The World Bank Implementation Status & Results Report E-Health Project (P131290) E-Health Project (P131290) EAST ASIA AND PACIFIC | Mongolia | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 10 | ARCHIVED on 21-Nov-2018 | ISR34578 | Implementing Agencies: Ministry of Health, Mongolia Key Dates Key Project Dates Bank Approval Date: 06-Jun-2014 Effectiveness Date: 17-Aug-2015 Planned Mid Term Review Date: 26-Mar-2018 Actual Mid-Term Review Date: 18-May-2018 Original Closing Date: 30-Sep-2019 Revised Closing Date: 30-Sep-2020 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve integration and utilization of health information and e-health solutions for better health service delivery in selected pilot sites. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Project Management:(Cost $1.22 M) Build the E-Health Integration System:(Cost $15.98 M) Institutional Strengthening and Capacity Building: Component:(Cost $2.30 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The midterm review of the Project was carried out in May 2018 and resulted in a restructuring of the Project, which was completed and agreed on October 1, 2018. The purpose of the restructuring was to simplify implementation and to ensure the core objectives around the design, development and piloting of Health Information Exchange Platform (HIEP) are achieved within the remaining timeframe. Post restructuring of the Project, the Project Implementation Unit has been actively working to fast track implementation. Progress has been made in revising the Project implementation Manual, developing a Procurement Strategy for Development, revising the Procurement Plan and getting initiated on various Project activities including the HIEP vision document, Primary care hardware procurement, and the training activities. While progress is visible on several indicators a key factor determining Project success will be the setting up of the Health information Exchange Platform (HIEP). The process for setting up the HIEP is in the early days and hence the progress on PDO and the overall implementation progress have been retained as moderately unsatisfactory. 11/21/2018 Page 1 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) To ensure sufficient time for development, implementation and testing of HIEP, a contract with the selected provider needs to be signed by May 2019. The mission has agreed clear milestones with the Government for the procurement process and contracting of the HIEP consultant team and will be monitoring this closely. Further to ensure systematic implementation the mission has agreed to sequence activities allowing for supporting activities to flow in tandem with the setting up of the HIEP. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- High High Macroeconomic -- Substantial Substantial Sector Strategies and Policies -- Substantial Substantial Technical Design of Project or Program -- Substantial Substantial Institutional Capacity for Implementation and Sustainability -- Substantial Substantial Fiduciary -- Substantial Substantial Environment and Social -- Low Low Stakeholders -- Substantial Substantial Other -- Substantial Substantial Overall -- Substantial Substantial Results PDO Indicators by Objectives / Outcomes Project Development Objective IN00643580 ►(1) Percentage of statistical reports out of total reports produced by pilot facilities that are transmitted electronically through HIEP to the National Centre for Health Development (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 75.00 Date 31-Dec-2013 11-Dec-2017 25-Oct-2018 31-Dec-2019 Denominator is the total number of reports produced by the pilot facilities and transmitted to the National Comments: Center for Health Development, electronically or otherwise. Numerator is the number of those reports transmitted electronically through the HIEP to the National Center for Health Development. IN00643646 ►(2) Percentage of electronic referrals out of total referrals at pilot facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 11/21/2018 Page 2 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) Value 0.00 0.00 0.00 50.00 Date 31-Dec-2013 11-Dec-2017 25-Oct-2018 31-Dec-2019 Denominator is the total number of referrals into and out of pilot facilities. Numerator is the number of Comments: those referrals that are electronically managed. IN00643647 ►(3) Number of project area soum and family health center facilities transmitting monthly e-health reports (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 200.00 200.00 250.00 450.00 Date 13-Jun-2018 13-Jun-2018 25-Oct-2018 30-Sep-2020 IN00643648 ►(4) Improvements in IT literacy and health information management capacity among health professionals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 120.00 1,000.00 Date 13-Jun-2018 13-Jun-2018 25-Oct-2018 30-Sep-2020 Overall Comments PDO Progress on PDO 1 (Statistical reports transmitted through HIEP) and the PDO 2 (electronic referrals in pilot sites) will be determined by the operationalization of the pilot sites and HIEP. As the piloting and HIEP is in process there is no progress on these indicators. The progress son PDO 3 (monthly reports transmitted electronically) and PDO 4 (capacity building) is well noted. Intermediate Results Indicators by Components Component 1: Build the E-Health Integration System IN00643649 ►Component 1: Health Data Standards are developed, validated and promulgated by MOH (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target No. Three Health data standards in progress (Healthcare actors’ Value no -- identifier standard, Yes patient summary standard, discharge summary standards ) Date 31-Dec-2013 11-Dec-2017 25-Oct-2018 30-Sep-2020 Comments: Yes/No IN00643652 ►Component 1: Percentage of pilot facilities which design, develop, and implement successful piloting of eHealth Portal, Viewer and HIEP. (Percentage, Custom) 11/21/2018 Page 3 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2013 11-Dec-2017 25-Oct-2018 30-Sep-2020 Denominator is the total number of facilities identified for the pilot tests. The denominator will be defined Comments: during Year 1. The numerator is the number of those pilot facilities that design, develop and successfully pilot the e-health Portal, Viewer, HIEP and PACS. IN00643653 ►Component 1: Percentage of digital images generated in pilot facilities which are transmitted to the central PACS. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2013 11-Dec-2017 25-Oct-2018 30-Sep-2020 Denominator is the total number of digital images generated at the pilot facilities per defined period (e.g. Comments: quarter, month etc). This period will be defined during Year 1. Numerator is the number of digital images, which are transmitted to the central PACS. IN00643654 ►Component 1: Number of primary healthcare facilities (soum, FHC) having at least 1 upgraded and working computer (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 110.00 110.00 110.00 500.00 Date 13-Jun-2018 13-Jun-2018 25-Oct-2018 30-Sep-2020 IN00643656 ►Component 1:Health data information storage capacities improved (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Limited Data storage Limited Data Storage Health Data Storage Value -- capacity Capacity capacities enhanced Date 13-Jun-2018 13-Jun-2018 25-Oct-2018 30-Sep-2020 Component 2: Institutional Strengthening and Capacity Building IN00643650 ►Component 2: Training Center has been designed, implemented and is ready for use. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 31-Dec-2013 11-Dec-2017 25-Oct-2018 30-Sep-2020 IN00643651 ►Component 2: Number of soum and family health centers connected to high speed internet highway (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 201.00 300.00 Date 13-Jun-2018 13-Jun-2018 25-Oct-2018 30-Sep-2020 IN00643655 11/21/2018 Page 4 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) ►Component 2: E signatures used as a valid endorsement for health insurance claims (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 13-Jun-2018 13-Jun-2018 25-Oct-2018 30-Sep-2020 IN00643657 ►Component 2: Beneficiary consultation outcomes and feedback integrated in project implementation (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 13-Jun-2018 13-Jun-2018 25-Oct-2018 30-Sep-2020 Overall Comments IR Progress on several intermediate indicators is noted including on Component 1 (health data standards, information storage and having hardware in PHC) and Component 2 ( on getting soum facilities connected to fiber optic and the training center established). Over the future progress on some low landing fruits like e- signatures and storage capacities could be achieved while the more longer term HIEP is set in place. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P131290 IDA-54890 Effective USD 19.50 19.50 0.00 1.16 16.79 6.5% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P131290 IDA-54890 Effective 06-Jun-2014 18-Jun-2015 17-Aug-2015 30-Sep-2019 30-Sep-2020 Cumulative Disbursements 11/21/2018 Page 5 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) Restructuring History Level 2 Approved on 11-Jun-2015 ,Level 2 Approved on 11-Sep-2018 Related Project(s) There are no related projects. 11/21/2018 Page 6 of 6