Republic of the Philippines ml
HOUSE OF REPRESENTATIVES || DATE December 6, 2022 ()
‘Quezon City

NINETEENTH CONGRESS
First Regular Session

HOUSE BILL No. _6521

Introduced by Representative Joseph Gilbert 20
EXPLANATORY NOTE

‘The 1987 Constitution enshrines the duty of the State to protect and promote the
right to health of the people and instill health consciousness among them. (Art. II, Sec.
15) 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. (Art. XII, Sec, 11)

Inhis State of the Nation Address last July 25, 2022, President Ferdinand Marcos
Jr, stressed the importance of having a strong health care system that is responsive to
the needs of the people especially during crises.

Thus, integrating information and communication technology (ICT) with the
national healthcare system provides an avenue to strengthen the latter. In fact, according
to a 2017 study, “Health information technology presents numerous opportunities for
improving and transforming healthcare which includes; reducing human errors,
improving clinical outcomes, facilitating care coordination, improving practice
efficiencies, and tracking data over time.”!

For this reason, this bill seeks to establish a Philippine Electronic Health
(eHealth) System and services in support of universal health care — which
institutionalizes a system that provides wide access to quality health information and
services using ICT. The same, therefore, shall 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) ~ all for the benefit of the
people. Moreover, the present proponent believes that institutionalizing a national
eHealth system will greatly help the country’s healthcare in the long run, especially with
the many uncertainties that the future holds, including the potential threat of another
pandemic hitting the Philippines.

2 Alotaibi, Y. and Frank Federico. “The impact of health information technology on patient safety’. Saudi Med J
2017; Vol. 38 (12), < https:/Auww.ncbi.nlm.nih.gov/pme/articies/PMC5787626/pdf/SaudiMed)-38-1173.pdf>


This commendable bill was filed in the 18" Congress by Rep. Angelina “Helen”
D.L. Tan, among others. It was approved on the Third Reading and was transmitted to
the Senate; however, the same was not enacted into law. The present proponent is
acknowledging the wisdom and hard work of his predecessors.

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

LBERT F. VIOLAGO



Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City

ETEENTH CONGRESS
First Regular Session

HOUSE BILL NO. _ 6521

Introduced by Representative Joseph Gilbert F. Violago

AN ACT
ESTABLISHING THE PHILIPPINE ELECTRONIC HEALTH SYSTEM AND
SERVICES IN SUPPORT OF UNIVERSAL HEALTHCARE, 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 of 2022”.

SECTION 2. Declaration of Policy. — It ss the policy of the State to protect and promote
the right to 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 eFlealth 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 of health data and education, especially in medically unserved and
underserved geographically isolated and disadvantaged areas (GIDAs).

SECTION 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 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.

SECTION 4. Scope and Application. — ‘This Act covers all existing health care
providers and other entities developing and using cHlealth 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.

SECTION 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” refer to the use of cost-effective and secure
information and communications technology for health care practice, also
referred to as digital health;

¢) “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” refer to the interplay of enabling and foundational elements
essential for a successful national Health 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;

¢) “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 IT component;

1) “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;

2) “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
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 socioeconomic 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. Socioeconomic 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.

SECTION 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
Health 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.

SECTION 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 IL
GOVERNANCE AND ACCOUNTABILITY

SECTION 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) DOH Secretary — Chairperson

b) DICT Secretary — Co-Chairperson

©) PhilHealth President & Chief Executive Officer — Co-Chairperson;
d) DOST Secretary;

¢) Department of Social Welfare and Development (DSWD) Secretary:
£) Department of Interior and Local Government (DILG) Secretary;

2) DBM Secretary:

h) University of the Philippines-Manila Chancellor;

i) Professional Regulation Commission (PRC) Chairperson;

j) Commission on Higher Education (CHED) Chairperson;

k) National Privacy Commission Chairperson;

}) Philippine Statistics Authority National Statistician;

1m) Two (2) representatives from professional medical or health societies;
1n) One representative from patients” groups; and

0) 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.

SECTION 9. Powers and Duties of the Council. - The Council shall exercise the
following powers and functions:

a) Define and promote overall cHealth policies, standards, and regulations at all
levels of health care system, public and private;

b) Ensure integration and coordination of national and local eHlealth strategies and
initiatives; and


©) 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,

SECTION 10. Ensuring Broader Participation in Health 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 Republic Act
No. 11223, otherwise known as the “Universal Health Care Act” and other related
issuances.

ARTICLE UL
STANDARDS AND INTEROPERABILITY

SECTION 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 defined and guided by the Council.

SECTION 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 Goverment interoperability and data security framework, and other
relevant standards.

ARTICLE IV
SERVICES AND APPLICATIONS

SECTION 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.

SECTION 14. Scope of eHealth Services and Applications. ~ eHealth services shall
include the following areas:

a) Mandatory eFiealth Data Services:

Master Person Index;

Master Provider (Human Resources) Index;
Master Facility Index;

‘Terminology or Health Services Registry:
National Immunization Registry;

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b) Compliant eHealth Services and Applications:

Electronic Health Record/Electronic Medical Record;
Health Information Exchange;

Health Facility Operations and Management;
Disease Registries;

‘TeleHealth/TeleMedicine;

Human Resources in eHealth;

Supply Chain Management.

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ARTICLE V
TELEHEALTH

SECTION 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.

SECTION 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 PRC and the DOH, in consultation with PhilHealth,
UPM-National TeleHlealth 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

SECTION 17. Human Resource in eHealth. — Health care professionals shall plan,
design, build, operate, use, maintain and support eHealth services and 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.

SECTION 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 continuing professional development
programs concerning the practice of eHealth. 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

SECTION 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.

SECTION 20, National Health Data Center. — The PhilHicalth, 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 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 VIII
STRATEGY AND INVESTMENT

SECTION 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.

SECTION 22. Financing the eHealth Strategic Framework and Plan. — Financing
for the 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.

SECTION 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


SECTION 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

SECTION 25. Research and Development. — Consistent with Republic ActNo. 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 research 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;

©) Establishment and strengthening of centers of excellence of eHealth policy
studies, research and development; and

4) 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 unit shall be determined by
PCHRD in consultation with the DOH, CSC and DBM.

ARTICLE XI
ADMINISTRATIVE PENALTIES

SECTION 26. Rules and Procedures for Administrative Violations and Complaints.
= The Council shall promulgate ruies and procedures relating to administrative
violations and complaints, insofar as they relate to the establishment and operations of
the NeHS.

ARTICLE XIL


MISCELLANEOUS PROVISIONS

SECTION 27. Appropriations. — The amount necessary for the implementation of this
Act shall be included in the Annual General Appropriations Act.

SECTION 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.

SECTION 29. Transitory Provisions. — The transformation of KMITS into a full-
fledged Bureau and the formulation of the intemal organic structure and regional and
local implementation structures, staffing pattem, 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.

SECTION 30. Separability Clause. —1f, for any reason, any part or provision of this
Act shall be declared unconstitutional or invalid, the remaining provisions hereof which
are not affected thereby shall continue to be in full force and effect.

SECTION 31. Repealing Clause. — All laws, decrees, executive orders, rules and
regulations or parts thereof which are inconsistent with this Act are hereby repealed,
amended, or modified accordingly.

SECTION 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,