This year, the National Telehealth Center celebrated the 10th Anniversary of CHITS, or Community Health Information Tracking System. CHITS is an electronic medical record, which utilizes an open-source software, that aims to increase the efficiency of local health centers and aid in the decision-making by improving their health information systems.
To quote Dr. Herman Tolentino, the project director of CHITS:
CHITS is a means to an end. My original vision is for CHITS to serve the health information needs of Philippine communities to improve community health. Where we need health information the most is where we don’t find it in its most useful form.
I was appalled seeing stacks of paper records back in the day just sitting in back rooms of health centers. This is like the concept of the inverse care law (1971 Lancet article by Julian Tudor Hart), but for health information, it seemed to me an insidious social injustice. The metaphors we used back in the day like “bayanihan” for managing health information stemmed from the idea of creating a health information revolution, a bottom up approach, that I was hoping would be complemented with top-down approaches (e.g., policy development, governance, standards, a national infrastructure) that would address this social injustice.
CHITS is about empowering community health workers and community members to use health information to serve local needs. The “bayani” metaphor also lends itself well to what implementing CHITS requires – a transformation in the hearts and minds of the people who are implementing it, so that they, in turn can transform the landscape. Without this change in hearts and minds, CHITS will fail as an intervention. As Gandhi said, be the change you want to see in the world.
Below is an infographic that shows the history of CHITS, from its first implementation at Elvira Lagrosa Health Center in Pasay City on May 10, 2004: