SEPR,
Kee “SON
* RECEIVED ‘3

Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

EIGHTEENTH CONGRESS
Second Regular Session

HOUSE BILLNo. 7318

Introduced by Representative Sharon S. Garin

EXPLANATORY NOTE

Section 15, Article II of the Constitution provides:

"Section 15. The State shall protect and promote the right to
health of the people and instil health consciousness among them.”

Moreover, Section 11, Article XIII of the Constitution states, in part:

“Section 11. The State shall adopt an integrated and
comprehensive approach to health development which shall endeavor
to make essential goods, health and other social services available to
all the people at affordable cost. xxx.”

Even before the global onslaught of the coronavirus disease 2019 (COVID-19)
pandemic, access to health care services was already one of the main challenges faced
by Filipinos. This is felt even more in rural and underserved areas in the country. The
COVID-19 pandemic has further revealed loopholes in the country’s healthcare
system. As parts of the country encountered mounting medical emergencies, the
people's lack of access to needed healthcare services was more evident in the face of
lockdowns and quarantines.

During the COVID-19 pandemic, health care providers have resorted to
telemedicine, electronic prescription, and other digital health (eHealth) services in
providing basic health care services to people. Through these eHealth services people
are provided a safer way to access health services at a minimal cost.


In 2018, the World Health Organization acknowledged the digital technologies’
major role in improving public health and called on Member States to prioritize the
development and greater use of digital technologies in healthcare services. Thus, the
term, electronic health, or eHealth was coined.

In its broadest sense, eHealth is concerned with improving the flow of
information, supporting and facilitating the delivery of quality and responsive health
services, and managing health systems through the use of technologies. It will enable
widespread access of health services for Filipinos even in the remote or in
geographically isolated and disadvantaged areas.

Thousands of Filipinos cannot go personally to hospitals and medical facilities
to get medical attention because of distance, immobility, lack of transportation or lack
of rooms and wards in hospitals or medical facilities. Having access to doctors
remotely is an important part of improving the delivery of healthcare most specially in
the rural areas. With eHealth, and its broad reach and ease of use, more patients
would be attended to. eHealth is an innovative way to ensure access to essential
healthcare services.

With 73 million Filipino internet users and 173.2 million mobile connections in
January 2020 alone, the use of an eHealth system will revolutionize access and
facilitate the delivery of health care services in the country. eHealth can be used by
the government as an enabling instrument to support a resilient system not only to
address the disparities in the delivery of healthcare services but also help achieve
public health priorities.

By embracing technology and establishing the National eHealth System, and
supporting the Philippine eGovernment master plan of linking government data
centers to create a secure network for government information systems, as advanced
by this bill, we will be taking the right step in improving the country’s delivery of
healthcare services.

The approval of this bill is earnestly sought.



eVaunwne

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Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City
EIGHTEENTH CONGRESS
Second Regular Session

House BILLNo, 7318
Introduced by Representative Sharon S. Garin

AN ACT
ESTABLISHING THE NATIONAL ELECTRONIC HEALTH SYSTEM AND
PROVIDING FUNDS THEREFOR
Be it enacted by the Senate and House of Representatives of the Philippines in
Congress assembled:
ARTICLE I
GENERAL PROVISIONS

SECTION 1. Short Title. - This Act shall be known as the "National eHealth
System Act.”

SEC. 2. Declaration of Policy. - It is the policy of the State to protect and
promote the right to health of all Filipinos and instill health consciousness among them.
Towards this end, the State recognizes the advancements in information and
communications technology (ICT) and adopts an integrated and comprehensive

approach to improve the public health system by institutionalizing electronic health or

eHealth in the public health institutions, including hospitals, clinics, and health care


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centers in the local government units (LGUs) and in the barangays. The State likewise
recognizes the role of the private sector in promoting and improving the delivery of
health care services to the people.

SEC. 3. Definitions of Terms, — As used in the Act:

(a) eHealth refers to the use of cost-effective and secure ICT in support of
health and health-related fields, including health care services, health surveillance,
health education, literature, knowledge and research;

(b) eHealth service refers to technology-based professional consultations,
patient monitoring, clinical observation, patient assessment, and any other health
service that utilize ICT;

(©) eHealth system refers to an organized and structured application of
eHealth, integrated in the regular workflow of healthcare providers and facilities;

(d) Health care provider refers to any of the following:

(1) Health care professional including a doctor of medicine, nurse, midwife,
dentist, or other skilled allied professional or practitioner duly licensed to practice in
the Philippines;

(2) Health facility including a public or private facility or institution devoted
primarily to the provision of services for health promotion, prevention, diagnosis,
treatment, rehabilitation and palliation of individuals suffering from illness, disease,
injury, disability, or deformity, or in need of medical and nursing care;

(3) Community-based health care organization or an association of members
of the community organized for the purpose of improving the health status of that

community;


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(4) Pharmacies or drug outlets including any establishment which sells or offers
to sell any health product directly to the general public as defined in Republic Act (RA)
No. 9711, otherwise known as the "Food and Drug Administration (FDA) Act of 2009;”
and

(5) Laboratories and diagnostic clinics including any facility where tests are
done on specimens from the human body to obtain information about the health status
of a patient for the prevention, diagnosis and treatment of diseases.

(e) Interoperability refers to the use of commonly accepted standards
regardless of jurisdiction, device, equipment, software, service provider, and other
relevant factors, without need of proprietary interfaces; and

(f) Geographically isolated and disadvantaged areas (GIDAS) refer to
communities with marginalized population physically and  socio-economically
separated from the mainstream society and characterized by:

(1) Physical factors, such as those isolated due to distance, weather conditions
and transportation difficulties like island, upland, lowland, landlock, hard to reach and
unserved and underserved communities; and

(2) Socio-economic factors such as high poverty incidence, presence of
vulnerable sector, communities recovering from armed conflict.

SEC. 4. Objectives. — This Act has the following objectives:

(a) Establish an eHealth system to accelerate the delivery of healthcare

services consistent with RA 11223, also known as the "Universal Health Care Act,”


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(b) Provide eHealth policy framework and standards that are strategic,
progressive, sustainable and facilitate coordination at various level of governance in
public health;

(©) Develop nationwide infrastructure for ICT in LGUs, including the barangays
to promote fast, convenient, equitable, and affordable access to universal healthcare
services;

(d) Utilize ICT to deliver eHealth services to improve access, timeliness, and
availability of healthcare services, improve health outcomes, and reduce inequalities,
particularly in rural and other medically unserved, geographically isolated and
disadvantaged areas in the country;

(e) Facilitate secured access, exchange, and sharing of health and medical
information; and

(f) Ensure integration, alignment and interoperability among various
government eHealth initiatives and programs in accordance with the national agenda
and priorities.

The provisions of this Act shall not alter the scope of practice of health care
providers or authorize the delivery of health care services in a setting or in a manner.
not authorized by law.

SEC. 5. Coverage. — This Act shall cover all health care providers, institutions
and entities developing and using eHealth systems and applications, whether public
or private. The Act shall also cover entities that provide other eHealth solutions,

services and applications including relevant standard equipment in the field of health


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and ancillary services that uses ICT and are complementary to existing minimum
modalities or standards of health care and other access to information.
ARTICLE IT
NATIONAL eHEALTH SYSTEM

SEC. 6. National eHealth System. —The National eHealth System is-created
to provide Filipinos immediate access to health care services, including exchange of
information and content for patients and health care providers by using ICT such as
mobile devices, computers and other gadgets capable of wireless connection to access
health care services remotely.

The National eHealth System is a comprehensive, integrative, sustainable,
measurable, synchronized, interoperable, and progressive system. It is based on best
practices and facilitates inter-agency and inter-sectoral coordination at various level
of governance covering the delivery of health services to the public. It recognizes
eHealth as equal with other health care delivery methods to the extent allowable by
existing laws. eHealth provides and supports health care delivery, including diagnosis,
consultation, treatment, transfer or care of patient, exchange of health data and
education specially in medically unserved, geographically isolated and disadvantaged
areas.

SEC. 7. Scope of eHealth Services and Solutions. —All covered health care
providers and entities shall provide and implement eHealth services and solutions,
subject to the provisions of this Act, including the following:

(a) Telehealth — the delivery of health-related services and information using

ICT to enable the diagnosis, consultation, treatment, education, care management,


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and self-management of a patient at a distance from health providers. It encompasses
preventive, promotive, curative and palliative health care;

(b) Telemedicine ~ the practice of providing remote healthcare services via
real-time two-way communication between the patient and the healthcare provider;

(©) Electronic medical record or electronic health record — a system that
contains encoded documentation of patient's health information and clinical history,
which include information such as test results, procedures and medication to support
actions of healthcare professionals;

(d) Electronic prescription or e-Prescription — an electronic generation of a
physician’s prescription, transmission and filling of medical prescription;

(e) Virtual healthcare teams —medical professionals who collaborate and share
information on patients with digital equipment;

(f) Mobile health or mHealth - medical and public health practice supported
by mobile devices such as mobile phones, patient monitoring devices, personal digital
assistants and other wireless devices;

(g) Social media for eHealth - the use of online communications channels
dedicated to community-based input, interaction content-sharing and collaboration to
give the health care industry the opportunities to engage with patients and healthcare
professionals;

(h)Electronic registries — electronic databases on specific medical subjects
which contain data on births, mortality, or other subjects of medical or epidemiological

interest and may be accessed by authorized users through the use of ICT;


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(i) Health information exchange — the solution which enables data sharing and
exchange between health care providers and facilities, and supports access to the
patients record across providers in many geographic areas of the country;

(j) Knowledge management system — any kind of information technology
system that retrieves information, improves cooperation and collaboration, locates
knowledge sources, manage repositories, and enhance knowledge management;

(k) Patient eHealth self-education — the patient’s use of internet through
personal computer or mobile devices to research on medical, information and search
for health care facilities available in the area; and

(I) Directories of healthcare professionals and institutions — electronic
databases of individuals and institutions providing health care which are usually

searchable by location, specialization, professional association or credentials.

SEC. 8. Implementing Agency. - The Department of Health (DOH) is the
lead agency responsible for the implementation of the provisions of this Act and its
components.

The DOH shall strengthen and transform its existing Knowledge Management
and Information Technology Services into a bureau, to be known as the eHealth
Knowledge Management and Sharing Bureau, which shall perform the overall
administration and management under this Act and shall serve as the secretariat to
the eHealth Policy and Coordination Council. Additional plantilla positions may be
created for the purpose by the Secretary of Health, subject to the approval of the

Department of Budget and Management.


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Within three (3) years from the effectivity of this Act, the DOH shall implement

a comprehensive National eHealth System strategically organized across the country.

ARTICLE III

eHEALTH POLICY AND GOVERNANCE

SEC. 9. eHealth Policy and Coordinating Council. — The eHealth Policy and

Coordinating Council, herein referred to as the Council, is created to provide policy

direction, relevant policies, and guidelines for the effective implementation of this Act.

The Council is composed of the following:

(a)
(b)
chairperson;
(©)
(d)
(e)
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(9)
(h)
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Secretary of Health, as chairperson;

Secretary of Information and Communications Technology, as vice-

Secretary of Science and Technology;
Secretary of Social Welfare and Development;

Secretary of the Interior and Local Government;

President of Philippine Health Insurance Corporation;
Chairperson, National Privacy Commission;

National Statistician, Philippines Statistics Authority;
Representative from professional medical or health societies; and

Representative from the ICT industry associations; as members.


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The representatives from the professional medical or health societies and the
ICT industry associations shall be appointed by the President of the Philippines upon
the recommendation of the Secretary of Health and Secretary of Information and
Communications Technology, respectively. They shall serve for a term of three (3)
years, subject to reappointment for another term.

SEC. 10. Powers and Duties of the Council. — The Council shall exercise
the following powers and duties:

(a)Establish eHealth policies, regulations, and standards as well as design
effective developmental strategies for eHealth integration into the mainstream health
delivery;

(b) Formulate strategic interoperability standards to ensure cost-effective

implementation of this Act;

(c)Set out policy direction and coordinated efforts in the implementation of an
eHealth system and the delivery of eHealth services at the national level and at the
LGUs, and ensure alignment of the system and services with the overall health goals
of the government;

(d) Set policies and guidelines for the further advancement and
development of eHealth and set out necessary regulatory mechanisms;

(€) Create and identify vital, essential and appropriate eHealth and
telehealth initiatives and services necessary for the successful implementation of the
provisions of this Act;

(f) Submit a yearly assessment to the Committee on Health and Demography

of the Senate, and the Committee on Health of the House of Representatives; and


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(g) Meet and convene at least twice a year.
ARTICLE IV
TELEHEALTH

SEC. 11. Accreditation of eHealth Centers and eHealth Practitioners. —
The DOH shall ensure that health care providers offering eHealth services and
solutions are equipped with skills for the safe practice of eHealth and the necessary
ICT that will enable them to effectively provide eHealth services. No eHealth
practitioner and eHealth center shall operate without the necessary accreditation
based on standards set by the DOH.

SEC. 12. Certification of Providers. — To complement the regulations of
telehealth services and eHealth-related devices, the DOH shall, in consultation with
the Professional Regulatory Commission, Philippine Health Insurance Corporation,
University of the Philippines-Manila - National TeleHealth Center, Department of
Information and Communications Technology (DICT), academia, medical and specialty
societies, non-government organizations, the private and business sectors, set the
standards of practice and implement a certification mechanism for health care
providers offering telehealth services.

ARTICLE V
STANDARDS AND INTEROPERABILITY

SEC. 13, Standards Compliance. ~ All health care providers and entities
covered by the provisions of this Act shall comply with the standards defined by the
Council based on established clinical and service guidelines. eHealth services given

must be the same regardless of whether a health care provider delivers health care


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services in person or through the eHealth system. The attending physician is primarily
accountable for the delivery of healthcare services.

SEC. 14. Interoperability of eHealth Information Technology. — All
health care providers and health-related entities shall comply with the data standards,
as defined by the Council, to allow interoperability and health information exchange,
and ensure data protection in accordance with the Data Privacy Act of 2012 and other
related laws and issuances. The Council shall mandate the interoperability framework
and standards, which must be in accordance with the national eGovernment
interoperability framework and established standards. These standards must facilitate
interoperability among systems and devices, provide unqualified privacy and security,

and address the unique needs of the eHealth system.

ARTICLE VI
ICT INFRASTRUCTURE

SEC.15. ICT Infrastructure. —- The DOH shall, in accordance with the
standards mandated by the Council, build the required ICT infrastructure to implement
the National eHealth System.

Tt shall likewise spearhead the maintenance and management of secured and
protected national health database and national data warehouse.

SEC. 16. National Health Data Center. — The Philippine Health Insurance
Corporation shall, in coordination with the DOH, DICT and the Department of Science
and Technology, establish and maintain the national health data center, and

implement an agile and sustainable data management and governance framework and


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‘system in support to the Universal Health Care Act and in compliance with the Data
Privacy Act of 2012 for data protection.

SEC. 17. Preservation and Protection of Security of eHealth Data. —A\l
data under the eHealth shall be considered protected under the Data Privacy Act of
2012 and shall be governed by established rules for access, authentication,
transmission storage and audit while taking into account the need for timely and
efficient exchange of health information to improve quality of care and ensure the
Prompt availability of health information necessary to make immediate medical
decision,

ARTICLE VII
LOCAL GOVERNMENT SUPPORT

SEC. 18. Integration of Local Government Health System. — The DOH
and the Department of the Interior and Local Government (DILG) shall assist LGUs
integrate into the National eHealth system and ensure that LGUs meet the minimum
ICT infrastructure and eHealth manpower requirements for them to properly provide
eHealth services to their constituents.

SEC. 19. Local Government Unit Support. — The LGUs shall enact
ordinances to increase their capability and broaden their existing health programs and
policies to complement efforts and programs of the National Government under this

Act.

Furthermore, the LGUs shall implement initiatives to improve health care
delivery in the unserved and underserved geographically isolated and disadvantage

areas under their jurisdiction.


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SEC. 20. Geographically Isolated and Disadvantage Areas (GIDAs). —
The DOH, in coordination with the DILG through the LGUs, shall annually update the
list of unserved and underserved GIDAs in the country, which list shall be used as a
basis for prioritization of eHealth services allocation.

ARTICLE VIII
PRIVATE SECTOR PARTICIPATION

SEC. 21. Private Sector Participation. — The Secretary of Health shall
promulgate rules on the participation of the private sector in providing eHealth services
and applications, including public-private partnerships, and other suitable
arrangements.

ARTICLE IX
RESEARCH AND DEVELOPMENT

SEC. 22. Research and Development. — The DOH shall, in coordination with
the DOST and DICT, healthcare societies and boards, the academe, and other research
institutions, regularly evaluate existing tools and technologies used for eHealth to
ensure cost efficiency, quality and safety.

SEC. 23. Funding Source for Research Development. - The DOH,
Philippine Health Insurance Corporation, DICT, DOST, and DILG shall allocate at least
one percent (1%) of their respective annual regular budget in support of eHealth
research and development budgetary requirement.

ARTICLE X

MISCELLANEOUS PROVISIONS


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SEC. 24. Administrative Violations and Complaints. — The Council shall
promulgate rules and procedures relating to administrative violations and complaints,
insofar as they relate to the establishment and operations of the National eHealth

‘System.

SEC. 25. Implementing Rules and Regulations. —Within sixty (60) days
from the approval of this Act, the Council shall promulgate the necessary rules and
regulations for the effective implementation of this Act.

SEC. 26. Appropriations. - The amount necessary to carry out the initial
implementation of this Act shall be charged against the current year’s appropriations
of the DOH. Thereafter, the amount necessary for the continued implementation of
this Act shall be included in the annual General Appropriations Act.

SEC. 27. Separability Clause. — If any part or provision of this Act is declared
unconstitutional or invalid, the remaining parts or provisions not affected shall remain
in full force and effect.

SEC. 28. Repealing Clause. ~ All laws, decrees, executive orders, rules and
regulations, and parts or provisions thereof that are contrary to or inconsistent with
the provisions of this Act are repealed, amended, or modified accordingly.

SEC. 29, Effectivity. — This Act shall take effect fifteen (15) days after its

publication in the Official Gazette or in a newspaper of general circulation.

Approved,