Leadership, Governance and Multi-Sector Engagement
1. Direct and coordinate eHealth goals, strategies and activities at all levels (i.e. health facilities, healthcare providers, policy/decision makers); ensure alignment with national health system goals and political climate; promote collective consciousness and awareness and engage stakeholders. Critical areas of governance are management of the following key result areas, among others:
a. Strategic architecture
b. eHealth stakeholders’ engagement
c. Clinical safety
d. Health operations, regulations and management
e. Monitoring and evaluation
f. Policy oversight
2. Use mechanisms, expertise, coordination and partnerships to develop and/or adopt eHealth components (e.g. standards).
3. Support and empower required change, implementation of recommendations and monitoring results for delivery of expected benefits.
1. Establishment of a national eHealth governance structure to direct, implement, enforce, monitor, and evaluate the national adoption of eHealth in the country.
2. Establishment of the eHealth software compliance structure.
3. Updating of the health sector enterprise architecture.
4. Implementation of the structures on national eHealth governance, eHealth software compliance, and health sector enterprise architecture.
1.Creation of the National eHealth Governance Steering Committee and Technical Working Group
2.Creation of eHealth Advisors Group
3.Creation of Various eHealth Experts Groups and Teams
3.1 Health Enterprise Architecture Experts Groups
3.2 National Health Data Standards Experts Group
3.3 National Health Data Privacy Experts Group
3.4 Electronic Medical Record Experts Group
3.5 Information Technology Experts Group
3.6 Risk Management Experts Group
3.7 Finance and Sustainability Experts Group
3.8 Monitoring and Evaluation Experts Group
3.9 Data Management Experts Group
3.10 Capability Building Experts Group
3.11 Terminology Asset Management Team
3.12 Health Information Technology Team
4.Conduct of regular National eHealth Steering Committee and Technical Working Group, eHealth Advisers Group, and eHealth Experts Groups and Teams’ consultations, and coordination and agreements meetings, and jointly issue and implement agreed eHealth policies, strategies, plans, guidelines, rules and procedures, and the like.
1. Formulate and adopt required national policies, legislations and protocols across health sector to support the attainment of the eHealth vision; review health sector segment policies for alignment and comprehensiveness; establish regular policy reviews and implementation monitoring. Examples of these are the national legislations, policies, and regulations on how health information are stored, accessed and shared across geographical and health sector boundaries; implementation of unique health identifier; implementation of national health data standards; and software certification or accreditation.
2. Create and sustain a legal compliant and policy-driven environment to establish trust, buy-in and protection among consumers and industries involved in eHealth practices and systems.
1. Push for the approval of an eHealth/Telemedicine/Telehealth Law.
2. Institutionalization of the National eHealth Program.
3. Formulation of the necessary policies, mechanisms and standard operating procedures for the use and adoption of health data standards and interoperability.
4. Formulation of the necessary policies, mechanisms and standard operating procedures to establish/institutionalize health data privacy and security.
5. Formulation of the necessary policies, mechanisms and standard operating procedures for the application/software compliance to DoH & PhilHealth reporting requirements, and related national standards.
6. Formulation of the necessary policies, mechanisms and standard operating procedures to establish a secure health information exchange.
7. Formulation of other related policies on administrative, legal, ethics, research, finance aspects of eHealth.
8. Regular review and updating with stakeholders, considering international and national policies and commitments, various eHealth policies and protocols, plans, and frameworks.
1.Draft eHealth Bill for the 17th Congress.
2.Draft Administrative Order on the Institutionalization of the Inter-Agency National eHealth Governance Committee of the National eHealth Program.
3.DOH Administrative Order No. 2013-0025: National Implementation of Health Data Standards for eHealth Standardization and Interoperability (eHSI Release 01)
4.DOH Administrative Order No. 2015-0037: National Implementation of Health Data Standards for eHealth Standardization and Information Interoperability
5.Joint DOH-DOST-PhilHealth Administrative Order on the Implementation of the Philippine Health Information Exchange
6.Joint DOH-DOST-PhilHealth Administrative Order on the Privacy Guidelines for the Implementation of the Philippine Health Information Exchange
7.Joint DOH-PhilHealth Administrative Order on the Adoption of the Philippine Health Information Exchange Lite
8.Joint DOH-PhilHealth Administrative Order on the Implementation of the National eHealth Electronic Medical Record System Validation for the Various National Health Data Reporting Requirements – for formal endorsement of respective Legal/Policy Offices of the concerned agencies.
9.DOH Administrative Order on the Institutionalization of the National TeleHealth Services under the Department of Health – ongoing revision of document.
10.DOH Administrative Order on the Implementation of the National Health Facility Registry – ongoing revision of document.
11.Memorandum of Agreement on the Management and Implementation of the Philippine Health Information Exchange (PHIE) and Other Related eHealth Projects signed last 17 March 2015.
12.Memorandum of Understanding on the Philippine National Public Key Infrastructure signed last 9 July 2015.
13.Resolution to Formally Manifest Before the Cabinet the Need to Establish the National Privacy Commission and Proposal for Creation of the National Health Data Privacy Board.National eHealth Information Interoperability Standards Change Management Manual – for final approval by the National eHealth Technical Working Group.
14.National eHealth Information Interoperability Standards Catalogue – for final approval by the National eHealth Technical Working Group.
Introduce and enable use of standards that enable consistent and accurate collection and exchange of health information across health systems and services, and geographical and health sector boundaries through use of common standards on data structure, terminologies, and messaging.
1. Establishment of governance and management structure on national health data standards.
2. Definition, advocacy for use, and implementation of health data standards.
3. Establishment of policies and mechanisms toward national adoption & institutionalization of various eHealth standards.
4. Regular review and updating of existing eHealth standards based on national, regional and international policies and best practice(s).
1.Creation of the National Health Data Committee
2.Creation of the National Health Data Standards Experts Group
3.Creation of the Terminology Asset Management Team
4.Implementation of the National Health Data Dictionary 3.0
5. Development of the National eHealth Information Interoperability Standards Change Management Manual.
6. Development of the National eHealth Information Interoperability Standards Catalogue.
7. Issuance of the Standard Codes and Structures for the PHIE Lite Use Case/Registries.
8. Activation of the Distributed Terminology Service within the PHIE.
1. Required core systems, services and applications to enable widespread access to and management of health care services, health information, health reports, health care activities, and securely share and exchange patient’s information in support to health system goals; the means may be supplied by the government or commercial enterprises.
2. Users include the general public, patients, providers, facilities, insurance companies, and other relevant stakeholders and institutions.
1. Development and implementation of standardized and harmonized eHealth solutions.
2. Implementation of an integrated health application or software compliance certification system.
3. Integration and harmonization of various electronic health record systems.
4. Implementation of a health information exchange.
5. Full scale implementation and expansion of telehealth/telemedicine services in selected areas.
6. Maintenance, enhancement and sustainability of eHealth solutions and services.
7. Conduct of relevant researches and further studies on emerging eHealth innovations.
1. Creation of the relevant experts groups and team to scale up interoperable systems such as the Electronic Medical Record Experts Group; Information Technology Experts Group; and Health Information Technology Team.
2. Upgrading and implementation expansion of the Integrated Clinic Information System, and the Integrated Hospital Operations and Management Information System as de facto reference models for software certification.
3. Development of PHIE Lite by DOH and PhilHealth.
4. Definition of standard codes and structures of PHIE Lite Use Case/Registries
5. Development of the Health Proof-of-Concept Enterprise Service Bus for the PHIE.
6. Development and/or refinement of the PHIE eHealth Government Common Platform Phase 1.
7. Signing of Memorandum of Understanding on the Philippine National Public Key Infrastructure.
1. Establish and support the operationalization of the health information exchange, i.e. the sharing of health information across geographical and health sector boundaries, and implementation of innovative ways to deliver health services and information.
2. Composite physical infrastructure, network resources and core services that form foundation for seamless electronic health information exchange across geographical and health sector boundaries.
1. Continuous assessment of existing national information infrastructure such as connectivity, data warehouse, and other ICT requirements, among others.
2. Establishment of connection to the government fiber optic network.
3. Provision of interconnection to hospitals and rural health units/health centers, among others.
4. Collaboration and coordination with concerned government and telecommunication companies to expand and/or upgrade broadband services up to remote areas.
5. Maintain and sustain the infrastructure.
1.Creation of the Electronic Medical Record Experts Group
2.Creation of the Information Technology Experts Group
3.Creation of the Health Information Technology Team
4.Establishment of Physical Infrastructure for Hosting Services for the PHIE
5.Memorandum of Agreement on Application Hosting Service Agreement for the PHIE
1. Workforce or manpower to develop, operate or implement the national eHealth environment such as the health workers who will be using eHealth in their line of works, health care providers, information and communication technology workers, and others.
2. Make eHealth knowledge and skills available through internal expertise and technical cooperation between the public and private health sector.
3. Build national, regional and specialized networks for eHealth implementation, management and sustainability.
4. Establish eHealth education, training programmes and other capability building initiatives for health human resources.
1. Conduct of needs assessment on human resources (information technology, engineering, business process outsourcing, among others).
2. Development of human resource eHealth capability plan.
3. Conduct of trainings and other relevant capability building activities on eHealth policies such as health data standards and privacy; solutions like electronic health record systems, and health information exchange; and other related eHealth services.
4. Update of educational programs to increase the number of health care providers knowledgeable and skilled in eHealth.
5. Push for the integration of various eHealth concerns or subject matters in the medical and paramedical curriculum, initially for data health privacy
6. Implementation of relevant eHealth educational programs.
7. Introduction to eHealth, and conduct of continuing eHealth education and evaluation.
8. Development of eHealth education and training delivery tools.
9. Provision of awareness campaigns and advocacies, training and education on telehealth/telemedicine.
10. Conduct of awareness campaign, fora, symposia, conferences and/or workshops to strengthen the adoption of eHealth.
1.Creation of the Capability Building Experts Group
2.Conduct of capability building activities on:
2.1 eHealth Systems
• PHIE Lite Implementation
• iHOMIS System Implementation Expansion to New Sites
• Decision Makers’ and Users’ Training on iClinicSys System Implementation
• Other Clinic/Hospital Information System Registries
2.2 Public Key Infrastructure
2.3 Enterprise Architecture Server Repository Tool
2.4 Service Oriented Architecture Application
2.5 Terminology Service
3. Integration of the following relevant courses to current college curricula of medical/engineering degrees:
1. Develop, implement and sustain the national eHealth vision through development of responsive strategies and plans to operate and maintain the national eHealth environment.
2. Lead planning with involvement of major stakeholders and sectors.
3. Align financing with priorities; donor, government and private sector funding identified for medium term ICT harmonization initiatives. Investment refers to the funding or amount needed for executing the strategies and plans.
1. Regular evaluation and update the Philippine eHealth Strategic Plan.
2. Establishment of regular funding or financing system.
3. Establishment of incentive mechanisms among health care providers and health facilities for the adoption of eHealth solutions, and investments in computing infrastructure for eHealth.
4. Incorporation of the adoption of eHealth solutions as an accreditation or licensing requirement for health care providers and health facilities.
1. Creation of the Philippine eHealth Strategic Framework and Plan
2. Creation of the Health Sector Enterprise Architecture
3. Creation of the eHealth Program Management Office
4. Creation of the Finance and Sustainability Experts Group
5. Hiring of the consultants for the following projects:
5.1. Development of the Health Enterprise Proof of Concept Service Bus for the Philippine Health Information Exchange – ongoing contract execution.
5.2. Development of Health Data Protection and Privacy Guidelines in Support of the Implementation of the Philippine Health Information Exchange – project closed.
5.3. Development of Health Enterprise Architecture for the Development and Implementation of the Philippine Health Information Exchange – project closed.
5.4. Conduct of Information Technology Process Maturity Level Assessment for the Philippine Health Information Exchange – ongoing contract execution.
6. Conduct of regular National eHealth Steering Committee and Technical Working Group, eHealth Advisers Group, and eHealth Experts Groups and Teams’ consultations, and coordination and agreements meetings, and jointly issue and implement agreed eHealth policies, strategies, plans, guidelines, rules and procedures, and the like.
Two main challenges of today’s health system are access to health care services, and access to real time information for decision making. At present, 70% of the population living in rural areas are still struggling with no or limited access to quality inpatient and outpatient care services. Recent health demographics studies showed that the segmented distribution of the health facilities and healthcare providers contribute largely to this alarming situation as exemplified by the fact that only 13% of healthcare providers and 40% of tertiary hospitals are situated in non-urban areas; let alone that on the average, the time it takes to travel to a local health facility usually takes around 39 minutes.
Moreover, delayed access to timely, reliable, accurate, and complete health information contributes to the challenges faced by decision makers. This condition is further worsened by various health data coming from disparate systems that use differing formats, lacking harmonization, and putting additional strain on already compromised data quality. Further, poor recording, processing and transfer of data from the health center/rural health unit to the provincial or city health office, the regional health office, and to the DOH Central Office takes more than a year with data validation at various levels.
Consistent with the foregoing, the health sector through the leadership of the Department of Health (DOH) has recognized the necessity of using information and communication technologies (ICT) for health or eHealth as one of the enabling strategic instruments not only to address these current disparities in service care delivery, and timely access to information for better decision making and intervention, but also, largely, to support and facilitate the achievement of the Universal Health Care (UHC) goals of better health outcomes, sustained health financing, and responsive health system. In its broadest sense, eHealth is concerned with improving the flow of information, through electronic means, to support and facilitate the delivery of quality and responsive health services, and better management of health systems and service delivery networks. It is envisioned that, “By 2020, eHealth will enable widespread access to health care services, health information, and securely share and exchange client’s information in support to a safer, quality health care, more equitable and responsive health system for all the Filipino people by transforming the way information is used to plan, manage, deliver and monitor health services.”
Guided by the Philippine eGovernment Master Plan of linking government data centers and databases to create a secure network for government information systems, and harmonize information technology systems, programs and projects in the public sector through the Medium-Term Information and Communication Technology Harmonization Initiative (MITHI), which is spearheaded by the Department of Budget and Management (DBM), DOST, and the National Economic Development Authority (NEDA), the Department of Health joined hands with the Philippine Health Insurance Corporation (PhilHealth) and Department of Science and Technology (DOST) in the development and implementation of the Philippine eHealth Strategic Framework and Plan (PEHSFP) 2013-2017.
The collaboration and partnership of the stakeholders are embodied in the issuance of the Joint DOH-DOST Department Memorandum (DM) No. 2013-0200 on the Creation of a Joint National Governance on eHealth (JNGeH), which later became the default MITHI eHealth Committee or Health Cluster, and later reconstituted with additional membership from the University of the Philippines Manila and Commission on Higher Education in April 2015 through Joint DOH-DOST DM No. 2015-0097 and 2015-0098. The aforesaid DM’s principal intents are to achieve synergy in the development, updating and implementation of the Philippine eHealth Strategic Plan to guide the establishment and sustainability of the National eHealth Program, and ensure harmonization, alignment and interoperability among various eHealth initiatives, programs and/or projects across the country, and in accordance with the MITHI objectives and international practices and directions.
Central to all these efforts is the robust collaboration and partnership among the various public and private segments in the healthcare and ICT sectors. The desired goal is an ICT-enabled environment for purposive, coordinated, harmonized and productive action among major stakeholders in building consensus on policies and protocols, facilitating optimal use of shared resources, and investing in ICT capacities in terms of infrastructure and competencies to support the national health system goals of better health outcomes, sustained health financing and equitable and responsive health systems.
PHILIPPINE eHEALTH STRATEGIC FRAMEWORK AND PLAN (2014-2020)