Hartigan-Go Kenneth Y, Prieto Melissa Louise M, Castillo Angel Faye G, Eleazar Ella Mae C
School of Government, Ateneo de Manila University.
Acta Med Philipp. 2025 Jul 31;59(10):7-20. doi: 10.47895/amp.vi0.10474. eCollection 2025.
In the Philippines, patients are constrained from accessing their own records, restricting their ability to freely choose who to seek care from. To address this, the study makes a case for the development of the health smart card in the Philippines, an integrative tool unique to each citizen carrying their lifetime medical record.
The prototype is developed using no-code programming technology and validated through a series of focus group discussions and stakeholder consultations with patients (n=4), healthcare administrators (n=4), and hospital personnel (n=13). It was then revised based on the collected insights and recommendations.
Findings report that the current facility-centric model utilizing paper records constrains patients' access to their records due to long wait times, slow turnaround periods, constant intra- and inter-hospital transfers, and even charging of fees to acquire a copy of their own data. The health smart card alternative was widely accepted by the participants, particularly for its contribution to increasing data accessibility, patient empowerment, and advancing patient data ownership. Nevertheless, several considerations for the upscale implementation of the health smart card emerged, including creating an interoperable environment through harmonizing standards and capacity-building programs, and ensuring data security through robust cybersecurity measures. Issues on scalability and funding of the project were also raised, centering on the critical role of the government in stepping up as regulator and potential funder. Concerns over potential abuse, dataveillance, and the digital divide are tackled, highlighting the need to account for socioeconomic factors to ensure that no one is left behind in the implementation.
The study makes a case for the development and adoption of a health smart card to address the inaccessibility of records to patients. The study concludes by recommending the conduct of a pilot implementation to comprehensively demonstrate and analyze the features of the proposed scheme.
在菲律宾，患者获取自身病历受到限制，这削弱了他们自由选择就医对象的能力。为解决这一问题，本研究主张在菲律宾开发健康智能卡，这是一种为每位公民配备终身病历的集成工具。
使用无代码编程技术开发该原型，并通过与患者（n = 4）、医疗保健管理人员（n = 4）和医院工作人员（n = 13）进行的一系列焦点小组讨论和利益相关者协商进行验证。然后根据收集到的见解和建议进行修订。
研究结果表明，当前以医疗机构为中心、使用纸质病历的模式，由于等待时间长、周转期慢、医院内部和医院之间频繁转诊，甚至获取自身数据副本还需收费等原因，限制了患者获取病历。健康智能卡方案得到了参与者的广泛认可，特别是因其有助于提高数据可及性、增强患者权能以及推进患者数据所有权。然而，出现了一些关于健康智能卡大规模实施的考虑因素，包括通过统一标准和能力建设计划创建可互操作的环境，以及通过强大的网络安全措施确保数据安全。还提出了项目的可扩展性和资金问题，重点是政府在加强作为监管者和潜在资助者方面的关键作用。解决了对潜在滥用、数据监控和数字鸿沟的担忧，强调需要考虑社会经济因素，以确保在实施过程中没有人被落下。
本研究主张开发并采用健康智能卡，以解决患者无法获取病历的问题。研究最后建议进行试点实施，以全面展示和分析所提议方案的特点。
