March 31, 2023 — Healthcare systems in the Philippines employ various methods to store and manage data and databases. Electronic Medical Record MR apps/softwares use different back-end languages with distinct ways of development and format. The UP Manila Standards and Interoperability Lab (SILab) observed this pressing problem of having health data in isolation from each other and sought to standardize the way of communication between providers by enabling interoperability.

To help translate narrative policies into computable representations, SILab promoted the use of the latest available technology in the country called the Fast Healthcare Interoperability Resources (FHIR) standard format which was developed by Health Level 7 (HL7). While HL7 focuses on clinicians venturing into IT, the FHIR standard focuses on developers. The hackathon invited developers from EMR provider-partners of the DOH in coding and delivering Use Cases in their systems.

The hackathon delved into 5 Use Cases using mock-up data under the viral hepatitis scenario. Use Cases 1 and 2 looked at searching for a patient and retrieving a result if there are matches or none. Cases 3, 4, and 5 were about creating a new patient record, creating the new visit record, and updating the new and existing patient records for the patient’s return. This builds capacity under progressive layer L4, Executable, in the WHO’s SMART guideline components that move from paper systems towards smart digital systems. Once data builds up over time, it will be possible to move to progressive layer L5, Dynamic, to gain a “precision health model.”

SILab’s initiative adheres to the World Health Organization’s (WHO) SMART guidelines of being Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable that steer localization and implementation. Should the DOH adopt the FHIR as a layer for its Philippine Health Information Exchange (PHIE) in the future, it will help EMR providers to be introduced to FHIR under the viral hepatitis scenario.

SILab works on an initial model that leads to a proof of concept bearing a potential for possible replication in other diseases.

SILab builds the capacity of facilities to use health data for decision-making and continuity of care aligned to the standards of the DOH and the Philippine Health Insurance Corporation. The FHIR uses the RESTful API model as a way of interfacing the information exchange. Its standard set of resources caters to 80% of the world while the remaining 20% can be extended/modified depending on the setting needs. Currently, there is no regulation yet on how EMRs should be developed. 

Haziel May C. Natorilla