Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Philippines

SEVENTEENTH CONGRESS
Second Regular Session

7426

HOUSE BILL NO.

INTRODUCED BY REPRESENTATIVE ALFRED VARGAS

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 practice
supported by electronic processes and communication. As early as 2005, the World Health
Assembly 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 World Health Assembly,
2005; Geneva, Switzerland). Since about 2011, the increasing recognition of the need for
better cyber-security and regulation may result in the need for these specialized resources
to develop safer eHealth solutions that can withstand these growing threats,

Under the Philippine Health Agenda (PHA) Strategy, ACHIEVE, the "I" stands for
“Invest(ing) in eHealth and data for decision making." The PHA 2016-2022 identifies this
guarantee on access to health interventions through functional Service Delivery Networks
which shall be enabled by telemedicine to expand access to specialty services,

This proposed legislation aims to establish, institutionalize and regulate a coherent,
coordinated and collaborative National eHealth System, guided by the Philippines eHealth
Strategic Framework and Plans for year 2013 -2017, organized by the Department of
Health and Department of Science and Technology. ‘This measure will help streamline and
address issues on provision, access, availability, accountability, patient rights, electronic
health data, security and information exchange, among others.

The implementation of Kalusugan Pangkalahatan or Universal Health Care is directed
towards ensuring the achievement of the health system goals of better health outcomes,
sustained health financing and responsive health system. Ultimately, investment in
infrastructures which ensures equitable accéss to health care services, most especially
those in geographically isolated and disadvantaged areas (GIDA) and particularly for the
Poor, disadvantaged, and vulnerable is the pivotal intent of this proposed legislation. It
also underscores the need and importance of quality access to real-time information for
evidence informed decision making.

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

FRED VAYGAS


Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Philippines

SEVENTEENTH CONGRESS
Second Regular Session
7426

HOUSE BILL NO.

INTRODUCE

2EPRESENTATIVE ALFRED VARGAS

AN ACT
ESTABLISHING THE PHILIPPINE eHEALTH SYSTEM AND SERVICES IN THE
DELIVERY OF HEALTH SERVICES WITH THE USE OF INFORMATION AND

COMMUNICATIONS TECHNOLOGY IN THE PHILIPPINES AND APPROPRIATING
FUNDS THEREOF

Be it enacted by the Senate and the House of Representatives of the

Congress of the
Philippines in session assembled:

ARTICLE 1
GENERAL PROVISIONS

SECTION 1. Short Title — This Act shall be known as the

"Philippine eHealth
Systems and Services Act"

SECTION 2. Declaration of Policy — The State shall protect and promote the
right to health of the people and instill health consciousness among, them. Hence, it is
the intent of the Legislature to institutionalize a system of providing wide access and
quality health care services through electronic means using Information and

Communication Technologies (ICT), or eHealth resulting in improved health outcomes
for every Filipino.

SECTION 3. Objectives — The cHealth Act shall provide a policy framework and
establish a National eHealth System that will direct and regulate the practice of eHealth
in the Philippines

The Philippine eHealth Systems and §

integrative, sustainable, measurable, synchronized,
based on best

ces shall be comprehensive,

interoperable, and progressive
Practices, and shall facilitate inter-agency and  inter-sectoral

coordination at various level of governance covering both the public and private
sectors. It shall:

(a) Recognize eHealth as equal with other health care delivery methods to the
extent’ allowable by existing laws, provide and support health care


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 dis

‘advantaged
areas (CIDA);

(b) Utilize information and communication technology (ICT) to deliver health
services which has the potential to lessen costs, improve quality, change
the conditions of practice, and improve access to health care, particularly
in rural and other medically underserved areas:

(c) Develop infrastructure for ICT for health to promote equitable affordable
and universal access to health services;

(d) Set policies and standards, and establish regul

lations regarding field of
eHealth;

(e) Designate national and regional centers and networks of excellence for

eHealth best practices, policy coordination, and technical support for
healthcare delivery; and

(f) Facilitate the exchange and access to secured personal health information,
including health providers snaring and use health and medical
information to improve care as well as public a
information for the promotion of their own personal health.

to relevant

SECTION 4. Defi
shall apply:

ion — For the purpose of this Act the following definition

a. "Act" refers to the Philippine eHealth Systems and Services Act.

b. "Distant Site” refers to the site where a health care

provider is located
While providing these services via telecommuni

‘ation systems.

“Electronic health or eHealth” refers to the use of cost-effective and
secure information communication technology for health.

“Geographically Isolated and Disadvantaged Areas (GIDAS)" refer to
Communities with marginalized population physically and  socio-
economically separated from the mainstream society and characterized
by: (a) Physical factors such as those isolated due to distance,

weather
conditions and transportation difficulties (island, “upland, lowland,
landlocked, hard to reach and unserved/underserved communities);

and (b) Socio-economic factors such as high poverty incidence, presence

of vulnerable sector, communities in or recovering from situation of
crisis or armed conflict.


@ "Information and Communications Technology" refers to the following:

i. Compressed digital interactive video, audio, or data transmission:

ii, Real-time synchronous video or
communications;

ili, Secure web-based communication;

iv. Still image capture or asynchronous store and forward; and

v. Modem smart medical devise use for diagnosis and health care
services.

web-conferencing

f. “Institutional Healthcare Provider" refers an organization or institution
that provides health care and related services, including but not limited
to the provision of inpatient and outpatient care, diagnostic or
therapeutic services, laboratory services, medicinal drugs, nursing care,
assisted living, elderly care and housing, including retirement
communities, and equipment used or useful for the provision of
healthcare and related services

8 “Originating site" refers to the site where the patic
time of provision of health care service:
systems.

ent is located at the
's through telecommunication

h. "Professional Healthcare Provider" refers to the healthcare practitioner
or license individual, which includes medical doctors, nurses,
pharmacist, physical therapist, and midwives, who provides healtheare
within the scope of his profession license.

i. “Licensable Healthcare Professionals” refer to health care professionals
applying for the license to practice telehealth services,

j. “ellealth Practitioner" refers to any health care provider

Health Center" refers to health agency involve in

elehealth System

“ellealth systems” refers to an organize

d and structure application of
eHealth, integrated in the regular workiloy

w of health care facilities,

m. "Telehealth" means the delivery of health-related services and
information via telecommunication technology. It

encompasses
preventive, promotive, curative, and palliative aspect

¢lemedicine” means the use of telecommunication
provide health care services from a distance:
curative/ treatment aspect.

technology to
focuses more on the

©. "Unserved and underserved areas” refe

r to communities such as those
isolated due to distant, physical

terrain, poverty, or lack of


transportation and social services, as well as those in situation of
disaster, crisis, and armed conflict.

SECTION 5. Scope of the Act — The act covers all existing eHealth practitioner
Institution, entities, services and related applications in both public and private. It
shall not alter the scope of practice of any health care provider or authorize delivery
of health care services in a getting or in a manner not authorized by law. It shall cover
all other eHealth solutions and services including relevant standard equipment in the
tield of health and ancillary services that uses ICT and are complementary to existing
ninimum modalities or standards of health care and other access to information.

ARTICLE II
HEALTH SYSTEMS' COMPONENTS.

SECTION 6. The eHeaith Components — The following components are the
building blocks that shall be put in place to realize the national ellealth vision and
allow the eHealth outcomes to be achieved:

(a) Leadership and Governance — Directs and coordinates eHealth activities at
alllevels like hospitals and health care providers. Critical areas of
governance are management of the eHealth agenda, stakeholders’
engagement, strategic architecture, clinical safety, management and
Operation, monitoring and evaluation, and policy oversight.

(b) eHealth Services/ Solutions — Required services and applications to enable
widespread access to health care services, health information, health
reports, health care activities; securely share 4 and exchange patient's
information in support to health system goals. These address the

needs of the various stakeholders like individuals, health care providers,
managers, officials, and others.

(c) Standards and Interoperability — Defines stand:

lards of ellealth systems and
services,

and promotes and enables exchange of health information across
geographical and health sector boundaries through use of common
standards on data structure, terminologies, and messaging, The
implementation of soft ¢ certification or accreditation where eHealth
solutions must comply in order to be certified as able to exchange health

information shall ensure compliance to eHealth data standards for
interoperability.

(d) Policy, and Compliance — Formulation of the required policies, guidelines
and compliance mechanisms to support the attainment of the quality and
acceptable eHealth systems and services.


(e) Infrastructure Establishes and supports the ICT and medical base to enable
Provision of eHealth services and health information exchange to enable
sharing of health information across geographical and health sector

bound:

aries, and implementation of innovative ways to deliver health

services and information.

(8) Human Resources — Workforce or professionals that develop, operate, uses
or implement the national eHealth environment such as the health workers

who will be using eHealth in their line
information and communication logy

(g) Strategy and Investment — Schemes and outlay that are ne:

works, health care providers,

eded to develop,

Operate and sustain the eHealth Systems and Services. These components
Support the development of a strategy and plans to serve as guide in the

implementation of the eHealth agenda. Investment re
amount needed for executing the strategies and plans.

fers to the funding or

ARTICLE IIL
LEADERSHIP AND GOVERNANCE

SECTION 7. Lead Agency - The Department of Health (DOH) shall be the lead

agency in implementing this Act. For the purpose of achieving th

a

d.

»bjectives of the Act,
the DOH shall

Establish an inter-agency and multi-sectoral National eHealth Ste

ering
Committee;

Spearhead the establishment of a National eHealth System and Service;

Coordinate with the Department of Science and Technology (DOST), the
Department of Information and Communication Technology Office
(DICT) and the Philippine Council for Health Research and Development
(DOST-PCHRD), Philippine Health Insurance Corporation (PhilHealth),
University of the Philippines-National Telehealth Center (UPM-NTHC),
Medical and Paramedical Specialty Societies, Boards and Associations,
Professional Regulation Commission (PRC) aind various health services
Providers and facilities including the academe and patient groups, and
other stakeholder; and

Create or identify an Office to coordinate the development and
implementation of a National eHealth System and Services among
agencies concerned and provide direction and guidance to all DOI

offices and attached agencies including the local government units and
the private sector.

6


SECTION 8. National eHealth Steering Commi
implementation of this Act and to serve as an executive body of the Philippine eHealth
System and Services (PNeHSS), the National ellealth Steering Committee shall be

created and made an integral part of the DOH. The composition of the Steering
Committee shall be as follows:

ee — To ensure the

Secretary, Department of Health;
Members:
a. Secretary, Department of Science and ‘Technology;

Secretary, Department of Information and Communication Technology:
Secretary, Department of Social Welfare and Development;
Secretary, Department of Interior and Local Government:
President and Chief Executive Officer, Philippine Health
Corporation;

Chancellor, University of the Philippines — Manila;

Commissioner, Professional Regulatory Commission

Commissioner, Commission on Higher Education;

Commissioner, National Privacy Commission;

Commissioner, National Anti-Poverty Commission:

President, Philippine Hospital Association:

President, Philippine Medical Association;
. President, Philippines Nurses Association;

President, Philippine Pharmacists Association;

A’ representative from the Association of

Officers/PHO/CHO; and

Two (2) representatives from a duly organized patient group

aes

=

Insurance

pe

epg rRre

Municipal Health

=

Members of the Committee shall be appointed by the President of the
Philippines and Shall serve for three (3) years for a maximum of two 2)

consecutive terms, unless recalled, replaced or resigned from office. The Committee
shall exercise the following function:

(a) Establish eHealth policies, standards,
frameworks pertinent to use, practice
(b) Direct and coordinate the e|
level and ensures alignment
health goals of the governme:

regulations, and ethical
d provision of eHealth services;

Health system and services at the national
of the system and services with the overall

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

(d) Formulate responsive plans and strategies for the development of a

national eHealth environment in coordination with major stakeholders
and affected sectors;


(e) Set and develop policies and programs for the furthe
eHealth, and impose necessary regulatory mi
penalties upon hearing and deciding on cases;

advancement of
echanisms including

(Create Technical Working Group, other Committees, and
to assist in the development of the eHealt! Projects;

perts Group

(g) Create or identify the Telehealth Licensing and Regulatory mechanisms
and body to implement these;

(h) Submit yearly assessments to Senate Committee on Health; and

(i) Convene at least twice a year.

ARTICLE IV
eHEALTH SERVICES AND SOLUTIONS

SECTION 9. Service and Application— the National
provide tangible means for enabling services and systems inc
exchange and management of information and conte
providers, insurance, and others whi
businesses.

tealth System shall
luding access to, and
‘nt for the general public, patients,
ich may be supplied by government or private

SECTION 10. Scope of eHealth Services and Solutions — eHealth is
umbrella term that covers the following areas

an
(a)"Health informatics" refers to interdisciplinary study of the design,

development, adoption, and application of IT-based innovations in healthcare
services delivery, management, and planning

{b) "Telehealth" means the delivery of health-related ser
telecommunication technology. It encompasses prever
and palliative aspects,

and information via

©, promotive, curative,

(©) "Telemedicine" means the
health care services from a
aspect.

Use of telecommunication technology to provide
distance; focuses more on the curative/ treatment

(d) "Electronic learning or e-learning” refers to les
technologies to access educational
classroom.

arning utilizing electronic
curriculum outside of a traditional

(ce) "Electronic Medical Record/ Electronic Health Record’

systems that contains encoded form of document
information

refers to software
ation of patients’ health


(f) "Electronic prescription or prescription" refers to an electronic generation of
a physician's prescription, transmission and filling of medical prescription,

(g) "Virtual healthcare teams” refer to professionals who collaborate and share
information on patients with digital equipment

(h)"Mobile health or mHlealth" refers to medical and public health practice
Supported by mobile devices such as mobile phones, patient monitoring devices,
personal digital assistants (PDAs), and other wireless devices,

(i) "Social media for eHealth" refers to the opportunities for the healthcare
industry to engage with patients and healthcare professionals through online
communications channels dedicated to community-based input, interaction,
content-sharing and collaboration.

(i) “Health information Exchange" refers to the
sharing and exchange between health care pro
access to the patient's record across provide:
country.

solution which enables data
viders and facilities, and support
rs in many geographic areas of the

() "Knowledge Management system” refers to any kind of IT system that stores
and retrieves information, improves cooperation and. collaboration,

locates
Knowledge sources, manage repositories, and enhance knowledge

management.

(1) "Patient Self Education about Healthcare" refers to the patient's use of internet
through personal computers or mobile devices to research on medical and/or

pharmacological information, treatment options, or search for healthcare
facilities available in their area.

SECTION 11. Telehealth and ‘Telemedicine

Services — Telehealth is an
approach of providing health care services and public health with the use of {er to
cnable the diagnosis, consultation, treatment, education, care manageme nt, and self-

Inder of patients at distance from health providers, However, it shall not be
understood to modify the scope of medical practice or any health care provider or

authorize the delivery of health care service in a setting or manner not otherwise
authorize by the law.

SECTION 12, Electronic Medical/Heaith Record (EMR/EHR) - All data in
EMR/EHR Shall be considered Protected health data and shall be

governed by
established rules for acces:

authentications, storage and auditing, and transmittal.

SECTION 12.1, Disclosure — Disclosure of and accessibility to protected data
in EMR/EHR Shall be limited and standardized following international and local rules
and regulation, Patients may secure a copy of their EMR/EMR upon request and shall
Provide informed consent if their EMR/EHR is shared with third partice except when



these are processed for the production of a
insurance claims based on established
concerns and national security.

iggregate health statistics, for social health
guidelines, for public health emergency

SECTION 12.2. Covered Entities — covered entities may disclose protected
health information to law enforcement Officials performing their Official duties and

responsibilities as required by existing national and local laws and with proper order
from duly concerned bodies,

SECTION 13, Standards of Care — The Standards of Care to be provided shall
be based on established Clinical or service guidelines and services given must be the
same regardless of whether a healthcare provider provides healthcare services in
Person or electronically. The primary accountable for the healthcare delivery shall be
the attending physician. eHealth shall not replace health care providers providing
Services in person or relegate them to less important role in the delivery of

healthcare, The fundamental healthcare provider-patient relationship is not only to
be preserved but also augmented and enhanced,

ARTICLE V
STANDARDS AND INTEROPERABILITY

eHealth systems and servic
health delivery, personal

5 can potentially transform healthcare through mobile
ed medicine, and social media eHealth applications.
Reaching the potential for advancements in eHealth will only be achieved through
information and communication technology standards efforts that facilitate
interoperability among systems and devices, of the developing world, and leverage

Gristing ubiquitous technologies such as social media applications and mobite
devices.

SECTION 14. Standards — Standards shall be introduced and imposed to
facilitate interoperability among systems and devices, provide unqualified privacy
and security and to address the unique needs. This must be complied with by various
Providers, centers, and systems developers to enable consistent and accurate
collection, and exchange of health information across health swstems and Services.
The appropriate Committee as may be defined in this Act shall define and regularly
update, and impose standards for interoperability among various eHealth systems
and services and shall ensure wide dissemination for easy access of all concerned

SECTION 15. Interoperability framework- The eHealth interoperability shall
be defined and must be in consonance to ational eGovernment interoperability
framework and established internal standards.


SECTION 16. Secure Health Information Exchange (HIE) - The DOH, DCS
DICT and Philllealth shall establish a secured health information exchange using a
common trust framework and a common set of rules which serves as the foundation
for electronic information exchange across geographical and health-sector
boundaries. The HIE includes the physical infrastructure, standards, core services,
and applications that will strengthen the national eHealth environment.

SECTION 17. Establishment and Accreditation of eHealth Centers and
clealth Practitioners — ‘The Act shall ensure that telchealth centers are
srutegically organized across the country within three (3) years upon enactment of
this law to ensure that telehealth practitioners are sufficiently equipped with skills
for the ethical safe practice of telehealth. Regional Telehealth Centers shall be

stablished. No telehealth center shall be allowed to operate unless it has been duly
accredited based on the standards set forth by the DOH. The Department of Health
shall be the lead agency for the accreditation for the facilities as Telehealth centers,
whereas the Professional Regulatory Commission shall be the lead agency for the
accreditation of the Telehealth Practitioners in close coordination with the National
ellealth Steering Committee. Practitioner shall be accredited by the PhilHealth for

reimbursement purposes. A Telehealth Center shall
requirements:

I have the following minimum

lipped with the needed applications suitable for telehealth in the
country;

b. Be supervised and staffed by trained personnel: and

Undergo periodic unannounced inspection by the DOH in, order to
evaluate and ensure quality telehealth center performance

ARTICLE VI
INFRASTRUCTURE

SECTION 18. ICT Infrastructure — ‘The
implement eHealth system and services shall
infrastructure plan and standards.

required ICT infrastructure to
conform to the national ICT

SECTION 19, Medical Devices and eHealth Solut
connects existing or new medical devices and gate
to ensure seamless data transfers. ba:
standards and standardization of EHR/E!

ns ~ Software platform that
ways shall be defined and regulated

ed on established industry and national
AR.

SECTION 20. Telehealth Centers Database — All telche:
originating sites shall coordinate with DOH for consolid
DOH shall maintain and manage a national database for
wellas health and medical education exchanges,

‘alth centers and
lation of pertinent databases.
consults on clinical cases as


SECTION 21, National Health Databases and Data Warehouse — The DOH
shall spearhead the maintenance and management of a secured and protected national
health database and national health data warehouse or defined shared EMIR/ EHR and

Of consultations on clinical cases as well as health and medical education exchanges
end other eHealth applications.

ARTICLE VIL
HUMAN RESOURCES

SECTION 22. Human Resources ICT Competencies — Minimum ICT or
ellealth competencies shall be established and imposed to medical and paramedical

Professionals practicing eHealth and be part of the medical and allied medical
curricula.

SECTION 23. Capability Building Plans & Policies — Human resource plans
and policies shall be fully taken into account any unique human resource and
Operations requirement involved in delivering Telehealth

and Telemedicine. The
following are to be considered

(a) Licensable health care professionals must a valid Philip

license based
on the requirement of the Professional Regul:

lation Commission (PRC);

(b) Appropriate policies concerning cases wherein a licensed telehealth

Practitioner in the Philippines intending to provide telchealth services to
Patient in another country should _be in place;

(c) In any event, a telehealth center should have
ensure that all relevant staff have the aj
safe telehealth services; and

policies and procedures to
ppropriate competencies to practice

(d) Telehealth centers should ensure r

egular review of human resource plans
and policies related to telehealth and telemed.
ARTICLE VIL
STRATEGY AND INVESTMENT

SECTION 24, eHealth Strategic Framework -
development and monitoring of strategic framework
implementation eHealth Systems and Services,

The DOH shall spearhead the
and plans to serve to guide the

SECTION 25, Monitoring Evaluation System — establishment of a robust

meric for monitoring and evaluation for eHealth to assess and analyze the impact of
ellealth systems and services.



SECTION 26. Appropriation - The amount necessary to carry out the
provisions of this Act shall be included in the General Appropriation of the year
following its enactment into a law thereafter,

SECTION 27. Financing eHealth Services - Financing for applicable eHealth
services by Philliealth and other partners, as defined by the National ellealth Steering
Committee

SECTION 28. Private Sector participation — The government shall encourage
Private sectors investment on eHealth systems and services subject to existing laws
and regulation through the appropriate government agencies and must be compliant
to the established national eHealth systems and services

ARTICLE IX
RESEARCH AND DEVELOPMENT

SECTION 29. Research and Development — The DOI, in coordination with
POST and DICT, the specialty societies and boards, the academe, and other research
institutions shall regularly endeavor to evaluate existing tools and technologies used
for ellealth to ensure the cost efficiency, appropriateness, safety and equality of

services provided to the patients in particular, and the health sector in general towards
this end, it shall

a. Develop the Research Agenda:
. Establish centers of excellence for eHealth research that will endeavor to

produce high quality research on distance learning for basic and continuing
professional education; and

Provide access to current specialized, accredited Knowledge for clinical
care, public health, other health research publications and databases.

SECTION 30. Funding Source for Research Devel
budget shall exceed 5% of the funding sources of the followi
a. Department of Health;

b. Department of Science and Technology; and
© Department of Information and Communication Technology.

lopment — The research
ing government agencies:

ARTICLE X
FINAL PROVISIONS

SECTION 31, Rules and Regulations — within ninety (120) days from the
{pProval of this Act, the Secretary of Health, after consultation with the DOST, Dict,
University of the Philippines - Manila, PhilHeaith, CHED, medical and paramedical
assotlations and societies and other stakeholders, shall promulgate the rules and
regulations implementing the provisions of this Act.


SECTION 32. Separab 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 33. Repealing Clause — All general and special
executive orders, proclamations and
which are inconsistent with this A
accordingly,

jaws, decrees,
administrative regulation, or any parts thereof
ict are hereby repealed, amended or modified

SECTION 34, Effectivity - This act shall take effect fifteen (15) days after
publication in the Official Gazette o1

a newspaper of general circulation

Approved,

4