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: 12 | ARCHIVED on 29-Oct-2019 | ISR38885 | 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 Satisfactory ►Moderately Satisfactory Overall Risk Rating ►Substantial ►Substantial Implementation Status and Key Decisions Progress on the Project Development Objectives (PDO) and implementation of the Project has shown steady and continued improvement. With strong leadership support, the Project team has remained focused on meeting the agreed actions and is beginning to see substantial progress on both foundational and mainstay activities of the Project. The initial selection of the Health Information Exchange Platform (HIEP) has been completed, IT equipment for pilot facilities are in place, and critical building blocks for 10/29/2019 Page 1 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) the new health information architecture in terms of development of health standards, protocols and legal frameworks are in advanced stages of development. Strong commitment has also been shown in ensuring last-mile internet connectivity and the government budgets now include internet charges for connecting remote Soum facilities. Capacity building activities are progressing well, and trainings are being conducted for health professionals both on improving IT literacy and e-Health basics. The Project Implementation Unit (PIU) is fully staffed and able to drive Project implementation. A major change since the last mission has been the appointment of a head of the e-Health Division at MoH, which has given the Project renewed direction and strong stewardship support. The Project is now in its final year of implementation and while there is overall progress on Project implementation and there is strong leadership support, several challenges remain. Most of the key procurement tasks including the establishment of the HIEP, the picture archiving system, and the enterprise architecture are in early stages of procurement. With a closing date of September 30, 2020, timelines available for critical Project activities like the setting up of the health information exchange platform, the picture archiving and communication system and the enterprise architecture will not be enough. When procurement processes are completed, and key contracts are signed, a critical decision for the Government of Mongolia would be to ensure enough time is available in the Project to complete the tasks. Extending the current Project closing date would be one of the choices to consider. Going forward, the Ministry of Health and Project Implementation Unit have been encouraged to continue to keep the Project processes on track and to ensure procurement activities are sequenced to contribute to the PDO. 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 IN00753722 ►(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 10/29/2019 Page 2 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) Value 0.00 0.00 0.00 75.00 Date 31-Dec-2013 13-Mar-2019 10-Oct-2019 31-Dec-2019 Denominator is the total number of reports produced by the pilot facilities and transmitted to the National Center for Comments: Health Development, electronically or otherwise. Numerator is the number of those reports transmitted electronically through the HIEP to the National Center for Health Development. IN00753723 ►(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 13-Mar-2019 10-Oct-2019 31-Dec-2019 Denominator is the total number of referrals into and out of pilot facilities. Numerator is the number of those referrals that Comments: are electronically managed. IN00753724 ►(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 200.00 508.00 508.00 450.00 Date 13-Jun-2018 13-Mar-2019 10-Oct-2019 30-Sep-2020 IN00753725 ►(4) Improvements in IT literacy and health information management capacity among health professionals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 290.00 380.00 1,000.00 Date 13-Jun-2018 13-Mar-2019 10-Oct-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 procurement. As the piloting and HIEP are in process there is no progress to reflect on these indicators. PDO 3 (monthly reports transmitted electronically) end target has been achieved and PDO 4 (capacity building) is proceeding well. Intermediate Results Indicators by Components Component 1: Build the E-Health Integration System IN00753756 ►Component 1: Health Data Standards are developed, validated and promulgated by MOH (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 10/29/2019 Page 3 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) Nine Health data Six health data standards Value no standards development in Yes development in progress. progress Date 31-Dec-2013 13-Mar-2019 10-Oct-2019 30-Sep-2020 Comments: Yes/No IN00753759 ►Component 1: Percentage of pilot facilities which design, develop, and implement successful piloting of eHealth Portal, Viewer and HIEP. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2013 13-Mar-2019 10-Oct-2019 30-Sep-2020 Denominator is the total number of facilities identified for the pilot tests. The denominator will be defined during Year 1. Comments: The numerator is the number of those pilot facilities that design, develop and successfully pilot the e-health Portal, Viewer, HIEP and PACS. IN00753760 ►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 13-Mar-2019 10-Oct-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) . Numerator is the number of digital images, Comments: which are transmitted to the central PACS. IN00753761 ►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 110.00 110.00 192.00 500.00 Date 13-Jun-2018 13-Mar-2019 10-Oct-2019 30-Sep-2020 IN00753763 ►Component 1:Health data information storage capacities improved (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Limited Data storage Limited Data Storage Limited Data Storage Health Data Storage Value capacity Capacity Capacity capacities enhanced Date 13-Jun-2018 13-Mar-2019 10-Oct-2019 30-Sep-2020 Component 2: Institutional Strengthening and Capacity Building IN00753757 ►Component 2: Training Center has been designed, implemented and is ready for use. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 10/29/2019 Page 4 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) Training Center Design Training Center Design Value No Yes Completed Completed Date 31-Dec-2013 13-Mar-2019 10-Oct-2019 30-Sep-2020 IN00753758 ►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 0.00 291.00 291.00 300.00 Date 13-Jun-2018 13-Mar-2019 10-Oct-2019 30-Sep-2020 IN00753762 ►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 No Yes Date 13-Jun-2018 13-Mar-2019 10-Oct-2019 30-Sep-2020 IN00753764 ►Component 2: Beneficiary consultation outcomes and feedback integrated in project implementation (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes, in process Yes Date 13-Jun-2018 13-Mar-2019 10-Oct-2019 30-Sep-2020 Overall Comments IR Progress on intermediate indicators on Component 1 (three out of five) are largely dependent on the HIEP and PACS being in place. Progress on Component 2 intermediate indicators is satisfactory with three of the four indicators on track. 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 2.07 15.28 12% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date 10/29/2019 Page 5 of 6 The World Bank Implementation Status & Results Report E-Health Project (P131290) P131290 IDA-54890 Effective 06-Jun-2014 18-Jun-2015 17-Aug-2015 30-Sep-2019 30-Sep-2020 Cumulative Disbursements Restructuring History Level 2 Approved on 11-Jun-2015 ,Level 2 Approved on 11-Sep-2018 Related Project(s) There are no related projects. 10/29/2019 Page 6 of 6