International Journal of Computing and Digital Systems

ISSN (2210-142X)
Int. J. Com. Dig. Sys. 16, No.1 (Jul-24)
[Link]

Exploring the Landscape of Health Information Systems in the

Philippines: A Methodical Analysis of Features and Challenges
Mia Amor C. Tinam-isan1 and January F. Naga1
1
IT Department, College of Computer Studies, MSU-IIT, Iligan City, Philippines

Received 20 Nov. 2023, Revised 13 Apr. 2024, Accepted 16 Apr. 2024, Published 1 Jul. 2024

Abstract: A thorough analysis was conducted to evaluate Health Information Systems (HIS) in the Philippines utilizing the PRISMA
approach. An initial pool of 313 potential articles, with 285 articles being excluded based on the exclusion criteria, resulting in a
focused analysis of 28 articles. This analysis classifies the many HIS features while highlighting each one’s distinct value inside the
Philippine healthcare system. These features encompass scheduling and communications, record-keeping and prescription, knowledge
and information management, and marketplace and payment systems. Common features to most HIS are the profiling of patient,
notification system, membership verification, laboratory result generation, and electronic appointment and scheduling. Parallel to this,
the study examined the many difficulties encountered in the adoption and application of HIS in the Philippines, tackling issues like
a lack of human resources, infrastructure-related challenges, and the impact of regional strategies and policies. Additionally, financial
issues were also found to be a major challenge hampering the successful development and maintenance of HIS within the hospital
system. This methodical investigation, Philippine-specific, provides insights into the dynamic environment of HIS, providing a basis for
wise choice-making and strategic planning adapted to the distinct healthcare context of the Philippines.

Keywords: HIS in the Philippines, Health Information Systems, EMRs in the Philippines, Challenges of HIS, Features of HIS

1. INTRODUCTION with the use of information and communication technolo-

”It bears stressing that the investment on building access gies (ICT). This is an emergent field between the medical
to health services is a crucial requirement for the realization informatics, public health, and business, referring to health
and success of the Universal Health Care for all Filipinos. services and information provided or developed through
Hence, investing in E-health is imperative to ensure equi- the Internet and related technologies [7]. E-information is
table access to health care services, most especially those today’s game-changing market tool in all industry sectors
in geographically isolated and disadvantaged areas and [8]. A hospital or clinic’s prompt and accurate dissemination
particularly for the poor, disadvantaged, and vulnerable,” of information to their patients is very vital. There are
Angelina Tan, Chairperson on the House Committee on varying challenges seen by decision maker in order to
Health. The Health Information Systems is a system that in- deliver timely and accurate medical assistance. Few of
tegrates the data gathering, processing, reporting, and use of these challenges are the delayed access to reliable, accurate
information for improving the efficiency and effectiveness and complete health information records due to disparate
of health care through enhanced management at all levels of systems that use differing formats, lack of information har-
health services. It encompasses all sources of health data, monization and compromised data quality. Thus, e-health
including those related to health facilities and communi- are often developed to reach geographically extended areas
ties, electronic health records for patient care, population- where healthcare providers can hardly go, and there is an
based data, information about human resources, finances, access delay in accurate and timely information relevant
supply chains, and surveillance, as well as how that in- to decision-makers. The application of ICT in the medical
formation is used and disseminated. [1]. Electronic health field has paved the way for opportunities to automate,
records (EHR), electronic medical records (EMR), health digitize, simplify, and hasten the acquisition of medical
information exchange (HIE), computerized physicians or- records. Timely and accurate medical data is significant
der entry (CPOE), hospital information systems, and tele- for effective diagnosis. HIS are significant tools for clin-
medicine/telehealth/e-health have all developed acronyms ical interaction, patient learning, and remote tracking and
over time to describe electronic HISs [2] [3] [4] [5] [6]. E- monitoring of patients. In order to streamline procedures
Health reinforces the delivery of service in the health sector and enhance data collecting, processing, and analysis, many

E-mail address: [Link]@[Link]; [Link]@[Link] https:// [Link]

226 Tinam-isan, MA; Naga, J: Exploring the Landscape of HIS in the Philippines

nations realized the significance of implementing ICT in the

health sector. This leads to the adoption and implementation
of ICT as concrete foundation for health modernizations
and investments. The Department of Health (DOH) in the
Philippines, has vigorously developed plans to elevate the
implementation and development of eHealth applications.
The DOH has acknowledged the significant contribution of
ICT in providing solutions to the current discrepancy of
health services, delivery, and timely access to information
but also supports the realization of Universal Health Care
(UHC) goals in health financing and the health response
system [9]. Consequently, the house of representatives has
approved the appropriation on House Bills 61, 171, 665,
and 4899, otherwise referred to as the proposed “National
E-health System Act”, recognizing the need of the country
to leverage the process in the healthcare sector [10]. “All for
Health towards Health for All.” This has been the campaign Figure 1. Process Diagram of the Systematic Review Conducted
of the Philippine Health Agenda for Healthy Philippines
by 2022. One of the strategies seen in achieving the goal
is to invest in Information Communications Technology contained studies, to synthesize result. Fig. 1 illustrates the
(ICT). There is still insufficient data quality collected at process taken to conduct review.
health institutions and insufficient analytical and utilization
capabilities to allow the kind of decision-making that can To gather related articles about eHealth in the Philip-
advance the attainment of universal health coverage. How- pines, inclusion and exclusion criteria were developed by
ever, the increase in registered users does not fully reflect the proponents. Table I shows the list of the inclusion and
the system’s uptake. To learn how the system is used by exclusion criteria used in considering what articles are to
the health facilities, it is necessary to delves deeper into be included in the study.
utilization [11]. The method of implementing electronic
health information systems has been regarded as difficult TABLE I. Inclusion and Exclusion Criteria
and complex. The purpose of HIS is to help the planning,
development, and decision-making of the various parties Inclusion Criteria Exclusion Criteria
involved in associated processes. And to create and arrange Published 2015 – December Published before 2015
knowledge and information needed and generated in the 2022
healthcare industry [12] [13]. The comprehensive capabili- English or Filipino Other Languages than En-
ties identified in this study will demonstrate the prospective glish and Filipino
strengths and functionalities of a modern healthcare man- eHealth application
agement system. Specifically, this work uses a systematic Country setting is Philip- Other countries than Philip-
review to address the following research objectives in three pines pines
areas: Study that develops one or The abstract does not de-
more eHealth applications scribe one or more eHealth
• How have publications on HIS developed over time Applications
in the Philippines? Study that develops a new Articles using an eHealth
• What are the features of HIS or EMRs applications module of an eHealth Ap- but not focused on the ap-
developed in the Philippines setting? plication plication system
The system is implemented Papers that do not relate to
• What kind of challenges and risks are considered in or prototype under develop- the health sector
the implementation of HIS or EMRs in the Philip- ment
pines? Duplicate publication from
multiple sources
2. METHODOLOGY
The objective of the study is to distinguish different
kinds of eHealth applications, based on an inclusion and The screening procedure is illustrated in the PRISMA
exclusion criteria. These criteria will determine what study flow diagram. It first reports the quantity of articles that
samples can be included or excluded. The inclusion criteria were searched, and then it makes the selection process
consistently identify study population in an objective man- transparent by disclosing the choices that were made at
ner, while exclusion criteria comprise factors that makes different phases of the systematic review. Every stage in-
the study population ineligible [14].The data is coded from cluded a record number of articles. The flow diagram also

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 Int. J. Com. Dig. Sys. 16, No.1, 225-237 (Jul-24) 227

included the reasons why certain items were excluded. To

assess the two coders’ (C1 and C2) coding choices, fifteen
articles were chosen at random. Cohen’s kappa () (Cohen,
1960) was employed to determine the reliability between
ratings. The level of agreement when a measurement is
repeated among several raters under the same circumstances
is known as inter-rater reliability [15]. Kappa has a range
from 0-1.00, with larger values indicating better reliability.
Kappa values of .40–.60 are characterized as fair, .60 to .75
as good, and over .75 as excellent [16]. The formula used
to calculate the Cohen’s Kappa of two raters is:

P(A) − P(E)
κ= (1)
1 − P(E)

where: P(A) is the observed agreement probability,

P(E) is the expected agreement probability.
Relevant articles are reviewed in full text. Relevant
information that supports the objective of the study were
recorded and codes were developed. Codes included the
nature of eHealth, type of application, features integrated
into the software, and the challenges and risks encountered Figure 2. PRISMA flow of the systematic review conducted
during development.
3. Results coders (A and B) to assess the reliability between assessors
After the preliminary screening, 313 potential articles using Cohen’s kappa (). Article details (title, year of pub-
were left for full-text screening in Fig. 2. Nevertheless, lication, publication detail, the author’s name and system
39 items could not be accessed by direct communication specifications or implementation issues) were included in
with the authors or the library’s order system. As a result, the codes. According to [17] and [18], kappas between
274 items were found, checked, and coded. The exclusion 0.40 and 0.60 are considered fair, 0.60 and 0.75 are good,
criteria resulted in the omission of 246 articles because and 0.75 and higher are exceptional. Coding consistency
they were written in languages other than English, country for articles included or excluded by raters A and B was
setting is not in the Philippines, or had no connection to an k =0.81. As a result, excellent interrater reliability for the
HIS or EMR systems, articles were published in the year inclusion and exclusion coding can be said to exist.
2014 or older, or the applications is intended to be deployed
The comprehensive features identified in Table II
outside the Philippines.
demonstrate the potential capabilities and functionalities of
Each review is constrained by the search approach used, a modern healthcare management system. These features
but this one was carried out as thoroughly as possible. encompass various aspects of healthcare scheduling and
Despite the fact that the three specified research databases communications, record-keeping and prescription, knowl-
are huge and have an international scope, barely a small edge and information, and marketplace and payment.
number of turnouts were considered based on the criterion
In order to enhance healthcare management and deliv-
of peer-reviewed articles released after 2015, and solely in
ery, the Philippines have made a significant investment in
English and in Philippine settings. As a result, the findings
Health Information Systems (HIS). This approach has not,
of this study apply to research in book chapters, conference
however, been without its share of challenges. The process
proceedings, and papers that are not yet published in
of HIS integration in the Philippines has been hampered
journals but are under consideration for indexing in the three
by a range of difficulties, from resource restrictions and
databases investigated. In order to broaden the review’s
infrastructure issues to interoperability problems, data se-
scope, future study may examine using a broader choice of
curity issues, and opposition to change. Table III explores
databases, publishing platforms, and publication languages.
some of the key challenges experienced throughout the
There were only 28 articles taken into consideration for
implementation of HIS.
the final evaluation. The screening of the publications
considered is summarized in Fig. 2.
A coding system was developed. Fifteen papers were
selected at random to assess the coding judgments of two

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228 Tinam-isan, MA; Naga, J: Exploring the Landscape of HIS in the Philippines

TABLE II. Summary of the Features Presented by every Articles

Screened

Notifications Keeps users Samonte et. al.

Features Description Author(s)/Reference
(covered informed about [8]Fuentes et. al.
SMS or appointments, test [19] De Guzman
Scheduling and Communications Appli- results, and other et. al. [21] Dela
cation important healthcare Cruz et. al. [24]
Electronic Enables users to Fuentes [Link]. Notifica- updates. Roldan et. al.
Appoint- schedule [19] Ancheta tions [25] dela Cruz
ment appointments [Link]. [20] De [31] Custodio et.
schedul- electronically, Guzman et. al. al. [32]
ing streamlining the [21] Del Castillo
appointment [Link]. [22] Queuing Receive service or Custodio et. al.
booking process Pulmano et. al. access to a resource [32]
[23] Dela Cruz in a sequential
et. al. [24] manner
e- Ancheta et. al.
Consultation Allows for remote [20] Del Castillo Record-keeping and Prescription
consultations with et. al. [22]
healthcare practi- E- This feature Ancheta [Link].
tioners,promoting Prescription facilitates electronic [20] De Guzman
accessibility to prescription et. al. [21] Del
healthcare services. generation, Castillo et. al.
enhancing the [22] Chan [Link].
Health Aids users in Samonte et. al. efficiency and [33]
Practi- selecting healthcare [8] Fuentes et. accuracy of
tioner practitioners based al. [19] Roldan medication
Selection on their preferences et. al. [25] management.
and needs
Profiling Encompasses patient Samonte et. al.
This feature enables Fuentes [Link]. (Edit, profile management, (2018) [8]
Follow- healthcare providers [19] Pulmano et. View, including editing, Acacio-Claro et.
ups/ to monitor patient al. [23] Ongkeko Delete, viewing, deleting, al. [11] Fuentes
Monitor- progress and et. al [26] Search- and searching for et. al. [19] De
ing conduct follow-up Ateneo de ing) patient records. Guzman et. al.
assessments Manila Univ. [21] Pulmano et.
[27] Muin [28] al. [23] Dela
Cruz et. al. [24]
Patient’s Underscore the De Guzman et. Chan et. al. [33]
Tracking importance of al. [21] dela Roldan et. al.
tracking patient Cruz and [25] Ongkeko et.
progress and Mendoza [29] al. [26] dela
movement within Ridad et. al. [30] Cruz and
healthcare facilities dela Cruz [31] Mendoza [29]
Ridad et. al. [30]
Chatbot A chatbot feature Ancheta et. al. dela Cruz [31]
offers automated [20] Roldan et. Samonte et. al.
responses and al. [25] Ateneo (2022) [36]
assistance to user de Manila Univ. Ateneo de
inquiries. [27] Manila Univ.
[27] Ateneo de
Reminder Notifies users of Custodio et. al. Manila
System upcoming events or [32] University et. al.
tasks [37] Muin [28]

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 Int. J. Com. Dig. Sys. 16, No.1, 225-237 (Jul-24) 229

Remote Emphasize the Samonte et. al. Knowledge Provides access to Acacio-Claro et.
Informa- health-related al. [11] Fuentes
Sharing of importance of [8] Pulmano et.
tion Page information, et. al. [19]
Medical sharing medical al. [23] Roldan
(Health promoting patient Roldan et. al.
Records records remotely, et. al. [25] dela
related education and [25] dela Cruz
enhancing Cruz and
collaboration among Mendoza [29] page) awareness. Offers a and Mendoza
healthcare providers. Ridad et. al. [30] Dash- consolidated view of [29] Ateneo de
Muin [28] De Board patient data and key Manila Univ.
Castro et. al. healthcare metrics. [27] Muin [28]
[34]
Membership Enables verification Samonte et. al.
Verifica- of patient and (2018) [8]
Hand Convert handwritten Dela Cruz et. al.
tion practitioner Fuentes et. al.
writing text or characters [35]
memberships, [19] Pulmano et.
recog- into digital or
ensuring accurate al. [23] Roldan
nition machine-readable
interface text. access to services. et. al. [25] dela
Cruz and
Lab Test Produces and Samonte et. al. Mendoza [29]
Result documents the [8] Fuentes et. Ridad et. al. [30]
Genera- outcomes of medical al. [19] Dela dela Cruz [31]
Samonte et. al.
tion laboratory tests. Cruz et. al. [24]
(2022) [36]
Ensures that Chan et. al. [33]
Ateneo de
healthcare providers Ridad et. al. [30]
Manila Univ.
have access to Ateneo de
[27] Muin [28]
precise and timely Manila Univ.
information about a [27] Muin [28]
patient’s health, De Castro et. al. QR Code This feature Roldan et. al.
aiding in diagnosis, [34] Reader facilitates the [25] dela Cruz
treatment planning, scanning and [31]
and monitoring of interpretation of QR
codes for various
medical conditions
healthcare purposes.
Medical Essential De Castro et. al.
Marketplace and Payment
Report documentation for [34]
Genera- healthcare
tion professionals to Delivery Allows tracking of Samonte et. al.
track patient Tracking medical deliveries, (2022) [36]
progress, ensuring timely and
communicate with accurate delivery of
other providers, and healthcare supplies.
make informed
Medical Offers access to a Roldan et. al.
decisions about
Care marketplace for [25]
patient care.
Solutions medical products
Market- and services.
Laboratory Allows healthcare Ancheta et. al.
place
Referrals providers to refer [20] Ateneo de
patients for Manila Univ.
laboratory tests [27] Home Enables the delivery Roldan et. al.
Service of healthcare [25] Samonte et.
Knowledge and Information Delivery services to patients al. (2022) [36]
in their homes
Mapping Aids in Roldan et. al.
Online Facilitates online De Guzman et.
location-based [25] dela Cruz
Payment payment for al. [21] Del
healthcare services. and Mendoza
healthcare services Castillo [Link].
[29]
and products. [22] Pulmano et.
al. [23]

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230 Tinam-isan, MA; Naga, J: Exploring the Landscape of HIS in the Philippines

TABLE III. Summary of the Challenges in the Implementation of

HIS in the Philippines Presented by every Article
Technical issues Garcia et. al. [38] 2
Ebardo and Tuazon [44]
Challenges Author(s)/Reference Frequency hardware Gesulga et. al. [39] 2
technicalities Ebardo and Celis [40]
Human Resource
Poor interface Gesulga et. al. [39] 3
Inadequately Garcia et. al. [38] 1 design Ebardo and Celis [40]
Trained Dela Cruz et. al. (2020)
Personnel [35]

Hesitant to Samonte et. al. (2018) 3 lack of Gesulga et. al. [39] Dela 4
Change/user [8] Gesulga et. al. [39] Interoperability Cruz et. al. [24] Lu et.
resistance Ebardo and Celis [40] al. [43] Ebardo and Tu-
azon [44]
Lack of Gesulga et. al. [39] Chan 3
computer skills et. al. [33] Ebardo and Designed to Ebardo and Tuazon [44] 1
Celis [40] address
individual needs
Lack of Gesulga et. al. [39] Dela 2
education and Cruz et. al. [41] No user Dela Cruz et. al. [41] 1
training feedback test

Lack of EMR Gesulga et. al. [39] 1 Infrastructure

awareness
Unstable internet Garcia et. al. [38] Dela 3
Preference of the Chan et. al. [33] 1 connection Cruz et. al. [24] Chan et.
Personnel over al. [33]
the manual
process Lack of Macabasag et. al. [42] 1
infrastructures
Limited Macabasag et. al. [42] 1
workforce Strategies and Policies

Age Dela Cruz et. al. [41] 1 Lack of planning Gesulga et. al. [39] Lu 3
and strategy et. al. [43] Ebardo and
User confidence Dela Cruz et. al. [41] 1 Tuazon [44]

Low degree of Lu et. al. [43] 1 Administrative Gesulga et. al. [39] 1
cooperating, policy support
collaboration,
and sharing Regulation Ebardo and Celis [40] 1
across all sectors Compliance

Widely differing Lu et. al. [43] 1 Reluctance of Samonte et. al. (2018) 1
levels of eHealth hospital to [8]
maturity access live data

ICT-Related Lack of medical Ebardo and Tuazon [44] 1

vision
Organizational Ongkeko et. al. [26] 1
limitations Evolving Llamzon et. al. [45] 1
regulatory and
lack of IT Gesulga et. al. [39] 3 legislative
facilities and Ebardo and Celis [40] requirements for
equipment Lu et. al. [43] healthcare
providers

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 Int. J. Com. Dig. Sys. 16, No.1, 225-237 (Jul-24) 231

Funding

Implementation Gesulga et. al. [39] 4

cost Ebardo and Tuazon [44]
Dela Cruz et. al. (2020)
[35] Chan et. al. [33]

Uncoordinated Lu et. al. [43] 1

investment in
ICTs in health

Limited public Lu et. al. [43] 1

sector capacity
to implement
eHealth
programs;

Slow and Dela Cruz et. al. (2020) 1

uncertain [35]
financial payoffs

Burden the Chan et. al. 1

hospitals with
financial and
educational
incentives

Figure 3. Milestone of the National eHealth Program Implementation

4. DISCUSSION
A. How have publications on HIS developed over time in
the Philippines? transition from paper-based systems with simple electronic
Despite having one of Asia’s fastest expanding record-keeping and administrative procedures. With the rise
economies, the Philippines continues to bear the triple in mobile phone usage and the expansion of internet cafes
burden of disease. It is a pioneer in business process in 2006, this change paved the way for the widespread
outsourcing and exports software engineering professionals, acceptance of eHealth. The groundwork for the digital
however, the nation has not yet taken advantage of its ICT revolution of healthcare in the Philippines was laid by
competence to benefit the health sector [46]. According to these developments. In 2010, the Department of Health
the DOH, 70% of Filipinos residing in rural regions con- has formulated the National eHealth Strategic Framework
tinue to face challenges due to a lack of or restricted access with the mission of using ICT effectively to improve health
to health care services. Accessibility to health care services delivery, health management and health communication.
and availability to real-time information for decision making The framework envisioned to support Health care with ICT
are two major impediments to the Philippines’ health system to increase health access, patient safety and satisfaction
[48]. Certain health organizations in the Philippines were and support policy makers and communities to come-up
making efforts to interconnect various health communities with best possible health decisions. Under the initiative
and the adoption and usage of eHealth or telehealth as one of DOH, the Philippine eHealth Strategic Plan (PeHSP)
means of health delivery. 2014- 2020 defines strategies to align and harmonize the
implementation of various digital health initiatives as well
In terms of implementing its national eHealth initiative, as ascertain the proper management of ICT to achieve
the Philippines has accomplished a number of significant national health goals. The introduction of the Philippine
milestones reflecting the country’s journey toward a more Health Information Exchange (PHIE) in 2016, which aimed
digitally integrated healthcare system. In 1998, the National to ease data exchange and improve interoperability, was one
Telehealth Center (NTHC) was established at the University of the significant developments in HIS that occurred from
of the Philippines Manila, a foundational development in 2016 to 2020 [46]. The launch of the ”eHealth Buddy”
the eHealth landscape [43]. This marked the start of a smartphone app in 2017 increased healthcare accessibility
larger change in the healthcare industry. In 2002, major by providing access to emergency services and health advice
hospitals and clinics adopted HIS, paving way for electronic [47]. In 2019, the ”eRPh” project significantly boosted drug
health records. Between 2003 and 2005, the focused was to management and prescription accuracy, improving patient
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232 Tinam-isan, MA; Naga, J: Exploring the Landscape of HIS in the Philippines

safety and healthcare quality. The year 2020 brought an the Philippines, paper-based record-keeping systems might
unexpected turning point as the COVID-19 pandemic accel- result in fragmentation, data loss, and challenges with
erated eHealth adoption. The Philippine healthcare system’s acquiring patient information, which can impair the quality
capacity for adaptation and agility was demonstrated by the of service. Profiling functionalities allow for efficient patient
crucial role that telehealth services, contact tracing apps, profile management, editing, viewing, deleting, and search-
and digital vaccine passports played in crisis management ing. E-prescription substitutes handwritten into electroni-
[47]. The Philippines’ healthcare system saw considerable cally generated prescriptions that optimizes accuracy and
changes between 2021 and 2023, with the formation of a reduces errors while streamlining medication management.
National Health Data Exchange. An important turning point Remote medical record sharing facilitates smooth collabo-
in the nation’s eHealth journey occurred in 2022 with the ration between healthcare professionals, ensuring all-around
introduction of the National Digital Health Strategy that patient care. The generation of lab test results and medical
placed a great emphasis on data security, the integration reports enables prompt and accurate data access, assisting
of artificial intelligence (AI), and the development of tele- in diagnosis and treatment. When healthcare professionals
health infrastructure. In addition, the launch of the ”eHealth have access to patient records and can send out electronic
Connect” program in 2023 was an important step toward prescriptions, rural locations in particular can benefit from
developing a uniform telemedicine framework across the telemedicine and remote consultations. Patients may no
country. This program sought to guarantee equal access longer have to travel as far for appointments, which is
to medical care, especially in isolated and underprivileged quite beneficial. Electronic records are also more resilient
communities. These developments overtime lay the foun- than paper records, which is important considering the
dation for a more digitally connected and patient-centric Philippines’ vulnerability to natural disasters like typhoons
healthcare system in the Philippines. and earthquakes. The Philippines’ archipelagic geography
frequently causes discrepancies in healthcare access, with
B. What are the features of HIS or EMRs applications isolated areas finding it difficult to get to medical services.
developed in the Philippines setting? Electronic access to health information and knowledge
In the context of healthcare in the Philippines, an under- are relevant features found in various health information
standing of the components and functionalities of health in- systems. Mapping tools integrated into HIS by enabling
formation systems (HIS) and electronic health management patients and healthcare professionals to identify the clos-
systems (EHMS) is crucial. These systems play a critical est healthcare facilities, boosting accessibility, and guar-
role in improving the overall quality and efficiency of anteeing prompt medical attention. Mapping can also be
healthcare delivery in the country. This study encompasses a key component of disaster readiness, allowing medical
various features in healthcare scheduling and communi- personnel to react quickly to situations. QR Code Readers
cations, record-keeping and prescription, knowledge and speed up medical procedures by cutting down on wait times
information, and marketplace and payment. In healthcare and overhead while membership verification is critical for
scheduling and communications, the integration of various security and privacy purposes as medical records are sensi-
scheduling and communication functions into HIS repre- tive information. Delivery tracking, medical care solutions
sents an essential part of the national healthcare infras- marketplace, home service delivery, and online payment are
tructure. Recent years have seen substantial improvements features encompass the marketplace and payment which
to these systems, especially in response to the difficulties are not typical in most HIS. In a nation with over 7,000
brought on by the COVID-19. Electronic Appointment, e- islands, it is vital to track the movement of medical supplies
scheduling, e-consultation, queuing system, and health prac- like medications, medical equipment, vaccines, and etc. It
titioner selection promote greater accessibility to healthcare is crucial to guarantee the prompt and precise distribution
services. These technological developments are especially of healthcare necessities due to the abundance of remote
useful in geographically dispersed areas since they enable places, notably in the archipelagic provinces. Patients now
people to consult doctors from the comfort of their homes. have more alternatives and opportunities to locate spe-
Simultaneously, these features not only enhance service cialized care in a country with a diversified healthcare
delivery but also mitigates patient wait times, improving system through a Medical Care Solutions Marketplace fea-
overall patient satisfaction. Furthermore, the inclusion of ture. With a centralized medical marketplace, specialized
follow-ups/monitoring, patient’s tracking, reminder system, care that patients need can solve healthcare inequities
and notifications has demonstrated the potential to improve and the varied healthcare environment of the countries.
patient outcomes through continuous monitoring of patient Additionally, telemedicine and home care services might
progress and movement and follow-up assessments. By now be delivered to patients at their front doors. This can
doing so, healthcare providers can optimize patient flow and solve the problem of patients with limited mobility and
ensure timely and efficient care delivery. According to [49] transportation challenges. It is critical to emphasize that
the PhilHealth has been aggressively investing in digital most HIS cited in the study have incorporated features in
health technologies to enhance patient booking, tele con- profiling, membership verification, lab generation, medical
sultations, and data exchange among healthcare providers. remote sharing, notifications, dashboard, electronic and e-
HIS had a number of functions that dealt with prescriptions scheduling, and lab generation. These features support the
and record-keeping. With a large and diverse population in Philippines’ dedication to addressing particular difficulties
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 Int. J. Com. Dig. Sys. 16, No.1, 225-237 (Jul-24) 233

in its healthcare system. The cornerstone of these advance- a physician-to-patient ratio of 0.6:1,000 [52]. Additionally,
ments is patient-centered care, with membership verification a structural problem that prevents the integration of HIS is
and profiling enabling people to take an active part in the low level of cooperation, collaboration, sharing across
keeping their health, and ensuring the security of access all sectors and lack of awareness of EMR. Healthcare is
to health information. Features including lab generation, delivered by a mix of public and private providers, and poor
medical remote sharing, and notifications play a crucial role communication between these sectors prevents the efficient
in supporting coordinated treatment and lowering healthcare interchange of electronic health information. Information
disparities given the country’s unique geography and the sharing and continuity of care are further complicated by the
necessity for healthcare accessibility across areas. Addi- large variations in eHealth adoption maturity across various
tionally, by actively promoting eHealth projects and digital geographic locations and healthcare organizations. Various
healthcare in the Philippines, the government has prepared challenges related to ICT were also found thru this study.
the path for the adoption of features like computerized These challenges encompass organizational limitations, a
scheduling, which guarantees effective resource allocation. lack of IT facilities and equipment, technical issues, and
The Philippines’ goal of using data to influence healthcare suboptimal design. Inadequate infrastructure is found to be
decisions facilitated by dashboard is in line with the em- a barrier to the adoption of EMRs and HIS across the nation,
phasis on data-driven decision-making. Lastly, the Chatbot, which is also supported by Torres and Marcelo (2018)
QR Code Reader, Medical Care Solutions Marketplace, [53]. The development and integration of these systems are
Home Service Delivery, Online Payment, and Notifications often hindered by constrained funding, disjointed health-
features represent the integration of modern technology and care systems, and organizational resistance [54]. Hardware
convenience into healthcare management. These qualities issues and technical issues are also major challenges in
enable a flexible and patient-centered approach to healthcare the Philippines. The viability of HIS and EMRs depends
delivery as they adjust to the changing requirements and critically on the availability of dependable and durable
expectations of patients and healthcare professionals. In IT infrastructure, hardware, and software. Inefficient or
conclusion, the study’s wide range of findings serve as a incompatible hardware can cause system failures and in-
roadmap for creating comprehensive healthcare solutions efficiencies in many healthcare institutions, which lowers
that put the needs of patients, accessibility, and operational the level of patient safety and the quality of healthcare
efficiency. These features also reflect the current trends and provided. In addition, the user experience and adoption of
challenges in healthcare management. The effectiveness, these systems can be negatively affected by bad interface
accessibility, and quality of healthcare services can be design. The relevance of usability and user-friendliness
considerably improved with the inclusion of these function- is indisputable, and systems that are challenging to use
alities. or understand may discourage healthcare providers from
using them [55]. According to Torres and Marcelo [53],
C. What kind of challenges and risks are considered in the other elements that might lead to fragmented treatment and
implementation of HIS or EMRs in the Philippines? inefficiencies in the healthcare industry include the lack of
The implementation of HIS in the Philippines encoun- interoperability across multiple healthcare systems and a de-
tered into a number of challenges, many of which are sign that prioritizes individual needs over holistic healthcare
human resource-related, ICT-related, infrastructure, strate- management. Additionally, another major issue that may
gies and policies, and funding. These difficulties have impede the successful integration of HIS and EMRs is the
made it harder for the nation to fully embrace and use absence of key infrastructures including a reliable power
eHealth technology like electronic medical records (EMRs). supply, suitable hardware, and well-equipped healthcare
Inadequately trained personnel, user resistance, and change facilities. Like many developing countries, the Philippines
reluctance are prevalent issues in many nations, but they experiences resource shortages that limit access to vital
are especially common in the Philippines. There are diverse healthcare technology infrastructure [54]. In particular, the
healthcare workers in the Philippines, and not all of them absence of backup power sources might be problematic
have adequate training they need to utilize HIS efficiently. because it could result in data loss during power outages
Additionally, the country’s healthcare industry has always and interfere with healthcare operations. A stable internet
relied on manual procedures, so even while switching connection is essential for accessing and updating EMRs.
to electronic systems is efficient, it has faced opposing Inconsistent or slow internet connectivity can hinder the
views. When requested to switch from manual record- effectiveness of EMRs. In 2016, the Philippines’ Internet
keeping to electronic medical records (EMRs), healthcare infrastructure has been reported to falls behind that of
providers in the Philippines exhibit hesitation, according other developing countries in Asia, particularly in terms
to a Marcelo report [50]. A study by Carandang et al. of Internet connectivity, by contrasting the current global
(2015) [51] also found that many healthcare workers lacked ICT situation with the current condition in the country
formal training in health informatics, which hindered their [56]. Healthcare personnel may also have difficulty using
ability to use EMRs effectively. Lack of staff has also digital systems efficiently in some locations due to limited
been identified as a barrier to HIS implementation. In availability to computer hardware and related equipment
reality, the Philippines suffers a considerable scarcity of [55]. Support from administrative policy is essential for
medical workers in distant and rural regions, as seen by motivating healthcare organizations to use HIS and EMRs.
https:// [Link]
234 Tinam-isan, MA; Naga, J: Exploring the Landscape of HIS in the Philippines

The adoption of these technologies must be encouraged from electronic appointment booking, lab result creation,
while privacy, security, and interoperability concerns are ad- and medical remote sharing, to patient profiling and mem-
dressed [57]. Furthermore, strong strategies are required to bership verification. Such features try to address the nation’s
guarantee that institutions are compliant with changing rules diverse healthcare environment and geographic challenges
due to regulatory compliance and evolving expectations by placing a high priority on patient-centered care, acces-
for healthcare providers [58]. A major issue is hospitals’ sibility, and data-driven decision-making. Notwithstanding,
resistance to using real-time data. To improve patient care there are several obstacles associated with the adoption of
and healthcare decision-making, healthcare facilities must HIS and EMRs in the country. These include a lack of coop-
have the infrastructure and desire to communicate real-time eration and interoperability within the healthcare industry,
information [59].The adoption process might also be slowed opposition to change, and undertrained healthcare workers.
down by leadership’s lack of medical vision in particular. Additional challenges include inadequate IT infrastructure,
Since their support and vision are essential for a success- technical problems, and inadequate system architecture. The
ful adoption, healthcare organization leaders must have a effective integration of eHealth technology is impacted by
thorough understanding of the potential advantages of HIS inadequate financing, administrative policies, and leadership
and EMRs [60]. The Philippines’ cybercrime legislation is vision; on the other hand, uncoordinated ICT expenditures
based on the Republic Act [RA] No. 10175, the Cybercrime and budgetary restrictions can hinder projects sustainability.
Prevention Act of 2012. There are provisions for prosecut- With the launch of the National Digital Health Strategy and
ing violations against data confidentiality and integrity, as programs like the ”eHealth Connect” program in 2023, the
well as offenses using computers (such as computer-related Philippines is moving forward with eHealth despite these
forgeries, fraud, and identity theft). Financial challenges obstacles. With a focus on data security, AI integration,
must be addressed if eHealth projects are to be implemented and telehealth infrastructure, these advancements are aimed
and sustained successfully. Medical companies might find at unlocking up opportunities for the Philippines’ health-
it hard to afford the high initial implementation costs [61], care system to become more patient-centered and digitally
and uncoordinated ICT expenditures within the industry linked.
may result in inefficiencies [62]. The implementation of
eHealth programs in the public sector may be hampered
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Mia Amor C. Tinam-isan is an educator
[52] Philippine Health Insurance Corporation. Strategic Plan for 2021- affiliated with the MSU-Iligan Institute of
2023- Changing Gears: Moving Philhealth on High Speed. 2021. Technology, where she has served in the
Information Technology Department within
[53] C. E. Pulmano, A. B. C. Dy, S. J. M. Wenceslao, L. S. Tanchanco,
and M. R. J. E. Estuar. Mind plug-in: Development of an electronic the College of Computer Studies for the past
medical record based data collection tool for research in autism six years. Her research expertise spans criti-
and neurodevelopment disorders. In CENTERIS - International cal domains in Information and Communica-
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national Conference on Project MANagement / HCist - International Cybersecurity, and Data Mining. Mia Amor
Conference on Health, pages 646–653, 2019.
C. Tinam-isan has demonstrated her com-
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O. K. Usman. Acceptability testing of a mobile application to

https:// [Link]
 Int. J. Com. Dig. Sys. 16, No.1, 225-237 (Jul-24) 237

January F. Naga is a doctoral candidate - Iligan Institute of Technology. Her re-

in Information Technology at De La Salle search interest encompasses a unique inter-
University- Manila. In addition to her rigor- section of social computing, cybersecurity,
ous academic pursuits, January is a faculty and health informatics.
member at the Mindanao State University

https:// [Link]