Discoursing Terminology Standards and Interoperability in relation to the Philippine eHealth Strategy

Abstract

Background. eHealth is the use of information and communication technologies (ICT) for health. It helps in improving the flow of information, through electronic means, in support of the delivery of health services, and the management of health systems. eHealth is used as the strategic context and tool in achieving population health, improved health system status, and socio-economic development goals.
 Objectives. This study is aimed at looking at the Philippine National eHealth Strategy, particularly the components of Terminology Standards and Interoperability concerning the eHealth strategy in the Philippines, and to assess the barriers and gaps in the integration of these two components.
 Methods. This study used secondary literature, internet search, Philippine laws, administrative orders, memorandum circulars, and grey literature to discourse terminology standards and interoperability in the Philippine eHealth system, and issues and gaps related to these components that may impede the delivery of Universal Health Coverage in the country.
 Results. The current Philippine National eHealth strategy includes the following sector governance, legislation, policy and compliance, eHealth solution (i.e., services and applications), strategy and investment, infrastructure (government), human resources, and standards and interoperability. Philippine Health Information Exchange (PHIE) is a software platform in the country that aims to connect many isolated electronic health systems. The proposed interoperability layer across health systems and services in the Philippines includes Patient’s Primary Healthcare Consultation at the Rural Health Unit, health research, legal information, patient healthcare at tertiary hospital, and health insurance claims. The study results showed that issues and gaps related to the interoperability of eHealth in the Philippines include technical issues such as lack of common semantics, lack of an institutional mechanism to regulate EMR, lack of incentives among eHealth providers and stakeholders to adopt standards for interoperability.
 Conclusion. The effort of the Philippines to achieve interoperability and standards in eHealth goals can be characterized as a work in progress. The government, private sector, physician, patient, and other stakeholders are deemed to continuously develop a shared vision and interoperate under a standardized guide as eHealth is a complex endeavor that covers many aspects.

Understanding Adoption of Electronic Medical Records (EMRs) during a Health Emergency: An Analysis of EMR Usage Logs from Rural Health Facilities in the Philippines

“…Indeed, interoperability, which should facilitate easier data transfer across health facilities is still a strategic challenge for the government and other key sectors. 8 The pandemic has also affected the EMR interactions of RHUs differently and may have further delayed progress in adoption of some users. Based on the Taiwan experience, where interinstitution exchange following EMR implementation took ten years, a strong incentive mechanism must be present for successful digitization of healthcare facilities.…”

“…On the EMR output process, the review reported variability on ICT interventions, standardization, and interface issues. 12 Based on the findings of the said review 12 as well as the factors identified as drivers of the eHealth strategy in the Philippines 7,8 , an IPO (input-process-output) framework 13 , commonly used in organizational behavior research, was adopted for this study (Figure 2). The model posits that adoption or use of EMR requires several direct inputs from the environment to produce the identified outputs.…”

“…Challenges surrounding the implementation and adoption of EMR in the country stem from a lack of institutional structure at the national level that would provide directions and support for needed policies/legislations, infrastructure, interoperability, and human resources. 7,8 Varying levels of adoption within the country as well as lack of cooperation among stakeholders also added to these challenges. 7 The COVID-19 pandemic in 2020 further disrupted eHealth strategies as the country's health system, particularly its workforce, was heavily burdened.…”

Incentive policies for retention of physicians in the private health sector in Portugal

“…In summary, physicians recognize that higher remuneration in the private sector is an incentive. However, they believe that they could be more dedicated to the sector and committed to a specific health group if there was a more attractive material and non-material incentive policy that valued the professionals and made a difference in the choice of the health group itself [45,46] . The structuring of the incentive system was mentioned in the various interviews, where physicians suggested being involved.…”