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.

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
incompleteness.

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.

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.

Step-by-step
CHITS Step-by-step Implementation
Note: This document describes the process by which CHITS can be implemented in your
municipal health office/RHU.

Step 1: Organize the local CHITS Team

We use a baseball diamond paradigm for this.

There should be people manning the following positions (and their responsibilities):

• PITCHER: the leader. S/He should be willing to throw the shots. Takes lead in all aspects
of the implementation. Preferably the doctor.
• BATTER: the players. Should be willing to learn and undergo a skills upgrade. The
health center staff.
• UMPIRE: the arbiter. Should be always ready to fix problems/provide new equipment if
old ones wear out. Preferably the mayor.
• STADIUM MANAGER: the technical expert. Makes sure that the diamond is ready for
play before every game. Preferably the LGU IT officer.

Altogether, they form the local CHITS team.

Once these players are involved [through internal discussions, presentations to RHU/SB/mayor],
then it is an appropriate time for CHITS implementation in the LGU/RHU/MHO/CHO.

Step 2: Seek assistance from your DOH-CHD and PHO.

Automating health center information systems is difficult to do alone. Partnerships are needed.
The following can help with the needed resources:

• DOH-CHD for training

• PHO for logistics such as part of the Internet connection. (Resources vary depending on
PHO.)
• local chambers of commerce for donations of computers
• local Internet cafes or PhilCeCNet Community e-Centers (CeCs)

Step 3: Engage the Inter-local Health Zone, CHO, PHO, CHD

Benefits of ILHZ-wide CHITS deployment:

• training cost shared by all ILHZ members

• bulk purchase of equipment allows for lower unit costs
• grant may be available from external funders and CHD

It is also good to inform the PHO and CHD of your desire to obtain the training. The draft
request letter of support can be sent to their offices for this purpose. They usually require a draft
programme.

Step 4: Contact UP Manila National Telehealth Center to request for training and
certification.

At this step, we strongly urge the ILHZ to contact us at the National Telehealth Center for their
training. Only the NThC provides certified training on CHITS.

There are three levels of training —

• CHITS User [health center staff]

• CHITS Administrator [MHO or PHN]
• CHITS Technical Support [LGU IT Officer]

Step 5: Prepare for training

Set common date with National Telehealth Center

Select venue:

• A) in UP Manila or
• B) in community-based computer laboratory with 20 networked computers [A cybercafe
is acceptable but a school computer laboratory is cheaper.]

Go through the training checklist.

Prepare other logistics: such as food, travel, etc