Nursing Care of the Community
CHAPTER 15
EHEALTH IN THE COMMUNITY SETTING
Instructional slides
Objectives
• Explain the importance of information and
communications technology (ICT) for public
health
• Describe existing implementations of ICT for
public health in the Philippines
• List the various roles community health
nurses have in implementing ICT for public
health
What is ICT?
• A diverse set of technological tools and
resources used to communicate, create,
disseminate, store, and manage
information (Blurton, 2002)
• Example technologies
– Computers
– The Internet
– Television
– Mobile phones
Differentiating Data and Information
• Data – unanalyzed raw facts that do not imply
meaning (Gudea, 2005)
Ex:
– The number ’39’
• Information – data with meaning
Example:
– The number ‘39’ as the patient’s respiratory rate
Is different from
– The number ‘39’ as the patient’s age
• The health care system heavily relies on
accurate recording of data and information
Good Data Qualities
• In order for information to be valuable, data
must have the following characteristics
(Abdelhak et al., 2012):
– Accurate
– Accessible
– Comprehensive
– Consistent/Reliable
– Current
– Defined
What is eHealth?
• eHealth is the use of ICT for health (World
Health Organization, 2012).
• Examples of eHealth:
– Communicating with patients through a
teleconference, e-mail, SMS
– Recording, retrieving and mining data in an
electronic medical record
– Providing patient teachings with the aid of
electronic tools (computers, television, tablets)
eHealth is the Umbrella Term
According to the WHO, eHealth encompasses
three main areas:
• The delivery of health information, for health
professionals and health consumers, through
the internet and telecommunications.
• Using the power of information technology (IT)
and e-commerce to improve public health
services, for example, through the education
and training of health workers.
• The use of e-commerce and e-business practices
in health systems management.
ICT in the Philippines
• Internet Access (ITU, 2011)
– 2001 – 2.5% of Filipinos had Internet access
– 2011 – increased to 29%
• Mobile Phone Usage
– 2009 - 80% of Filipinos own a mobile phone
– 73M subscribers
– The Philippines is ranked first in SMS usage in
the entire world (BusinessWire, 2010)
eHealth in the Philippines
• Factors to consider
• Limited health budget
– Emergence of Free and Open Source Software
(FOSS)
– Decentralized government
– Target users are unfamiliar with the technology
– Surplus of digital native-registered nurses
eHealth in the Philippines (continued)
• ‘Kalusugan Pangkalahatan’ and ICT
– Also known as KP one of its aims is to attain efficiency
by using ICT in all aspects of health care
• The DOH recognizes the valuable purpose of ICT
for health and has drafted its National eHealth
Strategic Framework for 2010-2016
– With the vision of ICT supporting UHC to improve
health care access, quality, efficiency, and patient’s
safety and satisfaction, for reducing cost and enabling
policy makers, providers, individuals, and
communities to make the best possible health
decisions.
Electronic Medical Records
• :
• An example is the Community Health
Information Tracking System (CHITS) of the
University of the Philippines Manila.
Telemedicine
• The delivery of health care services, where
distance is a critical factor, by all health care
professionals using information and
communication technologies for the
exchange of valid information for diagnosis,
treatment and prevention of disease and
injuries, research and evaluation, and for
the continuing education of health care
providers, all in the interests of advancing
the health of individuals and their
communities. - WHO
Four elements specific to Telemedicine - WHO
1. Its purpose is to provide clinical support.
2. It is intended to overcome geographical barriers,
connecting users who are not in the same
physical location.
3. It involves the use of various types of ICT.
4. Its goal is to improve health outcomes
An example of which is the National Telehealth
Service Program (NTSP).
eLearning
• The use of electronic tools to aid in teaching
• Instructional videos, informational
textblasts, interactive simulations
• Can be done asynchronously, synchrously,
or a combination of both
eHealth Projects in the Community
• BuddyWorks – allowed RHU physicians to send
telereferrals to clinical specialists in PGH via SMS
and eMail
• CHITS – an EMR, designed for and by the
community health workers, divided into different
modules based on existing DOH programs
• Electronic Field Health Service Information
System (eFHSIS) - An online version of the FHSIS
developed by the DOH
eHealth Projects in the Community (continued)
• Electronic Integrated Management of Childhood
Illness (eIMCI) - An electronic version of IMCI
accessible in mobile devices
• NTHC eLearning videos – funded by USAID,
created eLearning videos on tuberculosis, stroke,
bird flu, and child poisoning
• Segworks Rural Health Information System
(SEGRHIS) - An EMR created for rural health units
by Segworks, local software company in Davao
eHealth Projects in the Community (continued)
• RxBox - It is a mobile computer connected
with medical devices such as ECG, pulse
oximeter and electronic blood pressure and
heart rate monitors that is intended for
mobile deployment to rural health centers
• Secure Health Information Network
Exchange (SHINE) – An EMR developed by
Smart Communications
eHealth Projects in the Community (continued)
• Synchronized Patient Alert via SMS
(SPASMS) - an SMS reminder system for
patients who are due for follow-up
• Surveillance in Post Extreme Emergencies
and Disasters (SPEED) - Allows community
health nurses to submit daily reports of
prevalent diseases immediately after
disasters via SMS, e-mail, and other
information and communication technologies
eHealth Projects in the Community (continued)
• Wireless Access for Health (WAH) - WAH
augmented the existing CHITS by connecting
health centers through broadband Internet
access ; Implemented in 2010 in the Tarlac
Province through the Public–Private
Partnership (PPP) of Qualcomm, UPM-
NTHC, USAID, Smart, DOH-IMS, Center for
Health Development (CHD) Region III, RTI
International, National Epidemiological
Center (NEC), Tarlac State University, and
the local government
Community eHealth Nurses’ Roles
1. Data and Records Manager
2. Change Agent
3. Educator
4. Client Advocate
5. Telepresenter
6. Researcher
END OF CHAPTER
