The implementation of SMILHIS in three pilot LGUs-Municipality of Pulilan in Bulacan, Cagayan de Oro City, and Pangasinan Province demonstrated both the technical feasibility and operational value of deploying an interoperable LHIE platform. Each pilot considered different use cases: in Pulilan, the integration of health data with regulatory and treasury systems required reconciling heterogeneous data structures; in Cagayan de Oro, the absence of authoritative registries within the HCPN created barriers to unified patient tracking; while in Pangasinan, the scale and geographic dispersion of the health network complicated real-time health service visibility. Despite these challenges, the SMILHIS platform integrated patient, provider, and facility registries, facilitated secure data exchange across multiple systems, and provided real-time referral and facility capacity dashboards. The key outcome of the study was the demonstrated ability of LGUs to implement an interoperable, standards-based LHIE that significantly reduced data duplication, improved referral coordination, and strengthened health system responsiveness. In addition to enhanced technological capability, the study also showed notable improvements in LGU digital health governance. Moreover, it contributed to strengthening human resource capacity through hands-on implementation experience and multi-sector collaboration, while promoting greater alignment with national government digital health standards. These institutional and technical gains highlight SMILHIS as both a practical solution and a capacity-building mechanism for sustainable digital transformation at the local level.
Zuniga et al. (2026) studied this question.