Bhutan’s healthcare system has embarked on a remarkable transformation journey, leveraging the power of Information and Communication Technology (ICT) to enhance healthcare access, quality, and efficiency. This article explores the convergence of Bhutan’s healthcare landscape with the digital age, encompassing infrastructure, policy, and the ambitious Electronic Patient Information System (ePIS) project. 

In 2019, Bhutan’s healthcare landscape served a population of approximately 727,143 people across 20 districts. It boasted 46 hospitals, including three regional referral hospitals and a national referral hospital. Complementing this infrastructure were Primary Health Care Centers, a dedicated workforce of over 5,000 health professionals, and a reliance on more than 20 IT systems to manage healthcare services. The healthcare system conducted 24,687 surgeries, 1,016,477 laboratory tests, and provided 219,554 radiology department services during the year.

Bhutan’s commitment to healthcare accessibility is deeply embedded in its constitution, particularly in Sections 21 and 22 under Article 9. These sections ensure free access to basic public health services, including traditional medicines, and guarantee security in cases of sickness, disability, or lack of adequate livelihood. Aligning with global health priorities, the World Health Assembly (WHA) underscored the importance of digital technologies in healthcare, emphasizing their role in advancing Universal Health Coverage and the Sustainable Development Goals.

To harness the potential of ICT in healthcare, Bhutan established the ICT Division within the Ministry of Health (MoH) in 2016. In 2017, the Emergency Medical Service Division of MoH’s Department of Medical Service handed over the ePIS Project to the ICT Division. The eHealth Strategy, developed in 2018 in collaboration with the Asian Development Bank (ADB) and the World Health Organization (WHO), laid the foundation for Bhutan’s digital healthcare transformation. Key existing e-health solutions include DHIS2, Disease Surveillance System, Laboratory Information System (LIS), Picture Archiving and Communication System (PACS), Health Help Center (HHC) system, Telemedicine solutions, Blood Transfusion System, DocApp (Mobile App), and Inpatient Department (IPD) Reporting System. Despite these advances, challenges remained, including paper-based approaches, limited patient data platforms, and suboptimal treatment outcomes. In response, Bhutan initiated the ePIS project to provide improved data access, generate evidence-based information for healthcare decisions, and contribute to the goal of Universal Health Coverage (UHC).

The ePIS project is a pivotal component of Bhutan’s 12 Five Year Plan’s Digital Drukyul Flagship Project, jointly implemented by the Ministry of Information and Communications (MoIC) and MoH, supported primarily by the Asian Development Bank, with co-funding from the Royal Government of Bhutan. The project emerged following the Royal Bhutan Government’s cabinet directive in January 2020, leading to its award to Druk Holdings and Investments (DHI) through a direct tender process, subsequently outsourced to Thimphu Tech Park Limited (TTPL) following Bhutan’s Procurement Rules and Regulations for sustainability. 

Bhutan’s digital healthcare revolution, driven by the ePIS project and guided by constitutional principles, reflects a commitment to providing accessible, high-quality healthcare services to its citizens, while preserving its traditional healing heritage. This transformative journey promises a brighter, more equitable future for healthcare in Bhutan.