Plenary presentation at the first EHR Summit of the UP Manila Medical Informatics Unit and the Philippine Medical Informatics Society, 10 Nov 2019. Philippine Heart Center.

1. EHR in Ensuring UHC
EHR Summit 2019
Iris Thiele Isip Tan MD, MSc
Professor 3, UP College of Medicine
Chief, UP Medical Informatics Unit
Director, UP Interactive Learning Center

2. NOTHING TO DISCLOSE
I give consent for the audience to tweet this talk
and give me feedback (@endocrine_witch).
Feel free take pictures of my slides (though the
deck will be at www.slideshare.net/isiptan).

4. Role of EHR in UHC
Case Study: Taiwan
UHC Act Section 36

5. WHO (2010). Monitoring the Building Blocks of Health Systems:
A Handbook of Indicators and their Measurement Strategies

7. Ingun P et al. WHO Technical Brief Series 2010

8. — Ingun P et al. WHO Technical Brief Series 2010
While UHC implementation may provide the political and
financial impetus for implementing a NHIS, information
from the NHIS assists with decision-making and assessment
to improve accessibility, quality, and efficiency of the UHC.
”
“

9. Building a Health
Information Infrastructure
Why electronic health records? by
InfowayInfoRoute https://youtu.be/Lo_3qOejQzI

10. Ingun P et al. WHO Technical Brief Series 2010

11. — Hsieh, Chang-tseh (2010) "Electronic Medical Record System:
Current Status and Its Use to Support Universal Healthcare System,"
Communications of the IIMA: Vol. 10: Iss. 3, Article 7.
Although some hospitals and physician clinics have begun
using HIT, the industry as a whole is still pessimistic
toward the improvement and implementation of costly HIT
functions such as electronic medical records (EMR) and
their interoperability in current and future healthcare
systems.
”
“

12. Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to
Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7.
ADMINISTRATIVE Influences
to EMR Adoption
Need to share comparable
patient data among different
sites within a multi-entity
healthcare delivery system.
Need to improve clinical
documentation to support
appropriate billing service levels.
Requirement to contain or
reduce healthcare delivery costs.

13. Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to
Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7.
ADMINISTRATIVE Influences
to EMR Adoption
Need to establish a more
efficient and effective
information infrastructure as a
competitive advantage.
Need to meet the requirements
of legal, regulatory, or
accreditation standards.

14. CLINICAL Influences to EMR Adoption
Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to
Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7.
Improve ability to share patient
record information among
healthcare practitioners and
professionals within the
enterprise.
Improve quality of care.
Improve clinical processes or
workflow efficiency.
Improve clinical data capture.

15. CLINICAL Influences to EMR Adoption
Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to
Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7.
Reduce medical errors.
Provide access to patient
records at remote locations.
Facilitate clinical decision
support.
Improve employee/physician
satisfaction. Improve patient
satisfaction.

16. CLINICAL Influences to EMR Adoption
Hsieh, Chang-tseh (2010) "Electronic Medical Record System: Current Status and Its Use to
Support Universal Healthcare System," Communications of the IIMA: Vol. 10: Iss. 3, Article 7.
Improve efficiency via pre-visit
health assessments and post-visit
patient education.
Support and integrate patient
healthcare information from
Web-based personal health
records.

18. — Brailer, D., & Terasawa, E. (2003). Use and adoption of computer-based patient
records. California HealthCare Foundation. http://www.chcf.org
Overall, the barriers to electronic medical records
adoption are large … The policy challenge in many
ways is not to make the benefits of electronic
medical records more compelling, but to make the
barriers less challenging.
”
“

19. Role of EHR in UHC
Case Study: Taiwan
UHC Act Section 36

20. Syed-Abdul S et al. Telemed J E Health. 2015 Sep;21(9):742-7.
doi: 10.1089/tmj.2014.0189. Epub 2015 Apr 28.

21. https://www.csmonitor.com/USA/2009/1014/p25s04-usgn.html

22. Syed-Abdul S et al. Telemed J E Health. 2015 Sep;21(9):742-7.
doi: 10.1089/tmj.2014.0189. Epub 2015 Apr 28.

23. Syed-Abdul S et al. Telemed J E Health. 2015 Sep;21(9):742-7.
doi: 10.1089/tmj.2014.0189. Epub 2015 Apr 28.
Adoption of HIT on a national scale -
Involves both public and private health providers
Supported heavily by implementation of an e-claims system to
support administration of the national health insurance

24. Role of EHR in UHC
Case Study: Taiwan
UHC Act Section 36

26. Rule VIII. Governance & Accountablity
Sec. 36.1
All health service providers and insurers are required to
maintain a health information system on enterprise
resource planning, human resource information system,
electronic health records and electronic prescription
log including electronic health commodities logistics
management information, which shall electronically be
uploaded on a regular basis through interoperable
systems consistent with standards set by the DOH and
Philhealth in consultation with the DICT and the NPC …
RA 11223
Universal Healthcare Act

27. Rule VIII. Governance & Accountablity
Sec. 36.2
The DOH and PhilHealth, in consultation with the DICT
and NPC, shall issue detailed guidelines on the scope
and standards of electronic health records, enterprise
resource planning, human resource information
system and electronic prescription log including
electronic health commodities logistics management
information, and maintenance of said health information
system …
RA 11223
Universal Healthcare Act

28. Rule VIII. Governance & Accountablity
Sec. 36.3
The DOH and PhilHealth shall fund and engage
providers, through appropriate mechanisms, to develop
and upgrade information systems, which may be
availed at no cost by health care providers and insurers.
RA 11223
Universal Healthcare Act

29. Rule VIII. Governance & Accountablity
Sec. 36.4
The DOH, PhilHealth, health service providers and
insurers, shall ensure patient privacy and
confidentiality in the maintenance of health
information systems, in compliance with RA 10173
(Data Privacy Act).
RA 11223
Universal Healthcare Act

30. RA 11223
Universal Healthcare Act
Rule VIII. Governance & Accountablity
Sec. 36.5
PhilHealth shall use its contracts to incentivize the
incorporation of HIS, automation of clinical
information, improvement of data quality, integration
and use of telemedicine, and participation in regional
or national health information networks.

31. Art 4. Sec 3.3 Program Educational Objectives
With additional training, graduates of the MD program
may pursue any of the following careers to include:
• General medical practitioner
• Clinical specialist
• Researcher/Medical Scientist/Innovator
• Health professions teacher
• Health administrator
• Health information manager
• Health economist
• Health policy maker
CHED Memorandum Order 18
Series of 2016

32. Art 5. Sec 6.3 Minimum Curricular Content
The minimum curricular content regardless of the
curriculum design shall include the following:
• Research, evidence-based medicine and medical
informatics
CHED Memorandum Order 18
Series of 2016

34. EHR in Ensuring UHC
EHR Summit 2019
@endocrine_witch