SEVENTEENTH CONGRESS OF THE )
REPUBLIC OF THE PHILIPPINES )
Second Regular Session )

HOUSE OF REPRESENTATIVES
HOUSE BILL No. 7153

INTRODUCED BY REP. VICTOR A. YA!

AN ACT
ESTABLISHING THE PHILIPPINE eHEALTH SYSTEM AND SERVICES IN
THE DELIVERY OF HEALTH SERVICES WITH THE USE OF
INFORMATION AND COMMUNICATIONS TECHNOLOGY AND
APPROPRIATING FUNDS THEREFOR

EXPLANATORY NOTE

Article XIII, Section 11 of the 1987 Constitution provides that “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. There shall be priority for the needs of the under-privileged,
sick, elderly, disabled, women, and children. The State shall endeavor to provide free
medical care to paupers.”

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 health systems and
services (58th World Health Assembly, 2005; Geneva, Switzerland).

Under the Philippine Health Agenda (PHA) Strategy, ACHIEVE, “I” is to “Invest
in cHealth 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 bill aims to establish, institutionalize, and regulate a coherent, cordoned and
collaborative National eHealth System, guided by a national policy and strategic
framework. This measure will help streamline and address issues on provision, access,
availability, accountability, patient rights, electronic health data, security, information
exchange, among others. It is a revolutionary attempt to modernize the health sector in
the country by utilizing ICT to deliver medical services to the unserved and underserved
population particularly those in the provinces.

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

REP. VICTOR A. YAP
Second Distfict, Province of Tarlac


SEVENTEENTH CONGRESS OF THE )
REPUBLIC OF THE PHILIPPINES )
Second Regular Session )
HOUSE OF REPRESENTATIVES
HOUSE BILL NO. ‘7153

INTRODUCED BY REP. VICTOR A. YAP

AN ACT
ESTABLISHING THE PHILIPPINE eHEALTH SYSTEM AND SERVICES IN THE
DELIVERY OF HEALTH SERVICES WITH THE USE OF INFORMATION AND
COMMUNICATIONS TECHNOLOGY AND APPROPRIATING — FUNDS
THEREFOR

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

of the

ARTICLE I
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 healthcare
services through electronic means using Information and Communication Technologies (ICT)

or eHealth resulting in improved health outcomes for every Filipino.

SECTION 3. Objectives — The eHealth 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 Services shall be comprehensive, integrative,
sustainable, measurable, synchronized, interoperable, and progressive based on best 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 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

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and education, especially in medically unserved and underserved geographically
isolated and disadvantaged areas (GIDAS),

b) utilize ICT to deliver health services which has the potential to lessen costs, improve
quality, change the conditions of practice, and improve access to healthcare,
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 regulations regarding the 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 sharing and use health and medical information to improve care as
well as public access to relevant information for the promotion of their own personal

health.

SECTION 4. Definition — For purposes of this Act the following definition shall apply

a) “Act” refers to the Philippine eHealth Systems and Services Act;

b) “Distant Site” refers to the site where a healthcare provider is located while providing

these services via telecommunication systems;

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

4) “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,


°)

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“Information and Communications Technology (ICT)” refers to the following:

1. Compressed digital interactive video, audio, or data transmission;
Real-time synchronous video or web-conferencing communications;
Secure web-based communication;

Still image capture or asynchronous store and forward; and

when

Modem smart medical devise use for diagnosis and healthcare services.

"Institutional Healthcare Provider" refers to an organization or institution that provides
healthcare 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;

“Originating site" refers to the site where the patient is located at the time of provision

of healthcare services through telecommunication systems;

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

"Licensable Healthcare Professionals" refer to healthcare professionals applying for

the license to practice telehealth services;

“eHealth Practitioner" refers to any healthcare provider;

“Health Center" refers to a health agency involved in a Telehealth System;

"eHealth systems" refers to an organized and structure application of eHealth,
integrated in the regular workflow of healthcare facilities;

"Telehealth" means the delivery of health-related services and information via
telecommunication technology. It encompasses preventive, promotive, curative, and
palliative aspects;


CwrIraHeon

n) "Telemedicine" means the use of telecommunication technology to provide healthcare
services from a distance which focuses more on the curative/treatment aspect.

0) “Unserved and underserved areas" refer to communities such as those isolated due to
distance, 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 — This 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 healthcare provider or authorize delivery of healthcare services in any manner
not authorized by law. It shall cover all other eHealth solutions and services including
relevant standard equipment in the field of health and ancillary services that uses ICT and are
complementary to existing minimum modalities or standards of healthcare and other access to

information.

ARTICLE I
LEADERSHIP AND GOVERNANCE

SECTION 6. Lead Agency — The Department of Health (DOH) shall be the lead agency in
implementing this Act. For purpose of achieving the objectives of the Act, the DOH shall:
a) Establish an inter-agency and multi-sectoral National eHealth Steering Committee;

'b) Spearhead the establishment of a National eHealth System and Service;

c) 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) and various health services
providers and facilities including the academe and patient groups, and other
stakeholder; and

d) 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 DOH offices and attached agencies including the local

government units and the private sector.


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SECTION 7. National eHealth Steering Committee — To ensure the implementation of
this Act and to serve as an executive body of the Philippine eHealth System and Services
(PNeHSS), the National eHealth Steering Committee shall be created and made an integral
part of the DOH.

The Secretary of the Department of Health shall act as Chairperson.
The following will serve as members
a) Secretary, Department of Science and Technology;
b) Secretary, Department of Information and Communication Technology;
Secretary, Department of Social Welfare and Development;
4) Secretary, Department of Interior and Local Government;

©)

President and Chief Executive Officer, Philippine Health Insurance Corporation;
£) Chancellor, University of the Philippines — Manila;
g) Commi

ioner, Professional Regulatory Commission;
h) Commissioner, Commission on Higher Education;

i) Commissioner, National Privacy Commission;

j) Commissioner, National Anti-Poverty Commission;
k) President, Philippine Hospital Association;

}) President, Philippine Medical Association;

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President, Philippines Nurses Association;
n) President, Philippine Pharmacists Association;

0) A representative from the Association of Municipal Health Officers/PHO/CHO; and
‘Two (2) representatives from a duly organized patient group

z

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, regulations, and ethical frameworks pertinent to
use, practice and provision of eHealth services;

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

c) 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;


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e) Set and develop policies and programs for the further advancement of eHealth, and
impose necessary regulatory mechanisms including penalties upon hearing and
deciding cases;

f) Create Technical Working Group, other Committees, and Experts Group to assist in
the development of the eHealth Projects;

g) Create or identify the Telehealth Licensing and Regulatory mechanisms and body to
implement the provisions of this Act;

h) Submit yearly assessments to the Senate Committee on Health and House of
Representatives Committee on Health; and

i) Convene at least twice a year.

ARTICLE Il
eHEALTH SERVICES AND SOLUTIONS

SECTION 8. Service and Application— The National eHealth System shall provide
tangible means for enabling services and systems including access to, exchange and
management of information and content for the general public, patients, providers, insurance,
and others which may be supplied by government or private businesses.

SECTION 9. Scope of eHealth Services and Solutions — eHealth is an umbrella term that

covers the following areas:
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 services and information via
telecommunication technology. It encompasses preventive, promotive, curative, and

palliative aspects

c) "Telemedicine" means the use of telecommunication technology to provide healthcare

services from a distance; focuses more on the curative/treatment aspect.

d)

"Electronic learning or e-learning" refers to learning utilizing electronic technologies

to access educational curriculum outside of a traditional classroom.

e) "Electronic Medical Record/Electronic Health Record" refers to software systems that

contains encoded form of documentation of patients’ health information.


£) "Electronic prescription or e-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 mHealth” 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.

j) "Health Information Exchange" refers to the solution which enables data sharing and
exchange between healthcare providers and facilities, and support access to the
patient's record across providers in many geographic areas of the country.

k) "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 10. Telehealth and Telemedicine Services — Telehealth is an approach of
providing healthcare services and public health with the use of ICT to enable the diagnosis,
consultation, treatment, education, care management, and self-management of patients at
distance from health providers. However, it shall not be understood to modify the scope of
medical practice or any healthcare provider or authorize the delivery of healthcare service in a
setting or manner not otherwise authorize by the law.

SECTION 11. Electronic Medical/Health Record (EMR/EHR) - All data in EMR/EHR
shall be considered protected health data and shall be governed by established rules for

access, authentications, storage and auditing, and transmittal.


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SECTION 11.1. Disclosure — Disclosure of and accessibility to protected data in
EMR/ERR shall be limited and standardized following international and local rules
and regulation, Patients may secure a copy of their EMR/EHR upon request and shall
provide informed consent if their EMR/EHR is shared with third parties except when
ics, for social health

these are processed for the production of aggregate health stati
insurance claims based on established guidelines, for public health emergency

concerns and national security

The Data in the EMR/EHR shall be encrypted and any unauthorized access of
EMRVERR shall be punishable under the Data Privacy Act.

SECTION 12. Creation of EMR/EHR —EMRVEHR can be created by the following
professionals if it is necessary for the medical care of the patients

1. Doctors;

2. Dentists;

3. Pharmacists, pharmacist assistants, pharmacy engineers;
4. Psychotherapists;

5. Hospital assistants in preparation for their assisting occupation, insofar as this is
permissibly required for their occupational tasks and their access is being carried out
under supervision of the aforementioned persons

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

ARTICLE IV
STANDARDS AND INTEROPERABILITY

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 of the people. 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 systems and services. The appropriate Committee as may be
mandated in this Act shall define and regularly update, and impose standards for


interoperability among various eHealth systems and services and ensure wide dissemination

for easy access of all concerned

SECTION 15. Interoperability framework - The eHealth interoperability shall be defined
and must be in consonance with national eGovernment interoperability framework and

established internal standards.

SECTION 16. Secure Health Information Exchange (HIE) - The DOH, DOST, DICT and
PhilHealth 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 Accredi

ition of eHealth Centers and eHealth

mers — This Act shall ensure that telehealth centers are strategically organized
across the country within three (3) years upon effectivity of this Act to ensure that telehealth
practitioners are sufficiently equipped with skills for the ethical safe practice of telehealth
Regional Telehealth Centers shall be established. 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
eHealth Steering Committee. Practitioner shall be accredited by the PhilHealth for
reimbursement purposes. A Telehealth Center shall have the following minimum
requirements

a) Equipped 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 V
INFRASTRUCTURE

SECTION 18. ICT Infrastructure — The required ICT infrastructure to implement eHealth
system and services shall conform to the national ICT infrastructure plan and standards.


SECTION
existing or new medical devices and gateways shall be defined and regulated to ensure

). Medical Devices and eHealth Solutions - Software platform that connects

seamless data transfers based on established industry and national standards and
standardization of EMR/EHR.

SECTION 20. Telehealth Centers Database — All telehealth centers and originating sites
shall coordinate with DOH for consolidation of pertinent databases. DOH shall maintain and
manage a national database for consultations on clinical cases as well as health and medical

education exchanges

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 EMR/EHR and of
consultations on clinical cases as well as health and medical education exchanges and other

eHealth applications.

ARTICLE VI
HUMAN RESOURCES

SECTION 22. Human Resources ICT Competencies —
competencies shall be established and imposed to medical and paramedical professionals
practicing eHealth and be part of the medical and allied medical curricula

finimum ICT or eHealth

SECTION 23. Capability Building Plans & Policies — Human resource plans and policies
shall fully take into account in delivering Telehealth and Telemedicine. The following are to
be considered:

a) Licensable healthcare professionals must have a valid Philippine license based on
the requirement of the Professional Regulation Commission (PRC),

b) Appropriate policies concerning cases wherein a licensed telehealth practitioner in
the Philippines intending to provide telehealth services to patient in another

country should be in place;

©) In any event, a telehealth center should have policies and procedures to ensure that
all relevant staff have the appropriate competencies to practice safe telehealth

services; and


d) Telehealth centers should ensure regular review of human resource plans and
policies related to telehealth and telemedicine.

ARTICLE VIL
STRATEGY AND INVESTMENT
SECTION 24. eHealth Strategic Framework - The DOH shall spearhead the development
and monitoring of strategic framework and plans to serve to guide the implementation

eHealth Systems and Services

SECTION 25. Monitoring Evaluation System — There shall be established a robust metric

for monit

ring and evaluation for eHealth to assess and analyze the impact of eHealth 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 effectivity.

SECTION 27. Financing eHealth Services - Financing for applicable eHealth services by
PhilHealth and other partners, as defined by the National eHealth Steering Committee shall be
made available.

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.

SECTION 29. Tax Incentive. — Any private corporation that will engage in providing
eHealth services shall not be required to pay any national or local tax within its first two (2)

years of operation.

ARTICLE VIII
RESEARCH AND DEVELOPMENT

SECTION 30. Research and Development — The DOH, in coordination with DOST and
DICT, the specialty societies and boards, the academe, and other research institutions shall
regularly endeavor to evaluate existing tools and technologies used for eHealth 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 a research agenda;

b) 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 31. Funding Source for Research Development — The research budget shall
not be less than 5% of the funding sources of the following government agencies:

a) Department of Health;

b) Department of Science and Technology; and

c) Department of Information and Communication Technology.

ARTICLE IX
LIABILITIES

SECTION 32. LIABILITY OF SUPERVISING PERSONS. — Persons who directly
supervise and control staff members entitled to fill EMR/EHR are liable for injuries
associated with inaccurate or deficient summary reports provided by these staff members.

SECTION 33. LIABILITY OF EHEALTH CENTERS. ~ eHealth centers are liable for
injuries associated with inaccurate or defective treatment caused by their software and
database.

ARTICLE X
FINAL PROVISIONS

SECTION 34. Implementing Rules and Regulations — Within ninety (90) days from the
effectivity of this Act, the Secretary of Health, after consultation with the DOST, DICT,
University of the Philippines - Manila, PhilHealth, CHED, medical and paramedical
associations and societies and other stakeholders, shall promulgate the rules and regulations
implementing the provisions of this Act

SECTION 35. Separabi
to be unconstitutional or invalid, other provisions hereof which are not affected thereby shall

— If any part or provision of this Act shall be declared or held

continue to be in full force and effect.


eI Anew n a

SECTION 36. 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 or modified accordingly.

SECTION 37. Effectivity - This act shall take effect fifteen (15) days after publi
Official Gazette or a newspaper of general circulation

Approved,