Clinica Manila LaboratoryManila, PhilippinesDr. Raghavendra

Dr. Xxx, Xxx

Clinica Manila LaboratoryManila, PhilippinesDr. Raghavendra

Dr. Xxx, Xxx

Clinica Manila LaboratoryManila, Philippines

Bicol Cardiovascular Diagnostic CooperativeNaga City, Philippines

MMG Cooperative Hospital Puerto Princesa City, Palawan, Philippines

Private clinics dominate healthcare provision in the Philippines and they offer a more complete service than the public sector, but because they are an expensive option for most patients, the demand for high quality performance is ever-present. The Philippines, like many southeast Asian countries, is rapidly changing and so it has a diverse mix of healthcare needs within its population. However, a problem that is perhaps more associated with western cultures is now becoming prevalent here too: the increased incidence of obesity. Although the country ranks low on the international obesity scale, young Filipinos are increasingly suffering and this has encouraged the healthcare system to adopt a range of general preventative measures.

Clinica Manila Laboratory, Manila, Philippines

• Ambulatory Healthcare Institute

• 100,000 Clinical Chemistry results per year

Bicol Cardiovascular Diagnostic Cooperative, Naga City, Philippines

• Private cooperative Laboratory

• 90,000 Clinical Chemistry results per year

MMG Cooperative Hospital, Puerto Princesa City, Palawan, Philippines

• Community based Clinical Laboratory

• 110,000 Clinical Chemistry results per year

The Clinica Manila, also known as the Ambulatory Healthcare Institute, is serviced by a laboratory that recognizes the equal priority of prevention and treatment. Situated at the heart of a major shopping mall, the clinic services a high number of patients per day compared with other freestanding laboratories of similar size. It means that the clinic needs to run 14 hours a day, seven days a week and the spectrum of tests ranges from the routine to the esoteric.

Also, because the Clinica Manila has a strong focus on endocrinology, the HbA1c test is routinely run alongside the other specific tests on any individual person’s sample. So the cobas c 111 analyzer has to cope with a heavy, but largely routine workload and Peter Alcala, the Chief Medical Technologist, is clear about its performance against other comparable machines:

“I’ve used many different machines over time and for me the cobas c 111 analyzer is the gold standard. It’s mandatory for every laboratory in the country to participate in external quality assessment every year and we are certain that it helps us to maintain our accreditation.”

On a day-to-day practical level, progressing from the old manual method to automated Clinical Chemistry has been beneficial for both staff and patients because the processing time has been dramatically reduced. Mr. Alcala admits that, initially, all the laboratory staff had thought that the new system might be less accurate and more prone to errors, but this was quickly disproved. Now, the old labour-intensive methods seem a world away.

Clinica Manila – a pioneering initiativereliant on the best technology

“When we first started to place the whole blood sample on the machine and just

leave it to get on with the analysis, it was quite a culture shock, but it’s hard now to remember how we managed without it.”

The laboratory at the Bicol is not hospital-based but operates as a private cooperative and serves the immediate needs of around 20 specialist medical practitioners in areas such as cardiology, nephrology and pulmonary disease. But the Bicol is also a regional reference laboratory and so many other ‘external’ practitioners send their samples for analysis.

Dr Heriberto Fornoles runs the laboratory and is very aware of how exacting his customers can be.

“Our clinicians are very demanding when it comes to the accuracy and reliability of our results and when I arrived here as a pathologist I inherited machines that were not what I was used to. After several months it became clear that we were not able to perform to the standards expected and so with the doctors’ agreement we installed the cobas c 111 analyzer.”

That was over three years ago and the problems of accuracy and reliability have been totally resolved. Best of all, the decision was supported by the laboratory staff and any doubts they may have had about the transition very quickly disappeared. As Violeta Chua the Lab Manager described:

“The cobas c 111 analyzer is a very user-friendly machine and the changeover from the old system was very smooth. We can now run a specimen and release the results earlier than with our old system because of the ease of operation. This is especially true of HbA1c where we just insert the sample tube and then just get the result.”

The Bicol Medical Centre – deliveringresults for demanding clinicians

“Since we use whole blood testing for HbA1c, we just place the tube on the instrument and we just get the result.”

MMG Cooperative Hospital – run by and for the community

The MMG Cooperative Hospital is community based and runs a round-the-clock service over three shifts. They rely exclusively on cobas® analyzers because reliability and accuracy are essential. Ms. Lots Timbancaya the Lab Manager recalls:

“When we purchased the cobas instruments it was our aim to become a reference laboratory for the province of Palawan and as such, credibility and confidence in the results were vital in order to satisfy our doctors’ demands for quality.”

However there was also an other reason for the adoption of automated systems which resulted in the decision to go for the cobas c 111 analyzer - and that was the limited availability of qualified personnel. Recruiting medical technicians has proved difficult over the years and so a system that minimises the requirements for human intervention and management was desirable. Just as with the Clinica Manila, this is most clearly demonstrated in the way that cobas c 111 analyzer handles the large number of requests for HbA1c testing.

“The machine releases the results very quickly, especially the HbA1c, and it runs the whole test without supervision from any of our staff. We simply put the whole blood sample on and then get on with other things in the laboratory.“

“We are able to satisfy the doctors because we are confident in the results we provide them with. We know this because of their feedback – they tell us we are the most accurate and the fastest.”

cobas c 111 analyzer has proved to be a trusted performer for all these laboratories, especially when the HbA1c test is in demand. The managers and technicians involved have now experienced how easy it is to run this test - and to deliver quality in terms of consistency and reliability of results. None of them will be going back to the old way of doing things.

Bico Medical Centre

“Our experience of running the cobas c 111 analyzer has persuaded us to invest in a second, identical machine, so we can stay with a system that has served us so well in recent times.”

MMT Cooperative Hospital Laboratory

“We are considered here in Palawan now a reference lab. Because we are the only laboratory that performs some of the special tests that were before referred to Manila or Cebu or to other reference laboratories. So thanks to our automated machine.“

Clinica Manila Laboratory

“At first we weren’t used to relying on automated machines and we doubted its capability, simply be-lieving that, because it was auto-mated, maybe it was less accurate and prone to errors. But now we know better and we confidently just place the sample in the machine and let it do the job all at once.”

Three different stories – one conclusion

Clinica Manila LaboratoryManila, Philippines

Bicol Cardiovascular Diagnostic CooperativeNaga City, Philippines

MMG Cooperative Hospital Puerto Princesa City, Palawan, Philippines

0713

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