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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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Community Health Information Tracking System eRecords eLearning Telemedicine
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.
Community Health Information Tracking System eRecords eLearning Telemedicine
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
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