CHITS - Dr. Alvin Marcelo


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CHITS - Dr. Alvin Marcelo

  1. 1. “At its essence, every organization is a product of how its members think and interact.” -- Peter Senge
  2. 2. Community Health Information Tracking System: Towards an eRHU Alvin B. Marcelo National Telehealth Center University of the Philippines Manila
  3. 3. Outline National Telehealth Center  20th century RHU  CHITS: Integrated Health Services at the  Point-of-Care BuddyWorks Project  − e-learning − telemedicine The eRHU 
  4. 4. Welcome to San Pablo…..Eto ang community namin……
  5. 5. National Telehealth Center Vision created by the UP Board of Regents in 1998  mandated to study how ICT can be used to  improve the health of Filipinos
  6. 6. CHITS Partnership with the UP College of Medicine  Originally “Child Injury Tracking System”  Obtained small grant from IDRC/Panasia  (Canada) Intended to create a cellphone-based  reporting system for child injury in Pasay City Immersed project team in local health  centers (the frontline of the country's health system
  7. 7. FHSIS Field Health Service Information System  Fourth iteration of the DOH Management  Information System (since 1980s) A manual, paper-based system that required  aggregation of data at several levels of the hierarchy Data collection done by midwives;  consolidation and analysis by public health nurses and municipal health officers
  8. 8. Problems Data quality (based on WHO criteria)  − Incomplete − Inaccurate (errors in addition, 'guessing') − Illegibile − Not useful nor relevant for data collectors − Delayed Employed an “all-or-none” reporting scheme 
  9. 9. All or None Reporting Scheme HC B Province HC B Region B HC Province DOH B Region HC Province B HC
  10. 10. All or None Reporting Scheme HC B Province HC B Region B HC Province DOH B Region HC Province B HC
  11. 11. Problems with FHSIS Also contained vertical programs that had  their own vertical information systems − Expanded Program on Immunization − National TB Program − Family Planning − Maternal Care − and others
  12. 12. Vertical Programs Disintegrating at Philhealth the Health Center Maternal Care Level Child Care Family Planning Leprosy Overworked, underpaid, Filariasis demoralized government Schisto health worker Patient Family Barangay What quality of data will we get? Will it be good enough for decision making?
  13. 13. Proposed Solution Technology  Training  Teamwork 
  14. 14. Design Philosophy Create computer program side by side with  health workers inside the actual environment (c/o Dr. Herman Tolentino, system architect and lead developer) Build up the morale of health workers and  allow them to participate in the development Integrate the disintegrated vertical programs  [provide a unified interface] Empower the RHU staff to make evidence-  based decisions
  15. 15. Design Philosophy Design data structures like Lego® blocks so  we can build health information systems that interoperate
  16. 16. Integrating health information through data CORE MODULES PhilHealth modeling and Maternal Care business process Immunization re-engineering Child Care Maternal and Child Health DOTS CHITS Immunization CONSULTS TODAY DEMOGRAPHICS Notifiable Patient Diseases Family Barangay REPORTS Immunization Notifiable Diseases USER MODULES VERTICAL INTERFACE PROGRAMS
  17. 17. How It Works Suite of components:  − Technology − Training − Teamwork [LCE, SB, MHO, PHN, RHM, community]
  18. 18. How It Works Technology  − 3 computers − Standard computer networking (with WiFi) − Open source (free) software Total cost:  − 50,000
  19. 19. How It Works Technology  − Broadband Internet Total cost:  − 15,000 per year Benefits  − online backup − online troubleshooting − province-wide data integration − automated data submission
  20. 20. How It Works Training  − Policy makers LCE and SB  − Health center staff MHO, PHN, RHMs, RSI  − Content Level 0: Orientation  Level 1: Introduction to Health Information Systems  Level 2: Data for Decision Making 
  21. 21. How It Works Teamwork  − Policy Development Provision of mandate for the 'new way of doing things'  Most difficult/delicate part of the project  − Resource generation − Human resource development
  22. 22. How It Works Data for decision making  − Quick access to patient records − Integrated view for frontliners (TB, vaccination, maternal care, etc) − Vertical view for program managers Especially PhilHealth (important for reimbursement  and possible source of funds for sustainability)
  23. 23. Future Directions
  24. 24. - Connect cellphones to CHITS using GPRS (Internet over cellphones) - Establish partnerships with SMART/Globe/Nokia/Sony
  25. 25. - Establish Bluetooth intranets inside health centers (ASTI) - Allows Bluetooth-enabled phones to be used as input devices (obviates need for desktops)
  26. 26. - Develop Java midlets for field data collection and home-based monitoring - Partnerships with the various computer science programs of the UP System
  27. 27. - Connect CHITS to Geographic information systems (link up with Department of Geography, UPD) LAGROSA HEALTH CENTER MALIBAY HEALTH CENTER MANILA INTERNATIONAL AIRPORT 1 km N MAP OF PASAY CITY
  28. 28. - Involve the community in data entry - Build capacity for evidence-based resource allocation and local health systems governance - Provide a model for other LGUs to emulate - Establish partnerships with other LGUs (n=1700+)
  29. 29. Coming Soon: BuddyWorks! E-Learning  − RHU/BHW staff training over broadband Internet with Voice-over-IP Telemedicine  − Trauma − Poisoning − Referral coordination and networking
  30. 30. Quality health care for Filipinos, especially for those who cannot afford it.
  31. 31. Salamat po! Pangkaraniwang Araw sa Lagrosa Health Center, Pasay City