Title of the Project: eHealth Philippines

Brief Background:

The Department of Health is the over-all authority on health in the country that provides national policy direction, national plans development, technical standards development, and the creation of guidelines on health. It also serves as a regulator of all health services and products, and a provider of special or tertiary healthcare services as well as technical assistance to many health providers.

The implementation of the “Kalusugan Pangkalahatan” or Universal Health Care is geared towards ensuring the achievement of the health system goals namely: better health outcomes, sustained health financing, and responsive health system.

eHealth Philippines is the application of the Internet and other related technologies in the healthcare industry to improve the accessibility, efficiency, effectiveness, and quality of clinical and business processes that are utilized by various health organizations, practitioners, patients, and consumers in an effort to improve the health status of the people as defined by the Health Information and Management Systems Society (HIMSS).

The World Health Organization (WHO) recognizes eHealth as the use of information and communication technologies for health. It supports the delivery of health services and management of health systems to become more effective and efficient. It is described as a means to ensure that “right health information is provided to the right person at the right place and time in a secure, electronic form” to optimize the quality and efficiency of health care delivery, research, education, and knowledge.

At present, the Philippines’ health care system is facing two challenges on accessibility: lack of access to health care services and lack of access to real-time information for decision-making.

During the 1st eHealth Summit of the Philippines last February 4, 2014, Dr. Julie Hall, WHO representative to the country cited the critical role of electronic medium in bringing healthcare to remote communities.

“The access issue is absolutely critical, and in a country like the Philippines, and many other countries, being able to access communities in remote and rural areas is very challenging and having an information system that has the core of it a telemedicine concept will be a way forward to be able to access those communities” Hall stressed.

In response to Republic Act 10606 “Universal Health Care Act” signed by President Benigno S. Aquino III on June 19, 2010, the Department of Science and Technology (DOST) and Department of Health (DOH) is collaborating to explore the electronic dimension in delivering health care services with focus on the country’s far-flung areas.

The eHealth program is intended to provide solutions to achieve the goals of Kalusugan Pangkalahatan (KP).

 

Project Goal/Objective:

National eHealth Vision: By the year 2020, eHealth will enable widespread access to health care services, health information, and securely share and exchange patients’ information in support to a safer, quality health care, more equitable and responsive health system for all Filipinos by transforming the way information is used to plan, manage, deliver, and monitor health services.

 

Desired Outcomes

  1. Improved access to health information and maintenance of personal health record
  2. Improved access to appropriate health care services for those in rural, remote, and disadvantaged communities via electronic means
  3. Improved access to an integrated/single view of the patients’ health information at the point of care
  4. Improved monitoring and tracking of patients
  5. Improved access to reliable health information (health statistics, disease prevention, treatment, decision support tools, clinical knowledge, planning, and healthcare delivery
  6. Improved sharing and exchange of reliable and quality information

 

Communication Approaches/Strategies:

Key Strategic Guiding Principles

  • eHealth must serve the needs of the client or person
  • collaboration and partnerships with key healthcare stakeholders are critical in realizing the country’s eHealth vision
  • users must be involved at all phases of development and implementation
  • strategic approach in terms of phases enables more focus
  • eHealth activities must be aligned
  • implementation must comply to relevant laws and regulations
  • investments must be made on areas that deliver the greatest benefits to health consumers, providers, and managers

 

eHealth Components

  • Governance
  • Legislation, Policy, and Compliance
  • Standards and Interoperability
  • Strategy and Investment
  • Infrastructure
  • Human Resource
  • eHealth Solutions

 

Phases of Implementation

Phase 1 (2013-2014)

Governance: Department Order on Software Data Compliance Body for National Health Data Reporting and its Implementing Policies, Procedures, and/or Guidelines; Administrative Order on Institutionalizing the National Telehealth Services under the Department of Health

Foundations: Minimum Data Sets for Philippine Health Information Exchange Registries; Operational Infrastructure

eHealth Solutions: Telemedicine Pilot I; Development and Implementation of Philippine Health Information Exchange System; Integrated Clinic Information System (iClinicSys); eHealth Research conduction

Change and Adoption: Conduct of Awareness Activities

 

Phase 2 (2015-2016)

Governance: Working National Health Data Committee; Working Software Data Compliance Body for National Health Data Reporting

Foundations: Philippine Health Enterprise Architecture; National Health Data Dictionary; Administrative Order on Information Protection

eHealth Solutions: Enhancement and Implementation of the Philippine Health Information Exchange System; Implemented Philhealth Electronic Claims Systems; Conducted eHealth Researches; Information and Communication Technology Harmonization Initiative

Change and Adoption: Conduct of Awareness Activities; Enhanced Health Care Provider Licensing or Accreditation

 

Outcome/Result/Effect:

The following are the milestones of eHealth Philippines:

  1. Consensus-building – minimum data sets and standard format were disseminated to hospitals, clinics, and community centers March 2014. Sets include Patient Registry, Provider Registry, Facility Registry, Shared Records, Terminologies, and Health Interoperability Layer.
  • 70 DOH Hospitals input. December 2014; 53 of which uses iHOMIS
  • RxBox deployed in 140 RHUs/CHOs. December 2014
  1. PHIE Infrastructure operational on December 2014
  2. DOST-ICTO – Data warehouse and connectivity down to the barangays
  3. DOST-ASTI – Registry Database Infrastructure and Interoperability Layer Infrastructure.
  4. DOST-PCHRD – eHealth Researches: eHealth applications: tele-parasitology and teledermatology by 2014; Smart diagnostic devices 2015

 

Monitoring and Evaluation

There are two components of monitoring and evaluation of the eHealth roadmap: monitoring the execution of the plan, and monitoring the results if the plan delivers the desired outcomes.

The output indicators will be used to measure the adoption of eHealth and outcome indicators for the results of adoption. Regular status reporting and communication will be provided to ensure delivery of required outputs and attainment of expected outcomes.

The initial baseline measures for output and outcome indicators, the eHealth roadmap will utilize a working group that can be formulated to determine the numbers of figures based on historical data or zero for none. The governance model and processes for national monitoring and evaluation will be included in the establishment of the national eHealth governance structure to direct, implement, enforce, monitor, and evaluate the national adoption of eHealth in the country.

 

Estimated Cost

Total amount of estimated cost for the eHealth program is Php296,944,000.00

 

Program Evaluation:

The CIPO Evaluation model is used to evaluate the eHealth Philippines program.

 

Context

The implementation of the eHealth Philippines program began in 2013, initiating the Phase 1 of the three major phases proposed until 2020. The general objective of Phase 1 is standardization and connection where the focus is on the establishment of governance and foundations, and provides basic connections to start information sharing across the health sector. Phase 1 of the program has an estimated time frame from 2013 to 2014.

At present, the eHealth Philippines program is now on its Phase 2 (2015-2016) and its general objective is to transform where it will continue with innovations to develop and implement defined national eHealth solutions.

Based on the goals and objectives set prior to the implementation of the program, these are still relevant as the program is ongoing. Phase 1 and Phase 2 of the program focuses on creating a stable foundation for the eHealth system, involving organizations and stakeholders in the process.

On its third year, the eHealth goals and objectives are still intact, making sure that people can have access to health care services, information, and securely share and exchange patients’ information for a quality and responsive healthcare system through a stable pillars.

By the year 2020, eHealth will enable widespread access to health care services, health information, and securely share and exchange patients’ information in support to a safer, quality health care, more equitable and responsive health system for all Filipinos by transforming the way information is used to plan, manage, deliver, and monitor health services.

 

Inputs

The program plan and design was carefully thought of as the implementation plans are in detail and corresponds to the program objectives. The phases of implementation were broken down in three sets which contain projected time frames and general objectives for each. Phases are also classified whether “short-term,” “medium-term,” or “long-term.”

eHealth Philippines’ action plan describes how they will be able to attain the objectives. The plan was formulated with action lines, required resources, and strategic phases. The organization of action lines, tasks, and mapped eHealth components makes it comprehensive where national activities of similar focus and intent are clustered.

As the program progresses, the program has Targets where eHealth activities has projected time frames and deliverables anticipated for each phase. Under each action line, it contains significant programs or policies that has been implemented and has yet to be implemented.

The program implementation plans are adequate for guiding the program and for producing the desired outcomes.

 

Processes

The program has attempted to do Phase 1 and Phase 2 of the roadmap.

Within three years of implementation, the following commitments have been realized:

  1. MITHI (Health, 2014)
  • Philippine Health Information Exchange (integrating/harmonizing health data coming from different electronic medical record systems and hospital information systems)
  • Development and Implementation of the Health Enterprise Data Warehouse
  • Integrated Health Goods Licensing Information System
  • Standards Training and Change Management
  • Implementation of DOHs Integrated Clinic Information System
  • System Enhancement and Implementation of the National Disease Registry
  1. KOIKA – Interoperable Health Information System for CHD4A – CALABARZON (5 years)
  • Health Information Exchange
  • Implementation of the DOHs Integrated Clinic Information System
  • Upgrading and Implementation of the Integrated Hospital Operations and Management Information System
  • Data Warehousing
  1. PCHRD Funds
  • Devices to gather and transmit data (RxBox, mobile phones, tablets, diagnostic devices)
  • Applications (tele-referrals, tele-consultations)
  1. DOH and PhilHealth
  • Universal Coverage (85 Million Filipinos)
  • System Development, Implementation, and Maintenance of iClinicSys, iHOMIS, Philhealth eClaims Systems, and Philippine Health Information Exchange System
  • Operational Support to systems
  • Interoperability Standards Setting
  • Training/Capability Building
  • Legislations/Policies
  1. Funding for 2015, 2016, and beyond
  • Operational Support
  • System Maintenance
  • Infrastructure Upgrade
  • Capability Building
  • System Monitoring and Evaluation

With regards to the finance aspect of the Processes, budget for Foundation Strengthening and Solutions Development is currently being utilized and is in accordance with the action plan and standards.

 

Products/Outcomes

eHealth Philippines’ desired outcomes could not be evaluated at the time of evaluation since the program is still ongoing. The goals, outcomes, and indicators can be evaluated once Phase 3 of the program will commence (2017).

So far, the program is still being constructed in preparation for the second component of results monitoring.

 

(Published: May 22, 2015)