Baguio Cent ral Universit y

St o. Niño Jesus Medical Cent er

No. 28 Lower P. Bu r gos, Bagu io Cit y 2600

I nform at ion and Com m unit y Healt h

In NCM 113: Com m u n it y Healt h Nu r sin g 2

Pr esen t ed t o:
Froilan Adaci, PhD
Clin ical Instr u ctor

Pr esen ted by:

Ban t iyao, Alju ne
Ben t res, Ezzle Lyn
Besas, Dian ar a
Dawey, Ju liu s
Golin gab, Shedy
Lavar ias, Alexan der
Mar t in , Kyan
Ment in , Reym ar
Nar ciso, Bern adet te
Pedr o, Laidy
Tan , Han s
BSN III-C2

Date of Su bm ission
 Information and Community Health
Definition of E-Health
 Is the Use of ICT(Information and communication technology) for health
(WHO).
EXTENSIVE CAPABILITIES OF ICT
 Communicating with a patient through a teleconference, electronic mail
(e-mail), short message service (SMS).
 Recording, retrieving, and mining data in brown pa The he an electronic
medical record (EMR).
 Providing patient teachings with the aid of based electronic tools such as
radio, television, especial computers, smartphones, and tablets.
According to the WHO, E-Health encompasses 3 MAIN AREAS:
 Delivering of health information for health professionals and health consumers.
 Using the power of IT and e-commerce to improve public health services.
 The use of e-commerce and e-business practices in health system
management.
Storage Retrieval Transmittal
 Storage an  How much time  Typically e-Health
electronic health does your staff applications use the
record (EHR) is a spend on retrieving Internet to transmit
digital version of a medical records for and store patient
patient's paper referred patients? data either for a
chart. EHRs are  How long does it provider or payer.
real-time, patient- take to receive a These e-Health
centered records comprehensive applications are
that make patient medical used by doctors,
information record, including hospitals, and
available instantly images, pathology, insurance providers
and securely to and all relevant to record patient
authorized users. information for a health information,
referred patient? called protected
health information
or PHI.

Power of Data in Information

 Nurses are knowledge managers. They constantly process raw patient data into
valuable information to deliver evidence-based and individualized interventions.
  Data are the fundamental elements of cognition and are defined as unanalyzed
raw facts that do not imply meaning. When meaning is attributed to data and
when data are processed and analyzed, then data becomes information.
Patient Information System can have the Following Benefits:
1. Data are readily mapped, enabling more targeted interventions and feedback
- Through a system that delivers real-time and accurate patient and community
information, healthcare providers are able to deliver patient-centered care and
targeted disease prevention and management programs.
- Health professionals can also track the frequency and locale of diseases in
real-time through EMR and Geography Information System (GIS) like the
Philippine Health Atlas of the Department of Health (DOH, 2012a). GIS
technology enables detailed maps to be generated with relative speed and
ease.
2. Data can be easily retrieved and recovered
- In the event of force majeure, retrieval of patient information is not a problem
since data are automatically backed-up periodically in a secure server.
3. Redundancy of data minimize
- Patient data that are frequently required in various health forms such as
unique identifying information (e.g., name, birthday, age, gender) need to be
recorded only once.
4. Data for clinical research becomes more available
- Quality data stored in data bases provides faster and more reliable research
outputs that may eventually be translated to health care innovations and
actual interventions.
5. Resources are used efficiently
- By making patient information more readily available, EMRs reduce costs
related to chart pulls as well as supplies needed to maintain paper chart.
Studies have also shown that having an EMR as opposed to a paper file can
result in reduced transcription costs through point-of-care documentation and
other structured documentation procedures.
Good Data Qualities
- The nursing process begins with obtaining data through assessing the
patient’s signs and symptoms. These data are interpreted by the health care
professional into useful information and a diagnosis. This is then followed by
necessary interventions and again ends with gathering new data from
evaluating the results. Without data, it will be difficult for a health professional
to assist the patient.
- In order for information to be valuable, data must have the following
characteristics:
A. Accuracy- This ensures that documentation reflects the event as it
happened. All values should be correct and valid. In a computerized
system, a computer can be instructed to check specific fields for
validity and alert the user to a potential data collection error.
 B. Accessibility- This is a data characteristic which ascertains data
availability should the patient or any member of the health care staff
need it.
C. Comprehensiveness- Data inputted should be complete. This is done
by making sure that all required fields in the patient’s record are
properly filled up.
D. Consistency/Reliability- Having no discrepancies in data recorded
makes it consistent.
E. Currency- All data must be up-to-date and timely. This is exemplified
when the community health nurse records data at the point-of-care
when it happened.
F. Definition- Data should be properly labeled and clearly defined.
E-Health Situation in the Philippines
 The ubiquity of Internet services in the Philippines creates a promising ground for
e-health access
 ICT has change how Filipinos access information and how the government has
utilized this to inform its citizenry. Examples of these include regular updates of
traffic conditions, current events, and critical weather reports through various
social media.
 The DOH has introduced a member of health information systems that aim to
improve the access of health data, such as the Electronic Field Health Service
Information System (DOH, 20212b), Online National Electronic Injury
Surveillance System (DOH, 20212c), the Philippine Health Atlas, and the Unified
Health Management Information System (DOH,2012d).

Factors Affecting eHealth in the Country

1. Limited Health Budget
 The budget allocation for Health care is relatively small. This is one of
many reasons advancements in eHealth are postponed. ICT projects
usually require a huge budget, take a long period to implement, and are
occasionally seen as risky endeavors.
2. The Emergence of Free and Open-Source of Software
 An emerging trend all over the world is the development and increasing
popularity of Free and Open Source Software (FOSS). In a nutshell,
FOSS makes the source code of a program freely available for everyone,
hence the name “open source”. Using the same recipe analogy,
Information on the ingredients is made accessible to the public, allowing
anyone to “cook something up”. This allows anyone with the knowledge of
the programming to contribute to the source code, improving the program
and sharing the improvement with everyone. To some extent, FOSS can
theoretically cut costs in developing the software. One example of a
successful FOSS for Health in the Philippines is the Community Health
Information Tracking System (CHITS).
3. Decentralized Government
  Under RA 7160 or the Local Government Code of 1991, Local
Government Units (LGUs) are autonomous, and therefore in control of
their own basic health services, including the budget. LGUs may develop
their own systems. These efforts have accelerated the development of
eHealth in the community Health. However, to maximize advantages
derived from these systems and to produce a nationwide impact, the
different Health information systems will eventually need to connect with
each other.
4. Target Users are Unfamiliar with the Technology
 EHealth is not only about technology. Along with software development
and hardware procurement, staff training and maintenance of the systems
are key factors in determining its effectiveness.
 No matter how technology advanced the tools are, the success of an
EHealth implementation will eventually depend on the end-users
willingness to learn and accept the technology.
5. Surplus of “digital native” Registered Nurses
 A term coined by educator and writer Marc Prensky (2001), digital native
describes a person who grew up and is familiar with digital technologies,
and who uses them in daily living. The entry of digital native nurses into
the profession and their nationwide deployment to communities may
potentially aid the implementation of various ICT projects in health care.

Using E-Health in the Community

 The major goal of community health nursing is to preserve the health of
the community. This is best achieved by focusing on health promotion and
health maintenance of individuals, families, and groups within the
community.
Electronic Medical Records
 EMRs are basically comprehensive patient records that are stored and
accessed from a computer or server. Community health centers have the
capacity to rapidly adapt EMRs because they utilize a standard process
nationwide. For example, the workflow with a patient at a health center in
Quezon City is basically the same as that of a health center in Batanes.
 EMRs are vital to community health centers is that each patient record is
usually used more frequently. For instance, a patient undergoing
treatment for tuberculosis needs to make regular visits to the health center
for TB-DOTS (Tuberculosis Directly-Observed Treatment Short course).
Community health centers make health care services available to families,
enabling the community health worker to observe familial predispositions
 to certain diseases and provide appropriate health promotion and
prevention measure.
Telemedicine
 The WHO defines telemedicine as, “the delivery of health care services,
where distance is a critical factor, by all health care professionals using
information and communications 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”.
 The Philippines, the UPM-NTHC has been using telemedicine to provide
health services to remote and underserved areas of the country since
2004. It is a partner of the DOH in the Doctors to the Barrios programs. It
enabled Municipal Health Officers to teleconsult difficult cases with trained
telehealth medical specialists via SMS or e-mail. The teleconsults, which
are received by a server, are then triggered by the NTHC telehealth
nurses to appropriate medical specialists.
E-Learning
 Learning is basically the use of electronic tools to aid in teaching. It can be
done synchronously, asynchronously, or in a combination of both. This
can be in the form of simple instructional videos and information text
blasts to social network help group sand interactive simulations.
ELearning can be especially useful in correcting misconceptions about
health and health care. It permits access to reliable information about
health. For example, control of communicable diseases frequently
requires community participation. With the use of eLearning technology,
community health nurses can elicit community interest by showing
instructional videos on measures to control a particular disease

Roles of the Community Health Nurse in e-Health

1. DATA AND RECORDS MANAGER
 Monitor the trends of diseases through the EMR.
 Allowing for targeted interventions for health promotion
 Disease prevention
 Curative services
 Rehabilitation
 Nurses also maintain the quality of data inputs in the EMRs, (accurate,
complete, consistent, correct, and current)
 Nurses also participate in regular data audits
2. CHANGE AGENT
 Working closely with the community and implementing eHealth with them
and not for them.
  Change agents do not force technology on the community, but inform and
guide the community in selecting and applying appropriate ICT tools.
 Change agent also collaborate with:
 Health leaders
 Policy makers
 Stakeholders and
 Other community health professionals
 To determine their knowledge and awareness on eHealth and appropriate
ICT tools.
 Nurses then build on the baseline eHealth knowledge and help develop
appropriate eHealth tools for the community.

3. EDUCATOR
 Nurses provide health education to individuals and families through ICT
tools (e.g., teleconference, SMS e-mail, and virtual/ simulated
environment)
 They may also participate in making eLearning videos on specific
diseases ( e.g., diabetes mellitus, tuberculosis), which the patients can
watch during their waiting time at health centers.
 Nurses may also use scheduled text messages to patients among the
catchment population to send important health information, reminders, etc.
4. TELEPRESENTER
 In the event that a patient needs to be referred to a remote medical
specialist through telemedicine, nurses may function as telepresneter
 This means that the nurse may need to present the patients’s case to a
remote medical specialist, noting salient points for case assessment,
evaluation, and treatment. This usually occurs via a teleconference
5. CLIENT ADVOCATE
 Community health nurses must safeguard patient records, ensuring that
security, confidentiality, and privacy of all patients information are being
upheld.
 The client must also be well informed about the benefits and challenges of
EMRs, telemedicine, and other e-Health tools.
 Nurses must ensure that personal and health information handling through
e-Health ( i.e., collection, storage, and transmission) is well explained.
 Clients must sign an informed consent, if necessary.
 Nurses must also guarantee that all eHealth interventions are performed
in a safe and ethical manner, making sure that personnel involved in e-
Health are competent and have received e-Health training/certification.
6. RESEARCHER
 Using e-Health tools (e.g., EMRs), patient records can easily be retrieved
and analyzed retrospectively by community eHealth nurses.
 They are responsible for identifying possible points for research and
developing a framework, based on data aggregated by the system
  An e-Health nurse researcher also pursues continuing nursing informatics
education, with the goal of developing a research framework which will be
beneficial to the community.

Current Trends in Public Health: Global and National

National Health Trends
1. Continued focus on addressing mental health issues (Jan. 12, 2024)
 Mental health challenges affect 15–20% of Filipinos, with 73% of Gen-Zs
reporting struggles. Social stigma and misconceptions about mental health
often prevent open discussions, while factors like family issues, financial
instability, and job insecurity worsen the situation.
2. DOH observing pertussis trends after increasing immunization (Apr. 2,2024)
 Pertussis cases in the Philippines have reached 862 cases as of March
23, 2024, with 49 deaths. 79% of cases are under 5 years old, with 66%
being unvaccinated or unaware of their vaccination history. Adults aged 20
and older make up only 4% of cases.
 Furthermore, the effects of increasing immunization efforts to stem the
outbreak may not be seen in the data until 4-6 weeks after they are
started.
3. Cardiovascular disease in the Philippines: a new public health emergency?
 The Philippine Statistics Authority (PSA) has revealed that heart diseases
are the leading cause of mortality in the country accounting for 114 557
cases or 18.4% of all fatalities.
 A 2023 data from PSA revealed the top three causes of death in the
country from January to December 2022 which are ischemic heart
diseases, neoplasms and cerebrovascular diseases.
4. PH still world’s most at-risk to disasters
 The Philippines remains the most at-risk country for extreme natural
events and climate change, according to the 2024 edition of the World
Risk Report. The report's World Risk Index, which includes all 193 UN
member states, evaluates disaster risks by assessing exposure to natural
hazards, population susceptibility, and coping capacities. The Philippines
ranked highest with 46.91 points.
Global Health Trends
1. Digital Health Integration
 Telehealth, a digital alternative to doctor visits, has seen a significant
increase in usage since the COVID-19 pandemic. Previously, only 25% of
physicians reported using telehealth in their practice, but it has tripled to
74% in 2022. Telehealth addresses nursing shortages and burnout,
making healthcare services more accessible to underserved communities
and addressing underfunding in public health and healthcare.
2. Global Health Security
  The political aspect of healthcare is constantly changing, with global
health security often overlooked in international relations. The World Bank
funds countries' educational and healthcare systems, but public health
collaboration is lacking. The Global Health Security Index shows 70% of
countries have insufficient health capacity and only 25% have updated
health workforce strategies.

3. Mental Health Awareness

 Health equity is a key trend in public health, aiming to ensure every
individual has a fair opportunity to achieve high health. Technology, a key
component of healthcare, has contributed to health disparities,
necessitating a comprehensive understanding of its impact on health
outcomes and strategies for promoting equitable access to digital health
resources. Telehealth services and online health information have
increased, but they also reveal significant gaps in technology access in
underserved communities.
4. Health Equity
 Health equity is a key trend in public health, aiming to ensure every
individual has a fair opportunity to achieve high health. Technology, a key
component of healthcare, has contributed to health disparities,
necessitating a comprehensive understanding of its impact on health
outcomes and strategies for promoting equitable access to digital health
resources. Telehealth services and online health information have
increased, but they also reveal significant gaps in technology access in
underserved communities.
5. Vaccine Development
 Indian startup Innovodigm creates Theroptach, a thermostable, painless
vaccine delivery patch, aiming to make vaccines more accessible, reduce
wastage, and promote equitable distribution of point-of-care diagnosis and
drug delivery.
6. Surgery & Public Health
 Startups are revolutionizing surgery with advanced technologies like
robotic systems, AI, tele-surgery, and virtual reality, enhancing patient
comfort, reducing recovery times, and enhancing skill acquisition in public
health management.
7. Precision Medicine
 Personalized medicine uses genomics and AI to tailor treatments to
individual patient profiles, identifying genetic variations and adjusting
therapies based on genetic makeup. This includes early interventions and
genetic risk assessments.

Role of a Community Health Nurse in the National and Global Health Care
Delivery System
National Healthcare Delivery System
1. Health Promotion and Education
 Conduct health education campaigns on hygiene, nutrition, family
planning, and disease prevention.
 Empower communities with knowledge to make informed health decisions.
2. Disease Prevention and Control
 Participate in vaccination programs and monitor communicable and non-
communicable diseases.
 Implement early detection and intervention strategies.
3. Primary Care Services
 Provide direct care in rural health units, barangay health stations, or
community centers.
 Administer treatments and assist in maternal and child health services.
4. Policy Implementation
 Support the execution of health initiatives and national programs such as
TB-DOTS, HIV/AIDS management, and nutrition programs.
5. Collaboration and Advocacy
 Conduct health assessments to identify community needs.
 Develop and implement action plans tailored to the community.
Global Healthcare Delivery System
1. Global Health Initiatives Participation
 Support international programs like immunization campaigns and
responses to pandemics (e.g., COVID-19, polio).
 Collaborate with global organizations like WHO, UNICEF, and Red Cross.
2. Health Equity Advocacy
 Promote equitable healthcare access across diverse populations,
especially marginalized groups.
 Address social determinants of health to reduce disparities.
3. Disaster and Emergency Response
 Provide care and coordinate relief efforts during global emergencies such
as natural disasters, outbreaks, or refugee crises.
 Train communities in disaster preparedness.
4. Cross-Cultural Competence
 Adapt healthcare practices to suit cultural norms in diverse global
contexts.
 Build trust and rapport in multicultural settings.
5. Research and Innovation
 Contribute to global health research on diseases, public health trends, and
sustainable practices.
 Share best practices to improve healthcare systems worldwide.
Delivery the Health Care to the Filipino Family and Community
Filipino Culture
  Araceli Maglaya, in her work on community health nursing, discusses Filipino
culture in the context of health beliefs, practices, and the overall lifestyle that
influence the delivery of healthcare in the Philippines. According to her, Filipino
culture plays a significant role in shaping health practices, and understanding
these cultural factors is essential for effective nursing care.
1. Family-Centered Care
2. Respect for Authority and Hierarchy
3. Health Beliefs and Practices
4. Communication and Language
5. View on Illness and Health
6. Health and Wellness
 Filipino culture in community health nursing involves recognizing the centrality of
the family, respecting hierarchy and authority, understanding traditional healing
practices, navigating indirect communication styles, and addressing a holistic
view of health. Nurses who are culturally competent and sensitive to these
factors can provide more effective and compassionate care.
Filipino Customs and Traditions
1. FAMILY ORIENTED CULTURE
 EXTENDED FAMILIES: Filipino families often include extended members, and
it’s common for children to live with their parents until marriage.
 Respect for elders: Using gestures like “mano” (placing an elders hand on ones
forehead) shows respect, and using titles like ‘’ ate ‘’( older sister and “kuya’’
(older brother) is a sign of respect for older siblings.
2. RELIGIOUS PRACTICE
 Catholic and festivities : Many filipinos are catholic, and celebrations like
christmas and holy week are widely observed
 Fiestas: almost every town celebrates a “fiesta” to honor their patron saint
with parades, food, and festivities.
3. HOSPITALITY
 Filipinos are known for their hospitality, welcoming guest warmly and
generously, often serving a spread of food.
4. TRADITIONAL CELEBRATIONS
 Bayanihan: This traditions involves community cooperations, such as
helping a family move their house to a new location, symbolizing unity and
team work.
 Harana and pamamanhikan: These are courtship and engagement
traditions. harana involves serenading a love one, while pamamanhikan is
a formal visit to the bride's family to ask for her hand in marriage.

5. FOOD CULTURE
 Filipinos often share meals and celebrate through food. Common dishes
include adobo, sinigang, and letchon. Food is central to gatherings and
celebrations.
6. RESPECT FOR TRADITION AND LANGUAGE
  “ UTANG NA LOOB” (debt of gratitude ): a sense of obligations to help
those who have helped you.
 “PAKIKISAMA” (social harmony) : This value emphasizes maintaining
harmony and good relationship, avoiding confrontation when possible.
7. TRADITIONAL CLOTHING
 BARONG TAGALOG AND BARO’T SAYA : These are formal garments
worn during significant event. the barong tagalog is for men, and the baro’t
saya is a traditional dress for women.