Republicof the Philippines

Department of Health
OFFICE OF THE SECRETARY

OCT 21 2020

DEPARTMENT ORDER
No. 2020 - 0653

SUBJECT : Guidelines on the Creation of the One Hospital Command

System (OHCS)

I. RATIONALE

The Department of Health (DOH), as the nation’s leader in health, is committed in

guaranteeing equitable, accessible and quality health services to Filipinos at all times.
Leading the government’s efforts to respond to the coronavirus disease 2019 (COVID-19)
pandemic, the department shall ensure the continuous provision of health services especially
to the patients infected by COVID-19.

Recognizing the need to set forth guidelines on the appropriate management of

COVID-19 cases, the Inter-Agency Task Force on Emerging Infectious Diseases (IATF-
EID) released IATF Resolution No. 12, series of 2020, entitled “Recommendations for the
Management of the Coronavirus Disease 2019 (COVID-19) Situation”. The establishment
of Temporary Treatment and Monitoring Facilities (TTMF) and surge facilities have
provided necessary care to patients and alleviated the burden brought by the increasing cases
of COVID-19 on the healthcare system. As demands for these facilities increase, the
difficulty of referring and transferring patients is likewise an arising concern.

This Department Order (DO) aims to

establish a One Hospital Command System
(OHCS) to facilitate coordination between health facilities and health care provider
networks (HCPNs) as
well as to streamline the referral and transfer of COVID-19 cases. The
OHCS shall serve as the Interim National Referral System, as mandated by Section 7 of
Republic Act No. 11494, or the “Bayanihan to Recover As One Act”, and shall subsist
despite the expiration of the said Act.

II. OBJECTIVE

To provide guidance on the establishment of a One Hospital Command System

(OHCS) to streamline the referral system for COVID-19 cases and optimize the use of
medical care services at
a national level for a unified COVID-19 response.

lil. SCOPE AND COVERAGE

The guidelines shall apply to DOH bureaus and services, Centers for Health
Development (CHDs), Ministry of Health -
Bangsamoro Autonomous Region in Muslim
Mindanao (MOH-BARMM), government-owned hospitals, institutes, and facilities, and
other DOH offices that partake in the COVID-19 response. Engagements covered by thi

Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila ¢ Trunk Line 651-7800 loca 1131, Mos

Direct Line: 711-9502; 711-9503 Fax: 743-1829 @ URL: http://www.doh.gov.ph; e-mail: fiduqueqidol-gov.p
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issuance shall be in coordination with the concerned National Government Agencies
(NGAs), local government offices, and public and private health institutions.

IV. DEFINITION OF TERMS

A. One Hospital Command System (OHCS) — a system to interconnect the services of

hospitals and call centers to the other health facilities, such as temporary treatment
and monitoring facilities (TTMFs), hotel isolation facilities and DOH licensed
COVID-19 testing laboratories. It likewise covers health care provider networks
(HCPNs) for COVID-19 response facilities and local government units (LGUs). The
DOH teams and bureaus shall participate in the policy-making and planning,
operations, logistics and supplies management, and information technology and data
analytics of the OHCS.

One Hospital Command Center (OHCC) — is the operations base for the Operations
Manager and the teams for data analytics, medical dispatch, and communication,
where emergency calls and referral requests were responded and facilitated.

Oplan Kalinga — a national government-launched program that seeks to immediately

isolate reported asymptomatic or mild symptomatic COVID-19 positive individuals
in the communities to the identified hotel isolation facilities or mega quarantine
facilities in cooperation with the different local government units across the country.

Regional Emergency Operations Center (REOC) — a facility established in every

Regional Disaster Risk Reduction and Management Council (RDRRMC) for
coordination efforts of disaster preparedness, relief and response to support the
Incident Command System (ICS), as mandated by Republic Act No. 10121, or the
“Philippine Disaster Risk Reduction Management Act of 2010”. In the current
COVID-19 pandemic response, this facility supports the Regional Inter-Agency Task
Force (RIATF).

Regional Inter-Agency Task Force (RIATF) — the regional counterpart of the IATF
established under IATF Resolution Nos. 12 and 33 that strictly monitors health
system performance and capacity, strict compliance to surveillance, isolation, and
treatment protocols, and provides a weekly comprehensive report to the IATF.

Regional One Hospital Command Center (ROHCC) — is the regional coordinating

body of the National OHCC on patient referral, medical emergencies, and
information sharing and reporting.

GENERAL GUIDELINES

The (DOH) shall establish the OHCS (see Annex A) to optimize and ensure the
adequacy of healthcare services in hospitals to address COVID-19 and emergency
non-COVID-19 concerns and to strengthen the nation’s health system capacity.

The OHCS, in collaboration with the IATF-EID, National Task Force National
Incident Command - Emergency Operations Center (NTF NIC-EOC), NGAs, No
Government Organizations (NGOs), and the private sector shall:
 1. Provide data analysis on the availability and utilization of beds in different
levels of hospitals;

2. Provide a strong communication line and proper coordination between health

facilities in conducting referrals;

3. Ensure proper transportation and coordination, specifically for COVID-19

suspect, probable, and confirmed cases, and for emergency non-COVID-19
patients following health and safety protocols; and

4. Strengthen partnerships with NGAs, LGUs, NGOs, and the private sector.

. An OHCC
atofthe national level shall be established and shall be in charge
the OHCS.
of the daily
operations

. The different DOH teams and bureaus pursuant to their respective mandates and the
COVID-19 response existing guidelines shall provide assistance in the effective
implementation of OHCC functions.

. The existing REOCs shall serve as counterparts of the OHCC and shall take on the
roles and responsibilities of OHCC at the regional level.

VI. SPECIFIC GUIDELINES

. The One Hospital Command Center implementation, monitoring, and evaluation

shall be under the direct supervision of the Office of the Undersecretary of Health for
Hospitals/Chief of Staff;

. The Undersecretary of Health for Hospital/Chief of Staff shall designate an

Operations Manager who shall be responsible in the day-to-day activities of the
OHCC as supported by the following teams:
1. Data Analytics Team - shall be responsible for data gathering and analyzing
as needed by the Operations Manager in the OHCC planning, policy-making
and monitoring;

2. Medical Dispatch Team - shall respond to all the communications received

through the OHCC and facilitate the medical transport and dispatch requests
by the hospitals or individuals;

3. Communication Team - shall develop the risk communication messages and

health communication handles of the OHCC.

VII. ROLES AND RESPONSIBILITIES

A. The OHCC shallestablish and strengthen coordination, collaboration, and linkages

with the following offices and agencies:

1. DOH Teams and Bureaus

 The following DOH offices shall be called upon to provide guidance and
support to the OHCC for
policy-making and planning:

i. Disease Prevention and Control Bureau (DPCB) - shall be

responsible for in the planning and formulating of relevant
policies and guidelines supportive of the OHCC functions, most
specifically on accessible and streamlined health care
provisions.
il. Health Facilities Enhancement Program (HFEP) - shall align
investments in improving the health facilities with the strategies

lil.
in support of OHCC in the fight against COVID-19.
Health Facilities Development Bureau (HFDB) - provide data
analysis on COVID-19 dedicated beds.

The following DOH offices shall provide guidance and full support to the
OHCC operations:
i. Field Implementation and Coordination Team (FICT) - provide
oversight to CHDs and technical support for the Regional
Emergency Operation Centers as counterparts of the OHCC,
the establishment thereof, if necessary.
or
il. Health Emergency Management Bureau (HEMB) - provide
direct oversight, logistical and administrative support, and
manpower for the OHCC operations.
ili. Centers for Health Development (CHDs) - identify the existing
Regional Emergency Operations Center or coordination and
referral systems, and assure its compliance with the latest
OHCC protocols.
iv. DOH-Retained Hospitals - designate health emergency
management system (HEMS) or disaster risk reduction and
management for health (DRRM-H) managers as the OHCC
focal point persons, and allocate beds for COVID-19 patients.

c. The following DOH offices shall assure that efficient logistics and
supplies management support for the OHCC operations:

i. Public Health Service Team (PHST)

requested items, supplies or goods
-in
facilitate the inclusion of
the Project Procurement
Management Plan (PPMP).
il. Supply Chain Management Service (SCMS) - assist in
strengthening the coordination and supply chain processes of
health facilities responding to COVID-19 and ensure the
necessary logistical support for the immediate distribution and
delivery of COVID-19-related commodities, such as personal
protective equipment.
lil. Procurement Service (PS) - ensure that equipment and supplies
requested by OHCC for operations are included in the Annual
Procurement Plan and are timely provided.
iv. Financial Management Service (FMS)
of financial transactions in -
accordance
facilitate the processing
with auditing and
accounting rules and regulations, and provide technic
assistance on financial issues and concerns.

BY;
 v. Administrative Service - Personnel Administration Division (AS
- PAD) - coordinate with the OHCC in providing human
resource complement and emergency hiring.

d. The following DOH offices shall be called upon to provide information

technology support and accurate and timely statistics and data analytics:

i. Knowledge Management and Information Technology Service

(KMITS) - provide technical guidance and recommendation on
the information systems and tools to be utilized in accordance to
existing standards, such as data privacy, data security and
interoperability.
Through the DOH COVID 19-Hotline 1555, it shall ensure
that its call center provides COVID-19 information and triaging
through teleconsultation to refer a general public's call to the
appropriate team, including OHCC, as
needed.
ii. Health Facilities Development Bureau (HFDB)
health system capacity data related to the health
-
provide data of
facilities.
iii. Epidemiology Bureau (EB) - provide COVID-19 information
and statistics.

2. National Government Agencies, Local Government Units, and Private Sector

a. Oplan Kalinga
i. National Government Temporary Treatment and Monitoring
Facilities
ii. Hotel Isolation Facilities

b. Local Government Temporary Treatment and Monitoring Facilities

c. COVID-19 Testing Centers and Laboratories

i. National Government Mega Swabbing Facilities
li. Local Government Mega Swabbing Facilities
ili. Other Licensed COVID-19 Testing Laboratories

d. National Disaster Risk Reduction and Management Council (NDRRMC)

B. The National One Hospital Command Center shall be responsible these daily
activities:

1. Handle all calls from the Centers for Health Development (CHDs), Ministry
of Health — BARMM, Local Government Units (LGUs), Emergency
Operation Centers (EOCs), and institutions related to the referral to licensed
COVID-19 testing laboratories and medical dispatch of COVID-19 patients
to the appropriate hospitals, TTMFs, and other health facilities;
Coordinate with any participating third-party call centers for monitoring and
data accuracy;
Coordinate with the appropriate receiving facility and monitor the referral
status until admitted or discharged, as the case maybe;
wn
Facilitate the needed provision of transport vehicle or ambulance;
Maintain an updated directory of hospitals, TTMFs, Regional EOCs_for
COVID-19, Hospital EOCs, LGUs, Emergency Medical Service pro

Ee
and DOH licensed COVID-19 testing laboratories;
 Utilize available data for referrals to ensure provision of appropriate
management of COVID-19 patients;
Monitor information dashboards, such as DataCollect App, TTMF trackers
and other reliable source of information, as reference for referral and
coordination activities;
Submit daily consolidated reports of activities;
Provide advisories, as needed.

C. The One Hospital Command Center shall be provided with the following:

1. Adequate personnel for the efficient OHCC services as identified by the

Operations Manager;
YN
Working space for the duty staff;
Identified phone numbers, both telephone/landline and cellular phone;
wR
Desktop or laptop computer, printer and internet access;
Meals during the entire tour of duty.

D. The OHCC Operations Manager shall perform the following roles and
responsibilities:

1. Oversees the entire One Hospital Command Center

2. Finalizes decision-making on all operation-related matters;
3. Issues daily briefing to DOH officials and disseminates OHCC-related
bulletin through proper communication channels;
4. Prepares, reviews and approves OHCC-related protocols submitted for
approval by the DOH officials;
5. Orients the OHCC manpower of the new protocols;
6. Facilitates meetings for monitoring and evaluation of OHCC performance;
7. Coordinates with other government agencies and institutions, non-
government organizations, and private sector;
8. Coordinates with off-site call centers for the briefing and orientation of
protocols;
9. Reviews and approves the accomplishment report of OHCC and submits to
the DOH;
10. Identify the personnel needed for the OHCC;
11. Advise the OHCS Commander of matters related to the operations of the
OHCC and recommend improvements, as necessary.

E. Establishment of the Regional One Hospital Command Centers shall be the

responsibility of the respective Centers for Health Development:

1. The existing Regional Emergency Operation Centers (REOCs) or referral

system shall be designated as ROHCC counterparts and taking on the
applicable roles and responsibilities under section VI.D. of this Department
Order;
The designation of Operations Manager is under the discretion of the CHD
Directors;
Operations Manager shall be responsible for the day-to-day operations of the
ROHCC and perform the roles and responsibilities stated in VLF;
Ensure that the Regional One Hospital Command Center has adequate
personnel to fulfill its roles and responsibilities;
the
Provide needed logistic requirement and funds for the operation
Regional One Hospital Command Center;
6
 6. Facilitate and coordinate with the OHCC in the referral and transfer of
patients;
7. Organize communication and connection with other Emergency Command
in
Systems the different local government units within their region.

VII. FUNDING

The costs and expenses of the OHCC shall be charged to the Health Emergency
Management Bureau (HEMB) funds, and if necessary, additional funds shall be taken from
the Quick Response Fund (QRF).

OHCC counterparts in the regional level shall charge their expenses from the HEMB
sub-allotted funds, and augmentation shall be provided under the Quick Response Fund.

VIII. REPEALING CLAUSE

Unless otherwise stated, provisions from previous issuances and other related orders
that are inconsistent or contrary to this order are hereby repealed or modified accordingly.

IX. SEPARABILITY CLAUSE

If for any reason, any portion of this Order is declared unauthorized or rendered
invalid by any court of law or competent authority, parts or provisions not affected shall
remain in full force and effect.

X. EFFECTIVITY

This Order shall take effect immediately.

For strict compliance.

CISCO ¥. DUQUE, MD, MSc

Secretary of Health
 Annex A. One Hospital Command System

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