SummaryObjectives: This paper aims to provide an overview of research and education initiatives in the Philippines. Moreover, it outlines the various agencies and organizations that spearhead the eHealth projects. Methods: The researchers utilized internet-based review of literature, key informant interviews and proceedings from two eHealth conferences among Filipino researchers in 2011 organized by the authors. Results: eHealth capacities in the areas of research, education and service have progressed dramatically in the last four decades as a result of improved access to information and communication technology. The National Unified Health Research Agenda initiatives have been led largely by higher educational institutions and organizations specializing in eHealth. Educational reforms have been seen with the establishment of the Masters of Science in Health Informatics, infusion of Nursing Informatics into the nursing undergraduate curriculum and offering of short courses on eHealth. Service-oriented organizations and innovations have also been formulated to meet the needs of the practitioners as information and communication technologies are embedded into the healthcare delivery system. Conclusions: Experts, researchers, practitioners and enthusiasts have successfully promoted awareness and uplifted the standards in the practice of eHealth in research, education and service. However, three main areas of improvement need to be given priority: (1) Policy and standards creation, (2) capability building and (3) multi-sectoral collaborations.
The availability of large, deidentified health datasets has enabled significant innovation in using machine learning (ML) to better understand patients and their diseases. However, questions remain regarding the true privacy of this data, patient control over their data, and how we regulate data sharing in a way that that does not encumber progress or further potentiate biases for underrepresented populations. After reviewing the literature on potential reidentifications of patients in publicly available datasets, we argue that the cost—measured in terms of access to future medical innovations and clinical software—of slowing ML progress is too great to limit sharing data through large publicly available databases for concerns of imperfect data anonymization. This cost is especially great for developing countries where the barriers preventing inclusion in such databases will continue to rise, further excluding these populations and increasing existing biases that favor high-income countries. Preventing artificial intelligence’s progress towards precision medicine and sliding back to clinical practice dogma may pose a larger threat than concerns of potential patient reidentification within publicly available datasets. While the risk to patient privacy should be minimized, we believe this risk will never be zero, and society has to determine an acceptable risk threshold below which data sharing can occur—for the benefit of a global medical knowledge system.
Introduction. eHealth is described by the World Health Organization (WHO) as the use of information and communication technologies (ICT) for health. The use of eHealth closes the gaps in terms of geographical barriers, time constraints, lack of healthcare professionals in healthcare and service delivery. This study is important as it provides the current landscape and status of eHealth in the Philippines. Hence, policymakers, program implementors as well as other stakeholders, including the public, will be able to know which eHealth and telemedicine services and products are available in various sectors of society, either private or government, what are the existing gaps in eHealth, and the trajectory in the future based on the guide of the World Health Organization - International Telecommunication Union (WHO-ITU). Objectives. The objectives of the study are 1) to provide a landscape of eHealth in the Philippines since its start in the country; 2) to identify programs, services, and technology innovations implemented in the country on eHealth and telemedicine; and 3) to identify Philippine systems that correspond to the eHealth components laid out by WHO-ITU for a successful implementation of eHealth at a national level. Methods. We conducted an extensive review of the literature and key informant interviews with eHealth experts in the Philippines. The literature review covered research and studies, gray literature, peer-reviewed journals, databases, and government statistics. The years covered in this study span a total of 24 years from 1997, which is the beginning of the information management system as an institutional approach in the country, to 2020. The assessment tool was based on the framework provided by the WHO-ITU on the context for eHealth development. Results. The National Telehealth Center (NTHC) of the Philippines began with projects for 1) eLearning, 2) eMedicine, 3) eRecords, 4) eHealth Policy and Advocacy, and 5) eSurveillance. Telemedicine services are now being offered by hospitals in the country. This shows eHealth services, in general, and telemedicine are being utilized in not only targeting the poor, but also in giving faster, more efficient, and equally effective virtual health services to the general public, even the private-pay patients. Conclusion. The sustainability of eHealth in the Philippines still depends on the national effort to institutionalize an eHealth structure and eHealth system where the various components are interrelated.
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