10/14/21, 9:56 AM Module 4: Community Health Information Tracking System (CHITS)

Module 4: Community Health Information Tracking System (CHITS)

Site: New Era University Printed by: Zuriel P. San Pedro

MTHI11L-18 - Health Information System for Med Lab Science Date: Thursday, 14 October 2021, 9:56 AM
Course:
Lab
Module 4: Community Health Information Tracking System
Book:
(CHITS)

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10/14/21, 9:56 AM Module 4: Community Health Information Tracking System (CHITS)

Table of contents

1. Introduction

2. Course Learning Outcomes:

3. Lecture
3.1. First Decade of CHITS

4. Laboratory Activity

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1. Introduction

The Community Health Information Tracking System or CHITS (www.chits.ph) is an extensible, modular, open source information system for rural
health units (initially for the Philippines). It collects existing routine health data from vertical programs in the Field Health Service Information System
(FHSIS) and integrates them into a unified, comprehensive computerized information system. Through CHITS, community-based health information is
made available not only to public health agencies requiring community level information but also to the community itself which generates the
information. It enables the community to use this information for local decision-making and health planning. In addition to software, CHITS also
includes structured capability-building programs designed to improve the health information systems within local health centers, regardless of the level
of automation. CHITS began in Pasay City and is now in 18 health facilities (July 2008) around the country with requests for installation from many
more.

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2. Course Learning Outcomes:

At the end of this lesson, the student will be able to:

1. Discuss the rationale/objectives of the DOH and UP NTHC in organizing CHITS.

2. Enumerate and differentiate the models of implementation of CHITS.

3. Enumerate and differentiate the outcomes/benefits of CHITS to the Public Health.

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3. Lecture

Project Summary
CHITS is short for the Community Health Information Tracking system, a free and open source software electronic health record system for local
government health centers in the Philippines. CHITS was created by Dr. Herman Tolentino through a grant from the International Development
Research Centre of Canada. Since 2004, CHITS has been expanding to rural health units around the country.

CHITS integrates capability-building of government health center staff for new automated systems with information and communications technology for
routine operations of the municipal health office/ rural health unit/city local health center. It is an extensible, modular system that provides information
on DOH vertical programs Field health information and surveillance system (FHSIS).

Through CHITS, community-based health information is made available not only to public health agencies requiring community level information but
also to the community itself that generates the information. It enables the community to use this information for local decision-making.

CHITS is being managed by the UP Manila – National Telehealth Center. It is an integral part of the “Using Computers and Cellphones to Improve
Local Health Information Systems” program.

Information – A Critical Building Block in a Responsive Health System

The volumes of data being collected daily in a typical government health center provides the context of the continuing challenge to a system in need of
cohesive, relevant and timely health information critical in decision-making. Nationwide, reporting health data is still manual and paper-based, a system
adjudged to be prone to human error during its collection, consolidation and reporting; data is, as well, prone to destruction and alteration.
Consolidation of data on paper records is also time-consuming, causing significant delay which make the information stale and irrelevant.

The World Health Organization (WHO, 2007) defines “a well functioning health information system” as one that ensures the production, analysis,
dissemination and use of reliable and timely health information by decision-makers at different levels of the health system, both on a regular basis and
in emergencies. It involves three domains of health information: on health determinants; on health systems performance; and on health status.

In line with its mandate to increase access to health information and services through information and communications technology, the University of the
Philippines Manila - National Telehealth Center (NThC) manages the Community Health Information Tracking System or CHITS, a computerization
project for government primary care health centers – i.e. city local health centers and rural health units. CHITS was developed collaboratively in 2004
by the UP College of Medicine Medical Informatics Unit and the health staff of the Pasay City - led by Dr. Herman Tolentino and Dr. Marie Irene Sy,
respectively – through the support of the International Development Research Center of Canada.

The aim of CHITS is to automate the core processes in the health center and contribute to effective and efficient delivery of health services through
appropriate information and communications technology. As of December 2010, CHITS is installed in 49 government primary care centers (from
Batanes to Zamboanga) nationwide.

The Community Health Information Tracking System

The Community Health Information Tracking System or CHITS is made up of several critical components. At the core of CHITS is its capability
building program that gradually introduces important concepts of information systems – its rationale, ethical practice and skills - to health center staff.
Other important components of CHITS are hardware and software. CHITS employs free and/or open source software which makes it extremely flexible
and compliant to the current (and future) needs of the local health center and standards of the Department of Health (DOH). Once CHITS is installed in
a health center it now serves as a platform for further enhancements such as e-learning for health and telemedicine.

CHITS is continuously being rendered in different platforms and being developed in use for appropriate technology to serve the unique needs of each
health center/rural health unit. For instance, mCHITS enables health personnel to document the patient encounters during field visits and synchronizes
data it gathers from the mobile phone to desktop CHITS via the Internet. rCHITS on the other hand, is used to monitor key maternal and child health
indicators needed by the local civil registrar (or national statistics office at the macro level), municipal social welfare office (or DSWD nationally), and
the Department of Education for decision making and action planning. Other versions of CHITS are still being developed to suit local needs of the
community for universal health care coverage.

Objectives
a. General Objective -The project aims to improve health delivery and decision-making through interoperable health information systems.

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b. Specific Objectives

-To computerize / automate the generation of health center reports.

-To minimize loss and destruction of patient records by the use of electronic patient records.

-To increase ease of access to health center data.

Models of Implementation

There are essentially five basic models, with variations created for some models, depending on the device used. Classification into these five models is
based on the connectivity of the device used for data collection to the local server.

1. Desktop CHITS. This model used the local area network to connect to the local server, hence its use is limited to the Health Center. Each
workstation connected to the server only needs to have a browser installed to be able to access the system. It is only in this model that system
administration services may be done.

2. CHITS Rover. This model uses an offline processing of patients, to be used for field activities. A pared down version of CHITS is installed in a laptop
or netbook, with the database downloaded into the system prior to every field visit. On return to the health center, connectivity to the local server is
established and processing of transactions is done by the local server in batch mode. The database installed in the CHITS Rover device is erased after
synchronization is done.

3. mCHITS. Short for mobile CHITS, this model uses mobile devices with Internet connectivity. Limited versions of local server database files are
downloaded into the phone’s memory prior to a field visit. Forms are installed in the phone, as well as applications to be able to process information
from the field. In cases where Internet connectivity becomes limited or absent, physical connection to the local server may be used to download files
and/or upload transactions.

4. SMS CHITS. This model is limited to the reporting of patient transactions via SMS, using smart phones. A scaled down version of the patient
database is downloaded to the phone’s memory using a physical connection. In the absence of SMS connectivity, the physical connection may also be
used to upload the transactions, for batch processing.

5. Cloud-Based CHITS. To be used for emergency purposes only, this model will allow real-time processing of patient transactions when the local
server is down. Being cloud-based, all downloads of patient files using physical connections to the local server are disabled.

Outcomes
Affirms health workers in the public sector and contributes to efficiency in health service delivery.

Benefits of CHITS:

1. Rural Health Units or Health Centers

-Decreases time for patient record retrieval because patient data is readily accessible

-More accurate and efficient data entry and storage.

-Minimizes patient waiting time

-Streamlines the workflow inside the health center

-Decrease defaulter rates through appointment and follow-up scheduling system·

-Monitors community health status through daily data gathering

-Projects patient load for manpower adjustments

-Increases work productivity of health personnel, more time is allocated in the provision of health service since lesser time is required to record data of
patient

2. Municipal and City Health Offices (MHO, CHO)

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

-Potential for inter-health center integration, thus makes tracking of patient more convenient

-Detect possible disease outbreaks

-Review of the health of the community can be done on a regular basis

-Evidence-based projection of logistics and supplies

3. Department of Health (DOH)

-Integrates health programs

-Aggregates data to any format required by DOH and PhilHealth

-Facilitates epidemiology data analysis

-Ensures compliance for DOH and PhilHealth facility standards and timeliness of submission of FHSIS and other reports

4. Government to Citizen

-Makes information available to stakeholders in the community for better decision making

-Leads to more efficient use of community resources

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-Visible services to the community

-CHITS is a proactive public health tool which alerts and informs health professionals on possible program defaulters thus improving quality of service
delivery.

RxBox 
RxBox is a multi-component program (biomedical device, electronic medical record system and telemedicine training) designed to provide better
access to life-saving health care services in isolated and disadvantaged communities nationwide. It is one among the Department of Science and
Technology’s efforts for a “Smarter Philippines”. It is also an ICT (Information and Communications Technology) innovation designed to support the
Department of Health’s call for Kalusugang Pangakalahatan or Universal Health Care.

The RxBox is a telemedicine device capable of capturing medical signals through built-in medical sensors, storing data in an electronic medical record
(Community Health Information Tracking System –CHITS), and transmitting health information via internet to a clinical specialist in the Philippine
General Hospital for expert advice.

It also catalyzes improvement in the local referral system by facilitating teleconsultations (audio-video conferences) within the National Telehealth
Service Program.

The RxBox can reduce the overall cost of healthcare by enabling health workers to diagnose, monitor and treat patients within the rural health facility,
thanks to medical sensors inside the box!

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3.1. First Decade of CHITS

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Health Information Exchange

Community Health Information Tracking Systems (CHITS) Databases

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4. Laboratory Activity

Direction:

1. Answer the following questions on a PDF format by clicking this link: https://collvle.neu.edu.ph/mod/assign/view.php?id=33068&forceview=1

2. To submit your laboratory activity, you may follow the steps similar to your assignments, click this
link: https://college.neu.edu.ph/pluginfile.php/321490/mod_resource/content/1/HOW%20TO%20SUBMIT%20ASSIGNMENT%20IN%20A%20COURSE.pdf

3. You may also send your work in student.neal.allen05@gmail.com with a subject LastName, FullName_Laboratory Activity_Lesson 3_Section

for example Elquinto, Neil Allen_Laboratory Activity_Lesson4_1CMT-1234

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