The Philippines has adopted the AeHIN National eHealth Capacity Roadmap to build its national eHealth system. This recommends first establishing an eHealth strategy and governance structure, then developing an enterprise architecture and standards to ensure interoperability. The country created a National eHealth Governance Steering Committee and technical working groups to develop its Philippine eHealth Strategic Framework and Plan 2013-2020. This included establishing standards, privacy guidelines, and plans for a Philippine Health Information Exchange. However, challenges remain around inter-agency collaboration, integrated planning, and program management. The roadmap provides a framework, but strong governance is still needed to address complexities and ensure the system supports patient care and public health.
FEDERAL HEALTH IT STRATEGIC PLAN 2015 -2020David Sweigert
Created by:
The Office of the National Coordinator for Health Information Technology (ONC)
Office of the Secretary, United States Department of Health and Human Services
Upload as a courtesy by:
Dave Sweigert , CISA , CISSP , HCISPP, PMP , Security+
Since 2005, a group of stakeholder associations known as the Long Term and Post Acute Care (LTPAC)
HIT Collaborative, recognized their common interests and vision for health information technology. The
collaborative was formed to advance HIT issues through coordinated efforts, hosting of an annual LTPAC
HIT Summit and publishing of a Road Map.
AN EHEALTH ADOPTION FRAMEWORK FOR DEVELOPING COUNTRIES: A SYSTEMATIC REVIEWhiij
There is growing interest in the rate of eHealth uptake resulting from the increased potential to advance
the quality of healthcare services in both the developed and developing countries. Although the
implementation of information and communication technology to support healthcare delivery would
greatly address the quality and accessibility challenges in healthcare as well as reduction in the cost of
healthcare delivery, the adoption of eHealth has not been fully realized. This study aimed at conducting a
systematic literature review to establish the factors associated with the adoption of eHealth and propose a
context-specific framework for successful adoption of eHealth technologies in developing countries such as
Uganda. The systematic literature review process was guided by the Systematic Review Protocol. The
review of 29 journals from the period 2009-2021 showed that, although the most widely used frameworks
in the developing countries were Technology Adoption Model (TAM), Unified Theory of Acceptance and
Use of Technology (UTAUT) framework and Technology Organization Environment (TOE) framework,
there were other salient factors reported by other researchers that contributed to the adoption of eHealth
in developing countries. A novel framework for adoption of eHealth in the local context with eight (8)
dimensions namely; Socio-demographic, Technology, Information, Socio-cultural, Organization,
Governance, Ethical and legal and Financial dimensions is derived and presented as result of the
research.
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
Transforming Health Systems grants tackled four health systems concerns: stewardship and management, financing, information systems, and universal health care (UHC) policy and advocacy. In each target country, the grants provided transformative support to address key challenges.
Bangladesh faced serious constraints in its health sector workforce and weak health information systems. Thirty one grants helped provide training for health care professionals, assess and improve health information systems, and introduce UHC concepts to health sector stakeholders. The interventions increased awareness and commitment to UHC, contributed to improved and standardized medical education, and aided the development of integrated health information systems.
Ghana sought to build public sector capacity to steward and manage its mixed public-private health system. The program partnered with the International Finance Corporation, which assessed the private health sector. Thirteen grants subsequently sought to build capacity within the private sector unit in the Ministry of Health and to create a platform to facilitate engagement with the private sector. The interventions strengthened public sector capacity, increased policy dialogue around UHC, and strengthened the country’s National Health Insurance Scheme.
Rwanda’s health system reforms have sought to increase health service use, reduce out-of-pocket expenditures, and improve health indicators. Eleven grants focused particularly on building eHealth and technology platforms. The grants resulted in improved capacity to develop and implement sustainable eHealth solutions, as well as creation of a custom electronic medical records system and a Health Enterprise Architecture. Most grants included plans for sustainability beyond the life of the grant.
Vietnam wanted to find ways to expand coverage, improve financial protection, and reduce inequality, particularly through improving its provider payment system. Sixteen grants funded research to support reforms and design and test alternative capitation methods. The initiative built capacity in academic and research institutions, strengthened government capacity in health system management and planning, increased support for payment reform, and generated evidence to shape universal health insurance policies.
The study on social impact of free health service in Sri LankaRavi Kumudesh
Study on social impact of free health service in Sri Lanka
Ravi Kumudesh(kumudeshr@gmail.com)
Statistical data and the sense of community show a gap of total health expenditure and public health expenditure. This gap shows the problem of sustainability of free health and has created several problems on patients who visit the government hospital for their healthcare needs and health development in community.
This study is focused to clear out the disparity of the health policy by identifying the obstacles to obtain free healthcare facilities from state sector healthcare institutions, and to clarify evidently the circulation of additional amount of money in health service other than public health expenditure creating problems of free health service.
Questioner was the instrument used in primary data collection. Responses were analyzed with income levels. Availability of hospital facilities, mode of spending, utility of private and government health facilities, aptitude on current health trends and prevention healthcare were surveyed. Secondary data analysis also carried out based on WHO reports, reports of Ministry of Health and other international reports.
Primary data indicated inadequate facilities in state hospitals. Out of admitted patients 72% were requested some drugs and laboratory tests from outside. Every respondent spends some amount of money monthly for their health needs, even among low income levels. Only 21% was alert on preventive health care. Out of the respondents who utilize the private health care services 78% pay their expenditure from out of pocket. It includes both people with high income levels as well as low income levels. Secondary data analysis could justify the present situation of the country health. Public health expenditure share of total health expenditure is always less than 50%.
The research realized that all income levels utilize private sector for their health care needs. Most of people who utilize the private sector pay their bills out of pocket. These evidences show the disparity of free health policy and the nature of persisting health care service. Complete understand on this complicated underlying reality of health should be concerned in provision of sustainable health care service.
FEDERAL HEALTH IT STRATEGIC PLAN 2015 -2020David Sweigert
Created by:
The Office of the National Coordinator for Health Information Technology (ONC)
Office of the Secretary, United States Department of Health and Human Services
Upload as a courtesy by:
Dave Sweigert , CISA , CISSP , HCISPP, PMP , Security+
Since 2005, a group of stakeholder associations known as the Long Term and Post Acute Care (LTPAC)
HIT Collaborative, recognized their common interests and vision for health information technology. The
collaborative was formed to advance HIT issues through coordinated efforts, hosting of an annual LTPAC
HIT Summit and publishing of a Road Map.
AN EHEALTH ADOPTION FRAMEWORK FOR DEVELOPING COUNTRIES: A SYSTEMATIC REVIEWhiij
There is growing interest in the rate of eHealth uptake resulting from the increased potential to advance
the quality of healthcare services in both the developed and developing countries. Although the
implementation of information and communication technology to support healthcare delivery would
greatly address the quality and accessibility challenges in healthcare as well as reduction in the cost of
healthcare delivery, the adoption of eHealth has not been fully realized. This study aimed at conducting a
systematic literature review to establish the factors associated with the adoption of eHealth and propose a
context-specific framework for successful adoption of eHealth technologies in developing countries such as
Uganda. The systematic literature review process was guided by the Systematic Review Protocol. The
review of 29 journals from the period 2009-2021 showed that, although the most widely used frameworks
in the developing countries were Technology Adoption Model (TAM), Unified Theory of Acceptance and
Use of Technology (UTAUT) framework and Technology Organization Environment (TOE) framework,
there were other salient factors reported by other researchers that contributed to the adoption of eHealth
in developing countries. A novel framework for adoption of eHealth in the local context with eight (8)
dimensions namely; Socio-demographic, Technology, Information, Socio-cultural, Organization,
Governance, Ethical and legal and Financial dimensions is derived and presented as result of the
research.
Essential Package of Health Services and Health Benefit Plans Mapping BriefHFG Project
Many governments are scaling up health benefit plans, such as social health insurance, to increase population health coverage. This brief presents findings from a mapping between the services covered under the country’s prominent health benefit plan(s) to the country’s Essential Package of Health Services. The mapping analyzes the extent to which the plan(s) cover essential services.
Transforming Health Systems grants tackled four health systems concerns: stewardship and management, financing, information systems, and universal health care (UHC) policy and advocacy. In each target country, the grants provided transformative support to address key challenges.
Bangladesh faced serious constraints in its health sector workforce and weak health information systems. Thirty one grants helped provide training for health care professionals, assess and improve health information systems, and introduce UHC concepts to health sector stakeholders. The interventions increased awareness and commitment to UHC, contributed to improved and standardized medical education, and aided the development of integrated health information systems.
Ghana sought to build public sector capacity to steward and manage its mixed public-private health system. The program partnered with the International Finance Corporation, which assessed the private health sector. Thirteen grants subsequently sought to build capacity within the private sector unit in the Ministry of Health and to create a platform to facilitate engagement with the private sector. The interventions strengthened public sector capacity, increased policy dialogue around UHC, and strengthened the country’s National Health Insurance Scheme.
Rwanda’s health system reforms have sought to increase health service use, reduce out-of-pocket expenditures, and improve health indicators. Eleven grants focused particularly on building eHealth and technology platforms. The grants resulted in improved capacity to develop and implement sustainable eHealth solutions, as well as creation of a custom electronic medical records system and a Health Enterprise Architecture. Most grants included plans for sustainability beyond the life of the grant.
Vietnam wanted to find ways to expand coverage, improve financial protection, and reduce inequality, particularly through improving its provider payment system. Sixteen grants funded research to support reforms and design and test alternative capitation methods. The initiative built capacity in academic and research institutions, strengthened government capacity in health system management and planning, increased support for payment reform, and generated evidence to shape universal health insurance policies.
The study on social impact of free health service in Sri LankaRavi Kumudesh
Study on social impact of free health service in Sri Lanka
Ravi Kumudesh(kumudeshr@gmail.com)
Statistical data and the sense of community show a gap of total health expenditure and public health expenditure. This gap shows the problem of sustainability of free health and has created several problems on patients who visit the government hospital for their healthcare needs and health development in community.
This study is focused to clear out the disparity of the health policy by identifying the obstacles to obtain free healthcare facilities from state sector healthcare institutions, and to clarify evidently the circulation of additional amount of money in health service other than public health expenditure creating problems of free health service.
Questioner was the instrument used in primary data collection. Responses were analyzed with income levels. Availability of hospital facilities, mode of spending, utility of private and government health facilities, aptitude on current health trends and prevention healthcare were surveyed. Secondary data analysis also carried out based on WHO reports, reports of Ministry of Health and other international reports.
Primary data indicated inadequate facilities in state hospitals. Out of admitted patients 72% were requested some drugs and laboratory tests from outside. Every respondent spends some amount of money monthly for their health needs, even among low income levels. Only 21% was alert on preventive health care. Out of the respondents who utilize the private health care services 78% pay their expenditure from out of pocket. It includes both people with high income levels as well as low income levels. Secondary data analysis could justify the present situation of the country health. Public health expenditure share of total health expenditure is always less than 50%.
The research realized that all income levels utilize private sector for their health care needs. Most of people who utilize the private sector pay their bills out of pocket. These evidences show the disparity of free health policy and the nature of persisting health care service. Complete understand on this complicated underlying reality of health should be concerned in provision of sustainable health care service.
An EHealth Adoption Framework for Developing Countries: A Systematic Reviewhiij
There is growing interest in the rate of eHealth uptake resulting from the increased potential to advance the quality of healthcare services in both the developed and developing countries. Although the implementation of information and communication technology to support healthcare delivery would greatly address the quality and accessibility challenges in healthcare as well as reduction in the cost of healthcare delivery, the adoption of eHealth has not been fully realized. This study aimed at conducting a systematic literature review to establish the factors associated with the adoption of eHealth and propose a context-specific framework for successful adoption of eHealth technologies in developing countries such as Uganda. The systematic literature review process was guided by the Systematic Review Protocol. The review of 29 journals from the period 2009-2021 showed that, although the most widely used frameworks in the developing countries were Technology Adoption Model (TAM), Unified Theory of Acceptance and Use of Technology (UTAUT) framework and Technology Organization Environment (TOE) framework, there were other salient factors reported by other researchers that contributed to the adoption of eHealth in developing countries. A novel framework for adoption of eHealth in the local context with eight (8) dimensions namely; Sociodemographic, Technology, Information, Socio-cultural, Organization, Governance, Ethical and legal and Financial dimensions is derived and presented as result of the research.
AN EHEALTH ADOPTION FRAMEWORK FOR DEVELOPING COUNTRIES: A SYSTEMATIC REVIEWhiij
#Health #clinic #education #StaySafe #pharmacy #healthylifestyle
call for papers..!
-----------------------------
Health Informatics: An International Journal (HIIJ)
ISSN : 2319 - 2046 (Online); 2319 - 3190 (Print)
Here's where you can reach us : hiij@aircconline.com
visit us on : https://airccse.org/journal/hiij/index.html
**************
published articles..!
AN EHEALTH ADOPTION FRAMEWORK FOR
DEVELOPING COUNTRIES: A SYSTEMATIC REVIEW
https://aircconline.com/hiij/V10N3/10321hiij01.pdf
Antoine Mafwilla, MD, MPH, Chief of Monitoring and Evaluation, SANRU shares the challenges of performing evidence-based monitoring and evaluation on health programs in SANRU's program in the Democratic Republic of the Congo.
A quoi sert la recherche sur les politiques et les systèmes de santé? Point d...valéry ridde
Par Denis Porignon.
Plénière d'ouverture du Colloque Post-Vancouver 2016, sur la recherche francophone sur les politiques et systèmes de santé dans les pays à faible et moyen revenu, organisé par la Chaire REALISME, à l’IRSPUM, Montréal, le 21 novembre 2016.
Chapter 30 International Efforts, Issues, and InnovationsHyeoun-.docxchristinemaritza
Chapter 30 International Efforts, Issues, and Innovations
Hyeoun-Ae Park
To promote international development in health and nursing informatics it is necessary to provide tools for the development of national and regional ehealth initiatives and strategies.
Objectives
At the completion of this chapter the reader will be prepared to:
1.Outline key international health informatics initiatives
2.Describe key organizations leading international health informatics initiatives
3.Discuss the role of health practitioners such as nurses in international health informatics initiatives
Key Terms
Derived classifications, 482
eHealth initiatives, 474
Reference classifications, 482
Related classifications, 482
Abstract
This chapter highlights international health informatics initiatives, international organizations involved in these initiatives, and how health practitioners such as nurses are involved in the activities of these organizations. There are numerous international health informatics–related activities that have been initiated across the different regions of the world. In addition academic societies within these regions are pursuing health informatics theory and practice developments. These international health informatics initiatives, along with associated academic organizations, are introduced here with brief histories and the key activities of each region. There are also several international organizations involved in the development of health informatics, such as the World Health Organization, the International Medical Informatics Association, the International Organization for Standardization, the International Council of Nurses, the International Health Terminology Standards Development Organisation, and Health Level Seven. These organizations are introduced with a short description of health practitioners' contributions to their activities. Finally, global issues in health informatics initiatives are also described.
Introduction
In many parts of the world healthcare is one of the largest sectors of the economy. As a result, health spending plays a major role in economic policy throughout the world with growing pressure on the healthcare industry to streamline costs, gain efficiency, and become more innovative in improving and maintaining the health of the population. Today the health industry around the world is looking for better ways of providing healthcare and improved health for all. The application of health information technology (health IT), called information and communication technology or ICT in international settings, to healthcare is seen as key to realizing this aim. The World Health Organization (WHO) uses ehealth as an umbrella term to cover all aspects of the use of ICT in healthcare. While the terminology differs—from health IT to ICT to ehealth—the goal of using technology to effectively and efficiently improve the health of individuals, families, and communities remains the same. An important differenc ...
Similar to State of-the-Art of eHealth Governance in the Philippines (20)
PHA - Nov 17 Preparing Hospitals for the Digital Requirements of the UHC La...Alvin Marcelo
Dr Marcelo shares his insights on what Philippine hospitals must do to prepare for the new requirements of the Universal Health Care Act and the National Integrated Cancer Control Act.
eHealth: from Strategy to Governance to Architecture to Information ExchangeAlvin Marcelo
The slides demonstrate a systematic approach to building a national eHealth system that starts with strategy and flows into governance, enterprise architecture to health information exchanges.
A process server is a authorized person for delivering legal documents, such as summons, complaints, subpoenas, and other court papers, to peoples involved in legal proceedings.
Presentation by Jared Jageler, David Adler, Noelia Duchovny, and Evan Herrnstadt, analysts in CBO’s Microeconomic Studies and Health Analysis Divisions, at the Association of Environmental and Resource Economists Summer Conference.
This session provides a comprehensive overview of the latest updates to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (commonly known as the Uniform Guidance) outlined in the 2 CFR 200.
With a focus on the 2024 revisions issued by the Office of Management and Budget (OMB), participants will gain insight into the key changes affecting federal grant recipients. The session will delve into critical regulatory updates, providing attendees with the knowledge and tools necessary to navigate and comply with the evolving landscape of federal grant management.
Learning Objectives:
- Understand the rationale behind the 2024 updates to the Uniform Guidance outlined in 2 CFR 200, and their implications for federal grant recipients.
- Identify the key changes and revisions introduced by the Office of Management and Budget (OMB) in the 2024 edition of 2 CFR 200.
- Gain proficiency in applying the updated regulations to ensure compliance with federal grant requirements and avoid potential audit findings.
- Develop strategies for effectively implementing the new guidelines within the grant management processes of their respective organizations, fostering efficiency and accountability in federal grant administration.
Russian anarchist and anti-war movement in the third year of full-scale warAntti Rautiainen
Anarchist group ANA Regensburg hosted my online-presentation on 16th of May 2024, in which I discussed tactics of anti-war activism in Russia, and reasons why the anti-war movement has not been able to make an impact to change the course of events yet. Cases of anarchists repressed for anti-war activities are presented, as well as strategies of support for political prisoners, and modest successes in supporting their struggles.
Thumbnail picture is by MediaZona, you may read their report on anti-war arson attacks in Russia here: https://en.zona.media/article/2022/10/13/burn-map
Links:
Autonomous Action
http://Avtonom.org
Anarchist Black Cross Moscow
http://Avtonom.org/abc
Solidarity Zone
https://t.me/solidarity_zone
Memorial
https://memopzk.org/, https://t.me/pzk_memorial
OVD-Info
https://en.ovdinfo.org/antiwar-ovd-info-guide
RosUznik
https://rosuznik.org/
Uznik Online
http://uznikonline.tilda.ws/
Russian Reader
https://therussianreader.com/
ABC Irkutsk
https://abc38.noblogs.org/
Send mail to prisoners from abroad:
http://Prisonmail.online
YouTube: https://youtu.be/c5nSOdU48O8
Spotify: https://podcasters.spotify.com/pod/show/libertarianlifecoach/episodes/Russian-anarchist-and-anti-war-movement-in-the-third-year-of-full-scale-war-e2k8ai4
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
ZGB - The Role of Generative AI in Government transformation.pdfSaeed Al Dhaheri
This keynote was presented during the the 7th edition of the UAE Hackathon 2024. It highlights the role of AI and Generative AI in addressing government transformation to achieve zero government bureaucracy
State of-the-Art of eHealth Governance in the Philippines
1. eHealth Governance in the Philippines: State-of-the-Art
Alvin B. Marcelo, Portia F. Marcelo
Abstract
eHealth is defined by the World Health Organization as the use of information and
communications technology in health. Countries are beginning to realize its importance and are
starting to make key investments. Yet the complexity involved with building and maintaining
national-scale health information systems overwhelms most governments.
The Philippines is adopting the AeHIN National eHealth Capacity Roadmap which recommends
a proper sequence of structural reforms starting from strategy (WHO-ITU National eHealth
Strategy Toolkit) to governance (COBIT5) to architecture (TOGAF) and to program
management to build capacity in the public and private health sectors to cooperate and
collaborate around better information systems in support of patient care and public health.
Introduction
The Philippines underwent rapid reforms in governance over its national eHealth strategy at the
start of the Aquino administration. In 2016, the
Philippine Health Agenda 1
was released which cited eHealth as one of its main pillars. This paper reviews the context
behind the eHealth transformations the country has undergone in the past six years including its
chronology. It then proposes a roadmap for further reforms in the Duterte administration to
ensure that the benefits of eHealth reach all Filipinos.
Background
The Philippines is one of the fastest growing economies in Asia but is still saddled by the double
burden of disease. It exports personnel skilled in software engineering and is considered a
leader in business process outsourcing. Despite these advances however, the country has yet
to leverage its ICT expertise to reap the benefits for the health sector.
This paper discusses the efforts of the Philippine government to establish a multi-sector
governance structure to oversee the effective use of ICT in health. It lists the achievements and
the challenges that remain. Lastly, it recommends a roadmap to further strengthen and expand
eHealth to all Filipinos.
Objective
Describe the evolution of Philippine eHealth Strategic Framework and Plan and recommend a
roadmap for the next six years (2016-2022)
2. Methodology
This paper used a case study approach employing desk review of policies and key informant
interviews. It then maps the strategy vis-a-vis known eHealth development frameworks to
determine progress and remaining gaps.
Results
The researchers were able to gather various policies that relate to eHealth in the Philippines to
wit:
Draft National eHealth Strategy October 2010
The Department of Health shared a draft national eHealth strategy at a summit organized at the
beginning of the Aquino administration. Participants in the summit agreed that a multi-sectoral
ICT for Health Technical Working Group (ICT4H) should be formed under the leadership of the
DOH to assist the agency with policy directions.
Subsequently, the ICT4H began wide consultations across various sectors (health,
telecommunications, academe, private, etc.) to understand stakeholder needs. By February
2012, the ICT4H submitted its recommendations2
to DOH, to wit:
1. Governance and architecture: DOH needs to establish clear governance structures and
a transparent enterprise architecture (blueprint) to guide stakeholders
2. Standards and interoperability: DOH needs to recommend standards for interoperability
based on this architecture.
3. Compliance: once defined, DOH must ensure there are mechanisms to ensure
compliance to these standards and to achieve the benefits of interoperability
4. Capacity-building: a systematic approach to building capacity in the health and ICT
sector will be needed to ensure the success of the national eHealth program.
Around the same time, the World Health Organization together with the International
Telecommunications Union released the National eHealth Strategy Toolkit3
. Delegates from the
Department of Health and Department of Science and Technology attended an orientation and
began the work of enhancing the draft eHealth strategy around the framework proposed by the
toolkit (see figure).
3. At the first general meeting of the Asia eHealth Information Network, the participants launched
the National eHealth Capacity Roadmap (see figure). The roadmap started with the crafting of
the strategy followed by adoption of IT governance. The governance then empowers a health-
sector wide enterprise architecture which ensures interoperability through standards.
Subsequently, the capacity roadmap recommends building capacity for program management
and IT operations. This sequence was adopted by the Philippines resulting in a cohort of
certified professionals who provided support to the national eHealth strategy.
4. By July 2013, the DOHand DOST had released a joint department memorandum creating the
National eHealth Governance Steering Committee and Technical Working Group (see figure). A
consultative meeting on the draft Philippine eHealth Strategic Framework and Plan 2013-2020
was held thereafter and was formally approved by the Steering Committee in its first meeting
October 2013.
5. At their second meeting on January 2014, at the height of the Typhoon Haiyan relief operations,
the Steering Committee agreed to adopt COBIT5 (www.isaca.org/cobit) as the IT governance
framework for the PeHSFP and mandated the TWG to move forward on consensus agreements
reached by the participating agencies. By July 2014, a program management office (PMO) was
launched ensuring regular meetings with proper documentation. From thereon, commitments
and activities of agencies were tracked and monitored.
Standards, privacy, enterprise architecture, and private sector
In their initial meetings, the TWG agreed on the priority areas that need to be addressed.
Standards and interoperability was high on the list. Privacy was also a concern raised by private
hospitals who were wary of sharing personal patient information to the DOH. Consistent with the
recommendations by the WHO-ITU Toolkit, the Standards Expert Group (SEG) and the Privacy
Expert Group (PEG) were created. After some members of the TWG received certification
training on enterprise architecture, they suggested the creation of the health enterprise
architecture expert group (HEAEG). Subsequently, realizing the need to update the private
sector and understand their perspectives, the TWG invited them into the Advisers Group.
Relevant eHealth Policies
With resources coming from the national eHealth Steering Committee, these expert groups
convened and developed policies required to create a conducive environment for health
information exchange. The Standards Expert Group released the Standards Catalog4
and the
6. Standards Change Management Manual while the Privacy Expert Group published the eHealth
Privacy Guidelines5
.
The Philippine Health Information Exchange
Based on its vision (see figure), the major project of the PeHSFP was the Philippine Health
Information Exchange (PHIE). To this end, a proof-of-concept was commissioned after which a
procurement for commercial level PHIE was approved. An administrative order detailing its
implementation was also released6
. Unfortunately, procurement problems prevented the correct
sequence resulting in severe delays. As of this paper’s publication (November 2016), the PHIE
is still not in operation two years after it has been approved for funding.
Results and discussion
Computerizing a single hospital is an expensive endeavor and has been found to be prone to
failure7
. The reason is that hospitals have complex business processes and decision-making
algorithms that require collaboration across different departments. Effective hospital systems
must ensure that information are accessible to these departments at the right time and format
the health professionals can understand in order to make a decision. This complexity
contributes to the failed implementations.
Logically, national-scale health information systems, such as computerizing all hospitals in a
country, are in orders of magnitude more complex. There are almost two thousand hospitals
and three thousand local health centers in the Philippines each one using at least one of the
twenty available electronic medical records. Without an overseeing governance body and a
guiding blueprint, these systems have mushroomed into various areas in the country creating
silo information and has strained frontline workers with the burden of data encoding with
questionable primary care and public health benefit.
It was within this context that the national eHealth governance structure was created. Knowing
that information systems are complex, the Steering Committee was intent on establishing an
interoperability framework that enabled facilities to use any system responsive to their business
needs (e.g., primary care) while maintaining compliance with the reportorial requirements of the
DOH programs (e.g., public health reporting). This balance required collaboration of national,
regional, provincial, and local authorities and could only be made possible if there were clear
governance mechanisms in each of these levels (horizontally) and between then (vertically).
The Steering Committee’s decision to adopt an IT governance framework (COBIT5) was
groundbreaking for the Philippines and for Asia. Amidst the seemingly overwhelming
complexity, the governance framework provided a semblance of order and control from which
the leaders can observe the progress of the PeHSFP. This was still contingent on the
appropriate implementation of the governance framework and the availability of expert
resources to provide feedback to the Steering Committee. But it gave a solid ground to start the
eHealth transformation in the country.
7. COBIT5 is a comprehensive governance framework and helps in organizing the many
components needed for successful implementation of enterprise information technology. In the
case of eHealth, the enterprise was defined as the multi-agency body composed of DOH,
DOST, PhilHealth, and UP Manila. However, with differing mandates and agendas, these
agencies faced substantial challenges with aligning their activities under the directions set by
the Steering Committee.
For example, on the directive to lower maternal deaths using eHealth, there is as yet a lack of
clear alignment of activities of DOH, DOST, PhilHealth and UPM to show progress to the
Steering Committee. Properly aligned plans should clearly demonstrate the steps each agency
must undertake (and the interrelationship of these steps with each other) to ensure that
maternal deaths are decreasing. These will then be reported regularly to the Steering
Committee in their quarterly meetings.
The PHIE was designed to provide the backbone for the interagency collaboration but it was
stalled in procurement. The Steering Committee must look for more innovative ways to finance
its projects in order to overcome the barriers to implementation.
8. More challenges remain such as inter-agency transparency, integrated investment planning,
properly sequenced procurement, program management and monitoring. While they may seem
insurmountable, as long as the Steering Committee demands good governance from
themselves and down their line agencies, these challenges can be addressed systematically.
Proposed Roadmap
The AeHIN Roadmap has served the country well but its full value can only be achieved with
good governance and transparency. The whole country depends on government to lead but is
also dependent on private sector to implement. Using IT Governance frameworks, government
can clarify these roles and ensure that a healthy collaborative environment exists between
regulatory and operational entities.
An enterprise architecture (or blueprint) is an important resource for all stakeholders. If
government invests on a national blueprint, this will help stakeholders make the right
investments on technologies that are architecturally-compliant.
With the increasing number of interested stakeholders and new policies being generated, a
more robust program management office should be established to ensure proper coordination
and communication.
Summary
Country awareness on eHealth is increasing but most are overwhelmed by its complexity. While
many stakeholders understand the benefits ICT can bring to healthcare, without an overall
governance body and a guiding blueprint, they will create siloed solutions that will be parochial
and miss out on the possibility of offering patient-centered coordinated care.
The AeHIN National eHealth Capacity Roadmap being implemented in the Philippines
demonstrates that following a proper sequence of reforms starting from strategy (WHO-ITU
National eHealth Strategy Toolkit) to governance (COBIT5) to architecture (TOGAF) and to
program management can build stronger systems that allows public and private sectors to
cooperate and collaborate around better information systems in support of patient care and
public health.
1 The Philippine Health Agenda. Department of Health.
http://www.doh.gov.ph/philippine_health_agenda (last accessed November 15, 2016)
2 ICT for Health Technical Working Group Final Report, February 7, 2012.
http://bit.ly/ict4hrecommendations. Last accessed November 15, 2016
9. 3 WHO-ITU Natinal eHealth Strategy Toolkit. 2012. https://www.itu.int/dms_pub/itu-
d/opb/str/D-STR-E_HEALTH.05-2012-PDF-E.pdf
4 National eHealth Standards Catalog. http://bit.ly/standardscatalog (last accessed
November 15, 2016)
5 National eHealth Privacy Guidelines. http://bit.ly/ehealthprivacyonline (last accessed
November 15, 2016)
6 Adoption of the Philippine Health Information Exchange. PhilHealth.
http://bit.ly/adoptphie (last accessed November 15, 2016)
7 Iyoke CA, Ugwu GO, Ezugwu FO, Lawani OL, Onah HE. Risks associated with
subsequent pregnancy after one caesarean section: A prospective cohort study in a
Nigerian obstetric population. Niger J Clin Pract. 2014; 17(4):442-448.