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Challenges and Opportunities in Emergency Medicine from Public and Global Health Perspectives
Emergency medicine has grown significantly in the Philippines over the past few decades. The first certified emergency physician was in 1986, and the University of the Philippines created the first Department of Emergency Medicine in 1991. Several hospitals and medical centers have since established emergency departments led by emergency physicians. The field continues to develop within the context of broader health reforms aiming for universal healthcare coverage and strengthening health systems to improve access, efficiency, quality and continuum of care, including pre-hospital emergency services. Emergency medicine must operate considering the bigger national health system and reforms to help achieve world-class emergency care standards.
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Challenges and Opportunities in Emergency Medicine from Public and Global Health Perspectives
- 1. Challenges and Possibilitiesof Emergency Medicine from Public and Global Health Perspectives TEODORO JAVIER HERBOSA MD FPCS FPCEM! PROFESSOR! Department of Emergency Medicine! University of the Philippines, Manila! Undersecretary of Health (2010-2015) Philippines!
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- 9. Philippine General Hospital Universityof the Philippines, Manila
- 15. First Certified FACEPin the Philippines 1986 Dr. Joel Gernsheimer FACEP, fulltime Emergency Physician at PGH ERC 1986-1987 - introduced Emergency Medicine After, PGH created an Emergency Room Management Committee which took responsibility and administration of the ERC
- 16. UP PGH -Emergency Room Management Team ERMAT - headed by an orthopedic surgeon Dr. Antonio Montalban a multidisciplinary team, composed of ER nursing supervisor from Surgery, Orthopedics, Internal Medicine, Pediatrics & Family Medicine. Dr. Montalban published the first Aid Manual written in Filipino and founded the Philippine Society of Emergency Care Physicians (PSECP).
- 17. Philippine Society ofEmergency Care Physicians PSECP ! Formed on August 26, 1989 Group of different specialty doctors Led by Dr Antonio Montalban and Dr Victorio Pidlaoan Organized a meeting of various doctors from major hospitals Improve Emergency Care throughout the country Annual scientific meetings and postgraduate courses Journal of Philippine Emergency Care
- 18. Philippine Society ofEmergency Care PSECP 1989 ! National organisation of over 200 members of different specialties interested in improving emergency care throughout the Philippines Regular twice yearly conferences in Manila and the other islands to improve the emergency care Scientific meetings eventually led to the publication of the Official journal of the Society—Philippine Journal of Emergency Care The forum for further development of the practice of Emergency Medicine in the Philippines
- 19. Department of EmergencyMedical Services UP-PGH 1990 Dr. Richard Tiongco, travelled to Chicago, USA to observe the management of hospital ER’s. 1991 Department of Emergency Medical Services (DEMS) The University of the Philippines, Board of Regents created the first Department of Emergency Medicine in February 1991, with the department composed of specialists and consultants representing different disciplines. Returning from Trauma Fellowship at Cook County, USA, Dr. Teodoro Herbosa, in April, 1994 was appointed Chair of DEMS. 1995, additional specialists in the DEMS were recruited by Dr. Herbosa. One more trauma surgeon, three orthopedic surgeons, one internal medicine /pulmonologist and one family medicine toxicologist joined the department.
- 20. Dr. Lynn PalacolRopollo FACEP ! Undergraduate medical Student 1992 Clinical and research elective in the DEMS UP-PGH Preceptor: Prof. Dr. Peter Rosen of UCSD
- 21. Dr. Peter Rosen In1996, Dr. Herbosa met with Dr. Peter Rosen at the University of Southern California San Diego (UCSD) after he sent a medical student on elective rotation there at the PGH - DEMS. Dr. Rosen is one of the pioneers who encouraged us at UP-PGH to pursue the development of Emergency Medicine residency program in the University.
- 22. UP PGH EmergencyMedicine Faculty Dr. Wilma Geck FACEP Dr. Maria Acosta Soriano FACEP
- 23. First Emergency Medicine GraduatesUPPGH 1999
- 24. Department of EmergencyMedicine Universiti Kebangsaan Malaysia Medical Center 2007-2009
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- 27. East Avenue MedicalCenter
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- 30. Health Reforms, GlobalHealth, Universal Health Coverage and Emergency Medicine • UHC Reforms! • Financing! • Systems! • Health Inequity
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- 36. SUBSTANTIAL INCREASE INTHE DEPARTMENT OF HEALTH BUDGET Budget (in billion pesos) BillionPesos 0 22.5 45 67.5 90 Year 2008 2009 2010 2011 2012 2013 2014 Budget (in billion pesos) 18.91 23.67 24.65 31.83 42.08 50.44 89.7
- 40. IMPROVED ACCESS TOQUALITY HOSPITALS AND FACILITIES 3,576:Total health facilities upgraded and rehabilitated as of Feb 2013 1,049 hospitals Another 2,487 health facilities will be upgraded this 2013. 2,751 (91%) came from the 609 priority municipalities listed by the National Anti-Poverty Commission Result: Increase in deliveries of mothers in hospitals. 719,552 mothers (38.8%) (2009) vs 1,014,613 mothers (57.1%) (2011)
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- 43. Standards in EMSEducation
- 44. Emergency Medicine in UHC •Intermediate Key Performance Indicators • Efficiency! • Quality! • Access! • Continuum of care, prehospital, acute care, chronic care
- 51. Surveillance Post Extreme Emergencies and Disasters shortmessaging system or sms reporting of symptoms seen in evacuation centers
- 55. Priorities of Action SendaiFramework • Priority 1: Understanding disaster risk. • Priority 2: Strengthening disaster risk governance to manage disaster risk. • Priority 3: Investing in disaster risk reduction for resilience. • Priority 4: Enhancing disaster preparedness for effective response and to “Build Back Better” in recovery, rehabilitation and reconstruction.
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- 58. Take-home Messages • EmergencyMedicine operates in a National Health System. Always look at the BIG picture. • In, Asia we have very diverse Health Systems • To improve efficiency, quality and access to world class standards emergency care, one must understand the health reforms in your own country • Financing, payment schemes need to be re-thought and remodelled • Use health system organization & regulation to improve health outcomes
- 59. Take home Messages •Behaviour change of the Physicians, the Patients and the Population • The journey to health systems strengthening is a journey of the Emergency Medical Services System, Prehospital Care, Acure Care and even Disaster Medicine
- 61. Challenges and Possibilitiesof Emergency Medicine from Public and Global Health Perspectives! [email protected]! Facebook: Ted Herbosa! Twitter:Teddybird!