Hello, Hello?

Communication, the exchange of information is a powerful tool. As I have previously discussed in other entries, sharing of health information between different health institutions can help improve the speed and quality of healthcare in the country. Telehealth is a general term for using telecommunications technology in delivering health-related services. The concept is not that new. Using this definition, any phone call or text message from one health worker, asking for the opinion of another in health care management can be considered telehealth. However, there are electronic health systems that have been created that rely on telecommunications. The National Telehealth Center, based in U.P. Manila already has telehealth systems being put into use under their belt. Both CHITS and RxBox, which I have previously mentioned, are examples of telehealth systems that the NTC developed.

Private companies are also getting into telehealth. Just this year, Globe started KonsultaMD, which is a hotline that can be used by subscribers or prepaid customers for medical consultations. With this development, the issues of rules and regulations arise. Can anyone start a telehealth system? How can it be made sure that they are providing good services and not risking the lives of their costumers? If someone is providing poor telehealth services, can they be held responsible and punished? Who will set rules and guidelines to address these issues? This is why the Telehealth Act of 2012 was proposed. The assignment for this week was to review the proposed Telehealth Act (House Bill 6336), choose two sections, evaluate, and suggest revisions.

Before I go into the two sections I chose, here is a basic rundown of what the bill contains. Section 1 is the short title of the act, “Telehealth Act of 2012.” Section 2 is a declaration of policy, which states that the state must promote the right to health, and that it is the goal of the current administration to attain universal healthcare through the use of ICT. Section 3 states the objective of this bill; the basic purpose being “to provide a policy framework and establish a National Telehealth System that will govern the development and practice of telehealth in the country.” Section 4 lists the definition of terms mentioned in this bill. Section 5 is on telehealth being authorized to practice in the country and that all health providers practicing it must follow guidelines and undergo accreditation. Section 6 states the scope of the law, which covers all telehealth practitioners in both the pubic and private sector. Section 7 selects the DOH as the leading agency to implement the law and its responsibilities. Section 8 mentions the formation of the National Telehealth Board (NTB), the composition of the board, and its duties. Section 9’s topic is the formation of the National Telehealth Reference Center (NTRC), its head, and its duties. Section 10 goes into the establishment of Regional Telehealth Centers and requirements for accreditation. Section 11 is about the NTRC writing technical standards and providing technical assistance to telehealth centers. Section 12 states that the NTRC is to create national patient database that unifies all information gathered by the different telehealth centers. Section 13 says that violation of the regulations and guidelines set by the NTB will be sanctioned based on the NTB’s decision. Section 14 lists the funding for the implementation of this law. Section 15 is the repealing clause. Section 16 is on separability. Finally, section 17 is on effectivity.

The first section I evaluated was Section 8. Along with the DOH and DOST secretaries being the co-chairpersons of the board, the other members of the NTB are:

1. the Executive Director of the NIH as vice-chair
2. the Executive Director of the NTRC, as an ex-officio member
3. an Undersecretary of the Department of Interior and Local Government
4. a representative of the League of Municipalities in the Philippines
5. a representative of the League of Provinces in the Philippines
6. a representative of the Philippine Health Insurance Corporation (PhilHealth)
7. a representative of the Association of Municipal Health Officers of the Philippines (AMHOP)
8. a representative of any accredited medical organization
9. two representatives of underserved areas, as recommended by the NTRC

The board is tasked with:

1. establishing telehealth guidelines and regulations important to its practice and service provision
2. providing recommendations to the National Telehalth System pertinent to telehealth-related human resource development and compensation
3. recommending corrective measures and resolutions on issues related to telehealth as deemed necessary
4. setting and impose appropriate penalties
5. conducting an annual review of reports on quality assurance by the NTRC
6. setting policy and program recommendations for the development of telehealth
7. submitting yearly assessments to the DOH
8. meeting at least twice a year

Looking at the above duties of the NTB, particularly setting guidelines, regulations, and penalties, there should be proper representation in the board for all those involve in telehealth. However, looking back at the scope of this law:

Section 6. Scope of the Act - The Telehealth Act covers all existing telehealth practitioners in both the public and private sector…

With the private sector being affected by this law, I think that they should have some representation on the board as well. At least have someone from the business sector involved in health services as a consultant when setting the guidelines, regulations, and penalties. Similar to the representatives from underserved areas, it provides useful insight for the board on how private corporations develop and use telehealth. There is also no representation for network service providers. Since telehealth relies on telecommunication, they are greatly involved in providing these services.

The second section I chose was Section 13, which states: 

Section 13. Penalties - All individuals, groups, companies, and/or entities practicing telehealth who violate regulations and guidelines set by the National Telehealth Board shall be subjected to penalties as set by the Board, without prejudice to any criminal, civil, and administrative cases thereof.

This is pretty vague. Compared to the Data Privacy Act discussed previously, there are no real principles to be violated and their corresponding penalties. It’s all “to be determined” since there is no NTB yet. I think they should at least mention actual penalties for general violations, such as practicing telehealth without accreditation. Otherwise, set limits to penalties the NTB can give (length of imprisonment, cost of fine, number of people that can be penalized in a large-scale violation etc). 

While I think that the Telehealth Act is an important step in the development of telehealth in the country, it appears that it needs to be more refined that its current state. Creating the NTB and NTRC are only the beginning steps of a long road for telehealth in order to serve and improve the quality of health of those who are underserved.

Reference:

1. House Bill 6336. (2012). Retrieved from Republic of the Philippines House of Representatives: http://www.congress.gov.ph/download/basic_15/HB06336.pdf.