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developed small-scale technologies that hope to address the problem of data collection and usability. In 2004, a team from the University of the Philippines developed the “Community Health Information Tracking System” or CHITS – a low-cost computerized initiative whose ultimate aim is to increase efficiency in patient care and to provide aid in health decision making at the local level [9]. Originally developed as a community-based child injury surveillance system, CHITS was then later expanded to store and sort various kinds of health information at the health center level using open source software. An outstanding feature of CHITS is that it was developed by university experts in conjunction with local people working in health facilities. Since CHITS’s inception, the university’s National Telehealth Center has expanded its implementation nationwide, covering around 50 local health centers as of 2011 [5]. CHITS turned a purely paper-based vertical system into one that is electronic and horizontal. This EMR system contains built-in modules for general patient consultations, consultation scheduling, maternal care services, child care, and family planning. It can also generate the monthly reports required by FHSIS for submission to the city health office. Furthermore, since CHITS captures data at the point of patient encounter, it improves the quality of FHSIS reports, ensures timely submission of reports to the city level, and enables ease of access of data for health center personnel. These features make CHITS a more reliable method of data recording and reporting than the usual manual procedure. CHITS’s impact on communities so far Previous evaluations have listed the different benefits reaped from the establishment of CHITS. These include: faster patient record retrieval; reduced patient waiting time; streamlined work flow of health center transactions; more efficient data entry and storage; installation of an appointment and follow-up scheduling system; monitoring of community health through daily data accrual; and easier and more timely generation of FHSIS reports [10]. In 2012, as part of my health policy and community medicine elective, I performed a rough qualitative evaluation of CHITS in two local health centers [11]. Panel 1 summarizes the
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results of interviews that I conducted with local health center staff, from physicians to volunteer community health workers. Panel 1: General changes observed by local health center staff after 8 years of using CHITS in Pasay City, the Philippines. Improved daily health center operations • Organized and systematic collection of patient information • More efficient recording and storage of data • Streamlined workflow in the health facility Better management of health data • Faster and easier generation of reports • More reliable health information • Easier reviewing of records for patient care and management Better use of other resources • Reduced use of paper, folders, and envelopes • Health center space allotted for other purposes • Time saved for staff members to work on other tasks Capacity building of health center staff • Computer literacy • Enhanced managerial and analytical skills Enhanced patient satisfaction for health care • Reduced patient waiting time • Enhanced enthusiasm and trust towards health center
The benefits of CHITS also highlight the importance of reducing waste of resources to support UHC systems. Less time is wasted by health workers in collecting and retrieving data, and more time is spent on patient care and health promotion. Finally, an essential value of a UHC system is building solidarity to achieve greater equity in health. The CHITS experience illustrates the heightened capacity and sense of achievement among health workers who learned how to operate an electronic information system. Learning about, and utilizing, e-health systems has also become a shared community activity. This demonstrates that while improving health information systems enhance the technical management and provision of health care, such a transformation also brings intangible social benefits that are essential in ensuring health and equity for all.
References continued 5. Fernandez-Marcelo P, Sy MI, Bañez N. Community Health Information Tracking System. Center for Health Market Innovations and Philippine Institute for Development Studies [Internet]. [Place unknown]: Center for Health Market Innovations; 2012 [cited 2013 May 31]. Available from: http:// healthmarketinnovations.org/sites/healthmarketinnovations.org/ files/PIDS_case_study_CHITS_0.pdf 6. Robey JM, Lee SH. Information system development in support of national health programme monitoring and evaluation:
Promise for UHC and future direction Strengthening health information systems is absolutely critical in supporting the establishment of universal health care systems across the world. Given the current national situation in the Philippines, there is still much to be done in this arena.
the case of the Philippines. World Health Stat Q. 1990; 43 (1): 37-46. 7. Braa J, Hedberg C. The struggle for district-based health information systems in South Africa. The Information Society. 2002; 18: 113–27. 8. Premji S. The development of a framework to evaluate the organisational and policy impacts of the community health information tracking system (CHITS) in the Philippines. Calgary:
However, the example demonstrated by CHITS offers some promise. One lesson is the importance of harnessing resources in society, such as the technical capacity of academic institutions, and commitment and enthusiasm among community members. CHITS can also be scaled up by responsible engagement with the private sector, especially those members that promote information and communication technologies. Certainly, if poorer people have access to mobile phones and the internet, then with healthy partnerships among decision-makers, implementers, and innovators, health information can truly be made universally accessible to all people.
Unpublished dissertation, University of Calgary; 2010 Jan. 9. Tolentino H, Marcelo A, et al. Final Technical Report: Community-based child Injury surveillance system: Rapid data collection using short messaging services. Manila; 2004.
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from:
http://www.idrc.ca/uploads/us-
erS/11472716661Child_Injury_Surveillance_Final_Report.pdf 10. Community Health Information Tracking System. Center for Health Market Innovations [Internet]. [Place unknown]: Center for Health Market Innovations; 2011 [cited 2013 May 31]. Available from: http://healthmarketinnovations.org/program/ community-health-information-tracking-system-chits 11. Guinto RLLR. Translating health information into health decisions: How CHITS data can be used for decision-making at the local level? Manila: Unpublished paper, University of the Philippines Manila; 2012 Apr.
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