What is the Health & fitness Assessment Office (HFAO)?

The Health & fitness Office is a distinct unit in the LCP that is tasked to implement a scientific, rational and comprehensive approach to health and fitness assessment.

What is the rationale behind the establishment of the HFAO?

The Lung Center of the Philippines has always been in the forefront of health promotion and disease prevention as dictated by its mandate and guided by its mission and vision of being “the premier Institution for Lung and Chest Disease.” As such, it has always been involved with pre-employment evaluation and issuance of medical clearances for travel, sports, school and the like.

As a special mandate, the Department of Health, through its Legal Services Division, has given the Lung Center, as the tertiary medical center for lung and chest diseases, the task of performing clinical assessments relevant to the respiratory system. An important evaluation is the one that pertains to Pulmonary clearance among work applicants.

The HFAO implements a more standardized, algorithmic approach to the assessment, management and disposition of individuals undergoing fitness assessment. The aim is to upgrade the level and quality of care in all aspects of the evaluation utilizing protocols adapted from both local and international clinical practice guidelines.

Who may avail of the services of the HFAO?   

All adults (>16 years walk-in or referred) who require fitness evaluation and assessment to work, to enter school, to travel, engage in sport or related activities may avail of the services of the HFAO.

Who makes the assessment in the HFAO?

A multi-disciplinary team of medical and health care specialists are responsible for efficient implementation of the assessment protocols. Since the disposition of the clients/patients may have legal implications, only certified specialists who are bonafide staff of the Lung Center may issue certifications.

What assessment procedures are done by the HFAO?

Pre-employment assessment:

The procedures are as follows for all applicants: signing of a consent form by the applicant, completion of a screening questionnaire, standard chest x-ray and other imaging techniques, and, if deemed necessary, tuberculin skin testing and sputum examinations for acid-fast bacilli. Retrieval of old chest x-rays and other relevant documents are necessary to complete the background medical information. A thorough medical history will be obtained by the evaluating specialist along with a physical examinations will then be done followed by a written disposition: fit or unfit, along with appropriate reason(s).

Assessment for school entry, travel or sports fitness:

Procedures to assess fitness for these situations include the following: medical history, physical examination, chest x-ray, lung function evaluation tests and other tests deemed appropriate.

What is the expected output of the HFAO? 

After completion of the evaluation, the HFAO, through its clinical specialists, will issue relevant Lung Center certification of fitness to the requesting applicant. Certificates will be provided by the specialist who performed the evaluation. Then the official seal of the Lung Center will be applied to the certificate. A copy of the completed certificate will remain for safekeeping at the Medical Records. Access to these records will only be given upon the consent of the individual who was originally issued the certificate. All information obtained in the course of the assessment will be kept on file at the HFAO. A source document may be kept by the specialist who performed the evaluation.

What are important points to remember about certifications issued through the HFAO?

There is no assurance that all those who request for assessment will be issued a medical certification. The issuance of the certification will depend on the overall assessment and disposition.

Policies and Procedures: Pre-employment Assessment

1.  All patients who request or require pre-employment assessment specially
     focusing on pulmonary evaluation will be referred to the Health and Fitness
     Assessment Office (HFAO) using a referral form to be filled up by the
     referring individual, unit or agency.

2.  The following procedure will be followed for each patient referred:

  • Initial Consult:
    • The patient referred will complete an assessment request form (to include
        general information, biodata, reason for request)
    • Relevant documents, e.g. chest x-ray reading, sputum exam results, will
        be submitted along w/ the request form to the HFAO NA/clerk
    • A conformed will be signed by the patient to consent for procedures and
        assessment and a waiver releasing the Office and institution from any litigation
    • Request for standard laboratory procedures will be issued by the HFAO NA/clerk
        to the patient with the appropriate instructions: chest x-ray PA view (plus
        apicolordotic view, as appropriate), sputum (induced) AFB examinations
        (x 3), tuberculin skin test (as appropriate)
    • Instruction will be given to retrieve previous chest films and other relevant
        documents (e.g. written documentation previous T.B treatment)
    • Information as to the cost of procedures and assessment or any other inquires
        will be given
    • Schedule of follow-up will be not more then three (3) working days from time of
        initial consult
  • Follow-up Consult: 
    • The patient will be referred to the physician-on-call (scheduled on the day of
        follow-up) for evaluation. All relevant documents and results of procedures
        and examination will likewise be submitted to the evaluating physician.
    • Appropriate disposition will be given by the physician:
        • If declared as fit for employment, a pre-employment clearance will be
            issued using the LCP certification form issued by the Records Section.

        • If declared unfit for employment, appropriate management will be given.

3.  All dispositions will be considered final and are no longer subject to appeal or
     petition for reconsideration.

4.  All the files of patients who received assessment certification will be kept in the
     HFAO incase there is a need for further reference.