TERMS OF REFERENCEI.

PROJECT TITLE:
2017 Annual Physical Examination (APE) Program for all DOT
Officials and Employees (Permanent/Job Order Personnel)

II.

IMPLEMENTATION DATE:
November to December 2017

III.

NUMBER OF PAX:
696 (Head Office and Regional Offices)IV.

INCLUSIONS:
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Complete Physical Examination and Optical Screening (Work Site)
Mobile Chest X-Ray - 11x14 film or in digital form (CD or Paper)
Complete Blood Count (CBC)
Blood Typing
Fasting Blood Sugar (FBS)
HBa1C
Lipid Profile (Cholesterol, Triglycerides, HDL, LDL)
Sodium (Na)Potassium (K)
SGPT
SGOT
BUN
Creatinine
HBsAg
Uric AcidUrinalysis
Fecalysis
ECG (for 35 years old and above) - employees with existing Hypertension,
Heart Diseases and high BP reading.
Pap Smear (for female 35 years old and above)
Prostate Specific Antigen (for male 35 years old and above)
Abdominal Ultrasound (for 35 years old and above) - employees with afamily history, diagnosed or suspected with Gastrointestinal Cancer andAbdominal Mass regardless of their age.
Auditory Examination - portable machine with technician (to examine
hearing loss). Will be done onsite. DOT will provide a secluded room
where the equipment (egg chair) will be set-up.

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Dental Examination (check up with cleaning). Check up will be done
onsite. DOT will provide a space with a nearby water supply and drainage
for cleaning.
Mammogram will be done in the provider’s facility. Breast Ultrasound will
be done for all female employees who are 35 years old and above andthose who have a family history of malignancy regardless of their age as areplacement to the Mammogram. For those employees with a family
history of malignancy and with positive findings from the Breast Ultrasoundexamination, they will be required to undergo further Mammography.
Transportation to the facility for Mammography shall be provided by theprovider.
Spirometry
Bone Densitometry
BMI Detection

REQUIREMENTS:
1. Must be a registered and DOH accredited Health and Diagnostic Services
provider.
2. Must provide Physicians with staff to assist in the conduct of the Annual
Physical Examination (APE) Program. Medical Staff must be a graduate ofFamily Medicine or trained family physician and must provide certificate oftraining. All staff are required to provide their current PRC ID.
3. Checklist of what to do in preparation for the APE Program must besubmitted beforehand to the DOT Medical Officer for distribution to theemployees.
4. Must provide current Specialty Training Certificates of the Cardiologist,Radiologist, Pathologist and ENT.
5. Must be Five (5) years in operation.
6. Must provide Consent Forms for employees.
7. For Regional Offices, the provider may either have clinics/affiliate clinics inthe region concerned where employees can undergo the APE Program or
they may opt to proceed to the regional offices and conduct it on-site, withthe use of their mobile van and at their own expense. Mammogram to be
conducted in affiliate hospital/clinic.
8. Must provide free referral and consultation to Specialists in case ofabnormal laboratory results or physical examination in accordance with therecommendation/s on the APE Program.

9. Must provide free follow up Medical checkup.
Free follow-up laboratory and diagnostic tests/proceduresfor at least
three (3) times. (If needed or with abnormal test results)Free Medical Checkup and Consultations for at least three (3)timesuntil employee’s case has been diagnosed/resolved/treated andcan readily be followed up and managed at the DOT Medical Clinic.

10. Results of the examinations must be given Two (2) weeks after theconclusion of the APE in the Head Office. For Regional Offices, resultsmust be available within a week from the completion of the APE percluster. All results must be submitted to the DOT Medical Officer forevaluation, especially the results of the Regional Offices.
11. HBsAg results (Soft and Hard Copy) should be available and submitted tothe DOT Medical Clinic the day after the test was done.
12. Encoding and processing of APE results should be done or supervised bya Biostatistician using a Biostatistics software.
13. A series of meetings between the Medical Officer and the Biostatistician
must be done before, during and after the APE Program, and midway inwriting the results.
14. Below is the time frame for mass conduct of the APE Program:2017 APE PROGRAM
Head Office
Regional Offices
Head OfficeSubmission of the APE Report

1st Week
2nd Week
3rd Week
4th Week

15. The implementation dates shall be set as agreed by the provider and theHead Office and Regional Offices.
16. Final summary of APE results should be submitted in hard and soft copy tothe DOT Medical Clinic before the release of the Certificate of Completion.
Two hard copies of individual APE results should be submitted(Employees’ and Medical Clinic’s copy).
17. Provider should submit an APE Report based on the results requirementsof the DOT Medical Clinic.
VI.

PAYMENT PROCEDURE:
Government Procedure

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TOTAL BUDGET ESTIMATE:

VII.

CONTACT PERSONS:

Php 3,480,000.00

DR. RAUL S. ALCANTARA / MS. AIREEZE V. BAUTISTA
DOT Medical Clinic – Head OfficeTel. No. (02) 459-5200 Local # 220