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Sunday, June 11, 2023 Vol. 18 No. 237
P25.00 nationwide | 2 sections 12 pages | 7 DAYS A WEEK
Beating the dreaded ESRD n
AKSABIR | DREAMSTIME.COM
NKTI’s kidney patient, donor education made easy with AI
C
By Roderick L. Abad
HRONIC kidney disease (CKD) is a growing spectrum disorder in the Philippines that needs a better understanding from among the populace to prevent its progression, take care of, save, or even reverse, the deteriorating condition of patients with long-standing renal malfunction. While various treatments are now available for this disease, including its underlying conditions, the most common cures at its worse phase are dialysis and kidney transplantation. “When you are on stage five, then, that’s the time you’ll be on dialysis. Actually, the increase in the number of dialysis patients is like 17 percent per annum, or maybe getting to 20 percent now,” Dr. Rose Marie R. Liquete, executive director of the National Kidney and Transplant Institute (NKTI), said in a news briefing following the opening ceremony for the National Kidney Month (NKM) held at the hospital on Monday, June 5, 2023. Since one patient develops a CKD every hour, it is no doubt that many of the more than a hundred million population of Filipinos have been diagnosed with endstage renal disease (ESRD). “It will be either dialysis or a kidney transplant,” Dr. Concesa C. Casasola, deputy executive director for education, training and research services at NKTI, said of the procedures they need. “In NKTI, our priority is for our patients to have a kidney transplant. We do more than 320 kidney transplants every year.”
With this figure, NKTI is the top leading hospital that performs kidney transplants in the Philippines. It is also among the top in Asia with a big number of patients that are transplanted with a kidney from a single center, according to her. “So we really push and encourage our patients to have a new life and to have a kidney transplant,” she said.
Challenges
BY and large, there remain hindrances as regards the lesser popularity of transplantation among ESRD patients in the country. “These are the main problems: social-economic and the lack of donor,” Liquete emphasized. Due to poverty, underprivileged people who cannot afford to ease their suffering from kidney failure fail to engage in preventive management. Hence, their condition is, more often than not, severe already when they come to seek treatment as they come to the hospital very late. In the case of those with financial means yet living in the provinces or far areas, some think of NKTI right away or other private hospitals,
(FROM left) Adam Bolitho, General Manager, Astellas Pharma Philippines; Dr. Paulo Miguel David, Adult Nephrology; Dr. Romina A. Danguilan; Deputy Executive Director for Medical Services; and Dr. Concesa C. Casasola; Deputy Executive Director for Education, Training and Research Services, at the launching of kidney transplant recipient and kidney donor handbooks during the commemoration of the National Kidney Month on Monday, June 5, 2023, in Quezon City. NONOY LACZA
yet they cannot come to Manila. “They can go to their barangay, to the local government unit, or to the regional hospitals,” she pointed out. “That’s why in Universal Health Care, we should take care of them from the very start—on the barangay level and up. And our hospitals should be the end referral for [simple] transplantation and difficult transplantation.” Even though there is the PhilHealth to turn to, beneficiaries qualified to avail of its Z benefit package for kidney transplantation ought to have a donor first. And that is another challenge. In the Philippines, a living do-
nor must be the next of kin of the patient, either a legal spouse or children. To avail of a giver who is alive and, of course, in good health condition is ideal, while organ donation from the deceased is another option. These are the donors who met an accident mostly, or died of cerebral, vascular, or neurological illnesses. Unlike in the US and Europe, wherein 25 percent of donations are coming from living givers and 75 percent are dead ones, it’s the other way around in the Philippines. “I believe also in Singapore, Thailand and Asia in general, that is a problem. Even if some of the
countries are very active in organ donation, let’s say Spain and also the US, that are mainly cadaveric,” Liquete said.
AI-driven education
ORGAN donation and transplantation are complex processes that need ample understanding for both the giver and recipient to meet in the middle of these lifesaving procedures. “We found that there was a gap between our patients and donors who are coming to attend our prekidney transplant orientation and their next follow up. Some of them don’t even come back [afterwards],”
revealed Dr. Romina A. Dañguilan, deputy executive director for medical services at NKTI. Knowing that patient and donor education is complicated, time-consuming and stressful, the NKTI has found a way to do it faster, more effectively and with less effort, in just a click of a button—thanks largely to artificial intelligence (AI). This government-owned and -controlled corporate tertiary specialty center attached to the Department of Health (DOH) has strengthened its partnership with Singapore-based Bot MD to make kidney care education simpler, easier to access anytime, anywhere via messaging applications. They are taking a cue from the success of their initial teamup with the Hospital Super App that uses the Bot MD AI so clinical teams can instantly search duty schedules, hospital directory guidelines and protocols, drug and lab formularies, and even PhilHealth case rates within a single chat interface. Now, they have just launched the expansion of the second platform called the Bot MD Care to help automate patient education and monitoring. “Since 2021, we have used Bot MD Care to remotely monitor over 700 patients in NKTI with great results. We have seen how the AI can help doctors and nurses triage their patients for early signs of infection so they can intervene earlier,” Bot MD CEO Dorothea Koh said. This new feature of the Bot MD Care will enable potential kidney donors and recipients to undergo pretransplant orientation at their own pace and time, not only through Viber, but also through Facebook Messenger, without having to download a separate mobile Continued on A2
PESO EXCHANGE RATES n US 56.1470 n JAPAN 0.4043 n UK 70.5262 n HK 7.1647 n CHINA 7.8947 n SINGAPORE 41.8196 n AUSTRALIA 37.6915 n EU 60.5545 n KOREA 0.0433 n SAUDI ARABIA 14.9713 Source: BSP (June 9, 2023)