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LitCovid-PD-FMA-UBERON

{"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T53180","span":{"begin":2809,"end":2813},"obj":"Body_part"},{"id":"T32508","span":{"begin":2898,"end":2902},"obj":"Body_part"},{"id":"T10545","span":{"begin":5211,"end":5215},"obj":"Body_part"},{"id":"T52406","span":{"begin":5219,"end":5223},"obj":"Body_part"},{"id":"T1303","span":{"begin":8161,"end":8166},"obj":"Body_part"},{"id":"T78482","span":{"begin":11229,"end":11233},"obj":"Body_part"},{"id":"T19846","span":{"begin":11237,"end":11241},"obj":"Body_part"},{"id":"T11897","span":{"begin":15435,"end":15439},"obj":"Body_part"},{"id":"T28117","span":{"begin":15443,"end":15447},"obj":"Body_part"}],"attributes":[{"id":"A46630","pred":"fma_id","subj":"T53180","obj":"http://purl.org/sig/ont/fma/fma7195"},{"id":"A16019","pred":"fma_id","subj":"T32508","obj":"http://purl.org/sig/ont/fma/fma7195"},{"id":"A85641","pred":"fma_id","subj":"T10545","obj":"http://purl.org/sig/ont/fma/fma24728"},{"id":"A44633","pred":"fma_id","subj":"T52406","obj":"http://purl.org/sig/ont/fma/fma24728"},{"id":"A60314","pred":"fma_id","subj":"T1303","obj":"http://purl.org/sig/ont/fma/fma9670"},{"id":"A70390","pred":"fma_id","subj":"T78482","obj":"http://purl.org/sig/ont/fma/fma24728"},{"id":"A87467","pred":"fma_id","subj":"T19846","obj":"http://purl.org/sig/ont/fma/fma24728"},{"id":"A6316","pred":"fma_id","subj":"T11897","obj":"http://purl.org/sig/ont/fma/fma24728"},{"id":"A8345","pred":"fma_id","subj":"T28117","obj":"http://purl.org/sig/ont/fma/fma24728"}],"text":"5 TELEHEALTH AS A RESPONSE TO HEALTH INFORMATION INEQUITIES\nIn addition to translation initiatives, telehealth practice illustrates what can be done to address an otherwise crippling lack of access to vital health‐related information.\nAdvocates of telehealth have been taking the opportunity to highlight how the practice can help address inequities in access to health information and to healthcare more broadly. Even before the onset of the COVID‐19 pandemic, they were already promoting the use of digital means to address healthcare issues faced by vulnerable sectors. Telehealth has been demonstrated to help close the gaps in healthcare service delivery as a way of ensuring that national healthcare systems are responsive, efficient, and equitable in providing healthcare to all, especially the traditionally underserved and vulnerable populations. The World Health Organization (WHO) developed a National eHealth strategy framework in 2012 to guide countries in effectively integrating ehealth in their systems.36 World Health Organization \u0026 International Telecommunication Union. (2012). National eHealth Strategy Toolkit Overview. World Health Organization. Retrieved May 16, 2020, from https://www.who.int/ehealth/publications/overview.pdf\nThe Philippine government was able to develop an ehealth strategic framework in 2013, but as early as 2008, the University of the Philippines (UP) National Telehealth Center (NTHC) was already practicing telemedicine.37 Patdu, I.D., \u0026 Tenorio, A.S. (2016, December 31). Establishing the Legal Framework of Telehealth in the Philippines. Acta Medica Philippina. (50)4, 237‐246. Retrieved May 15, 2020, from https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/763\nRecognizing the gaps in the healthcare system and the inequitable delivery of healthcare services, the UP NTHC provided telehealth services to aid physicians who were assigned to remote communities all over the Philippines upon being recruited to the Doctors to the Barrios Program (DTTB). Clinical specialists from the UP Philippine General Hospital (PGH) became the remote source of valuable knowledge to DTTB physicians as they provided healthcare services to their patients. This enabled the patients from far flung communities to access quality healthcare from specialists based at a tertiary hospital that was otherwise beyond their reach.\nIn various ways, the COVID‐19 pandemic has turned the once underrated practice of telehealth into a widely explored alternative mode of practice. It is riding on the wave of the new normal in healthcare service delivery. Both the Department of Health (DOH) and the private sector have scrambled to utilize telehealth to provide consults and information to a nation hit hard by anxiety and uncertainty. One of the early users was the Lung Center of the Philippines COVID‐19 Task Force. Through a social media platform, the Lung Center held teleconsultations and provided answers to COVID‐19 related questions.38 Nonato, V., Crisostomo, S., \u0026 Calica, A. (2020, March 31). The Doctor Is Online: Physicians Offer Free Services to Decongest Hospitals. One News. Retrieved July 27, 2020, from https://www.onenews.ph/the‐doctor‐is‐online‐physicians‐offer‐free‐services‐to‐decongest‐hospitals\n, 39 Perez, R. (2020, April 7). DOH COVID‐19 Hotline Now Provides Free Telemedicine Consultations. Smart Parenting. Retrieved July 27, 2020, from https://www.smartparenting.com.ph/life/news/doh‐covid‐19‐hotline‐telemedicine‐a00041‐20200407\nThe Philippine General Hospital established the \"Bayanihan na\" call center where consults were made through a hotline.40 Dela Cruz, R.C. (2020, March 31). PGH Launches Covid‐19 Hotline for Consultations, Donations. Philippine News Agency. Retrieved May 20, 2020, from https://www.pna.gov.ph/articles/1098332\n, 41 Romualdo, A.VCD.P. (2020, March 31). Bayanihan Na! UP‐PGH Launches COVID‐19 Ops Center. University of the Philippines Manila News. Retrieved May 20, 2020, from https://www.up.edu.ph/bayanihan‐na‐up‐pgh‐launches‐covid‐19‐ops‐center/\nThe DOH, having no telehealth platform of its own, has collaborated with private providers to establish the DOH (Telehealth) hotline.42 Anonymous. (2020, April 7). DOH Boost Telemedicine Services for NCR Service to Expand to Other Regions Soon. Press Release. Department of Health. Retrieved May 16, 2020, from https://www.doh.gov.ph/doh‐press‐release/DOH‐BOOST‐TELEMEDICINE‐SERVICES‐FOR‐NCR‐SERVICE‐TO‐EXPAND‐TO‐OTHER‐REGIONS‐SOON\n, 43 CNN Philippines Staff. (2020, April 27). DOH Launches Telemedicine Consultation for Metro Manila Residents. CNN Philippines. Retrieved April 27, 2020, from https://cnnphilippines.com/news/2020/4/7/Telemedicine‐consultation‐COVID.html https://www.pna.gov.ph/articles/1047575\nWhereas only a few physicians practiced telehealth in the country at the beginning of the year, the COVID‐19 pandemic has certainly accelerated the acceptance of telehealth as a means to improve healthcare. Aside from providing healthcare access to remote patients, the practice of telehealth has served to limit physical contact in order to reduce the risk of contracting COVID‐19. Physicians who previously disliked the use of technology and preferred face to face consultations are now forced to “see” patients remotely. The tide has started to turn and this appears to have happened also in other countries.44 Galewitz, P. (2020, March 27). Telemedicine Surges, Fueled by Coronavirus Fears and Shift in Payment Rules. Kaiser Health News. Retrieved May 17, 2020, from https://khn.org/news/telemedicine‐surges‐fueled‐by‐coronavirus‐fears‐and‐shift‐in‐payment‐rules/\nMultiple studies have shown how telemedicine has enhanced health service delivery.45 Williams, O.E., et al. (2017). The Use of Telemedicine to Enhance Secondary Care: Some Lessons from the Front Line. Future Healthcare Journal. 4(2), 109–114. Retrieved May 20, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502630/\n, 46 Bryant, B. (2018, December 11). Telemedicine Improves Healthcare through Innovative Service Delivery. National Association of Counties (NACO). Retrieved May 20, 2020, from https://www.naco.org/articles/telemedicine‐improves‐healthcare‐through‐innovative‐service‐delivery\n, 47 Siddiquee, N.K.A., et al. (2019). Telemedicine in Resource‐Limited Setting: Narrative Synthesis of Evidence in Nepalese Context. Smart Homecare Technology and TeleHealth. Retrieved May 21, 2020, from https://www.dovepress.com/telemedicine‐in‐resource‐limited‐setting‐narrative‐synthesis‐of‐eviden‐peer‐reviewed‐fulltext‐article‐SHTT.\nEven before launching the COVID‐19 telemedicine hotline, the DOH already launched multiple telehealth initiatives: a non‐COVID‐19 clinical Helpdesk (through hotlines), email, and chat (including a DOH internet‐based messaging app group that is open to lay people and another group for health care workers).48 Anonymous. (No date). National Telehealth Center. National Institutes of Health. Retrieved August 21, 2020, from http://nih.upm.edu.ph/institute/national‐telehealth‐center\n, 49 Anonymous. (2016‐2020). PH COVID‐19 Health Workers. Rakuten Viber. Retrieved August 21, 2020, from https://invite.viber.com/?g2=AQA70%2FYXR8FXAEs1ff7nzV%2BJvuR8LVkveAaVASkICVnUaqX7In%2F%2Fp8nQ%2BzXeW%2BDr\u0026lang=en\u0026fbclid=IwAR3YDLl3YQJ5rxb‐UA6GI2NDfo5muokHKdcHYHUWFV7GUtSjUPlxFM3Ptqo\nAnother heavily used platform is Facebook where infographic materials, videos, and press releases are done.50 Anonymous. (No date). Department of Health Philippines. Facebook. Retrieved August 21, 2020, from https://www.facebook.com/OfficialDOHgov/\nThe use of a digital platform in these ways is in line with what we expect post‐COVID‐19 society to be like. It is useful for people with COVID‐19 symptoms as well as for those with non‐COVID‐19 health related issues.\nA device called RxBox has become an important tool for the practice of telemedicine. The RxBox is a telemedicine device developed by the University of the Philippines Manila and supported by the DOH and the Department of Science and Technology. It captures medical signals through built‐in medical sensors and has several capabilities such as functioning as a blood pressure and pulse rate monitor, pulse oximeter, and temperature sensor.51 National Telehealth Center. (2014). RxBox: Advancing Community Healthcare 2014. Retrieved May 23, 2020, from https://telehealth.ph/project‐rxbox/\n Primarily used in isolated and disadvantaged communities nationwide, it is able to store data in an electronic medical record, and transmit this information via internet to a clinical specialist at regional government hospitals including PGH, the doctors from which can then offer expert advice. By facilitating teleconsultations within the National Telehealth Service Program, the RxBox can reduce the overall cost of healthcare by enabling healthcare workers to diagnose, monitor and treat patients within the rural healthcare facility, using medical sensors inside the box.52 Ibid.\nAs part of an initiative of the University of the Philippines and the Department of Science and Technology to respond to the pandemic, devices are being installed at PGH. The RxBox is now being developed to have telemetry capability, which means being able to connect with a dashboard at the nurses’ station where vital signs can be read. The device therefore allows for remote monitoring that minimizes risks associated with the proximity of healthcare workers to patients with communicable diseases. The installation of 100 RxBox devices at PGH as a response to the COVID‐19 pandemic will significantly improve access by people in remote locations to health care and information.53 Macan, J.G. (2020, April 1). PGH to Use DOST's RxBox for COVID‐19 In‐patient Monitoring. Philippine Council for Health Research and Development. Retrieved August 5, 2020, from http://www.pchrd.dost.gov.ph/index.php/news/6527‐pgh‐to‐use‐dost‐s‐rxbox‐for‐covid‐19‐in‐patient‐monitoring\n, 54 Sambatyon, E. (2020, April 4). UP and DOST‐developed RxBox Vital Signs Monitor for COVID‐19 Patients Now in Use at Philippine General Hospital. Good News Philippines. Retrieved August 5, 2020, from https://www.goodnewspilipinas.com/up‐and‐dost‐developed‐rxbox‐vital‐signs‐monitor‐for‐covid‐19‐patients‐now‐in‐use‐at‐philippine‐general‐hospital/\nAnother initiative under the UP College of Medicine's Surgical Innovation and Biotechnology Laboratory (SIBOL) in cooperation with UP Diliman’s Electrical and Electronics Engineering Institute is a “telepresence\" device, a computer programmed to automatically answer calls from authorized accounts using available teleconferencing and remote‐control applications, minimizing contamination and allowing effortless access even by patients with no technological know‐how.55 Gonzalez, C.J. (2020, June 1). COVID‐19 Telepresence Device Connects Frontliners to Patients, Patients to Loved Ones. Philippine Council for Health Research and Development. Retrieved June 25, 2020, from http://www.pchrd.dost.gov.ph/index.php/news/6559‐covid‐19‐telepresence‐device‐connects‐frontliners‐to‐patients‐patients‐to‐loved‐ones.\nLike the RxBox, a “telepresence” device allows healthcare workers and patients to communicate with each other without need for face to face contact.56 CNN Philippines Staff. (2020, April 16). New Device Developed to Limit COVID‐19 Exposure of Frontline Health Care Workers. CNN Philippines. Retrieved May 23, 2020, from https://www.cnnphilippines.com/news/2020/4/16/telepresence‐device‐pgh‐.html\nThis paper notes the use of telehealth devices for healthcare providers to listen to stakeholders and not merely to observe them and implement programs without consultation, as we reiterate the view that caring is a two‐way exercise. Measures responding to the pandemic have to maintain and enhance the two‐way conversation between the carer and the cared for.\nIt has significantly improved the quality of delivery by overcoming geographic barriers, increasing accessibility and efficiency by reducing the need to travel, providing clinical support, offering access through multiple platforms that patients can easily connect with, and ultimately improving patient health outcomes.57 Alvandi, M. (2017, March 10). Telemedicine and its Role in Revolutionizing Healthcare Delivery. American Journal of Accountable Care. 5(1), e1‐e5. Retrieved May 16, 2020, from https://www.ajmc.com/journals/ajac/2017/2017‐vol5‐n1/telemedicine‐and‐its‐role‐in‐revolutionizing‐healthcare‐delivery\nThe current pandemic has hopefully provided an irreversible inertia for the DOH and other healthcare authorities and stakeholders to accelerate their preparedness and capability to respond to pandemics and disasters not only in the short term but also in the foreseeable future. This approach can be possible by focusing on removing barriers to inequitable access to healthcare communication and other healthcare resources, an important strategy in support of the prioritization of the worst off.\nParadoxically, the use of telehealth to address one kind of need highlights a problem of another kind. This has to do with healthcare being essentially an expression of closeness, of solidarity, and of removing physical and emotional barriers to well‐being.58 Kelley, J.M., et al. (2014, April). The Influence of the Patient‐Clinician Relationship on Healthcare Outcomes: a Systematic Review and Meta‐Analysis of Randomized Controlled Trials. PLoS ONE. 9(4). Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981763/pdf/pone.0094207.pdf\n, 59 Eton, D.T., et al. (2017, September 26). Healthcare Provider Relational Quality Is Associated with Better Self‐Management and Less Treatment Burden in People with Multiple Chronic Conditions. Patient Preference and Adherence. 2017(11). 1635‐1646. Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630069/pdf/ppa‐11‐1635.pdf\n, 60 Ndjaboue, R., et al. (2020). Patients’ Perspectives on How to Improve Diabetes Care and Self‐Management: Qualitative Study. BMJ Open. 10(4). Retrieved August 21, 2020, from https://bmjopen.bmj.com/content/bmjopen/10/4/e032762.full.pdf\nThus, we have seen how family members have bemoaned their inability to be close to their loved ones who are being administered critical (possibly end of life) care.61 Wakam, G.K., et al. (2020, June 11). Not Dying Alone — Modern Compassionate Care in the Covid‐19 Pandemic. The New England Journal of Medicine. 382(24). Retrieved August 21, 2020, from https://www.nejm.org/doi/full/10.1056/nejmp2007781\n, 62 Anonymous. (2020, April 16). Coronavirus: Family of Dead Boy, 13, 'Happy' with Policy Change. BBC. Retrieved August 21, 2020, from https://www.bbc.com/news/uk‐england‐london‐52312653\nPhysical distancing appears to be antithetical to human beings’ emotional closeness.63 Walker, R.C., et al. (2019, April). Patient Expectations and Experiences of Remote Monitoring for Chronic Diseases: Systematic Review and Thematic Synthesis of Qualitative Studies. International Journal of Medical Informatics. 124, 78‐85. Retrieved August 21, 2020, from https://reader.elsevier.com/reader/sd/pii/S1386505618309821?token=AE5D9B38531915EFC954F90AE486E57D24337F6D95DD1C3ED6B50094A68FD07DF5474EB5F4C4488859E0BD8D7311577B\n, 64 Mirzaei, T., \u0026 Kashian, N. (2020, May). Revisiting Effective Communication between Patients and Physicians: Cross‐Sectional Questionnaire Study Comparing Text‐Based Electronic Versus Face‐to‐Face Communication. Journal of Medical Internet Research. 22(5). Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254277/#ref2\nBut this is another issue that is beyond the scope of this paper. The physical availability of health care workers is a related concern that the next section deals with."}

LitCovid-PD-UBERON

{"project":"LitCovid-PD-UBERON","denotations":[{"id":"T3","span":{"begin":2809,"end":2813},"obj":"Body_part"},{"id":"T4","span":{"begin":2898,"end":2902},"obj":"Body_part"},{"id":"T5","span":{"begin":5211,"end":5215},"obj":"Body_part"},{"id":"T6","span":{"begin":5219,"end":5223},"obj":"Body_part"},{"id":"T7","span":{"begin":8161,"end":8166},"obj":"Body_part"},{"id":"T8","span":{"begin":11229,"end":11233},"obj":"Body_part"},{"id":"T9","span":{"begin":11237,"end":11241},"obj":"Body_part"},{"id":"T10","span":{"begin":15435,"end":15439},"obj":"Body_part"},{"id":"T11","span":{"begin":15443,"end":15447},"obj":"Body_part"}],"attributes":[{"id":"A3","pred":"uberon_id","subj":"T3","obj":"http://purl.obolibrary.org/obo/UBERON_0002048"},{"id":"A4","pred":"uberon_id","subj":"T4","obj":"http://purl.obolibrary.org/obo/UBERON_0002048"},{"id":"A5","pred":"uberon_id","subj":"T5","obj":"http://purl.obolibrary.org/obo/UBERON_0001456"},{"id":"A6","pred":"uberon_id","subj":"T6","obj":"http://purl.obolibrary.org/obo/UBERON_0001456"},{"id":"A7","pred":"uberon_id","subj":"T7","obj":"http://purl.obolibrary.org/obo/UBERON_0000178"},{"id":"A8","pred":"uberon_id","subj":"T8","obj":"http://purl.obolibrary.org/obo/UBERON_0001456"},{"id":"A9","pred":"uberon_id","subj":"T9","obj":"http://purl.obolibrary.org/obo/UBERON_0001456"},{"id":"A10","pred":"uberon_id","subj":"T10","obj":"http://purl.obolibrary.org/obo/UBERON_0001456"},{"id":"A11","pred":"uberon_id","subj":"T11","obj":"http://purl.obolibrary.org/obo/UBERON_0001456"}],"text":"5 TELEHEALTH AS A RESPONSE TO HEALTH INFORMATION INEQUITIES\nIn addition to translation initiatives, telehealth practice illustrates what can be done to address an otherwise crippling lack of access to vital health‐related information.\nAdvocates of telehealth have been taking the opportunity to highlight how the practice can help address inequities in access to health information and to healthcare more broadly. Even before the onset of the COVID‐19 pandemic, they were already promoting the use of digital means to address healthcare issues faced by vulnerable sectors. Telehealth has been demonstrated to help close the gaps in healthcare service delivery as a way of ensuring that national healthcare systems are responsive, efficient, and equitable in providing healthcare to all, especially the traditionally underserved and vulnerable populations. The World Health Organization (WHO) developed a National eHealth strategy framework in 2012 to guide countries in effectively integrating ehealth in their systems.36 World Health Organization \u0026 International Telecommunication Union. (2012). National eHealth Strategy Toolkit Overview. World Health Organization. Retrieved May 16, 2020, from https://www.who.int/ehealth/publications/overview.pdf\nThe Philippine government was able to develop an ehealth strategic framework in 2013, but as early as 2008, the University of the Philippines (UP) National Telehealth Center (NTHC) was already practicing telemedicine.37 Patdu, I.D., \u0026 Tenorio, A.S. (2016, December 31). Establishing the Legal Framework of Telehealth in the Philippines. Acta Medica Philippina. (50)4, 237‐246. Retrieved May 15, 2020, from https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/763\nRecognizing the gaps in the healthcare system and the inequitable delivery of healthcare services, the UP NTHC provided telehealth services to aid physicians who were assigned to remote communities all over the Philippines upon being recruited to the Doctors to the Barrios Program (DTTB). Clinical specialists from the UP Philippine General Hospital (PGH) became the remote source of valuable knowledge to DTTB physicians as they provided healthcare services to their patients. This enabled the patients from far flung communities to access quality healthcare from specialists based at a tertiary hospital that was otherwise beyond their reach.\nIn various ways, the COVID‐19 pandemic has turned the once underrated practice of telehealth into a widely explored alternative mode of practice. It is riding on the wave of the new normal in healthcare service delivery. Both the Department of Health (DOH) and the private sector have scrambled to utilize telehealth to provide consults and information to a nation hit hard by anxiety and uncertainty. One of the early users was the Lung Center of the Philippines COVID‐19 Task Force. Through a social media platform, the Lung Center held teleconsultations and provided answers to COVID‐19 related questions.38 Nonato, V., Crisostomo, S., \u0026 Calica, A. (2020, March 31). The Doctor Is Online: Physicians Offer Free Services to Decongest Hospitals. One News. Retrieved July 27, 2020, from https://www.onenews.ph/the‐doctor‐is‐online‐physicians‐offer‐free‐services‐to‐decongest‐hospitals\n, 39 Perez, R. (2020, April 7). DOH COVID‐19 Hotline Now Provides Free Telemedicine Consultations. Smart Parenting. Retrieved July 27, 2020, from https://www.smartparenting.com.ph/life/news/doh‐covid‐19‐hotline‐telemedicine‐a00041‐20200407\nThe Philippine General Hospital established the \"Bayanihan na\" call center where consults were made through a hotline.40 Dela Cruz, R.C. (2020, March 31). PGH Launches Covid‐19 Hotline for Consultations, Donations. Philippine News Agency. Retrieved May 20, 2020, from https://www.pna.gov.ph/articles/1098332\n, 41 Romualdo, A.VCD.P. (2020, March 31). Bayanihan Na! UP‐PGH Launches COVID‐19 Ops Center. University of the Philippines Manila News. Retrieved May 20, 2020, from https://www.up.edu.ph/bayanihan‐na‐up‐pgh‐launches‐covid‐19‐ops‐center/\nThe DOH, having no telehealth platform of its own, has collaborated with private providers to establish the DOH (Telehealth) hotline.42 Anonymous. (2020, April 7). DOH Boost Telemedicine Services for NCR Service to Expand to Other Regions Soon. Press Release. Department of Health. Retrieved May 16, 2020, from https://www.doh.gov.ph/doh‐press‐release/DOH‐BOOST‐TELEMEDICINE‐SERVICES‐FOR‐NCR‐SERVICE‐TO‐EXPAND‐TO‐OTHER‐REGIONS‐SOON\n, 43 CNN Philippines Staff. (2020, April 27). DOH Launches Telemedicine Consultation for Metro Manila Residents. CNN Philippines. Retrieved April 27, 2020, from https://cnnphilippines.com/news/2020/4/7/Telemedicine‐consultation‐COVID.html https://www.pna.gov.ph/articles/1047575\nWhereas only a few physicians practiced telehealth in the country at the beginning of the year, the COVID‐19 pandemic has certainly accelerated the acceptance of telehealth as a means to improve healthcare. Aside from providing healthcare access to remote patients, the practice of telehealth has served to limit physical contact in order to reduce the risk of contracting COVID‐19. Physicians who previously disliked the use of technology and preferred face to face consultations are now forced to “see” patients remotely. The tide has started to turn and this appears to have happened also in other countries.44 Galewitz, P. (2020, March 27). Telemedicine Surges, Fueled by Coronavirus Fears and Shift in Payment Rules. Kaiser Health News. Retrieved May 17, 2020, from https://khn.org/news/telemedicine‐surges‐fueled‐by‐coronavirus‐fears‐and‐shift‐in‐payment‐rules/\nMultiple studies have shown how telemedicine has enhanced health service delivery.45 Williams, O.E., et al. (2017). The Use of Telemedicine to Enhance Secondary Care: Some Lessons from the Front Line. Future Healthcare Journal. 4(2), 109–114. Retrieved May 20, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502630/\n, 46 Bryant, B. (2018, December 11). Telemedicine Improves Healthcare through Innovative Service Delivery. National Association of Counties (NACO). Retrieved May 20, 2020, from https://www.naco.org/articles/telemedicine‐improves‐healthcare‐through‐innovative‐service‐delivery\n, 47 Siddiquee, N.K.A., et al. (2019). Telemedicine in Resource‐Limited Setting: Narrative Synthesis of Evidence in Nepalese Context. Smart Homecare Technology and TeleHealth. Retrieved May 21, 2020, from https://www.dovepress.com/telemedicine‐in‐resource‐limited‐setting‐narrative‐synthesis‐of‐eviden‐peer‐reviewed‐fulltext‐article‐SHTT.\nEven before launching the COVID‐19 telemedicine hotline, the DOH already launched multiple telehealth initiatives: a non‐COVID‐19 clinical Helpdesk (through hotlines), email, and chat (including a DOH internet‐based messaging app group that is open to lay people and another group for health care workers).48 Anonymous. (No date). National Telehealth Center. National Institutes of Health. Retrieved August 21, 2020, from http://nih.upm.edu.ph/institute/national‐telehealth‐center\n, 49 Anonymous. (2016‐2020). PH COVID‐19 Health Workers. Rakuten Viber. Retrieved August 21, 2020, from https://invite.viber.com/?g2=AQA70%2FYXR8FXAEs1ff7nzV%2BJvuR8LVkveAaVASkICVnUaqX7In%2F%2Fp8nQ%2BzXeW%2BDr\u0026lang=en\u0026fbclid=IwAR3YDLl3YQJ5rxb‐UA6GI2NDfo5muokHKdcHYHUWFV7GUtSjUPlxFM3Ptqo\nAnother heavily used platform is Facebook where infographic materials, videos, and press releases are done.50 Anonymous. (No date). Department of Health Philippines. Facebook. Retrieved August 21, 2020, from https://www.facebook.com/OfficialDOHgov/\nThe use of a digital platform in these ways is in line with what we expect post‐COVID‐19 society to be like. It is useful for people with COVID‐19 symptoms as well as for those with non‐COVID‐19 health related issues.\nA device called RxBox has become an important tool for the practice of telemedicine. The RxBox is a telemedicine device developed by the University of the Philippines Manila and supported by the DOH and the Department of Science and Technology. It captures medical signals through built‐in medical sensors and has several capabilities such as functioning as a blood pressure and pulse rate monitor, pulse oximeter, and temperature sensor.51 National Telehealth Center. (2014). RxBox: Advancing Community Healthcare 2014. Retrieved May 23, 2020, from https://telehealth.ph/project‐rxbox/\n Primarily used in isolated and disadvantaged communities nationwide, it is able to store data in an electronic medical record, and transmit this information via internet to a clinical specialist at regional government hospitals including PGH, the doctors from which can then offer expert advice. By facilitating teleconsultations within the National Telehealth Service Program, the RxBox can reduce the overall cost of healthcare by enabling healthcare workers to diagnose, monitor and treat patients within the rural healthcare facility, using medical sensors inside the box.52 Ibid.\nAs part of an initiative of the University of the Philippines and the Department of Science and Technology to respond to the pandemic, devices are being installed at PGH. The RxBox is now being developed to have telemetry capability, which means being able to connect with a dashboard at the nurses’ station where vital signs can be read. The device therefore allows for remote monitoring that minimizes risks associated with the proximity of healthcare workers to patients with communicable diseases. The installation of 100 RxBox devices at PGH as a response to the COVID‐19 pandemic will significantly improve access by people in remote locations to health care and information.53 Macan, J.G. (2020, April 1). PGH to Use DOST's RxBox for COVID‐19 In‐patient Monitoring. Philippine Council for Health Research and Development. Retrieved August 5, 2020, from http://www.pchrd.dost.gov.ph/index.php/news/6527‐pgh‐to‐use‐dost‐s‐rxbox‐for‐covid‐19‐in‐patient‐monitoring\n, 54 Sambatyon, E. (2020, April 4). UP and DOST‐developed RxBox Vital Signs Monitor for COVID‐19 Patients Now in Use at Philippine General Hospital. Good News Philippines. Retrieved August 5, 2020, from https://www.goodnewspilipinas.com/up‐and‐dost‐developed‐rxbox‐vital‐signs‐monitor‐for‐covid‐19‐patients‐now‐in‐use‐at‐philippine‐general‐hospital/\nAnother initiative under the UP College of Medicine's Surgical Innovation and Biotechnology Laboratory (SIBOL) in cooperation with UP Diliman’s Electrical and Electronics Engineering Institute is a “telepresence\" device, a computer programmed to automatically answer calls from authorized accounts using available teleconferencing and remote‐control applications, minimizing contamination and allowing effortless access even by patients with no technological know‐how.55 Gonzalez, C.J. (2020, June 1). COVID‐19 Telepresence Device Connects Frontliners to Patients, Patients to Loved Ones. Philippine Council for Health Research and Development. Retrieved June 25, 2020, from http://www.pchrd.dost.gov.ph/index.php/news/6559‐covid‐19‐telepresence‐device‐connects‐frontliners‐to‐patients‐patients‐to‐loved‐ones.\nLike the RxBox, a “telepresence” device allows healthcare workers and patients to communicate with each other without need for face to face contact.56 CNN Philippines Staff. (2020, April 16). New Device Developed to Limit COVID‐19 Exposure of Frontline Health Care Workers. CNN Philippines. Retrieved May 23, 2020, from https://www.cnnphilippines.com/news/2020/4/16/telepresence‐device‐pgh‐.html\nThis paper notes the use of telehealth devices for healthcare providers to listen to stakeholders and not merely to observe them and implement programs without consultation, as we reiterate the view that caring is a two‐way exercise. Measures responding to the pandemic have to maintain and enhance the two‐way conversation between the carer and the cared for.\nIt has significantly improved the quality of delivery by overcoming geographic barriers, increasing accessibility and efficiency by reducing the need to travel, providing clinical support, offering access through multiple platforms that patients can easily connect with, and ultimately improving patient health outcomes.57 Alvandi, M. (2017, March 10). Telemedicine and its Role in Revolutionizing Healthcare Delivery. American Journal of Accountable Care. 5(1), e1‐e5. Retrieved May 16, 2020, from https://www.ajmc.com/journals/ajac/2017/2017‐vol5‐n1/telemedicine‐and‐its‐role‐in‐revolutionizing‐healthcare‐delivery\nThe current pandemic has hopefully provided an irreversible inertia for the DOH and other healthcare authorities and stakeholders to accelerate their preparedness and capability to respond to pandemics and disasters not only in the short term but also in the foreseeable future. This approach can be possible by focusing on removing barriers to inequitable access to healthcare communication and other healthcare resources, an important strategy in support of the prioritization of the worst off.\nParadoxically, the use of telehealth to address one kind of need highlights a problem of another kind. This has to do with healthcare being essentially an expression of closeness, of solidarity, and of removing physical and emotional barriers to well‐being.58 Kelley, J.M., et al. (2014, April). The Influence of the Patient‐Clinician Relationship on Healthcare Outcomes: a Systematic Review and Meta‐Analysis of Randomized Controlled Trials. PLoS ONE. 9(4). Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981763/pdf/pone.0094207.pdf\n, 59 Eton, D.T., et al. (2017, September 26). Healthcare Provider Relational Quality Is Associated with Better Self‐Management and Less Treatment Burden in People with Multiple Chronic Conditions. Patient Preference and Adherence. 2017(11). 1635‐1646. Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630069/pdf/ppa‐11‐1635.pdf\n, 60 Ndjaboue, R., et al. (2020). Patients’ Perspectives on How to Improve Diabetes Care and Self‐Management: Qualitative Study. BMJ Open. 10(4). Retrieved August 21, 2020, from https://bmjopen.bmj.com/content/bmjopen/10/4/e032762.full.pdf\nThus, we have seen how family members have bemoaned their inability to be close to their loved ones who are being administered critical (possibly end of life) care.61 Wakam, G.K., et al. (2020, June 11). Not Dying Alone — Modern Compassionate Care in the Covid‐19 Pandemic. The New England Journal of Medicine. 382(24). Retrieved August 21, 2020, from https://www.nejm.org/doi/full/10.1056/nejmp2007781\n, 62 Anonymous. (2020, April 16). Coronavirus: Family of Dead Boy, 13, 'Happy' with Policy Change. BBC. Retrieved August 21, 2020, from https://www.bbc.com/news/uk‐england‐london‐52312653\nPhysical distancing appears to be antithetical to human beings’ emotional closeness.63 Walker, R.C., et al. (2019, April). Patient Expectations and Experiences of Remote Monitoring for Chronic Diseases: Systematic Review and Thematic Synthesis of Qualitative Studies. International Journal of Medical Informatics. 124, 78‐85. Retrieved August 21, 2020, from https://reader.elsevier.com/reader/sd/pii/S1386505618309821?token=AE5D9B38531915EFC954F90AE486E57D24337F6D95DD1C3ED6B50094A68FD07DF5474EB5F4C4488859E0BD8D7311577B\n, 64 Mirzaei, T., \u0026 Kashian, N. (2020, May). Revisiting Effective Communication between Patients and Physicians: Cross‐Sectional Questionnaire Study Comparing Text‐Based Electronic Versus Face‐to‐Face Communication. Journal of Medical Internet Research. 22(5). Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254277/#ref2\nBut this is another issue that is beyond the scope of this paper. The physical availability of health care workers is a related concern that the next section deals with."}

LitCovid-PD-MONDO

LitCovid-PD-CLO

LitCovid-PD-CHEBI

LitCovid-PD-HP

{"project":"LitCovid-PD-HP","denotations":[{"id":"T3","span":{"begin":2753,"end":2760},"obj":"Phenotype"},{"id":"T4","span":{"begin":12536,"end":12543},"obj":"Phenotype"}],"attributes":[{"id":"A3","pred":"hp_id","subj":"T3","obj":"http://purl.obolibrary.org/obo/HP_0000739"},{"id":"A4","pred":"hp_id","subj":"T4","obj":"http://purl.obolibrary.org/obo/HP_0030216"}],"text":"5 TELEHEALTH AS A RESPONSE TO HEALTH INFORMATION INEQUITIES\nIn addition to translation initiatives, telehealth practice illustrates what can be done to address an otherwise crippling lack of access to vital health‐related information.\nAdvocates of telehealth have been taking the opportunity to highlight how the practice can help address inequities in access to health information and to healthcare more broadly. Even before the onset of the COVID‐19 pandemic, they were already promoting the use of digital means to address healthcare issues faced by vulnerable sectors. Telehealth has been demonstrated to help close the gaps in healthcare service delivery as a way of ensuring that national healthcare systems are responsive, efficient, and equitable in providing healthcare to all, especially the traditionally underserved and vulnerable populations. The World Health Organization (WHO) developed a National eHealth strategy framework in 2012 to guide countries in effectively integrating ehealth in their systems.36 World Health Organization \u0026 International Telecommunication Union. (2012). National eHealth Strategy Toolkit Overview. World Health Organization. Retrieved May 16, 2020, from https://www.who.int/ehealth/publications/overview.pdf\nThe Philippine government was able to develop an ehealth strategic framework in 2013, but as early as 2008, the University of the Philippines (UP) National Telehealth Center (NTHC) was already practicing telemedicine.37 Patdu, I.D., \u0026 Tenorio, A.S. (2016, December 31). Establishing the Legal Framework of Telehealth in the Philippines. Acta Medica Philippina. (50)4, 237‐246. Retrieved May 15, 2020, from https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/763\nRecognizing the gaps in the healthcare system and the inequitable delivery of healthcare services, the UP NTHC provided telehealth services to aid physicians who were assigned to remote communities all over the Philippines upon being recruited to the Doctors to the Barrios Program (DTTB). Clinical specialists from the UP Philippine General Hospital (PGH) became the remote source of valuable knowledge to DTTB physicians as they provided healthcare services to their patients. This enabled the patients from far flung communities to access quality healthcare from specialists based at a tertiary hospital that was otherwise beyond their reach.\nIn various ways, the COVID‐19 pandemic has turned the once underrated practice of telehealth into a widely explored alternative mode of practice. It is riding on the wave of the new normal in healthcare service delivery. Both the Department of Health (DOH) and the private sector have scrambled to utilize telehealth to provide consults and information to a nation hit hard by anxiety and uncertainty. One of the early users was the Lung Center of the Philippines COVID‐19 Task Force. Through a social media platform, the Lung Center held teleconsultations and provided answers to COVID‐19 related questions.38 Nonato, V., Crisostomo, S., \u0026 Calica, A. (2020, March 31). The Doctor Is Online: Physicians Offer Free Services to Decongest Hospitals. One News. Retrieved July 27, 2020, from https://www.onenews.ph/the‐doctor‐is‐online‐physicians‐offer‐free‐services‐to‐decongest‐hospitals\n, 39 Perez, R. (2020, April 7). DOH COVID‐19 Hotline Now Provides Free Telemedicine Consultations. Smart Parenting. Retrieved July 27, 2020, from https://www.smartparenting.com.ph/life/news/doh‐covid‐19‐hotline‐telemedicine‐a00041‐20200407\nThe Philippine General Hospital established the \"Bayanihan na\" call center where consults were made through a hotline.40 Dela Cruz, R.C. (2020, March 31). PGH Launches Covid‐19 Hotline for Consultations, Donations. Philippine News Agency. Retrieved May 20, 2020, from https://www.pna.gov.ph/articles/1098332\n, 41 Romualdo, A.VCD.P. (2020, March 31). Bayanihan Na! UP‐PGH Launches COVID‐19 Ops Center. University of the Philippines Manila News. Retrieved May 20, 2020, from https://www.up.edu.ph/bayanihan‐na‐up‐pgh‐launches‐covid‐19‐ops‐center/\nThe DOH, having no telehealth platform of its own, has collaborated with private providers to establish the DOH (Telehealth) hotline.42 Anonymous. (2020, April 7). DOH Boost Telemedicine Services for NCR Service to Expand to Other Regions Soon. Press Release. Department of Health. Retrieved May 16, 2020, from https://www.doh.gov.ph/doh‐press‐release/DOH‐BOOST‐TELEMEDICINE‐SERVICES‐FOR‐NCR‐SERVICE‐TO‐EXPAND‐TO‐OTHER‐REGIONS‐SOON\n, 43 CNN Philippines Staff. (2020, April 27). DOH Launches Telemedicine Consultation for Metro Manila Residents. CNN Philippines. Retrieved April 27, 2020, from https://cnnphilippines.com/news/2020/4/7/Telemedicine‐consultation‐COVID.html https://www.pna.gov.ph/articles/1047575\nWhereas only a few physicians practiced telehealth in the country at the beginning of the year, the COVID‐19 pandemic has certainly accelerated the acceptance of telehealth as a means to improve healthcare. Aside from providing healthcare access to remote patients, the practice of telehealth has served to limit physical contact in order to reduce the risk of contracting COVID‐19. Physicians who previously disliked the use of technology and preferred face to face consultations are now forced to “see” patients remotely. The tide has started to turn and this appears to have happened also in other countries.44 Galewitz, P. (2020, March 27). Telemedicine Surges, Fueled by Coronavirus Fears and Shift in Payment Rules. Kaiser Health News. Retrieved May 17, 2020, from https://khn.org/news/telemedicine‐surges‐fueled‐by‐coronavirus‐fears‐and‐shift‐in‐payment‐rules/\nMultiple studies have shown how telemedicine has enhanced health service delivery.45 Williams, O.E., et al. (2017). The Use of Telemedicine to Enhance Secondary Care: Some Lessons from the Front Line. Future Healthcare Journal. 4(2), 109–114. Retrieved May 20, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502630/\n, 46 Bryant, B. (2018, December 11). Telemedicine Improves Healthcare through Innovative Service Delivery. National Association of Counties (NACO). Retrieved May 20, 2020, from https://www.naco.org/articles/telemedicine‐improves‐healthcare‐through‐innovative‐service‐delivery\n, 47 Siddiquee, N.K.A., et al. (2019). Telemedicine in Resource‐Limited Setting: Narrative Synthesis of Evidence in Nepalese Context. Smart Homecare Technology and TeleHealth. Retrieved May 21, 2020, from https://www.dovepress.com/telemedicine‐in‐resource‐limited‐setting‐narrative‐synthesis‐of‐eviden‐peer‐reviewed‐fulltext‐article‐SHTT.\nEven before launching the COVID‐19 telemedicine hotline, the DOH already launched multiple telehealth initiatives: a non‐COVID‐19 clinical Helpdesk (through hotlines), email, and chat (including a DOH internet‐based messaging app group that is open to lay people and another group for health care workers).48 Anonymous. (No date). National Telehealth Center. National Institutes of Health. Retrieved August 21, 2020, from http://nih.upm.edu.ph/institute/national‐telehealth‐center\n, 49 Anonymous. (2016‐2020). PH COVID‐19 Health Workers. Rakuten Viber. Retrieved August 21, 2020, from https://invite.viber.com/?g2=AQA70%2FYXR8FXAEs1ff7nzV%2BJvuR8LVkveAaVASkICVnUaqX7In%2F%2Fp8nQ%2BzXeW%2BDr\u0026lang=en\u0026fbclid=IwAR3YDLl3YQJ5rxb‐UA6GI2NDfo5muokHKdcHYHUWFV7GUtSjUPlxFM3Ptqo\nAnother heavily used platform is Facebook where infographic materials, videos, and press releases are done.50 Anonymous. (No date). Department of Health Philippines. Facebook. Retrieved August 21, 2020, from https://www.facebook.com/OfficialDOHgov/\nThe use of a digital platform in these ways is in line with what we expect post‐COVID‐19 society to be like. It is useful for people with COVID‐19 symptoms as well as for those with non‐COVID‐19 health related issues.\nA device called RxBox has become an important tool for the practice of telemedicine. The RxBox is a telemedicine device developed by the University of the Philippines Manila and supported by the DOH and the Department of Science and Technology. It captures medical signals through built‐in medical sensors and has several capabilities such as functioning as a blood pressure and pulse rate monitor, pulse oximeter, and temperature sensor.51 National Telehealth Center. (2014). RxBox: Advancing Community Healthcare 2014. Retrieved May 23, 2020, from https://telehealth.ph/project‐rxbox/\n Primarily used in isolated and disadvantaged communities nationwide, it is able to store data in an electronic medical record, and transmit this information via internet to a clinical specialist at regional government hospitals including PGH, the doctors from which can then offer expert advice. By facilitating teleconsultations within the National Telehealth Service Program, the RxBox can reduce the overall cost of healthcare by enabling healthcare workers to diagnose, monitor and treat patients within the rural healthcare facility, using medical sensors inside the box.52 Ibid.\nAs part of an initiative of the University of the Philippines and the Department of Science and Technology to respond to the pandemic, devices are being installed at PGH. The RxBox is now being developed to have telemetry capability, which means being able to connect with a dashboard at the nurses’ station where vital signs can be read. The device therefore allows for remote monitoring that minimizes risks associated with the proximity of healthcare workers to patients with communicable diseases. The installation of 100 RxBox devices at PGH as a response to the COVID‐19 pandemic will significantly improve access by people in remote locations to health care and information.53 Macan, J.G. (2020, April 1). PGH to Use DOST's RxBox for COVID‐19 In‐patient Monitoring. Philippine Council for Health Research and Development. Retrieved August 5, 2020, from http://www.pchrd.dost.gov.ph/index.php/news/6527‐pgh‐to‐use‐dost‐s‐rxbox‐for‐covid‐19‐in‐patient‐monitoring\n, 54 Sambatyon, E. (2020, April 4). UP and DOST‐developed RxBox Vital Signs Monitor for COVID‐19 Patients Now in Use at Philippine General Hospital. Good News Philippines. Retrieved August 5, 2020, from https://www.goodnewspilipinas.com/up‐and‐dost‐developed‐rxbox‐vital‐signs‐monitor‐for‐covid‐19‐patients‐now‐in‐use‐at‐philippine‐general‐hospital/\nAnother initiative under the UP College of Medicine's Surgical Innovation and Biotechnology Laboratory (SIBOL) in cooperation with UP Diliman’s Electrical and Electronics Engineering Institute is a “telepresence\" device, a computer programmed to automatically answer calls from authorized accounts using available teleconferencing and remote‐control applications, minimizing contamination and allowing effortless access even by patients with no technological know‐how.55 Gonzalez, C.J. (2020, June 1). COVID‐19 Telepresence Device Connects Frontliners to Patients, Patients to Loved Ones. Philippine Council for Health Research and Development. Retrieved June 25, 2020, from http://www.pchrd.dost.gov.ph/index.php/news/6559‐covid‐19‐telepresence‐device‐connects‐frontliners‐to‐patients‐patients‐to‐loved‐ones.\nLike the RxBox, a “telepresence” device allows healthcare workers and patients to communicate with each other without need for face to face contact.56 CNN Philippines Staff. (2020, April 16). New Device Developed to Limit COVID‐19 Exposure of Frontline Health Care Workers. CNN Philippines. Retrieved May 23, 2020, from https://www.cnnphilippines.com/news/2020/4/16/telepresence‐device‐pgh‐.html\nThis paper notes the use of telehealth devices for healthcare providers to listen to stakeholders and not merely to observe them and implement programs without consultation, as we reiterate the view that caring is a two‐way exercise. Measures responding to the pandemic have to maintain and enhance the two‐way conversation between the carer and the cared for.\nIt has significantly improved the quality of delivery by overcoming geographic barriers, increasing accessibility and efficiency by reducing the need to travel, providing clinical support, offering access through multiple platforms that patients can easily connect with, and ultimately improving patient health outcomes.57 Alvandi, M. (2017, March 10). Telemedicine and its Role in Revolutionizing Healthcare Delivery. American Journal of Accountable Care. 5(1), e1‐e5. Retrieved May 16, 2020, from https://www.ajmc.com/journals/ajac/2017/2017‐vol5‐n1/telemedicine‐and‐its‐role‐in‐revolutionizing‐healthcare‐delivery\nThe current pandemic has hopefully provided an irreversible inertia for the DOH and other healthcare authorities and stakeholders to accelerate their preparedness and capability to respond to pandemics and disasters not only in the short term but also in the foreseeable future. This approach can be possible by focusing on removing barriers to inequitable access to healthcare communication and other healthcare resources, an important strategy in support of the prioritization of the worst off.\nParadoxically, the use of telehealth to address one kind of need highlights a problem of another kind. This has to do with healthcare being essentially an expression of closeness, of solidarity, and of removing physical and emotional barriers to well‐being.58 Kelley, J.M., et al. (2014, April). The Influence of the Patient‐Clinician Relationship on Healthcare Outcomes: a Systematic Review and Meta‐Analysis of Randomized Controlled Trials. PLoS ONE. 9(4). Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981763/pdf/pone.0094207.pdf\n, 59 Eton, D.T., et al. (2017, September 26). Healthcare Provider Relational Quality Is Associated with Better Self‐Management and Less Treatment Burden in People with Multiple Chronic Conditions. Patient Preference and Adherence. 2017(11). 1635‐1646. Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630069/pdf/ppa‐11‐1635.pdf\n, 60 Ndjaboue, R., et al. (2020). Patients’ Perspectives on How to Improve Diabetes Care and Self‐Management: Qualitative Study. BMJ Open. 10(4). Retrieved August 21, 2020, from https://bmjopen.bmj.com/content/bmjopen/10/4/e032762.full.pdf\nThus, we have seen how family members have bemoaned their inability to be close to their loved ones who are being administered critical (possibly end of life) care.61 Wakam, G.K., et al. (2020, June 11). Not Dying Alone — Modern Compassionate Care in the Covid‐19 Pandemic. The New England Journal of Medicine. 382(24). Retrieved August 21, 2020, from https://www.nejm.org/doi/full/10.1056/nejmp2007781\n, 62 Anonymous. (2020, April 16). Coronavirus: Family of Dead Boy, 13, 'Happy' with Policy Change. BBC. Retrieved August 21, 2020, from https://www.bbc.com/news/uk‐england‐london‐52312653\nPhysical distancing appears to be antithetical to human beings’ emotional closeness.63 Walker, R.C., et al. (2019, April). Patient Expectations and Experiences of Remote Monitoring for Chronic Diseases: Systematic Review and Thematic Synthesis of Qualitative Studies. International Journal of Medical Informatics. 124, 78‐85. Retrieved August 21, 2020, from https://reader.elsevier.com/reader/sd/pii/S1386505618309821?token=AE5D9B38531915EFC954F90AE486E57D24337F6D95DD1C3ED6B50094A68FD07DF5474EB5F4C4488859E0BD8D7311577B\n, 64 Mirzaei, T., \u0026 Kashian, N. (2020, May). Revisiting Effective Communication between Patients and Physicians: Cross‐Sectional Questionnaire Study Comparing Text‐Based Electronic Versus Face‐to‐Face Communication. Journal of Medical Internet Research. 22(5). Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254277/#ref2\nBut this is another issue that is beyond the scope of this paper. The physical availability of health care workers is a related concern that the next section deals with."}

LitCovid-PD-GO-BP

{"project":"LitCovid-PD-GO-BP","denotations":[{"id":"T8","span":{"begin":76,"end":99},"obj":"http://purl.obolibrary.org/obo/GO_0006413"},{"id":"T9","span":{"begin":76,"end":87},"obj":"http://purl.obolibrary.org/obo/GO_0006412"},{"id":"T10","span":{"begin":6318,"end":6327},"obj":"http://purl.obolibrary.org/obo/GO_0009058"},{"id":"T11","span":{"begin":6509,"end":6518},"obj":"http://purl.obolibrary.org/obo/GO_0009058"},{"id":"T12","span":{"begin":14960,"end":14969},"obj":"http://purl.obolibrary.org/obo/GO_0009058"}],"text":"5 TELEHEALTH AS A RESPONSE TO HEALTH INFORMATION INEQUITIES\nIn addition to translation initiatives, telehealth practice illustrates what can be done to address an otherwise crippling lack of access to vital health‐related information.\nAdvocates of telehealth have been taking the opportunity to highlight how the practice can help address inequities in access to health information and to healthcare more broadly. Even before the onset of the COVID‐19 pandemic, they were already promoting the use of digital means to address healthcare issues faced by vulnerable sectors. Telehealth has been demonstrated to help close the gaps in healthcare service delivery as a way of ensuring that national healthcare systems are responsive, efficient, and equitable in providing healthcare to all, especially the traditionally underserved and vulnerable populations. The World Health Organization (WHO) developed a National eHealth strategy framework in 2012 to guide countries in effectively integrating ehealth in their systems.36 World Health Organization \u0026 International Telecommunication Union. (2012). National eHealth Strategy Toolkit Overview. World Health Organization. Retrieved May 16, 2020, from https://www.who.int/ehealth/publications/overview.pdf\nThe Philippine government was able to develop an ehealth strategic framework in 2013, but as early as 2008, the University of the Philippines (UP) National Telehealth Center (NTHC) was already practicing telemedicine.37 Patdu, I.D., \u0026 Tenorio, A.S. (2016, December 31). Establishing the Legal Framework of Telehealth in the Philippines. Acta Medica Philippina. (50)4, 237‐246. Retrieved May 15, 2020, from https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/763\nRecognizing the gaps in the healthcare system and the inequitable delivery of healthcare services, the UP NTHC provided telehealth services to aid physicians who were assigned to remote communities all over the Philippines upon being recruited to the Doctors to the Barrios Program (DTTB). Clinical specialists from the UP Philippine General Hospital (PGH) became the remote source of valuable knowledge to DTTB physicians as they provided healthcare services to their patients. This enabled the patients from far flung communities to access quality healthcare from specialists based at a tertiary hospital that was otherwise beyond their reach.\nIn various ways, the COVID‐19 pandemic has turned the once underrated practice of telehealth into a widely explored alternative mode of practice. It is riding on the wave of the new normal in healthcare service delivery. Both the Department of Health (DOH) and the private sector have scrambled to utilize telehealth to provide consults and information to a nation hit hard by anxiety and uncertainty. One of the early users was the Lung Center of the Philippines COVID‐19 Task Force. Through a social media platform, the Lung Center held teleconsultations and provided answers to COVID‐19 related questions.38 Nonato, V., Crisostomo, S., \u0026 Calica, A. (2020, March 31). The Doctor Is Online: Physicians Offer Free Services to Decongest Hospitals. One News. Retrieved July 27, 2020, from https://www.onenews.ph/the‐doctor‐is‐online‐physicians‐offer‐free‐services‐to‐decongest‐hospitals\n, 39 Perez, R. (2020, April 7). DOH COVID‐19 Hotline Now Provides Free Telemedicine Consultations. Smart Parenting. Retrieved July 27, 2020, from https://www.smartparenting.com.ph/life/news/doh‐covid‐19‐hotline‐telemedicine‐a00041‐20200407\nThe Philippine General Hospital established the \"Bayanihan na\" call center where consults were made through a hotline.40 Dela Cruz, R.C. (2020, March 31). PGH Launches Covid‐19 Hotline for Consultations, Donations. Philippine News Agency. Retrieved May 20, 2020, from https://www.pna.gov.ph/articles/1098332\n, 41 Romualdo, A.VCD.P. (2020, March 31). Bayanihan Na! UP‐PGH Launches COVID‐19 Ops Center. University of the Philippines Manila News. Retrieved May 20, 2020, from https://www.up.edu.ph/bayanihan‐na‐up‐pgh‐launches‐covid‐19‐ops‐center/\nThe DOH, having no telehealth platform of its own, has collaborated with private providers to establish the DOH (Telehealth) hotline.42 Anonymous. (2020, April 7). DOH Boost Telemedicine Services for NCR Service to Expand to Other Regions Soon. Press Release. Department of Health. Retrieved May 16, 2020, from https://www.doh.gov.ph/doh‐press‐release/DOH‐BOOST‐TELEMEDICINE‐SERVICES‐FOR‐NCR‐SERVICE‐TO‐EXPAND‐TO‐OTHER‐REGIONS‐SOON\n, 43 CNN Philippines Staff. (2020, April 27). DOH Launches Telemedicine Consultation for Metro Manila Residents. CNN Philippines. Retrieved April 27, 2020, from https://cnnphilippines.com/news/2020/4/7/Telemedicine‐consultation‐COVID.html https://www.pna.gov.ph/articles/1047575\nWhereas only a few physicians practiced telehealth in the country at the beginning of the year, the COVID‐19 pandemic has certainly accelerated the acceptance of telehealth as a means to improve healthcare. Aside from providing healthcare access to remote patients, the practice of telehealth has served to limit physical contact in order to reduce the risk of contracting COVID‐19. Physicians who previously disliked the use of technology and preferred face to face consultations are now forced to “see” patients remotely. The tide has started to turn and this appears to have happened also in other countries.44 Galewitz, P. (2020, March 27). Telemedicine Surges, Fueled by Coronavirus Fears and Shift in Payment Rules. Kaiser Health News. Retrieved May 17, 2020, from https://khn.org/news/telemedicine‐surges‐fueled‐by‐coronavirus‐fears‐and‐shift‐in‐payment‐rules/\nMultiple studies have shown how telemedicine has enhanced health service delivery.45 Williams, O.E., et al. (2017). The Use of Telemedicine to Enhance Secondary Care: Some Lessons from the Front Line. Future Healthcare Journal. 4(2), 109–114. Retrieved May 20, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502630/\n, 46 Bryant, B. (2018, December 11). Telemedicine Improves Healthcare through Innovative Service Delivery. National Association of Counties (NACO). Retrieved May 20, 2020, from https://www.naco.org/articles/telemedicine‐improves‐healthcare‐through‐innovative‐service‐delivery\n, 47 Siddiquee, N.K.A., et al. (2019). Telemedicine in Resource‐Limited Setting: Narrative Synthesis of Evidence in Nepalese Context. Smart Homecare Technology and TeleHealth. Retrieved May 21, 2020, from https://www.dovepress.com/telemedicine‐in‐resource‐limited‐setting‐narrative‐synthesis‐of‐eviden‐peer‐reviewed‐fulltext‐article‐SHTT.\nEven before launching the COVID‐19 telemedicine hotline, the DOH already launched multiple telehealth initiatives: a non‐COVID‐19 clinical Helpdesk (through hotlines), email, and chat (including a DOH internet‐based messaging app group that is open to lay people and another group for health care workers).48 Anonymous. (No date). National Telehealth Center. National Institutes of Health. Retrieved August 21, 2020, from http://nih.upm.edu.ph/institute/national‐telehealth‐center\n, 49 Anonymous. (2016‐2020). PH COVID‐19 Health Workers. Rakuten Viber. Retrieved August 21, 2020, from https://invite.viber.com/?g2=AQA70%2FYXR8FXAEs1ff7nzV%2BJvuR8LVkveAaVASkICVnUaqX7In%2F%2Fp8nQ%2BzXeW%2BDr\u0026lang=en\u0026fbclid=IwAR3YDLl3YQJ5rxb‐UA6GI2NDfo5muokHKdcHYHUWFV7GUtSjUPlxFM3Ptqo\nAnother heavily used platform is Facebook where infographic materials, videos, and press releases are done.50 Anonymous. (No date). Department of Health Philippines. Facebook. Retrieved August 21, 2020, from https://www.facebook.com/OfficialDOHgov/\nThe use of a digital platform in these ways is in line with what we expect post‐COVID‐19 society to be like. It is useful for people with COVID‐19 symptoms as well as for those with non‐COVID‐19 health related issues.\nA device called RxBox has become an important tool for the practice of telemedicine. The RxBox is a telemedicine device developed by the University of the Philippines Manila and supported by the DOH and the Department of Science and Technology. It captures medical signals through built‐in medical sensors and has several capabilities such as functioning as a blood pressure and pulse rate monitor, pulse oximeter, and temperature sensor.51 National Telehealth Center. (2014). RxBox: Advancing Community Healthcare 2014. Retrieved May 23, 2020, from https://telehealth.ph/project‐rxbox/\n Primarily used in isolated and disadvantaged communities nationwide, it is able to store data in an electronic medical record, and transmit this information via internet to a clinical specialist at regional government hospitals including PGH, the doctors from which can then offer expert advice. By facilitating teleconsultations within the National Telehealth Service Program, the RxBox can reduce the overall cost of healthcare by enabling healthcare workers to diagnose, monitor and treat patients within the rural healthcare facility, using medical sensors inside the box.52 Ibid.\nAs part of an initiative of the University of the Philippines and the Department of Science and Technology to respond to the pandemic, devices are being installed at PGH. The RxBox is now being developed to have telemetry capability, which means being able to connect with a dashboard at the nurses’ station where vital signs can be read. The device therefore allows for remote monitoring that minimizes risks associated with the proximity of healthcare workers to patients with communicable diseases. The installation of 100 RxBox devices at PGH as a response to the COVID‐19 pandemic will significantly improve access by people in remote locations to health care and information.53 Macan, J.G. (2020, April 1). PGH to Use DOST's RxBox for COVID‐19 In‐patient Monitoring. Philippine Council for Health Research and Development. Retrieved August 5, 2020, from http://www.pchrd.dost.gov.ph/index.php/news/6527‐pgh‐to‐use‐dost‐s‐rxbox‐for‐covid‐19‐in‐patient‐monitoring\n, 54 Sambatyon, E. (2020, April 4). UP and DOST‐developed RxBox Vital Signs Monitor for COVID‐19 Patients Now in Use at Philippine General Hospital. Good News Philippines. Retrieved August 5, 2020, from https://www.goodnewspilipinas.com/up‐and‐dost‐developed‐rxbox‐vital‐signs‐monitor‐for‐covid‐19‐patients‐now‐in‐use‐at‐philippine‐general‐hospital/\nAnother initiative under the UP College of Medicine's Surgical Innovation and Biotechnology Laboratory (SIBOL) in cooperation with UP Diliman’s Electrical and Electronics Engineering Institute is a “telepresence\" device, a computer programmed to automatically answer calls from authorized accounts using available teleconferencing and remote‐control applications, minimizing contamination and allowing effortless access even by patients with no technological know‐how.55 Gonzalez, C.J. (2020, June 1). COVID‐19 Telepresence Device Connects Frontliners to Patients, Patients to Loved Ones. Philippine Council for Health Research and Development. Retrieved June 25, 2020, from http://www.pchrd.dost.gov.ph/index.php/news/6559‐covid‐19‐telepresence‐device‐connects‐frontliners‐to‐patients‐patients‐to‐loved‐ones.\nLike the RxBox, a “telepresence” device allows healthcare workers and patients to communicate with each other without need for face to face contact.56 CNN Philippines Staff. (2020, April 16). New Device Developed to Limit COVID‐19 Exposure of Frontline Health Care Workers. CNN Philippines. Retrieved May 23, 2020, from https://www.cnnphilippines.com/news/2020/4/16/telepresence‐device‐pgh‐.html\nThis paper notes the use of telehealth devices for healthcare providers to listen to stakeholders and not merely to observe them and implement programs without consultation, as we reiterate the view that caring is a two‐way exercise. Measures responding to the pandemic have to maintain and enhance the two‐way conversation between the carer and the cared for.\nIt has significantly improved the quality of delivery by overcoming geographic barriers, increasing accessibility and efficiency by reducing the need to travel, providing clinical support, offering access through multiple platforms that patients can easily connect with, and ultimately improving patient health outcomes.57 Alvandi, M. (2017, March 10). Telemedicine and its Role in Revolutionizing Healthcare Delivery. American Journal of Accountable Care. 5(1), e1‐e5. Retrieved May 16, 2020, from https://www.ajmc.com/journals/ajac/2017/2017‐vol5‐n1/telemedicine‐and‐its‐role‐in‐revolutionizing‐healthcare‐delivery\nThe current pandemic has hopefully provided an irreversible inertia for the DOH and other healthcare authorities and stakeholders to accelerate their preparedness and capability to respond to pandemics and disasters not only in the short term but also in the foreseeable future. This approach can be possible by focusing on removing barriers to inequitable access to healthcare communication and other healthcare resources, an important strategy in support of the prioritization of the worst off.\nParadoxically, the use of telehealth to address one kind of need highlights a problem of another kind. This has to do with healthcare being essentially an expression of closeness, of solidarity, and of removing physical and emotional barriers to well‐being.58 Kelley, J.M., et al. (2014, April). The Influence of the Patient‐Clinician Relationship on Healthcare Outcomes: a Systematic Review and Meta‐Analysis of Randomized Controlled Trials. PLoS ONE. 9(4). Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981763/pdf/pone.0094207.pdf\n, 59 Eton, D.T., et al. (2017, September 26). Healthcare Provider Relational Quality Is Associated with Better Self‐Management and Less Treatment Burden in People with Multiple Chronic Conditions. Patient Preference and Adherence. 2017(11). 1635‐1646. Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630069/pdf/ppa‐11‐1635.pdf\n, 60 Ndjaboue, R., et al. (2020). Patients’ Perspectives on How to Improve Diabetes Care and Self‐Management: Qualitative Study. BMJ Open. 10(4). Retrieved August 21, 2020, from https://bmjopen.bmj.com/content/bmjopen/10/4/e032762.full.pdf\nThus, we have seen how family members have bemoaned their inability to be close to their loved ones who are being administered critical (possibly end of life) care.61 Wakam, G.K., et al. (2020, June 11). Not Dying Alone — Modern Compassionate Care in the Covid‐19 Pandemic. The New England Journal of Medicine. 382(24). Retrieved August 21, 2020, from https://www.nejm.org/doi/full/10.1056/nejmp2007781\n, 62 Anonymous. (2020, April 16). Coronavirus: Family of Dead Boy, 13, 'Happy' with Policy Change. BBC. Retrieved August 21, 2020, from https://www.bbc.com/news/uk‐england‐london‐52312653\nPhysical distancing appears to be antithetical to human beings’ emotional closeness.63 Walker, R.C., et al. (2019, April). Patient Expectations and Experiences of Remote Monitoring for Chronic Diseases: Systematic Review and Thematic Synthesis of Qualitative Studies. International Journal of Medical Informatics. 124, 78‐85. Retrieved August 21, 2020, from https://reader.elsevier.com/reader/sd/pii/S1386505618309821?token=AE5D9B38531915EFC954F90AE486E57D24337F6D95DD1C3ED6B50094A68FD07DF5474EB5F4C4488859E0BD8D7311577B\n, 64 Mirzaei, T., \u0026 Kashian, N. (2020, May). Revisiting Effective Communication between Patients and Physicians: Cross‐Sectional Questionnaire Study Comparing Text‐Based Electronic Versus Face‐to‐Face Communication. Journal of Medical Internet Research. 22(5). Retrieved August 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254277/#ref2\nBut this is another issue that is beyond the scope of this paper. The physical availability of health care workers is a related concern that the next section deals with."}

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