TELEBARANGAY HEALTHCARE

TeleBarangay Healthcare
“Making Primary Health Care Closer to Home”

A. Project Description

1. Brief Summary of the Project

TeleBarangay Healthcare system is the use of information and communication technology to deliver health services and exchange health information to and from the barangay when distance and accessibility cost separates the participants. This system will allow medical personnel at one location to see and talk to a patient in the barangay health centers in the far flung areas. The TeleBarangay Healthcare system can be divided into two major areas:
1.) Telemedicine
Telemedicine is the application of clinical medicine where medical information is transferred via telephone, the internet or other network for the purpose of consulting, and sometimes remote medical procedures or examinations.
2.) e-Health Management Information System.
E-Health Management Information System is a web-based personal health record that can be used by patients and the municipal health office to collect and manage their health information (e.g. Medical History, past surgeries, medications, and allergies to request referrals, and to store a record of their consultations.

The 2005 CBMS survey reports that only twenty seven percent (27%) of the number of households that needed treatment had availed of the health services of the Municipal Health Centers and only fourteen percent (14%) had availed of the services of the Marinduque Provincial Hospital. Most of the population do not avail health services due to distance and high cost of transportation. Most of them are from the interior barangays of Boac, namely: Binunga, Canta, Boi, Bayuti, Hinapulan, Tambunan, Tumagabok, Sabong and Duyay.

There is a need to redesign the health services delivery system and redefine priorities to improve management, resource allocation and utilization, and inter-organizational collaboration. The TeleBarangay Healthcare System will address the traditional delivery of health services that are affected by distance, high transportation cost and the lack of local or barangay based specialist clinicians to deliver services.

2. Project Goals and Objectives

The main goal of the project is making primary health care closer to home. The primary objective is to provide an affordable and equal access to high quality care and health services in the most appropriate place (barangay level), as much as closer to their homes.

Under the TeleBarangay Healthcare System, the municipal health personnel will regularly visit the interior barangays to provide medical consultation services through Telemedicine and at the same time recoding of patient’s health data through the use of eHealth Management Information System (to be developed by the municipality). Further, the municipal and barangay midwives and health workers will be trained by the municipal health officer on basic history taking and physical examination and will also undergo training on basic computer knowledge and use of telecommunication system. All of these will be provided by the municipality. With this process, the patient need not travel to the municipal health and diagnostic center for basic health services.

3. Targeted Beneficiaries

The direct beneficiaries of this project are the nine (9) interior and rural barangays of Boac namely Binunga, Canat, Boi, Bayuti, Hinapulan, Tumagabok, Tambunan, Sabong and Duyay. The CBMS survey indicated that only a small percentage of the number of households (5-10%) in the said barangays are availing the health services of the municipal health and diagnostic center and the Marinduque Provincial Hospital due to the distance, rugged terrain and high transportation cost.

The indirect beneficiaries of the project are the rural barangays of the Municipality who would like to request for the implementation of this project in their own communities’ poor families.

4. Partners

Municipality of Boac

The Municipality will provide additional funding for the technical training of Municipal and barangay midwives, health workers and volunteers, and other logistical needs of the project.



Philippine Charity Sweepstakes Office

The PESO will provide free medicines for children aged 12 and below under the Child Centered Medicine Support Program of the municipality.

Marinducare

A non-government organization, the Marinducare will provide technical and manpower support as well as free medicines for the TeleBarangay Healthcare Program.

Fund Sources (20% Community Development Fund)

Telehealth Training Program P 50,000.00
Child Centered Medicine Support Program 1,000,000.00
Health and Nutrition Special Project 100,000.00
TOTAL 1,150,000.00

5. Project Sustainability

Since the TeleBarangay Healthcare Program is a pro-poor special project, our consideration of the outcome of the project is focused on the following;
1. Benefit to patients and families;
2. Benefits to medical providers;
3. Benefits to our Municipal Health and Diagnostic Center
4. Benefits to society

As cost effectiveness analysis is particularly useful where benefits are difficult to quantify, we have identified both “tangible” and “intangible” benefits in our summary table below.

Tangible benefits Intangible benefits
Benefits to patients and families • Reduced costs of travel and accommodation.
• Reduced time-off from work by parents/relatives of the patient. • Faster management of medical problems.
• Reduced anxiety where specialist opinion is rapidly provided.
• Equitable access to specialist level opinion.
• If patient transfer is necessary, it can be fully coordinated and planned beforehand.
Benefits to medical staff/provider • Better management of patients.
• Increased competency of interpreting medical specialist (due to large case load, exposure to more rare conditions) • Increased exposure to expertise for rural staff.
• Staff retention in rural areas by improved peer and specialist support.
• Increased satisfaction that management at the health center is appropriate following rapid expert advice.
• Enable to develop a more organized approach to second opinion referrals.
Benefits to Municipal Health Center • Wider delivery of services.
• Decrease in unnecessary patient transfer • Increased efficiency
• Improved care and health outcomes
• Facilitates health services delivery on remote barangays
Benefits to society
• Less time off from work/improved productivity
• Decreased burden of illness on society
• Great equity in quality, efficiency and access to medical care
• Reduced morbidity and mortality
• Aids appropriate allocation of overall health resources
• Less social disruption as continuity of care is facilitated locally

The TeleBarangay Healthcare program will be a continuing project of the municipality due to its positive impact on the financially disadvantaged families in the remote barangays.
The municipal development council will provide and annual appropriation of P100,000.00 from the 20% community development fund (CDF) for the maintenance and operational expenses of the project.
6. Evaluation

The project will be evaluated through the number of households that will avail of the TeleBarangay Healthcare project particularly in the target areas. And its effectiveness in decreasing the number of casualties brought by various diseases.

On the part of the implementer, the system will be evaluated based on efficiency, effectivity and timeliness in the delivery of basic health services in the barangay level.

B. Workplan and Timetable

Objective

In the municipality’s health system, the TeleBarangay Healthcare program will play a valuable role in increasing access, supporting collaboration and ensuring that Boac has the health workforce that is required. Barriers such as distance, rugged terrain, high transportation cost and lack of knowledge to use telehealth/telemedicine will be overcome. New technologies and technology application will be readily adopted.

Improved Access

Boakeños will be able to access clinical services, support for self manage care, and even educational health programs in their barangay health centers and schools.

Residents from remote barangays will have the ability to access a range of health services closer to home.

Enhanced Clinical Integration

Health providers both from the municipal and barangay level will see th provision of specialized services by TeleBarangay Healthcare System as a typical part of a clinical practice just as they view outpatients care as typical today.

TeleBarangay Healthcare System will be a highly valued tool used by the municipal health office to help manage their workload.

Enhanced Knowledge base and health workforce

TeleBarangay Healthcare System will become part of the field functions of the Barangay Health workers and volunteers.

On-going educational and technical skills training will be provided on municipal and barangay health workforce.

Workplan

Activity 1. Acquisition of computer hardware and software development program.
The Municipality of Boac with the funding support of CBMS-UNDP will acquire computer hardware. At the same time, technical personnel of the Municipal Planning and Development Office will develop the necessary software/computer program for the TeleBarangay Healthcare System.

Activity 2. Technical Assistance and Capacity Building Activities
The Municipality of Boac will render technical assistance and capacity building seminar/trainings on municipal and barangay health workforce. The Municipal Planning and Development Office will handle the technical training on basic computer operation and the use of TeleBarangay Healthcare System. While the Municipal Health Office will conduct training on basic history taking and physical examination of patients.

Timetable


Activity J
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Software Development
Acquisition of Computer Hardware
Training on Basic Computer Use
Basic History and Physical Examination Seminar
Electronic Health Information Management Training
Project Implementation



C. Budget Information

Line Items Total Cost Local Counterpart Amount for Others
Grant Proponent Beneficiary LGU Donors
Salaries 50,000.00 50,000.00
Staff Development 100,000.00 100,000.00
System Development 20,000.00 20,000.00
MCCE 100,000.00 100,000.00
Others
Total Insti Support 270,000.00 270,000.00

Field Visits 100,000.00
Skills Trainings 100,000.00 50,000.00 50,000.00
Others (Medicine) 1,500,000.00 1,000,000.00 500,000.00
Total Client Dev 1,700,000.00

Working Capital
Equipment 250,000.00 200,000.00 50,000.00
Infrastructure
Land
Total Direct Proj. Cost 250,000.00

TOTALS
% Share



D. Risk Analysis

There is no existing privacy regulations on electronic health data/records, however, the Municipality of Boac has the power to formulate policies and procedures to protect patient’s health information from non-permitted uses and disclosures. The following are sample telehealth policies:

Telehealth encounters must protect patient health information
• Proper patient registration
• Notice of privacy rights and practices
• Acknowledgment
• Telehealth Visit Consent form
• Providing a private and secure telehealth transmission
• Providing a private and secure physical location for the telehealth encounter
• Authorized personnel in attendance for telehealth medical visit.

E. Project Management

Since the project is implemented by the Municipal Planning and Development Office, the Municipal Development Officer will head the technical working group that will be directly in charge of the project implementation.

A technical personnel from the Municipal Planning Office will be assigned to come up with the technical process of the telebarangay healthcare system and specifications of required equipment. He/she will also be in-charge of the software development and training of personnel on its use.

The municipal health officer, on the other hand, will be working closely with the technical personnel on the systems and software development. He/she will be in-charge of training midwives, health personnel and volunteers on basic history taking and physical examination of the patient.