Information Technology in Community Health

Digital Health

also known as information and communication technology (ICT) in the health system

field of theory and practice associated with any aspect of adopting digital technologies to improve health from its conceptualization to application or operation (World Health Organization (WHO), 2019; Ghebreyesus, 2017)

the use of different healthcare technologies in administering healthcare services to improve patients' health and well-being (Mellodge and Vendetti, 2011; Kostkova, 2015; Baumann, 2015; Sonnier, 2016)

DIGITAL HEALTH

• broader

• focuses on smart devices, huge data storage, and big analytics (WHO, 2019)

• everything under eHealth, plus modern technologies like smartphones, wearable devices (like smartwatches), artificial intelligence (AI), big data, and mobile health apps.

e-HEALTH

focuses on using the internet and computer for healthcare like online consultations, electronic medical records, telemedicine, or hospital information systems. mostly about communication and data exchange in healthcare through electronic means.

to help health systems use Information and Communication Technology (ICT) to improve people’s health and wellness

The main goal of digital health is_______________________, while supporting national health plans and global goals like Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs).

Digital disease surveillance systems

To track and monitor diseases faster and more accurately.

Electronic medical records (EMR)

To store and share patient information safely and efficiently.

Social health insurance payment systems

To make paying and processing health insurance easier.

Health education and digital interventions

To spread health information through online platforms, apps, and social media

1960

- The earliest form of digital health in the Philippines began when doctors used telephones to ask for medical advice or consult senior doctors about patient care.

1998

- Establishment of the National Telehealth Center (NTHC)

The University of the Philippines Manila created the NTHC as the main research unit for health technology.

Its goal was to design affordable ICT tools to help people in remote, rural, and underserved areas who had limited access to healthcare

2004 to 2008

- First breakthrough of NTHC

The NTHC conducted telemedicine research and services in remote communities.

Worked together with the Commission on Information and Communications Technology (now the DICT) and the Department of Science and Technology – Philippine Council for Health Research and Development (DOST-PCHRD).

This project made it possible for rural doctors to consult specialists from cities using digital communication.

2009

- WHO conducted a global survey on eHealth

The World Health Organization found that the Philippines could strengthen its digital health workforce by offering ICT training for both students and healthcare professionals.

2011- 2016

- National Unified Health Research Agenda (NUHRA) recognized ICT in the health sector as a priority research focus

VISION

“By 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 to health systems for all the Filipino people by transforming the way information is used to plan, manage, deliver and monitor health services. ”

Standardize and connect

Transform

Maintain and measure

STRATEGIES

Standardize and connect

- the key focus is on the establishment of governance and foundations and provide basic connections to start information sharing across the health sector. This phase started in 2014 and was concluded in 2016.

Transform

- involves continuing innovations to develop and implement defined national eHealth solutions. This phase started in 2016 and is expected to conclude in 2019 and beyond.

Maintain and measure

- eHealth is expected to be established at this point and there is a need to maintain, sustain, continuously measure in terms of performance, and ongoing innovations and updates need to be managed. This phase is set to commence in 2020.

GOVERNANCE

LEGISLATION, POLICY AND COMPLIANCE

STANDARDS AND INTEROPERABILITY

STRATEGY AND INVESTMENT

INFRASTRUCTURE

HUMAN RESOURCES

EHEALTH SOLUTIONS

COMPONENTS

GOVERNANCE

Directs and coordinates eHealth activities at all levels of the health system. Critical areas of governance include agenda setting, stakeholder engagement, overall architecture, clinical safety, monitoring and evaluation and policy oversight.

LEGISLATION, POLICY AND COMPLIANCE

Involves creation of the required legislation, policies and compliance to support the attainment of the eHealth vision.

STANDARDS AND INTEROPERABILITY

Promotes and enables the exchange of health information across geographical and health sector boundaries through the use of common standards and terminologies

STRATEGY AND INVESTMENT

This refers to the funding support and guidance needed to execute the strategic plan.

INFRASTRUCTURE

Establishment of necessary physical technology, software platforms, services and applications to support health information exchange

HUMAN RESOURCES

Refers to the workforce needed to develop, operate and maintain the national eHealth plan.

EHEALTH SOLUTIONS

The required services and applications to enable widespread access to health care services, information, and securely share and exchange patient's information in support of health system goals.

Health information exchange (HIE)

is the practice of sharing patient-level electronic health data among various healthcare facilities, professionals, and organizations.

Integration of various health information systems (HIS) addresses the need for better information for decision making, while health information exchange addresses the portability of patient data information to government agencies, including health insurance providers, and healthcare providers.

Through this, the gaps in management of health care delivery networks, health care delivery, and social determinants on health can be analyzed and eventually addressed. This leads to a sound evidence-based health policy which is catered by different government agencies that supports public health.

DATA

Un-analayzed raw facts that do not imply meaning

INFORMATION

Meaning is attributed to data and data is processed and analyzed

Continuity and interoperability of care stops in the unlikely event that a record gets misplaced.

Illegible handwriting results to misinterpretation of data.

Patient privacy is compromised

Data are difficult to aggregate

Actual time for patient care gets limited

Problems caused by Paper-based Data Gathering

Data are readily mapped, enabling more targeted intervention and feedback

Redundancy of data is minimized

Data can be easily retrieved and recovered

Data for clinical research becomes more available

Resources are used efficiently

Benefits of a Well-managed Patient System

Accuracy

Accessibility

Comprehensiveness

Consistency / Reliability

Currency

Operational Definition

Characteristics of Good Quality Data

Accuracy

Information must be correct and valid

Accessibility

Data should be easy to find and available when needed

Comprehensiveness

All required information must be filled out completely

Consistency / Reliability

Information should be uniform and free from contradictions

Currency

Data must be updated regularly and reflect the most recent information

Operational Definition

Data should be clearly defined so there’s no confusion

1.Easily retrieve patient data especially on their follow-up visits.

2.Track patient progress over time

3.Monitor and improve overall quality of care

Some documented advantages of EMR use are:

Community Health Information Tracking System (CHITS)

the pioneering community based EMR in the country

developed by Dr. Herman Tolentino of the University of the Philippines Manila - Medical Informatics Unit (MIU) in 2004

At present, it is being used in 179 health centers nationwide partciularly in Quezon City, Taguig, Pasay City, and other selected citiies and municipalities in Visayas and Mindanao

Integrated Clinic Information System (iClinicSys)

homegrown EMR of the DOH developed in 2013

widely used community-based EMR

eHealth

In year 2012 DOH included in the National Objectives for Health (NOH) 2011-2016 the use of ___________ as a key strategy to address the problems of poor access to good quality data, fragmentation and persistent delays in health information systems.

Universal Health Care and EMR use

Purpose: To improve access to quality health data and reduce delays and fragmentation in health systems.

NOH 2011–2016 Initiative

Accelerated the adoption of Electronic Medical Records (EMRs) for disease surveillance, logistics, financial management, and e-Claims for insurance payments.

Republic Act 11223 (UHC Law of 2019)

: Mandates full adoption of information systems such as EMRs, electronic prescriptions, and HR systems.

Requires regular data uploading through interoperable systems across health facilities.

Role of PhilHealth

Ensures financial risk protection for all Filipinos.

Uses EMRs to process insurance payments (e.g., PFP scheme).

Provides service packages: PCB, maternal and newborn care, TB-DOTS, HIV/AIDS.

Since 2016, certifies EMR providers to meet national data and security standards

Double Charting

Interference with face to-face patient care

The Perception that EMR is just a simple replacement of the paper record

Managing data privacy and confidentiality

The Four Most Common Challenges Encountered in a Healthcare Facility When Implementing EMR

Double Charting

As the facility transition to fully electronic, health workers tend to record patient data on both paper and electronic charts. This phenomenon of double charting frequently cause frustration amon the users and forces them to revert back to paper charts.

Interference with face to-face patient care

Since the use of EMR involves frequent typing and requires a substantial amount of screen-time, health workers feel that they compromise a level of attention they could devote to patients.

The Perception that EMR is just a simple replacement of the paper record

This perception will only duplicate the weakness inherent to paper-based records.

Managing data privacy and confidentiality

Health workers face a new set of ethical and legal dilemma as they use eHealth solutions. Existing policies such as Republic Act of 10173 - Data Privacy Act of 2012 must be monitored regularly for strict compliance.

Public Health Information Management Systems

Purpose: To enhance efficiency, accessibility, and accuracy of health data across community health centers.

Key Points:

Various electronic health information systems (EHIS) are now used in public health facilities.

Continuous growth in eHealth infrastructure supports better data management and service delivery.

The PhilHealth website lists certified EMR and eClaims providers, regularly updated as new systems are added.

These systems help standardize information sharing and strengthen national health reporting.

eHealth

refers to the use of digital tools and technology to improve public health outcomes

Impact: Strengthens the healthcare system by integrating technology for faster, data-informed, and more efficient health services.

1.Improve access to health information and services.

2.Enhance public health surveillance for data-driven decisions.

3. Support health promotion efforts and preventive care initiatives.

eHealth Main Uses:

Telehealth

: The WHO defines telehealth as, "the use of telecommunications and virtual technology to deliver health care outside of traditional health care facilities. ”

Project RxBox

: It is a biomedical device with sensors to collect patient's blood pressure, peripheral capillary oxygen, electrocardiogram data, and temperature. The device is also built with a fetal heart monitor and a maternal tocometer to monitor pregnant women during labor (Lontoc, 2017). Data collected by this device are stored in CHITS and accessible to authorized health professionals (NTHC, n.d.). In cases that the community physician needs a specialist opinion, these data can be electronically transmitted to a clinical specialist in tertiary care facilities such as regional hospitals and medical centers and the Philippine General Hospital.

KonsultaMD

: a 24/7 health hotline service offered by Globe Telecom. Upon subscription, callers can talk to a licensed physician to access a range of medical information which includes maternity and pediatrics for primary conditions like fever, rashes, and allergies.

MyDocNow App

: another similar telemedicine platform that offers video consultations, comprehensive patient education and remote monitoring in selected metropolitan areas.

Lifeline Rescue

: (has an existing partnership with MyDocNow App); an emergency response service provider to manage the coordination and continuity of Enhance health promotion efforts services from primary care to specialized care services.