Implementation Challenges of Smarter and Integrated Local Health Information System

Health Information Systems (HIS) play a vital role in forming coordinated and data-driven healthcare. However, in many local settings, these systems operate in isolation, unable to share data with other platforms, which causes interoperability issues. Interoperability is essential for linking records, enabling timely decisions, and achieving Universal Health Care (UHC). In response to this, the Smarter and Integrated Local Health Information System (SMILHIS) emerged to connect health databases and promote interoperability. However, SMILHIS’ implementation has faced challenges. Understanding these challenges is essential for strengthening strategies, improving healthcare delivery, and supporting the realization of Universal Health Care. This study used a descriptive qualitative design, employing Key Informant Interviews (KIIs) with 10 purposively selected participants in Cagayan de Oro and San Carlos City, Pangasinan. Thematic analysis revealed four major themes: (1) Governance and Strategic Direction, including leadership turnover, shifting priorities, local autonomy, policy gaps, and the need for national support; (2) Institutional Capacities and Readiness, highlighting staffing shortages, limited technical expertise, and the need for training and organizational commitment; (3) Technological, Financial, and Infrastructure Constraints, such as inadequate funding, equipment shortages, and data privacy concerns; and (4) External and Environmental Challenges, including geographic inaccessibility and competition from private systems. The study revealed that the success of health information systems is determined not only by technology but also by governance, leadership stability, and institutional readiness. The results underscore the importance of developing stable policies that can withstand political transitions, ensuring long-term financial stability, building institutional and human resource capacity, and fostering stronger coordination between national and local governments. By addressing these areas, HIS such as SMILHIS can become more resilient and sustainable, leading to more efficient service delivery, continuity of care, and promoting the country’s progress toward Universal Health Care.