CASE STUDY GROUP 4 - G4-NEW-

TECHNOLOGY-RELATED-TO- PUBLIC-
HEALTH-ELECTRONIC- INFORMATION
DOH RELEASES NEW IMPLEMENTING GUIDELINES ON HEALTH TECHNOLOGY
ASSESSMENT (HTA)
The Department of Health (DOH) released Administrative Order No. 2020-0041 as part of its
commitment towards achieving Universal Health Care (UHC). The new implementing guidelines
on Health Technology

Assessment (HTA) serves to inform policy, coverage, and funding allocation on health
technologies. In line with the mandate of HTA to serve as a transparent priority setting
mechanism in the development of policies and programs, regulation, and the determination of a
range of entitlements to all Filipinos, the issuance provides guidance towards the purchase and
coverage of health technologies funded by the DOH and the Philippine Health Insurance
Corporation (PHIC). Aside from DOH offices, attached agencies, and decision-makers, the
policy likewise engages with the public and private health sectors as primary stakeholders
involved with implementing the HTA process.

PATIENT COMPLIANCE WITH TOOLS THAT PROVIDE REMOTE MONITORING OF

CERTAIN HEALTH CONDITIONS AND MEDICAL DEVICES

The Department of Health (DOH) released Administrative Order No. 2020-0041 as part of its
commitment to achieving Universal Health Care (UHC). The new implementing guidelines on
Health Technology. Assessment (HTA) serves to inform policy, coverage, and funding allocation
on health technologies. In line with the mandate of HTA to serve as a transparent priority-setting
mechanism in the development of policies and programs, regulation, and the determination of a
range of entitlements to all Filipinos, the issuance provides guidance towards the purchase and
coverage of health technologies funded by the DOH and the Philippine Health Insurance
Corporation (PHIC). Aside from DOH offices, attached agencies, and decision-makers, the
policy likewise engages with the public and private health sectors as primary stakeholders
involved with implementing the HTA process.

The document is an iteration of the earlier Philippine eHealth Strategic Framework and Plan
2013- 2020, which was developed, updated and being implemented by the inter-agency
National eHealth Steering Committee and Technical Working Group. It largely takes after the
WHO-ITU National eHealth Strategy Toolkit, which highlights the interplay of various eHealth
components that are prerequisites to a sound and successful national eHealth program. These
components are leadership, governance and multi-sector engagement; strategy and investment;
legislation, policy and compliance; standards and interoperability; infrastructure; human
resources; and eHealth solutions (services and applications).

The PeHSP is divided into four parts: (1) Strategic Context for eHealth in the Philippines, which
depicts the current overall health state of the country, and how this situates in the overall
eHealth implementation; (2) An ICT-Enabled Philippine Health System, which defines the
eHealth vision, mission, goals and strategic thrusts responsive to the overall national health
systems and development goals; (3) National eHealth Action Plan, which lays down the key
strategies, resources, and activities to achieve the national eHealth vision; and (4) Monitoring
and Evaluation, which provides the key tactical foundations to ensure that the NeHP is on track
based on the PeHSP requirements. The PeHSP shall be regularly updated to accommodate the
changing eHealth climate, national eHealth strategic directions and priorities, and evolving
health sector requirements and health care technologies, among others.

RLE TASKS
As healthcare technology evolves, nurses serve on the front lines of applying the latest
advancements to serve their patients with increasing efficiency and effectiveness. Technology is
continuing to impact the nursing industry in a variety of ways, with the pace of change expected
to increase with time. What Impact Does Technology Have on Nursing in the Areas of:

1. Monitoring
- When it comes to prevention, health monitoring is important, especially if the early
detection of diseases can reduce/lessen suffering and medical expenses. The early
detection and treatment of many diseases can radically enhance the patient’s options for
medical care. The use of technology will make it easier to monitor health status. The
condition of patients can be easily checked using a variety of high-tech tools and
equipment.
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● Monitoring devices enable nurses to regularly check on patients on time, even if they
have a heavy workload and various administrative obligations, because these
instruments make their job simpler.
● It also gives them a flexible routine for gathering data from the patient, such as
respiration rates and electrocardiography, as well as oxygen levels.
● These monitoring devices assist all nurses in delivering optimal patient care, and if a
patient requires immediate attention, the nurses will receive a warning or alarm, and they
will instantly proceed to the patient's room, reducing reaction time and giving the patient
the essential health care.

FINAL ANSWER
 ● It helps and allows the healthcare providers or the nurses to constantly check the
patients' status without exerting a lot of effort or time. It also helps with heavy
workload and various administrative obligations because these kinds of
instruments make their job simpler.
● It provides information on vital indicators and gives necessary data, including
electrocardiograms, respiratory rate, pulse rate, oxygen level, temperature, and
blood pressure.
● It allows nurses to be more aware in the event that a patient requires urgent,
optimal, or alarming care. It significantly reduces the time it takes for a response.
This implies that if there is an emergency, nurses will receive an alert warning and
provide appropriate and immediate health care.
● It can also be shared immediately with other professionals for further assessment
and analysis.

Here are several technologies that are being utilized in healthcare to improve proactive care
methods, improve patient experiences, and create a healthier society.

Automated IV pumps

● It facilitate quicker nursing tasks

● It may be essential when a rapid change is required
● Its approach for changing medications also eliminates potential human error hazards for
clinical patients and hospitals.
● The nurses rely on automated IV pumps when need to control the drips and dosages of
their patients
● It allows nurses to change the amount of medication so that valuable time is not wasted
on physically altering the dosage.

Portable Monitors

● It can easily check on patients even while they are busy with other duties.
● It provides information on vital indicators including electrocardiograms, respiratory rate,
pulse rate, oxygen level, temperature, and blood pressure.
● It allows nurses to be more aware in the event that a patient requires urgent care.
● It significantly reduces the time it takes for a response. This implies that if there is an
emergency, nurses will receive an alert warning.
● It can also be shared with other professionals immediately for further assessment and
analyses.

Smart bed technology

● It helps nurses track the patient's weight, vitals, and movement.
 ● It assists the patients in staying safe and comfortable.
● It helps nurses since it provides a continuous in-room monitor that provides them with
frequent information on a patient's activity.
● it can aid in the identification of patterns, which can lead to a new diagnosis or a different
understanding of a condition.

Telehealth and Apps

● Telehealth saves both patients and physicians money and time.
● It prevents sick people from visiting public areas and potentially infecting other patients.
● This technology is changing the way clinics operate and how patients are treated.
● Doctors and nurses can check patients' vital signs even when they are not present in the
office.
● They may be used for general health and wellbeing or for more specific medical
conditions like diabetes or seizure disorders.
● Apps can educate individuals about when to seek medical attention and when a
straightforward over-the-counter drug may be helpful.
● Have cleared the path for easy, effective communication between patients and
healthcare workers, despite not being developed as nursing technology.
● Automatically transmit critical health information to doctors and nurses.

Health wearables
● It measured heart rate and pace while highlighting possibilities in the healthcare industry.
● Wearable health technology can identify cardiovascular irregularities earlier and avert
serious problems.
● These devices can keep track of exercise, sleep, respiration, heart rates, and much
more. With that, many people are tracking their health without much trouble. Nurses can
access these apps and devices daily.

There are a number of different wearable items or devices patients can keep on their
person to help improve overall healthcare, including:

- Biosensors
- Smart thermometers for
- Connected inhalers
- Smart watches
- Fitness trackers (FitBits)
- ECG monitors
- Blood pressure monitors
- (Luat)

Portable Diagnostics
 ● This helps to make the nurses in a easiest, fastest, and time friendly
access with their clients.
● The health of their clients can be measured in the simplest way and not
require big or massive machines to get the result.
● It is not a time consuming process because it gives data and information
for just a short span of time.
● It can also be shared with other professionals immediately for further
assessment and analyses.
● This provides vital informations such as respiratory rate, pluse rate,
oxygen level, temperature, and blood pressure.

Electronic Charting
● An electronic health record that can be made, gathered, managed, and
consulted by authorized clinicians and personnel inside a single
healthcare organization.
● Typically acquired via software suites from third parties. EHR systems are
patient-centered, real-time records that make information instantaneously
and securely available to authorized users.
● This provides precise, current, and comprehensive information about
patients at the point of care, it aids doctors in better managing patient
care and delivering better healthcare.
● Facilitating fast access to patient records to facilitate better coordinated
and effective care. Since you don't need to buy paper and a pen merely to
make a note, this approach takes time and saves money. Since they can
access their portals whenever they want, patients can also benefit from
this.

Wearable Technology
● Wearable technology gadgets, is a devices are making their way into the
healthcare industry. These devices can keep track of exercise, sleep,
respiration, heart rates, and much more. With that, many people are
tracking their health without much trouble. Nurses can access these apps
and devices daily.

Smartphones
● Have cleared the path for easy, effective communication between patients
and healthcare workers, despite not being developed as nursing
technology.
● Mobile apps can work with medical monitoring devices to automatically
transmit critical health information to doctors and nurses.
 ● Smartphones not only offer simple calling and texting capabilities
regardless of location. Through simple tapping and message composition,
the healthcare practitioner and the patient can exchange updates without
using any of their allotted time.
-Pialane

Luat
Pialane

2. Medications

- Smart pump is a commonplace term given to a programmable computerized

drug infusion device that contains a drug library, also known as a dose error-
reduction system. Smart pumps enable the delivery of i.v. fluids and medications
within the bounds of preset parameters, such as drug concentration and dose.
One advantage of adopting smart pumps was the ability to catch problems like
incorrect dose, incorrect rate, and incorrect pump setting. ~ Reyes

- A hearing aid is a tiny electronic device worn in or behind the ear. It amplifies some
sounds so that a person with hearing loss may listen, speak, and engage in daily
activities more completely. Hearing aids can help people hear better in both calm and
loud environments. - Marquez
-

3. Health Records,

-One of the essential records that we all need to retain is a patient's health
Records that details every operation the patient has had to undergo for medical
treatment.Since keeping health records is important, nurses have spent a lot of time over
the years writing down each patient's information on a stack of paper. As the number of
patients has increased, managing all of these documents has become more difficult. We
are grateful to our modern developer who helped create our modern health record, which
is now used for the utmost accessibility. Due to the ongoing advancement of technology,
medical records are now at a level where all patient detail is digitalized. Examples of this
are:

EHR- stands for electronic health records, which are kept electronically. EHRs contain
details on your age, gender, ethnicity, medical history, medications, allergies,
immunization status, lab test results, hospital discharge instructions, and billing
information. - VERAN

The benefits of EHRs include:

● The ability to automatically share and update information among different offices and
organizations
● More efficient storage and retrieval
● The ability to share multimedia information, such as medical imaging results,
between locations
● The ability to link records to sources of relevant and current research
● Easier standardization of services and patient care
● The ability to aggregate patient data for population health management and quality
of care programs
● Provision of decision support systems for healthcare professionals
● Less redundancy of effort
● Potential long-term lower costs to medical system- TORRES

EMR-An EMR(electronic medical records) is a digital version of a patient’s healthcare

chart. EMR systems are software programs that allow healthcare practices to create,
store and receive these charts.This applications can boost the quality and safety of
patient care. With an EMR system, you can prescribe and order medication for patients
online more safely as you will know if the patient was prescribed any medication from
another physician.

EMRs can house valuable information about a patient, including:

● Demographic information
● Diagnoses
● Notes
● Medication information
● Lab test results
● Immunization records
 ● Allergy information

In addition to storing and organizing patient data, EMRs can also be used to:

● Give patients access to their medical data via online patient portals
● Help providers prescribe medications
● Be used to order certain laboratory tests
● Code medical bills more easily thanks to built-in integrations with coding and billing
software - TORRES

4. Error Reduction
- Technology significantly lowers the possibility of error while recording patient
data such as pharmaceutical allergies, medical histories, and health conditions
and illnesses. The administration of medication is far less complicated and
prone to human error thanks to apps. As a result, health outcomes are enhanced,
and hospital readmission rates are decreased.(GALLEGO)
- Technology helps reduce medical errors with the help of systems that enable
physicians to send electronic messages directly to pharmacies. Technology also
helps with alerting nurses when a patient needs help or assistance, it has also
made responding to patients needs easier and much more efficient. (Villanueva)

5. Communication
- Technology has an impact on communication as it makes it easier, quicker, and more
efficient. It allows us to carry on conversations and, therefore provide better customer
services. Additionally, technology makes it simpler to collect customer feedback and
enhance the entire customer experience. - SANDANG
- In today's age where social media skills are becoming vital to people, various platforms
have become popular that are not only used by simple youths but also to others with
profession. If we take our time in scrolling through some of them, we will encounter
medical personnel such as dentists, doctors, and even nurses who have shared their
experiences and knowledge. There they can show the people watching some of the
things that medical personnels encounter in their daily life and even their skills and
knowledge in that field. - RAMOS
 - Today’s nurses may communicate with their co-workers in real time by using headsets,
instant messaging, and team collaboration tools. By reducing the time needed to get test
data and identify and diagnose illnesses, these tools greatly simplify the coordination of
care. Patient handoff between departments is also made efficient with improved
communication. - SANDANG
- In general, technology is used to make life simpler, and it has a significant impact on
how nurses perform their duties. When there is an emergency, medical workers can now
communicate quickly without running the danger of losing or losing files due to messy
handwriting or spilled substances. - SANDANG
- Effective communication in health care can make a life or death difference when done
properly or poorly. Providers and administrators need to share information and convey
treatment plans properly and effectively in a clear and concise way so that patients can
and should receive optimal care. MANALILI
- Technology and communication goes hand in hand especially in the hospital setting.
Patients need to feel safe and confident enough to communicate freely without being
prejudiced to receive effective care. MANALILI
- Skillful and effective communication enables healthcare professionals to establish
rapport with their patients to extract crucial information and to be able to hand down
proper instructions for the different members of the healthcare team. MANALILI
(nakabold yung lalagay sa ppt)

6. Telehealth
- Technology has the potential to improve the quality of healthcare and expand access to
it. Telehealth may offer chances to improve the effectiveness, coordination, and
accessibility of healthcare. Because patients can more easily access professionals
through telehealth and nurses can focus more on patient care and satisfaction without
the "red tape" of typical on-site appointments, efficiency is significantly increased, which
lessens the impact of the nursing shortage. -SANDANG
- Mobile apps have made it possible for patients to contact doctors and nurses from the
comfort of their homes. Patients update their own data to the applications while nurses
offer advice on a variety of health issues so that doctors can regularly evaluate their
diseases and general health. - SANDANG
- Is the use of the information and communication to access health care services remotely
and manage your health care. MANALILI
- Is the practice of medicine remotely and covers all components and activity of the
healthcare system. It ranges from consultations and video conferences that promote
convenience, access and sustainability. MANALILI
- It also cuts down on travel, time off work and the need for child care, and shortens the
wait for an appointment and also increases access to specialists who are located far
away from home. Although telehealth is not perfect for all types of medical conditions,
make sure to discuss everything with your primary provider. MANALILI
5&6
Ramos
Manalili
Sandang

Faster communication, effective charting, enhanced patient safety,

quicker lab results, and easier scheduling are just a few advantages
of technology in nursing. The amount of physical effort is reduced
while productivity is raised. However, there are also disadvantages,
such as broken equipment, power shortages, a disregard for detail,
and privacy data leaks.

Cons of Technology in Nursing

● Requires time to adapt fast
● Data and Security Threats
● Threat to Human elements
● Malfunctioning Equipment:

Requires time to adapt fast

As we know, technology is constantly evolving. Many times there will be new softwares, new
upgrades, new ways of doing things. In order to keep up with the competitive edge, hospital
staff have to keep up with such changes. This can be a struggle for some, especially for the
older staff.

Data and Security Threats

As with most any computerized information, EHRs kept in the cloud or in the form of big data
are more susceptible to being hacked. Cybercrimes for hospitals are not uncommon as patient
profile data can be sold on the black market . If an inexperienced employee accidentally clicks
on malware, a whole EHR system may be at risk of being compromised. Hospitals that have a
breach in data or EHR can pay hefty fines depending on the severity. Security threats to a
patient’s data can ultimately make a facility think twice before storing important patient records
in the cloud

Threat to Human elements

Improved technology can threaten to replace person to-person interaction between nurse and
patient. Nurses have the role of establishing a relationship with their patients and their families;
they are responsible for explaining medications, taking vitals and helping patients with daily
needs. In some hospitals, nurses are required to wheel in their workstation (a computer on
wheels) to record information about the patient. While typing information on a computer is
perceived to be more trustworthy by patients and healthcare professionals alike, it will inevitably
create less face-to face interaction. As a response to the aging population, robotics has become
an emerging field in healthcare. In Japan, nurse robots are being manufactured and tested as a
way to lessen the burden of nurses; however, these robots lack empathy and a “human touch.”
More research is required before understanding if these machines will improve patient care

Malfunctioning Equipment:

One of the biggest headaches of technology is what happens when technology just doesn’t
work. Technology may be useful and an efficient way to make life easier, but when it fails, it can
really derail the whole day. This is especially true for organizations that rely on technology for
almost all their operations. With this in mind, you need to ensure that you have someone ready
and accessible to fix any technical problems that may arise as well as a backup method to
provide patient care.

Disadvantages of Medical Technology in Healthcare:

1. Automatic Machine Treatment:

There is a kind of machine which is fixed in the patient’s body. It analyzes the patient’s body and
inserts the medicines into patients’ bodies according to their body conditions. These machines
are made by programming in their programming if there come some errors and bugs.Then it is
very harmful to the patients because it can insert the wrong diagnosis into the patient’s body
which causes the critical condition and death of the patient.

2. Show the Wrong Result of the Patients Condition

One of the cons of medical technology is sometimes the machinery or technological devices
show the wrong result. Sometimes it didn’t show the accurate result of the patients to the doctor.
The technological machines are made by engineers and programmers. Sometimes errors and
bugs come into it. Then it didn’t work properly. If it shows the wrong result and the doctor gives
the wrong diagnosis to the patient then it takes the patient’s life in danger. This is one of the
most dangerous cons of medical technology for the patients

3. Increased Cost of the Treatment for the Patients

The increased cost of treatment is also one of the disadvantages of medical technology. Mostly
all the treatments and surgeries through technology are very costly, like robotic surgery, and
other kinds of technological machinery surgeries are very costly. And most of the patients
belong to rural areas and they are poor. For poor patients, it’s impossible to pay for costly
surgeries. Technology increased health care but also increased the cost of that. Which is
impossible for the patients to pay.

4. Lack of Information about the Patients

Lack of information is also a disadvantage of medical technology. Safety and privacy are some
of the laws of hospitals.to protect the patient’s privacy. But by technology, this law can be a
break. The information of the patients which is stored in the computer database of the hospitals
can be a leak. The computer systems can be a hack and the secret information about the
patient’s treatment can be stolen and also can be changed. If someone changes the complete
history of the patient’s treatments. So, it can be a danger for the patient’s next treatments.

5. Patients’ Online Treatment Through Technology

Nowadays doctors do online treatments. The patients contact them online and suggest the
diagnosis to take. The patients do have not to go to the clinic of the doctors. They can easily get
the treatment at home. Without any checkup and analysis of the patient, the doctor gives them
the diagnosis. Which can be wrong and can be dangerous for the patient’s health.

6. Damaging Cells and Organs of the Body of the Patients

Nowadays laser surgeries are very famous. Which has a lot of bad effects on the human body?
The lasers can damage the cells of the body. It can damage our other internal organs in our
body, which is very harmful

7. Time-Consuming in Recovery of Medical Machines and Devices

The technological machines and gadgets which are used in the hospital for treatments and
checkups of patients are made by engineers and programmers. If there come some kind of
faults and errors. So, no one can fix it because they didn’t have the knowledge of recovering
and fixing that machine. It required a specific person who has knowledge of it. The engineers
who made it. He can fix it. So, it consumes a lot of time fixing and recovering the machines.
Obstacles to effective RPM usage (REMOTE PATIENT MONITORING)

Is not accessible for everyone. RPM requires good broadband connectivity, which is hard to
achieve for small healthcare institutions and rural hospitals. On the other hand, it’s important to
take into account that not everyone owns a smartphone, and elderly people often face
difficulties in using modern gadgets, such as mobile phones.

Patients and doctors' skepticism. RPM appears to be the least effective patient engagement
initiative according to the NEJM Catalyst Insights Council survey. The researchers explain these
statistics by the fact that the use of wearables is still not available for everybody. By the way,
doctors that were taking part in the survey haven’t noticed any improvements in chronic disease
management. In addition, healthcare professionals based on their experience expressed doubt
that the technology alone is likely to change behavior of higher-risk patients. Doctors are also
concerned about the difficulties they can face handling received data. Some patients are afraid
that their private health data can be obtained by third parties and used for dubious purposes.

The need for additional custom healthcare software. After the data has been collected, IT
departments have to redirect it from RPM devices to electronic medical record systems (EMRs)
by means of multiple third-party applications.

Doubtful reliability. Popular fitness wearables tracking physical activity appeared to have large
variations of accuracy with error margins up to 25 percent. The reliability of RPM data is called
into question as well. For instance, a review in JAMA Dermatology showed that smartphone
apps for melanoma detection have a 30 percent failure rate. The lack of reliability is the most
serious problem that needs to be fixed before devices and applications could be used by
healthcare providers.
Cons of Remote Patient Monitoring
https://www.adsc.com/blog/pros-and-cons-of-remote-patient-monitoring

Some healthcare professionals may be laboring under the idea that remote patient monitoring is
simply too expensive for them to set up, let alone have their patients sign up to use.

But this is not really a cause for concern because it’s a trivial matter to get started with a pilot
program, focusing on the patients you can help reduce healthcare costs for the most. For
example, you enable RPM to track your patients’ blood glucose levels, which will allow you to
reduce the amount of insulin they need.

Another perceived con to RPM is that most providers will find it too hard to deploy. Since
modern RPM systems work out of the box, there’s not a huge learning curve for your staff. You
just set it up and start connecting with patients. And on the patient end, you can avoid any initial
hiccups by first screening your patients to determine which of them are the most digital-savvy.

A common misperception is that remote patient monitoring won’t work without broadband
connections. Since many candidates for RPM live in rural, isolated areas with fewer clinics,
connectivity is an issue to consider.

https://tigerconnect.com/blog/pros-and-cons-of-telehealth-nursing-what-you-need-to-know/