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: 11 | ARCHIVED on 20-Mar-2019 | ISR36280 | 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 Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions Mid-Term 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 the Health Information Exchange Platform (HIEP) are achieved within the remaining timeframe. Post restructuring of the Project, the Project Implementation Unit (PIU) has been actively working to fast track implementation. Overall progress on the Project Development Objectives and implementation of the Project has shown steady improvement. With strong leadership support the Project team has remained focused on meeting the agreed actions and the Project is beginning to show substantial progress on both foundational and mainstay activities of the Project. The initial selection of the Health Information Exchange Platform is nearing completion, purchase of primary care IT equipment for pilot facilities is at an advanced stage, and critical consultancies for development of health standards and protocols are in place. Strong commitment has also been shown in ensuring last mile internet connectivity, and the 2019 budgets now include internet charges for 3/20/2019 Page 1 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) connecting remote soum facilities. Capacity building activities are progressing, and trainings are being conducted for health professionals both on improving IT literacy and E Health basics. The PIU is fully staffed and now well able to drive Project implementation. Despite the recent loss of key staff from the E Health Division, institutional structures remain robust, and the Project continues to receive strong stewardship support. Project implementation progress has been rated as moderately satisfactory. Going forward key activities for the Project include completing the selection of the Health Information Exchange Consultant, establishing the Picture Archiving and Communication System and finalizing the health standards, protocols and legal frameworks for health data exchange. A beneficiary assessment will also be carried out by mid-year to facilitate citizen feedback into the Project. Further the training center will be established to support the ongoing capacity building activities. In the last month, several key staff of the E Health Division have transferred out leaving vacancies in this nascent body. Ministry has agreed to have these vacancies filled with suitable replacements by April 15, 2019, to ensure that Project oversight continues to be available as critical activities are implemented. 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 IN00679282 ►(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 25-Oct-2018 13-Mar-2019 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. IN00679283 3/20/2019 Page 2 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) ►(2) Percentage of electronic referrals out of total referrals at pilot facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 31-Dec-2013 25-Oct-2018 13-Mar-2019 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. IN00679284 ►(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 200.00 250.00 508.00 450.00 Date 13-Jun-2018 25-Oct-2018 13-Mar-2019 30-Sep-2020 IN00679285 ►(4) Improvements in IT literacy and health information management capacity among health professionals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 120.00 290.00 1,000.00 Date 13-Jun-2018 25-Oct-2018 13-Mar-2019 30-Sep-2020 Overall Comments PDO Progress on PDO 1 (Statistical reports transmitted through HIEP) and the PDO 2 (electronic referrals in pilot sites) are dependent on the operationalization of the pilot sites and HIEP. As the piloting and HIEP is in process there is no progress to reflect on these indicators. The progress on PDO 3 (monthly reports transmitted electronically) and PDO 4 (capacity building) is proceeding well. Intermediate Results Indicators by Components Component 1: Build the E-Health Integration System IN00679321 ►Component 1: Health Data Standards are developed, validated and promulgated by MOH (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Six health data standards Value no -- Yes development in progress. Date 31-Dec-2013 25-Oct-2018 13-Mar-2019 30-Sep-2020 Comments: Yes/No IN00679324 ►Component 1: Percentage of pilot facilities which design, develop, and implement successful piloting of eHealth Portal, Viewer and HIEP. (Percentage, Custom) 3/20/2019 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 25-Oct-2018 13-Mar-2019 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. IN00679325 ►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 25-Oct-2018 13-Mar-2019 30-Sep-2020 Denominator is the total number of digital images generated at the pilot facilities per defined period (e.g. quarter, month etc). This period will be defined during Year 1 ( i.e. when the PACS is in place) . Comments: Numerator is the number of digital images, which are transmitted to the central PACS. IN00679326 ►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 25-Oct-2018 13-Mar-2019 30-Sep-2020 IN00679328 ►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 25-Oct-2018 13-Mar-2019 30-Sep-2020 Component 2: Institutional Strengthening and Capacity Building IN00679322 ►Component 2: Training Center has been designed, implemented and is ready for use. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Training Center Value No -- Yes Design Completed Date 31-Dec-2013 25-Oct-2018 13-Mar-2019 30-Sep-2020 IN00679323 ►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 0.00 201.00 291.00 300.00 Date 13-Jun-2018 25-Oct-2018 13-Mar-2019 30-Sep-2020 IN00679327 3/20/2019 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 25-Oct-2018 13-Mar-2019 30-Sep-2020 IN00679329 ►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 25-Oct-2018 13-Mar-2019 30-Sep-2020 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 1.73 15.96 9.8% 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 3/20/2019 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. 3/20/2019 Page 6 of 6