ROJoson PEP Talk: Usefulness of Telemedical Consultation and Round

1. April 27, 2024
1400H - 1500H
Via Zoom
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.

2. April 27, 2024
1400H - 1500H
Via Zoom
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
There will be group pictures
at start and end of PEP TALK –
show your face in video.

3. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

4. Reminder:
25 OLETE Certificates = 1
Voucher for ROJoson
Medical Consultation
either Face-to-Face or
Telemedical.

5. USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

6. USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START PEP TALK
PROPER IN 2
MINUTES!
Pls. turn on your
video!
Show your face!

7. USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

8. I started the PEP Talk
on May 15, 2021
during the COVID19
Pandemic. There are
3 courses in the PEP
Talk. I completed the
Core Course on
October 9, 2021.

9. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses.
This may take 3 years or
longer depending on our
enthusiasm, discipline
and perseverance.
We are now on our 3rd
year!

10. USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.
My PEP TALK today is
entitled:
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND

11. Contents
• What is a telemedical consultation?
• What is a telemedical round?
• What is current history of telemedical
consultations and telemedical rounds in the
Philippines and as being promoted by
ROJoson?
• What are the usefulness of a telemedical
consultation and round?
• What are limitations of a telemedical
consultation and round?
• What are ROJoson’s advice on Telemedical
Consultations?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
Perceptions,
Opinions and
Recommendations
(TPORs) culled from
experiences of
ROJoson and other
professionals.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

12. • What is a telemedical consultation?
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

13. • What is a telemedical consultation?
Telemedical Consultation is NOT a face-to-face medical consultation
where the physician directly sees and touches a patient to evaluate
his /her medical concern, then to make a clinical diagnosis and then
recommendations for treatment.
In Telemedical Consultation, interactions between the physician and
patient for purposes of medical evaluation and medical
recommendations are made through information technology such as
telephone, email, Facebook Messenger, Viber, Zoom and other online
apps with no face-to-face interaction.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

14. • What is a telemedical consultation?
Telemedical Consultation is NOT a face-to-face medical consultation
where the physician directly sees and touches a patient to evaluate his
/her medical concern, then to make a clinical diagnosis and then
recommendations for treatment.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

15. • What is a telemedical consultation?
In Telemedical Consultation, interactions between the physician and
patient for purposes of medical evaluation and medical
recommendations are made through information technology such as
telephone, email, Facebook Messenger, Viber, Zoom and other online
apps with no face-to-face interaction.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

16. • What is a telemedical consultation?
In Telemedical Consultation, interactions between the physician and
patient for purposes of medical evaluation and medical
recommendations are made through information technology such as
telephone, email, Facebook Messenger, Viber, Zoom and other online
apps with no face-to-face interaction.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

17. • What is a telemedical round?
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

18. • What is a telemedical round?
Medical round is a visit by a physician on a hospital patient for a health
management purpose. Physician making a medical round usually goes to
the room of a patient confined in a hospital to assess patient’s progress;
to discuss the diagnosis; to discuss further plans of management; to
instruct patients on self-care at home; etc. Thus, the conventional
meaning of medical round entails a visit to the hospital by the physician
and a face-to-face interaction with a patient.
Telemedical round is the same as medical round except there is NO
hospital visit and NO face-to-face interaction between the physician and
patient. Interactions are done through information technology such as
telephone, email, Facebook Messenger, Viber, Zoom and other online
apps.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

19. • What is a telemedical round?
Typical Medical Round – Medical Round with
Face-to-face Interactions with Patient
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

20. • What is a telemedical round?
Typical Medical Round – Medical Round with
Face-to-face Interactions with Patient
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

21. • What is a telemedical round?
ROJoson Telemedical Round
Telemedical round is the same as medical round except there is NO
hospital visit and NO face-to-face interaction between the physician and
patient. Interactions are done through information technology such as
telephone, email, Facebook Messenger, Viber, Zoom and other online
apps.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

22. • What is current history of telemedical
consultations and telemedical rounds in the
Philippines and as being promoted by
ROJoson?
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

23. • What is current history of telemedical consultations and telemedical
rounds in the Philippines and as being promoted by ROJoson?
Services for telemedical consultation have been present even before the
COVID19 Pandemic in 2020. However, they were not widely used as they
are not yet popular. So, are the telemedical rounds.
Telemedical consulations and rounds were forced to become popular
during the COVID19 Pandemic because of safety issues of face-to-face
medical consultations and rounds and the limitation of movements of
physicians and patients.
Telemedical consultations and rounds have become one of the NEW
NORMALS during and after the COVID19 pandemic.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

24. • What are the usefulness and limitations of a
telemedical consultation?
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

25. • What are the usefulness and limitations of a
telemedical consultation?
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
If there is medical
concern, go for
TELEMEDICAL
CONSULTATION first.
Wait for the advice of
the physician in the
telemedical
consultation on what
to do next,
particularly on
whether there is a
need to go to a
hospital or not.

26. TELEMEDICAL CONSULTATION after COVID19 PANDEMIC
Filipino Patients with a Health Concern
TELEMEDICAL CONSULTATION FIRST
Home
Management
Clinic / Outside Hospital
Setting Management
Hospital
Management
With Medical Emergency
Total Heath
Care
Expense
NOT SURE of Medical Emergency
With NO Medical Emergency
Only when needed Only when needed
HIGHER
LOWEST HIGHEST
Quick Consult
If there is medical
concern, go for
TELEMEDICAL
CONSULTATION first.
Wait for the advice of
the physician in the
telemedical
consultation on what
to do next, particularly
on whether there is a
need to go to a
hospital or not.

27. • What are the usefulness and limitations of a
telemedical consultation?
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
If there is medical
concern, go for
TELEMEDICAL
CONSULTATION
first.
Wait for the advice
of the physician in
the telemedical
consultation on
what to do next,
particularly on
whether there is a
need to go to a
hospital or not.

28. What were the usefulness of telemedical consultations and
rounds during the COVID19 pandemic?
• Efficacy – 99% if done properly (in terms of achievement of
the intended objectives of a medical consultation and round)
• Risk – 0% COVID19 exposure risk because consultation is
done through digital means (video medical consultation – not
face-to-face consultation)
• Safe – safer because of 0% COVID19 exposure risk
• Cost – lesser expense in the long run and overall – no travel
expense; no pre-face-to-face consultation COVID19 screening
test expense; no PPE-use expense; etc.
• Availability – readily available
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

29. What are the usefulness of telemedical consultations and
rounds after the COVID19 pandemic?
• CONVENIENCE – on the part of the patient and the physician
in arranging a medical consultation - NO hassle of physical
travels – distance and traffic and expense; physician and
patient can be far apart, even world apart
• CONVENIENCE in terms of TIME of medical consultation –
there is a mutually agreed time by both physician and patient
– booked appointment or pre-arranged date and time.
• AVAILABILITY – telemedical consultation more readily
available nowadays compared to pre-COVID19 era
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

30. What are the usefulness of telemedical consultations and
rounds after the COVID19 pandemic?
• EFFICACY OF CONSULTATIONS AND ROUNDS – 99% if done
properly (in terms of achievement of the intended objectives
of a medical consultations and rounds)
• COST – lesser expense in the long run and overall – especially
on no travel expense and patients being guided when to go
to emergency room and to hospital (quite expensive
nowadays)
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

31. • What is current history of telemedical consultations and telemedical
rounds in the Philippines and as being promoted by ROJoson?
With the telemedicine becoming a vogue during the COVID19 pandemic
(starting 2020), I and other physicians have used telemedical
consultations and telemedical rounds.
I started using telemedical consultations and telemedical rounds starting
March 17, 2020.
I am still using them up to now on top of the face-to-face medical
consultations and medical rounds that I resumed in May 2022.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

32. • What is current history of telemedical consultations and telemedical
rounds in the Philippines and as being promoted by ROJoson?
Scope of ROJoson Telemedicine (Basic Steps)
ROJoson Telemedical Consultation approximates the standard ROJoson's
face-to-face medical consultation with patients in ROJoson Medical Clinic.
• Greeting; getting to know the patient (personal data);
• Elicitation of concern or reason for consultation;
• Gathering of data to be used in arriving to a primary clinical diagnosis:
• symptom data; data on previous and past medical treatment;
• sign data - inspection (looking at the patient's body and pointed
area/s of concern with still and video pictures) and physician-
guided patient-self-palpation of areas of concern];
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

33. • What is current history of telemedical consultations and telemedical
rounds in the Philippines and as being promoted by ROJoson?
Scope of ROJoson Telemedicine (Basic Steps)
ROJoson Telemedical Consultation approximates the standard ROJoson's
face-to-face medical consultation with patients in ROJoson Medical Clinic.
• ROJoson doing medical recording in a stationary which contains
primary clinical diagnosis; explanations; recommendations; discussion
with shared decision-making and informed consent on treatment plan.
A scanned medical record will be given to the patient.
• Patient shall acknowledge understanding and receipt of the medical
record.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

34. • What is a telemedical round?
ROJoson Telemedical Round
In May 2022, after I resumed inpatient surgical
operations, I have been doing mostly telemedical
rounds up to discharge time. I would do physical
visit to the hospital to make rounds only when
needed. I have surgical residents doing rounds in
the hospital. They would report to me on the
status of the patients.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

35. • What is a telemedical round?
ROJoson Telemedical Round
The day after the operation, with prior
arrangement with patients or their relatives, we
would do video chat through any of these
platforms, Viber, Facebook messenger, or Zoom
(whichever is accessible and easier to utilize).
Through the video chat, I can do the usual things
that I do in a physical medical round, except
palpation of the patient’s body. If there is a need
to do a palpation, I would ask the assistance of a
surgical resident who is on duty in the hospital.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

36. • What is a telemedical round?
ROJoson Telemedical Round
Here is a picture of a patient under telemedical
round, a day after a major operation. She was
happy with the telemedical round. She had a
picture taken with me with her caregiver. She
would be discharged one to two days postop
without me having to do a physical medical
round.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

37. • What is a telemedical round?
ROJoson Telemedical Round
By the way, after she is discharged, if there is any
concern related to her operation, she is welcome
to contact me anytime for a video chat. This
video chat can be labelled as telemedical
consultation and also as a telemedical round as
there is monitoring of the patient’s progress
being done as in a medical round. The only
difference here is that the monitoring is done
this time outside the hospital (at home).
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

38. • What is a telemedical round?
ROJoson Telemedical Round
I foresee that telemedical rounds will eventually
be defined as monitoring and following-up the
progress of patients’ conditions at a distance
(teleround), not only with the patient being
confined in the hospital. The patients can be at
any place outside a hospital as long as the main
objectives of a conventional medical rounds are
being accomplished, essentially following-up
patients’ progress.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

39. • What are the LIMITATIONS of a telemedical
consultation and round?
• NO DIRECT PALPATION of body parts of the
patient if needed to be done
• NO DIRECT AUSCULTATION of the patient If
needed to be done
Innovations that can be done:
Physician can ask and teach patients and relatives
to do some maneuvers in physical examination
(of course under video-guidance of the
physicians).
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Despite the
limitations, the
accuracy of diagnosis
on telemedical
consultations and
rounds can still
approximate that of a
face-to-face medical
consultations and
rounds as long as the
physicians do some
adjustments and
innovations.

40. • What are the LIMITATIONS of a telemedical consultation and
round?
NOTE: THIS IS NOT A LIMITATION.
Telemedical consultations and rounds that approximate the
processes and procedures of a face-to-face medical consultation
and round and with physicians being conscientious in achieving
utmost accuracy and offering adequate explanation usually TAKE
LONGER - usually double the time or longer, thus, MORE TEDIOUS.
A lot of patients tend to appreciate this, especially the explanations
which are usually abbreviated during face-to-face interactions.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

41. • What are ROJoson’s advice on Telemedical Consultations?
Nowdays, all physicians must have two modes of services for
medical consultations – one, face-to-face and the other,
telemedical.
This gives the patients the opportunity and the leeway to choose
which mode of medical consultations will be convenient and
advantageous for them based on the circumstances they are in.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

42. • What are ROJoson’s advice on Telemedical Consultations?
There are indications for each of the two modes of medical
consultations.
In NON-emergency situations:
Essentially, if face-to-face consultation is possible based on the
distance and expense and there is a need for the physicians to
touch a patient’s body in physical examination for more accurate
diagnosis, then go for FACE-TO-FACE MEDICAL CONSULTATION.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

43. T
• What are ROJoson’s advice on Telemedical Consultation?
There are indications for each of the two modes of medical
consultations.
In NON-emergency situations:
Essentially, if face-to-face consultation is not possible or difficult
based on the distance and expense and other factors like a bed-
ridden patient and physicians may forego touching a patient’s body
in physical examination for more accurate diagnosis, then one may
opt for TELEMEDICAL CONSULTATION.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

44. • What are ROJoson’s advice on Telemedical Consultations?
There are indications for each of the two modes of medical consultations.
In EMERGENCY situations:
If one has access to a physician who does telemedical consultation, get a
quick TELEMEDICAL CONSULTATION first and then follow the advice of
the physician – whether need to bring patient to an emergency room,
where and when to go and what first-aid to do, etc. Rushing to an
emergency room may not be needed after a telemedical consult.
However, the decision is based on the discretion of the relatives of the
patient.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

45. • What are ROJoson’s advice on Telemedical Consultations?
There are indications for each of the two modes of medical consultations.
In situations where EMERGENCY IS UNCERTAIN:
If one has access to a physician who does telemedical consultation, get a
quick TELEMEDICAL CONSULTATION first and then follow the advice of
the physician – whether need to bring patient to an emergency room or
not (such as bring to clinic or stay home). Rushing to an emergency room
may not be needed after a telemedical consult. However, the decision is
based on the discretion of the relatives of the patient.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

46. Contents
• What is a telemedical consultation?
• What is a telemedical round?
• What is current history of telemedical
consultations and telemedical rounds in the
Philippines and as being promoted by
ROJoson?
• What are the usefulness of a telemedical
consultation and round?
• What are limitations of a telemedical
consultation and round?
• What are ROJoson’s advice on Telemedical
Consultations?
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Summary
Take Away

47. Take Away in
relation to
Patient
Empowerment
Be always in touch with reliable medical
information on USEFULNESS OF TELEMEDICAL
CONSULTATION AND ROUND.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan to gain greater control over
decisions / make better decisions on the
USEFULNESS OF TELEMEDICAL
CONSULTATION AND ROUND as part of
your health management.
USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND

48. USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.
This ends my PEP
TALK today on:
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND

49. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

50. Reminder:
25 OLETE Certificates = 1
Voucher for ROJoson
Medical Consultation
either Face-to-Face or
Telemedical.

51. USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

52. USEFULNESS OF
TELEMEDICAL
CONSULTATION
AND ROUND
Empowerment
objective - for laypeople
to have an essential
understanding on the
USEFULNESS OF
TELEMEDICAL
CONSULTATION AND
ROUND
as part of their health
management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START Q&A AND
INTERACTIONS!
Pls. turn on your
video!
Show your face!