ee PEPRE, SE,

Republic of the Philippines ” RECEIVED
House of Representatives DATE: JUL 18 2d

Quezon City, Metro Manila

EIGHTEENTH CONGRESS
Second Regular Session

House Bill No. 714

INTRODUCED BY
REP. ALFRED VARGAS

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

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?. 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,

* World Health Organization. “eHealth” .httos://www.who.int/ehealth/en/ (Accessed July 8, 2020)
* 58" World Health Assembly. 2005. Geneva, Switzerland.
* Department of Health. Philippine Health Agenda 2016-2022.


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 goal
of better health outcomes, sustained health financing, and responsive health
system. Ultimately, investment in infrastructures which ensures equitable
access 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 earnestly

sought.

ALFRED V. ‘AS


Republic of the Philippines
House of Representatives
Quezon City, AMetes Manila

EIGHTEENTH CONGRESS
Second Regular Session

House Bill No._/114

INTRODUCED BY
REP. ALFRED VARGAS

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

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

CHAPTER 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 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 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 Philippines 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 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 disadvantaged 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 regulations regarding field
of eHealth.

(c) Designate national and regional centers and networks of excellence
for eHealth best practices, policy coordination, and technical
support for healthcare delivery; and

( 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 access to
relevant information for the promotion of their own personal
health.

SECTION 4. Definition. - For the purpose 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 e health care provider is
located while providing these services via telecommunication
systems.

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

(d) “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 web-conferencing
communications;

iii. 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.

(f) “Institutional Healthcare Provider” refers an organization or
institution that provides health care and related services, including
but not limited to the provision of impatient 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.

(2) “Originating Site” refers to the site where the patient is located at
the time of provision of health care services through
telecommunication systems.

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

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

(i) “eHealth Practitioner” refers to any health care provider.

(k) “Health Center” refers to health agency involve in a Telehealth
System.

() “eHealth systems” refers to an organized and structure application
of eHealth, integrated in the regular workflow 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 aspects.

(n) “Telemedicine” means the use of telecommunication technology to
provide health care services from a distance; 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 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 field of health and
ancillary services that uses ICT and are complementary to existing
minimum modalities or standards of health care and other access to
information.

CHAPTER II
eHEALTH SYSTEMS’ COMPONENTS

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

(a) Leadership and Governance - Directs and coordinates eHealth
activities at all levels 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 standards of eHealth 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 software 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.

(c) 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 boundaries, and implementation of innovative ways to
deliver health services and information.

()) 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 of works, health
care providers, information and communication logy workers and
others.

(g) Strategy and Investment — Schemes and outlay that are needed 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
refers to the funding or amount needed for executing the strategies
and plans.

CHAPTER III
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 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 identity an Office to coordinate the development and
implementation of a National eHealth System and Services Network


among agencies concerned and provide direction and guidance to all
DOH offices and attached agencies including the local government
units and the private sector.

SECTION 8. National eHealth Steering Committee. - To ensure the
implementation of this Act and to serve as an executive body of the
Philippine National eHealth System and Services Network (PNeSSN), the
National eHealth Streeting Committee shall be created and made an integral
part of the DOH. The composition of the Steering Committee shall be as

follows:

Chairperson: Secretary, Department of Health:

Members:

a.
b.

ao

9

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Pp.

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

Insurance 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, Philippine Nurses Association;
. President, Philippine Pharmacists Association;
. A representative from the Association of Municipal Health

Officers /PHO/CHO; and
‘Two (2) representatives from duly organized patient group.

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 e Health
services;

(b) Direct and coordinate the eHealth system and services network at
the national level and ensures alignment of the system and
services network 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.

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

() 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 these;

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

(i) Convene at least twice a year.

CHAPTER IV
eHEALTH SERVICES AND SOLUTIONS

SECTION 9. Service and Application. - The National eHealth System shall
provide tangible means for enabling services and systems including access
to, and exchange and management of information and concern for the
general public, patients, providers, insurance, and others which may be
supplied by government or private businesses.

SECTION 10. 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) “Telepath” means the delivery of health-related services and
information via telecommunication technology. It encompasses
preventive, promotive, curative, and palliative aspects.

() “Telemedicine” means the use of telecommunication technology to
provide health care 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 health care
professionals through online communications channels dedicated to
community-based input, interaction, content- sharing and
collaboration.

() “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
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 health care provider or authorize the delivery of
healthcare service in a setting or manner not otherwise authorize by the law.

SECTION 12. Electronic Medical/ Health Record (EMR/ HER). - All data
in EMR/HER shall be considered protected health data and shall be
governed by established rules for access, authentications, storage and
auditing, and transmittal.

SECTION 12.1. Disclosure. — Disclosure of and accessibility to
protected data in EMR/HER shall be limited and standardized following
international and local rules and regulation. Patients may secure a copy of
their EMR/HER upon request and shall provide informed consent if their
EMR/EHR is shared with the parties except when these are processed for
the production of aggregate health statistics, for social health insurance
claims based on established guidelines, for public health emergency
concerns and national security.

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 form 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.

CHAPTER V
STANDARDS AND INTEROPERABILITY

SECTION 14. Potential for Advancements. - eHealth systems and services
can potentially transform healthcare through mobile health delivery,
personalized 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 existing ubiquitous technologies such as social media applications
and mobile devices.

SECTION 15. 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
compiled with by various providers, centers, and systems developers to
enable consistent and accurate collection, and exchange of health
information across health systems and the 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 16. Interoperability framework. - The eHealth interoperability
shall be defined and must be in consonance to national eGovernment
interoperability framework and established internal standards.

SECTION 17. Secure Health Information Exchange (HIE). - The DOH,
DCST, 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 18. Establishment and Accreditation of eHealth Center and
eHealth Practitioners. — The Act shall ensure that telehealth centers are
strategically 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 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

(c) Undergo periodic unannounced inspection by the DOH in order to
evaluate and ensure quality telehealth center performance.

CHAPTER VI
INFRASTRUCTURE

SECTION 19. ICT Infrastructure. - The required ICT infrastructure to
implement eHealth system and services shall conform to the national ICT
infrastructure plan and standards.

SECTION 20. Medical Devices and eHealth Solutions. - Software
platform that connects existing or new medical devices and gateways shall
be defined and regulated to ensure seamless data transfers based on
established industry and national standards and standardization of EHR/
EMR.

SECTION 21. 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
consults on clinical cases as well as health and medical education
exchanges.

SECTION 22. 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.


CHAPTER VII
HUMAN RESOURCES

SECTION 23. Human Resources ICT Competencies. — Minimum ICT or
eHealth competencies shall be established and imposed to medical and
paramedical professionals practicing eHealth and be part of the medical and
allied medical curricula.

SECTION 24. Capability Building Plans and 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 Philippine licensed
based on the requirement of the Professional Regulation Commission
(PRO);

(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;

(c) 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 polices related to telehealth and telemedicine.

CHAPTER VIII
STRATEGY AND INVESTMENT

SECTION 25. 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 26. Monitoring Evaluation System. - Establishment of a robust
metric for monitoring and evaluation for eHealth to assess and analyze the
impact of eHealth systems and services.

SECTION 27. Appropriations. - The amount necessary to carry out the
provisions of this Act shall be included in the General Appropriations of the
year following its enactment into a law thereafter.

SECTION 28. Financing eHealth Services. — Financing for applicable
eHealth services by PhilHealth and other partners, as defined by the
National eHealth Steering Committee.


SECTION 29. 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.

CHAPTER IX
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 ends, it shall:

(a) Develop the 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

(c) 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 exceed 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.

CHAPTER X
FINAL PROVISIONS

SECTION 32. Implementing Rules and Regulations. - Within one
hundred twenty (120) days from the approval 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 33. Separability Clause. - 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 34. Repealing Clause. — All general and special laws, decrees,
executive orders, proclamation and administrative regulation, or any parts
thereof which are inconsistent with this Act are hereby repealed, amended
or modified accordingly.

SECTION 35. Effectivity. - This Act shall take effect fifteen (15) days after
publication in the Official Gazette or a newspaper of general circulation.

Approved,