The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) LATIN AMERICA AND CARIBBEAN | Argentina | IBRD/IDA | Investment Project Financing (IPF) | FY 2024 | Seq No: 4 | Archived on 09-Apr-2025 | ISR03590 Implementing Agencies: Provincial Directorate of Multilateral Organizations and Bilateral Financing 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 05-Jul-2023) Increase access to health services and improve coordination and continuity of care in the public healthcare network of the Province of Buenos Aires. Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name Strengthening the Implementation of Electronic Medical Records (EMRs) / Integrated Health Record (IHR) in public health facilities:(Cost 39,100,000.00) Developing and Implementing Virtual Tools for Health Provision and Communication:(Cost 10,600,000.00) Project Management:(Cost 300,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial 4. KEY ISSUES & STATUS Apr 09, 2025 Page 1 of 9 The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) 4.1 Implementation Status and Key Decisions The Strengthening the Digital Health Agenda in the Province of Buenos Aires Project aims to increase access to health services and improve coordination and continuity of care in the public healthcare network of the Province of Buenos Aires. Significant progress has been made since effectiveness with 16 of 30 targeted municipalities developing actions to implement Interoperable Electronic Health Records (IEHRs) and 71 primary health facilities implementing IEHRs. Additionally, 39 of 40 provincial hospitals are advancing with IEHR implementation, with 90% using the outpatient module and 15% using the inpatient module. The Project has also contributed to the use of telehealth to cover Dengue consultations. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 03 - 10 Oct Proposed Rating 05 Jul 2023 2024 Political and Governance Substantial Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Moderate Moderate Moderate Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Overall Substantial Substantial Substantial Apr 09, 2025 Page 2 of 9 The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Improving coordination and continuity of care. Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of consultations 0.00 Nov/2022 2.74 30-Jun-2024 2.95 30-Dec-2024 14.00 Dec/2027 properly registered in the Comments on Women: 3.23 percent - Men: 2.69 percent. Annual target surpassed. IHR, by gender. achieving targets (Percentage) Percentage of women 25 to 0.00 Nov/2022 6.50 30-Jun-2024 28.86 30-Dec-2024 20.00 Dec/2027 64 years old with positive Comments on The end-Target has been surpassed. However, it is important to note that this indicator is cervical cancer screening that achieving targets calculated using only the project municipalities currently implementing HSI. As new project have received a colposcopy municipalities begin implementation and registration also improves, changes in the or have a scheduled denominator may occur – potentially leading to an increase or decrease in the reported colposcopy consultation result. within a three-month period. (Percentage) Increasing access to healthcare services. Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of diabetics that 0.00 Nov/2022 0.00 30-Jun-2024 0.00 30-Dec-2024 15.00 Dec/2027 received an eye fundus exam Comments on The Province is still designing the tele-ophthalmology network and protocols. Progress and through the tele- achieving targets reporting is expected by December 2025 ophthalmology strategy. (Percentage) Apr 09, 2025 Page 3 of 9 The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) 6.2 Intermediate Results Indicators by Components Strengthening the Implementation of Electronic Medical Records (EMRs) / Integrated Health Record (IHR) in public health facilities Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year People receiving quality health, nutrition, and Comments on This indicator has been added as part of the WBG’s new corporate scorecard. Discussions population services (Number achieving targets are underway between the WB and PIU on the methodology and calculations, including for of people) CRI setting an end-target. Reporting is expected by the next ISR. People receiving quality health, nutrition, and Comments on This indicator has been added as part of the WBG’s new corporate scorecard. Discussions population services – achieving targets are underway between the WB and PIU on the methodology and calculations, including for Youth (Number of setting an end-target. Reporting is expected by the next ISR. people) CRI People receiving quality health, nutrition, and Comments on This indicator has been added as part of the WBG’s new corporate scorecard. Discussions population services – achieving targets are underway between the WB and PIU on the methodology and calculations, including for Female (Number of setting an end-target. Reporting is expected by the next ISR. people) CRI 0.00 Nov/2022 17.14 30-Jun-2024 12.48 30-Dec-2024 30.00 Dec/2027 Comments on This indicator is related to PDI2 and measures the number of women who, after receiving an achieving targets appointment for a colposcopy consultation, attend the center and receive the service. The denominator for this indicator is the numerator for PDI2. Lower absenteeism is better, and Absenteeism in scheduled the indicator is currently performing beyond its end target. However, it is important to note colposcopy (Percentage) that, similar to PDI2, this indicator is calculated using only the project municipalities currently implementing HSI. As new project municipalities begin implementation and registration improves, changes in the denominator may occur, potentially leading to an increase or decrease in the reported result. 0.00 Nov/2022 13.00 30-Jun-2024 16 30-Dec-2024 30.00 Dec/2027 Apr 09, 2025 Page 4 of 9 The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) Comments on Municipalities that have signed the agreement to implement IHR: Adolfo Alsina, Avellaneda, Municipalities that started achieving targets Carlos tejedor, Carmen de Areco, Coronel Suárez, Florencio Varela, Hipólito Irigoyen, implementing IHR Ituzaingó, Presidente Perón, Lobos, Roque Pérez, San Andrés de Giles, Tornquist, Saladillo, (Number) Necochea y Villarino. Annual target achieved. Primary Health Care (PHC) 0.00 Nov/2022 0.00 30-Jun-2024 0.00 30-Dec-2024 150.00 Dec/2027 facilities with adequate ICT Comments on The indicator will be updated in the next ISR as ICT equipment is being distributed to primary equipment (Number) achieving targets health care facilities (PHC) . Hospital facilities with 0.00 Nov/2022 0.00 30-Jun-2024 0.00 30-Dec-2024 40.00 Dec/2027 adequate ICT equipment Comments on The indicator will be updated in the next ISR as ICT equipment is being distributed to eligible (Number) achieving targets hospitals implementing IHR. 0.00 Nov/2022 58.00 30-Jun-2024 71.00 30-Dec-2024 150.00 Dec/2027 PHC facilities that received Comments on A PHC facility is considered to have that received training if its staff haves been trained in at IHR training (Number) achieving targets least one IHR module. Annual target achieved. 0.00 Nov/2022 38.00 30-Jun-2024 39.00 30-Dec-2024 40.00 Dec/2027 Hospital facilities that received IHR training Comments on A hospital facility is considered to have received training if its staff have been trained in at (Number) achieving targets least one IHR module. Annual target achieved. Health Facilities with IHR 0.00 Nov/2022 96.00 30-Jun-2024 110 30-Dec-2024 190.00 Dec/2027 implemented and fully Comments on IHR is considered implemented and operational if at least one IHR module is in used at the operational (Number) achieving targets facility. Annual target achieved. Patients with a consultation 0.00 Nov/2022 120,437 30-Jun-2024 227,743 30-Dec-2024 334,114.00 Dec/2027 properly registered in the Comments on Women: 142,868 - Men: 84,823 - Not Specify: 52 IHR, by gender (Number) achieving targets 0.00 Nov/2022 3.00 30-Jun-2024 3.00 30-Dec-2024 5.00 Dec/2027 Prioritized functionalities Comments on Number of prioritized functionalities developed. Functionalities refer to: developed (Number) achieving targets Functionality 1 - Integration with RIS system Functionality 2 - Organization of two-way referral system integrated with appointment booking system Apr 09, 2025 Page 5 of 9 The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) Functionality 3 - Integration with Laboratory System Functionality 4 - Integration with Pharmacy System Functionality 5 - CDSS and Provincial Dashboard / data science and AI Annual target achieved. Selected municipalities with 0.00 Nov/2022 0.00 30-Jun-2024 0.00 30-Dec-2024 4.00 Dec/2027 their own EMR solution Comments on Selected municipalities should comply with cybersecurity standards. Still pending. interoperable with IHR achieving targets platform (Number) Percentage of Health 0.00 Nov/2022 4.00 30-Jun-2024 19.35 30-Dec-2024 20.00 Dec/2027 Facilities implementing Comments on Annual target achieved digital two-way referral achieving targets (Percentage) Percentage of SUMAR 35.00 Nov/2022 32.61 30-Jun-2024 30.00 30-Dec-2024 43.00 Dec/2027 beneficiaries with basic Comments on Denominator: People enrolled in SUMAR Program in December 2024. effective coverage, by gender achieving targets (Percentage) Percentage of people 0.00 Nov/2022 13.29 30-Jun-2024 13.72 30-Dec-2024 40.00 Dec/2027 registered in IHR with self- Comments on Annual target achieved. perceived gender identity achieving targets (Percentage) Developing and Implementing Virtual Tools for Health Provision and Communication Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Citizen consultations 0.00 Nov/2022 0.00 30-Jun-2024 0.00 30-Dec-2024 150,000.00 Dec/2027 managed through the web Comments on Total consultations managed by teleoperators or medical professionals through the web portal of the PBA (Number) achieving targets portal of the PBA. Percentage of people 0.00 Nov/2022 0.00 30-Jun-2024 74.69 30-Dec-2024 50.00 Dec/2027 satisfied with the use of the Comments on End-Project Target surpassed Citizen Web Portal and achieving targets Apr 09, 2025 Page 6 of 9 The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) telemedicine applications (Percentage) 0.00 Nov/2022 3.00 30-Jun-2024 4 30-Dec-2024 6.00 Dec/2027 Comments on Annual target achieved. Stages achieved in the achieving targets Stages achieved in the development of the ecosystem for the virtual healthcare operational development of the center: ecosystem for the virtual Stage 1- Software development. healthcare operational Stage 2 - Portal. center. (Number) Stage 3 - Access to consultation with teleoperators. Stage 4 - Access to Consultation with Basic Physicians. Stage 5 - Medication prescription access portal funded by the PBA Ministry of Health. Stage 6 - Integration with IHR. Average number of days 31.00 Nov/2022 0.00 30-Jun-2024 0.00 30-Dec-2024 20.00 Dec/2027 between the prescription of Comments on Medication prescription for breast cancer refers to those treatment medicines included in breast cancer medication and achieving targets the Vademecum approved and financed by the Provincial Cancer Institute. Measurement is the delivery of this pending. medication to women with exclusive public coverage. (Number) Apr 09, 2025 Page 7 of 9 The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed IBRD-95410 Effective 50.00 50.00 0.00 8.63 41.37 17.26% 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IBRD-95410 Effective 05-Jul-2023 20-Oct-2023 13-Dec-2023 30-Apr-2027 30-Apr-2027 8. KEY DATES Apr 09, 2025 Page 8 of 9 The World Bank Implementation Status & Results Report Strengthening the Digital Health Agenda in the Province of Buenos Aires (P179534) Key Events Planned Actual Approval 05-Jul-2023 05-Jul-2023 Effectiveness 13-Dec-2023 13-Dec-2023 Mid-Term Review No. 01 16-Nov-2025 Operation Closing/Cancellation 30-Apr-2027 9. RESTRUCTURING HISTORY 10. ASSOCIATED OPERATION(S) There are no associated operations Apr 09, 2025 Page 9 of 9