Could access to real-time data enable smarter targeting of health and social services in the Philippines?
An interview with Liz Bautista, a Frontier Tech Pioneer
By her own admission, Liz Bautista is a bit of a geek. Early in her career, she had taken supplemental courses on robotics, coding and data analytics simply because she was interested in how those technologies might supplement her interests in governance, public policy and development.
It was that combination of skills and interests that brought Bautista to the British Embassy in Manila where she took on the role of Health Advisor and began working on the Better Health Programme in 2019, a global project that looked to address the rising burden of non-communicable diseases and improve access to safe, equitable care.
Traditionally, local health information systems in the Philippines have relied on offline, paper-based record-keeping methods. Printed forms and physical log-books are common tools at community health centre settings and it’s still common for mothers to keep physical copies of ‘baby books’ to record and access a child’s health history. The Better Health Programme led to a pilot of the Philippines’ first digital patient registry for primary care, consolidating reporting requirements into a single, real-time dashboard of data on patients, risk assessments and resourcing requirements.
Bautista, the Philippines’ first Frontier Tech Pioneer, is now proposing another application for this technology: to triage health and social services for data-driven targeting of vulnerable population groups.
“The Better Health Programme in the Philippines allowed the British Embassy to work with two local governments (Iloilo City in Western Visayas and Pasig City in Metro Manila) to develop the Philippines’ first digital health registry for non-communicable disease,” Bautista says. “This is a country that remains reliant on paper-based reporting, so the programme’s support for digital transformation in local health systems is something we are proud of.”
Harnessing the power of reliable, up-to-date data
While working with those local governments, Bautista was able to see firsthand how access to the right kind of information could improve the way decisions were made. “Public health operations and standards for procurement become much more cost-effective when clinicians, decision-makers and policy specialists have access to transparent and reliable data,” she explains, “because that data can alert a City Health Department about demand for prescription medicine or vaccines, or a geographical area’s patient and population profile based on health risks.”
Currently, not everyone has access to this kind of public health information in the Philippines, where data is aggregated at the national level but is seldom consolidated at the community or local level. With this Frontier Tech pilot in the Philippines, Bautista is aiming to expand access to this kind of reliable data, so that the targeting of social and health services can be better informed, especially in areas where there are limited resources for public health.
“The Better Health Programme in the Philippines developed a tool to digitise data recording and management of patient records,” Bautista explains, “and that helped transform the policy and process for local health information systems, to an extent. With this grant we want to test how that tool can be used for targeting social and health services, so local governments’ decision-making can be better informed by data and less reliant on paper-based data collection methods, especially during emergency or crisis scenarios.”
This is particularly important for a country where tropical storms, such as last year’s Storm Nalgae, can cause significant devastation. “If there’s a typhoon or a flood, the local government would often be distributing cash transfers or mapping out which communities are the most vulnerable. But targeting for these programs can be disaggregated, often requiring physical sign-up posts at different locations,” says Bautista. “This tool would enable local governments to triage those prioritisation schemes based on existing population and public health data. The two local governments that we're working with are in highly urbanised cities that help augment emergency support and public health services for more rural surrounding municipalities. This tool could help inform their emergency response through a dashboard that contains all the up-to-date population data they need. Beyond that, it could also help with decision-making for procurement and a more targeted delivery of social services.”
Unshackling data to drive genuine transformation for public health
Called ‘e-Triage for Social Inclusion - Navigating Out of Vulnerable Scenarios (eTSI-NOVuS)’, the project will formally begin in March 2023, in collaboration with the Ateneo de Manila University and its Institute of Philippine Culture - a research centre with existing programme links with national government to develop local health system capacity and enable interoperable digital health information systems across the Philippines.
For this team there are two main challenges that await anyone looking to take on digital health transformation in the Philippines. The first is the fragmented nature of the healthcare ecosystem, where infrastructure gaps and the finite capacity of those working in emergency or public health response, means different points of data collection and management across national and local governments.
The other challenge is the need for more practical case studies to encourage institutional investment for digitisation of local health information systems, including workforce development. As Bautista puts it, “The only successful examples of data-driven use cases have focused on managing data. Through the FTL pilot, we’ll test assumptions around the impact on efficiency and cost-effective decision-making in public health, and if real-time data can help inform decisions for policy or programming.”
One of the team’s biggest challenges though, will be ensuring that they have enough data to inform the recommendations that will come out of the tool. The good news is that, because this FTL opportunity comes off the back of the Better Health Program, the team has a head start when it comes to the digitisation of historical data. “In Pasig City, the tool has allowed the encoding of data across all community health centres,” Liz says, “which gives the project enough starting data to testing e-triage of vulnerabilities for public health, emergencies or pandemics moving forward.”
In the Philippines, procurement decisions are often made based on averages. In some instances, a public health centre will only procure or receive medicine when stocks are depleted. The project’s ambition is for data dashboards to inform advanced analysis of demand trends to anticipate decisions for procurement, staffing and other resourcing requirements for health service delivery.
Finally, there is one other, more welcome, challenge for Bautista and the team. “We do anticipate wide demand and interest from other local governments,” she says. “Resources for this pilot might limit our scope to one or two local governments in the Philippines, but our ambition is to make an investment case for other local governments to adopt the same innovation to improve local health information systems and enable data-driven public health policy. I would assume a growing interest from more local governments might be a challenge later on for this project too. But it's a good challenge to have, I think!”
It’s clear that Bautista is not one to shy away from a challenge, and that her interest in the ways in which technology can help her continue to push at the boundaries of what’s possible is not going to abate anytime soon.
If you’d like to dig in further…
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