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