BUILDING A NATIONAL INFORMATION INFRASTRUCTURE: Do we need the government?
Task 5 for #HI201 #MSMHI
This week’s driving question asks if free market forces alone are adequate for providing appropriate deployment of the national information infrastructure in support of health and health care in the Philippines?
In the Philippines, we need our PPPs–public-private partnerships to build a robust national information infrastructure (NII) supporting health and healthcare. Free market forces alone cannot be adequate if the NII is envisioned for the country’s greater good. There is a realisation, however, that we need both the private sector (driven by market forces) and our own government represented by the Department of Health (DOH) and the Department of Science and Technology (DOST) see this through. For the Philippines, key movers led to the creation of the technical working group, now under the leadership of the DOH-DOST Steering Committee. For several years, our national information infrastructure has been slowly taking shape.
“The DOH is mandated to be the overall technical authority on health that provides national policy direction and develop national plans, technical standards and guidelines on health.”(1). It is the regulator, provider, policy maker, health financier (together with the Philippine Health Insurance Corporation), developer of standards and softwares, ensurer of equitable healthcare delivery and access, protector of rights of privacy, intellectual property and security, and the entity tasked to overcome jurisdictional barriers to cooperation. (1, 2) The DOH recognised the need for internet technology (IT) governance including the health sector need for an enterprise architecture. Only government can convene stakeholders, discuss standards, publish them and implement the same. Only government can rein in the players in the wide open field of health informatics.
The Department of Science and Technology on the other hand, possess the technical knowhow. It is the “director, provider, leader, coordinator of the country’s scientific and technological efforts…It is mandated to provide central direction, leadership and coordination of scientific and technological efforts, and ensure that the results thereof are geared and used in areas of maximum economic and social benefits for the people.”
Thus, these two agencies are at the very core of the government’s efforts for a national health information infrastructure.
It is not unusual to expect free market forces to be driven by profit. It is naiveté to expect free market forces to influence players morally to think about health and healthcare much less provide a NII. Privacy, interoperability, and even setting of standards cannot be expected of private enterprise without government regulation. In the country known for monopolies and cartels, only the moral persuasion of the government can regulate this business milieu. In a free market system, that which is not profitable, is not sustainable, and is unavailable. Only government can change that.
The noble cause of providing for an NII for health and health care should be the responsibility of government. Only when government cannot do this alone is there a need to tap into the private sector. Allowing government to take the lead role in this undertaking should be built on trust, as only the government can lead such an enormous project. Only government can assure equitability of health care benefits across the country.
In the Philippines, we need both government and the free market economy to work together for a NII for health and health care.
1. Harmonize and strengthen health information systems. Health Policy Nots of the Department of Health 2008; 2(3).
2. Shortliffee EH, Bleigh HL, Caine CG et al. The federal role in the health information infrastructure: a debate of the pros and cons of government intervention. J Am Med Informatics Assoc 1996; 3 (4), 249-257.
3. Republic of the Philippines, Executive Order 128.
4. Philippines eHealth Strategic Framework & Plan 2013-2017. http://uhmis1.doh.gov.ph/UnifiedHMIS/draft-issuances/229-philippines-ehealth-strategic-framework-and-plan-2013-2017-version-3-0.html
5. Why do we need COBIT5? http://www.csi-india.org/c/document_library/get_file?uuid=6d3e2cd0-8004-48b7-91ab-b2823215dbcd&groupId=10157