Driving Question:
If a hospital information system in one facility is a
complex process by itself, how much more complex will a national health
information system be? How can government manage this complexity?
The plans have been laid. All we need to do is execute these
plans. During a HI201 lecture of Dr. Alvin Marcelo, he showed how the
Philippine Health Information Exchange was born and how every component fell to
their right places. As, the blueprint was set and the path is continuously
cleared, I came to realize that the whole idea was enormous and complex. But in
this world, there is no such word as impossible. Complexity is just a hurdle.
The big question is how will we
make this possible? As stated by Dr. Peter Drury during his AeHIN sessions,
Institutional readiness enriches the capacity on a National eHealth Strategy. Solidify
the core and strengthen the foundation, those are the things that were instill
in my mind during the fruitful webinar. And by these phrases, I tried to find the
answers.
Solidify the core
What we need are champions who will
take the lead for these advocacies. The joint memorandum of the Department of
Health (DOH) and the Department of Science and Technology on eHealth is a very good head start. The eHealth
initiatives created by these 2 influential departments pushed the vision
further from its starting line. It
created an environment of camaraderie towards a common goal. It brought light
to those who are gloomy towards its feasibility.
The leaders of our society are the
most qualified entities to jumpstart the unified health information revolution
and steer its future. They should also be responsible to strategize on how to disseminate
these to its most important stakeholders, the Filipino people. For me, showing
the objectives why the government is doing this and its benefits will provide
support to the core.
Complying with the commitment, the
government will surely encounter constraints and gaps that might topple its
balance and tempo. More initiatives, policies, laws and regulations will help fill
the gaps of these pathways. One of the biggest problems is the establishment of
the National Information Infrastructure. It is a very critical part of the
national health information system. It will test the government’s dedication on
executing the blueprint. Define the purpose of the Information System, how it
will be used, what will it measure and what will be the end goal. Through this
the stakeholders and committees will have a grasp of their functions and
contributions.
Free market forces and monetary
issues are just a few of the obstacles that it might collide into. The
democratic identity of the Philippines will be put into the test. Command and
control versus democracy will be a confusing dilemma. Security breaches,
ethical and legal issues will be considered as factors of its success or failure.
The government must find ways on how to manage these risks. Thorough risk
analysis should be performed first before anything else. Frameworks applicable
to our setting must be established.
Strengthen the foundation
Other major challenges are the
domains of standards and interoperability. The process of unifying hundreds (or
thousands including various facility) of information system will be tedious. It
will require a tremendous amount of time and effort in order to gather them
together for a single cause. From here, government policies and laws should
take charge. Standards should be re-evaluated to suit our needs. If these fail,
it should not fetter to modify or create its own.
Identify the roles of each
stakeholder to not overlap functions that might cause bottlenecks and disorder.
Encourage the participation of agencies
that may help achieve the objectives and may enrich the capacity of the
steering committee. Agencies/ institutions will have cell groups that will be
tasked to execute sections of these projects. They will use a well designed
training plot that rooted from program/ project conception to ensure proper user
adoption during implementation. They will also act as the monitoring bodies that
will identify stumbles of the project and will provide adequate support.
For example:
DBM will allot budget
DOST will lead the innovations
DOH will be act as consultant, will
test and deploy the innovation
ICTO and NEC will provide the infrastructure
NTC will regulate the free market
on telco’s
DSWD and Philhealth will provide the
incentives
Etc.
The last but most important part is
sustaining it to become an integral portion of the Health System. Incentives
will be very beneficial when it comes to maintenance and utilization. The mere
fact that a stable incentive system exists will ignite involvement of stakeholders.
Example: Increased financial capability of Local Health Units with a “devolved”
set up definitely brings a more robust environment through ICT and facility upgrades.
When the plan fails, we should not
be afraid to restructure and retry. It will be the best time to reflect and
look back to where it fell short. Failures will always serve as the cement to
bind concrete harder. At least we fell
down trying to make the unimaginable possible.
To summarize the concepts of my
blog post:
Solidify the core:
1. Summon the Champions
2. Steer the government for
initiatives
3. Plan extensively
4. Lay down the design
Strengthen the foundation
1. Engage the stakeholders
2. Execute the plans
3. Sustain and maintain
4. Think about incentives
5. Rise whenever you fall
Readings and sources:
AeHIN Academy (Self-Study) videos
WPRO webinar 2 institutional
readiness Final Final.pdf
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