FAMILY HEALTH • Disadvantages:

o Less income
FAMILY o Lack of mother/father figure
o Child misses other parent
• Two or more individuals
4. Blended
• Joined by ties of blood, marriage and
• Advantages
adoption
o Better quality of life
• Constitute a single household
o More money
• Interact in their respective familial roles
o Child will have another adult to
• Create and maintain a common culture talk to
• 2 major functions o More advice from other members
o Socialization- most important group of the family especially adult
that socializes a person members
o Reproduction • Disadvantages:
o Sibling rivalry
TYPES OF FAMILY: o Role confusion (who is going to
1. Nuclear discipline the children?)
• Advantages: 5. Compound
o Less expenses • Advantages:
o Decisions are coming from the o More children
family itself • Disadvantages:
o Always meet or together o Rivalry (competition among
o Has the right to choose care wives)
provided to the family w/o o Role confusion
interference from other relatives 6. Communal- congregations, Dominicans,
• Disadvantages: missionary sisters
o Lack of support person
o Can be boring 7. Co-habitation- live in w/o marriage
• Disadvantage:
2. Multi-generational/ Extended o If they separate but already
• Advantages: had a child, who will be
o More support person responsible for the child?
o More sources of support and 8. Foster- temporary raising of a child
help • Advantage:
o More fun o Security for child
o Child develops more bc of • Disadvantage:
having other children of the o Moving from one home to
same age another
Disadvantages: o Difficulty settling down
o Lack of privacy o Disruptive behavior
o More expenses
o Disagreements about how to 9. Homosexual/ Same-sex marriage
bring up children
• Advantage:
o Interference on decision-making
o More loving and caring
from other relatives
environment for child
• Disadvantages:
3. Single-parent/ Incomplete
o Prone to HIV
• Advantages:
o Bullying and discrimination of
o Closer relationship with parent
child
o More focused on children
o No mother and father figure,
o Closer relationship with parent
confusion regards identification
o Independent child
of mother and father
o If the parents are always fighting,
it’s best for the child
CHN
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Family as a client
• Sum of individual family members
• How family members will react to an
illness of a member of a family
Family as a system
• The whole is more than the sum of its part
STAGES OF FAMILY DEVELOPMENT:
FAMILY DEVELOPMENT THEORY (SMITH AND
HAMON, 2017)
Married couple à Childbearing à Preschool age
à School age à Teenage à Launching center à
Middle-age parents à Aging family members
MARRIED COUPLE
• Rely to each other in making decisions
• Married couple learns teamwork
• Ex. How often they should visit their in-laws
CHILDBEARING:
• Number of hours spent by couples will be
lessen due to presence of child
• Assumption of the parent role
PRESCHOOL:
• “No”, they love to play
• Requires more energy for the couple
• Parents are usually more tired bc they have
to look after their child after work
• Promote a safe environment for their child
SCHOOL AGE:
• Responsible
• Helping in the house concept
• Child spends more time outside due to
learning of new skills
• Child becomes independent
TEENAGE:
• Rapid physical and psychosocial change
• Child’s identity confusion
• Child’s rebellious behavior (want freedom
and independence)
LAUNCHING CENTER:
• Moving of child to a new home
• Parents are left alone
• Family adjusts to new responsibility of their
child
MIDDLE-AGE PARENTS
• Family becomes now downsized
• Only the couples will be left
• Family à Couple again (Empty nest)
AGING FAMILY MEMBERS:
• Time for old couples to relax and enjoy their
new hobbies
• Death of spouse
• Becomes a widow
VULNERABLE FAMILIES
1. With genetic handicap
• Cannot perform daily activities
2. Very poor
• Do not have enough resources to
provide their needs
3. Migrant
• Reasons:
o Job transfer
o Financial (may not have security,
may not feel belongingness)
4. Incomplete
• Lack of members to assume roles
• Other members should step up to
compensate (can be physically and
emotionally exhausting)
5. Young family with working mom
• Mom will feel guilty bc of difficulty in
balancing work and taking care of child
6. Multi-problem or crisis prone
• Poor coping mechanism
7. Inadequately functioning
• Immature attitude towards
responsibilities
• EX. Mother does vices
REASONS FOR HAVING THE FAMILY AS THE
BASIC UNIT OF SERVICE
1. Family is the natural and fundamental unit
of any society
2. Generates, prevents, tolerates and corrects
within its membership
• Family corrects you when you do
something wrong
• Family also acts as HCP
3. Health problems of family members are
interlocking
• Sickness is overlapping
• If mom is sick, all her roles are
impaired and all of the family
members are affected
4. Family is the most frequent locus of health
decision
• Family as the center of decision-
making
5. Family is an effective and available channel
for much of the CHN effort
6. Family provides a crucial environmental
force
 7. Family through its interaction with a larger
social system validates and influences
health efforts
• Instances wherein family does not want
their children vaccinated
• These habits are passed on to
generations
GENERAL FAMILY TASKS:
1. Physical maintenance
• Food, clothes, health maintenance,
shelter
2. Socialization of family
• Children are taught behaviors that are
acceptable to the community
• Ex. youth organizations
3. Maintenance of order
• Sets rules and guidelines
4. Allocation of resources
• Budget allotment
5. Division of labor
• Chores
6. Recruitment, reproduction and release of
members
• For family members to be part of a
larger society
7. Placement of members into society
• Family members will have a role In the
society
8. Maintenance and motivation of morale
FAMILY HEALTH TASKS:
1. Recognizing interruptions of health or
development such as illness or child’s
failure to thrive
• Ex. Bunso is usually the jollies
member but suddenly became quiet
• Able to assess if there’s something
wrong
2. Seeking health care
• Encourage sick family members to seek
help from professionals
3. Managing health and non-health crises
• Teaching them how to cope with
stresses of life
• Support each other through difficult
times
4. Providing nursing care to he sick, disabled,
or dependent members of the family
5. Maintaining a home environment conducive
to good health and personal development
6. Maintaining a reciprocal relationship with
the community and its institution
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• Good relationship with neighbors
• Aware of community’s events and
happenings
FAMILY HEALTH CARE PLAN
FAMILY NURSING CARE PLAN
• Blueprint of care designed to eliminate or
identify family health problems
Characteristics of FNCP:
1. Action-oriented
• Makes sure things are to be resolved
2. Systematic process
• Follows a process (ADPIE)
3. Relates to the future
• We don’t just address the present
problem, but also educate them to
prevent future health problems
4. Based upon identified health problems
• Upon diagnosis as a basis
5. Means to an end NOT an and end in itself
• Goal
• Ex. Child with resp disease
• Goal: To end resp condition
• Means: Ensures child to have a strong
immune system
STEPS OF THE NURSING PROCESS IN THE CARE OF
THE FAMILY:
1. Assessment
2. Priority setting of family health
3. Formulation of FNCP
4. Implementation of FNCP
5. Evaluation of FNCP
ASSESSMENT
• Status of family as a client
• Ability of the family to maintain itself as a
system and functioning unit
• Ability of the family to maintain wellness,
prevent, control
ASSESSMENT: DATA GATHERING METHODS
• Observation (5 senses)
• Physical examination
o Head to toe assessment, s/s
• Interview
o Go beyond what is written in the DB
• Records view
o Charts, medical records
• Laboratory/ diagnostic tests
CHN
ASSESSMENT PHASE IN FAMILY HEALTH o Decision maker about money
PRACTICE: • Educational attainment
Data collection à Data analysis à Nursing • Ethic background and religious affiliation
diagnosis • Significant others
• Relationship of the family to the larger
1. DATA COLLECTION: community
LEVEL 1
• Data on status/ condition of: 3. Home and environment
o Family/ household through IDB • Housing
§ Family structure, characters o Adequacy of living space
and dynamics o Sleeping arrangement
o Home and environment o Breeding places of vectors
o Accident hazards
LEVEL 2 o Food storage and cooking
• Data on family’s: facilities
o Assumption of health o Water supply
§ What are the possible o Toilet supply
causes of malnutrition in the o Garbage/ refuse disposal
family? o Drainage system
o Tasks on each health condition/ o Ventilation
problem identified in first level § Formula:
assessment Total window
opening/ total space
2. DATA ANALYSIS: area x 100%
o Sort § Interpretation:
o Cluster/ group related data 20 and above= fair
o Distinguish relevant from irrelevant 18-19= satisfactory
data 17 and below= poor
o Identify patterns o Overcrowding index
o Compare patterns with norms or § Formula:
standards Total space area >
o Interpret results total space
o Make inferences/ conclusions requirement of family
§ 1 room:
3. NURSING DIAGNOSIS: 10 yo and above= 3m2
o Family nursing problems 1-10 y/o = 1.5 m2
o Use of typology of nursing problems 0- 1 y/o =0
in family health care § Multiroom:
10 and above= 2.5m2
LEVEL 1 ASSESSMENT: FAMILY DATA BASE 1 - 10 = 1.25m2
1. Family structure 0–1=0
• Family structure, characters and
dynamics o Kind of neighborhood
• Members of the household and o Social facilities
relationship to the head of the family o Health facilities
• Demographic data o Communication facilities
• Place of residence of each member o Transportation facilities
• Type of family structure
4. Health status of each member
• Dominant family member
• Medical and nursing history or past
• General family relationship/ dynamic
significant illnesses or beliefs and
practices
2. Socio-economic and cultural characteristics
• Nutritional assessment
• Income and expenses
o Anthropometric data: weight,
o Occupation, place of work and
height, etc
income
o Dietary history
o Adequacy of income
 o Eating/ feeding habits or o Wellness condition
practices o Health deficit
• Developmental assessment of infants, o Health threat
toddlers, preschool, school-age, o Foreseeable crisis/ stress point
teenagers, adult, and elderly
• Risk factor assessment 1. Presence of wellness condition
• Physical assessment • Potential for enhanced capability
• Result of diagnostic exams and for…
laboratory results o From the observation of
health worker
5. Values and practices on health promotion/ o Ex. Health workers saw right
maintenance and disease prevention breastfeeding techniques
• Immunization status from mother
• Health lifestyle practices • Readiness for enhanced capability
• Adequacy of: for…
o Rest and sleep o Family members initiate
o Use of protective measures behavior and asks questions
o Relaxation and other stress • Areas:
management activities o Healthy lifestyle
o Use of promotive-preventive o Health maintenance/
services management
o Parenting
LEVEL 2 ASSESSMENT: FAMILY HEALTH TASKS o Breastfeeding
1. Family’s perception of the problem o Spiritual well-being
• Help them see the problem; DO
NOT IMPOSE 2. Presence of health threat
2. Decisions made and appropriateness, if Failure to recognize one’s potential
none, reasons; actions taken and results, if • Can be seen in:
none, reasons o In the family members
3. Effects of decision and actions on other themselves:
family members o Biological
o Lifestyle
DATA ANALYSIS o In the family environment:
1. Sorting of data for broad categories o Physical
2. Clustering of related cues o Social
• Diarrhea: poor sanitation, practices, o Psychosocial
water source § Drinking
3. Distinguishing relevant from irrelevant data § Smoking
4. Identifying patterns
5. Comparing patters with norms or standards 3. Presence of health deficit
of health, family functioning and assumption • Illness
of health tasks • Failure to develop according to
• What they need to prevent diarrhea normal rate
• Ex. Family should have their own • Disability
toilet with flush, and you compare it NOTE:
with actual situation • Illness- deficit
6. Interpreting results of comparison • Conditions that may pose harm to
others- threat
NURSING DIAGNOSIS o Smoker family member, poor
TYPOLOGY OF FAMILY NURSING PROBLEM house ventilation.
1 st LEVEL ASSESSMENT: Recognizing the overcrowding
presence of health problems
4. Presence of foreseeable crisis or stress
• Classifications:
points
CHN
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 • Pregnancy= FORESEEABLE CRISIS • Family living
• Earthquake, typhoon= STRESS o How well they get along with each
POINTS other
• Physical environment
2 ND LEVEL ASSESSMENT : Identifying health tasks o Safety
1. Inability to recognize the presence of the • Use of community resources
problem due to _______ o Awareness of the services
2. Inability to make decision with respect to
taking appropriate health action due to PLANNING : PRIORITY SETTING CRITERIA
______
3. Inability to provide adequate nursing care to 1. NATURE OF THE PROBLEM
the sick, disabled, dependent on the I. NATURE OF THE PROBLEM
vulnerable member of the family due to A. WELLNESS STATE 3
______ B. HEALTH DEFICIT 3
4. Inability to provide a home environment C. HEALTH THREAT 2
conducive to health maintenance and D. FORESEEABLE CRISIS/ 1
personal development due to ______ STRESS POINT
5. Inability to utilize community for health care WEIGHT 1
due to _____
2. MODIFIABLITY OF THE CONDITION
FAMILY COPING INDEX:
It is affected by:
• Purpose: • Available technology
o To provide a basis for estimating the
• Resources of the family
nursing needs of a particular family
• Resources of the nurse
• A family nursing need is present when:
• Resources of the community
o The family has a health problem which
they are unable to cope
MODIFIABILITY OF THE CONDITION
o Reasonable likelihood that nursing will
A. EASILY MODIFIABLE 2
make a difference to family’s ability to
cope B. PARTIALLY MODIFIABLE 1
Scale: C. NOT MODIFIABLE 0
1= totally unable to cope WEIGHT 2
3= partially able to cope
5= able to cope 3. PREVENTIVE POTENTIAL (What would
happen if we wouldn’t interfere?)
No problem= if particular category is not
relevant It is affected by:
• Seriousness of the existing problem
Criteria: • Duration of the existing problem
• Physical independence PREVENTIVE POTENTIAL
o Ability to perform daily living tasks A. HIGH 3
• Therapeutic competence B. MODERATE 2
o Capability of the family to comply C. LOW 1
with treatment, medication and WEIGHT 1
exercise • Measures that have been
• Knowledge of health condition implemented
o Understand the communicability of • Probability of exposure of high risk
the disease groups
• Application of principles of general hygiene
o Maintaining nutrition, immunization, 4. SALIENCE
meals
• Health attitudes SALIENCE
o How the family feels about a A. SERIOUS PROBLEM 2
treatment NEEDING IMMEDIATE
o Ex. “hindi ako naniniwala dyan” ATTENTION
• Emotional competence B. PROBLEM NOT NEEDING 1
o Cope easily IMMEDIATE ATTENTION
C. NOT A PROBLEM 0
WEIGHT 1
SCORING
1. Decide on a score for each criteria
2. Divide the score by the highest possible
score and multiply by the weight
3. Add all scores
4. Health problem with highest score will be
the priority

SMART
o Used in formulating
o Goals (general)
o Objectives (specific)
o S-pecific
o M- easurable
o A- ttainable
o R- ealistic
o T- ime bound

INTERVENTIONS/ IMPLEMENTATION
Categories of intervention:
o Promotive
o Preventive
o Curative
o Rehabilative

EVALUATION
Dimensions of evaluation:
o Effectiveness
o Efficiency
o Appropriateness (tama)
o Adequacy (sapat)

TWO PARTS OF DIAGNOSIS:

1. Health task
2. Specific cause

CHN  FINALS  -­‐  SABAREZA   7  

 
 i. Five variables: physiological,
APPROACHES TO FAMILY psychological, sociocultural,
HEALTH developmental, and spiritual
ii. Client as an open system
FAMILY THEORIES that responds to stressors in
• Set of relatively specific and concrete the environment
concepts and propositions that describe, f. Dorothea Orem’s self care model
explain, or predict something about family i. Universal self- care
requisites, developmental
EMERGING FAMILY NURSING THEORIES self-care requisites, health
• Family social science theories deviation self-care requisites
g. Martha Roger’s science of unitary
• Nursing model/ theories
human beings
• Family therapy theories
i. Nursing as both a science
o Most popular
and an art
o Used by psychiatrists
h. Margaret Newman’s expanding
consciousness model
i. Every person (disordered
and hopeless) is part of the
universal process of
expanding consciousness –
a process of becoming more
of oneself, of finding greater
meaning in life, and of
reaching new dimensions of
connectedness with other
people and the world,

2. Family social science theories

a. Developmental theory
b. System theory
FAMILY NURSING MODELS
i. Input, process, output
1. Nursing conceptual models and theories
c. Structure-function theory
a. Florence Nightingale’s
d. Interactional theory
environmental model
i. Air, water, light, drainage and
3. Family therapy theories (Psychological)
cleanliness
a. Interactional/ communication family
b. Imogene King’s theory of goal
therapy theory
attainment
b. Structural family therapy theory
i. Personal system,
c. Family systems therapy theory
interpersonal and social
system
ASSUMPTIONS OF STRUCTURAL-
c. Nola Pender’s health promotion
FUNCTIONAL THEORY
model
• A family is a social system with function
i. Variables of HPM:
requirements
Commitment to plan of
action, immediate competing • Family is a small group possessing certain
demands and behavioral generic features common to all small groups
outcome • Family as a social system accomplishes
d. Sister Callista Roy’s adaptation functions that serve both the individual and
model society
i. Four components: • Individuals act in accordance with a set of
Person, environment, health, internalized norms and values that are
nursing learned primarily in the family through
e. Betty Neuman’s health systems socialization
model
STRUCTURAL-FUNCTIONING THEORY
§
Concept of structure:
• The structure represents the relations of Sample attachments:
different units (a set of relation between • Adaptive
entities) as the elements together
• Relationship

• Maladaptive

Elements:
• Role
o Indicates his status of their existence GOAL OF FAMILY NURSING
• Values • Help assist families to help themselves
o Inherited faith from the old to the achieve a higher level of functioning or
new generation wellness within the context of their
particular aims, aspirations and abilities
• Communication
(Bell, 1996; Friedman 1995; Wright and
o Way to know oneself and others
Leahey 2000)
• Power structure
o Shows the interaction of the family
SYSTEMS THEORY
• Need to interact with environment In order
FAMILY FUNCTION (Friedman, 1986)
for them to survive
• Affective function
• Economic
• Socialization
• Reproductive
• Family coping
• Provision of physical necessities

FAMILY INTERACTION: ATTACHMENT THEORY

Symbol used in attachment diagram:
• Male

• Female
• Attachment
o Strongly
§

o Moderately
§

o Slightly
§
o Very slightly
§
o Negatively

CHN  FINALS  -­‐  SABAREZA   9  

 
 a. Provide maximum opportunity for the
family with their development

TYPES OF FAMILY NURSE CONTACT

1. Clinic visit
2. Group conferences
3. Telephone contact
4. Written communication
5. Home visit
FAMILY SYSTEM THEORY (Dr. Murray Bowen)
5 concepts of family system theory: CLINIC VISIT
1. Emotional triangles Advantages:
2. Differentiation of self • Saves nursing time
3. Family projection process • Demonstration of equipment
4. Emotional cut off • No distractions
5. Multigenerational transmission process • With staff and consultants
• Basic responsibility for self-help
FILIPINO CULTURE, VALUES AND Disadvantages:
PRACTICES IN RELATION TO HEALTH • No first-hand appraisal of home and family
CARE OF INDIVIDUAL AND FAMILIES situation
• Family solidarity • Real hardship to the family
• Filipino family values • Less ease in sharing
o Communication • Conflict of schedule
o Helping others and gratitude
o Respect TELEPHONE CONTACT
o Independence Advantages:
o Service • Inexpensive
o Trust • Frequent contact
• Filipino family culture and tradition • No burden on both part of family and nurse
• More personal than written communication
CHARACTERISTICS OF HEALTH FAMILY • Valuable screening device
• Communicate well and listen to all members Disadvantages:
• Affirms and supports all its members • Cannot see real home situation
• Valued respect • Cannot assess patient properly
• Has sense of trust
• Plays together and humor is present WRITTEN COMMUNICATION
• Privacy of the members is honored by the Advantages:
family • Low cost
• Open its boundaries to admit and seek help • Family develops responsibility
with problems Disadvantages:
• Shares leisure time together • Cannot gauge total family situation
• Has shared sense of responsibilities • Cannot uncover/ help with problem other
• Members interact with each other and a than immediately considered
balance in interaction is noted among • May not reach intended person
members
GROUP DISCUSSION
FAMILY HEALTH CARE Advantages:
Criteria: • Sharing and helping
1. Least costly • Leadership
2. Development and self-direction of the family • Practical and tested solutions
3. Feasible in relation to available nursing time • Expression of feelings and concerns
and the total community needs • Problem-solving
4. Consistent with the community habits and Disadvantages:
expectations • Individual problems
• Generalized outcome
 • Lesser service to those really in need • Decide on method of FNC
• Consider other possible ways
HOME VISIT
Advantages: ACTIVITY/ IMPLEMENTATION
• Accurate appraisal of family condition Approaches:
• Teaching in actual situation • Social phase
• Discover new health problems o Introduction of self and the
• Ease in sharing problems establishment
• Personalized service • Professional phase
Disadvantages: o Intervene
• Time-consuming o Carry out nursing intervention
• Home distractions o Writing of summary
• No sharing with other family
SUMMARIZATION
DETERMINANTS OR FACTORS IN SELECTING • Outline verbally
A FAMILY FOR HOME VISIT • Write summary
• Recognition of family’s needs
• Severity of needs BAG TECHNIQUE
• Family’s acceptance Principles:
• Availability of other health agencies 1. Minimizes or total prevents spread of
infection
• Policy of a given agency
a. Proper way of carrying and opening
• Evaluation of past services
bag
2. Saves time and effort
PHASES OF HOME VISIT
3. Effective care
Planning à Activity à Summary
4. Done in variety of ways
PLANNING
EVALUATION
• Set objectives and purpose
• Input
• Consider resources and prioritize needs o Resources spent and consumed by
the visit (time, nurse’s effort,
ACTIVITY equipment, supplies transportation)
• Implementation • Process
• Actual home visit o Appraisal of nurse’s performance
• Demonstration, health teaching (HOWs)
• Outcome
SUMMARY
• Summing up of findings whether progress is
made or services rendered
FIELD HEALTH SERVICES
PRINCIPLES IN PLANNING A HOME VISIT AND INFORMATION SYSTEM
• Objective/ purpose
• Available family’s information (FHSIS)
o Review family health record • Recording and reporting system in the
• Family’s recognized needs public health system
o Prioritize needs • Provide summary data on health service
o DO NOT IMPOSE!! delivery and attainment of the objectives
• Flexible and practical of public health programs
• Provide a standardized, facility-level
GUIDELINES IN PLANNING database
• Study records • Minimize the recording and reporting burden
• Appraise needs—recognized and at service delivery
unrecognized
• Contact health and social agencies
CHN  FINALS  -­‐  SABAREZA   1
  1  
FOCUS OF FHSIS: b. Morbidity report (Q2)
• Dental health 3. Annual form
• Environmental health a. A1—report on vital statistics:
• Maternal and child health care demographic, environmental,
• EPI natality, and mortality
• Family planning b. A2—Lists all diseases and their
• Nutrition occurrence in municipality/ city.
• Control of diarrheal diseases Broken down by age and sex
c. A3—All deaths occurred in
• Tuberculosis, malaria, schistosomiasis and
municipality/city. Also, broken down
leprosy control
by age and sex
4. Occurrence of event
4 COMPONENTS
a. E-1 – Notification of death report
1. Individual/ family health record
b. E-2 – Maternal death report
a. Building block of FHSIS
Ex. immunization monitoring chart,
pregnant woman’s booklet
FAMILY ASSESSMENT
2. Target or client list
Ecomap
a. Important in monitoring compliance
to treatment • Visual map of family’s connection to its
b. Filled up and made by nurses environment
Ex. DOTS case • Provide a useful tool for assessment of
3. Tally report/ summary table family and community relationships and
a. Listing of cases and # of client going the quality of these connections
for treatment in health center • Shows the family dynamics, each
b. Passed to district à national à individual family member connections to
regional region social support system and the community,
4. Monthly consolidation table (MCT)/ areas of deprivation where resources may
output table need to be mobilized or strengthened and
areas of service duplication
SUMMARY TABLE
1. Health program accomplishment
2. Morbidity disease

PROCESS OF REPORTING THROUGH FHSIS:

NURSING CARE OF THE

CODES IN FHSIS COMMUNITY
1. Monthly form EHEALTH IN THE COMMUNITY SETTING
a. Program report (M1)
b. Morbidity report (M2) What is INFORMATION AND
2. Quarterly form COMMUNICATIONS TECHNOLOGY (ICT)?
a. Program report (Q1)
 • Diverse set of technological tools and
resources used to communicate, create,
disseminate, store and manage
information (Blurton, 2002)
• Example technologies:
o Computers, internet, tv, mobile
phones
DIFFERENTIATING DATA AND INFORMATION
DATA
• Unanalyzed raw facts that do not imply
meaning (Gudea, 2005)
• Ex. Number 39
INFORMATION
• Data with meaning
• Ex. Number 39 as the patient’s respiratory
rate
The health care system heavily relies on
accurate recording of data and information
GOOD DATA QUALITIES
• In order for information to be valuable, data
must have the following characteristics
(Abdelhak et al., 2012)
1. Accessible
2. Accurate
3. Comprehensive
4. Consistent/ reliable
5. Current
6. Defined
WHAT IS eHealth?
• It is the use of ICT for health (WHO, 2012)
• Examples of eHealth:
o Communicating with patients thru a
teleconference, email, sms
o Recording, retrieving and mining
data in an electronic medical record
o Providing patient teachings with the
aid of electronical tools (computers,
tv, tablets)
eHEALTH IS THE UMBRELLA TERM
Three main areas
• Delivery of health information, for health
professionals and health consumers,
through the internet and
telecommunications
• Using the power of information
technology (IT) and e-commerce to
improve public health services, for
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 SABAREZA
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example, through the education and training
of health workers
• Use of e-commerce and e-business
practices in healthy systems management
ICT IN THE PHILIPPINES
• Internet access (ITU, 2011)
o 2001 – 2.5% of Filipinos had internet
access
o 2011 – Increased to 29%
• Mobile phone usage
o 2009 – 80% of Filipinos own a
mobile phone
o 73m subscribers
o Philippines ranked first in SMS
usage in the entire world
Businesswire, 2010)
eHEALTH IN THE PHILIPPINES
Factors to consider:
• Limited health budget
• Emergence of free and open source
software (FOSS)
• Decentralized government
• Target users are unfamiliar with the
technology
• Surplus of digital native-registered nurses
Continuation of eHealth in the Philippines
• Kalusugan pangkalahatan and ICT
o Also known as KP, one of its aims is
to attain efficiency by using ICT in all
aspects of health care
• DOH recognizes the valuable purpose of
ICT for health and has drafted its National
eHealth Strategic Framework for 2010-2016
o With the vision of ICT supporting
UHC to improve health care access,
quality, efficiency, and patient’s
safety and satisfaction, for reducing
cost, and enabling policy makers,
providers, individuals, and
communities to make the best
possible health decisions
ELECTRONIC MEDICAL RECORDS
• Comprehensive patient records that are
stored and accessed from a computer or
server.
• Ex. Community Health Information Tracking
System (CHITS) of the University of the
Philippines Manila.
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TELEMEDICINE
• The delivery of health care services, where
distance is a critical factor, by all health care
professionals using information and
communication technologies for the and
injuries, research and evaluation, and for
the continuing education of health care
providers, all in the interests of advancing
the health of individuals and their
communities. – WHO
• Four elements of telemedicine according to
WHO:
1. Its purpose is to provide clinical
support.
2. It is intended to overcome
geographical barriers, connecting
users who are not in the same
physical location.
3. It involves the use of various types
of ICT
4. Its goal is to improve health
outcomes
Ex. National Telehealth Service
Program (NTSP)
eLEARNING
• The use of electronic tools to aid in teaching
• Instructional videos, informational text
blasts, interactive simulations
• Can be done asynchronously, synchrously,
or a combination of both
EHEALTH PROJECTS IN THE COMMUNITY
• BuddyWorks
o Allowed RHU physicians to send
telereferrals to clinical specialists in
PGH via SMS and email
• CHITS
o an EMR, designed for and by the
community health workers, divided
into different modules based on
existing DOH programs
• Electronic Field Health Service
Information System (eFHSIS)
o Online version of the FHSIS
developed by the DOH
• Electronic Integrated Management of
Childhood Illness (eIMCI)
o Electronic version of IMCI accessible
in mobile devices
• NTHC eLearning videos
o Funded by USAID, created
eLearning videos on tuberculosis,
stroke, bird flu, and child poisoning
• Segworks Rural Health Information
System (SEGRHIS)
o EMR created for rural health units by
Segworks, local software company
in Davao
• RxBox
o Mobile computer connected with
medical devices such as ECG,
pulse oximeter and electronic blood
pressure and heart rate monitors
that is intended for mobile
deployment to rural health centers
• Secure Health Information Network
Exchange (SHINE)
o An EMR developed by Smart
Communications
• Synchronized Patient Alert via SMS
(SPASMS)
o SMS reminder system for patients
who are due for follow-up
• Surveillance in Post Extreme
Emergencies and Disasters (SPEED)
o Allows community health nurses to
submit daily reports of prevalent
diseases immediately after disasters
via SMS, e-mail, and other
information and communication
technologies
• Wireless Access for Health (WAH)
o Augmented the existing CHITS by
connecting health centers through
broadband Internet access ;
Implemented in 2010 in the Tarlac
Province through the Public–Private
Partnership (PPP) of Qualcomm,
UPM-NTHC, USAID, Smart, DOH-
IMS, Center for Health Development
(CHD) Region III, RTI International,
National Epidemiological Center
(NEC), Tarlac State University, and
the local government
COMMUNITY EHEALTH NURSES ROLES:
1. Data and records manager
2. Change agent
3. Educator
4. Client advocate
5. Telepresenter
6. Researcher

CHN  FINALS  -­‐  SABAREZA   1

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