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Derek Ritz

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  • OS02 - Strategic Integration: A Global Perspective (ID 1)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/05/2017, 04:00 PM - 05:30 PM, Room 201EF
    • OS02.03 - Developing a Health Sector Enterprise Architecture for the Philippines (ID 156)

      Derek Ritz, ecGroup Inc., ecGroup Inc.; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives: The purpose of this presentation is to discuss the processes employed to develop a Health Sector Enterprise Architecture (HSEA) for the Philippines. The presentation will particularly focus on the ways digital health infrastructure is to be leveraged to improve universal health coverage, health equity, and population health outcomes in a lower middle income country. Aspects of the HSEA that presented challenges will be explored, including: governance; low resource care delivery settings; health human resource shortages; financial barriers to care-seeking; and mis-alignments between national and sub-national health adminstrations.

      Methodology/Approach: The presentation will describe the use of a "storytelling" approach to health enterprise architecture development. This methodology is particularly well-suited to use in LMIC/developing country environments. It was developed and published by the Joint Learning Network for Universal Health Coverage and published in a 2014 eBook: Connecting Health Information Systems for Better Health -- Leveraging interoperability standards to link patient, provider, payor, and policymaker data ( The presenter will focus on how this "storytelling" methodology augmented other stakeholder engagement techniques and was employed to evolve, harmonize and itegrate prior enterprise architecture efforts conducted within the Philippine Department of Health (DOH) and the national health insurer, PhilHealth.

      Finding/Results: Over the course of a short but intensive donor-funded engagement, existing enterprise architecture artefacts were analysed, stakeholder "stories" were gathered and rigorously processed, and a new, harmonized HSEA was developed. The presentation will review the attributes of this comprehensive health enterprise architecture and how it is being leveraged to inform the construction of durable, re-usable, standards-based digital health infrastructure within the Philippine health sector.

      Conclusion/Implication/Recommendations: Digital health infrastructure is a key enabler for improving health equity and population health outcomes in low resource environments. There is a moral imperative to investing wisely. Given competing uses of funds, effectiveness and efficiency improvements must result from successfully implementing such infrastructure -- or else the money should be spent elsewhere. In a country like the Philippines, this moral imperative informs the goals of a HSEA undertaking. In wealthy countries like Canada, there is a motivation to divest efficiency improvements to "bend the cost curve" -- to try to accomplish the same degree of "health production" from a reduced expenditure of resources. In the Philippines, or any LMIC environment, the motivation is the invest the efficiency improvements -- to be able to increase the "health production" that may be realized from the scarce resources available. The presentation will compare and contrast HSEA approaches and motivations between Canada and the Philippines and draw out, for attendees, particular lessons that might be taken by each, from each other's experience.

      140 Character Summary: This session describes the development of a comprehensive health enterprise architecture for the Philippines and the particular challenges LMICs face to do this.

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