CHITS

In May 10, 2004, the Community Health Information Tracking System or CHITS was pilot-tested in Pasay City. Six years after, health centers in M. Dela Cruz and Kalayaan join the roster of Lagrosa, Malibay, Doña Marta, Villamor, San Isidro, and Doña Nena as health centers in Pasay City which are now running on the electronic medical record system developed for government health centers.

Logistics and training was spearheaded by the Pasay City Health Office led by Dr. Peachy Sy with Public Health Nurses Rosendo Pantino (PHN II) of Lagrosa and Josefa Tresvalles (PHN I) of Malibay facilitated the orientation and workshop for the health care workers of M. Dela Cruz and Kalayaan.

The CHITS orientation gathered the health care workers from both health centers at the conference room of the Doña Marta Health facility last May 31, 2010. The orientation consisted of an overview on CHITS, attributes of good data quality interspersed with games which enable them to develop team work.

“Nangangapa pa kami ‘nung una (Initially, we were clueless),” admits Dr. Charito Julaila of Kalayaan Health Center on the first day of their five-half days of CHITS training. “Pagkatapos malaman namin ‘yung 6 basic steps, okay na kami (After we learned the 6 basic steps, we were fine.) The health care teams were taught the CHITS basic steps on patient registration, family folder assignment, household head designation, consultation, and PhilHealth number assignment.

After the health care workers learned the basic rudiments of CHITS, the succeeding days of their training were devoted on the use of the Maternal Care, Expanded Program on Immunization (EPI), and the National Tuberculosis Program (NTP) modules. They utilized the workstations installed in their health centers as they encoded patients and practiced the modules with the assistance of the city’s public health nurses which include Rosendo Pantino,  Josefa Tresvalles, Rotchie Paneda; Noel Bañez of UP-NThC and software developer Earl Justin Garcia.

Implementation of CHITS in the health care centers were initiated as soon as the training was done. “Nalilito kami ng konti pero mabilis ‘yung system. Exciting siya kasi napapabilis lahat (We were a little bit confused but the system is fast. It is exciting because it speeds up everything),” enthuses Charito Lechico (PHN I) of M. Dela Cruz Health Center. “Magaling nag-train din sa amin kaya nakaya namin (Our trainers were good. That is why we were able to cope with it.)”

With 8 out of 14 health centers in Pasay City that are currently running on CHITS, Dr. Sy is optimistic that they will be able to install the system in all of their health centers to render quality, effective patient record system and delivery of health care to their residents.

There is some confusion going around about CHITS (UP Manila’s Community Health Information Tracking System) and FHSIS (DOH’s Field Health Service Information System). Off the bat, CHITS is not FHSIS and FHSIS is not CHITS. These are two different systems but they are related. CHITS collects service level data from RHUs. FHSIS collects data for epidemiology purposes from the LGUs.

The automated election system (AES) is most useful in explaining how CHITS works.

The PCOS machine where you fed your ballot is very similar to CHITS. It collects the data on a per precinct level.

The Consolidation/Canvassing System (or CCS) is similar to FHSIS (Field Health Service Information System) which receives data from the PCOS machines and puts them together to come up with city-wide, province-wide, region-wide results. If you go to ibanangayon.ph, that is what FHSIS would ideally look like. Enhancements can be added but at the minimum, ibanangayon.ph will show you the current statistics by region, province, city, municipality, barangay, and precinct.

The PCOS and the CCS are made up of different software. The PCOS software is designed to be very good at collecting precinct level data. The CCS software is very good at collecting data from these PCOS machines and putting them together to get population level data (but not allowing the CCS to see who made the votes). Though composed of different software, they are able to talk to each other via election markup language (eml).

That is what is missing right now in the Philippine national health information system — the FHSIS-markup language (fml) — the language that connects the CHITS (and other electronic health records) to the FHSIS.

Now that we have a new president, we can look forward to the FHSIS markup language. And soon, we will have timely health data from the field.

The first region-wide CHITS-EMR conference was held at the Azaya, Capas, Tarlac with over sixty participants. CHD3 ARD Dr Arca invited the various provincial and city health offices in the region and the Wireless Access for Health Project (led by Dr Ric Ramos, PHO Tarlac) proudly presented their output. UP Manila (Drs Alex Gavino and Alvin Marcelo) were on hand to provide history and capacity-building opportunities while Smart put up a booth and offered a discounted package for all interested RHUs.

A partial list of CHOs, PHOs, and MHOs represented were: San Fernando, Pamapanga (Dr Eloisa Aquino), Plaridel, Bulacan, Angeles, Pampanga, and Cabanatuan City. (longer list to follow)

The four pilot areas of tarlac represented by their MHOs and PHNs ably demontstrated CHITS to their colleagues and shared the ups and downs of health center automation. All in all, though none said it was smooth sailing, everyone did say that it was gratifying and fulfilling.

Managing the Wireless Access for Health is Ms Jona Cabaguio while lead technical support is Mr. Alison Perez. Tarlac State University, a designated CHITS Provincial Reference Center, was represented by Mr. Angelo de Guzman.