Amid COVID-19, NMMC doctors resort to ‘teleconsultation’

CAGAYAN DE ORO CITY –– With health protocols still in place amid the coronavirus disease (COVID-19) pandemic, medical practitioners here are finding new ways to stay in touch with patients even while their clinics are closed.

At the state-run Northern Mindanao Medical Center (NMMC), a COVID-19 referral hospital here, medical doctors are making use of teleconsultation to meet up and treat non-COVID-19 patients without exposing themselves and their patients to infection.

For the first time in her 30 years of practice, Dr. Corazon Mata, in charge of the obstetrics and gynecology hotline for the Telekonsulta Service of the NMMC, attends to patients remotely.

She fields queries from ob-gyn patients all over Region 10, which covers the provinces of Misamis Oriental, Misamis Occidental, Bukidnon, Camiguin, and Lanao del Norte.

With the rapid spread of COVID-19, health professionals were worried that other health cases would be overshadowed, as many hospitals like NMMC recorded a significant drop in patient consultations at the emergency room and out-patient clinics.

As most of the facilities at the NMMC are now being used to accommodate confirmed COVID-19 cases, non-COVID patients are either being referred to other hospitals or are served through the teleconsultation.

“This is the main reason we decided to start the NMMC Telekonsulta Service,” says Dr. Aris Austria, Telekonsulta project leader.

Austria said they were concerned for patients with chronic conditions requiring long-term medical care.

“Every health care facility should not focus only on handling the COVIC-19 crisis but also consider minimizing ‘collateral damage’ on non-COVID patients,” he added.

The NMMC Telekonsulta Service targets noncritical cases and aims to provide a venue for patients to directly consult medical professionals through their mobile phones.

In his previous press briefings, Mayor Oscar Moreno has encouraged people to avail of the teleconsultation services as he reminded patients, especially those giving birth, to go to their health centers and hospitals other than the NMMC.

Since those with preexisting medical conditions or those who are immunocompromised are prohibited from going out, Moreno said it would be best for these patients with chronic illnesses to seek expert medical advice through teleconsultation rather than putting themselves at further risk by getting out of their houses.

Telco giant Smart Communications has partnered with NMMC by providing doctors with LTE phones capable of unlimited texts and calls to all networks and data connection.

Each phone was assigned to doctors handling a specific field of specialization such as pediatrics, obstetrics, and gynecology, surgery, or internal medicine, according to Smart in a press statement.

Since the project took off in late March, NMMC doctors have handled more than 400 consultations, sent out almost 200 electronic prescriptions, and facilitated around 50 referrals.

Physicians handling the teleconsultations have also set appointments for actual clinic consultations for cases where clinic visits were needed.

“A good part of diagnosing a patient is doing a complete physical,” said Dr. Ramon Yap, an internist-gastroenterologist.

“But I believe the majority of patients can be safely managed through teleconsultation, albeit some patients may have to be seen by a doctor in a clinic or referred to an appropriate institution like NMMC,” Yap said.

This distant consultation is a new practice suited for the “new normal,” but Yap stressed doctors had to adapt.

“The threat to doctors is very real. We also have to think about protecting ourselves and our families, aside from trying to give comfort and healing to our patients. The limited resources in our locality have made the practice of medicine daunting and probably even unsettling,” he added.

The doctors admit that there are limitations to what they could perform without physical interaction, but they are finding ways to cope.

Austria, a pediatrician, encouraged parents to check the condition of their children before calling up a physician.

“Listen to the child’s breathing, feel their skin or pulse, touch the tummy, and describe what you find,” Austria said.

Since it is not the ideal way of examination, he said doctors should be cautious in using information drawn only from a teleconsultation to diagnose a patient’s condition.

“Teleconsultation should remain an option for patients under any circumstances that call for it to hasten medical interventions and to keep NMMC accessible to all the people in Region 10,” Austria said.

Dr. Jannie Lyne Palisbo, whose clinic is closed, said she was grateful that she could continue to treat her patients from home.“It is reassuring to both the patient and us physicians,” Palisbo said.

This being the institution’s first time to implement teleconsultation, the Telekonsulta team faced a lot of challenges, including a lack of proper guidelines or standard operating procedures, especially in consideration of patients’ informed consent and data privacy.

LZB