Connecting Patients: Challenges in Establishing Electronic Health Records in the Philippines
A lot of challenges in different services in the Philippines are driven by governance which is further made difficult by economic and geographical challenges. The Philippine healthcare is no different to these services. It faces the realities of underfunding and misgovernance. This leads to the lack of health information technology (Health IT) agendas, leading to little to no call for human resource training, hardware and software infrastructure development, and ethical and political considerations.
The status of healthcare in the Philippines is without a doubt underfunded and understaffed. Along with these, the basic requirements of even running a computer are not always met, from having electricity and internet up to having a computer itself. This leads to the lack of software utilization and training as well, since these skills cannot be developed and utilized without the equipment needed.
“Could you learn to type and encode if you don’t even have a computer and electricity? Even if you could, why would you?”
These issues push institutions, especially in rural areas, into utilizing traditional paper-based records. As great as governance is, when an institution is transitioning to EHR (Electronic Health Records), funding should be one of the factors being reviewed by the executive and steering committees, according to the World Health Organization. Transitioning into electronic health records can be quite costly, as automation in inputting records and data requires not only the technology but also hiring more staff trained in encoding and maintaining the health system. Not considering the right number and skills of staff can end up in the system being weak, causing it to crash, and have errors or shutdowns. This can affect the accuracy of the data of the patient, which hinders the goal of implementing EHR — improved healthcare by easily accessing the health records and personal history of the patient.
According to a case study by Ebardo and Celis in 2019, they identified three main barriers in adapting EMR (Electronic Medical Records): Technological, Organizational, and Environmental. Technological barriers include a lack of computer skills, weak technological architecture and support for the maintenance of the system, and poor interface for the system. Organizational barriers include resistance to adaption or transition from traditional paper charts to EMR and lack of skills of the IT staff. Environmental barriers are external factors that can hinder the transition. These include data protection policies that the government does not clearly state and a lack of prior knowledge (not included in health-allied courses) of the staff regarding electronic medical records alongside the unclear ethical guidelines on patient data-keeping.
Despite these challenges, a few Philippine-based health information technology experts are still trying to do their best to address these issues one step at a time. However, support and prioritization from the government: the Health and IT sectors, are needed for these efforts to grow on a larger scale and not go to waste.
References:
Ebardo, Ryan & Celis, Nelson. (2019). Barriers to the Adoption of Electronic Medical Records in Select Philippine Hospitals: A Case Study Approach. 123–128. 10.1145/3330482.3330503.
World Health Organization. Regional Office for the Western Pacific. (2006). Electronic health records: manual for developing countries.
