PhilHealth is the sole administrator of national social health insurance for all Filipinos, which makes effective data management a vital to achieve the mandate of providing financial risk protection to the entire population. Led by Jovita Aragona, Senior Vice President and CIO, PhilHealth’s data management strategy commenced in 2016 with business intelligence and cloud technologies. As it broke down traditional barriers to efficiency, information accessibility-availability, and collaboration, data became a strategic asset for PhilHealth.
With integrity of mission-critical data, system- and process- harmonization, and standard data report-analysis-mining techniques, PhilHealth has improved its programs and services for Filipinos through a comprehensive analysis of health insurance claims over time periods, diseases, social classes, national-LGU geographical areas, demographics, benefits programs, payment schemes, and other insurance-health dimensions. With advanced analytics, artificial intelligence, and machine learning, PhilHealth has also initiated a framework in detecting fraud and abuse in insurance claims. Finally, data on hand has also empowered PhilHealth to support the Department of Health in the creation of health programs, control of real-potential epidemics and emerging health conditions and trends, and synchronization of Universal Health Care initiatives.