eHealth in the Community Setting Disadvantages of Paper-Based Methods

1. Continuity and interoperability of care stops

Information and Communications Technologies in the unlikely event that a record gets
(ICTs) misplaced.
• Diverse set of technological tools and 2. Illegible handwriting poses
resources used to communicate, and to misinterpretation of data.
create, disseminate, store, and manage 3. Patient privacy is compromised.
information. 4. Data are difficult to aggregate.
5. Actual time for patient care gets limited.
eHealth
• The use of ICT for health (World Health Good Data Qualities
Organization, 2012). 1. ACCURACY
• eHealth as the cost-effective way of using - ensuring that a documentation reflects the
ICT in health care services, health event as it happened.
surveillance, health literature, health - all value should be correct and valid.
education, and research (WHO Resolution, - in a computerized system, a computer can
th
58 World Health Assembly; May 25, be instructed to check specific fields for
2005). validity and alert the user to potential data
collection error.
eHealth can be considered any of the following: *In electronic systems, format requirements must
• Communication with patient throughbe followed. Example of a format requirement:
teleconference, electronic mail (e-mail),DATE (MM/DD/YYYY).
short messages services (SMS). 2. ACCESSIBILITY – This is a data
• Recording, retrieving, and mining data in characteristic which ascertains data
the electronic medical record (EMR). availability, should a patient or any member
• Providing patient teachings with the aid of of the health staff needs.
electronic tools such as radio, television, 3. COMPREHENSIVENESS – Data inputed
computers, smartphones, and tablets. should be complete. This is done by making
sure that all the required fields in the
3 Main Areas of eHealth patients care are properly filled up.
• Delivery of health information for health 4. CONSISTENCY/RELIABILITY –
professionals and health consumers through Having no discrepancies in data record
the internet and telecommunications. makes it consistent.
• Using the power of information technology 5. CURRENCY – All data must be up-to-date
(IT) and e-commerce to improve public and timely.
health services. 6. DEFINITION – Data should be properly
• The use of e-commerce and e-business labelled and clearly defined.
practices in health systems management.
eHealth Situation in the Philippines
The Power of Data Information • Lack of health care professionals and
• DATA – unanalyzed raw facts that do not infrastructure contribute to inadequate
imply meaning. health care and medical services.
• Mobile technologies and internet services
• INFORMATION – meaning attributed to create a promising ground for eHealth.
data which are processed and analyzed. • Mobile phone penetration rate increases
(80%).
• Health sector has utilized ICT to improve
its services.
Factors Affecting eHealth • The delivery of health care services by all
• Limited health budget health care professionals using information
• Emergence of free and open source and communication technologies for the
software exchange of valid information for diagnosis,
• Decentralized government treatment and prevention of disease and
• Target users are unfamiliar with the injuries, research and evaluation, and for the
technology continuing education of health care
• Surplus of “digital native” registered nurses providers, all in the interest of advancing
the health of individuals and communities
Universal Health Care and ICT (AO No. 2010- (World Health Organization).
0036) or Kalusugan Pangkalahatan (KP)
• Financial risk protection through expansionFour Elements of Telemedicine
in National Health Insurance Program 1. Its purpose is to provide clinical support.
enrollment and benefit delivery. 2. It is intended to overcome geographical
• Improved access to quality hospitals and barriers, connecting users who are not in the
health care facilities. same physical location.
• Attachment of the health-related 3. It involves the use of various types of ICT.
Millennium Development Goals (MDG). 4. Its goal is to improve health outcomes.
eLearning
Benefits of eHealth and Telemedicine • Use of electronic tools to aid teaching.
• Enhancement to existing human • Can be done synchronously or
relationships established through asynchronously or combination of both.
conventional routes.
• Solution to a long-felt community need. Uses of eLearning
• Correcting misconceptions about health and
Electric Medical Records (EMR) health care.
• Comprehensive patient records that are • Access to reliable information.
stored and accessed from a computer or • Elicit community interest by showing
server. instructional videos on measures to control
• Community health centers have the capacity a particular disease.
to adapt electric medical records (EMRs) • Educate health care professionals.
because they utilize a standard process • Continuing professional education.
nationwide.
• Difficult to implement in hospitals because eHealth Projects in the Philippines used in
each hospital has its own set of protocols Community Health Practice
coupled with its own documentation.
• EMRs is vital to community health centers. Name Type Key
• EMRs allow computerized processing of Information
indicators, making it easier for nurses to
focus on other important aspects of health BuddyWorks Telemedicine Allowed RHU
care. and eLearning physicians in
• CHITS = widely used community-based GIDAS to send
EMR; funded by the International transferrals to
Development Research Center (IDRC); medical
created by Dr. Herman Tolentino of the specialists at
University of the Philippines Medical Philippine
Informatics Unit (UP MIU). General
Hospital (PGH)
Telemedicine via short
 messages intended for
(SMS) and e- mobile
mail. deployment to
CHITS Electronic Program is rural health
(Community Medical Record divided into centers.
Health different
Information modules based Able to store
Tracking on existing and send
System) DOH programs patient
(EPI, NTP, etc.) information and
and is a Free allow video and
and Open chat
Source conferencing
Software with a medical
(FOSS). specialist.

eFHSIS Health An online SEGRHIS Electronic An electronic

(Electronic Information version of (Segworks Medical Record medical record
Field Health System and FHSIS Rural Health created for rural
Service Electronic developed by Information health units.
Information Reporting the DOH where System)
System) you can upload SHINE Electronic An electronic
FHSIS data. (Secure Health Medical Record medical record
eIMCI eLearning Created Information and SMS developed by
(Electronic eLearning Network Reporting Smart
Integrated videos on Exchange) Communication
Management tuberculosis, s.
of Childhood stroke, bird flu, SPASMS Add-on to
Illness) and child (Synchronized SMS Alert WAH (Wireless
poisoning. Patient Alert System Access to
NTHC eLearning Created via SMS) Health)
eLearning eLearning SPASMS is an
Videos videos on SMS reminder
tuberculosis, system for
stroke, bird flu, patients who
and child are due for
poisoning. follow-up.

RxBox Telemedicine Mobile SPEED Disaster Allows

computer (Surveillance Management community
connected with in Post and SMS health nurses to
medical devices Extreme Reporting submit daily
such as ECG, Emergencies reports of
pulse oximeter, and Disasters) prevalent
and electronic diseases
blood pressure immediately
and heart rate after disasters
monitors that is via SMS, e-
mail, and other
 information and - nurses may also use scheduled text
communication messages to patients among the population
technologies. to send important health information
reminders.
WAH Health WAH 4. TELEPRESENTER – the nurse may need
(Wireless Information augmented the to present the patient’s case to a remote
Access for System and existing CHITS medical specialist; noting salient points for
Health) Electronic by connecting case assessment, evaluation, and treatment.
Medical Record health centers 5. CLIENT ADVOCATE
through - community health nurses safe guard the
broadband patient records, ensuring the security,
internet. confidentiality, and privacy of all patient
and information are being upheld.
- client must be well informed about the
benefits and challenges of the electronic
medical records, telemedicine, and other
eHealth tools.
6. RESEARCHER – using eHealth tools, for
Roles of Community Health Nurses in eHealth example, Electronic Medical Records; you
1. DATA AND RECORDS MANAGER can use this patient records to be retrieved
- community health nurses monitor the trans and analyzed in the near future by the
of disease through the electronic medical community or eHealth nurses.
records, allowing for targeted interventions - nurses are responsible for identifying
for health promotion, disease prevention, possible points for research and developing
curative services or rehabilitation. a framework based on data aggregated by
- nurses also maintain the quality of data the system.
inputs in the electronic medical records and
making sure that informations are accurate,
complete, consistent, correct, and current.
- nurses also participate in regular data
audits; anything in record that are gathered
by the nurses can be shared with other
health care professionals to monitor the
trend.
2. CHANGE AGENT
- nurses act as a change agent by working
closely with the community and
implementing eHealth with them and not
for them.
- nurses also collaborate with health leaders
(Local Government Officials).
3. EDUCATOR
- nurses provide health education to
individuals and families through
information and communication technology
tools.
- they may also participate in eLearning
videos on specific diseases (ex: Diabetes).