eHealth Program

Philippine Dev’t. Plan

SDGs
Philippine Health Agenda
Philippine Strategic Framework National Objectives for Health
for ICT Sector, Philippine WORLD HEALTH ASSEMBLY
eGovernment Master Plan 2013- 58th & 62nd WHA eHealth
2016 Health Enterprise resolutions
Architecture
Philippine Digital Strategy
2011-2016 DOH Info. System
Strategic Plan (DOH
ISSP2015-2017)

Phil. eHealth Strat.

Framework & Plan (2013
– 2020)
Philippine Health Information System
Health Policy Support to
Health Regulation Hospital Services Technical Support
Services Operations

2
eGov Master Plan Framework
 Government’s Move to eHealth

Philippine
Health System Challenges trying to help address
eHealth Strategic  Access to health care services
Framework &  Access to real-time information for decision-making
Plan 2014-2020 • Delayed availability of health data and statistics
• Many health data or information coming from disparate
systems and locations with different formats, and lacking in
harmonization
• Data quality problems in terms of reliability, timeliness,
accuracy and completeness
• Poor and slow recording and data processing
• Very long reporting process from the RHU/HCs to the M/CHO,
PHO, RO then to the DOH CO.
Philippine eHealth Strategic Framework and Plan
COMPONENTS

WHO-ITU eHealth Tool Kit

 eHealth within the framework of the Philippine Health
Agenda, 2016-2020
1. Use Electronic Medical Record in Health Facilities

PHIC-
DOH,
PhilHealth: +DICT
• Hospitals: eClaims implementation
• Primary Care Benefits (initial Use Case)
Existing Manual System at hospitals transmission of healthcare-related data
DOH:
and primary care facilities among health facilities, health info
• Quality health service statistics
• Quality vital statistics organizations & government agencies
• Better referral system & resource TA according to national standards.
Health Facilities- Improved patient care, care coordination &
diagnostics and patient’s outcome; cost savings & better
efficiencies ++
Improve Civil Registration & Vital Statistics

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2. On-line data submission of clinical, drug dispensing, and administrative and financial
records as prerequisite for registration, licensing & contracting
eHealth within the framework of the Philippine Health
Agenda, 2016-2020

PhilHealth
DOH Licensing, accreditation &
registration requirements *
• Health Facilities (Hospital, DTLs,
Clinical Lab, OFW clinics++) FDA
• Drug outlets
• Food
• Drugs HFSRB
• Cosmetics ++
PhilHealth Accreditation & Contracting
Requirements *
Pay on-line Regional
• Health care institution
Office
• Health Professional
Check Status on-line
DOH ++
* Some Operational

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 Enhanced by
telemedicine

Invest in eHealth & Data

for Decision Making
Philippine Health Agenda 2016-2022
ACHIEVE 12Legacies
12 Legacies
 “eHealth is the use of
information and communication technologies
(ICT) for health.”
-- WHO
 What is eHealth?

• The World Health Organization defines eHealth as the use of information

and communication technologies for health.

• It is described also as a means to ensure that “the 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.
 Philippine Strategic
Framework & Plan, 2014-2020

VISION IT-Enabled Health Services

By 2020, an ICT-enabled
IT in All Public Health Facilities
Philippine Health System
towards better and
equitable access to quality EHR Systems Validation or
health care services, and Certification
easier access to secure Health Data Standards Use
real time and quality
health data and PHIE Implementation
information for
evidenced-based decision Hospital
EMR Implementation
making. Management
Information
Systems
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 Philippine Health Information Exchange

• Philippine Health Information Exchange (PHIE) is a system

that basically allows easy access to health information from
the national to the barangay level.
• The Philippine Health Information Exchange will store health-
related data in the country and can be viewed by authorized
health care providers
 Philippine Health Information Exchange

Advantages
• eliminate double counting very high maternal mortality
records that might be inaccurate
• prevent under reporting that may result to budget allocated
incorrectly
• assure reliability of data and avoid using obsolete data
• avoid double data collection by different agencies
 Philippine Health Information Exchange

Advantages
• standardize data to allow ease of sharing and analysis
• improve the completeness of data because of the exchanges
among different health facilities
Philippine Health Information Exchange

Disease
HMIS Registries
Ultimate goal is Integrated Patient Care

Philhealth Primary
Benefit Health
Packages Care

Personal
Health Hospital
Record

Health
Pharmacy Services
(Labs…)
Compliance to PhilHealth & National Reporting Requirements

EMR for PCB and other benefit packages

Electronic submission of reports and claims as required
Philhealth Systems (e.g. Membership Verification, Philhealth Membership Registration for
New Members, PCB)
• PhilHealth Circular No. 2016-013: Per Family Payment (PFP) Processing Using the Automated Payment Utility in the PhilHealth HCI Portal and Other
Certified Electronic Medical Records (EMRs)
• PhilHealth Advisory No. 2017-0012: Submission of Primary Care Benefit (PCB) Data
• PhilHealth Advisory No. 2016-0040: Electronic Medical Record System
• PhilHealth Circular No. 2016-016: Full Implementation of Electronic Claims
• Philhealth Advisory 2017-11: Engagement of Health IT Providers to facilitate Electronic Claims Submission effective April 2017

Field Health Services Program (e.g. Maternal Care, Family Planning, Child Care,
Dental Care, Tuberculosis, Filariasis, Malaria, Leprosy, Environmental Health,
Natality, Morbidity, Mortality)
Unified Disease Registries (Cancer, Diabetes, Stroke, COPD, Injuries and others)
 Philippine Health Information Exchange (PHIE) +++
ADDRESS DATA MANAGEMENT & EXCHANGE PROBLEMS

Challenges
Many data or health
information coming from
disparate systems (EMRs)
and locations…
Different Data Formats Poor Data Quality
mm/dd/yyyy Different Data Codes Eq. Available Data are
yyyy/mm/dd ‘F’ Female | ‘M’ Male outdated, 3 yrs/ late
1 Female | 2 Male
Lack of Standard Terminologies &
Meanings Lack of Harmonization in Processes
Sex, Gender, Lab results.. Department of Health collects data
Philhealth collects the same data
OLD Scenario

Philhealth Benefit/Claims Data

Service Statistics & Data Reporting

Current eHealth/EMR Implementation

PHIE/
HITP

PHIE - Phil. Health Information Exchange

HITP - Health Information Technology Provider
Future eHealth/EMR Implementation
HF Requirements

Other
Authorized
HCPs
PHIE/
HITP

Laboratories

CRVS
Hospital EMR Cumulative Capabilities

4 5
2 3
0 1
Paper-based + Billing, +Admission, + Nursing +Financial, Integrated
Medical ER, OPD, Care/Ward, Administrative, with
Records OR, ancillary & Logistics Philippine
Systems Health
Electronic Internal Information
Philhealth submission of Health Data Analytics Exchange
eClaims DOH required Information External data (PHIE)
submission reports Exchange sharing for
(HIE) doctors
Basic Data
Analytics
 Primary Health Care Facility EMR
Cumulative Capabilities
3 4 5
1 2
0
Paper- Patient +Patient + Doctor’s +Financial, Integrated
based Profiling/ Care sharing of Administrative with
Enlistment Manageme patient record , & Logistics Philippine
nt, Other from referral Systems Health
Philhealth facilities Information
Primary Care Benefit Exchange
Benefit (PCB1) Packages, External data (PHIE)
Requirement Electronic sharing for
submission Electronic submission of doctors
submission
 EMR Functionality
Graph2: % of RHUs with Functional EMRs (N=2,582) Number of Hospitals : As of May 24, 2017

Total: 1,553
Government 566
120
Private 987
100
100 Number of RHUs : As of May 24, 2017
89
84
77
80
Total 2,582
59 59 56
60 55 54 54
47
43 40 40 Reasons for high achievers on
38
40 33
25 operationalization of EMRS in
20 RHUs:

0 1. Presence of dedicated
REG 6 REG 5 REG 2 REG REG 1 REG 8 REG REG REG 3 CAR REG 7 REG REG 9 REG NCR ARMM REG encoders hired by LGUs
4B 11 12 13 10 4A

2. Good connectivity

HIGH PERFORMERS: REG. 2, 4B, 5, & 6 3. Access to computers

provided by LGUs or DOH CO
Total No. of EMR ready RHU facilities : 1,305 (50%)
Data as of May 31, 2017 Source: KMITS- DOH CO 28
 HEALTH CARE FACILITIES implementing DOH EMR System
Facility Total No.* iClinicSys iHOMIS
Government Hospitals 601 - 104
Rural Health Units/Health 2,588 666 (+595) -
Centers
Barangay Health Stations 20,107 389 -
3000
600
2500
400 Total No.
2000
200
1500
0 No. with
1000
500 iClinicSys
0 With Other
EMRS
*Source:
http://nhfr.doh.gov.ph/Philippine_health_facility_statuslist.php Total no. of RHUs with
(as of Mar 13, 2017)
Total No. No. with EMR (iHOMIS) EMRs
Practice areas affecting EMR implementation
“Man is still the most extraordinary computer of all.”
- John F. Kennedy

•Leadership THREE-LEGGED STOOL

•Provider engagement
•Workflow
•Training
•Data and user interfaces Source: McCarthy, C. & D. Eastman (2010) ‘Change management
strategies for an effective EMR implementation,’ HIMSS, Chicago
Points of engagement and cooperation
• DOH Regional Offices commit to:
 Provide technical assistance and support in the implementation of
UDRS and other DOH IS within their area of jurisdiction.
 Ensure timely submission of reports
 Conduct compliance monitoring
 Perform Coaching and mentoring

• DOH CO Program Managers commit to:

 Utilize data from different DOH IS in program planning and other
interventions
 Provide overall supervision in the operation and implementation of
the system
Points of engagement and cooperation
• Health Facilities commit to:
 Provide the needed hardware, supplies and internet connection
 Operate/Use the system
 Utilize the data
 Designate Personnel assigned in the implementation of the UDRS
 Ensure timely and accurate submission of the data
eHealth will improve our work & how we do things!
Thank you.