Electronic Medical Records in the Philippines

Issues and Challenges

ROMSTY C. SANTOSMaster of Science in Health Informatics

University of the Philippines Manila

What are the implementation issues and challenges

of some of the leading EMR providers in the country?

Lack of manpowerNo designated encoder in RHUs

Fast turnover of health workersSome midwives or nurses are at retirement ageSome are not techy or computer savvy or literate

Management issues in the LGUSome LCEs do not prioritize health

Health workers are overburdened of tasks Instead of encoding data, they would prefer to maximize patient services

Lack of resources, e.g. computer units and internet, due to lack of funds or the area doesn't have internet connection such as GIDA sites

legalware• Healthcare is multi-disciplinary: policies for

health information exchange are not yet in place

• Specific policies related to security, privacy and confidentiality of patient information are not yet laid down: some informatics pessimists are unconvinced that EMRs are good/efficient tools

hardware• Poor hardware maintenance

• Regular budget allocation to replace parts/units

• Network problems, i.e. IP conflict and slow internet connectivity

software• Local technical expertise to

troubleshoot software-related issues

• Health care data requirements are dynamic/ever changing: costly for some LGUs to budget for customizations

peopleware

Intended usersMaking the system relevant to them is more than just informing them. Users need to actually use it in their workflow. Until such time that they experience the full cycle: from recording, reminding, prescribing and use it for decision making, etc. then it is as of now just a database of patient information.

PolicyEMR providers listen to what DOH, PHIC and DOST require. However, delays in implementation, changes in administration are set backs. We go to the field promising that the system is relevant for claims yet it remains a promise after two years.

PartnersAs a private provider of EMRS, we also need to ensure that our partners are satisfied with our

work. Sometimes, there is already scope creep and we can not avoid including the work as it

becomes relevant to the project based on circumstances.

TechnologyAs implementation plans change and

slow down, technology on the other hand changes fast. We need to constantly upgrade which increases the cost of

maintenance even before ROI kicks in.

Sustainability

We need to include a model for sustainability despite the software

being free as there are real costs in maintaining the system.

Lack of

funding support from the national government

Weak policy

Weak

infrastructure environment

Sustainability (unlike pharmacies, PHIC IT support are channeled to LGUs, and difficult to negotiate individually)

Training and support for users

Hardware for health workers

Addressing the implementation

issues and challenges of EMR providers

through the issuance of a Joint Communique

Joint Communique of the Members of the Electronic Medical Record Experts Group (EMREG) under the National Governance Technical Working Group on eHealth for the Philippine Health

Information Exchange

Joint Communique of the Members of the Electronic Medical Record Experts Group (EMREG) under the National Governance Technical Working Group on eHealth for the Philippine Health

Information Exchange