Electronic Medical Records in the Philippines: Issues and Challenges

1. Electronic Medical Records in the Philippines
Issues and Challenges
ROMSTY C. SANTOS
Master of Science in Health Informatics
University of the Philippines Manila

2. What are the implementation issues and challenges
of some of the leading EMR providers in the country?

3. Lack of manpower
No designated encoderin RHUs
Fast turnoverof health workers
Some midwives or nurses are at retirement age
Some are not techy or computer savvy or literate
Management issues in the LGU
Some LCEs do not prioritizehealth
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 fundsor the area doesn't have internet
connection such as GIDAsites

4. 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

5. Intended users
Making 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.
Policy
EMR 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.
Partners
As 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.
Technology
As 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.

6. Lack of funding
support from the national
government
Weak policy
Weak
infrastructure
environment

7. Sustainability
(unlike pharmacies, PHIC IT support
are channeled to LGUs, and difficult
to negotiate individually)
Training
and support for users
Hardware for
health workers

8. Addressing the implementation
issues and challenges of EMR providers
through the issuance of a Joint Communique

9. 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

10. 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