Data Insights create more possibilities to create
programs for the poor and indigent
"Bawat Filipino, Miyembro, Bawat Miyembro,
Protektado, Kalusugan Ng Lahat, Segurado"
(Every Filipino is a member. Every member is protected.
Everyone’s health is ensured.)
The Philippine Health Insurance Corporation (PhilHealth)
was established in 1995 with this vision and has then existed with a mandate to
ensure that all Filipinos have comprehensive social health insurance coverage
should they need medical attention. To date, the PhilHealth covers about 92% of
the Filipino population – just a little more and it has accomplished its vision
of universal health coverage.
While people only think of health insurance when they're
sick, PhilHealth’s vision – which includes ‘Kalusugan Ng Lahat, Segurado”
(Everyone’s health is ensured) – also includes plans to sustain a nation of
healthy citizens and protect the poor, marginalized and vulnerable Filipinos,
as well. A hale and hearty people can focus more on productive pursuits and
contribute significantly to a growing economy.
Run of Success
Two years ago, PhilHealth’s success run stumbled upon a
roadblock. The increase in membership resulted to a rise in claims and the
health insurance agency found out that their existing system could not
adequately meet the demands of the mounting scale of available data. They
needed a new way of organizing the influx of data and interpreting its
strategic and operational implications to have a single version of truth that
will allow management to create better programs and make a more informed
decision on how these programs can run.
To turn their wealth of data into a strategic asset,
PhilHealth turned to implement Microsoft’s Power BI. Before the advent of
Microsoft Power BI at PhilHealth, data was embedded in the functional reports.
One of the advantages of Power BI is shifting the mindset
from hindsight to foresight, such as improving PhilHealth’s delivery network of
primary care service providers, whose main mission is to minimize patient care
through preventive measures in rural health. Sick patients may then be referred
to hospitals under PhillHealth and the Department of Health’s new strategy of
providing primary care.
PhilHealth during the launch of their Corporate Dashboard
By making sense of historical data, the solution allowed
PhilHealth to make primary care more accessible to members. In effect, Power BI
brought in a bigger group of providers to deliver primary care in the 15
regions of the country and expanded the health service delivery network, one of
the guarantees of the government’s Philippine health agenda for 2016 – 2022.
Ms. Jovita Aragona, CIO-SVP at PhilHealth says that
“Microsoft’s Power BI helps us understand a lot about our members, and with
this information, we were able to make strategies and approaches to improve
PhilHealth’s service, which would then get us closer to our mandate of making
healthcare accessible to every Filipino.”
Dr. Arturo Alcantara, PhilHealth Head of Task Force
Informatics says, “We encourage PhilHealth beneficiaries to go to RHUs and
smaller facilities and from there, they will be given referrals to hospitals as
necessary. It’s the new concept of primary care where there are linkages in
addressing preventive and primary health care. PhilHealth beneficiaries can be
looked into at the primary care level and those who are really sick get
referred for admission in hospitals.”
Partnerships and Collaborations
The Department of Health is already in the process of
acquiring the same interactive solution implemented at PhilHealth. PhilHealth is also working with the
Department of Social Welfare and Development, tapping into their indigent data,
and other agencies like the National Anti-Poverty Commission which coordinates
the poverty reduction programs of the government.
“The idea is to initiate a good groundswell,” explains
Alcantara. “While we are much aware of our responsibility to data privacy,
we’re not using that as a barrier in sharing valuable and useful information
with critical decision makers.
“You ask: Why is the incidence of pneumonia much higher
in metropolitan areas that are very much challenged by pollution? You look
beyond the averages. Maybe the national government agencies should concentrate
on proper interventions on all fronts not just on health care but also consider
factors such as deteriorating air quality,” Alcantara added.
Microsoft’s Power BI connects to all the 17 regional
offices of PhilHealth. Presently, the agency has a national way of collecting
and looking at health data. Change is happening organically and naturally, with
innovative technology.
In the long run, these changes will be institutionalized
to match all the positive impacts from the solution with rules and policies and
help improve PhilHealth’s coordination with agency partners.
All these improvements are ongoing because PhilHealth
carefully considers proper implementation and compliance in pursuing the vision
and mandate of comprehensive healthcare for all Filipinos.
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