Beruflich Dokumente
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Phif Heafth
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DEPARTMENT OF'HEALTH
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SUBJECT:
L RATIONALE
one of the main challenges of today's health systems is access to real-time quality heatth
information for evidence-based decision *akiog. In the recent years, health
carc experts, managers,
providers and recipients have long recognized the growing impact
and utility of information-and
communication technologies (ICTs) in addressing thJaforesaia freatth disparitythrough
bringing the
delivery of health care and making the health iystems more efftcient and rbsponsiv*
to feof,le's
and expectations, and concomitantly, promoting univeral access to care, including
1ryds access to
information for decision making. This *as e*emplifr.d by the rise in the develoiment
and
implementation of various health information systemiand other related eHealth
initiatives.
However, the plryning and utilization of ICTs for Health or eHealth during that period
has
been heavily rifed with minimal coordination and integration during developmints
among key
eHealth players. This, in turn, have resulted to implementaiion of eHealth
solutions that are op"Ltiog
in silo,-and duplication of point of service application systems being developed and implemrnt"A.
particular concern is the q.olfng pervasiveness of vari-ous vertical
Of
and uninteroperabli systems and
data sources, which-use differingtechnology platforms, solutions, standards
and structures, being
used by various health facilities, and in uarious health programs at
the national, regional and local
levels' Overall, this fragmentation and absence of a s.utrtes exchange anO repirting of
health
information deter and render healthcare services and delivery ineffective, let
alone, thJ grrr*rut"d
information and reports unreliable for meaningful interpretation and decision
making 5r public
health interventions. This has posed a major dilehma especially when the national gover.imentieeds
to analyze health service data coming from various systims at the health facilities.With the evolving
national health priorities and strategic direction itis imperative to serve nationql,
, regional, locat and
organizational mandates and ob.iectives that administrative levels of policy *uf."t* progr;
planners' and service prwiders get an overall, timely and
accurats picture of the country's'staie of
nd resource needs for program planning resource management, and
health sector.
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KmTS - RECOROS SECT|OII
Doplrtmant of H.ith rrr & {
To achieve standardization on elechonic health reporting protocols, and optimization on the
use of technological resources, the Department of Health (DOH) has developed the Electronic Health
Record Systems (EHRSs), the Integrated Clinic Information System (iClinicsys), and the Integrated
Hospital Operations and Management Information System (iHOMIS) as reference models for
electronic medical record systems (EMRSs) for rural health unit/health centers (RHUs/HCs),
barangay health stations (BHSs), clinics and their equivalent, and health management information
systems (HMISs) for hospitals, respectively. These reference models have not only made service
delivery and facility management more effrcient over the years, but also proved that required
national heatth data reports can be extracted and electronically submitted to DOH andor Philippine
Health Insurance Corporation @hilHealth). To date, these two (2) systems capture not only the
national health data reporting needs, but also include organizational requirements. With the advent
implementation of the Philippine Health Information Exchange (PHIE), these reference models can
therefore serve as benchmarks to achieve interoperability.
Guided by the Philippine eHealth Strategic Plan for Universal Health Care (UHC) as
embodied in the Philippine Health Agenda (PHA), one of the identified policy interventions to
tangibly realize, streamline and optimize the investments in eHealth and data for decision making is
through the implementation of the National eHealth Electronic Health Record System Validation
(NEHEHRSV). The NEHEHRSV is envisioned to serve as the policy arm to implement national
systems conformity assessment protocol for national health data reporting requirements of DOH
and/or PhilHeatth. Specifically, the NEHEHRSV shall confirm if an EHRS measures up and
conforms to defined reporting requirements and submission protocols. Further, it is envisaged that its
implementation will improve data capture, processing, aggregation, exchange and reporting on
national health data requirements and standardize submission protocols among implementing health
facilities and other health reporting institutions/organizations.
This Joint Administrative Order aims to establish the policies and guidelines in the
implementation of the NEHEHRSV. It specifically serves as guide for DOH and PhilHealth to
implement a harmonized approach to validate an EHRS for national health data reporting for
improved data collection, processing and generation of country health reports.
II. OBJECTIVES
ilI.SCOPE OF APPLICATION
This Administrative Order shall apply to all national, regional, local and branch offices under
the DOH and PhilHeatth; the centralAread office of the Deparfinent of Science and Technology
(DOST), particularly the Philippine Council for Health Research and Development, and the
Department of Information and Communications Technology (DICT); regional and provincial health
offices; public and private health facilities; health care providers; software developers/providers of
HMIS, and registry systems; local or international institutions, medical
CfiRiTffi5E"trRtE 60nU and other stakeholder organizations with an EHRS component;
and all concerned stakehr in health data collection, processing and reporting.
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KrlTS - RECOROS SECTIOI
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V. GENERAL GUIDELINES
A. The Department of Health in coordination with the DOH Monitoring and Evaluation, and Data
Governance Oversight Committee and Technical Working Group (DOH Department Personnel
Order 2016-2630), the National eHealth Governance Structure and concerned stakeholders shall
reach national agreements on the standards or uniform data set for national health data reporting
to provide statistics for health service plans, interventions, national surveys and programs, and
measure the quality of health care, performance and nation's health profile.
B. The source of data for national health data reporting shall come from health facilities, medical
societies, government agencies like PhilHealth, and concerned stakeholders to the DOH.
C. The implementation of the NEHEHRSV shall be jointly managed and/or administered by the
DOH and PhilHealth, with technical support of the DOST, and DICT.
D. The NEHEHRSV shall respect the universal principles of ethics, legal standards, and guiding
principles on primacy of human rights and protection of health information privacy as defined by
iolal instruments, ruleso and other applicable policies.
CRTIFE&rfiRIE GW EHEHRSV shall be measured by the progress made in improving
national health data and sr ice statistics reporting from the source to the DOH and/or PhilHealth
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KtrlTS . RECORDS SECnoll
DoDartment of Hc*lh
to support and facilitate the achievement of the national health system guarantees of population-
and individual-level interventions for all life stages; access to health interventions; and financial
freedom as defined in the PHA. Specifically, progress shall be measured based on the agreed
upon PHA-related and programmatic indicators for monitoring and evaluation.
F. Health facilities like hospitals, rural health units or health centers (RHUs/HCs), provincial health
offices (PHOs), municipal/city health offices (MHO/CHOs), barangay health stations (BHSs),
clinics and the like shall be required to use an EHRS that passed the NEHEHRSV.
G. The EHRS developed by Software Developers and Providers shall be required to pass the
NEHEHRSV.
3. I\-EHEHRSV Team
a. Composition
i. The NEHEHRSV Team shall be composed of representatives from DOH, PhilHealth,
DOST, DICT, and the private sector as duly appointed through the NoHGS.
ii. Revisions on the composition, functions, and status of the NEHEHRSV Team shall
require approval of the NoHGS, and shall be updated accordingly through the issuance
of an appropriate Joint Department Memorandum. Non-member stakeholders may be
invited by the NEHEHRSV Team subject to the required approvals.
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iii. Determine and manage the delivery, service, and support requirements for the
implementation, operations, management and sustainability of the NEHEHRSV
operations in accordance to the Health Sector Enterprise Architecture (HSEA).
(a) Design, develop, test-run and implement the test methods and/or products for the
NEHEHRSV for various national health data reporting requirements.
(b) Administer and manage the testing facilities, databases, services, methods and
applications for NEHEHRSV, subject to existing privacy, security and other
operational protocols of the hosting source or identified owner.
(c) Facilitate the conduct of NEHEHRSV from application, issuance of certificate, and
monitoring and evaluation of issued certification status.
(d) Prepare the validation report with recommendation, and issue the NeHEHRS
Certificate of Validation for the EHRS that passed the NEHEHRSV testing.
(e) Manage complaints and appeals in accordance with the Incident Response and
Mitigation Policy, and Appeal Procedures as stipulated in the NEHEHRSV Manual
of Operations as duly approved by NeHGS
(f) Revoke or suspend the certificate for those that have committed violations that
threaten or undermine the integrity of the validation process, and/or whose software
have been found non-compliant with set operational criteria for NEHEHRSV good
standing at the health facility in accordance with the Non-Compliance and
Corrective Action Procedure.
(g) Validate and recommend for publication via the eHealth website all latest and
approved issuances, updates and advisories on NEHEHRSV, including the most
recent list of software developers, providers/vendors, and implementers that have
passed the validation testing as duly approved by the NeHGS.
iv. Perform periodic quality assurance and control reviews of the NEHEHRSV operations,
and ensure that the delivery, service and support requirements meet the evolving HSEA
standards.
v. Recommend to the NeHGS test methods, products and parameters, and provide advice
on policy and tactical matters that will best implement the NEHEHRSV in accordance
to the HSEA.
vi. Evaluate, address or resolve issues, conflicts, risks and challenges that may affect the
implementation, operations, management and sustainability of the NEHEHRSV and
elevate unresolved issues or complaints to the NeHGS, if deemed necessary, for
appropriate resolution, or decision.
vii. Develop and recommend relevant capacity-building and advocacy protocols to increase
stakeholder participation and compliance and promote the NEHEHRSV service value.
viii. Perform such other fi.rnctions which may be critical in expediting and implementing
effectively the key policies/strategies procedures, protocols and activities of the
NEHEHRSV as duly approved by the NeHGS.
c. Tenure
Members of the NEHEHRSV Team shall serve for a minimum term of tlree (3) years, or as
may be decided upon by the NeHGS.
4. Observers
a. To foster transparency, the NEHEHRSV Team shall be required to invite two (2) to five (5)
observers to attend and witness the conduct of the actual testing. The observers shall come
agency, non-goveflrment organization, academe, or any institution,
viduals hold/share no conflict of interest.
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2. Reference Models
a. The DOH-developed Integrated Clinic Information System (iClinicSys) for RHU/IICs,
PHOs, MHO/CHOs, and BHS, and Integrated Hospital Operations and Management
Information System (LHOMIS) for hospitals shall serve as the official de facto reference
models for all NEHEHRSV testing prior to rollout to other soffware developers. As such,
these two (2) eHealth solutions shall be exempted from undergoing the NEHEHRSV for
national health data reporting requirements. DOH shall be required to regularly update
these systems in compliance with the requirements of its mandate as the national health
authority of the country.
b. All pre-NEHEHRSV testing for new and/or updated national health data reporting
requirements and their corresponding electronic submission and exchange protocols shall
be conducted using these reference models, prior to official publication of the updates.
3. Application
a. Who CanApply foTNEHEHRSV
i. Software developers and providers; govemment/public and/or private health facilities;
and local or intbmational institutions, medical societies, donor or funding agencies, and
other stakeholder organizations that have in-house developed and/or implemented
EHRS, or intend to develop EHRS for use by their institution or at the health facility.
b. Application Cost
Application for the NEHEHRSV for various national health data reporting requirements
shall initially be free of charge. However, the NEHEIIRSV Team, upon approval of the
NeHGS, shall have the right to charge application cost in the future for operational
maintenance and sustainability..
c. Implementing Mechanisms
i. Application for NEHEHRSV can be made at any time, provided that all necessary
application requirements have been duly fulfilled and submitted to the NEHEHRSV
Team through its official communication instrument.
inquiries, and other relevant updates on NEHEHRSV shall be made
CERTIFIED TRIIT email address.
- RECORDS SECT|OIi
lartmenl of Health
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iii. All latest issuances, updates and advisories on NEHEHRSV, including the most recent
list of validated EHRS shall be posted only at the eHealth website.
5. Procedural Guidelines
Implementation of the NEHEHRSV shall be in accordance with the most recent standard
operating guidelines as stipulated in the NEHEHRSV Manual of Operations as duly approved
by NeHGS through the NEHEHRSV Team such as:
i. Submission and Processing of Application
ii. EHRS Software Enhancement
iii. Testing and Evaluation of Test Results
iv. Issuance of Certificate
v. Monitoring and Evaluation
vi. Maintenance of Good Standing
vii. Validity and Termination of the Certificate
viii. EHRS Software Re-Validation
ix. EHRS Software Re-Certification
x. Incident Response and Mitigation
xi. Appeal Procedures
xii. Non-Compliance and Corrective Action Procedure
xiii. Publication of NEHEHRSV Issuances and Other-Related Documentations
xiv. Financing and Sustainability
xv. Management of the NEHEHRSV Artifacts and Repository
remain valid for the specified duration, provided that there are no
health data reporting requirements that affect the current procedural
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. RECOROS SECTIOX
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integrity of the validation and the issued certificates, and/or implemented specifications and
version updates made on the EHRS at the health facilities, institutions or by the software
developers.
c. For those with issued certificates that have become obsolete due to new NEHEHRSV
updates and requirements instituted, re-validation and re-certification shall be required to
maintain their validated status. Re-validation and re-certification shall also apply to those
with validated EHRS that have implemented internal specifications and/or version updates
on their respective solutions.
2. Other DOII Attached Agencies, other Government Agencies, Regional and Provincial
Health Offices, and other Private and Non-Government Institutions shall:
a. Provide technical expertise and subject matter inputs pertaining to the implementation,
management and operational maintenance of the NEHEHRSV as informed by the NeHGS.
b. Participate in all requests for collaborative works and technical assistance with the DOH,
PhilHealth, DOST, and DICT through the NEHEHRSV Team, in the implementation,
management and operational maintenance of the NEHEHRSV as informed by the NeHGS.
3. All Health Facilities that are Implementing or Intending to Implement an eHealth Solution;
Software Developers and Providers/Vendors of eHealth Solutions; Local or International
Institutions, Medical Societiesn Donor or Funding Agencies, and other Stakeholder
Organizations with an EHRS component shall:
a. Mandatorily subject their EHRS to NEHEHRSV for national health data reporting
requirements.
b. Report issues, concerns, and/or problems that may arise in the subjection of their EHRS to
health data reporting requirements, and/or the institution of the
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requirements and mechanisms at the health facilities/institution.
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Krl].s-RECORDS SECTTOX
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c. Provide relevant inputs to further improve the implementation, management, and operational
maintenance of the NEHEHRSV.
X. GOVIRNING CLAUSE
Issues arising from the implementation of this Joint Adminishative Order shall be resolved
jointly by the DOH, PhilHealth, DOST, and DICT.
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In the event that any provision or part of this Joint Administrative Order is declared
unauthorized or rendered invalid by any Court of Law or competent authority, those provisions not
affected by such declaration shall remain valid and in force.
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F'ORTUNATO T. DELA PENA
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Secretary
Department of Science and Technology Department of Infonnation
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JEAN B. MD, MPH, CESO IIDR CELESTINA MA. JT]DE P. DE LA SERNI
Secretary I tnterimlOfC President and CEO
Department of Health i ptritip.piry tleal$ Insurance Co{por?tign
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AIINEX A: INITIAL LIST OF.NHDRCS FOR MAI\DATORY NEHEHRSV
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Reeistry System).
NCD-OO4 Coronary Artery DOH Administrative Order No. 2013-0005: National
Diseases Policy on the Unified Registry Systems the of
Department of Health (Chronic Non-Communicable
Diseases, Injury Related Cases, Persons with
Disabilities, and Violence Against Women and Children
Registry System).
NCD-OO5 Diabetes DOH Administrative Order No. 2013-0005: National
Policy on the Unified Registry Systems of
the
Department of Health (Chronic Non'Communicable
Diseases, Injury Related Cases, Persons wittl
Disabilities, and Violence Against Women and Children
Reeistry System).
NCD-OO6 Mental Health DOH Administrative Order No. 2013-0005: National
Policy on the Unified Registry Systems of
the
Department of Health (Chronic Non'Communicable
Diseases, Inj,rry Related Cases, Persons with
Disabilities, and Violence Against Women and Children
Resistrv Svstem).
NCD-OO7 Stroke DOH Administrative Order No. 2013-0005: National
Policy on the Unified Registry Systems of
the
Deparfinent of Health (Chronic Non-Communicable
Diseases, Injury Related Cases, Persons with
Disabilities, and Violence Against Women and Children
Reeistrv System).
PHG-OOI Field Health Services DOH Administrative Order No. 2011-0010:
(Public Health Programs Implementing Procedures and Guidelines in Reporting
Grouo) Field Health Services Data to the DOH Central Office
PHG.OO2 Injury DOH Administrative Order No. 2013-0005: National
Policy on the Unified Registry Systems of
the
Department of Health (Chronic Non'Communicable
Diseases, Injury Related Caseso Persons with
Disabilities, and Violence Against Women and Children
Resistrv Svstem).
PHG-OO3 Maternal and Child DOH Administrative Order No. 2008-0029:
Mortalities Implementing Health Reforms for Rapid Reduction of
Maternal and Neonatal Mortalitv
PHG.OO4 Persons with DOH Adminishative Order No. 16-A, s. 1999:
Disabilities Guidelines on the Issuance of Certification of Disability
to Persons with Disabilities.
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DOH Administrative Order No. 2013-0005: National
Policy on the Unified Registry Systems of the
Department of Health (Chronic Non-Communicable
Diseases, Injury Related Cases, Persons with
Disabilities, and Violence Against Women and Children
Resistrv Svstem)
PHG-OO6 Expanded Primary PhilHealth Circular No. 010 s. 2012: Implementing
Care Benefit Guidelines of Universal Health Care Primary Care
(TSeKAP) Benefits Package for Transition Period CY 2012-2013.
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