ROJoson PEP Talk: Usefulness of Telemedical Consultation and Round

ROJoson PEP Talk: Usefulness of Telemedical Consultation and Round

1. April 27, 2024 1400H - 1500H Via Zoom USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management.

2. April 27, 2024 1400H - 1500H Via Zoom USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management. Welcome all! MUTE yourself but always show your video picture. Sign in your name, FB account, or email address in the Chat Box! Include names of companions attending. Use the Chat Box to ask questions and make comments while the PEP TALK is on. There will be group pictures at start and end of PEP TALK – show your face in video.

3. Reminder after the PEP Talk: Take the Online Learning cum Evaluation Test Exercise (OLETE) for mastery of learning and have a perfect score to get a Certificate. Link is in Chat Box.

4. Reminder: 25 OLETE Certificates = 1 Voucher for ROJoson Medical Consultation either Face-to-Face or Telemedical.

5. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management. ROJOSON’S REQUEST: FEEDBACK TO THIS PEP TALK! Pls. type in your feedback in the chat box during the open forum and before we adjourn! Thank you!

6. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management. LET’S NOW HAVE A GROUP PICTURE TAKING BEFORE WE START PEP TALK PROPER IN 2 MINUTES! Pls. turn on your video! Show your face!

7. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management. ROJoson PEP Talk I have a Patient Empowerment Program in which I like to empower the lay people or patients to take control in the management of their health.

8. I started the PEP Talk on May 15, 2021 during the COVID19 Pandemic. There are 3 courses in the PEP Talk. I completed the Core Course on October 9, 2021.

9. From October 23, 2021 onwards, I have been tackling Health Disorder and Health Issue Courses. This may take 3 years or longer depending on our enthusiasm , discipline and perseverance . We are now on our 3 rd year!

10. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management. My PEP TALK today is entitled: USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

11. Contents What is a telemedical consultation? What is a telemedical round? What is current history of telemedical consultations and telemedical rounds in the Philippines and as being promoted by ROJoson ? What are the usefulness of a telemedical consultation and round? What are limitations of a telemedical consultation and round? What are ROJoson’s advice on Telemedical Consultations ? Disclaimer: ROJoson PEP Talk contains ROJoson’s Thoughts, Perceptions, Opinions and Recommendations (TPORs) culled from experiences of ROJoson and other professionals. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

12. What is a telemedical consultation? USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

13. What is a telemedical consultation ? Telemedical Consultation is NOT a face-to-face medical consultation where the physician directly sees and touches a patient to evaluate his /her medical concern, then to make a clinical diagnosis and then recommendations for treatment.   In Telemedical Consultation, interactions between the physician and patient for purposes of medical evaluation and medical recommendations are made through information technology such as telephone, email, Facebook Messenger, Viber, Zoom and other online apps with no face-to-face interaction . USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

14. What is a telemedical consultation ? Telemedical Consultation is NOT a face-to-face medical consultation where the physician directly sees and touches a patient to evaluate his /her medical concern, then to make a clinical diagnosis and then recommendations for treatment.   USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

15. What is a telemedical consultation ? In Telemedical Consultation, interactions between the physician and patient for purposes of medical evaluation and medical recommendations are made through information technology such as telephone, email, Facebook Messenger, Viber, Zoom and other online apps with no face-to-face interaction . USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

16. What is a telemedical consultation ? In Telemedical Consultation, interactions between the physician and patient for purposes of medical evaluation and medical recommendations are made through information technology such as telephone, email, Facebook Messenger, Viber, Zoom and other online apps with no face-to-face interaction . USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

17. What is a telemedical round? USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

18. What is a telemedical round ? Medical round is a visit by a physician on a hospital patient for a health management purpose. Physician making a medical round usually goes to the room of a patient confined in a hospital to assess patient’s progress; to discuss the diagnosis; to discuss further plans of management; to instruct patients on self-care at home; etc. Thus, the conventional meaning of medical round entails a visit to the hospital by the physician and a face-to-face interaction with a patient . Telemedical round is the same as medical round except there is NO hospital visit and NO face-to-face interaction between the physician and patient. Interactions are done through information technology such as telephone, email, Facebook Messenger, Viber, Zoom and other online apps. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

19. What is a telemedical round ? Typical Medical Round – Medical Round with Face-to-face Interactions with Patient USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

20. What is a telemedical round ? Typical Medical Round – Medical Round with Face-to-face Interactions with Patient USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

21. What is a telemedical round ? ROJoson Telemedical Round Telemedical round is the same as medical round except there is NO hospital visit and NO face-to-face interaction between the physician and patient. Interactions are done through information technology such as telephone, email, Facebook Messenger, Viber, Zoom and other online apps. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

22. What is current history of telemedical consultations and telemedical rounds in the Philippines and as being promoted by ROJoson ? USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

23. What is current history of telemedical consultations and telemedical rounds in the Philippines and as being promoted by ROJoson ? Services for telemedical consultation have been present even before the COVID19 Pandemic in 2020. However, they were not widely used as they are not yet popular. So, are the telemedical rounds. Telemedical consulations and rounds were forced to become popular during the COVID19 Pandemic because of safety issues of face-to-face medical consultations and rounds and the limitation of movements of physicians and patients. Telemedical consultations and rounds have become one of the NEW NORMALS during and after the COVID19 pandemic . USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

24. What are the usefulness and limitations of a telemedical consultation ? USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

25. What are the usefulness and limitations of a telemedical consultation ? USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND If there is medical concern, go for TELEMEDICAL CONSULTATION first.  Wait for the advice of the physician in the telemedical consultation on what to do next, particularly on whether there is a need to go to a hospital or not.

26. TELEMEDICAL CONSULTATION after COVID19 PANDEMIC Filipino Patients with a Health Concern TELEMEDICAL CONSULTATION FIRST Home Management Clinic / Outside Hospital Setting Management Hospital Management With Medical Emergency Total Heath Care Expense NOT SURE of Medical Emergency With NO Medical Emergency Only when needed Only when needed HIGHER LOWEST HIGHEST Quick Consult If there is medical concern, go for TELEMEDICAL CONSULTATION first.  Wait for the advice of the physician in the telemedical consultation on what to do next, particularly on whether there is a need to go to a hospital or not.

27. What are the usefulness and limitations of a telemedical consultation ? USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND If there is medical concern, go for TELEMEDICAL CONSULTATION first.  Wait for the advice of the physician in the telemedical consultation on what to do next, particularly on whether there is a need to go to a hospital or not.

28. What were the usefulness o f telemedical consultations and rounds during the COVID19 pandemic? Efficacy – 99% if done properly (in terms of achievement of the intended objectives of a medical consultation and round) Risk – 0% COVID19 exposure risk because consultation is done through digital means (video medical consultation – not face-to-face consultation) Safe – safer because of 0% COVID19 exposure risk Cost – lesser expense in the long run and overall – no travel expense; no pre-face-to-face consultation COVID19 screening test expense; no PPE-use expense; etc. Availability – readily available USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

29. What are the usefulness o f telemedical consultations and rounds after the COVID19 pandemic? CONVENIENCE – on the part of the patient and the physician in arranging a medical consultation - NO hassle of physical travels – distance and traffic and expense; physician and patient can be far apart, even world apart CONVENIENCE in terms of TIME of medical consultation – there is a mutually agreed time by both physician and patient – booked appointment or pre-arranged date and time. AVAILABILITY – telemedical consultation more readily available nowadays compared to pre-COVID19 era USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

30. What are the usefulness o f telemedical consultations and rounds after the COVID19 pandemic? EFFICACY OF CONSULTATIONS AND ROUNDS – 99% if done properly (in terms of achievement of the intended objectives of a medical consultations and rounds) COST – lesser expense in the long run and overall – especially on no travel expense and patients being guided when to go to emergency room and to hospital (quite expensive nowadays) USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

31. What is current history of telemedical consultations and telemedical rounds in the Philippines and as being promoted by ROJoson ? With the telemedicine becoming a vogue during the COVID19 pandemic (starting 2020), I and other physicians have used telemedical consultations and telemedical rounds. I started using telemedical consultations and telemedical rounds starting March 17, 2020. I am still using them up to now on top of the face-to-face medical consultations and medical rounds that I resumed in May 2022. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

32. What is current history of telemedical consultations and telemedical rounds in the Philippines and as being promoted by ROJoson ? Scope of ROJoson Telemedicine (Basic Steps) ROJoson Telemedical Consultation approximates the standard ROJoson's face-to-face medical consultation with patients in ROJoson Medical Clinic. Greeting ; getting to know the patient (personal data ); Elicitation of concern or reason for consultation; Gathering of data to be used in arriving to a primary clinical diagnosis: symptom data; data on previous and past medical treatment ; sign data - inspection (looking at the patient's body and pointed area/s of concern with still and video pictures) and physician-guided patient-self-palpation of areas of concern]; USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

33. What is current history of telemedical consultations and telemedical rounds in the Philippines and as being promoted by ROJoson ? Scope of ROJoson Telemedicine (Basic Steps) ROJoson Telemedical Consultation approximates the standard ROJoson's face-to-face medical consultation with patients in ROJoson Medical Clinic. ROJoson doing medical recording in a stationary which contains primary clinical diagnosis; explanations; recommendations; discussion with shared decision-making and informed consent on treatment plan. A scanned medical record will be given to the patient. Patient shall acknowledge understanding and receipt of the medical record . USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

34. What is a telemedical round ? ROJoson Telemedical Round In May 2022, after I resumed inpatient surgical operations, I have been doing mostly telemedical rounds up to discharge time. I would do physical visit to the hospital to make rounds only when needed. I have surgical residents doing rounds in the hospital. They would report to me on the status of the patients. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

35. What is a telemedical round ? ROJoson Telemedical Round The day after the operation, with prior arrangement with patients or their relatives, we would do video chat through any of these platforms, Viber, Facebook messenger, or Zoom (whichever is accessible and easier to utilize). Through the video chat, I can do the usual things that I do in a physical medical round, except palpation of the patient’s body. If there is a need to do a palpation, I would ask the assistance of a surgical resident who is on duty in the hospital . USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

36. What is a telemedical round ? ROJoson Telemedical Round Here is a picture of a patient under telemedical round, a day after a major operation. She was happy with the telemedical round. She had a picture taken with me with her caregiver. She would be discharged one to two days postop without me having to do a physical medical round. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

37. What is a telemedical round ? ROJoson Telemedical Round By the way, after she is discharged, if there is any concern related to her operation, she is welcome to contact me anytime for a video chat. This video chat can be labelled as telemedical consultation and also as a telemedical round as there is monitoring of the patient’s progress being done as in a medical round. The only difference here is that the monitoring is done this time outside the hospital (at home). USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

38. What is a telemedical round ? ROJoson Telemedical Round I foresee that telemedical rounds will eventually be defined as monitoring and following-up the progress of patients’ conditions at a distance ( teleround ), not only with the patient being confined in the hospital. The patients can be at any place outside a hospital as long as the main objectives of a conventional medical rounds are being accomplished, essentially following-up patients’ progress. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

39. What are the LIMITATIONS of a telemedical consultation and round? NO DIRECT PALPATION of body parts of the patient if needed to be done NO DIRECT AUSCULTATION of the patient If needed to be done Innovations that can be done: Physician can ask and teach patients and relatives to do some maneuvers in physical examination (of course under video-guidance of the physicians). USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Despite the limitations, the accuracy of diagnosis on telemedical consultations and rounds can still approximate that of a face-to-face medical consultations and rounds as long as the physicians do some adjustments and innovations.

40. What are the LIMITATIONS of a telemedical consultation and round? NOTE: THIS IS NOT A LIMITATION. Telemedical consultations and rounds that approximate the processes and procedures of a face-to-face medical consultation and round and with physicians being conscientious in achieving utmost accuracy and offering adequate explanation usually TAKE LONGER - usually double the time or longer, thus, MORE TEDIOUS. A lot of patients tend to appreciate this, especially the explanations which are usually abbreviated during face-to-face interactions. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

41. What are ROJoson’s advice on Telemedical Consultations? Nowdays , all physicians must have two modes of services for medical consultations – one, face-to-face and the other, telemedical . This gives the patients the opportunity and the leeway to choose which mode of medical consultations will be convenient and advantageous for them based on the circumstances they are in. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

42. What are ROJoson’s advice on Telemedical Consultations? There are indications for each of the two modes of medical consultations. In NON-emergency situations: Essentially, if face-to-face consultation is possible based on the distance and expense and there is a need for the physicians to touch a patient’s body in physical examination for more accurate diagnosis, then go for FACE-TO-FACE MEDICAL CONSULTATION. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

43. T What are ROJoson’s advice on Telemedical Consultation? There are indications for each of the two modes of medical consultations. In NON-emergency situations: Essentially, if face-to-face consultation is not possible or difficult based on the distance and expense and other factors like a bed-ridden patient and physicians may forego touching a patient’s body in physical examination for more accurate diagnosis, then one may opt for TELEMEDICAL CONSULTATION. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

44. What are ROJoson’s advice on Telemedical Consultations? There are indications for each of the two modes of medical consultations. In EMERGENCY situations: If one has access to a physician who does telemedical consultation, get a quick TELEMEDICAL CONSULTATION first and then follow the advice of the physician – whether need to bring patient to an emergency room, where and when to go and what first-aid to do, etc. Rushing to an emergency room may not be needed after a telemedical consult. However, the decision is based on the discretion of the relatives of the patient. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

45. What are ROJoson’s advice on Telemedical Consultations? There are indications for each of the two modes of medical consultations. In situations where EMERGENCY IS UNCERTAIN: If one has access to a physician who does telemedical consultation, get a quick TELEMEDICAL CONSULTATION first and then follow the advice of the physician – whether need to bring patient to an emergency room or not (such as bring to clinic or stay home). Rushing to an emergency room may not be needed after a telemedical consult. However, the decision is based on the discretion of the relatives of the patient. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

46. Contents What is a telemedical consultation? What is a telemedical round? What is current history of telemedical consultations and telemedical rounds in the Philippines and as being promoted by ROJoson ? What are the usefulness of a telemedical consultation and round? What are limitations of a telemedical consultation and round? What are ROJoson’s advice on Telemedical Consultations? USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Summary Take Away

47. Take Away in relation to Patient Empowerment Be always in touch with reliable medical information on USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND. Knowledge is power; it gives power. Use the 4Ks of Patient Empowerment: Kaalaman , Kakayanan , Karapatan and Kapangyarihan to gain greater control over decisions / make better decisions on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of your health management. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

48. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management. This ends my PEP TALK today on: USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND

49. Reminder after the PEP Talk: Take the Online Learning cum Evaluation Test Exercise (OLETE) for mastery of learning and have a perfect score to get a Certificate. Link is in Chat Box.

50. Reminder: 25 OLETE Certificates = 1 Voucher for ROJoson Medical Consultation either Face-to-Face or Telemedical.

51. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management. ROJOSON’S REQUEST: FEEDBACK TO THIS PEP TALK! Pls. type in your feedback in the chat box during the open forum and before we adjourn! Thank you!

52. USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND Empowerment objective - for laypeople to have an essential  understanding on the USEFULNESS OF TELEMEDICAL CONSULTATION AND ROUND as part of their health management. LET’S NOW HAVE A GROUP PICTURE TAKING BEFORE WE START Q&A AND INTERACTIONS! Pls. turn on your video! Show your face!