Perspectives on the Use of Telegenetics Services in the Philippines
Authors: Silao Catherine Lynn T. 
Published: August 2023

The Philippines is a densely populated nation faced with multiple challenges in the healthcare field given its geographic,cultural, and socioeconomic barriers. Due to the geographic limitations of medical services in the country, many patientsmust travel a great distance to referral centers. This was further exacerbated by the Coronavirus disease 2019 (COVID-19)pandemic, which spread across the world and upended lives. This pandemic triggered a public health crisis that impactedhealthcare systems, healthcare workers, and communities worldwide. It compounded current difficulties with the provision andaccessibility of medical services, necessitating the employment of alternative methods of providing health coverage. As a result,advanced technological methods for patient diagnosis, monitoring, treatment, and counseling were rapidly implemented.1

Interest in these technological advances began prior to the COVID-19 pandemic, though primarily in developed countries.However, during this global outbreak, telehealth practices – which refer to online health care services provided by all healthcare professions – have seen a rapid increase in popularity.2,3 Telehealth was brought to the forefront in all countries inorder to surmount lockdown constraints, allow continuous provision of health care for patients, and limit exposure to healthsystems and health providers.4

Traditional medical education and training were likewise disrupted during this time, resulting in the incorporationof telehealth into medical education. To reduce the risks associated with more personnel in the hospital, medical studentswere withdrawn from clinical environments during the COVID-19 outbreak. This created an environment of uncertaintyand limited clinical exposure, with concerns surrounding progression through the medical course and training program.5Continuing medical education, which has traditionally been based on clinical knowledge and skills, now requires onlinetechnical communication skills. Innovative services were rapidly developed with health professionals embracing this newtechnological competence, enabling general consultation for patients, remote patient monitoring, and self-directed patientcare, thereby decreasing the burden on health facilities. Digital learning platforms also provided an effective way to address thelearning gaps caused by the pandemic.

The restriction of “in-person” delivery of healthcare services due to the global outbreak has prompted physicians, includingclinical geneticists and genetic counselors, to investigate alternative methods of providing health care to patients. A telehealthinnovation for online delivery of clinical genetic and genetic counseling services is the Philippine General Hospital’s TelegeneticsService. Despite being launched in 2013 to serve genetics patients across the country, this service has since been upgradedand capitalized resulting in patient appreciation for its COVID-19 exposure prevention, increased access, and time and costefficiency. However, the telegenetics service has its limitations.6,7 Despite the expanding scope of telehealth/telegenetics and itsimmediate application, issues such as data/patient privacy, organizational readiness, digital maturity, regulatory impediments,access and acceptance of the technology, geographical and digital disparities, and its integration with traditional medicalservices have emerged.8  Lack of a detailed physical examination is also lost in a virtual visit, with focused questions leading tofragmented, impersonal interactions.

Even when restrictions were lifted, telehealth usage nonetheless remained significantly higher than it had been prior tothe pandemic. This may indicate a shift in public opinion in favor of this innovative medical practice.9 With the expansion of genetic services in the country, there is now a greater need for telegenetics due to the increased demand for clinical genetic andgenetic counseling expertise. Therefore, evidence on the safety and efficacy of this technology in comparison to the traditionalhealthcare delivery approach is required. If the technology has the potential to improve health care, we must guarantee itsavailability in all resource-limited areas. Future efforts should thus focus on establishing solutions to address the aforementionedissues and concerns within our healthcare and education systems, thereby ultimately enhancing the standard of medical care.

Catherine Lynn T. Silao, MD, PhDInstitute of Human Genetics, National Institutes of HealthDepartment of Pediatrics, College of Medicine and Philippine General HospitalUniversity of the Philippines Manila

 

REFERENCES

1. Keesara S, Jonas A, Schulman K. COVID-19 and Health Care’sdigital revolution. N Engl J Med. 2020 Jun;382:e82. doi: 10.1056/NEJMp2005835.2. Scott R, Mars M. Telehealth in the developing world: current statusand future prospects. SHTT. 2015;3:25-37. doi:10.2147/shtt.s75184.3. Telemedicine: opportunities and developments in member states -Report on the second global survey on eHealth (Global Observatoryfor eHealth Series, 2). Geneva, Switzerland: World HealthOrganization; 2010.4. Patel SY, Mehrotra A, Huskamp HA, Uscher-Pines L, Ganguli I,Barnett ML. Trends in outpatient care delivery and telemedicineduring the COVID-19 pandemic in the US. JAMA Intern Med.2021 Mar;181(3):388–91. doi: 10.1001/jamainternmed.2020.5928.5. Sharma D, Bhaskar S. Addressing the COVID-19 burden onmedical education and training: the role of telemedicine and teleeducation during and beyond the pandemic. Front Public Health2020 Nov;8:589669. doi: 10.3389/fpubh.2020.589669.6. Herlao IAV, Maceda EBG, Abacan MAR, de Castro Hamoy LG,Alcausin MMLB. Telegenetics services in a tertiary hospital: utilityand patient satisfaction. Acta Med Philipp. 2022. doi: 10.47895/amp.vi0.4981.7. Tumulak MJR, Pascua AV, Jover EJM, Guerbo RJ, Canoy GMR,Laurino MY. Genetic counseling in the time of COVID-19: ThePhilippine experience with telegenetics. J Genet Couns. 2021Oct;30(5):1285-91. doi: 10.1002/jgc4.1518.8. Doraiswamy S, Abraham A, Mamtani R, Cheema S. Use of telehealthduring the COVID-19 pandemic: scoping review. J Med InternetRes. 2020 Dec;22(12):e24087. doi: 10.2196/24087.9. Omboni S, Padwal RS, Alessa T, Benczúr B, Green BB, Hubbard I,et al. The worldwide impact of telemedicine during COVID-19:current evidence and recommendations for the future. Connect Health.2022 Jan;1:7-35. doi: 10.20517/ch.2021.03.