1. Community Health Information Tracking System 21st Century Health Information System for Local Governance

2. “ At its essence, every organization is a product of how its members think and interact.” -- Peter Senge

3. Welcome to San Pablo….. Eto ang community namin……

4. UP College of Medicine Vision Towards excellence and leadership in community-oriented medical education directed to the underserved using the primary health care approach

6. Introduction to CHITS

7. CHITS Free and/or Open Source Software?

8. Next steps

10. Why does the problem persist?

11. How can we solve the problem?

12. How are we solving the problem?

13. What remains to be solved

15. A cellphone-based reporting system for child injury in Pasay City

16. Obtained small grant from IDRC (Canada)‏

17. Immersed project team in Pasay local health centers

19. Fourth iteration of the DOH Management Information System (since 1980s)‏

20. A manual, paper-based system that required aggregation of data at several levels of the hierarchy

21. Data collection done by midwives; consolidation and analysis by public health nurses and municipal health officers

22. What are the problems?

24. Inaccurate (errors in addition, 'guessing')‏

25. Illegibile

26. Not useful nor relevant for data collectors

28. All or None Reporting Scheme B B B B B HC Province Region DOH HC HC HC Province Province Region HC

29. All or None Reporting Scheme B B B B B HC Province Region DOH HC HC HC Province Province Region HC

31. National TB Program

32. Family Planning

33. Maternal Care

34. and others

35. Patient Family Barangay Child Care Maternal Care Philhealth Family Planning Leprosy Filariasis Schisto Overworked, underpaid, demoralized government health worker What quality of data will we get? Will it be good enough for decision making? Vertical Programs Disintegrating at the Health Center Level

37. The 3-Legged Stool of HIS 1. collection 2. consolidation 3. analysis/presentation

39. Story 2: ten children die of measles in Caloocan

41. assuming 1 midwife per barangay

42. and each midwife adds one extra dose of BCG/month to her data (to meet targets)‏

43. Result: 44,000 extra doses of BCG/month

44. 44,000 X 12 months = 528,000 (half a million of unnecessary extra doses of BCG)‏

47. target-based systems pressured collectors to manipulate data

48. poor data quality at the collection level resulted in poor data at the higher levels and in erroneous decisions

50. information systems re-engineering

52. Build up the morale of health workers and allow them to participate in the development

53. Integrate the disintegrated vertical programs (provide a common interface)‏

56. less record loss

57. more efficient data entry/storage

58. data analysis/mining

59. helps with completeness

60. can streamline workflow

61. resource management

62. time management (appointment system)‏

63. Integrating health information through data modeling and business process re-engineering

65. Capability-building

66. Policy development

67. Data for decision making

69. Standard computer networking

71. Minimum: one PC

72. Ideal: three PCs

75. Introduction to Health Information Systems

76. (Yes! Midwives can use Linux!)‏

99. Most difficult/delicate part of the project

101. Integrated view for frontliners (TB, vaccination, maternal care, etc)

103. Fig. 1: Consults Page Registration page

104. SCREENSHOTS Fig. 2: Patient Record Individual Treatment Record

105. SCREENSHOTS Fig. 3: NTP Module National Tuberculosis Program

106. SCREENSHOTS Fig. 4: Maternal Care Module Maternal Care

107. SCREENSHOTS Fig. 5: Child Care Development Module Expanded Program on Immunization

108. SCREENSHOTS Fig. 6: PhilHealth Module PhilHealth

109. SCREENSHOTS Fig. 7: Appointments Page Appointments

110. SCREENSHOTS Fig. 8: Appointment Per Patient Appointments

111. SCREENSHOTS Fig. 9: Daily Service Report Standard Daily Reports

112. SCREENSHOTS Fig. 10: EPI Weekly Monitoring Report Special Program Reports (EPI)‏

113. SCREENSHOTS Fig. 11: EPI Target Client List (TCL)‏ Target Client List

114. Future Directions

115. - Connect cellphones to CHITS using GPRS (Internet over cellphones) - Establish partnerships with SMART/Globe/Nokia/Sony

116. - Establish Bluetooth intranets inside health centers (ASTI)‏ - Allows Bluetooth-enabled phones to be used as input devices (obviates need for desktops)‏

117. - Develop Java midlets for field data collection and home-based monitoring - Partnerships with the various computer science programs of the UP System

118. - Connect CHITS to Geographic information systems (link up with Department of Geography, UPD)‏

119. - Mine the database for new knowledge and for evidence-based policy making - Partnerships with Department of Health, College of Public Health [CPH], National Center for Public Administration and Governance [NCPAG], School for Urban and Regional Planning [SURP], etc

120. CHITS Ideal Set-up RHU/ CHITS RHU/ CHITS RHU/ CHITS CHO/PHO LCE DOH

122. Total of 60,000 transactions

123. Marikina now starting with 3 RHUs

124. Quezon province starting with 2 RHUs

125. CHD IV-A will assist in training program

126. For presentation to AMHOP in annual meeting March 2007

128. Pasay - 2004 Marikina - 2005 Alabat Island - 2006

129. CHITS is a Finalist in the 2006 Stockholm Challenge!!! The only Filipino entry in the health category www.stockholmchallenge.se

130. If Interested, Next Steps: Create a CHITS project team (or assign to existing office/unit -- will coordinate with the UP National Telehealth Center)‏ LCE provides leadership and vision for the digital strategy

131. Contact Info Dr. Alvin B. Marcelo CHITS Project Manager National Telehealth Center PGH, Taft Avenue, Manila Tel: 522-9231 Email: alvin.marcelo@miu.ph http://www.chits.info

132. Salamat po! Pangkaraniwang Araw sa Lagrosa Health Center, Pasay City