts forward a bold and novel model of health education. Aimed at developing a physician who is simultaneously an expert clinician, a skilled manager and a catalyst for social change, the ASMPH promises to be a medical school like no other in the country.

At the Asian Hospital and Medical Center, Dr. Jorge Garcia holds court as one of the world’s best cardiovascular surgeons. He has led his team in the performance of some 750 cardiovascular procedures in a span of five years. With most of them in the category of high-risk operations, Dr. Garcia has carved a splendid track record of successes, making him a highly sought after global consultant for the setting up of state-of-art cardiovascular units. Dr. Garcia, who is also a Clinical Professor of Surgery at Georgetown University in Washington DC, is a perfect example of a Filipino medical expert who straddles the continents, providing his remarkable expertise for both the Eastern and the Western worlds.

Over at the National Kidney and Transplant Institute is Dr. Dante P. Dator, chair of the department of urology and currently the president of the Asia Pacific Association of Pediatric Urology. A graduate of the University of the Philippines College of Medicine, he did a Pedriatric Urology fellowship in 1990-1991 at Harvard University, Children’s Hospital in Boston. Well-recognized for his work on pediatric urology and recently, for the experimental work on immunological treatment of cancer using dendritic cells – a novel form of immunotherapy which harnesses the body’s immune system, specifically using dentritic cells and fusing it with known tumor antigens to create a tumor vaccine or as a direct injection into the prostate cancer. Dr. Dator is often invited as lecturer in international meetings

The bio-data of the Dr. Samuel Bernal, The Medical City Consultant, veritably reads like a list of advanced course offerings. With a passion for knowledge not only in the medical field but also in other related disciplines, Dr. Bernal is Board Certified in Internal Medicine and is a Diplomate of the American Board of Internal Medicine. He completed his training as Fellow in Internal Medicine at the Harvard Medical School, as Fellow in Medicine at the Peter Brent Brigham Hospital in Boston. He completed his Doctor of Jurisprudence degree at the Loyola University Law School and now specializes in Regulatory Law and Medical Malpractice. He completed his M.B.A. degree in a business program for company presidents at the Pepperdine University in Malibu, California.

He is currently Professor of Medicine, Director Emeritus of the Cancer Center of the Greater Los Angeles VA Health Care System, Chief of Cancer Research Laboratory and Attending Physician at Cedars-Sinai Medical Center, Century City Hospital and Enrico-Tarzana Hospital. He has published several books including one on Lung Center Differentiation and Drug Resistance in Oncoloy. He is an active member of the American Association of Clinical Oncologists, a researcher-member of the American Association of Cancer Researchers.

Dr. Felipe Tolentino, President and Medical Director of the Asian Eye Institute, pursues his track in ophthalmology and couples his achievements in medical science with clear focus on helping the poor through the Ophthalmological Foundation of the Philippines which he founded and through the establishment of a Mobile Eye Clinic that serves indigent patients of cataract surgery.

Dr. Tolentino is a member of the School Faculty, Senior Clinical Scientist at the Schepens Eye Research Institute and Surgeon in Ophthalmology at the Massachusetts Eye and East Infirmary and Consultant at Tufts University at the Medical Center/New England Eye Center. He also authored over 100 peer-reviewed papers in Ophthalmology, published in prestigious journals in the US.
These leaders in Philippine medicine and healthcare facilities management are but only a few of the many Filipino medical doctors with inspiring backgrounds, common as it is among Filipino graduates of medical degrees to seek affiliations with US medical associations for continuing programs for career development and specialty-building

A good number of those who have served in prestigious US hospitals have returned to the Philippines to cascade their knowledge to younger practitioners and to head the departments of the renowned medical hospitals and centers.

The country’s world-class physicians and its medical facilities using modern technology are good banners for its medical tourism program. Yet, add to this the Philippine brand of health care — one that is summed up as “tender loving care,” one is led to conclude that there are, indeed, more than enough compelling incentives to seek medical attention in the country through the medical tourism program.