Administrative Order No. 2023-0002 entitled “Institutionalization of the Expanded National Practice Guidelines Program” mandates concerned DOH offices, attached agencies, and other stakeholders are enjoined to use NPGs in the development of plans strategies and the delivery of individual- and population-based health services in clinical and public health settings.

LOCAL IMPLEMENTATION IN PROVINCE AND CITY-WIDE HEALTH SYSTEMS

Section 19 of the UHC Act states that the DOH, Department of Interior and Local Government, PhilHealth, and LGUs shall integrate local health systems into P/CWHS to address fragmentation issues in health service delivery and health systems management. Furthermore, Section 27 mandated the establishment of a mechanism for the development, adoption, and dissemination of CPGs. In line with this Administrative Order (AO) No. 2020-0037: Guidelines on Implementation of the Local Health Systems Maturity Levels (LHS ML) provided the mechanism for the monitoring of P/CWHS on their integration of the local health systems. The adoption and implementation of NPGs in P/CWHS is one of the key result areas (KRA) in the service delivery block under the referral system characteristics, per DOH Department Memorandum No. 2021-0277:  FY 2021 Local Health Systems Maturity Levels (LHS ML) Annual Monitoring and Updated LHS ML Monitoring Tool. This Quick Guide on the Adoption and Implementation of Clinical Practice Guidelines and Other Case Management Protocols for Local Health Systems Maturity Level Monitoring is being disseminated to assist LGUs in achieving this KRA.

CLINICIAN SUPPORT TOOLS

Recognizing the need to derive tools based on NPGs that will aid in the translation of policy into practice and sustain care quality, different clinician support tools are being developed in accordance with Administrative Order (AO) No. 2023-0002: Institutionalization of the Expanded National Practice Guidelines Program, AO No. 2022-0018: The Development and Utilization of the Omnibus Health Guidelines per Lifestage, and Department Memorandum No. 2022-0582: Interim Guidance on Developing Guideline Implementation Tools for the Omnibus Health Guidelines and Sample Clinician Support Tools for Hypertension.

Health Examination Forms (HEFs)
The HEFs are comprehensive history taking & physical examination forms which aim to standardize and maximize patient encounters, to link routine and targeted screening tests for primary care and provide intuitive clinical decision support, to facilitate health information exchange between various providers and facilities within healthcare provider networks (HCPNs), and to ensure that relevant public health and surveillance data are obtained during patient encounters. The HEFs shall be adopted by and used as the main reference for electronic medical records fields and health risk assessment applications to optimize the impact of comprehensive health screening efforts. The complete details on the use of HEF including the user’s quick guide can be accessed through the Department Circular No. 2023-0556: Dissemination of the National Practice Guidelines Program Outputs for CY 2023.

Disease-Specific Algorithms
The DOH leads the translation of NPGs into user-friendly Guideline Implementation Tools such as Clinician Support Tools, Patient Support Tools, Implementation Support Tools, and Evaluation Support Tools. More disease-specific algorithms based on NPGs will be developed and disseminated in the future.

NPG Implementation and Clinician Support Tools

Name of Implementation ToolPublication Year
Health Examination Form (HEF) for Children five (5) to under 10 years old (v.1.2023)2023
Health Examination Form (HEF) for Adolescents 10 to 19 years old (v.1.2023)2023
Health Examination Form (HEF) for Adults 20 to 59 years old (v.1.2023)2023
HEF Users’ Quick Guide (ver.1.2023)2023
Clinician Support Tool for Hypertension2022
Quick Guide on the Adoption and Implementation of Clinical Practice Guidelines and Other Case Management Protocols for Local Health Systems Maturity Level Monitoring2021