Ay

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

EIGHTEENTH CONGRESS
First Regular Session

65

House Bill No. z=

Introduced by Representatives Ron P. Salo

EXPLANATORY NOTE

The World Health Organization (WHO) defines eHealth as “the use of
information and communication technologies (ICT) for health.” It is a relatively recent
healthcare delivery method supported by electronic processes and ICTs. As early as.
2005, the World Health Assembly (WHA) recognized the potential of eHealth to
strengthen health systems and improve quality, safety and access to care, and
encouraged Member States to take action to incorporate eHealth into their health
systems and services (58th WHA, 2005; Geneva, Switzerland). Since then, the
Department of Health (DOH) harnessed the potential value of eHealth as an innovative
measure to deliver cost-efficient and sustainable interventions towards an integrated
and comprehensive approach to health development and universal access to
healthcare. Specifically, its use has provided new and more efficient ways of improving
the delivery of healthcare and making the health systems more efficient and
responsive to people's needs and expectations, and concomitantly, in promoting
access to evidence-based information for decision making.

Under the Accelerating Human Capital Development Pillar of the Philippine
Development Plan 2017-2022, one of the key cross-cutting strategies identified to
improve nutrition and health for all is to invest in eHealth and data collection
mechanisms to address data gaps. Moreover, under the Governance in Health and
Service Delivery Pillars of the Department of Health's Fourmula One Plus for Health
Policy and Strategic Framework, eHealth has been identified as a strategic
intervention to “ensure generation and use of evidence in health policy development,
decision-making, and program planning and implementation,” and “transparency and
accountability measures at all levels instituted.”

Given the growing prevalence of eHealth technolegies and applications, and to
achieve optimum and meaningful use of ICTs in health and to protect all the
beneficiaries and stakeholders, this Bill aims to provide a policy framework and
establish a national eHealth system that will direct and regulate the practice of eHealth
in the country. Specifically, this measure will help direct and regulate action of
Providers; streamline and make systems and services interoperable; ensure patient
safety and protection; define and guarantee quality of service; define and
institutionalize governance mechanism to achieve coherence, cooperation and
Complementation; address issues on provision, access, availability, privacy and
cybersecurity and information exchange, among others; support research,

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REPRISE
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development and innovation; avoid duplication among eHealth services and efforts
among government agencies with the private sector; establish the critical
infrastructure; and define a budget to finance and sustain it. The vision is “An ICT-
enabled and integrated Philippine Healthcare System delivering quality health
‘outcomes to all Filipinos” to support the attainment of Universal Health Care (UHC).

In view of the foregoing, the immediate passage of this Bill is earnestly sought.

RON Q SALO

KABAYAN Partylist

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

EIGHTEENTH CONGRESS
First Regular Session

House Bill No. 665

Introduced by Representatives Ron P. Salo

AN ACT
ESTABLISHING THE PHILIPPINE eHEALTH SYSTEM AND SERVICES IN
SUPPORT OF UNIVERSAL HEALTH CARE USING INFORMATION AND
COMMUNICATIONS TECHNOLOGY IN THE PHILIPPINES, AND APPROPRIATING
FUNDS THEREFOR

Be iit enacted by the Senate and House of Representatives of the Philigpines in
Congress assembled.

ARTICLE |
GENERAL PROVISIONS

SECTION 1. Short Title. - This Act shall be known as the “eHealth System
and Services Act”.

SEC. 2. Declaration of Policies. —\t 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 shall institutionalize a system of providing wide
access and quality healthcare information and services through electronic means
using information and communication technologies (ICT) or eHealth resulting in
improved health outcomes for every Filipino, and further recognizing public and private
partnership.

The national eHealth system shall be comprehensive, integrated,
interconnected, sustainable, measurable, synchronized, interoperable, and
Progressive based on best practices, and shall facilitate inter-agency and inter-sectoral
Coordination at various levels of governance covering both the public and private
sectors. It shall recognize eHealth as equal with other healthcare delivery methods to
the extent allowable by existing laws, provide and support healthcare delivery,
including diagnosis, consultation, treatment, transfer of care of patient, exchange of
health data and education, especially in medically unserved and’ underserved
geographically isolated and disadvantaged areas (GIDAs).

SEC. 3. Objectives. — This Act shall provide a policy framework and establish

a national eHealth system that shall direct and regulate the practice of eHealth, which
shall:

a) Set policies, standards, regulations and services in eHealth to reduce

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inequalities, achieve universal health care and improve health outcomes;

b) Realize health information exchange to measure and monitor health system
performance and responsiveness; and

c) Enable the citizenry with access to health information and health services,
including teleHealth, needed for better management and control of their own
health.

SEC. 4. Scope and Application. — This Act covers all existing healthcare
providers and other entities developing and using eHealth systems, services and
applications, whether public or private. It shall cover all eHealth solutions, services
and applications including relevant standard equipment in the field of health and
ancillary services that use ICT and are complementary to existing minimum modalities
or standards of health care and other access to information.

SEC. 5. Definition of Terms. — As used in this Act:

a) eHealth System refers to the interplay of enabling (governance and
accountability; strategy and investment; human resources; standards and
interoperability; monitoring and compliance; research and development)
and foundational (infrastructure; and services and applications) elements
essential for a successful national eHealth implementation;

b)

eHealth Services and Applications refer to the solutions and products with
defined objectives to serve its intended clients or users, such as Health
Information Systems, EMR Systems, EHR System, Hospital Information
System, ePharmacy System, Laboratory System, Radiology System,
Registry systems, mobile health, teleHealth, telemedicine, wearables, and
biomedical and reiated devices with ICT component;

ic)

Electronic Health or eHealth refers to the use of cost-effective and secure
information communications technology for health;

d) Electronic Health Record (EHR) refers to a computerized health record
used to capture, store, access and share information for a patient between
healthcare organizations and providers;

e)

Electronic Medical Record (EMR) refers to a computerized medical record
used to capture, store and share information between healthcare providers
in an organization;

f) Geographic Isolated and Disadvantage 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 (island, upland, lowland,
landlocked, hard to reach and unserved or underserved communities); and
(2) Socio-economic factors such as high poverty incidence, presence of
vulnerable sector, communities in or recovering from situation of crisis or

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armed conflict;

Health Sector Enterprise Architecture refers to the blueprint on which
eHealth services and applications shall be developed, implemented and
scaled up;

9)

h

Health Knowledge Resources refers to those services that manage and
provide access to trusted information to support health care providers and
individuals, including local and international online journals and resource
collections, national electronic journals printed information, archives, and
other information resources;

i) Information and Communications Technology refers to all technologies
for the communication of information, which includes data, application or
information systems, internet, network, connectivity, telecommunications,
among others;

j) Mobile Health (mHealth) refers to the services and information supported
by mobile technology, such as mobile phones, wearables, and handheld

computers;

Personal Health Record (PHR) refers to a computerized health record

created and maintained by an individual;

k)

) TeleHealth refers to the delivery of health-related services and information,
at a distance, which encompasses preventive, promotive, curative, and
palliative aspects. It is also a collection of means or methods for enhancing
health care, public health, health research and health education delivery
and support in the various heaith fields using telecommunications and
virtual technologies;

m) Telemedicine refers to the remote diagnosis and treatment of patients by
means of telecommunications technologies.

SEC. 6. Implementing Agency. ~ The Department of Health (DOH) shall be
the lead implementing agency to carry out the provisions of this Act, including its
components. The DOH shall strengthen and transform its existing Knowledge
Management and Information Technology Service (KMITS) into a full-fledged Bureau,
to be named as Knowledge Management and Health Information Technology Bureau,
which shall perform the overall management and administration of this Act. Additional
plantilla positions shall be created for this purpose.

The Bureau shall also serve as a secretariat of the eHealth Policy and
Coordination Council as provided on Sec. 7 hereof.

SEC. 7. Regional and Local Implementation Structures and Staffing
Pattern. — To assist in the implementation of this Act and Subject to the approval of the
Department of Budget and Management, the DOH shall determine the regional and
local implementation structures and create divisions or units as it may deem
necessary, and shall appoint officers and employees with permanent appointments

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and supported with an adequate yearly budget in accordance with the civil service law,
rules, and regulations.

ARTICLE I
GOVERNANCE AND ACCOUNTABILITY

SEC. 8. Creation of the eHealth Policy and Coordination Council. — There
shall be created an independent body to be known as the eHealth Policy and
Coordination Council (geHPCC) to provide and promote relevant policies and
guidelines for the effective coordination and implementation of this Act. The Council
shall be composed of the following key officials:

a)

b)

)

qd)

e)

e

k)

Secretary, Department of Health — Chairperson

Secretary, Department of Information and Communications Technology
(DICT) - Co-Chairperson

President & Chief Executive Officer, Philippine Health insurance
Corporation (PhilHealth) — Co-Chairperson

Members:
Secretary, Department of Science and Technology (DOST);

Secretary, Department of Social Welfare and Development (DSWD);
Secretary, Department of Interior and Local Government (DILG);
Secretary, Department of Budget and Management (DBM);
Chancellor, University of the Philippines — Manila (UPM);
Chairperson, Commission on Higher Education (CHED);
Chairperson, National Privacy Commission (NPC);

National Statistician, Philippine Statistics Authority (PSA);

|-m) Two (2) representatives from professional medical or health societies;

n)

0)

One (1) representative from patients group; and

One (1) representative from the IT industry associations

The heads of government agencies may be represented by an official whose
rank shall not be lower than an Assistant Secretary or its equivalent. Members
representing the private sector shall be appointed by the President of the Philippines

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not later than thirty (30) days after the date of enactment of this Act and shall serve for
a term of three (3) years, renewable upon recommendation of the Council for a
maximum of two (2) consecutive terms.

SEC. 9. Powers and Duties of the Council. — The Council shall exercise the
following powers and functions:

a) Establish eHealth policies, standards, regulations, and ethical frameworks
pertinent to use, practice and provision of eHealth services;

b) Direct and coordinate the eHealth services and applications at the national
level and ensure alignment of the system and services with the overall
health and ICT goals of the government;

©) Spearhead the activities that promote eHealth awareness and engage the
participation of stakeholders; and

d) Submit yearly assessments to the Senate Committee on Health and
Demography and the House of Representatives Committee on Health.

SEC. 10. Creation of the Sub-Structure or Mechanism. - The Council shall
create multi-sectoral groups, composed of both the private and public sectors to
ensure broader stakeholder participation and for the furtherance of its objectives.

ARTICLE Ill
STANDARDS AND INTEROPERABILITY

SEC. 11. Health Sector Enterprise Architecture. — The Council shall develop,
regularly update, and implement a health sector enterprise architecture to provide
guidance to align and ensure that data can easily be made available and accessible,
business processes are harmonized and integrated, and services and applications are
usable, safe, efficient and effective.

All health and health-related entities shail adopt a health enterprise architecture
as defined and guided by the Council.

SEC. 12. Standards Compliance. — Al health 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 R.A. No.
10173, otherwise known as the “Data Privacy Act” and other related laws and
issuances.

These standards shall include, inter alia, patient identifier, provider identifier,
health facility identifier, terminology and messaging standards, and shall be in

accordance with the Philippine eGovernment interoperability framework and other
relevant standards.

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ARTICLE IV
SERVICES AND APPLICATIONS

SEC. 13. Rationalization of eHealth Services and Applications. — Design,
development, and implementation of eHealth services and applications shall focus on
the automation and interoperability of the various mandatory eHealth business
processes and data services as laid out in the Health Sector Enterprise Architecture.

SEC. 14. Scope of eHealth Services and Applications. — eHealth shall
include the following areas:

a) Mandatory eHealth Data Services:
1) Master Person Index

2) Master Provider Index
3) Master Facility Index

4) Terminology Registry
b) Compliant eHealth Application:
1) Electronic Medical Record

2) Enterprise Resource Planning
3) Laboratory, Radiology, and ePrescription
4) Human Resources for Health Information System

5) TeleHealth

Article V
TELEHEALTH

SEC. 15. Regulations of TeleHealth Services and eHealth Related Devices.
~ The Council, through the DOH, shall establish and maintain a regulatory system for
telehealth services and eHealth-related devices.

SEC. 16. Standards of Practice and Certification of Individuals and
Entities Providing TeleHealth Services. — To complement the regulations of
telehealth services and eHealth-related devices, the DOH, in consultation with
Professional Regulatory Commission (PRC), PhilHealth, UPM — National TeleHealth
Center, DICT, academia, medical and Specialty societies, non-government
organizations, the private and business sectors, shall set the standards of practice and

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ARTICLE Vi
HUMAN RESOURCES

SEC. 17. Human Resource in eHealth. — The human resource for eHealth
are health professionals who shall plan, design, build, operate, use, maintain and
support the eHealth services and applications, and innovations.

The DOH, CHED, DICT, Technical Education and Skills Development Authority
(TESDA), and Professional Regulation Commission (PRC), in consultation with
medical and specialty societies, IT professional associations, and academia, shall
establish the minimum competencies and impose the same on health, health-related
and digital health professionals. This shall be part of the curriculum of health and
health-related courses.

SEC. 18. Human Resource Development Plan. — The DOH, CHED, TESDA,
and PRC shall formulate the Human Resource Development Plan which shall develop
new curricula, integrate changes in existing curricula, create formal and non-formal
training programs, and continuing professional development programs. There shall
also be creation of personnel services item, plantilla positions, and other employment
opportunities for human resource in government hospitals and institutions to manage
and enable eHealth in healthcare and related services.

ARTICLE Vil
INFRASTRUCTURE

SEC. 19. ICT Infrastructure. - The DICT, in coordination with DOH,
PhilHealth, and DOST, shall establish the necessary national ICT infrastructure to
implement eHealth services and applications.

SEC. 20, National Health Data Center. - The PhilHealth, in coordination with
the DOH, DICT and DOST, shall establish and maintain the national health data
center, and implement an agile and sustainable data management and governance
framework and system in support to R.A. No. 11223, otherwise known as the
“Universal Health Care Act,” and in compliance with R.A. No. 10173, otherwise known
as the “Data Privacy Act of 2012” for data protection.

ARTICLE Vill
STRATEGY AND INVESTMENT

SEC. 21. National eHealth Strategic Framework and Plan. - The Council
shall spearhead the development and monitoring of strategic framework and plan to
‘serve and guide the operations of a national eHealth system.

SEC. 22. Financing the eHealth Strategic Framework and Plan. — Financing
for the national eHealth system by DOH, PhilHealth and other partners, as defined by

the Council, shall be made available to scale up eHealth implementation at the national
level.

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SEC. 23. Private Sector Participation. ~ The DOH shall promulgate rules
regarding the participation of the private sector in the provision of eHealth services
and applications, including public-private partnerships, and other suitable
arrangements.

ARTICLE IX
MONITORING AND COMPLIANCE

SEC. 24. Monitoring and Compliance. - The Council shall measure and
monitor the performance and progress of the implementation of this Act.

ARTICLE X
RESEARCH AND DEVELOPMENT

SEC. 25. Research and Development. — Consistent with the Republic Act No.
10532 otherwise known as the “Philippine National Health Research System Act of
2013,” and the mandate of the DOST, the DOST — Philippine Council for Health
Research and Development (DOST-PCHRD), in consultation with DOH, CHED, DICT,
PhilHealth, UPM — National TeleHealth Center, academia, regional health research
consortia, medical and specialty societies, non-government organizations, the private
and business sectors, shall ensure the development of new eHealth services,
applications and innovations through:

a) Formulation of eHealth research priority areas under the National Unified
Health Research Agenda (NUHRA), and other research agendas;

b) Funding and mobilizing resources for researches on eHealth which are
aligned with the research agenda;

c) Establishment and strengthening of centers of excellence of eHealth policy
studies, research and innovation, including creation of formal and non-formal
capability building programs; and

d) Adherence of eHealth research outputs to the health technology assessment
process as provided in the Universal Health Care Act.

A separate unit within the PCHRD shall handle and manage eHealth related
activities and programs. The human resource requirement of such unit shall be
determined by PCHRD in consultation with DOH, CSC and DBM.

SEC. 26. Funding Source for Research and Development. — The DOH,
PhilHealth, DOST, DICT, CHED, and DILG shall allocate at least 1% of their respective
annual regular budget in support of eHealth research and development. Other
government agencies, state universities and colleges (SUCs), private entities, and
non-government organizations are encouraged to provide financial support for eHealth
research and development.

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ARTICLE Xi
ADMINISTRATIVE PENALTIES

SEC. 27. Rules and Procedures for Administrative Violations and
Complaints. — The Counci! 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

ARTICLE Xil
MISCELLANEOUS PROVISIONS

SEC. 28. Transitory Provisions. — The transformation of KMITS into a full-
fledged Bureau and the formulation of the internal organic structure and regional and
local implementation structures, staffing pattern, operating system, and the revised
budget of the Department for health information technology shall be completed within
six (6) months from the effectivity of this Act, during which time, the existing KMITS
and regional and local implementation personnel shall continue to serve in holdover
capacities until a full and permanent bureau is constituted and functioning, and new
appointments are issued.

SEC. 29. Appropriations. - The amount needed for the initial implementation
of this Act shall be taken from the current fiscal year’s appropriation of the DOH for
health information technology.

For the succeeding years, the amount needed for eHealth in the DOH budget
and in the budget of other agencies with specific mandates provided in this Act shall
be based on the strategic plan formulated by the Council, in coordination with other
stakeholders. The amount shall be included in the National Expenditure Program
(NEB) as basis for the General Appropriations Bill (GAB).

Further, other sources of funds can come from the Private Sector Participation
Program, Joint DOH-PhilHealth-DICT-DOST undertakings on eHealth, and Medium-
Term Information and Communications Technology Harmonization Initiative (MITHI).

SEC. 30. Implementing Rules and Regulations. — Within ninety (90) days
from the effectivity of this Act, the Secretary of DOH, after consultation with the
Secretaries of DICT and DOST, the President and Chief Executive Office of
PhilHealth, the Chancellor of UPM, the Chairperson of CHED, the National Statistician
of PSA, and representatives of medical and paramedical associations and societies,
and other stakeholders, shall promulgate the necessary rules and regulations
implementing the provisions of this Act.

_ SEC. 31. Separability Clause. — |f any part or provision of this Act is held
invalid or unconstitutional, the remaining parts or provisions not affected shall remain
in full force and effect.

‘SEC. 32. Repealing Clause. — All general and special laws, decrees, executive

orders, proclamations and administrative regulation, or any parts thereof which are
inconsistent with this Act are hereby repealed, amended and modified accordingly.

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SEC. 33. Effectivity. — This Act shall take effect fifteen (15) days after its
publication in the Official Gazette or in any newspaper of general circulation.

Approved.

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