E-Sakto: Lowering the Cardiovascular Risk of Patients with Hypertension and Diabetes Through Public–Private Partnership
Abstract
Background: Technologically-enabled “whole-of-society” upgrading of a Rural Health Unit (RHU-Samboan) in data collection & records management, and determining the Cardiovascular risk score (CVD-RS) of patients with hypertension (± diabetes) was the aim of the e-Sakto program. Methodology: A descriptive study with four
components: e-Sakto Sukod (right measurements), e-Sakto Suwat (right recording), e-Sakto Sibya (right information), and e-Sakto Serbisyo (right service). Samboan, a fifth-class municipality in Cebu, Philippines, is the pilot site. For data collection, this study used SHINE OS+ Electronic Medical Records (EMR) provided by SMART
Communications, Inc. through public-private partnership (PPP). Furthermore, WHO WPR-B CVD-Risk Score was used to monitor the effect of using EMRs in relation to patients’ 10-year cardiovascular risks. Results: A competency check revealed that all health staff were adept at taking vital signs while only 59% (38/65) of health
volunteers were competent. An inventory of the equipment revealed that 4 out of 15 barangays (villages) had appropriate tools for vital signs measurement. A municipal resolution institutionalized the use of EMR and linked Samboan with higher health institutions for referrals. Out of the total 414 hypertensive patients, 106 subjects underwent 3 monitoring visits. This resulted to a statistically-significant lowering of their 10-year cardiovascular risk score using the 3- and 5- point scoring CVD risk scale (p = 0.041; p = 0.001). Conclusion: e-Sakto made sure that the health workers were competent; equipment needed were available; EMR was institutionalized; and linkages were formed. The use of EMRs in monitoring hypertensive patients result in
significant reduction of their 10-year CVD risk.
Keywords: WHO Cardiovascular Risk Score, Data Privacy Protocol, Diabetes Mellitus, Electronic Medical Records (EMR), Hypertension, Package of Essential Non-communicable (PEN) Disease Interventions
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