Community Health Information and Tracking System (CHITS):  Lessons from Eight Years Implementation of a  Pioneer Electronic Medical Record System in the Philippines

Ongkeko, Arturo M.; Fernandez, Randy; Sylim, Patrick G.; Amoranto, Abegail Jayne P.; Ronquillo-Sy, Marie-Irene; Santos, Abby Dariel F.; Fabia, Jonathan G.; Fernandez–Marcelo, Portia H.

doi:10.47895/amp.v50i4.769

Cited by 17 publications

(15 citation statements)

References 6 publications

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“…34 Social influence is found to be a significant factor in several other studies among health professionals. 22,[35][36][37][38][39] This study underscores the positive influence of UTAUT sub-construct social factors. PCHC professionals tend to use the device "because my co-workers use it," and when colleagues endorse it, "we are influenced when nurses from other municipalities would tell us about their experience with the RxBox."…”

Section: Discussionmentioning

confidence: 85%

Factors Affecting Adoption of a Telemedicine Device by Primary Care Health Workers in the Philippines

2021

Acta Med Philipp

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Background and Introduction. The RxBox is a telemedicine device that measures and transmits vital signs to remote experts. It has been deployed to primary care health centers (PCHC) in the Philippines serving disadvantaged populations, to decrease morbidity and mortality due to common diseases and poor access to care. Factors affecting its adoption by healthcare workers is unknown. Materials and Methods.The study determined social and behavioral factors that affect adoption of a telemedicine device into the clinical workflow using the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. This is a mixed methods research using review of records, survey and focused group discussions.Results and Discussion. RxBox telemedicine devices were installed in 79 primary care health centers (PCHC) and were used a total of 15,705 times within the study period. An ordinary least squares regression analysis using the combined site and individual-level data showed that among the UTAUT parameters, only compatibility, facilitating conditions, and social factors have significant relationships with intent-to-use of the RxBox. The innovation assisted primary care health workers in their clinical responsibilities, improved the stature of their PCHC in the community, and helped in the care for patients. Training and technology support after deployment as well as encouragement by peer and champions (the PCHC physician, local government leaders) reinforced continuous use after training. Users described the experienced improvements in quality of services provided by the PCHC and the consequent benefits to their patients.Conclusions. These factors should be accounted for in designing strategies to reinforce health workers' attitudes and enhance support towards acceptance and use of novel telemedicine devices into clinical routine in local health centers. Lessons are immediately useful for local leaders in low-and lower middle-income countries that suffer disproportionately from unnecessary maternal deaths and mortality due to non-communicable diseases. This contributes to the body of knowledge and should bolster national-level advocacy to institute an enabling policy on telehealth Information Communication Technology (ICT) and use of Filipino innovations towards health

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Section: Discussionmentioning

confidence: 85%

Factors Affecting Adoption of a Telemedicine Device by Primary Care Health Workers in the Philippines

2021

Acta Med Philipp

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“…For the health centers, more than half (10/16, 62%) utilize an online web-based database for patient records through the Integrated Clinic Information System (iClinicSys), while only 1 (6%) uses the Community Health Information Tracking System (CHITS), as shown in Table 1 . iClinicSys is a system owned by the DOH that efficiently and effectively monitors patient cases in rural health units (RHUs) [ 31 ], while CHITS is an EMR system for government primary care health centers in the Philippines [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study

Garcia¹,

Vega²,

Mercado³

2022

J Med Internet Res

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Background The rapid aging of the world’s population requires systems that support health facilities’ provision of integrated care at multiple levels of the health care system. The use of health information systems (HISs) at the point of care has shown positive effects on clinical processes and patient health in several settings of care. Objective We sought to describe HISs for older persons (OPs) in select government tertiary hospitals and health centers in the Philippines. Specifically, we aimed to review the existing policies and guidelines related to HISs for OPs in the country, determine the proportion of select government hospitals and health centers with existing health information specific for OPs, and describe the challenges related to HISs in select health facilities. Methods We utilized the data derived from the findings of the Focused Interventions for Frail Older Adults Research and Development Project (FITforFrail), a cross-sectional and ethics committee–approved study. A facility-based listing of services and human resources specific to geriatric patients was conducted in purposively sampled 27 tertiary government hospitals identified as geriatric centers and 16 health centers across all regions in the Philippines. We also reviewed the existing policies and guidelines related to HISs for OPs in the country. Results Based on the existing guidelines, multiple agencies were involved in the provision of services for OPs, with several records containing health information of OPs. However, there is no existing HIS specific for OPs in the country. Only 14 (52%) of the 27 hospitals and 4 (25%) of the 16 health centers conduct comprehensive geriatric assessment (CGA). All tertiary hospitals and health centers are able to maintain medical records of their patients, and almost all (26/27, 96%) hospitals and all (16/16, 100%) health centers have data on top causes of morbidity and mortality. Meanwhile, the presence of specific disease registries varied per hospitals and health centers. Challenges to HISs include the inability to update databases due to inadequately trained personnel, use of an offline facility–based HIS, an unstable internet connection, and technical issues and nonuniform reporting of categories for age group classification. Conclusions Current HISs for OPs are characterized by fragmentation, multiple sources, and inaccessibility. Barriers to achieving appropriate HISs for OPs include the inability to update HISs in hospitals and health centers and a lack of standardization by age group and disease classification. Thus, we recommend a 1-person, 1-record electronic medical record system for OPs and the disaggregation and analysis across demographic and socioeconomic parameters to inform policies and programs that address the complex needs of OPs. CGA as a required routine procedure for all OPs and its integration with the existing HISs in the country are also recommended.

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“…One of the key findings is that a hospital’s lack of adequate health information technologies can drive (or force) nurse administrators and staff nurses to be resourceful in using an existing technology that they can use in their work regardless of policy constraints. This is somewhat expected in most, if not all, hospitals in the Philippines because the deployment and implementation of even the most basic forms of health information technologies (eg, electronic health records) are lagging [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although allowing staff nurses to use smartphones for work purposes contradicts a hospital’s blanket ban policy on mobile devices, this policy can only be implemented realistically if a hospital provides nurses with adequate technologies. Unfortunately, this is not the case for most hospitals in the Philippines considering that deployment of health information technologies is relatively low [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…This study aimed to identify organizational issues related to staff nurses’ use of smartphones for work purposes and examine whether such issues influence nurse administrators to support such practice in the Philippines. As a developing country in Southeast Asia, the Philippines is an interesting context for this study because most hospitals in the Philippines do not have sufficient health information technologies that can support health care professionals’ clinical work [ 28 ]. Moreover, the country is currently facing a decline in its nursing workforce [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Influence of Organizational Issues on Nurse Administrators’ Support to Staff Nurses’ Use of Smartphones for Work Purposes in the Philippines: Focus Group Study

Bautista¹,

Lin²,

Theng³

2020

JMIR Nursing

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Background Studies show that nurses use their own smartphones for work purposes, and there are several organizational issues related to this. However, it is unclear what these organizational issues are in the Philippines and the influence they have on nurse administrators’ (ie, superiors) support to staff nurses’ (ie, subordinates) use of smartphones for work purposes. Objective Drawing from the Organizational Support Theory (OST), this study aimed to identify organizational issues that influence nurse administrators’ support to staff nurses’ use of smartphones for work purposes. Methods Between June and July 2017, 9 focus groups with 43 nurse administrators (ie, head nurses, nurse supervisors, and nurse managers) were conducted in 9 tertiary-level general hospitals in Metro Manila, the Philippines. Drawing from OST, issues were classified as those that encouraged or inhibited nurse administrators to support nurses’ use of smartphones for work purposes. Results Nurse administrators were encouraged to support nurses’ use of smartphones for work purposes when (1) personal smartphones are superior to workplace technologies, (2) personal smartphones resolve unit phone problems, and (3) policy is unrealistic to implement. Conversely, issues that inhibited nurse administrators to support nurses’ use of smartphones for work purposes include (1) smartphone use for nonwork purposes and (2) misinterpretation by patients. Conclusions Nurse administrators in the Philippines faced several organizational issues that encouraged or inhibited support to staff nurses’ use of smartphones for work purposes. Following OST, the extent of their support can influence staff nurses’ perceived organizational support on the use of smartphones for work purposes, Overall, the findings highlight the role and implication of organizational support in the context of smartphone consumerization in hospital settings, especially in developing countries.

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Community Health Information and Tracking System (CHITS): Lessons from Eight Years Implementation of a Pioneer Electronic Medical Record System in the Philippines

Cited by 17 publications

References 6 publications

Factors Affecting Adoption of a Telemedicine Device by Primary Care Health Workers in the Philippines

Factors Affecting Adoption of a Telemedicine Device by Primary Care Health Workers in the Philippines

Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study

Influence of Organizational Issues on Nurse Administrators’ Support to Staff Nurses’ Use of Smartphones for Work Purposes in the Philippines: Focus Group Study

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