Community Health Information

Tracking System (CHITS)

 Learning
Objectives:
The learners will be able to answer the following:
1. What is CHITS?
2. How does it work in health centers?
3. How do they implement CHITS?
4. What is telenursing? what are its advantage and
disadvantage?
5. Enumerate measures to protect computer data and
systems.
6. Compare and contrast the development of hospital
information systems in some Philippines Hospital
 Community Health Information
Tracking System (CHITS)
• Is a free open source software electronic health record
system for local government health centers in the
Philippines.
• CHITS was created by Dr. Herman Tolentino in 2004
through a grant from the International Development
Research Center of Canada.
• Managed by UP Manila National Telehealth Center (UPM
NThC which was established in 2006 currently headed by
Dr. Alvin Marcelo.)
• It is an extensible, modular, open source information
system for rural health units.
• Being developed from a free and open source software or
FOSS (LINUX is a popular example), CHITS enabled that
developers and user to open up several opportunities for
health systems development in the country.
• FOSS also proves integral in data consolidation among clinics
and hospitals. Allison Perez cities the advantages of a unified,
paper-less medical data.
• The CHITS program is composed of the following modules
namely: patient, registration, maternal care, child care, TB
program, family planning and general services.
 How does CHITS work in a
health center?

• As the patient comes in, his/ her record is retrieved in

seconds. If the patient is new he/she would be registerd that
would take few minutes.

• CHITS is accessible in all departments within the health center

so once the patient information is processed in the admission
area, the doctor and other health provider are promptly
informed of the patient’s chief complaint, vital signs
and history without having to wait on the patient.
• Appointment and follow-up scheduling is set. By
looking ahead at appointment calendar, the health
provider will have a projection of patient loads and thus
can plan manpower allocation ahead of time.

• All health workers in a health center can access CHITS at

various levels. They are required to have atleast background in
the basic word processing, internet browsing and basic
computer operations like keyboarding, using the mouse,
booting up, turning off the computer, saving and printing
Implementing CHITS
 Implementing CHITS

RxBox:
https://rxbox.chits.ph/what_is_rxbox/

CHITS:
https://telehealth.ph/project-chits/
To implement CHITS, the following steps are recommended:

1. Creation of the CHITS Team (physician, health center staff

composed of nurses, aides, midwives, barangay health
worker, mayor, and LGU IT officer)

2. Seek Assistance from DOH-CHD (Center for Health

Development) for training; Provincial Health Office for
logistics such as internet connectivity; Local chambers for
commerce for donation of computers local internet cafes or
PhilCeCNet Community e-centers (CECs)

3. Engage the inter-local health zone, CHO (City Health

Office), PHO (Provincial Health Office) and CHD for lower
spending on mass training.
4. Get in touch with UP Manila Telehealth Center for
consultation, training and certifications.

5. Schedule for training. Training requires a local area

network preferably with 20 computers like a computer
laboratory or internet shop.
TELENURSING
 APPLICATION OF
TELENURSING

HOME
CARE
SE TE
CA E M E LE
E T PH
AG
MAN T RI ON
AG
N
E
•Telenursing, is a considered a form of telehealth where nursing
practice Is delivered
via telecommunication.

• Telenursing allows health care nurses to use remotely connected

medical devices
in the evaluation, diagnosis and treatment of patients in locations
outside the hospital.

•Telehealth applications range from simple telephone

communications to sophisticated wireless systems hooked to
monitoring and diagnostic equipments.

•A personal computer with the data storage and wired or wireless

connectivity, database management software, and compatible
medical devices capable of collection and transmission.
Advantages and
Disadvantages of
Telenursing
 Some of the advantages of
utilizing Telenursing are:
•nurses can help more patients in less
time due to the fact that there
is no travel involved for the nurse

•less nurses are required to reach more

people

•emergency room visits and

hospitalisations may be decrease as
patients don’t have to wait as long to be
“seen”
•patients can be monitored more closely
 Some of the advantages of
utilizing Telenursing are:

•call centres can answer questions that are within

their scope, reassuring patients and saving them a
visit to the ER, or identify patients that need to be
seen sooner than the patient may have thought, thus
saving lives
•providers can collaborate more easily via the use of
technology, saving both money and time

•telenursing can improve patient compliance to

prescribed care patients who are discharged early from
the hospital can be monitored at home for complications
 Disadvantages of
Telenursing:

Decrease face-to-face
interactions
Risk of decreasing quality of
care
May increase liability
Concerns with security
Concerns with maintaining
confidentiality
 Measures to protect
computer data and systems
 Protection of Computer Data and Systems
1. Education of user is most important to ensure that they
understand their roles.

2. Restriction of access providing users with username

and password that is changed every three months.

3. Encoding procedures for sensitive data

4. Transactions records to document access of system

5. Biometrics use such as electronic signature,

fingerprints, iris scans for stricter identification of
users

6. Protect network systems from physical damage.

7. Maintain integrity of data by:

a. Use of backup
b. Use of uninterruptible power source (UPS)
8. Enforce policies for breaches of security

9. Store only needed data. Dispose of unneeded data by

shredding.
Development of
Hospital
Information
Systems in
some
Philippines
Hospital
 Philippine General
Hospital
Future Directions

With the rapid evolution of laboratory medicine and emergence

of newer and superior technology, the department realizes the
need to constantly upgrade its service capability. The Section of
Hematology plans to acquire a Flow Cytometry machine as well
as to expand its coagulation studies to include D-dimer, fibrin
degradation products (FDP), and fibrinogen assays. The Section
of Immunopathology will soon offer immunoflourescence
examinations. The Section of Clinical Chemistry will initiate
therapeutic drug monitoring while the Section of Surgical
Pathology will perform immunohistochemical staining
procedures. The Section of Microbiology plans to conduct
testing on multiple drug-resistant organisms.
 Philippine Heart Center

Inaugurated on February 14, 1975, the Philippine

Heart Center was dedicated to the Filipino people as
an institution committed to caring for patients with
heart and related ailments.

Since then, the Heart Center has stood as a testimony

to that commitment to save lives and alleviate
thousands who suffer from cardiovascular diseases, a
leading cause of death in the Philippines. The Center
has brought new hope especially to those who
otherwise could not afford specialized medical care.
 Philippine Heart Center

As symbolized by its four-heart logo, the Heart

Center offers a comprehensive program of
patient care, education and training, research,
and public information. The Center extends the
best and most efficient medical services to its
patients by maintaining a pool of well-trained
and highly-experienced physicians and other
medical personnel who utilize some of the
latest technology and procedures in
cardiovascular science.
Next Topic: Module 7