Development and Implementation of an Interoperable Local Health Information Exchange Platform for the Attainment of Universal Health Coverage in the Philippines

Philip Christian Zuniga^1*Dennis Batangan²Jan Jacob Carpio²Queen Anne Tayam²Patria Luwalhati Garcia²Andrew Lacsina²Jaztine Calderon²Jose Francisco Santiago²

• ¹UP Diliman, Quezon City, Philippines
• ²Ateneo de Manila University School of Social Sciences, Quezon City, Philippines

Introduction: The implementation of Universal Health Coverage (UHC) in the Philippines requires the formation of Local Government Unit (LGU)-centric Health Care Provider Networks (HCPNs). A key enabler of this reform is the development of secure, scalable, and interoperable digital health ecosystems. However, challenges persist, including fragmented and non-standardized health information systems, siloed data repositories, and limited interoperability among Electronic Medical Records (EMRs) and Hospital Information Systems (HIS), especially at the LGU level. This paper presents the Smarter and Integrated Local Health Information System (SMILHIS), a Local Health Information Exchange (LHIE) platform designed to address these issues. Objective: This work aims to support LGUs in deploying an LHIE platform that improves health data exchange, enhances continuity of care, and strengthens local health systems. Specifically, it seeks to: 1.Deploy a modular, open-source LHIE platform that enables real-time interoperability across primary, secondary, and tertiary facilities; and 2.Implement an HL7 FHIR-based integration model aligned with the OpenHIE architecture and national interoperability specifications. Findings and Conclusion: SMILHIS was implemented in three pilot LGUs—Pulilan (Bulacan), Cagayan de Oro City, and Pangasinan Province—demonstrating both technical feasibility and operational value. Each pilot tackled unique challenges: Pulilan integrated health data with treasury and regulatory systems; Cagayan de Oro faced the absence of authoritative registries; and Pangasinan contended with scale and geographic dispersion affecting service visibility. SMILHIS addressed these by integrating patient, provider, and facility registries, enabling secure data exchange, and deploying dashboards for referrals and bed capacity. The pilots confirmed that LGUs can implement a standards-based LHIE that reduces duplication, improves referral coordination, and strengthens responsiveness. Beyond technology, SMILHIS enhanced LGU digital governance, built local capacity, and aligned with national standards—positioning it as both a practical interoperability solution and a mechanism for sustainable digital health transformation.