HITTING THE GROUND AND READY TO RUN

The new PHA President, Atty. Bu Castro, M.D.,  has hit the ground , so to speak, and is in the process of planting his two feet firmly before running off.   This is opposed to the saying “hitting the ground running”. Atty. Bu is to be perceived as  a cautious man.  He lands, he pauses and thinks , before going into a decisive run.  This is in contrast to some leaders who, prior to landing on the ground have already began running and therefore, never got to plant their feet on the ground to the extent of never finding it, running without reaching the destination.

Last Wednesday, December 14, 2011, he has put on the role of coordinator for several groups in the medical communicty, namely: the Philippine Medical Association and its various sub-specialty groups,  the Private Hospital Association and the Philippine Hospital Association, to get together  and pursue continuous discussions on the issues with regard to the Philippine Health Insurance Corporation’s pronouncements on case rate/case mix.

In attendance were stakeholders from:

Philippine Medical Association	Association of Provincial Health Officers
Phil college of Hospital Administrators	Philippine Academy of Family of Physicians
Philippine Hospital Association	Philippine Society of Anesthesia
Members of the PMA Commission On Legislation	Philippine Society of Pathologists
Private Hospital Assn of the Philippines	Philippine Academy of Ophthalmologists
Philippine College of Surgeons	Philippine College of Hospital Administrators
Philippine Obstetrics and Gynecology Society	Phil Society of Otolaryngology & Head/Neck Surgery
Philippine College of Physicians	Philippine Pediatrics Society

The meeting was well attended.  Concerns and proposals from the various groups in attendance were heard, discussed and noted.

Shortly, a joint letter from the PMA , PHAP and PHA Presidents shall be sent to the PHIC President containing the studied proposals from the group.  It is with much anticipation and hope that the continuous dialogue between the parties shall bring forth happy resolution to the case rate / case mix and NBB issues.

The route being taken by the medical community is in consonance with the pronouncements made by the new President Dodo Banzon of pursuing the case rate/mix and NBB strategy for the benefit of all,  with prior and due consultations with various stakeholders which include those who will be  affected from the medical community.

The recent pronouncement of Dr. Banzon on the increase in the premium of the PHIC members is part of the strategy designed to widen and improve the benefits for all concerned.

Apparently, the designated leaders concerned with the issues have “hit the ground and are pausing to think before running” which should be a healthy sign that all will end well.

Best of the Season to All!

NEW PHA PRESIDENT CALLS FOR AN EMERGENCY MEETING ON DEC 14 2011

The issue on case rate/case mix payment scheme has rocked the medical community in the past  months. The new PHIC President is exerting efforts to correct any misimpressions / misinterpretations that may have been created by earlier pronouncements by PHIC on the matter. He has urged all concerned specialty groups to come out with their respective recomputations so that it may be given due course.

In this regard, the PHA President has taken it upon himself to coordinate efforts and activities in this regard.

Below is his NOTICE OF MEETING to all concerned, to be held on December 14, 2011 at 2:30-5:00pm at the PMA Board Room.

OCT. 23, 2011-PHA’s ENDS ITS SERIES OF REG’L CONFERENCES FOR 2011 IN TAGAYTAY CITY.

Region IV A/B and NCR Regional Conference. The fine Sunday weather last October 23, 2011 saw some 200 representatives of member hospitals of the PHILIPPINE HOSPITAL ASSOCIATION troop to the “country’s 2^nd Summer Capital”. It had been the last of the 2011 Series of Regional Conferences of the organization.

PHIC President Dr. Eduardo P. Banzon. The PHA had the distinct pleasure of welcoming the newly - installed Philippine Health Insurance Corporation President and Chief Executive Officer Dr. Eduardo Banzon, MSc, as its guest speaker. His appointment was announced by DOH Secretary Ona during the flag ceremony held at the PHIC grounds in Pasig City last October 17, 2011, barely 5 days before the PHA Regional Conference. Dr. Banzon used to be Philhealth’s Vice President for Health Finance Policy Service but left the agency to join the World Bank.

Highlights of Dr. Banzon’s speech .

Dr. Eduardo Banzon expressed his desire to push for the attainment of the Universal Health Coverage for all Filipinos’ program of Philippine President Benigno Aquino III.

He stated further that the protection extended by the government should be substantial enough and that there is a need to deepen the health coverage of Filipinos.

His speech centered on several premises for Universal Health Coverage:

1. More money for health.

a. To be able to extend wider benefits, funds should be made available

b. Consider increase in premiums to be able to sustain UHC

2. Use of the funds more on the demand side of the economic chart towards basic health insurance

a. Spending more money for more hospitals and doctors is no longer the typical and model response

b. Filipinos’ access to healthcare should be supported by health insurance; healthcare becomes free only because people have health insurance; insurance imbues people with right to health.

3. Primary Care Case Gate Keeping Approach.

a. It is not sustainable to have a free market (charge patients any amount hospitals and doctors want)

b. Case payment is part of the approach

c. Push for all rates to be case payment

d. Ensure that amount is fair

e. Hospitals should coordinate and assert itself to doctors who practice in their establishments

f. Employ incentives such as or maybe : high rates for Centers of Excellence, availability of specialized diagnostic equipment, highly skilled/trained doctors, hospitals located in remote and areas of conflict or great difficulties, etc.

4.  Case payment.

a.  It will come.

b.  It cannot just be imposed however on the private sector; a contracted negotiation is necessary

c.  Case payment can be viewed as a powerful marketing tool for hospitals

d.  Rates should be studied well and discussed thoroughly; consultations.

Other matters covered by Dr. Banzon were:

1.      Change is necessary and that it shall be driven by technology.

2.      Electronic filings, on line inquiries, computers and connectivity at all hospitals as part of accreditation

3.      Educate PHIC members how to navigate their health insurance

4.      Work closely with HMOs as supplementary/complementary partners

5.      Come up with a good dbase where list of members shall be complete down to their dependents

6.      Hospitals and Doctrors as necessary part of insurance

7.      Expect a differentiated approach where the “good guys” shall have an easy time while the “bad guys” will have to watch out.

He ended his speech with a call for dialogue between professionals and urged everyone to TRUST and WORK with PHIC.

His speech was received with a resounding applause from the audience.

Recap of the PHA  Conferences for 2011.

To recap, conferences for the different regions starting in February, 2011 were held in major cities:

Regn 3 Angeles City-Feb. 27,

Regn 7 & 8 Cebu City-March 27,

Regns 1, 2 & CAR Baguio City-April 17,

Regn 11, 12 & ARMM Davao City-May 29,

Reg 5 Legazpi City-June 26,

View of the majrestic Mayon Volcano from the airport tarmac

PHA BODs Dr. Maano , Dr. Salud and Dr. Ante taking a breather
the night before the Regional Conference in Legazpi

Mayor of Legazpi addressing the general membership

Regn 6 & Panay Islands Group Iloilo City-Aug 21,

Honorable Arthur Defensor , Governor of Iloilo
 addressing the general membership

Regns 9, 10 & CARAGA Cagayan de Oro City-Sept. 25,

Deputy Speaker Hon. Erin Tanada addressing the general membership

PHA President Ruben Flores giving his report to the general membership

Dondie Aranda of Isuzu Phil. Corp. who donated a
Samsung Mini Tablet as raffle prize

and Regns IV-A/B & NCR Tagaytay City-Oct 23.

Conferences' mainstay partner UNILAB's Ed Kanapi, Dr. Ruben Flores, Dr. Janet Tan

Winner of the Isuzu sponsored raffle prize, a 32" Sony
Bravia LCD TV, Jayanne May Esperacion of the
Vian Family Hospital

Isuzu's Prototype Ambulance

posing besides the Congratulatory greetings
for Dr. Ruben Flores as Asian Hospital Federation's
Presidentelect for 2012-2913
President for 2014-2015

 The Annual National Convention and Exhibits shall be the culminating activity and will be held on November 23-25, 2011 at the Manila Hotel.

The foregoing reflects part of the busy schedules of the National Board as well as the respective PHA Provincial Councils.  This is not to mention the multitude activities (symposium, seminars, trainings, speaking engagements, resource speaker, moderator, reactor, etc.)  that the various Directors and designated members have attended carrying the name of the PHA.

PHA Directors and Officers
Front Row L to R:  Dr. Janet del Mundo-Tan-Chief of Hospital, Ospital Ng Maynila Medical Center and PHA Secretary, Dr. Ruben Flores-Medical Center Chief II, Dr. Jose Fabella Memorial Hospital and PHA President, Dr. Concepcion Lim-Medical Director, Leona Lim Memorial Hospital and PHA VP-Vizayas, Dr. Winifreda Cagulada-Chief of Hospital, Teodoro Galagar District Hospital
Back: Dr. Edgardo Salud-Hospital Director, Quezon City General Hospital and PHA Treasurer, Dr. Conrado Brana, Jr.-Chief of Hospital, South Cotabato Provincial Hospital, Dr./Atty. Bu Castro-Official Representative of Bernardino General Hospital and PHA PRO, Dr. Hermogenes Jarin-Medical Director, Fairview General Hospital and PHA VP-Luzon, Dr. Jesus Jardin-Medical Director, Capitol University Medical City and PHA VP-Mindanao, Dr. Rodolfo Ante, Medical Director, Sta. Teresita Hospital, Dr. Romeo Maano-Medical Director, United Candelaria Doctors Hospital

Support of the various PHA Councils, DOH, PHIC as well as its mainstay partner for Regional Conferences, UNILAB,  has been invaluable. Participations of Healthsolutions Inc., BPI Leasing, Comlogik , Isuzu Philippines Corporation and their attractive raffle prizes during some of the Regional Conferences have provided spices and added flavors to the events.

Election of the new Board beckons come November 24, 2011.  PHA members, we know you will exercise your right to vote and will choose wisely.

ACCREDITATION: THE PHILIPPINE EXPERIENCE

(This is a blog post by the President of the Philippine Hospital Association, Dr. Ruben C. Flores. He is currently the Medical Center Chief of the Dr. Jose Fabella Memorial Hospital.  This is the article he submitted to the Asian Hospital Federation for feature in their Journal to come out in the Third Quarter of 2011.)     

Dr. Ruben C. Flores
Phil. Hospital Assn. President

     Accreditation as a way to ensure compliance to quality standards and continuous quality improvement is just beginning to take root in the Philippines’ health care system.

The passage of the National Health Insurance Act of 1995 saw the establishment/creation of the Philippine Health Insurance Corporation (PHIC).  Because PHIC as per RA 9241, Article 1, Section 2 is mandated to promote the improvement of quality through the institutionalization of quality assurance at all levels of the health care delivery system, accreditation was the next step. 

Thus in 2002, PHIC launched its Benchbook for national application.  The Benchbook standards were developed based on International standards, more particularly, the ACHS and JCI standards for hospitals adopted to the Philippine situation taking into account the local circumstances, laws and culture.  This Benchbook was perceived as a new way of incentivizing hospitals to adopt quality improvement activities in order to be granted by PhilHealth an accreditation status. Accreditation is linked with PHIC reimbursement. 

This PhilHealth Benchbook aims to assess the other aspects of hospital operation focusing on the process and outcome beyond mere structural standards compliance.  Specifically the Benchbook look at the following areas:

1.    Patient Rights and Organizational Ethics

2.    Patient Care

3.    Leadership and Management

4.    Human Resource Management

5.    Information Management

6.    Safe Practice and Environment

7.    Improving Performance

This Benchbook was adopted as the new accreditation standards for hospitals and was implemented in 2010.  In its first year of the PhilHealth Benchbook implementation, many hospitals exerted efforts to comply with the standards and the table below shows the percentage of achievement per level:

Level of Accreditation	Number of Hospitals	Percentage
Center of Safety	1246	87.99%
Center of Quality	126	8.90%
Center of Excellence	44	3.11%
T O T A L	1416	100%

Based on the survey results, the following can be concluded.

1.    Benchbook compliance seems not a significant problem among higher level hospitals (Lavado et al, 2010)

2.    Some lower level hospitals experience hardship in complying with the standards because of the administrative and financial constraints.

3.    Training and educational assistance should enable the majority of hospitals to obtain accreditation in one to two years.

4.    The impact of the Benchbook on improving health outcomes has yet to be established.

The Philippines can be considered unique in a sense because accreditation is being undertaken by a government instrumentality.  

To further institutionalize the national accreditation initiatives, a body that will undertake the accreditation of hospitals was espoused by the Department of Health. Towards this end, a national multi-stakeholders consultation meeting was conducted last June 10, 2011.

In this meeting, the Philippine Council for the Accreditation of Healthcare Organization (PCAHO) was unanimously endorsed by the delegates to the Secretary of Health to be designated as the National Accrediting body for hospitals adopting the PhilHealth Benchbook standards as the accreditation tool. 

This new development would effect a shift on the task of accreditation from being performed by government (PHIC) to one that is carried out by a private entity thru a 3^rd party accreditation scheme.  PCAHO is actually a multi-stakeholder organization dedicated to quality improvement initiatives and accreditation and has been in existence for almost thirteen (13) years now.  PCAHO was borne out of an ADB Funded Project – Strengthening of Licensing and Regulation of Hospitals, DOH, 1995-1997 – that saw the need for Accreditation of Hospitals for the improvement of the Quality of hospital services.  The Department of Health currently recognizes PCAHO as the National Accrediting Body for Accreditation of Health Facilities for Medical Tourism and the Certifying Body for the QSS of medical clinics of OFW and CDTL.  PCAHO is currently an institutional member of the International Society for Quality in Healthcare (ISQua) and an Associate member of the ISQua Accreditation Federation (IAF).  It is also a National member of the Asian Society for Quality in Healthcare (ASQua) and a member of the Executive Board.  It has been invited to serve on the JCI Asian Pacific Advisory Council

The task ahead is Herculean. PCAHO has to gain the credibility and acceptability in the hospital community by establishing a track record for competence in accreditation at par with local and eventually international standards.

It is to be hoped that with this new development, accreditation in the country will leapfrog and thereby ensure safe, quality, and excellent health services to the Pilipino and the global community. 

                                         By:  RUBEN C. FLORES, MD, MHA

                                                                                 PHA- President

Philippine Hospital Association to Present an On-Line Webinar on Social Media on July 18, 2011

An On-Line WEBINAR.

Title:	Social Media 101: Engaging and Connecting Healthcare
Date:	Monday, July 18, 2011
Time:	6:00 PM - 7:00 PM CST

Social Media is sweeping society by leaps and bounds.  It is going the way of how the mobile phones gained worldwide popularity.  Mobile phone subscribers, “ by the end of  1990 were just 11 million world-wide; eight years later that figure had jumped to 320 million and is now forecast to exceed 550million by the end of next year. “ 

In the “20+ Mind-blowing social media statistics: One year later”  posting made in 25 March 2011 by Jake Hird , he gave us some statistics as his attempt to picture the speed by which wireless communications is taking place and social media along with it.  With the readers’ indulgence and with proper attribution to Mr. Jake Hird, herewith are quotes of his statistics:


Then: Twitter has 75m user accounts, but only around 15m are active users on a regular basis.


Now: Twitter now officially claims to have 175m registered users, although it's unclear what percentage regularly use the service. 


Then: LinkedIn has over 50m members worldwide. 


Now: Officially, Linkedin has grown 100%, now having over 100m professionals who use the platform worldwide. 


Then: Facebook has 350 million active users on global basis.


Now: Facebook officially hit the half-billion member mark last year. According to figures from Socialbakers, there are now some 640m Facebook users worldwide.


Then: 50% of active users log into Facebook each day. This means at least 175m users every 24 hours.


Now: Still citing the 50% active rate, using the official 500m figure, this means at least 250m users every 24 hours. This is more than a 40% increase in 12 months.


Then: Flickr hosts more than 4bn images.


Now: Flickr continues to grow at a steady rate, having increased by some 25% in the last twelve months. At the end of 2010, it was hosting more than 5bn images.


Then: Wikipedia has 14m articles and 85,000 contributors.


Now: Wikipedia now has more 17m articles. The site now has an army of 91,000 active contributors.


Then: 65m users access Facebook through mobile-based devices.


Now: It may well be the year of mobile... For Facebook. Users accessing the site through mobile devices now tops 200m - an enormous 200% increase in around a twelve-month period.


Then: There are more than 3.5bn pieces of content (web links, news stories, blog posts, etc.) shared each week on Facebook.


Now: Clearly, Facebook is still growing: More than 30bn pieces of content is shared each month, which is an average of 7bn pieces a week.


Then: There are 11m LinkedIn users across Europe.


Now: Go Europe! There are now 20m+ EU Linkedin members.


Then: The average number of tweets per day was over 27m.


Now: Twitter now states that 95m tweets are written each day. This is a staggering 250% increase.


Then: The average number of tweets per hour was around 1.3m.


Now: At the new rate of growth, its calculated that there are nearly 4m tweets per hour.

In a way, it is creating a great divide between the learned and unlearned in the said cyber arena. The baby boomers (estimated to be 78 million) , born between 1946 to 1964 , though aging and most of them retired and about to retire,  possess great spending capacity and therefore remain good target for the marketing of product and services.  I ventured making a guess that over half of them are not yet into social media, not due to their choice, but simply due to lack of opportunity to be exposed to the basic ways of getting unto it.  Internet monitoring site comScore  however states :  “ Social networking stats: 16.5 million adults ages 55 and older engage”.

The same may very well be true in the case of the non baby boomers.  There are those who are within our midst who definitely have heard about Facebook (600 million users and USD2B in estimated revenues, Twitter (“the wine sucks”,  “sorry, walang pogi rito #Vietnam” and “eh di magreklamo ka sa lolo mong panot”) , blogs (food, travel, opinions, etc).  While they have entertained in their minds on hopping unto it they never got around to doing it.

The thing is that people need to adapt and adapt well to the changes and developments happening around us, for reason that are good for one’s self , the family and the community.

It is for this reason that as part of the Philippine Hospital Association’s advocacy, it has thought of sponsoring a   free on-line WEBINAR on SOCIAL MEDIA. Primary target will be its members and stakeholders but anybody interested is welcome to it, subject to the limit of 100 participants.  The PHA will be using the trial version of the “gotomeeting” software which has set the limit.  However, possibilities for follow through sessions are not to be discounted. The WEBINAR  will be made possible with the cooperation of the Digital Filipino.com and its founder and prime mover, the ever energetic power house of woman, Ms. Janette Toral.  She is a renowned master in the field of e-Commerce whose reputation precedes her. The Phil. Hospital Assn. (PHA) advocates L.E.A.P.! It means it Leads, Enables, Assists & Protects Hospitals. These advocacies for its hospital members are driven by the organization's ultimate desire for the Filipino people to obtain the best in quality health services.  Bringing the vehicle of Social Media within the reach & capabilities of the health institutions shall be a big boost in CONNECTING & ENGAGING all concerned.  Together through Social Media, i.e. the hospitals, the public, allied organizations and other stakeholders, and UNITED, they will WIELD a BIG VOICE, the better to be heard and influence policy & law makers to address the sentiments & needs of the people.  The mechanics for joining is very simple: 1.       PHA will send an email / FB / text messages blast invitation to all its members who are wirelessly “connected”. Members and their staff who are interested can register through the WEBINAR software. Registration will be confirmed and more details on checking in with the Webinar on the appointed date will be sent back promptly by PHA. 2.      Interested non-PHA member friends , are now welcome to register subject to availability of slots , first come first served. They will be sent emailed invitations and once they have registered, they will be confirmed and emailed back details on checking in with the Webinar on the appointed date.

For any further inquiries, you may reach PHA by email at executive.officer@pha.ph. or tweet us at @PHA1949.

Happy Webinar, everyone!


Thank you.