Digital HealthNews Letter

National Digital Health Guidelines and Standards (version 2.1)

The National eHealth Guidelines & Standards were first published in 2016 with the aim of streamlining the implementation of eHealth solutions in the health sector of Sri Lanka. These Guidelines and Standards were intended to be adopted when implementing eHealth solutions in the state and private healthcare institutions in the country.

The new developments in the digital health ecosystem in the country and innovations in the ICT sector demanded reviewing the existing National Health Guidelines & Standards (NDHGS). Recognizing this need the National eHealth Steering Committee appointed a Technical Working Group (Technical Working Group: Digital Health Standards & Interoperability (TWG – DHSI)) to review the NeGS and recommend necessary changes. Meanwhile recognizing the importance of digital health in strengthening primary health care services, the Primary Healthcare Services Strengthening Project (PSSP); included updating the e-health guidelines and standards as one of the Disbursement Linked Results “DLR 5.1 Standards to support the robust development of HMIS platforms and use of electronic HMIS at public health service providers, including with unique individual patient records”.

Based on the recommendation of the above TWG, current developments in the field were incorporated in the NeGS and changed its name as ‘National Digital Health Guidelines and Standards (NDHGS)’ while maintaining the major themes and the structure as of the first version. The following are the main changes that were made in this version of the NDHGS document:

  1. A new chapter included;
    1. Chapter 3 – Digital health software services
  2. New sections and subsections added to the existing chapters
  3. Sec. 3.2. Electronic Medical Record Systems
  4. Sec. 3.3. National Electronic Health Record
  5. Sec. 3.4. Personal Health Record
  6. Sec. 7.2. Master Patient Index
  7. Sec. 7.7. Minimal dataset for National Electronic Health Records (NEHR)
  8. Changes were also made to the content of other chapters to improve the relevance and accuracy of the guidelines and the standards, and to address the current needs.

The document lays down standards and guidelines in the following seven areas which are important in adopting ICT in the healthcare sector:

  1. Digital Health Architecture – This gives a holistic view of digital health architecture in accordance with the National ICT Architecture and Infrastructure.
  2. Hardware for Digital Health – This chapter prescribes guidelines on the management of hardware for digital health services.
  3. Digital Health Software Services – The chapter is on the management of digital health software, Electronic Medical Record Systems, National Electronic Health Record, and Personal Health Records.
  4. Network and Connectivity – This emphasizes the importance of having a proper network plan for individual health care institutions and maintaining them.
  5. Communication Interface – The importance of having proper website standards, domain name structure, and official email nomenclature is mentioned in this section. This also emphasizes the proper use of emails as this could be used as an official mode of communication.
  6. Privacy, Confidentiality, Security and Medical Ethics – Unlike in many other sectors, the practice of proper ethical standards and patient privacy bears the highest importance in the field of healthcare. The importance of ensuring privacy, confidentiality, and information security during the adoption of ICT in the health sector is mentioned in this section.
  7. Digital Health Systems Interoperability – This chapter prescribes guidelines and standards to achieve seamless communication between digital health solutions.
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