Advocating computer-based information systems in health centers

Making medical care more accessible to the poor is a challenge the country needs to address, says Dr. Portia Marcelo, coordinator of the Urban Community Based Health Program of the University of the Philippines (UP) College of Medicine.

Aside from developing more socially aware doctors who have the interpersonal skills to deal with poor patients, health information management also needs to be improved, she adds.

Technology plays a key role in efficient data recording. If the files are computerized, health center workers can do fieldwork in the afternoon after spending the morning processing patients.  “Community work is important to make sure that everybody is covered,” says Marcelo. “Red areas” (i.e. where the indigent usually reside) need to be targeted since the people here lack the education to seek medical care on their own (e.g. vaccinations for young children). “But if records are sorted manually, the health workers will use up the afternoon working on these tedious reports, leaving no time for field work.” 

The UP College of Medicine is advocating the use of Community Health Information Tracking System (CHITS), a computer-based information system that serves the needs of the barangay health centers, as well as the national public health system. CHITS allows health center workers to create electronic medical records, and efficiently monitor the progress of patients, as well as identify targets.

“It was developed by Dr. Herman Tolentino, a health informatics practitioner, also of the UP, with the help of people in health centers and following the government’s field health information and surveillance system,” says Marcelo. In 2004, it piloted in two of the 13 public or government health centers in Pasay City and will be implemented in a total of 10 health centers by 2010. Currently, the UP Manila National Telehealth Center has installed CHITS in 20 public health centers nationwide, from Batanes to Zamboanga.

To help achieve this goal, Smart Communications, Inc. (SMART) donated 16 computers and Internet Connectivity to Pasay City through the UP College of Medicine last December 8.

“CHITS shows how ICT can make much-needed health information easily accessible to health workers so that they can deliver services more effectively.  This is another example of how technology can truly improve people’s lives,” said Ramon R. Isberto, group head of SMART Public Affairs.

“We want to find out how our technology can assist in concrete ways in the delivery of health services at the local level. This is a good opportunity since the local government of Pasay seems to be very progressive in health services delivery. It’s a good testing ground for us,” explains Darwin Flores, SMART’s senior manager for community partnerships

 “We can then use this as a basis for developing other related services, like telemedicine, which allows health workers to extend their expertise through VoIP, internet and SMS. Through the CHITS program here in Pasay, we can develop more services that we can also extend to other communities.”

During the turnover ceremonies, Mayor Peewee Trinidad related their plans for the 16 computers. “The computers will be distributed to four health centers, which will get four PCs each. Within each health center, the data will be shared through the local area network. Eventually, we will also connect them to the main network at City Hall, so that the health centers can share information among themselves, such as records of diseases, incidents of sickness, etc.”

The usual setup in a health center involves two computers at the front where patients are sorted by nurses and midwives into those who need to see the physician for consultation for illnesses and those seeking wellness care (e.g. pre-natal care or immunization). The third is for the doctor who attends to the more emergent cases. And the fourth computer is used by the nurse, who makes sure the patient understands the doctor’s orders and provides the medicines available. 

Mayor Trinidad said computerization will certainly help improve the delivery of services. “Since the data is immediately on hand, it can facilitate decision making and planning. We’re happy about SMART’s support. It’s a company with a good social conscience. They’re able to see if there’s a problem or a need and they’re able to provide the right assistance to the community.”

Dr. Ma. Lourdes San Juan, Pasay City Health Office Medical Officer V, says CHITS and SMART’s donation of 16 computers has several advantages.  “Patients don’t have to wait long for their turn. If they already have an electronic record, they can be processed faster. Data can also be retrieved and updated more efficiently. For example, for children, we can easily find out who have not received their vaccinations yet because their names are already in the computer. Electronic data also means less use of paper so it’s environment-friendly. And finally, this is also for personality development. Even if some health center workers are already old, they can still learn how to use the computer.”

Dr. Marcelo, who also advocates the use of Internet to facilitate health services delivery, says even more benefits will be gained when the health centers are connected online.

“We’ll be able to know the total number of patients treated in a given area in real-time. For example, by 10 am, we can find out that ‘x’ number of vaccines were given to ‘x’ number of kids in the city of Pasay.”

Imagine then, she says, if this is already being done on a national level. “There are more than 2,000 municipalities in the country. If all have CHITS and all are connected via the Internet, at any given time, the Department of Health will know what’s happening in all the different areas.”

(Published 22 December 2008, Smart Communications, Inc.)