Digital Healthcare

Philippine Hospitals HIS Adoption: Which Level Are You in?

Philippine Hospitals HIS Adoption: Which Level Are You in? 768 487 Exist Software Labs

This blog is the first in a series where we examine the state of HIS use among Philippine hospitals.

Information systems in healthcare have evolved tremendously over the years. The use of some level of information management has become virtually indispensable among care providers, facilities, and health systems.  Around the world, the current pandemic has placed a spotlight on healthcare. It also set a level of scrutiny on how care is safely and efficiently provided. In this era, it generally involves the use of tools and IT systems.

WHO states that what constitutes its importance is that, “such information systems serve multiple users and a wide array of purposes that can be summarized as the generation of information to enable decision-makers at all levels of the health system to identify problems and needs, make evidence-based decisions on health policy and allocate scarce resources optimally.”

Health information systems are called upon to enable tracking along the continuum of inputs to the health system, from processes, outputs, as well as outcomes and impact. 

Yet, owing to prohibitive costs and competing priorities, few developing countries have hospital and care facilities that have sufficiently strong and effective health information systems to meet all these diverse and important information needs.

Like a growing enterprise, achieving a level of care system requires carefully thought out strategies. These involve starting with organizational objectives before even thinking about core features.  It also means assessing and building up support capabilities while considering the tools that will help lead the team towards its goal.

Leading healthcare analytics company Health Catalyst, has brilliantly laid out a historical table that helps hospitals figure out which stage they are in their healthcare systems.

  • The main healthcare drivers in this era were Medicare and Medicaid. The IT drivers were expensive mainframes and storage. Because computers and storage were so large and expensive, hospitals typically shared a mainframe. Shared hospital accounting systems were the principal applications emerging in this environment.

  • One of the main healthcare drivers in this era was the need to do a better job communicating between departments (ADT, order communications, and results review) and the need for discrete departmental systems (e.g., clinical lab, pharmacy). The reduction of hardware size allowed the installation of computers in a single department without environmental controls. As a result, departmental systems proliferated. Unfortunately, these transactional systems, embedded in individual departments, were typically islands unto themselves.

  • Healthcare drivers were heavily tied to DRGs and reimbursement. For the first time, hospitals needed to pull significant information from both clinical and financial systems to be reimbursed. At the same time, personal computers, widespread, non-traditional software applications, and networking solutions entered the market. As a result, hospitals began integrating applications so financial and clinical systems could interact in a limited way.

  • In this decade, competition and consolidation drove healthcare, along with the need to integrate hospitals, providers, and managed care. From an IT perspective, hospitals now had access to broad, distributed computing systems and robust networks. Therefore, we created an integrated delivery network (IDN)-like integration, including the impetus to integrate data and reporting.

  • The main healthcare drivers were increased integration and the beginnings of outcomes-based reimbursement. We now had enough technology and bedside clinical applications installed to make a serious run at commercial, real-time clinical decision support.

The information above gives us a concrete way to frame where most Philippine hospitals are in their hospital information systems journey — which more or less cuts and jumps through the different periods while also dependent on the level of and type of hospital organization (primary, secondary, tertiary and teaching) to which they belong.

It is also good to point out that several factors mainly influence part of the adoption of these systems in local settings (approximating the following in order of importance):

For the most part, Philippine hospitals were mostly using systems primarily supporting ADT and other operational requirements. While leading hospitals have blazed a trail of their own by benchmarking their systems globally, most had systems that were mostly siloed or islands among themselves.  Using paper, these hospitals barely even touch and encode clinical data. Such practice leaves doctors and care professionals to depend solely on their own competencies, sorting through paper medical records, and delivering successful outcomes against the growing complexities of providing care.

But lately, things have been accelerating towards the adoption of better systems that require substantial clinical data because of government mandates related to DOH EMR compliance and Philhealth financial reimbursements.  

Modern requirements subtly push Philippine hospitals to make use of electronic medical records for reporting statistics. Some of these include the renewal of licenses as well as providing correct clinical data to support claims reimbursements.  The outcome is multi-fold as this forces Philippine healthcare to shift from paper to electronic. It also promotes increased use of data in providing care and upgrade to systems that make better use of IT. Implementing these technologies will reduce manual errors and manage care complexities. Thus, leading to more team collaboration.

So, can we say that the use of better hospital systems in the country is making progress?  Tell us what you think!

In another article, we will discuss the available options for hospitals that aspire to step up in their healthcare proposition. As well as differentiate themselves against the competition using IT innovation.

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Virtual Launch of the PhilHealth Registry of Newborns

Virtual Launch of the PhilHealth Registry of Newborns 768 487 Exist Software Labs

Nearly 350,000 babies are born prematurely in the Philippines each year, accounting for about two in 10 of all babies born. This urgent health crisis faced by our newborns heeds for raising awareness of preterm birth. That’s why on November 17 of every year, the Philippines is one in commemorating World Prematurity Day.

As the country’s largest health insurance provider, PhilHealth moves a step forward in utilizing accurate data that will improve our vulnerable newborns’ care and health outcomes.

Tomorrow, at 9 AM, PhilHealth will be hosting a webinar on its official Facebook pageTogether for Babies Born Too Soon: Caring for the Future highlights the virtual launch of the PhilHealth Registry of Newborns.

Wolters Kluwer, Exist Highlight Evidence-Based, Decision Support in Healthcare IT Webinar

Wolters Kluwer, Exist Highlight Evidence-Based, Decision Support in Healthcare IT Webinar 768 487 Exist Software Labs

As an important step towards its ultimate goal of improving the quality of care and support the frontline healthcare providers make better evidence-based decisions, Wolters Kluwer, a global provider of professional information, software solutions, and services, teamed up with Exist in the healthcare IT webinar entitled “How Reducing Variations is Key to Improving Patient Outcomes (and defeating COVID-19)“, held last August 13, 2020.

Exist Vice President for Sales & Marketing; Director of Healthcare Solutions Mr. Willex Perez and Partner Business Lead ASEAN Region at Wolters Kluwer Clinical Effectiveness Ms. Amanda Tay were the event speakers.

The following are among the key takeaways from the event:

      1. Reduce risks in treatment errors, and its Financial consequences
      2. Provide Consistency in Quality of Care 
      3. Get the latest clinical evidence-based treatment 
      4. Improve patient monitoring, safety, and reductions in adverse drug interactions 
      5. Increase inpatient consultations and avoidance of unnecessary tests.

With the banner theme of providing the best evidence to make harmonized decisions, Ms. Tay presented valuable data from studies conducted by researchers all over the world, indicating the shortcomings in providing quality patient care, and prevalent medication errors occurring around the globe.

She elaborated on how healthcare solutions bring clinical effectiveness and improve the overall patient journey. Moreso, how their solutions, UpToDate and Lexicomp, are the top providers of world-class clinical decision support at the Point of Care.

She also highlighted that what sets them apart from other support systems is that these applications are backed by experts in the medical field performing continuous and updated reviews. 

These two build up a network of thousands of clinician experts, pharmacists, specialists, and more all actively contributing to the contents of the applications. They are the ones who will help you scour through all journals, and clinical studies to provide the synthesized and summarized content so that you don’t need to read every single resource,” she said.

Mr. Perez also expressed his appreciation for the event participants. 

We hope that this learning session has helped the frontline healthcare community understand that unwanted variability in care brings inefficiencies and provides negative impacts on the quality of care that the patient receives,” he stated. 

“Also, we hope that we were able to show how extensive the coverage of UpToDate and Lexicomp is, and why it is preferred by clinicians all over the world for being an unbiased, evidence-based clinical decision support resource. The things that set it apart from other resources in the rigorous editorial process that is being updated constantly, the graded recommendations for diagnosis and treatments, clinical pathways and lab interpretations, and the wide range of access, including mobile devices.” Mr. Perez said as he ended the online event.

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How Reducing Variations is Key to Improving Patient Outcomes (and Defeating COVID 19) Webinar Highlights

How Reducing Variations is Key to Improving Patient Outcomes (and Defeating COVID 19) Webinar Highlights 768 487 Exist Software Labs

Speaker 1: Mr. Willex Perez | Exist Vice President for Sales & Marketing; Director of Healthcare Solutions

Our current situation right now is like the rug pulled under our feet. We were forced to transform, and ultimately, change how we will be doing things moving forward.

This can be related to two buzz words we may have been hearing for about 3-5 years already.

The term “Digital Transformation” is felt (more pronounced this time as the use of digital platforms has become ubiquitous. We have heard about this term, but what does it really mean for the organizations that we belong to, and what are the challenges that they encounter? 

Digital is not just a computer and a network connection. While it is true that computers enable us to adjust to this situation, “digital” really means:

      • The ability to take physical work by a person at a place, and be able to take it to a virtually
      • Automating the work to be done by anyone or anything (machine) anywhere. These services are given to the clients to address their needs while providing better convenience and customer experience

Transformation, on the other hand, is predominantly used in Economics and Sociology as this is people-driven. It touches the very infrastructure and the people surrounding it from each socio-economic class. Transformation or change involves people, businesses, and organizations as well as the workforce and the customers, bringing change into new ways of how we conduct our work into our lives using digital platforms.

The biggest challenge for organizations in implementing a digital strategy is providing leadership—a leadership team that understands and is ready to face the challenge. While a lot of resources are being poured towards this transformation, many are failing. A winning team needs to keep its eye on where the ball will be and not where it has been. The question that you may ask is: Are you investing in the future or are you still working on what you currently need? But Technology is only as an enabler. To wield its great potential, great leadership is needed to get the most out of new opportunities it brings, and avoid the dangers that come along with it.

Here are some examples of adoptions of digital solutions that we may, or may not, be aware of, either by force or by choice:

Like mobile Banking, for example, which we take for granted.

Our banking experience is way different compared with that of the previous generation. To transact nowadays, we need not go to a physical bank. Banks will do well to target clients, not just by managing their physical branch but improving their online services which impact how they maintain their presence as well as managing their operational expenses.

Entertainment is enjoying the greatest hit of all industries at the moment with leading providers distributing their multimedia content globally online through streaming platforms such as Netflix.

With the threat of infection, education is now forced to shift online, too. 

Our days begin and end consuming news and information online from our preferred digital platforms. But with the prevalence of fake news nowadays, we are careful about our sources of information and realize how important it is to do fact-checking.

Doctors like yourselves face the same dilemma. As you may observe, doctors (especially clinicians) need a reliable resource to help them as they are always pressed for time to diagnose and treat patients.

Why is your source — for the latest evidence-based medical information to update your medical knowledge and answer your clinical questions important?

The importance of getting reliable information affects the high occurrence of medical errors. This ability to get hold of evidence-based information helps in assisting the doctors at the point of care. When a clinician experiences fatigue and information overload in making a clinical decision.

 

 

This study highlights that medical error is the 3rd biggest killer in the United States.

Yet in 2019, medical errors are about as prevalent as in 1999. “To Err Is Human” was an uneasy read; so is a September 2019 report on patient safety from the World Health Organization.

Among WHO’s findings:

      • Globally, hospital-acquired infections afflict about 10% of hospitalized patients.
      • Medical errors harm some 40% of patients in primary and outpatient care. 
      • Diagnostic and medication errors hurt millions and cost billions of dollars every year.

– TIME BY KATHLEEN SUTCLIFFE NOVEMBER 5, 2019

Things haven’t changed much. Medical errors harm 40% of patients in primary and outpatient care.

The good news is this handling this error are:

      • It is preventable
      • There are tools and digital platforms available, such as UpToDate, wherein information is
            • Evidence-based 
            • Updated regularly by a team of over 6,000 doctors
            • Comes with Graded recommendations
      • Affordable to countries in Asia, especially in the Philippines wherein UpToDate is already being used by numerous clients

UpToDate is the best online resource being used by over 34,000 medical institutions and hospitals with over 1.3 Million doctors across the world. Evidence shows that UpToDate is proven to result in better hospital performance and improve patient outcomes.

Speaker 2: Ms. Amanda Tay | Partner Business Lead, ASEAN Region at Wolters Kluwer Clinical Effectiveness

How we can help and support your institution in delivering the best clinical decisions support resources to enable you to improve patient outcomes as well as improve patients’ safety?

There are studies that support the idea that patients only receive about half of the recommended processes involved in care. This is due to imperfect information flow, different skill sets across the organization, patients who are able to determine what type of treatments they would like to go after as well, and of course inefficiencies and inconsistencies in the approaches that they take, which is apparent in the current day context.

But this also translates into prescribing errors according to this issue of BMJ Quality & Safety. This study shows that 43 million adverse drug events related to medication errors, drug screening misses, or else occur each year around the globe. It’s very appalling to think about what’s the impact on patient outcomes then.

With all these inconsistencies and unwanted variability in care, up to 30% of global healthcare spend is wasted on unnecessary costs on healthcare annually and that’s about $1,700 per person each year. 

With all of these evolving things that are happening around the world, are we in the right position to tackle such unwanted challenges?

Wolters Kluwer’s healthcare team has already started working with their editorial team, making sure that our support allows our frontline healthcare community to be well equipped to handle and tackle challenges like this pandemic.

In January, Wolters Kluwer already released their first COVID19 topic. From then on, there have been countless contributions to the creation of new topics as the pandemic develops.

As they deem this very important, they provided free UpToDate access for two (2) months in March to support the frontline users and non-users, allowing them to access to clinical decision support resources during this sensitive time.

Since January, all the way to July, they consistently contributing evidence-based clinical contents, making sure that it’s credible and well supported. These contents are immediately available to users which is important in providing assistance to healthcare providers in tackling their uncertainties during their in-depth journey. As of now, there are over 500 updates regarding COVID19 topics alone.

UpToDate became the predominant resource when it comes to COVID19, with millions of views of their topics that have been recorded since the spike of cases.

To tackle unwanted variability in care, the improvement in patient outcomes is determined by the quality of care team decisions, and how it aligns across teams. It is also dependent on the care team behavior, and care team alignment.

When you look at care team behavior, you’ll think of doctors with varying experiences, and different team members with different temperaments and personalities. Would they use software to support their clinical decision making? This also determines how efficient they make decisions, and how accurate it is, and they pass it on to their care team in the pharmacy department to proceed with the drug orders, to the patient ward, and others. It is not a one-man effort. It is across various departments.

How do you put everything together to ensure that you are leaning on a consistent, evidence-based resource? At every step at every point in a patient’s journey, you have to make a decision. That is why it is very important to have evidence-based content that is very credible. It is important to think about what other resources can you consider to ensure that you are well supported with an integrated playbook.

Imagine having that across every step of the journey, with different types of tools and resources that play different parts in supporting your care team.

UpToDate is a global leader for evidence-based clinical decision support. It is now upgraded to support physicians by having interactive pathways that can help them in the decision-making process. Laboratory interpretations feature were also added to help the physicians assessing the software to understand the types of scenarios that might occur.

Lexicomp, on the other hand, is a drug referential resource, with a huge drug database that is accessible for the users, which can certainly reduce medication errors as well using the tools available in it. Thousands of hospitals and retail pharmacies lean on Lexicomp as the key drug resource.

What could UpToDate and Lexicomp offer?

 

UpToDate and Lexicomp provide the ability to go into complex cases and go into recommendations. It is graded, thus signifies that it is supported with evidence-based, and unbiased and neutral clinical studies. These two build up a network of thousands of clinician experts, pharmacists, specialists, and more all actively contributing to the contents of these two applications. They are the ones who will help you scour through all journals and clinical studies to provide the synthesized and summarized content so that you don’t need to read every single resource which will save you some time, especially at the point of care.

UpToDate and Lexicomp provide harmonized care decisions throughout a patient’s journey. Information is easily accessible to users at each department. It ties everything together. The whole clinical healthcare team across all the departments are able to lean on a synthesized and integrated playbook, a single source of truth that can support all departments. They get consistent information and have a good discussion with each other through these two.

Japan did a retrospective study across hundreds of diagnostic reports prepared by doctors against a group that did not use UpToDate versus a group that uses UpToDate. What they found was extraordinary in that for those using UpToDate, the diagnostic error was 2%, as compared to a 24% diagnostic error for those who were not. Imagine the impact on the patients who could have benefitted if the doctors referred to UpToDate, ensuring that not many medication errors occur.

In a recent Hospital Insights Asia interview with Asian Hospital’s Dr. Ana Maria Jimenez, she stated that by using UpToDate for two (2) years, there has been a decreasing trend in their ICU mortality ratio.

Meanwhile, The Medical City’s Dr. Rafael S. Claudio said that UpToDate is comprehensive and authoritative with an extensive list of clinical topics available that is easy to use for its simple interface. This supported his physician team on their journey to treat patients.

Also, Wolters Kluwer’s Clinical Information Drug Surveys show that the impact of Lexicomp is definitely broad and overwhelmingly positive.

Another consideration that you might have is if it is recognized/accredited.

 

See full list of accreditations.

It is understandable that training and education is one of the key areas that healthcare institutions focus on. How do you make sure that everyone is well-equipped, and is continuously upskilled? That is why you should consider what other resources are available to support you on this journey. With our efforts to get UpToDate recognized in PRC, we offer continued professional development support.

In summary, these solutions that we offer provide:

      • A harmonized approach to help you support and improve your quality of care.
      • Reduce diagnostic and medication errors to help you treat your patients fast 
      • Quicker and more efficient flow to shorten their length of stay so that you can help more patients
      • Improve patient education and engagement

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.

Healthcare IT and Digital Tools Help Clinicians Provide Quality Care

Healthcare IT and Digital Tools Help Clinicians Provide Quality Care 768 487 Exist Software Labs

If improving treatment and patient care is the goal, then we need to help clinicians and support their pursuit of quality improvement initiatives.

In a study published in the International Journal for Quality in Health Care, researchers at Sacramento, Calif.-based UC Davis Health analyzed survey responses from 212 clinicians and measured self-efficacy and effectiveness of clinicians in conducting and leading QI activities.  

Five main factors that increased clinicians’ effectiveness in QI:

1. Dedicated time for quality improvement.

2. Working within multidisciplinary improvement teams.

3. Professional development in QI, including formal training inside and outside the organization and QI organizational memberships.

4. Ability to select areas for improvement that the clinician views as high priority or that interests them.

5. Organizational values and culture that support QI.

The study also found that some of the most successful clinical QI initiatives focused on improving patient safety and reduction in medical errors, reducing waits and delays in care, reducing overuse of unnecessary services, improving patient- and family-centered care, and/or reducing health disparities.

Even in non-crisis situations, these suggestions are easier said than done on paper.  

Hospitals are under siege and medical personnel now work double-time to accommodate patients while at the same time expected to research clinical protocols to help those with COVID.  Time has become scarce while the quality improvement, along with other initiatives take a backseat.

This is precisely the reason why healthcare IT is becoming a significant ally in the medical front.  With the use of systems and digital applications, medical staff and clinicians can reduce manual interventions and duplicate efforts and ensure that coordination among teams needs to be quick and timely.

With the urgency and pressure required for overworked personnel to deliver patient services, the risk of committing medical errors also increases. From missed diagnosis and protocols to accidental medication errors, any of these can be fatal. The use of clinical decision support embedded into systems reduces clinical variability.  These tools alleviate the cognitive stress suffered by clinicians and ensure strict observance of correct protocols much like pilots rely on checklists before the plane leaves the tarmac.

At Exist, we believe that digitally-transformed healthcare institutions can provide better patient services by tearing down information silos—keeping various working departments in sync at all times. From operational to clinical processes, enterprises of all types have already taken advantage of IT systems’ ability to keep transactions moving efficiently and well-coordinated.  

However, employing healthcare systems is still just a part of the whole care quality ecosystem. Doctors and medical personnel remain vital for they are the ones equipped with the abundant knowledge required to treat the patient.  It is the same knowledge that also needs to be continuously reviewed, tested, and updated.  A task that can be impossibly difficult given the massive amount of information we all now have to deal with.

But innovative solutions do exist and we are proud that Wolters Kluwer Health has chosen us to be one of their partners to help Filipino clinicians by providing medical resources needed at the point of care in a 21st-century manner. 

The benefits are multifold. Through UpToDate and Lexicomp, clinicians access valuable and updated medical information at the point of care — one that promotes and strengthens the use of evidence-based care.  At the same time, provide hospitals with a powerful tool that keeps quality improvement initiatives for personnel moving continuously as new and updated research becomes available in any part of the world.

Learn More!

Learn more about UptoDate, Lexicomp, and our partnership with Wolters Kluwer in our shared pursuit of promoting clinical excellence.

COVID Puts Spotlight on Healthcare IT

COVID Puts Spotlight on Healthcare IT 768 487 Exist Software Labs

Immune to IT’s charms, digital healthcare gets an unwelcome boost.

Every crisis is a challenge as well as an opportunity.  It has always been the case for healthcare. Right now, the case for hospitals and care centers to go digital has never been stronger. 

In the IT industry, it only takes weeks to months to jump and move into action when there’s a glimpse of technology that could potentially disrupt the way things work. Small, incremental improvements are often enough to elicit a quick decision to adopt a particular app or system into an existing process. Winning the business battle in today’s economy often begins in the front-ends and back-ends but like the rest of the other verticals, healthcare executives still suffer from cold-feet about this.

Until COVID 19 happened.

Within a month, care providers and institutions have realized that fighting the pandemic requires equipping the workforce with digital cover. At Geisinger, these digital efforts were organized in three areas:

      1. Communicating information to prevent future infections;
      2. Leveraging technology to advance clinical protocols; and
      3. Shifting the majority of the workforce to telecommuting.

Information about the COVID 19 virus was unfolding by the day requiring that communication platforms and channels were kept running smoothly to provide timely and updated guidance into managing the disease as an institution.  

Corollary to this is the rise of contact-tracing apps aimed at preventing the spread of infection. Hospitals can rely on this app to protect both staff and family visitors who need to be with the patients. Aside from being an effective monitoring tool for persons that were at a given location, these digital apps limit the need for in-person touchpoints which reduce the risk of contagion.

Information resources about COVID 19 are just as essential when news about treatment reaches both the medical community and the public at roughly the same time. Note however that in the practice of medicine, the job of separating facts from fiction passes through stringent medical research which is most likely under the greatest pressure it has ever been.  

Simply combing through research papers about COVID 19 wouldn’t work in this hectic scenario. Ensuring that doctors, nurses, and the entire hospital team operate using updated and guided protocols at the point of care requires implementing and integrating decision support resources into hospital systems to reduce the variability of care.

The use of virtual teams and telemedicine has never been so important to keep a semblance of a patient-doctor relationship amidst social distancing. Infrastructure teams perform important work in keeping networks running and secure at all times. Software teams are scrambling to improve apps that allow full patient experience done virtually from home including appointments, video consultation, payment, and remote monitoring which benefits the doctors and hospitals as well.

By reducing the need to meet personally, the need for doctors and hospital staff to be onsite is also minimized and this keeps them safe as well. For hospital IT teams, the use of web-based frameworks allows them to monitor, update, and perform fixes for hospital systems offsite which reduce crowding the premises as well. 

We are nowhere near the end of the pandemic as all businesses, including healthcare have been greatly affected by COVID 19. Whether hospitals will continue with a ‘patch and resolve’, segmented, and siloed IT approach or incorporate all this into a comprehensive and cohesive strategy remains to be seen. Regardless, the benefits of adopting a digital approach will continue to reveal itself. Let’s just hope it doesn’t take another global pandemic to enforce this realization.

Join us as Wolters Kluwer and Exist host a learning session on “How Reducing Variations is Key to Improving Patient Outcomes (and Defeating Covid 19)” and take a deeper look into proven approaches for improving your hospital organization’s care quality and clinical effectiveness!

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.

Philhealth: Promoting Quality Care For Filipino Patients

Philhealth: Promoting Quality Care For Filipino Patients 768 487 Exist Software Labs

As the country’s largest health insurance provider and primary source of hospital funds, Philhealth can single-handedly affect healthcare policy changes unlike any other.  Even as the Dept of Health struggles with handling the COVID 19 pandemic – the accuracy of reporting, recruiting, and empowering medical personnel not to mention managing its public persona, Philhealth has continued to stealthily move powerful care institutions to do its bidding with less fanfare.

This is not to say that resistance is non-existent.  On the contrary, Philhealth is among the most difficult to please, for being quite unpredictable and dynamic as it responds to situations with its advisories via its circulars.  One must understand that it is responsible for a huge amount of money. Leaving hospitals huffing and puffing with sudden policy changes and updates to ensure proper disbursements, claims and billing departments can only breathe a sigh of relief if their counterpart team of doctors, nurses, and other care providers are as flexible as their IT personnel.

Beginning in 2018, Philhealth has made and remade its eClaims system not just as the primary payment system for medical services but a valuable cross-checking clinical tool.  It wouldn’t be surprising that as time passes, the eClaims will be requiring more and more supporting data in the form of clinical information that will be good enough to paint a picture of patient health statuses and clinical protocols for every medical condition.  

What may initially be just diagnoses, the data in eClaims submitted by hospitals for their patients include procedures, medications, and other forms of treatment received. By being digital, cross-referencing the case rates with allowable treatment is now possible. One could surmise that the eClaims will not just offer proof but more importantly, ensure that globally-accepted, evidence-based clinical protocols were followed to approve the reimbursements.

In this scenario, hospital information systems will play a vital role in streamlining the process of eClaims processing.  While doctors and care teams ensure that correct and minimally varied treatment protocol is followed in treating patients, they would also be looking to match these with case rates and requirements as well. With digital systems in place that store clinical data such as EMR, the eClaims reimbursement forms would then require minimal manual encoding and prevent literally, ‘costly’ errors.

If payment reimbursements are not enough reason to adopt better hospital IT systems and use of medical records instead of paper, then they will need to find other sources of revenue and prepare to suffer business consequences.  

Once all things fall into place, patients would also get to benefit the most.  With the requirements outlined in the eClaims, they get to receive the right treatment their condition requires and hopefully, the improved patient outcomes that healthcare institutions are primarily in existence for.

Check out our healthcare product, MEDCURIAL, and see how it helped some of the biggest hospitals in the country provide better patient outcomes.