FREQUENTLY ASKED QUESTIONS ON CHITS-EMR (ADAPTED FROM WIRELESS ACCESS FOR HEALTH)
BASIC INFORMATION ON CHITS-EMR
1. What is CHITS-EMR?
Community Health Information Tracking System or CHITS-EMR is an open source electronic medical record designed to run in public health centers and rural health units. CHITS-EMR has built-in modules for general patient consultations, consultation scheduling, maternal care services, child care, family planning and reporting features for the DOH Field Health Service Information System. CHITS-EMR runs over a local area network (LAN) installed inside the health center and accessible to computers installed within the health center.
CHITS-EMR was created by Dr. Herman Tolentino of UP Medical Informatics Unit in 2004 and was initially deployed in Pasay. Presently, it is continuously being developed by a community of end-users and developers. Training and accreditation of reference centers is being handled by the UP Manila – National TeleHealth Center.
2. Why do Health Clinics need CHITS-EMR?
Public health centers are the frontline health care service providers all over the country. As such, large volume of public health data are being processed and submitted to the higher level health departments (PHO, CHD, DOH-NEC). The public health reporting system is guided by the Field Health Information Service Information System or FHSIS. Yet the manual (paper-based) process of data collection, recording, consolidation and generation of reports has become prone to errors, inconsistencies and
CHITS-EMR intends to improve three aspects of records management: 1) quality of FHSIS reports, 2) timeliness of submission, and 3) ease of access of data for health center personnel. By automating critical areas of public health data management, health center personnel are somehow eased with the burden of manually consolidating reports and could provide more in providing health care services to their patients.
3. How does CHITS-EMR enable RHUs to produce significant quality data?
CHITS-EMR works by capturing health information at the actual point of encounter (i.e. right after health worker provides service to patient). As the data comes in and saved on a local server, data collection and recording is already done. Data entry forms are patterned after the actual paper forms but with built-in input filters.
Once data has been recorded, the different indicators for the various FHSIS reports have already been programmed inside CHITS-EMR and as such, these reports can be automatically generated out of the system. There is no need to compute numbers and consolidate totals manually thus avoiding possible inadvertent errors in calculation.
4. Does it follow the standard reporting system of the Department of Health?
Since its inception in 2004, CHITS-EMR has been following the FHSIS manual and guidelines for various health programs. Development of CHITS modules are done in consultation with end-users (i.e. PHO, MHO’s, PHN’s, midwives). The Wireless Access for Health project in Tarlac has also allowed CHITS- EMR to have official partnership with various DOH offices such as NEC (for the FHSIS definitions), IMS (for the data dictionary) and CHD-3 (for data integration).
CAPABILITIES AND FEATURES
1. What are the FHSIS Reports that CHITS-EMR can generate?
Presently, target client list (TCL’s), summary tables and periodical reports (weekly, monthly, quarterly and annual reports) can be produced in the following health programs: maternal care, child care, family planning, morbidity and notifiable diseases, tuberculosis, leprosy, and dental health care. Future developments are being set to include non-FHSIS reports as well (i.e. laboratory services, PhilHealth reports).
2. How does CHITS-EMR helps in RHU/Clinic Management?
Aside from improving the health center’s record management, one of the advantages of using CHITS- EMR is streamlining the workflow. As the patient comes in, searching of his/her record would normally take around 4-5 minutes. For a health center with 50 patients per day, that is 200 minutes of searching individual records. Using CHITS-EMR, search and accessing the patient record is just a matter of seconds.
CHITS-EMR is accessible over different areas of the health center (i.e. admission, consultation, treatment room). Once a patient is encountered at the admission, the doctor will immediately know the chief complaint, vital signs and history without waiting for the patient to come in. Drugs for dispensing at treatment room can be prepared beforehand since the doctor’s treatment plan can be viewed immediately on the computer.
3. Does CHITS-EMR have features that can help in needs projection and planning?
One of the features of CHITS-EMR is the appointment and follow-up scheduling system. A patient can be set to return on a certain date (i.e. prenatal visits, EPI follow-up). By looking at the ahead at appointments calendar, health center personnel will immediately have a projection of patient loads and therefore, can distribute and plan manpower allocation ahead of time.
Another potential feature is the projection of logistical needs. Recording of patient services like maternal care and EPI will provide forecast on how much supplies and commodities will be needed in the future.
4. Can CHITS-EMR help clinicians access patient data easily?
CHITS-EMR data is stored on a local server inside the health center. Access to the data is not just convenient but secured as well. Only authorized health center personnel with login accounts can access the information stored on the server.
5. Can CHITS-EMR integrate and interconnect with other information systems?
Yes. Present efforts are being done to demonstrate data integration of CHITS-EMR. In cooperation with DOH-CHD 3, mechanisms and functionalities are being developed to integrate CHITS-EMR data set (RHU-level) to the E-FHSIS program (PHO-level). CHITS-EMR is built with free and open source software making interoperability possible.
REQUIREMENTS IN INSTALLING CHITS-EMR
1. Who can use the CHITS-EMR? What level of computer skills is needed?
Anybody in the health center can use CHITS-EMR. Each health center personnel have a particular role in using the system. Basic word processing (i.e. typing), internet browsing and computer hardware operations (i.e. use of keyboard and mouse, turning on and shutting down computers) are essential preliminary skills end-users must possess in order to use the system.
2. What equipments are needed to install a complete CHITS-EMR facility?
CHITS-EMR facilities are required to have one local server. Preferably, the server should have at least 2GB of memory, 160 GB of hard disk drive and at least 4 hours of battery life with a backup UPS. To provide local area connection and 3G network, a wireless router with 3G modem connectivity is necessary. A minimum of three data entry machines should be in place. It can either be a laptop or desktop but should have a wireless card installed.
3. Does the RHU need to install internet connection?
Internet connection is not necessary to use CHITS-EMR for recording health center transactions. But in order to submit data electronically, an Internet connection should be present.
4. What trainings are needed to capacitate the RHU personnel to be able to use the CHITS-EMR
The first level of training is on basic computer skills. This is typically composed of topics on word processing, internet browsing and computer hardware operation. The next level involves teaching and training the health center personnel on the use of the CHITS-EMR. An optional onsite mentoring can be done to guide the health centers on the initial phase of using the CHITS-EMR.
5. Approximately how long does it take to prepare an RHU to use the CHITS-EMR?
Two weeks of training would be needed to capacitate the RHU personnel in using CHITS-EMR. RHUs would need at least 5 days for the Basic PC Skills Training and 3 days for the training on how to use the CHITS.
6. How much is the cost for setting up of CHITS?
Budgetary requirements can be per Rural Health Unit, per citywide or province-wide depending on the number of health centers to be automated, # of health workers to be trained, etc. Budgetary requirements can be requested through e-mail at firstname.lastname@example.org.