NUR 192 (CHN1- LECTURE

SESSION 17  The dose of BCG is 0.05 ml for children < 12

Mandatory Infants and Children Health Immunization Act of
months of age and 0.1 ml for children > 12 months
2011 / Expanded Program of Immunization of age
MANDATORY INFANTS AND CHILDREN HEALTH  Given at the earliest possible age after birth
IMMUNIZATION ACT OF 2011 preferably within the first 2 months of life
For healthy infants and children > 2 months who were not
Republic Act Number. 10152 given BCG at birth, PPD prior to BCG vaccination
 An act providing for mandatory basic immunization is not necessary. However, PPD is recommended prior to
services for infants and children BCG vaccination if any of the following is present:
 Congenital TB
The Expanded Program on Immunization (EPI)
 History of close contact to known or suspected
 was established in 1976 to ensure that infants/children
and mothers have access to routinely recommended infectious TB cases
infant/childhood vaccines.  Clinical findings suggestive of TB and/or chest x-
Over-all Goal: To reduce the morbidity and mortality among ray suggestive of TB In the presence of any of
children against the most common vaccine-preventable diseases. these conditions, an induration of ≥ 5mm is
considered positive and BCG is no longer
Specific Goal: recommended
 To immunize all infants/children against the most common
vaccine-preventable diseases;
In the presence of any of these conditions, an induration of
 To sustain polio-free status of the Philippines;
≥ 5mm is considered positive and BCG is no longer
 To eliminate measles infection;
recommended.
 To eliminate maternal and neonatal tetanus;
 To control diphtheria, pertussis, hepatitis b and German
Measles; B. Hepatitis B Vaccine (HBV)
 To prevent extra pulmonary tuberculosis among children. Given intramuscularly (IM)
Administer the first dose of monovalent HBV to all
Six preventable diseases were initially included in the EPI: newborns >2kgs within 24 hours of life.
 Tuberculosis A 2nd dose is given 1-2 months after the birth dose
 Poliomyelitis The final dose is administered not earlier than 24 weeks of
 Diphtheria age. Another dose is needed if the last dose was given at
 Tetanus age
 Pertussis
 Measles a. For infants born to HBsAg (+) mothers:
 Administer HBV and HBIG (0.5ml) within 12
Vaccines under the EPI are:
hours of life. HBIG should be administered not later
 BCG birth dose
than 7 days of age if not immediately available.
 Hepatitis B birth dose
 Oral Poliovirus Vaccine b. For infants born to mothers with unknown HBsAg
 Pentavalent Vaccine status:
 Measles Containing Vaccines (Anti-measles  with birth weight >2kgs, administer HBV within
Vaccine, Measles, Mumps, Rubella) 12 hours of birth and determine the mother’s
 Tetanus Toxoid HBsAg as soon as possible. If HBsAg (+),
 Pneumococcal Conjugate Vaccine 13 administer also HBIG not later than 7 days of age.
 with birth weight <2kgs, administer HBIG in
addition to HBV within 12 hours of life.

c. For preterm infants:

 If born to HBsAg (-) mothers and medically stable,
the 1st dose of HBV maybe given at 30 days of
A. Bacillus Calmette–Guérin (BCG) chronological age regardless of weight, and this ca
 Given intradermally (ID) be counted as part of the 3-dose primary series.

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d. For those <2 kgs, the 1st dose received at birth is not Vaccines for Special Groups for Pneumococcal Vaccine
counted as part of the vaccine series. Additional 3 HBV recommendation in high-risk children.
doses are needed.
F. Influenza Vaccine (Trivalent/Quadrivalent Influenza Vaccine)
Trivalent influenza vaccine (TIV)
C. Hemophilus Influenzae Type B Conjugate Vaccine (Hib)
 given intramuscularly (IM) or subcutaneously (SC)
 Given intramuscularly (IM)
 Given as a 3-dose primary series with a minimum Quadrivalent influenza vaccine (QIV)
age of 6 weeks and a minimum interval of 4 weeks  given intramuscularly (IM)
 A booster dose is given between 12-15 months of
age with an interval of 6 months from the 3rd Given at a minimum age of 6 months
dose.  The dose of influenza vaccine is 0.25 ml for children 6
months to 35 months and 0.5 ml for children 36
D. Diphtheria and Tetanus Toxoid and Pertussis Vaccine (DTP)  months to 18 years
 Given intramuscularly (IM)  Children 6 months to 8 years receiving influenza vaccine
 Given at a minimum age of 6 weeks with a minimum for the 1st time should receive 2 doses separated by
interval of 4 weeks  at least 4 weeks
 Complete a 5-dose series at ages 2, 4, 6, 15 through 18  If only one dose was given during the previous influenza
months, and 4 through 6 years. The recommended season, give 2 doses of the vaccine then one dose
interval between the 3rd and 4th dose is 6 months, but a  yearly thereafter
minimum interval of 4 months is valid  Children aged 9 to 18 years should receive one dose of
 The 5th dose of DTaP vaccine may not be given if the the vaccine yearly
4th dose was administered at age 4 years or older.  Annual vaccination should begin in February but may
be given throughout the year
E. Inactivated Poliovirus Vaccine (IPV)
 Given intramuscularly (IM)
 Usually given in combination with DTaP and Hib, with or
without Hep B
 Given at a minimum age of 6 weeks with a minimum
interval of 4 weeks
H. Measles Vaccine
 The primary series consists of 3 doses
 Given subcutaneously (SC)
 A booster dose should be given on or after the 4th
 Given at the age of 9 months, but may be given as early
birthday and at least 6 months from the previous dose
as 6 months of age in cases of outbreaks as declared by
public health authorities
 If monovalent measles is not available, MMR may be
given
F. Rotavirus Vaccine (RV)
 Given per Orem (PO) I. Japanese Encephalitis Vaccine (JE)
 Given at a minimum age of 6 weeks with a minimum  Given subcutaneously (SC)
interval of 4 weeks between doses. The last dose should  Given at a minimum age of 9 months
be administered not later than 32 weeks of age.  Children 9 months to 17 years of age should receive one
 The monovalent human rotavirus vaccine (RV1) is given primary dose followed by a booster dose 12-24 months
as a 2-dose series and the pentavalent human bovine after the primary dose
rotavirus vaccine (RV5) is given as a 3-dose series.  Individuals 18 years and older should receive a single
dose only
G. Pneumococcal Conjugate Vaccines (PCV)
 Given intramuscularly (IM) J. Measles-Mumps-Rubella (MMR) Vaccine
 Given at a minimum age of 6 weeks for PCV10 and PCV  Given subcutaneously (SC)
13  Given at a minimum age of 12 months
 Primary vaccination consists of 3 doses with an interval  2 doses of MMR vaccine are recommended
of at least 4 weeks between doses plus a booster dose  The 2nd dose is usually given from 4-6 years of age but
given 6 months after the 3rd dose. may be given at an earlier age with a minimum of 4
 Healthy children 2 to 5 years old who do not have weeks interval between doses.
previous PCV vaccination may be given 1 dose of PCV
13,or 2 doses of PCV 10 at least 8 weeks apart Refer to K. Varicella Vaccine
 Given subcutaneously (SC)

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 Given at a minimum age of 12 months Fully immunized is defined as 5 doses of DTP or 4 doses of DTP if
 2 doses of varicella vaccine are recommended the 4th dose was given on or after the 4th
 The 2nd dose is usually given at 4-6 years of age, but birthday
may be given earlier at an interval of 3 months from the
first dose. For pregnant adolescents
 If the 2nd dose was given 4 weeks from the first dose, it  Fully immunized
is considered valid.  Administer 1 dose of Tdap vaccine during 27 to 36 wks.
 For children 13 years and above, the recommended AOG regardless of previous Td or Tdap
minimum interval between doses is 4 weeks  vaccination

L. Hepatitis A Vaccine (HAV) Unimmunized: v

 Given intramuscularly (IM)  administer a 3-dose tetanus-diphtheria containing
 Given at a minimum age of 12 months vaccine (Td) following a 0- 1- 6-month schedule.
 2 doses of the vaccine are recommended  Tdap should replace one dose of Td given during 27 to
 The 2nd dose is given at least 6 months from the 1st dose 36 wks. AOG

M. Measles-Mumps-Rubella-Varicella Vaccine (MMRV)

 Given subcutaneously (SC)
 Given at a minimum age of 12 months
 MMRV may be given as an alternative to separately
administered MMR and Varicella vaccines
 The maximum age is 12 years
 The recommended minimum interval between doses is 3
month

N. Human Papillomavirus Vaccine (HPV)

 Given intramuscularly (IM)
 For ages 9-14 years, a 2-dose series is recommended
 Bivalent HPV (2vHPV), quadrivalent (4vHPV) or
nonvalent (9vHPV) given at 0 and 6 months
 If the interval between the 1st and 2nd dose is less than
6 months a 3rd dose is needed. The minimum interval
between the 2nd and 3rd dose is 3 months.
 For ages 15 years and older, a 3-dose series is
recommended.
 Bivalent HPV (2vHPV), quadrivalent (4vHPV) or
nonvalent (9vHPV) at 0, 2 and 6 months.
 The minimum interval between the 1st and the 2nd dose
is 1 month and the minimum interval between the 2nd
and 3rd dose is 3 months. The 3rd dose should be given
at least 6months from the 1st dose.
 For males 9-18 years of age, a 4vHPV and 9vHPV can
be given for the prevention of anogenital warts and and
cancer

O. Tetanus and Diphtheria Toxoid (Td) / Tetanus and Diphtheria

Toxoid and Acellular Pertussis Vaccine
(TdaP)
 Given intramuscularly (IM)
 For children who are fully immunized, Td booster doses
should be given every 10 years.
 For children aged > 7 years old, a single dose of Tdap
can be given and can replace due Td. It can be
administered regardless of the interval since the last
tetanus and diphtheria toxoid containing vaccine.
Subsequent doses are given as Td

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SESSION 18
Early Essential Intrapartum and Newborn Care, Newborn
Screening, Basic Emergency Obstetric and Newborn Care and
Comprehensive Emergency Obstetric and Newborn Care
Early Essential Intrapartum and Newborn Care
 practices are evidenced-based standards for safe and quality
care of birthing mothers and their newborns, within the 48
hours of Intrapartum period (labor and delivery) and a week
of life for
the newborn.
 A series of time bound, chronologically- ordered,
standard procedures that a baby receives at birth.
 Can prevent at least half of newborn death without
additional cost to both families and hospitals.

At the heart of the protocol are four time- bound interventions:

1. Immediate and thorough drying of the newborn
2. Early skin to skin contacts between mother and the newborn
 Hypothermia Infection
 Hypoglycemia
3. Properly timed cord clamping and cutting
 Clamp and cut the cord after cord pulsations have
stopped (typically at 1 to 3 minutes)
 Put ties tightly around the cord at 2 cm using cord
clamp and 5 cm from the newborn’s abdomen.
 Cut between ties with sterile instrument.

This prevents:
 Anemia
 Protects against brain hemorrhage in premature
newborn

4. Non-separation of baby from mother

Time bound:
 Within 90 minutes of age
Continuous non-separation
 for early breastfeeding which protects the infants from
infection.

Early Essential Newborn Care within 90 minutes to 6 hours of life

Nursing Intervention:
 Give a single dose of Vitamin K 1mg (IM route)

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 Inject hepatitis B and BCG vaccinations at birth

 Record.
 Thoroughly examine the baby. Weigh the baby and Results available:
record.  Seven (7) working days from the time the newborn
 Check for birth injuries, malformations or defects. screening samples are received.
 Laboratory result indicating an increased risk or of a
heritable disorder (i.e. positive screen) shall be
immediately released, within twenty-four (24) hours
Newborn Screening followed by confirmatory testing can be immediately
 is a public health program designed to screen infants done.
shortly after birth for a list of conditions that are
treatable but not clinically evident in newborn period. Secondary Test:
Goal:  An abnormal finding on newborn screening test is not
 Early Detection of children at increased risk for diagnostic of a disorder.
selected metabolic or genetic diseases so that medical  Additional tests should be performed to substantiate the
treatment can be promptly initiated to avert metabolic original finding.
crises and prevent irreversible neurological and  Also, the original specimen is retested for the analysis
developmental sequelae. that is abnormal.

Components of NBS:
a. Education: Professionals, parents and policy makers
b. Screening: Collection activities, Specimen delivery, Laboratory
testing and Result reporting
c. Early Follow-up:
d. Diagnosis:
e. Management: Medical management, Long term follow-up,
Specimen mgt
f. Evaluation:

Cardinal Principles of Screening:

 The disorder has a relatively high incidence so that the cost
per diagnosed individual is reasonable
 An effective and not overly expensive treatment is
available.
 A relatively inexpensive screening test that is suitable for
high volume testing (preferably automatable)
 The screening test has a very high sensitivity (very low
false negatives) and high specificity (low false positives
which require expensive follow-up)
Specimen Collection:
 Blood specimen is obtained from heel of infant should be
obtained from medial or lateral side of the heel

Timing of Collection:
Normal Term Newborn:
 Before nursery discharge or 3rd day of life whichever is
earlier.

Preterm or LBW:
 2 weeks of age or at discharge whichever is earlier
 Newborn who is to receive blood transfusion. One
specimen collected before transfusion & second
specimen 2 days after transfusion

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consist of the core district hospital. For geographically

isolated/disadvantaged areas/ densely populated areas, the
designated BeMONC facilities are the following:
 Rural Health Unit,
 Barangay Health Station,
 Lying-in Clinics and Birthing Homes.
 Accessibility within 1 hour from residence or referring
facility within the ILHZ (Inter-local Health Zones)

 Shall operate within 24 hours with 6 signal obstetric

function.
 Shall have access to communication and transportation
facilities to mobilize referrals.
 Staff composition:
 Medical Doctor
 Registered Nurse,
 Registered Midwife.

Comprehensive Emergency Obstetrics and Newborn Care facility

 Refers to lifesaving services for emergency maternal and
newborn conditions/complications as in Basic
Emergency

Obstetric and Newborn Care plus

 the provision of surgical delivery and blood bank services
and other specialized obstetric interventions

Signal Functions
1: Administer Parenteral Antibiotics
 Puerperal sepsis accounts for 8% of global maternal deaths
and 33% of maternal death
 Effectively managed with injectable antibiotics
 IV Penicillin G 2MU every 6 hours
 Plus, Gentamicin 5 mg/kg body weight IV every 24 hours
 Plus, Metronidazole 500mg IV every 8 hours

2: Administer Uterotonic Drugs

 Postpartum hemorrhage accounts for 15% of global
maternal deaths Up to 33% of maternal deaths
 Effectively managed through active management of third
stage of labor (AMTSL)
 IM oxytocin within 1 minute of delivery

3. Administer Parenteral Anticonvulsants

 Severe pre-eclampsia and eclampsia account for 10% of
global annual maternal deaths.
 Hypertensive disorders account for 35% of maternal deaths
in Kenya. *
 Effectively managed through use of parenteral
anticonvulsants
Basic Emergency Obstetric and Newborn Care
 It refers to lifesaving services for emergency maternal
4: Manually Remove Placenta
and newborn conditions/complications being provided
by a health facility or professional

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 Retained placenta: A major cause of postpartum

hemorrhage and puerperal sepsis – both leading causes COMPONENTS OF ENVIRONMENT:
of Maternal mortality The environment is consisting of different several factors which is
 Managed through manual removal of the placenta; responsible for good health and environment. T
requires elbow-length sterile gloves he component which is consist of good environment is are as
follows:
5: Remove Retained Products of Conception 1.Physical environment.
 Complications from abortion account for 15% of global 2.Biological environment.
annual maternal deaths. 3.Social environment
 Managed effectively through manual vacuum aspiration
or medical evacuation using misoprostol ENVIRONMENTAL HEALTH:
 Postabortion care provides an opportunity to prevent  According to W.H.O, “the control of all those factors in
further unplanned pregnancy by promoting man’s physical environment which exercise or may
contraceptive use. exercise harmful effect on his physical development,
health and survival.
6: Perform Assisted Vaginal Delivery
 Obstructed labor accounts for 6% of maternal deaths. IMPORTANCE OF ENVIRONMENTAL HEALTH:
 Assisted vaginal delivery, using forceps or vacuum  Factors which influence sustainable growth in the of the
extraction, when done appropriately, can avert community are:
unnecessary hospital referral and caesarian delivery. 1. Migration (Masons).
 Human migration is the movement of individuals and
7: Perform Basic Neonatal Resuscitation families from one place to another in search of
 Perinatal asphyxia is a leading cause of child mortality, employment, food, shelter and better living conditions.
accounting for 11% of global under-five deaths Members in certain occupations like masons, semi-skilled
annually.* masons, laborers, painters, plumbing workers, carpenters
 Severe forms are associated with serious long-term and others migrate from one place to another. Migration
complications. may be temporary or a permanent arrangement in
search of jobs and better wages depending on the
 Effective newborn resuscitation can reduce morbidity
individual’s interest. There are a number of economic
and mortality associated with perinatal asphyxia.
activities related to sanitation which can result in the
economic growth of the local community, thus possibly
8: Perform Caesarean Delivery
reducing migration.
 Caesarean section is a life-saving procedure required
when vaginal delivery places the life or health of the
2. Organic Farming through urine and feces:
mother or baby at risk.
 Farming, with the use of natural fertilizers, has been
 it is the first of two additional signal functions required
practiced by our ancestors for thousands of years. The
in facilities designated to provide CEmONC.
developments after the 18th century have led to use of
chemical fertilizers and pesticides along with hybrid crop
varieties and genetically modified crops, which have now
become common agricultural practice. Usage of chemical
fertilizer and pesticide results in decreased crop production,
loss of soil fertility, water contamination due to chemicals,
9: Provide Blood Transfusion
death of surface drinking water sources due to
 Blood transfusion is a life-saving procedure for women
eutrophication, ground water contamination from chemicals
suffering from postpartum hemorrhage – the leading
and loss of indigenous type of crop varieties all of which
single cause of maternal mortality.
lead to environmental degradation. All these factors at
 Facilities providing CEmONC are required to provide global level have diverted the interest of individuals,
blood transfusion. scientists, researchers and practitioners to shift from
chemical fertilizers to organic fertilizers. Human feces and
SESSION 20 urine have high levels of NPK (Nitrogen, Phosphorus and
Environmental Sanitation, Sanitation Potassium).
Code, Clean Air Act
3. Health Cost:
Environmental sanitation
 Sustainable environmental sanitation practices, safe
 is that branch of public health that is concerned with the
drinking water supplies and proper waste management
control of all those factors in man’s surrounding’s or
systems result in reducing money spent on ill health
physical environment which may have a bad effect on
caused due to poor access to sanitation.
human health and well - being.

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4. Clean Environment:  Refuse and garbage disposal

 The environment comprises of both living and non-  Excreta disposal
living organisms. Our environment is becoming  Insect vector and rodent control
increasingly polluted due to various reasons. An  Housing
important cause for environmental contamination is poor  Air pollution
sanitation facilities. Ensuring a proper solid and liquid  Noise
waste management system and ensuring a 100% open  Radiological Protection
defecation free status results in a sustained clean
 Institutional sanitation
environment.
 Stream pollution
LEVEL OF ENVIRONMENTAL SANITATION:
6Fs proposed by Sanitation and Hygiene Promotion Programing
1. Sanitation at house hold:
Guidelines that form part of the means to transmit
 Good quality housing is a key element for ensuring a
microorganism in fecal materials to a new host namely:
healthy community.
1. Fingers
 Poor housing can lead to many health problems and is
2. Fluids
associated with infectious diseases as-TB etc.
3. Flies
 Everyone should therefore have associated to good 4. Fields/Floors
quality housing and home environment. 5. Food

2. Sanitation Community Level: Implemented barriers to prevent the spread of pathogens:

 Good health is not merely the absence of disease. A. Primary barriers
 Take proper waste disposal.  are structures and facilities that prevent the fecal
 Avoid waste from water source. contaminations of 6Fs
 Avoid the high noise and remove the source of
pollutants. B. Secondary barriers
 are practices that prevent 6Fs from coming in contact
with food or the new host.
 It includes but are not limited to, handwashing
practices, insects and vermin control, water treatment,
Sanitation Code and proper food handling.
Code on Sanitation of the Philippines (Presidential Decree 856) –
Empower the Department of Health with the Clean Air Act
following powers and functions: Undertake the promotion and Clean Air Act (R.A.8749)
preservation of the health of the people and raise the health  the government's measures to reduce air pollution and
standards of individuals and communities throughout the incorporate environmental protection into its
Philippines. development plans.

Sanitation Code of 1976 (Presidential Decree 856) Air Pollutant

 define as the hygienic and proper management,  is defined by DENR, as any matter in the atmosphere
collection, disposal, or reuse of human excreta (feces and other than the natural concentrations of oxygen,
urine) and community liquid waste to safeguard the nitrogen, water vapor, carbon dioxide, and inert gases
health of individuals and communities. that may be detrimental to health or the environment.
Sanitation
 refers to public health conditions related to clean Two major sources of air pollution identified by Clean Air Act
drinking water and adequate treatment and disposal of 1. Mobile source
human excreta and sewage.  Any vehicle /machine propelled by or through oxidation
Objective: or reduction reactions.
 Directing public health services towards protection and  Constructed or operated conveyance of persons.
promotion of the health of the Filipinos.  Transportation of property or goods that emit air
pollutants as a reaction product.
Environmental Sanitation Code Composition:
 The study of all factors in man’s physical environment, 2. Stationary source
which may exercise a deleterious effect on his health,  refers to any building or fixed structure, facility, or
well-being and survival.
installation that emit air pollutants as a reaction
Includes:
product.
Water sanitation
 Food sanitation

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Occupational safety and health are a discipline with a broad

scope involving three major fields:
1. Occupational Safety deals
 with understanding the causes of accidents at work and
ways to prevent unsafe act and unsafe conditions in any
workplace. Safety at work discusses concepts on good
housekeeping, proper materials handling and storage,
machine safety, electrical safety, fire prevention and
control, safety inspection, and accident investigation.
2. Occupational Health
 is a broad concept which explains how the different hazards
and risks at work may cause an illness and emphasizes that
health programs are essential in controlling work-related
and/or occupational diseases.

3. Industrial Hygiene
 discusses the identification, evaluation, and control of
physical, chemical, biological and ergonomic hazards.
The way by which the occupational health team could classify
occupational health concerns in workplace is to identify
SESSION 21 Health Hazard
 are the elements in the work environment that can cause
School Occupational Safety and Health
work related diseases to the worker.

Safety Hazard
 are the unsafe conditions or unsafe acts that
School Health refers to a state of complete physical, mental, social
significantly increase the risks of a worker to be injured
and spiritual well-being and not merely the absence of disease or
infirmity among pupils, teachers and other school personnel
Identified health hazard in the workplace as follows:
Biological infectious hazards:
School Health Service
 infectious biological agents such as bacteria, virus,
 refers to need based comprehensive service rendered to
fungi, or parasites transmitted via contact with infected
pupils, teachers and other personnel in the school to
clients or coworkers and contaminated materials.
promote, protect their health, prevent and control
disease and maintain their health.
Chemical hazards
 various forms of chemical agents, including medications,
AIM OF SCHOOL HEALTH SERVICES:
solutions, gases, that interact with body tissues and cells
The ultimate aim of school health service is to promote, protect
and are potentially toxic or irritating to body system
and maintain health of school children and reduce morbidity and
mortality among them.
Enviromechanical hazards
 factors encountered in work environments that cause
PRINCIPLES OF SCHOOL HEALTH SERVICES:
accidents, injuries, strain, or discomfort (e.g., poor
 Planned in coordination with schools, health personnel,
equipment, or lifting device, and slippery floors)
parents and community people.
 A school health council needs to be set up. Be based on
Physical hazards
health needs of school children.
 agents within work environments such as radiation,
 Emphasize on preventive and promotion aspect. Be a part
electricity, temperatures and noise that can cause tissue
of community health services.
trauma through transfer of energy from these sources.
HEALTH PROBLEMS OF SCHOOL CHILDREN:
Psychosocial hazards
These are:
 factors and situations encountered or associated with
 Malnutrition
the job or work environment that create stress,
 Infectious diseases emotional strain, or interpersonal problems.
 Intestinal parasites
 Disease of skin, eye and ear
 Dental caries

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 To provide clinical support

 To overcome geographical barriers, connecting users
SESSION 22 who are not on the same physical location
 It involves the use of various types of ICT.
New Technologies Related to Public and
 Its goal to improve health outcomes.
Health Electronic Information
eLearning
iClinic System
 Essential in health promotion and maintenance, can be
 supports the functions of a clinic, i.e., barangay health
facilitated by ICT.
station, rural health unit, or other health care facility
that is devoted to providing primary health care service
of patient. Benefits on using iClinic Systems
 Provides a systematic way to manage patient records 1. Efficiency Gains
and generates standardized reporting requirements  Enhanced health workforce productivity in retrieving
both at the local and national level. patient information, record keeping, administration and
referrals
Integrated Hospital Operations and Management Information 2. Improved Quality of Care
System (IHOMIS)
 Reduced instances of medically avoidable adverse events
 is a windows based computerized hospital information
 Improved ability to monitor compliance to medications
system for government hospitals.
and other treatment regimes
eHealth Vision By 2020
3. Improved Operations Planning and Management
 Will enable widespread access to health care services,
 Improved access to quality data to inform healthcare
health information, and securely share and exchange
service and workforce planning and development.
patients ’ information in support to a safer, quality health
care, more equitable and responsive health system for all
4. Improved Health Monitoring & Reporting
the Filipino people by transforming the way information is
 Track patients’ data over time
used to plan, manage, deliver and monitor health services.
 Monitor how patients measure up to certain parameters
Technology Improved Public Health by Means of: like vital signs (e.g. blood pressure readings, respiratory
rate readings), vaccinations, and others
 Better equipment has allowed doctors to provide more
 Identify patients who are scheduled for visits
comprehensive care.
 Better treatments have increased the quality of life of a  Improved ability to support surveillance and
number of different people suffering from long-term management of public health interventions
illnesses.  Improved ability to report and analyze health outcomes
 Better medicine has completely wiped out the fear of
some life-threatening illnesses of the past. 5. Innovation & Growth
 Use of health data standards comply or conform to
Public Health Changing Electronic Records Data Registries national requirements
Electronic health records (EHRs)  Complies to DOH health data reporting requirements
 can improve public and population health outcomes. By (e.g., FHSIS, disease registries and surveillance,
efficiently collecting data in a form that can be shared inventory) PhilHealth reporting requirements
across multiple health care organizations and leveraged (TSeKAP)
for quality improvement and prevention activities, HER  Other government agency reporting collaboration
scan: Improve public health reporting and surveillance. Increased opportunity for continuing innovations

Using E-Health in the Community:

Universal health care and ICT (known as Kalusugan
Pangkalahatan)
 To attain efficiency by using IT in all aspects of health
care.

Electronic medical records (EMRs)

 Are basically comprehensive patient records that are
stored and accessed from a computer or server. iClinic System has two system status:
1. Online Status:
Telemedicine

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 It is highly recommended to use the online status. The

online status stores the data directly to the DOH Central
Office Server, therefore providing real-time information
as data is being entered.
 Data is always readily and available to authorized
iClinic system users anytime and anywhere they have
internet access

2. Offline Status:
 This status is designed for facilities that have limited
access or no access at all to an internet connection.
 It has the same features and functions with the online
status.
 Since the off-line status stores data locally, additional
system tools were added in automating the data
synchronization, extraction, uploading, and back up
which should be religiously and strictly done on a
regular basis.

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