II. CONCEPT OF THE COMMUNITY
A shared sense of being a community
· A community is similar to a living creature,
comprising different parts that represent
specialized functions, activities, or
interests, each operating within specific
boundaries to meet community needs.
· For the community to function well, each
part has to effectively carry out its role in
relation to the whole organism. A healthy
community has well-connected,
interdependent sectors that share
responsibility for recognizing and
resolving problems and enhancing its well-
being.
· For example, schools focus on education,
the transportation sector focuses on
moving people and products, economic
entities focus on enterprise and
employment, faith organizations focus on
the spiritual and physical well-being of
people, and health care agencies focus on
the prevention and treatment of diseases
and injuries (Henry, 2011).
A. TYPES OF COMMUNITY
THREE TYPES OF COMMUNITIES
1. RURAL
- A Rural communities are placed where the
houses are spread very far apart. Many
people think of rural communities as
farmland (Boondocks).
2. URBAN.
- Urban communities are located in cities.
3. SUBURBAN.
- The suburban areas are the mix of the
urban and rural.
B. CHARACTERISTICS OF A HEALTHY
COMMUNITY
A healthy community is one in which all residents
have access to a quality education, safe and
healthy homes, adequate employment,
transportation, physical activity, and nutrition, in
addition to quality health care.
- A healthy community has mechanisms
that assures all citizens a decent way of
life in all aspects (Rabinowitz, 2012).
- "The process of enabling people to
increase control over, and to improve,
their health." Ottawa Charter (WHO 1986)
CHARACTERISTICS OF HEALTHY COMMUNITY
INCLUDES:
1.
based on history and values.
2. A general feeling of empowerment and
control over matters that affect
community as a whole
3. Existing structures that allow subgroup
within the community to participate in
decision making in community matters.
4. The ability to cope with change, solve
problems, and manage conflicts within the
community through acceptable means.
5. Open channels of communication and
cooperation among the members of the
community.
6. Equitable and efficient use of community
resources, with the view towards
sustaining natural resources.
C. FACTORS AFFECTING HEALTH OF THE
COMMUNITY
1. Characteristics of the population
2. Location of the community
3. Social Systems within the Community
I. ROLES AND ACTIVITIES OF COMMUNITY
HEALTH NURSE
Community Health Nurse Roles and Functions
 Identifies needs, priorities, and problems
of individuals, families, and communities.
 Formulates municipal health plan in the
absence of a medical doctor.
 Interprets and implements nursing plan,
program policies, memoranda, and
circular for the concerned staff personnel
MAJOR ROLES OF A COMMUNITY HEALTH
NURSE ARE:
CARE PROVIDER ("CLINICIAN ROLE")
 Uses nursing process to provide direct
nursing intervention to individuals, family,
or population.
EDUCATOR
 facilitates learning for positive health
behavior change
ADVOCATE
 speaks or acts on behalf of client
MANAGER
 overseeing client care
COLLABORATOR
 works with people
LEADER
 initiates changes
RESEARCHER
 engage in systemic investigation
IV. INFORMATION TECHNOLOGY AND
COMMUNITY HEALTH
A. WHAT IS eHEALTH?
- It is the use of Information and
Communication Technology (ICT) for
health (WHO 2012).
- In its broadest sense, HEALTH is
concerned with improving the flow of
information, through electronic
means, to support and facilitate the
delivery of quality, especially the
Internet, to improve or enable health
and health care
Examples eHEALTH?
- Communicating with patients through a
teleconference, e-mail, SMS
- Recording, retrieving and mining data in
an electronic medical record
- Providing patient teachings with the aid of
electronic tools (computers, television,
tablets
(WHO) member states recognizing Health as the
cost- effective way of using ICT in :
- health care services,
- health surveillance,
- health literature,
- health education
- and research (WORLD HEALTH ASSEMBLY,
2005)
WHAT IS ICT?
A diverse set of technological tools and resources
used to communicate, create, disseminate, store,
and manage information (Blurton, 2002)
Example technologies
· Computers
· The Internet
· Television
· Tablets
· Mobile phones
DIFFERENTIATING DATA AND INFORMATION
· Data - unanalysed raw facts that do
not imply meaning (Gudea, 2005)
Example:
- The number '49'
· Information - data with meaning
Example:
- The number '49' as the patient's
respiratory rate
Is different from
- The number '49' as the patient's age
· The health care system heavily relies
on accurate recording of data and
information
GOOD QUALITY DATA
· In order for information to be
valuable, data must have the following
characteristics (Abdelhak et al.; 2012):
- Accurate
- Accessible
- Comprehensive
- Consistent/Reliable
- Current
- Defined
HEALTH IS THE UMBRELLA TERM
According to the WHO, eHealth encompasses
three main areas:
 The 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
example, through the education and
training of health workers.
 The use of e-commerce and e-business
practices in health 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 The Philippines is ranked first in
SMS usage in the entire world
(BusinessWire, 2010)
HEALTH 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
HEALTH IN THE PHILIPPINES
'Kalusugan Pangkalahatan' and ICT
 Also known as KP one of its aims is to
attain efficiency by using ICT in all aspects
of health care
 The 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.
 An example is the Community Health
Information Tracking System (CHITS) of
the University of the Philippines Manila.
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 exchange of valid
information for diagnosis,
 Treatment and prevention of disease 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 SPECIFIC TO TELEMEDICINE-
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
An example of which is the National Telehealth
Service Program (NTSP).
eLEARNING
 The use of electronic tools to aid in
teaching
 Instructional videos, informational
textblasts, interactive simulations
 Can be done asynchronously,
synchronously, or a combination of both
eHEALTH PROJECTS IN THE COMMUNITY
 BuddyWorks - allowed RHU physicians to
send telereferrals to clinical specialists in
PGH via SMS and eMail
 CHITS - 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) - An online version of the
FHSIS developed by the DOH
...continue
 Electronic Integrated Management of
Childhood Illness (elMCI) - An electronic
version of IMCI accessible in mobile
devices
 NTHC elearning videos - funded by USAID,
created elearning videos on tuberculosis,
stroke, bird flu, and child poisoning
 Segworks Rural Health Information
System (SEGRHIS) - An EMR created for
rural health units by Segworks, local
software company in Davao
..continue
 RxBox - It is a 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) + An EMR developed by
Smart Communications
 Synchronized Patient Alert via SMS
(SPASMS) - an SMS reminder system for
patients who are due for follow-up
..continue
 Surveillance in Post Extreme Emergencies
and Disasters (SPEED) - Allows community
health nurses to submit daily reports of
prevalent diseases immediately after
disasters via SMS, e-mail, and other
information and communication
technologies
...continue
Wireless Access for Health (WAH) – WAH
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
WHAT IS THE ROLE OF eHEALTH IN THE
COMMUNITY?
 E-Health is being recognized as a method
to improve the overall health status of the
population. It is important to build
partnerships among health care providers,
local community organizations, and
national health care associations to
ensure the continued development of e-
Health initiatives.
BENEFITS OF eHEALTH
 An increase in patient safety through a
reduction in medical and clinical adverse
events.
 Improved communications between the
patient and the carer.
 Reduction in length of stay due to
improved operational efficiency.
 Reduce medical errors
 Less travel and time consuming
paperwork's
1. STORAGE
 Systems and supporting technology for
health- care, carried out with the help of
information technology, in terms of data
acquisition, data storage, data retrieval,
data maintenance, and data
dissemination. It can be considered as the
electronic version of a more conventional
health- care system
 Kiosks can also be used to collect data and
information from users. DVDs, USB flash
drives, and other media are used to store
data digitally.
2. RETRIEVAL
 An operational service for payers that
need to retrieve medical records for risk
adjustmentand quality with scale and real-
time transparency.
3. TRANSMITTAL
 " the transfer of health resources and
health care by electronic means
KEY TERMS
 Information and communications
technology (ICT)
 Electronic medical record ( EMR)
 Electronic Health Record (EHR)
 eHealth
 Telemedicine
 elearning
 Geographic Information System (GIS)
 *Health Informatics
 Mobile Health (mHealth)
EXTENSIVE CAPABILITIES OF ICT
 Communicating with a patient through a
teleconference, electronic mail ( e-mail),
short message service ( SMS)
 Recording, retrieving, and mining data in
an electronic medical record (EMR)
 Providing patient teachings with the aid of
electronic tools such as radio television
computers, smartphones and tablets.
THREE MAIN AREAS ENCOMPASSES eHEALTH
1. The delivery of health information, for health
professional and health consumers, through
internet and telecommunications.
2. Using the power of information technology (IT)
and e - commerce to improve public health
services, for example, through the education and
training of health workers.
3. The use of e-commerce and e-business
practices in health system management. EHealth
B. POWER OF DATA AND INFORMATION
 Nurses are knowledge managers. They
constantly process raw patient data into
valuable information to deliver evidence-
based and individualized interventions. It
is imperative for every eHealth
practitioner to know the importance and
difference between the two. Data are the
fundamental elements of cognition
(Gudea,2005), and are defined as
unanalysed raw facts that do not imply
meaning.
PROBLEM EMERGES DURING POWER OF DATA
AND INFORMATION
1. Continuity and interoperability of care
stops in the unlikely event that a record
gets misplaced
2. Illegible handwriting poses
misinterpretation of data. Incomplete or
illegible prescriptions
 1. (Tissot et al 2003)
2. Patient privacy is compromised
3. Data are difficult aggregate
4. Actual time for patient care gets limited
IN CONTRAST, WELL-MANAGE INFORMATION
SYSTEM BENEFITS THE POWER OF DATA AND
INFORMATION
1. Data are readily mapped, enabling more
targeted intervention and feedback
2. Data can easily retrieve and recovered
3. Redundancy of data is minimized
4. Data for clinical research becomes more
available
5. Resources are used efficiently
C. eHEALTH SITUATION IN THE PHILIPPINES
 Based on the Philippines eHealth Strategic
Framework and Plan 2014-20, the DOH
envisions that "By 2020, eHealth will
enable widespread access to health care
services, health information, and securely
share and exchange client's information in
support to a safer, quality health care,
more equitable and responsive health.ICT
has changed how Filipinos access
information and how the government has
utilized this to inform its citizenry.
eHEALTH SITUATION IN THE PHILIPPINES
 WHERE DO WE STAND WHEN IT COMES
TO HEALTH CARE?
 DO YOU THINK WE HAVE ENOUGH
HEALTH CENTERS OR HOSPITALS?
 DO YOU THINK WE HAVE GOOD
FACILITIES?
 DO YOU THINK WE HAVE ENOUGH
HEALTH PROFESSIONALS WORKING HERE?
 DO YOU THINK WE HAVE INCORPORATED
TECHNOLOGY INTO OUR HEALTH CARE
SYSTEM?
FACTORS AFFECTING eHEALTH IN THE COUNTRY
1. Limited health budget
2. The emergence of free and open source
software
3. Decentralized government
4. Target users are unfamiliar with the
technology
5. Surplus of "digital native" registered
nurses
WHAT ARE THE MAJOR PROBLEMS FACING THE
HEALTH
CARE SYSTEM OF THE PHILIPPINES?
 The country has a high maternal and
newborn mortality rate, and a high
fertility rate. This creates problems for
those who have especially limited access
to this basic care or for those living in
generally poor health conditions. Many
Filipinos face diseases such as
Tuberculosis, Dengue, Malaria and
HIV/AIDS
D. USING e-HEALTH IN THE COUNTRY
 The major goal of community health
nursing is to preserve the health of the
community. This is best achieved by
focusing on health promotion and health
maintenance of individuals, families, and
groups within the community.
 The use of e-health can give people in
rural and remote areas access to quality
care, empower patients and communities
to engage at all levels of the health
system, and provide timely information or
the prevention, diagnosis and
management of illness
E. ROLES OF A COMMUNITY HEALTH NURSE IN
eHEALTH
 The primary role of community health
nurses is to provide treatment to patients.
Additionally, community health nurses
offer education to community members
about maintaining their health so that
they can decrease the occurrence of
diseases and deaths
MAJOR ROLES OF AN eHEALTH NURSE IN THE
PHILIPPINE COMMUNITY SETTINGS
1. Data and Record manager
2. Change agent
3. Educator
4. Telepresenter
5. Client advocate
6. Researcher