ADVANCING health care calls for adopting new technologies and shifting to a holistic approach that integrates technology into infrastructure, governance and health procedures. This was a key point made during The Manila Times’ Executive Health forum at EDSA, Shangri-La Manila, on Feb. 26. For Beyond Medical Hub CEO Ma. Victoria Lualhati, the pressing challenge for health leaders is to advance medical capabilities. Health institutions have been investing in technology, which raises the patients’ expectations. However, all these expectations stem from the demand for a sense of care. There are various ways in which health leaders can mobilize their resources and health care providers to deliver better health care, she said. Hospitals also experience financial pressure. One way to address this is through collaborating with other agencies. “Health care pressures are converging, but the biggest risk is complacency,” she said. The health sector must also leverage the advancements in technology. “We need to be future ready and provide health care solutions by advancing the level of capabilities in robotics, digital therapeutics and even health apps.” However, future proofing is not only applicable in modern technology; it should also be integrated in resilient infrastructure. “This is where construction would come in. We need to make sure that we are doing a future-proofing of our hospitals and diagnostic centers. Which means that we do not cut corners to put up that hospital,” she said. Along with these, hospitals also need to look into warehouse and materials management to minimize costs. Moreover, health care institutions should examine their environment, social and governance frameworks. Environmental programs such as waste management and renewable energy usage contribute to better health care for people. Lualhati cited the importance of taking care of their employees, workplaces and customer groups. Essentially, this entails creating a patient-centered design. “This is one of my advocacies. We [need] to look into the mental health of our employees. Remember, we cannot give something we don’t have. If they are already burned out, can you imagine the level of care [they can only give?],” she said. “Your employees take care of the patients and the doctors. All this would be in the gamut of the culture of care because without that culture — even if you say [that you are] conducting a lot of training programs but [you] are not addressing the needs of [your] doctors and patient — then somehow you would fail,” Lualhati added. “This is one DNA that we have. We are resilient, [and] we are also patient-centered. It is also in our DNA to be very caring.” Lualhati reminded health leaders to govern and invest wisely. Every machine, equipment and medicine that must be procured must serve and be used well. She advised them to invest in diagnostic centers to enable preventive health care. Rise of robotic surgery In terms of technology, the Makati Medical Center is spearheading surgery for women using robots. Makati Med Urogynecology and Pelvic Reconstructive Surgery Section Chief Jennifer Marie Jose demonstrated how robotic surgery is conducted using the Da Vinci system, which is currently installed in the United States and many countries in Europe. The Da Vinci system is a three-dimensional high-definition vision of surgical instruments designed to have doctors take surgery beyond the limits of the human hand. “This helps overcome the challenges of traditional open endoscopic surgery, and this has actually changed the experience of surgery for women all over the world,” Jose said. The patient is docked to the robot, while the surgeon sits on the console. Jose clarified that even with the involvement of robots, human surgeons are still actively doing the work. “People who are not in the medical field think that what I’m doing is unethical because they think it’s the robot doing the surgery on the patient, [but] I would like to state to you that by doing this robotic surgery, I am still the surgeon. I am controlling the whole operation, including the camera, the instruments, and also my footwork and handwork,” she said. Aside from ease, the learning curve for the Da Vinci system is more efficient than the traditional laparoscopic procedure, she said. The Da Vinci system also enables better mobility with its three-dimensional feature compared to laparoscopy’s two-dimensional imaging. The system facilitates dissection and stitching with ease, allowing the surgeon to sit during the operation and guard against fatigue. It also helps in dealing with difficult procedures through greater access, precision and control in the entire procedure. “As a surgeon, you have surgical autonomy and also efficiency,” Jose said. In terms of patient care, the system enhances sharpness, dexterity, control and three-dimensional procedure. This results in less blood loss, quicker recovery and shorter hospital stays. Chances of acquiring infection are also significantly lower. Urologists and gynecologists are doctors who are actively immersed in robotic surgery, which is also a way of promoting minimally invasive surgery. However, in the Philippines, the majority of surgery cases are still done in open procedure. Jose is projecting that robotic surgery will proliferate in the Philippines soon for its health benefits. Robotic surgery had been used in procedures for fibroids, endometriosis, pelvic organ prolapses, and endometrial and cervical cancer. “This is a new innovation in technology right now, which I highly recommend to everybody because you can see the advantages that the patients will enjoy,” Jose said.