UPM-NThC Community Health Information Tracking System (CHITS) Primer

8/4/2019 UPM-NThC Community Health Information Tracking System (CHITS) Primer

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Community Health Information Tracking System eRecords eLearning Telemedicine

Transcending the delivery ofhealthcarefor Filipinos through

Electronic Health Recordsin Rural Health UnitsCapability-building, Deployment and

Implementation of the Community Health

Information Tracking System (CHITS)

The Plan of Action for CHITS deployment1. Memorandum of Agreement between UPM-NThC and LGU.2. Identify local technical support (c/o State Colleges

and Universities in the Region to be Accredited

CHITS Reference Centers)3. Establishment of Infrastructure

a. Secure hardware and network equipment

b. Setup hardware and networkc. Install and configure software

4. Computer Literacy Capability-building

for Health Workers (c/o LGU or local technical support).

5. CHITS Capability-building for Health Workers

Benefits of CHITSRural Health Units or Health Centers

- Faster patient record retrieval

- Patient spent waiting for services are minimized

- Streamline workflow of health center transactions- More efficient data entry and storage

- Appointment and follow-up scheduling system- Monitor the health of the community through

data accrual daily

- Projection of patient loads

- Secure access to health care workers (including audit trail)

Municipal and City Health Offices (MHO, CHO)

- Easier and timely generation of health report thatthe Field Health Service Information System (FHSIS) requires

- Potential for inter-health center integration, thus

makes tracking of patient more convenient

- Detect possible outbreaks

- Review of the health of the community can be

done on a regular basis- Projection of logistical needs to allocate

supplies and manpower

Department of Health (DOH)

- Integrates health programs

- Aggregate data to any format required by DOH andPhilHealth

- Facilitates epidemiology data analysis

- Activities of the RHUs are monitored if compliant with

Sentrong Sigla standards

- Improves quality of FHSIS reporting

- Timeliness of submission of reportsGovernment to Citizen

- Makes information available to stakeholders in

the community for better decision making- Leads to more efficient use of community resources

- Visible services to the community

- CHITS is a proactive public health tool. It can alert andinform health professionals on possible program defaulters

thus increasing the level of health service delivery.

The Need to Deliver Quality DataAt the helm of policy analysis and planning in the public health system

hierarchy in the Philippines is the data for the Field Health Service

Information System (FHSIS) which originates during a patients

encounter at barangay health stations (BHS), city and rural health units

(RHU). With the volumes of data being collected in a typical RHU, it hasalways been a challenge to consolidate data into a cohesive andrelevant whole. Reporting health data is still paper based, which is prone

to error, destruction, and alteration. Consolidation of data on paper

records is also time consuming causing severe delays which make the

information stale and irrelevant.

CHITS: The Open Source for Health Development InitiativeIn line with its mandate to increase access to health information andservices through information and communications technology, the

University of the Philippines Manila - National Telehealth Center

(UPM-NThC) has developed the Community Health Information

Tracking System or CHITS, a low cost computerization initiative for local

health centers. CHITS was envisioned to automate the core processes in

the health center and contribute to effective and efficient delivery ofservices.

CHITS is made up of several

components which work together

to form a cohesive whole. At thecore of CHITS is its capacity-building

program component that gradually

introduces important concepts of

information systems to health

center staff. CHITS employs a free

and/or open source software whichmakes it extremely flexible and

compliant to the needs of the local

health center and other partners in

the future such as the DOH. Once

CHITS is installed in an RHU, it nowserves as a platform for further enhancements such as e-learning for

health and telemedicine.

General ObjectiveIt aims to extend the technology resources and services of the

UPM-NThC to the level of the local government units. Using health

information systems, CHITS hopes to increase the efficiency of the localhealth center in caring for its constituents and to aid in health decision

making at the local level.

Specific Objectives1. To computerize / automate the generation

of health center reports;

2. To minimize loss and destruction of patient recordsby the use of electronic patient records;

3. To improve access to health center data.

Lagrosa Health Center, Pasay City

Dr. Herman D. Tolentino and Pasay Cityhealth center workers (doctors, nurses,

midwives, and barangay health workers)

collaborated on the design of CHITS and

was pilot-tested in May 10, 2004.

Today, CHITS is installed in 36 health

facilities* around the country including

Pasay City, Marikina City, QuezonProvince, Cavite, Laguna, Bataan,

Batanes, Zamboanga, Quezon City,and Tarlac.

--*as of July 2010


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How CHITS WorkThe deployment and implementation of the Community Health

Information Tracking System is composed of four (4) major

components namely: Information Technology Infrastructure,Capability-building, Policy Development, and Data for

Decision-making.

I. Information Technology InfrastructureA. Hardware and Networking

Composed of workstations connected over a network that will

allow end-users to enter their health center data to CHITS. Oneworkstation will be assigned to each of the three stations

(admissions, consultation and treatment) inside the health

center.

All workstations are connected via the router thus forming a

local area network or intranet. In order to access CHITS, allcomputers must be connected over the Internet. CHITS is hosted

in an external industry-grade and secure application server.

Health centers will be provided with login accounts and

appropriate access level such that only those that have been

authorized can access the system.

a. Local Workstations 3 units (admissions, consultation,

and treatment)

b. Hardware Peripherals printer, UPS

c. Local Area Network Hardware router, LAN cables or

wireless LAN cards

d. Internet Connection to be catered by a localInternet Service Provider

e. Workstation Support to be provided by the

hardware distributor

B. Software ServicesThe support services intended to run

and configure the application in the

initial phase and provide application

level support during

implementation phase. The

application level support has anannual subscription charge and can

be renewed upon the agreement of

the stakeholders.

Development of additional and

more specialized modules is done

on a separate occasion upon therequest of the CHITS end-users. Work

schedule for implementation and

cost will be determined based on the number programming

man-hours needed and level of the requirements complexity.

a. Data Center houses the health center data. Provides

security and better management of system maintenance

tasks such as back up of data and optimization of server

resources. This service includes purchase of two server racks,

system administration support, co-location management,data center power supply and internet connection.

b. Server Configuration setting up and configuring the

CHITS application and its corresponding databases on the

data center.c. Annual Subscription for Application Level Support

support includes phone, SMS, electronic trouble ticket andon-site troubleshooting.

d. Subscription to New Module Releases

e. Development of End-User Customized Module

II. Capability- BuildingA. Orientation to CHITS the session is provided for public

health practitioners in order to orient them about basic

concepts on health information management and CHITS as a

public health electronic health record.

B. Capability-Building for End-Users intended for health

centers who are about to implement CHITS. This moduleincludes basic electronic health record features of CHITS and

specialized modules based on Field Health ServiceInformation System (FHSIS).

C. Capability Building for CHITS Administrators intended

for the physician or public health nurses who will be acting as

the local CHITS administrator in the health center. Topics that

are included are providing access level to various users,understanding basic system maintenance task, report

generation and techniques in maintaining good and quality

data. This is given free of charge.

III. Policy DevelopmentRefers to the provision or mandate for the 'new way of doingthings' in a particular health facility in a locality. Considered asthe most crucial and delicate part of CHITS deployment, a

supportive local government unit who is willing to express

commitment of support through ordinance or resolution; a

pro-active MHO who is ready to lead; and RHU personnel who

are aware of the significance of delivering quality health data

and willingness to be trained spells a difference in the success orfailure of the deployment of CHITS in an area.

IV. Data for Decision-MakingEssential data from health programs are integrated in CHITS and

viewed by the frontliners (Physician-incharge, MHO, CHO, PHO),

and program managers of the DOH. With the inclusion of the

PhilHealth module, PhilHealth will benefit from it as data will beused for reimbursement and possible source of funds for

sustainability.

The linking of the CHITS and the

E-FHISIS will be helping theFHSIS coordinator a lot as it

would save her time from

encoding municipality and RHU

data into the system. It wouldalso be easier for the FHSIS

coordinator to provide the PHO

with summary data usually

requested from their office forsubmission to decision makers

of the province.

-Pinky Cacdac

FHSIS CoordinatorTarlac Provincial Health Office


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Solution Snapshot

CHITS is an extensible, modular system that leverages

existing routine health information systems (vertical

programs of the Department of Health) in publichealthcare to serve as a starting point for implementing

comprehensive information system integration.

Know more about CHITS:

CHITS: Looking Ahead- CHITS deployment and training to various rural health units

nationwide are underway.

- The Department of Health and the Commission onInformation and Communications Technology (CICT) are

looking into the possibility of deploying CHITS in health

facilities across the country.

- The UPM-NThCs homegrown electronic health record that

is CHITS continues to lead in making public-privatepartnerships possible with the Wireless Access for Health

(WAH) initiative in Tarlac province which was supported by

various stakeholders through a multisectoral partnership.

- The UPM-NThC proposes

the use of an electronichealth record featuring

CHITS as an application

used by student nurses in

their Nursing Informaticscourse.

- To build a national

network of users that

would benefit with the

developments on CHITS.

Demo WebsiteFor an online demonstration of CHITS,open your Internet browser and visit:

http://demo2010.chits.ph

login name: user password: user

For online information on CHITS,

visit the official website athttp://www.chits.ph

Contact usFor inquiries on deployment,

and capability-building, contact:

UPM - NATIONAL TELEHEALTH CENTER

University of the Philippines Manila

The Health Sciences Center

Information Technology Complex

3rd floor, Philippine General HospitalTaft Avenue, Manila

PHILIPPINES 1000

Telefax: (+63) 2 525-6501

Email: [email protected]: www.telehealth.ph

Budgetary Requirements for CHITS deployment for

Rural Health Units are available upon request.


eRecords eLearning Telemedicine

We have 120-200 patients seen every day,and thus if record keeping is not good,

how can we give efficient service and

accommodate all the patients?

With CHITS, waiting time in the RHU was lessened;

RHU staff are not stressed out anymore.

- Mayor Miguel Rivilla

Paniqui, Tarlac

About NTHC

The National Telehealth Center (NThC) of the University of the

Philippines Manila was established in June 1998 through a

University of the Philippines Board of Regents resolution withthe mandate to increase access of Filipinos to health

information and services through the appropriate use of

technology.

UP Manila aims to improve the health of Filipinos through the

optimal use of information and communications technology.

Content by:Herman D. Tolentino, M.D.

Alvin B. Marcelo M.D.Alex I. Gavino, M.D.

Noel A. Baez, R.N.

CHITS Primer published on August 2010

UPM-NThC Community Health Information Tracking System (CHITS) Primer

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