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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

FIFTEENTH CONGRESS
Second Regular Session

House Bill No. 63386

Introduced by HON. JOSEPH EMILIO AGUINALDO ABAYA

EXPLANATORY NOTE

Accessible quality healthcare remains beyond the reach of majority of
Filipinos. The Aquino Health Agenda report (2010) showed that around
60% of Filipinos who succumb to illness still die without medical attention
The country’s infant mortality, with 25 deaths per 1000 live births (NDHS,
2008), and maternal mortality rates, with 200 deaths for every 100, 000
live births (UNICEF, 2004), rank among the highest in Asia. Because of
the country’s archipelagic nature, basic health statistics are even worse in
rural, often isolated areas.

Isolation due to distance, weather conditions, and transportation, as well
as poverty and situations of disasters or armed conflict continue to be
significant barriers to access to health services.

There are also parts of the country where it is difficult to attract and retain
health professionals, as well as obtain support for local health facilities to
provide the necessary range of health care services. In 2005, the Health
Human Resource Development Bureau (HHRDB) of the Department of
Health (DOH) explained that the inadequacy and uneven distribution of
health providers in the country is largely due to the migration of Filipino
health and medical professionals for foreign employment. HHRDB


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furthered that professionals who practice in the Philippines are
concentrated in urban areas. Even health care providers in medically
unserved and underserved areas are isolated from expert clinical
specialists and from information necessary to support them professionally.

Advances in information and communications technology (ICT) have
made the delivery of medical services and information across a distance
(telemedicine) a recognized and accepted approach for addressing
problems of uneven provider distribution and discontinuous and
inequitable health system development, especially in medically unserved
and underserved areas.

The World Health Organization (WHO) recognizes the use of information
and communications technology (ICT) to deliver medical services and
information across a distance (telemedicine) as an accepted approach in
addressing problems of uneven provider distribution and discontinuous
and inequitable health system development.

The use of telecommunications to deliver health services has the potential
to reduce costs and facilitate better access to health care in far flung
areas. Telehealth can lessen direct and indirect healthcare costs,
especially out-of-pocket expenses that are a major burden to patients and
their families. Based on the 2008 NDHS report, the average out-of-pocket
expenses in terms of transport and treatment for healthcare is P3966.
With telehealth, such expenses can be minimized.

At the same time, the private sector has become more actively engaged in
various forms of telemedicine, especially since most of them are attached
to ICT companies in one way or another. As the field of telemedicine
progresses, there is a need not only to unify existing systems but to
monitor and regulate current practices.

From the foregoing, the passage of this bill is earnestly sought.

ba a Ca ee
JOSEPHTEMILIO “ound ABAYA



Ce wAueene

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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

FIFTEENTH CONGRESS
Second Regular Session

House Bill No. 6336

Introduced by HON. JOSEPH EMILIO AGUINALDO ABAYA

AN ACT
PROMULGATING A COMPREHENSIVE POLICY FOR
A NATIONAL SYSTEM FOR TELEHEALTH SERVICE
IN THE PHILIPPINES.

Be it enacted by the Senate and the House of Representatives of the
Congress of the Philippines in session assembled:

SECTION 1. Short Title — This Act shall be known as the “Telehealth Act
of 2012.”

SECTION 2. Declaration of Policy — It is the policy of the State to protect
and promote the right to health of the people, especially for those in
medically unserved and underserved areas.

The Aquino administration, through the Kalusugan Pangkalahatan, seeks
to use health information to support the “immediate and efficient provision
of health care and management of province-wide health systems’. At the
same time, the Department of Health (DOH), through its National eHealth
Strategic Framework, 2010-2016, recognizes the need to “capitalize on
ICT to reach and provide better health services to geographically isolated


and disadvantaged areas (GIDA), support the attainment of Millenium
Development Goals (MDGs) and dissemination of information to citizens
and providers (Telemedicine/mhealth Services)’.

SECTION 3. Objectives and Purpose —The Telehealth Act shall provide
a policy framework and establish a National Telehealth System that will
govern the practice and development of telehealth in the country. The
National Telehealth System shall be a comprehensive, integrative,
sustainable, and progressive system that will facilitate inter-agency and
inter-sectoral coordination at various levels of governance (national and
local) covering both the public and private sectors.

The National Telehealth System shall:

(1) provide and support health care delivery, including diagnosis,
consultation, treatment, and transfer of care of patients, exchange of
health data, and education, specially in medically unserved and
underserved communities, multiple health care providers involved in
patient care, and health care providers, and managers involved in
educational and/or professional activities;

(2) provide a mechanism for gathering, collating, and making
available all health data using eHealth applications, from the local
health systems to various managers at different levels within the
health care system, including the Secretary of Health, and other
leaders/managers to enable timely and appropriate action.

(3) set standards and establish regulations regarding field of
telehealth

(4) address the problems of health provider distribution in medically
unserved and underserved areas of the state;

(5) strengthen the health systems and infrastructure;

(6) attract and retain health care providers in local areas;


(7) help reduce costs associated with health care and make health
care more accessible and affordable; and

(8) help improve health outcomes

SECTION 4. Definitions — Under this Act, the following terms shall have
the meanings respectively given to them below:

eHealth refers to the more broad term for describing the use of
information and communication technologies (ICT) for health.

National Telehealth Reference Center refers to the main agency
responsible for developing accreditation mechanisms for telehealth
and telemedicine systems, maintaining national databases and
case registries, training and assistance, and continuing education
for all telehealth practitioners

Originating site refers to the remote or rural site where the patient
and/or the telemedicine presenter is located during the telehealth
encounter or consult.

Telemedicine means the use of telecommunications technology to
provide health care services from a distance; more narrowly
focuses on the curative aspect.

Telehealth means the delivery of health related services and
information via telecommunications technology; it encompasses
preventive, promotive, curative, and palliative aspects.

Telehealth Practitioner refers to any health care provider or health
agency involved in a Telehealth System.


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Telehealth System refers to an organized and_ structured
application of Telehealth, integrated in the regular workflow of
health care facilities.

Telehealth Center refers to the telehealth site where the specialist
is, at a distance from the patient or referring physician or health
professional from an originating site.

Unserved and underserved areas refers to communities such as
those isolated due to distance, physical terrain, poverty, or lack of
transportation and social services, as well as those in situations of
disasters, crisis, and armed conflict

SECTION 5. Telehealth as an Authorized Procedure — The delivery of
health care via telehealth is recognized and encouraged as a safe,
practical, and necessary practice in the Philippines. All health care
providers shall be encouraged to participate in telehealth pursuant to the
Telehealth Act. In using telehealth procedures, health care providers shall
comply with all applicable State guidelines and shall follow established
State rules that are consistent with accepted safe clinical norms, as well
as security, confidentiality, and privacy protections for health information.

The Department of Health (DOH) and Philippine Health Insurance
Corporation (PHIC) shall require telehealth practitioners in both originating
and distant sites to undergo accreditation, through the National Telehealth
Reference Center.

SECTION 6. Scope of the Act — The Telehealth Act covers all existing
telehealth practioners in both the public and private sector. It shall not alter
the scope of practice of any health care provider or authorize the delivery
of health care services in a setting, or in manner, not otherwise authorized
by law.


SECTION 7. Lead Agency — The Department of Health (DOH) shall be
the lead agency in implementing this Act. For purposes of achieving the
objectives of this Act, the DOH shall:

(1) Establish a National Telehealth Board

(2) Ensure the continuing relevance of the National Telehealth
Reference Center (NTRC) in terms of development, implementation,
and quality assurance of related health programs

(3) Coordinate with the Department of Science and Technology
(DosT)

SECTION 8. National Telehealth Board — To ensure the implementation
of this Act and to serve as the executive body of the National Telehealth
System, the National Telehealth Board shall be created and made an
integral part of the Office of the Secretary of the DOH

The Board shall be composed of twelve members and shall be co-chaired
by the DOH and the DOST Secretaries. Other members of the Board shall
be as follows:

(1) the Executive Director of the National Institutes of Health (NIH),
as vice-chair;

(2) the Executive Director of the National Telehealth Reference
Center, as an ex-officio member;

(3) an Undersecretary of the Department of Interior and Local
Government;

(4) a representative of the League of Municipalities in the Philippines;
(8) a representative of the League of Provinces in the Philippines;
(6)a representative of the Philippine Health Insurance Corporation
(PHIC);

(7) a representative of the Association of Municipal Health Officers of
the Philippines (AMHOP);

(8) a representative of any accredited medical organization; and

(9) two community representatives of underserved areas, as
recommended by the NTRC.


era

All members of the Board, except for the co-chairs, vice-chair and
Executive Director of the NTRC, shall be appointed by the President of the
Phillipines and shall serve for a maximum of two consecutive two-year
terms, unless recalled and replaced by the respective group or sector that
have chosen them.

The Board shall:

(1) establish telehealth guidelines and regulations pertinent to its
practice and provision of service;

(2) provide recommendations to the National Telehealth System
pertinent to telehealth-related human resource development and
compensation, and other sustainability plans;

(3) recommend corrective measures and resolutions on issues
related to telehealth as deemed necessary,

(4) set and impose the appropriate penalties;

(5) conduct an annual review of reports on quality assurance by the
National Telehealth Reference Center;

(6) set policy and program recommendations for the further
development of telehealth;

(7) submit yearly assessments to the DOH; and

(8) meet at least twice a year.

SECTION 9. The National Telehealth Reference Center — The National
Telehealth Reference Center (NTRC) shall be established by the National
Telehealth Board as its executive arm, and will be initially housed by the
National Institutes of Health.


The NTRC shall be responsible for developing accreditation mechanisms
for telehealth and telemedicine systems, maintaining national databases
and case registries, training and assistance, and continuing education for
all telehealth practitioners throughout the country. It shall act serve as the
secretariat of the National Telehealth Board

The NTRC shall be headed by an Executive Director who shall serve a
maximum of three two-year terms.

SECTION 10. Establishment and Accreditation of Telehealth Centers
and Telehealth Practitioners — The NTRC shall ensure that Telehealth
Centers are strategically organized across the country within five (5) years
upon enactment of this law to ensure that telehealth practitioners are
sufficiently equipped with skills for the ethical and safe practice of
telehealth. NTRC shall establish Regional Telehealth Centers in each
region in a DOH-retained hospital. This is in order to make accessible to
the public relevant telehealth services, compliant with the standards
approved by the National Telehealth Board upon the recommendation of
the NTRC. No Telehealth Center shall be allowed to operate unless it has
been duly accredited based on the standards set forth by the NTRC.

A Telehealth Center shall have the following minimum requirements: (i.)
be equipped with the needed ICT applications suitable for telehealth in the
country; (ii.) be supervised and staffed by trained personnel who have
been duly qualified by the NTRC; and (ii.) submit to periodic unannounced
inspection by NTRC in order to evaluate and ensure quality Telehealth
Center performance.

SECTION 11. Quality Assurance — The National Telehealth Reference
Center shall be responsible for drafting and ensuring technical standards
for Telehealth Centers, including establishing a standard accreditation
process and certification program. It shall also act as the principal
repository of technical information relating to telehealth standards and


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practices, and shall provide technical assistance to Telehealth Centers
and originating sites needing such assistance.

SECTION 12. Database — All Telehealth Centers and originating sites
shall coordinate with the National Telehealth Reference Center for
consolidation of patient databases. The NTRC shall maintain and manage
a national database for consults on clinical cases, as well as health and
medical education exchanges made through the NTHS. It shall submit
reports annually to the Committee and to the DOH on the status of and
relevant health information derived from the database. A plan for long-
term outcome evaluation of telehealth service utilizing the cases registries
shall be developed within one (two) years of passage of this Act by the
NTRC in consultation with the Advisory Committee on Telehealth Service.
Implementation of this plan shall be the responsibility of the Advisory
Committee.

SECTION 13. Penalties — All individuals, groups, companies, and/or
entities practicing telehealth who violate the regulations and guidelines set
by the National Telehealth Board shall be subjected to penalities as set by
the Board, without prejudice to any criminal, civil, and administrative cases
arising thereof.

SECTION 14. Financing — The national government shall allocate an
initial funding of one hundred and thirty million pesos (Php 130,000,000)
from the General Appropriations Act, composed of one hundred million
pesos (Php 100,000,000) through the DOH and thirty million peros (Php
30,000,000) from the DOST, for the implementation of the National
Telehealth System and the establishment of the National Telehealth
Reference Center. An amount of 70 million pesos (Php 70,000,000) shall
be appropriated annually thereafter, composed of fifty-five million pesos
(Php 55,000,000) from the DOH and fifteen million pesos (Php
15,000,000) from DOST.


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Additional funding amounting to a minimum of fifteen million pesos (Php
15,000,000) annually shall be obtained from the PHIC for telehealth
transactions and/or systems

SECTION 15. Repealing Clause — All general and special laws, decrees,
‘executive orders, proclamations and administrative regulations, or any
parts thereof, which are inconsistent with this Act are hereby repealed or
modified accordingly

SECTION 16. Separability — If any part or provision of this Act shall be
declared or held to be unconstitutional or invalid, other provisions hereof
which are not affected thereby shall continue to be in full force and effect.

SECTION 17. Effectivity — This Act shall take effect fifteen (15) days after
its publication in at least two (2) newspapers of general circulation.

Approved.