Performing pilot procedures as proof of concept is not the real goal of PHC. Enabling these regional heart centers to perform procedures independently with the shortest possible incubation period is a structured and definitive program for PHC.

The maturity scale designed by PHC for the certification of PhilHealth Health Care Institutions (HCI) both private and government, will be used to evaluate the capabilities to serve as regional heart centers. There will compliance issues for some centers. The most daunting challenge is to complete the physical infrastructures. With the change in DOH leadership, release of allocated funds to finish ongoing constructions have recently been put on hold pending review of priorities. The withholding of last mile support has forced regional centers to tap limited, even if still substantial internal resources to complete their ongoing regional heart center projects. PHC continues to lobby for these centers whose PHC branding to inspire confidence by patients on their new regional heart center included buildings with the iconic PHC facade. Access to more responsive Philhealth reimbursements which have long been planned, have yet to materialize. When this becomes reality, then specialized care in regional heart centers will be sustainable and may encourage the rest of the regions of the country to invest in their own programs.

An Orientation Meeting for Regional Heart Centers was conducted last August 20, 2015. All of the regional hospital plotted their maturity scale and 5 year development plan. A Memorandum of Agreement indicating PHC support for the regional hospitals will be as follows :

Davao's Southern Philippines Medical Center was the first regional center supported by PHC. It has put to good use the foreign grant of a brand new catheterization laboratory and open heart surgery equipment endorsed by PHC soon after PHC received its own grant nearly 10 years ago. SPMC performs over 100 heart surgeries annually. It has a full complement of PHC trained cardiovascular staff, including the Medical Center Chief of SPMC, and the Director of its Mindanao Heart Institute. They are now certified Z-Benefit packages for open heart surgery Coronary Artery Bypass, Ventricular Septal Defect and Tetralogy of Fallot since 2014.

Vicente Sotto Memorial Medical Center in Cebu city launched its Cath Lab in 2000 and already performed a total of 17 Surgeries since their first heart surgery procedure in 2014. After the PHC-initiated surgical mission in January 2015, they were able to apply for Philhealth Z-benefits packages and was accredited.

The recent open heart surgery mission last March 2015 in Ilocos Norte practically required PHC to bring the whole cardiac surgery set-up but we still managed to operate on 12 children with congenital heart disease over 2 ½ days. The team was prepared to do more cases but there were not enough patients ready for surgery. The heart lung machine was transported by PHC ambulance because it did not fit into the bus which transported most of 31 PHC cardiac specialists and all the other cardiac surgery equipment such as cardiac monitors, suction machines, and mobile echocardiography machine. There were initial hesitation to proceed with the machine due to logistic issues but since the PHC EXECOM already committed, the heart teams proceeded and actually enjoyed the experience of providing full services from scratch.

Cagayan De Oro's Northern Mindanao Medical Center started to perform open heart surgeries with PHC support since 2013 when the first graduate of cardiovascular surgery returned to CDO. Several cardiac missions have been performed since then with 2 upcoming open heart missions scheduled for July 2016 for adult heart patients and September 2016 for pediatric patients. They have a cardiac lab that has remained in crates since 2007, but will soon be installed in a temporary location until their new heart center building is completed.

Recently, a surgical mission was conducted September 28 to October 2, 2015. A total of 14 patients were operated, making CDO ready for accreditation October first week, with approval in November 2015.

The first 2013 surgical mission was conducted in February 2013- the first among the satellites. PHC however was just started with Philhealth Z-benefit at the same time and cascading was not ready. A total of 9 patients were operated sponsored by Children's Heart Foundation and Children's International local foundation.

For this year, October 18-20, 2015, a Surgical Mission will be conducted : 4 Adult CABG and 2 VSD patients. A bypass machine will be brought by PHC with OR materials, and Clinical Pathway will be piloted for both procedures. By November, BRTTH will be endorsed for Z- benefit Accreditation. A greater mission is scheduled in June of 2016, using the Z- benefit accreditation for patient support.