View the web version here.  More information at the PSHBT website here.  We also made a Facebook event here.

CHITS hailed as one of the four “Best Health Market Innovation Award” in RP from hundreds of creative projects on health care delivery and financing.

Makati, Philippines-The Community Health Information Tracking System (CHITS), the country’s first electronic medical record system for government health facilities, shares its triumph with public health workers upon winning a “Best Health Market Innovation Award” in last night’s Galing-Likha Kalusugan Awards.

Department of Health Secretary Enrique Ona, Presidential Sister Aurora Corazon Aquino-Abellada, Mr. Reiner Gloor, President of the Pharmaceutical and Healthcare Association of the Philippines, and Dr. Alejandro Herrin, Chair, Project Steering Committee of the Galing Likha Kalusugan Awards presented the award. Dr. Portia Fernandez-Marcelo, Director of UP Manila National Telehealth Center (NTHC), along with the CHITS team members Dr. Marie Irene Sy and Noel A. Bañez, RN received the award. In her acceptance speech, Dr. Marcelo emphasized the role of public health workers as the “real” champions in improving health care delivery through CHITS.

CHITS was given the award due to its significant contribution to improving health care delivery in government health centers. Nurses and midwives who usually record health data on paper were trained to use the system to generate timely reports for DOH national vertical health programs. With the persistence of its program implementers, delays for accessing of health data were minimized giving more time for health workers to give care to patients at the health center.

“Kung hindi tayo, sino? Kung hindi ngayon, Kailan pa? (If not us, then who? If not now then when?) was Dr. Marcelo’s bold statement after describing CHITS’ success in revolutionizing record-keeping in government health centers. It has been recorded that CHITS has surpassed challenges in making the system work with most public health workers who do not know how to use computers.

CHITS, along with Wireless Access for Health (WAH), NKTI Hemodialysis Center-Fresnius Medical Care Lease Agreement, and the Franchise Networks of Generics Pharmacies, topped other 117 health programs in health care service delivery, financing, facilitation, regulation, and promotion that have creatively address problems that plague health care in the Philippines.

The award was given by the Philippine Institute for Development Studies (PIDS) in partnership with the Center for Health Market Innovation (CHMI) to innovative health programs that have changed how health care transactions are delivered in the market place.

CHITS implementers underwent a tedious process of revalidas and interviews by the PIDS screening committee and several health experts in the country. From the 117 programs, CHITS was streamlined to 46 health projects and down to top 20 outstanding health programs. The top four programs hailed as the “Best Health Market Innovation” were chosen based on;

• Impact on many agents or principals with the overall effect deemed to be positive for the society;
• Sustainability for the purpose of replication and implementation on a larger scale;
• Pro-poor orientation to meet the health needs of the people in lower income groups and those with insufficient access; and
• Adoption of appropriate technology that is interesting, unique and pioneering

NTHC not only brought home the bacon with CHITS but also with the BuddyWorks Telehealth Project entering Top 20. Ms. Lucille Nieverra, World Health Organization Representative from the Philippines, lauded Buddywork’s promise “to deliver health care despite barriers of distance” in her opening message.

NTHC also co-received the Best Health Market Innovation Award for the Wireless Access for Health with the Provincial Government of Tarlac, RTI international, United States Agency for International Development, Smart Communications, Inc., Tarlac State University, and the National Epidemiological Center and Information Management Service of DOH in scaling up the use CHITS in the province of Tarlac.

CHMI is an international global network that researches and documents innovative health programs around that have significantly changed how health is delivered in the marketplace. CHMI puts importance to projects that can be scaled up and replicated in other regions of the world.

About CHITS

CHITS or Community Health Information Tracking System is the first ever electronic medical record system for Philippine health centers operating in open source‐software. It was designed by Dr. Herman D. Tolentino, together with the health professionals of Pasay and operates on open‐source software. In May 2004, CHITS was piloted in Pasay through a grant from PANASIA‐ICT, a joint
funding of the International Development Research Center of Canada and the United Nations Development Programme. As of July 2011, CHITS has been installed in over 50 health centers nationwide.
http://www.chits.ph/

The UP Manila National Telehealth Center

Established in June 1998, the University of the Philippines National Telehealth Center (UPM NTHC), has been collaborating with different sectors in the realm of information and communications technology (ICT) for health and development. The Center affirms its mandate of “putting health in the hands of the people” through available technologies by linking health care professionals of the Premier State University and the communities, especially the underserved.

The Center works under the OneHealth banner, NTHC’s three-point program that merges innovative applications in eLearning, eRecords, and eMedicine for health care and eHealth policy advocacy.

UPM NTHC collaborates with like-minded institutions to harness support for better health care for all through technologies that are accessible, affordable, appropriate, and culturally acceptable for Filipinos. By banking on individual’s capacities, the center believes that people can use information and communications technology for sound decision making contributing to better health outcomes. NTHC technologies are built in the strength of free and open source software.

http://www.telehealth.ph

The 29th batch of DTTBs

Tagaytay City, Philippines- National Telehealth Center (NTHC) of the University of the Philippines Manila is preparing 70 new DOH Doctors to the Barrios (DTTBs) in using telemedicine applications in an effort to support their practice in doctorless communities in the countryside.

The 29th batch of DTTBs under the Doctors to the Barrios Program of the Department of Health (DOH) began their training last October 17 at the Development Academy of the Philippines Campus. They are officially enrolled in NTHC’s Certificate Course in eHealth and Telemedicine which is a part of the 30-million National Telehealth Service Program (NTSP) recently forged by the NTHC with the DOH. NTSP aims to help DTTBs handle patients in their assigned communities; including those that need specialty care. Currently, there are already 109 doctors – from Batanes to Zamboanga – enrolled in the NTSP. DTTBs are being taught how to do telereferrals to refer difficult to handle cases in 5th to 6thclass municipalities of the country. 26 of them will be deployed in the Mindanao while some will be assigned in Geographically Isolated and Disadvantaged Areas.

Due to the absence of doctors in rural communities, most patients have to travel long hours in order to seek medical attention from clinical specialists in provincial or city centers. According to President Benigno S. Aquino III, as reported by DOH Secretary of Health Enrique T. Ona in his speech last March, 30 percent of Filipinos die without seeing a health professional.

Telemedicine offers some relief to the country’s health challenges by connecting health workers in poor remote rural communities with specialists in the Philippine General Hospital. With the implementation of the 5-year partnership of DOH and UP under the National Telehealth Service Program (NTSP), local health professionals from 606 poorest municipalities and regional centers will be connected to clinical specialists via telemedicine.

“Telemedicine has to be practiced professionally, grounded on a strong ethical-legal base; hence the need to train health professionals is a core component of the NTSP,” Dr. Portia Fernandez-Marcelo, NTHC director said.

“Telemedicine, under the NTSP is free of charge to the patients since this is subsidized by the DOH and the UP. While ICT advancements are beginning to be used in health care in the Philippines, the public is warned against those who take advantage of the situation,” she added. According to Dr. Marcelo, there were informal reports that some doctors in the rural areas, who are not enrolled in the certificate course of NTSP, are charging 300 pesos for telemedicine of NTHC.

The course consists of a two day-intensive hands-on training on the ethics and practice of telemedicine. On the first day, a series of discussions for the doctors’ Continuing Medical Education was held. This was followed by the hands-on training on mobile health technologies.

The Certificate Course in eHealth and Telemedicine is a 6-month blended learning course with 2-day face-to-face learning activities, followed by field practice and mentoring, capped by another 1-day face-to-face seminar workshop.

The UP Manila National Telehealth Center
Established in June 1998, the University of the Philippines National Telehealth Center (UPM NTHC), has been collaborating with different sectors in the realm of information and communications technology (ICT) for health and development. The Center affirms its mandate of “putting health in the hands of the people” through available technologies by linking health care professionals of the Premier State University and the communities, especially the underserved.

The Center works under the OneHealth banner, NTHC’s three-point program that merges innovative applications in eLearning, eRecords, and eMedicine for health care and eHealth policy advocacy.

UPM NTHC collaborates with like-minded institutions to harness support for better health care for all through technologies that are accessible, affordable, appropriate, and culturally acceptable for Filipinos. By banking on individual’s capacities, the center believes that people can use information and communications technology for sound decision making contributing to better health outcomes. NTHC technologies are built in the strength of free and open source software.

Source:
Melissa J. Pedreña, RN
eHealth Nurse and Coordinator for Telemedicine Certificate Course
Phone:+63 2 5256501(telefax)
Email: melpedrena@gmail.com

UP Manila National Telehealth Center (UPM NTHC)
admin@info.telehealth.ph
http//:www.telehealth.ph

eHealth Seminar on October 8, 2011

The said seminar aims to:

• Introduce you to various e-Health initiatives in the Philippines led by the NTHC;
• Give an you an overview of the principles of the ethical, safe and effective practice and implementation of e-Heath; and
• Open you to a whole new spectrum of career opportunity in health informatics.

Group discounts:

• Groups of 3-9: less Php 50.00
• Groups of 10 or more: less Php 100.00

On the seminar date, we will be giving away freebies such eHealth resources such as CDs, booklets, and many more straight from the International Open Source Network-UNDP Asia-Pacific Development Information Programme!

You can register here online! Hurry limited slots only for October 8 participants.

Community Health Information Tracking System

Via Noel A. Bañez, R.N.
Project Coordinator
Phone: +63 2 5256501 (telefax)
Email: nabanez@gmail.com
UP Manila National Telehealth Center
admin@info.telehealth.ph
http://www.telehealth.ph

QUEZON CITY, PHILIPPINES — The Quezon City Health Department reports that dengue cases are up by 3,447 cases from January to August, reaching the “alert threshold.”

This singular figure – a result of painstaking manual collation of reports gathered collectively by more than 250 public health nurses and midwives – is a powerful piece of information that should guide the public health management of the vector-borne disease.

However, because health information is manually obtained, collected, and aggregated, it loses its relevance by the time it reaches the desk of health managers. Therefore, it follows that the response mounted is not optimum.

This scenario is not unique to the Quezon City Health Department. Everywhere in the country, health managers struggle with having to rely on outdated or stale data to achieve a semblance of “evidence-based” decision-making.
But with its visionary leadership, Quezon City will be the first city to become an exception.

On September 12, the Quezon City government, led by Mayor Herbert M. Bautista, launched the P8.5 million Computerized Health Information System project utilizing the University of the Philippines’ homegrown electronic medical record system called Community Health Information Tracking System or CHITS.

This was formally sealed with Mayor Bautista and newly-installed UP President Alfredo E. Pascual signing of the Memorandum of Agreement at the Bulwagang Amoranto in this city.

Because of this, the “most populous city in the Philippines” is the first urban city to automate its entire health department.

“We can easily address the problem in a click of a button; unlike before, when we had to call our district supervisors to submit reports,” said City Health Officer Dr. Antonieta V. Inumerable of the Quezon City Health Department. “Now they can concentrate in the monitoring and easily apply preventive measures.”

Inumerable expounds that with the system, QC “can easily track the occurrence of communicable diseases which are of public importance.”

Vision for a “More People-Responsive Health Care”
“I dream of a healthier citizenry for Quezon City, “ declared Bautista. “This project is part of my overall plan to harness information technology as a tool to strengthen and secure services to our constituents.”

The automation of QC’s health information system is aligned with the national government’s five-year Philippine Digital Strategy (PDS) 2011-2016. The strategy aims to use information and communications technology (ICT) in promoting efficiency in the delivery of public service, which includes health care.

Bautista added, “This will enable us to better monitor inventories, patients, types of diseases attended to, actual consumption of resources as they occur, as well as to obtain objective measurements of efficiencies in attending to health needs of how many of our poor constituents.”

This vision was concretized and reinforced by the City Council under the leadership of Vice Mayor Joy G. Belmonte as they passed City Ordinance No. SP-2070. The ordinance stipulates for the computerization of all health centers in the city to serve as an “indispensable tool in providing emergency health services to all clients.”

One Health Information System for the Green City
CHITS is to aggregate relevant health information from 5 health districts, 7 lying-in clinics, 3 social hygiene clinics, and 63 health centers without using papers, folders and envelopes. This enables more than 3 million residents to have their consultation and health care services record stored and retrieved electronically.

“Paperless records [save us] papers and envelopes,” expressed Inumerable, echoing the city’s commitment to protect the environment.

Through CHITS, long waiting time for patients seeking medical services is reduced.

Data management, report generation, and inventory system are centralized to facilitate decision-making and planning purposes for the City’s health officers.

“CHITS tremendously unloads the health workers in reporting and spending more time in service delivery,” articulated Inumerable as health personnel usually spend their afternoons writing and recording in the registries and reports required by the City Health Office and the Department of Health.

CHITS has programs/modules that could store data on typical health center services such as consultation, maternal and child health, immunization, anti-tuberculosis, dental, family planning, leprosy, laboratory and notifiable diseases.

CHITS also features a PhilHealth module which monitors health services rendered to its members and dependents. It automatically generates reports that are compliant with the DOH’s Field Health Service Information System (FHSIS).

“For Quezon City, we [integrate] the other health programs of the DOH and requirements of the City Health Department such as communicable and non-communicable diseases, environmental sanitation, elderly program, social hygiene services, and lying-in clinic services,” enumerated Director Portia F. Marcelo of the National Telehealth Center.” CHITS also includes a drug inventory system for Quezon City’s health department.”

Created by the UP College of Medicine in 2004 with Pasay City, CHITS is “the longest running EMR in the country.”

The National Telehealth Center has since expanded its implementation in up to 50 rural health units nationwide. Recently, Navotas City also signed an agreement for the implementation of CHITS using Smartphones.

The technology is only as good as its user
Central to CHITS is building capacities of the government health staff – CHITS strengthens or even introduces skills in ICT use for health, deepens their appreciation for better quality data, strengthens their commitment in serving the public – mostly the poor who seek care in their health centers. CHITS introduces the values of FOSS or free and open source software – openness, sharing, accountability, giving back to the community.

CHITS anchors its existence with the support of health personnel such as physicians, midwives, public health nurses, and barangay health workers in the development of the software.

“Our strategy to partner with health workers in the development of the DOH health programs into modules made a great impact in the success of CHITS,” explained Marcelo. “Partnership matters a lot in the process as we have experienced in Pasay.”

With the forging of the partnership between Quezon City and the premier State University, health care delivery is transcended to new heights for its citizens.

About CHITS

The UP Manila National Telehealth Center
NTHC collaborates with like-minded institutions to promote better health care for all through technologies that are accessible, affordable, appropriate, and culturally-acceptable for Filipinos. By banking on individual’s capacities, the center believes that people can use information and technology for sound decision making for better health care. NTHC technologies are built in the strength of free and open source software.
http://www.telehealth.ph

via Scrubs Magazine

I just posted, “The only thing men ever learn from history is that men never learn from history” on my other blog and this comment from Scrubs Magazine also placed that not on the bulls-eye. You can view the original post here.

Part of being a nurse should be having pride in our profession.
Part of having pride in our profession should be knowing its history.

Read a little and you will find that nursing was not invented by Nightingale—it was reinvented by her. In actuality, both genders were involved in nursing since before it was even called “nursing.”

Caring for wounded soldiers wasn’t a new thing that suddenly occurred in the Crimean war…. Guess who provided care to the wounded soldiers at the time of the crusades and even earlier treating sick pilgrims? Monks and knights who were—gasp!—MEN.

Let’s put this whole “woman’s profession” argument to bed. If anyone needs further convincing, allow me to point you to the orders of the Knights Hospitallers and the Teutonic Knights (circa way the heck before certain gender-biased people were born, got jaded and decided that nursing only has room for one gender).

—NursingWhileMale on 3 Male Nurse Myths

Your thoughts then?

PSEM Poster

‘Tis such a long title for a post, yet it was also a long course with series and bouts of lectures at Nesta’s Hilltop Hotel, Roxas City yesterday.  It was my first time in Roxas City, the seafood capital of the Philippines.  I didn’t get the chance explore the city, since we left Kalibo at 6:15am and arrived around 7:30am at Nesta’s Hilltop Hotel.  There were three of us and our attendance was personal.  Meaning we were not sent to represent, in my case I was both eager and curious to join lectures other than Bible conferences.  Registration was a breeze with materials:  writing pad, notes, pen and the like.  The program started fairly on time.  It was my first time though to see the PSEM Hymn which was also a music video!  How about that?

Notes and Materials

CSI

Oh, before even the program began there was some sort of a teaser lecture called the Clinical Sign Investigation (CSI:  The Endocrine Eye).  You’ve got to give them credit for those acronyms.

Plenary Lecture I

The lecture kicked off with The Ominous Octet:  A New Paradigm in Understanding Type 2 Diabetes by Leilani B. Mercado-Asis, MD, PhD, FPCP, FPSEM.  Again, you got to love the titles.  If you don’t know what ominous means, it means evil or threatening.  I would have titled this as TOO:  A New Paradigm in Understanding Type 2 Diabetes but that would doing it too much.  Anyway, I’ve learned new terms like prandial (even WordPress doesn’t know!) and ominous.  It’s a good thing I brought along Apple (my iPhone) with me with some handy apps.  In summary, these are the ominous octet and believe me they are pure evil, medically.

1. Decreased Incretin Effect
2. Increased Lipolysis
3. Increased Glucose Reabsorption
4. Decreased Glucose Uptake
5. Neurotransmitter Dysfunction
6. Increased HGP
7. Increased Glucagon Secretion
8. Decreased Insulin Secretion

1. Type 1 DM (formerly known as insulin dependent DM or Juvenile DM).
2. Type 2 DM (formerly known as non-insulin dependent DM or adult-onset DM).
3. Gestational DM:  Diabetes first diagnosed during pregnancy.
4. Secondary DM:  Genetics defects, drug or chemical induced diabetes or other endocrine diseases.

She also noted that we should use Type “1″ and “2″ not “I” or “II” to avoid confusion.

In summary, if you think you have risk factors like overweight, obese, sedentary lifestyle, hypertension and the like then it is much better to have yourself screened for DM and other cardiovascular diseases.  The Unite for DM Philippine Practice Guidelines for Diabetes recommends the following:

1. All individuals being seen at any physician’s clinic or by any health care provider should be evaluated annually for risk factors for type 2 diabetes or pre-diabetes.
2. Universal screening using laboratory tests is not recommended as it would identify very few individuals who are at risk.
3. Laboratory testing for diabetes and pre-diabetes is recommended for individuals with any of the risk factors for Type 2 DM.

All patients suspected to have diabetes or those who are at risk for developing diabetes mus first be interviewed regarding any of the classical signs of DM including polyuria, polydipsia, polyphagia and weight loss.

An Obese Note

I didn’t need to jot down the other risk factors but I know being overweight is a pre-requisite to obesity! I know my way in the kitchen (thanks for Mum and happy birthday!) and we love to eat as a family but I think it’s start to hit the road again and start running and to have a change of eating habits. I think it’s hypocritical to any medical professional to be doing quite the opposite of what his profession is all about. Sadly, this is the case nowadays including myself.

Booths & Freebies

After the 2nd speaker there’s an open forum which lasted around 5 minutes or less.  We Filipinos love to participate indirectly on forums.  We love to watch on the sidelines as other people try to speak there minds.  I guess it’ a cultural thing and I think  that’s why we as a a nation are entertainment driven, we love to watch people living their lives – soaps!

Anyway, during the break we were directed to the booths upstairs for some treats and freebies.  There were bags, bags, more bags, pens, notepads, sweets and some health drink.

I love freebies!  Especially icons and fonts but these kind of bags, well, it’s not that I’m not grateful or anything but not really my type.  I don’t know why I lined myself up for bags with all the rushing and the pushing and the double queuing and all of that hassle.

Freebies

Plenary Lecture II

The lecture opened up with Gestational Diabetes Management by Iris Thiele C. Isip-Tan, MD, FPCP, FPSEM.  Here are some notes:

1. Pregnant women should lose their pregnancy weight in one year after delivery or you don’t lose it at all and carry it on to your next pregnancy.
2. All women with GDM should receive nutritional counseling by  a registered dietitian when possible.
3. Monitor urine ketones before breakfast to detect starvation ketonuria.
4. Non-caloric sweeteners may be used in moderation.
5. Daily SMBG appears to be superior to intermittent office monitoring of plasma glucose.
6. For women treated with insulin, limited evidence indicates that postprandial monitoring is superior to preprandial monitoring.
7. Urine glucose monitoring is not useful in GDM

You can also visit her website at Endocrine Witch.  Think  that’s scary?  She’s got also a blog called Bubbles From My Cauldron.

To Each Staff Member of this Facility:

As you pick up that chart today and scan that green Medicaid card, I hope you will remember what I am about to say. I spent yesterday with you. I was there with my mother and father. We didn’t know where we were supposed to go or what we were supposed to do, for we had never needed your services before. We have never before been labeled charity.

I watched yesterday as my dad became a diagnosis, a chart, a case number, a charity case labeled “no sponsor” because he had no health insurance. I saw a weak man stand in line, waiting for five hours to be shuffled through a system of impatient office workers, a burned-out nursing staff and a budget-scarce facility, being robbed of any dignity and pride he may have had left. I was amazed at how impersonal your staff was, huffing and blowing when the patient did not present the correct form, speaking carelessly of other patients’ cases in front of passersby, of lunch breaks that would be spent away from this “poor man’s hell.”

My dad is only a green card, a file number to clutter your desk on appointment day, a patient who will ask for directions twice after they’ve been mechanically given the first time. But, no, that’s not really my dad. That’s only what you see. What you don’t see is a cabinetmaker since the age of 14, a self-employed man who has a wonderful wife, four grown kids (who visit too much), and five grandchildren (with two more on the way) – all of whom think their “pop” is the greatest.

This man is everything a daddy should be – strong and firm, yet tender, rough around the edges, a country boy, yet respected by prominent business owners. He’s my dad, the man who raised me through thick and thin, gave me away as a bride, held my children at their births, stuffed a $20 bill into my hand when times were tough and comforted me when I cried. Now we are told that before long cancer will take this man away from us.

You may say these are the words of a grieving daughter lashing out in helplessness at the prospect of losing a loved one. I would not disagree. Yet I would urge you not to discount what I say. Never lose sight of the people behind your charts. Each chart represents a person – with feelings, a history, a life – whom you have the power to touch for one day by your words and actions. Tomorrow it may be your loved one – your relative or neighbor – who turns into a case number, a green card, a name to be marked off with a yellow marker as done for the day.

I pray that you will reward the next person you greet at your station with a kind word or smile because that person is someone’s dad, husband, wife, mother, son, or daughter – or simply because he or she is a human being, created and loved by God, just as you are.