Page | 1 
Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City 
Nineteenth Congress 
First Regular Session 
HOUSE BILL NO. __________ 
__________________________________________________________________________ 
Introduced by Representative JOEY SARTE SALCEDA 
__________________________________________________________________________ 
AN ACT 
ESTABLISHING THE PHILIPPINE ELECTRONIC HEALTH OR 
eHEALTH SYSTEM AND SERVICES IN SUPPORT OF UNIVERSAL 
HEALTH CARE, AND APPROPRIATING FUNDS THEREFOR 
EXPLANATORY NOTE 
The COVID-19 pandemic was the ultimate stress test for the public health system. It 
emphasized vulnerabilities in urgent need of change and action. One such area is the remote 
delivery of health services. Because our conventional health resources were occupied with 
pandemic treatment and management, most other medical needs have been sidestepped, both 
essential processes and elective procedures. 
The following findings lead us to the need for a framework for the development of electronic 
health systems in the country: 
The lack of primary care, specialty providers, and transportation are significant barriers full 
implementation of universal health care.  
There are glaring geographical disparities are far as the distribution of basic medical facilities 
are concerned. The number of hospital beds per 100,000 persons is a quick illustration of such 
disparities, and the inequities in access to healthcare that such disparities create. 
Hospital beds per 100,000, 2016 
Area 
Hospital beds 
per 100,000 
NCR 
23.1 
Rest of Luzon 
8.2 
Visayas 
7.8 
Mindanao 
8.3 
PHILIPPINES 
10.1 
Sources: Philippine Statistics Authority, 2016; Department of Health-HFSRB, 2016 
July 1, 2022
8:00 am
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Accentuating geographic disparities in facilities is access to health professionals. Parts of the 
country have difficulty attracting and retaining health professionals and supporting local health 
facilities to provide a continuum of health care.  
Health workers in institutions per 10,000 population, 2017 
Region 
Doctors Nurses Midwives 
Medical 
Technologists 
NCR 
10.6 
12.6 
3.3 
3.2 
CAR 
6.4 
15.8 
9.9 
2.2 
I 
4.0 
11.2 
5.6 
1.4 
II 
3.4 
12.1 
6.9 
1.4 
III 
3.6 
7.5 
3.J
1.2 
IV-A
2.8 
6.5 
2.J
0.6 
IV-B
1.9 
5.8 
5.2 
0.6 
V 
2.5 
7.8 
5.1 
0.9 
VI 
3.1 
7.2 
4.9 
1.0 
VII 
3.1 
10.4 
4.3 
1.3 
VIII 
2.6 
7.0 
4.1 
1.3 
IX 
2.6 
9.5 
4.8 
I.I
X 
2.9 
9.3 
5.2 
0.9 
XI 
3.0 
7.1 
3.0 
1.0 
XII 
2.3 
7.6 
48 
1.0 
CARAGA 
2.1 
7.9 
5.J
1.1 
ARMM 
0.9 
4.2 
2.6 
0.3 
Philippine
s 
3.9 
8.6 
4.1 
1.3 
Source: The Philippines Health System Review, WHO 
While the “Doctors for the Barrios” programs and similar initiatives have encouraged heroic 
individuals to serve in underserved communities, clearly, a systemic solution is both a necessity 
and, given the high penetration rate of cellphones in the country, an opportunity. Universal 
health care should not be dependent on the individual virtue and heroism of doctors, but on 
virtuous systems. 
An even more unacceptable fact is that Filipinos are often one serious sickness away from 
poverty, and lack of access to primary care that could have been provided by telehealth facilities 
(such as early and timely check-ups) make health care costs for even initially curable diseases 
expensive.  
A 2013 study suggests that about 1 million Filipinos fall into poverty every year due to out of 
pocket expenses1. 
1 Ulep VGT, Dela Cruz NA (2013). Analysis of out-of-pocket expenditures in the Philippines - Policy Notes. 
Philippine Institute for Development Studies (https://think-
asia.org/bitstream/handle/11540/6839/pidspn1621. pdf?sequence=1, accessed 18 July 2018). 


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Opportunities for telemedicine and eHealth 
The market statistics and research company Statista estimates that this year, some 75.66 million 
Filipinos have access to a smartphone2. This very high smartphone penetration rate (almost 
70%) is an opportunity to link a high-access technology with a low-access service (healthcare). 
There are already existing telemedicine facilities in the country, such as the National Telehealth 
Center. There are also private-sector initiatives, but these are primarily in the business process 
outsourcing (BPO) sector, and whose services are available primarily to persons living abroad. 
The stunted growth of telemedicine is in part due to regulatory uncertainty. There is not yet an 
existing telemedicine and eHealth framework in the country. 
This bill aims to address this vacuum in regulatory framework by instituting a national policy 
framework for the regulation and promotion of eHealth as an industry and as a dependable 
health service system. 
The bill has the following main areas: 
1. Establishes the components of electronic health systems;
2. Identifies the structure for leadership and governance of the sector, identifying the
Department of Health (DOH) as its primary regulator, and setting fundamental policies
for coordination and governance of the sector;
3. Enables and regulates eHealth services and solutions;
4. Sets basic sector standards and mechanisms for interoperability with conventional and
other modes of healthcare service delivery, by defining standards of eHealth systems
and services, and promoting synergies between different modes;
5. Sets mechanisms for policy making, monitoring, and compliance, including the
formulation of required policies, guidelines and compliance mechanisms to support the
attainment of the quality and acceptable eHealth systems and services. This would also
make telehealth services accredited with PhilHealth;
6. Promotes and regulates the necessary health and supporting infrastructure;
7. Lays the regulatory foundations for human resources in the eHealth system;
8. Develops a framework for strategy and investment in the eHealth sector; and
9. Identifies strategies for industry development, such as promoting the accreditation of
eHealth with insurance providers, training medical and non-medical support personnel,
and ensuring eligibility to industry-promoting incentives, among others.
Optimization of national health outcomes 
Because the Philippine Health Insurance Corporation (PhilHealth) will be able to access a 
significant volume of timely patient data digitally, telehealth, especially if they make primary 
care more accessible, would help the country’s health policymakers optimize the country’s 
health outcomes. Health policy will be able to benefit from data-driven decisions. 
As telehealth leaves an electronic record of patient care, it is also less susceptible to fraud. 
Together with patient data, which would also make PhilHealth’s actuarial projections more 
2 https://www.statista.com/statistics/558756/number-of-mobile-internet-user-in-the-philippines/ 


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robust, these benefits will be immensely favorable for the sustainability of the country’s 
national health insurance program. 
Finally, the establishment of telehealth facilities will provide livelihood opportunities for the 
country’s health professionals without having to displace them physically to high-demand, 
high-wage areas. 
As a mode for delivering universal health care, eHealth optimizes the country’s strength in ICT 
and mobile phone penetration as well as its growing health BPO industry. By leveraging the 
country’s unique strengths to address a weakness in the country’s human capital development 
strategies, this bill yields health, economic, and social synergies that have not fully developed 
in the absence of a concrete regulatory framework. 
In view of the foregoing, the approval of this bill is urgently sought. 
JOEY SARTE SALCEDA 


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Republic of the Philippines 
HOUSE OF REPRESENTATIVES 
Quezon City 
Nineteenth Congress 
First Regular Session 
HOUSE BILL NO. __________ 
__________________________________________________________________________ 
Introduced by Representative JOEY SARTE SALCEDA 
__________________________________________________________________________ 
AN ACT 
ESTABLISHING THE PHILIPPINE ELECTRONIC HEALTH OR 
eHEALTH SYSTEM AND SERVICES IN SUPPORT OF UNIVERSAL 
HEALTH CARE, AND APPROPRIATING 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 “eHealth System and Services 
Act”. 
SEC. 2. Declaration of Policies. – It is the policy of the State to protect and promote the 
right to the health of all Filipinos and instill health consciousness among them. Toward this 
end, the State shall institutionalize a system of providing wide access to quality health 
information and services using information and communication technology (ICT), referred to 
as the National eHealth System (NeHS), resulting in better health outcomes for every 
Filipino, and further recognizing whole-of-society and whole-of-government approaches. 
The NeHS shall be integrated, comprehensive, interoperable, progressive, 
secure and sustainable based on best current and future 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 supplemental and complementary 
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 on health data and education, especially in medically unserved and 
underserved geographically isolated and disadvantaged areas (GIDAs). 
SEC. 3. Objectives. – This Act shall provide a holistic framework that establishes a NeHS, 
which shall: 
a) Set policies, standards, priorities, plans, programs and projects that promote
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and ensure streamlined and safely regulated delivery of eHealth services to reduce 
inequalities, achieve universal health care, and better health outcomes; and 
 
b) Clarify roles of agencies, institutions, and entities regarding their 
performance and accountabilities in building national and local eHealth capacity and 
measuring results. 
 
SEC. 4. Scope and Application. – This Act covers all existing health care providers and 
 other entities developing and using eHealth systems, services and applications and tools, 
whether public or private, 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 means of access to information. 
 
SEC. 5. Definition of Terms. – As used in this Act: 
 
 a) Compliant eHealth services and applications refer to the requirements of a 
defined architecture of eHealth standards that enable services and systems, allow for 
interoperability of health services and information exchange across geographic, 
organizational, network, vendor boundaries, and ensure data protection in accordance with 
Republic Act (R.A.) No. 10173, otherwise known as the “Data Privacy Act” and other related 
laws and issuances; 
 
b) eHealth or Electronic health refers to the use of cost-effective and secure 
information and communications technology for health care practice, also referred to as 
digital health; 
 
c) eHealth data services refer to key architectural data registries of the health 
sector needed to enable and support large scale health information interoperability and 
exchange; 
 
d) eHealth System refers to the interplay of enabling and foundational 
elements essential for a successful national eHealth implementation, namely, (1) governance 
and accountability, (2) standards and interoperability, (3) services and operations, (4) 
telehealth, (5) human resources, (6) infrastructure, (7) strategy and investment, (8) 
monitoring and compliance, and (9) research and development; 
 
e) eHealth services and applications refer to the solutions, products and 
innovations with defined objectives to serve its intended clients or users, such as health 
information systems, electronic medical record systems, electronic health record  system,  
enterprise  resource  planning  system,  ePharmacy  system, laboratory system, radiology 
system, electronic prescription system, human resource  information  system,  registry  
systems,  mobile  health,  telehealth, telemedicine, wearables, and biomedical and related 
devices with ICT component; 
 
f) Electronic health record (EHR) refers to a computerized health record 
used to capture, store, access and share information of a patient between and across health 
care providers and health-related entities; 
 
g) Electronic medical record (EMR) refers to a computerized medical record 
used to capture, store and share information of a patient to health care providers in an 
institution or organization; 
 
h) Electronic prescription (ePrescription) refers to a system that allows 
healthcare providers to write and send prescriptions in an automated or electronic way to a 
pharmacy with capability to receive such; 
 
i) Geographically isolated and disadvantaged areas (GIDAs) refer to 


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barangays specifically disadvantaged due to the presence of both physical and socio-
economic factors. For a barangay to be classified as GIDA, both physical and socio-economic 
factors must be present; 
 
 1. Physical factors are characteristics that limit the delivery of and/or access to 
basic health services to communities that are difficult to reach due to distance, weather 
conditions, and transportation difficulties; 
 
 2. Socio-economic factors are social, cultural, and economic characteristics of 
the community that limit access to and utilization of health services; 
 
j) Health sector enterprise architecture refers to the blueprint on which 
eHealth services and applications shall be developed, implemented, and scaled up; and 
 
k) Information and communications technology refers to all technologies 
for the communication of information, which include data, application or information 
systems, internet, network, connectivity, telecommunications, among others. 
 
SEC. 6. Implementing Agency. – The Department of Health (DOH) shall be the lead 
implementing agency to carry out the provisions of this Act. The DOH shall strengthen and 
transform its existing Knowledge Management and Information Technology Service 
(KMITS) into a full-fledged Bureau, to be called as the National eHealth Information and 
Services Bureau (NeHISB), and which shall perform the overall management and 
administration of this Act. The additional plantilla position to be created for this purpose shall 
be submitted to the Department of Budget and Management (DBM) for evaluation and 
approval. 
 
The Bureau shall also serve as a secretariat of the eHealth Policy and Coordination 
Council as provided in Sec. 8 hereof. 
 
SEC. 7. Regional and Local Implementation Structures and Staffing Pattern. – To assist 
In the implementation of this Act, the regional organizational structures shall be lodged under 
the Center for Health Development of the DOH while local organizational structures shall be 
subject to the discretion of the local government units (LGUs) in relation to Section 76 of 
R.A. No. 7160 or the “Local Government Code of 1991.” 
 
 
ARTICLE II 
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, 
hereby referred to as the Council, 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) Secretary, DOH – Chairperson 
b) Secretary, DICT – Co-Chairperson 
c) President & Chief Executive Officer, PhilHealth – Co-Chairperson 
d) Secretary, DOST; 
e) Secretary, Department of Social Welfare and Development (DSWD); 
f) 
Secretary, Department of Interior and Local Government (DILG); 
g) Secretary, DBM; 


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h) Chancellor, University of the Philippines – Manila (UPM); 
i) 
Chairman, Professional Regulation Commission (PRC); 
j) 
Chairperson, Commission on Higher Education (CHED); 
k) Chairperson, National Privacy Commission (NPC); 
l) 
National Statistician, Philippine Statistics Authority (PSA); 
m)  Two (2) representatives from professional medical or health societies; 
n) One (1) representative from patients’ group; and 
o)   One (1) representative from the ICT industry associations. 
 
 
The heads of government agencies may be represented by a designated official whose 
rank shall not be lower than Assistant Secretary or its equivalent. Members representing the 
private sector shall be appointed by the President of the Philippines not later than thirty (30) 
days after the effectivity 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. 
 
The government agency-members of the Council shall have the authority to act upon 
and decide on all urgent matters pending the formation of the Council and the appointment of 
members from the private sector by the President of the Philippines. 
 
SEC. 9. Powers and Duties of the Council. – The Council shall exercise the following 
powers and functions: 
 
a) 
Define and promote over-all eHealth policies, standards and regulations at 
all levels of health care system, public and private; 
 
b) 
Ensure integration and coordination of national and local eHealth 
strategies and initiatives; and 
 
c) 
Submit yearly assessments and accomplishment reports to the Senate 
Committee on Health and Demography and the House of Representatives Committee on 
Health for performance monitoring and evaluation. 
 
SEC. 10. Ensuring Broader Participation in eHealth Implementation. – 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. Setting up of the 
sub-structures or mechanisms shall be in accordance with R.A. No. 11223, otherwise known 
as the “Universal Health Care Act” and other related issuances. 
 
 
ARTICLE III 
STANDARDS AND INTEROPERABILITY 
 
SEC. 11. Health Sector Enterprise Architecture. – The NeHS shall be operated within the 
health sector enterprise architecture that aligns and ensure that health and health-related data 
are made available and accessible anytime and anywhere to various stakeholders, business 
processes for health are streamlined and integrated, and services and applications are usable, 
safe, efficient and effective, following the health care business model provided under R.A. 
No. 11223, otherwise known as the “Universal Health Care Act” and other related issuances. 
 
Rationalization for safety and cost effectiveness, scope and standards for design and 
use of technologies in the health sector shall also be defined in this architecture. All health 
care providers and health-related entities shall adopt a health enterprise architecture as 


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defined and guided by the Council. 
 
SEC. 12. Standards Compliance. – All health care providers and health-related entities shall 
comply with the data standards 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, health care provider 
identifiers, and terminology and messaging standards, and shall be in accordance with the 
Philippine eGovernment interoperability and data security framework, and other relevant 
standards. 
 
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 business processes and data services in the health 
sector as laid out in the Health Sector Enterprise Architecture which shall comply with 
regulatory requirements and may be subjected to health technology assessment. 
 
SEC. 14. Scope of eHealth Services and Applications. – eHealth services shall include the 
following areas: 
 
a) 
Mandatory eHealth Data Services: 
 
1) Master Person Index 
 
2) Master Provider (Human Resources) Index 
 
3) Master Facility Index 
 
4) Terminology or Health Services Registry 
 
5) National Immunization Registry 
 
 
b) 
Compliant eHealth Services and Applications: 
 
1) Electronic Health Record/Electronic Medical Record 
 
2) Health Information Exchange 
 
3) Health Facility Operations and Management 
 
4) Disease Registries 
 
5) TeleHealth/TeleMedicine 
 
6) Human Resources in eHealth 
 
7) Supply Chain Management 
 
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- 


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related devices, the PRC and the DOH, in consultation with PhilHealth, UPM–National 
TeleHealth Center, DICT, academia, medical and specialty societies, non-government 
organizations, and the private and business sectors, shall set the standards of practice and 
implement a certification mechanism for health care providers and health-related entities 
providing telehealth services. 
 
ARTICLE VI 
HUMAN RESOURCES 
SEC. 17. Human Resource in eHealth. – Health care professionals shall plan, design, build, 
operate, use, maintain and support eHealth services applications. The DOH, PRC, CHED, 
DICT, and Technical Education and Skills Development Authority (TESDA), 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 for eHealth Development Plan. – The DOH, PRC, CHED, and 
TESDA shall formulate the Human Resource for eHealth Development Plan which shall 
develop new curricula, integrate changes in existing curricula, create formal and non-formal 
training programs, and continue professional development programs concerning the practice 
of eHealth. There shall also be creation of personnel services items, 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 VII 
INFRASTRUCTURE 
SEC. 19. ICT Infrastructure. – The DICT, in coordination with DOH, PhilHealth, and 
DOST, 
shall establish and maintain the necessary national ICT infrastructure to implement eHealth 
services and applications. 
 
SEC. 20. National eHealth Data Center. – The PhilHealth, in coordination with the DOH, 
DICT and DOST, shall establish and maintain the National eHealth Data Center, and 
implement an agile and sustainable data management and governance framework and system 
in support of 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 VIII 
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 the NeHS. 
 
SEC. 22. Financing the eHealth Strategic Framework and Plan. – Financing for the 


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NeHS 
by DOH, PhilHealth and other partners, as defined by the Council, shall be made available to 
scale up eHealth implementation at the national level. 
 
SEC. 23. Private Sector Participation. – The DOH shall promulgate rules regarding the 
participation of the private sector, including public-private partnerships, and other suitable 
arrangements, in the provision of eHealth services, applications, and ICT infrastructure. 
 
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 R.A. 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, PRC, CHED, DICT, PhilHealth, UPM – National 
TeleHealth Center, academia, regional health research consortia, medical and specialty 
societies, non-government organizations, and the private and business sectors, shall ensure 
the development of new eHealth services and applications 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, including 
creation of formal and non-formal capability building programs for the development of a pool 
of eHealth researchers and innovators, which are aligned with the research agenda; 
 
c) Establishment and strengthening of centers of excellence of eHealth policy 
studies, research and development; and 
 
d) Establishment and adherence of mechanisms that strengthen eHealth 
innovation research and strategy to the health technology assessment process as provided 
under R.A. No. 11223, otherwise known as the “Universal Health Care Act,” and that 
integrate explicit use of evidence into the policy and decision-making process and national 
eHealth standards, and support the growth of research consortia on eHealth; 
 
 
A separate unit within the PCHRD shall handle and manage eHealth related activities 
and programs. The human resource requirement of such a unit shall be determined by 
PCHRD in consultation with the DOH, CSC and DBM. 
 
ARTICLE XI 
ADMINISTRATIVE PENALTIES 
 
SEC. 26. Rules and Procedures for 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 NeHS. 


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ARTICLE XII 
MISCELLANEOUS PROVISIONS 
 
SEC. 27. Appropriations. – The amount necessary for the implementation of this Act shall 
be included in the Annual General Appropriations Act. 
 
SEC. 28. Implementing Rules and Regulations. – Within one hundred eighty days (180) 
days from the effectivity of this Act, the Secretary of DOH, shall, after consultation with the 
Secretaries of DICT and DOST, the President and Chief Executive Office of PhilHealth, the 
Chancellor of UPM, the Chairman of the PRC, the Chairperson of CHED, the National 
Statistician of PSA, and representatives of medical and paramedical associations and 
societies, and other stakeholders, promulgate the necessary rules and regulations 
implementing the provisions of this Act. 
 
SEC. 29. 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 DOH for health 
information technology shall be completed within six (6) months from the promulgation of 
the Implementing Rules and Regulations 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. 30. Separability Clause. – If 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. 31. Repealing Clause. – All general and special laws, decrees, executive orders, 
proclamations and administrative regulation, or parts thereof which are inconsistent with this 
Act are hereby repealed, amended and modified accordingly. 
 
SEC. 32. Effectivity. – This Act shall take effect fifteen (15) days after its publication in the 
Official Gazette or in a newspaper of general circulation. 
 
Approved,