JMIR Publications

ABSTRACT

Background:

The rapid aging of the world’s population requires systems that support health facilities provision of integrated care at multiple levels of the health care system. The use of health information systems (HIS) at the point of care has shown positive effects on clinical processes and patient health in several settings of care.

Objective:

We sought to describe the health information systems for older persons (OPs) in select government tertiary hospitals and health centers in the Philippines. Specifically, we aimed to review the existing policies and guidelines related to HIS for OPs in the country, determine the proportion of select government hospitals and health centers with existing health information specific for OPs, and describe the challenges related to HIS in select health facilities.

Methods:

We utilized the data derived from the findings of the Focused Interventions for Frail Older Adults Research and Development Project (FITforFrail), a cross-sectional and ethics committee-approved study. A facility-based listing of services and human resources specific to geriatric patients was conducted in purposively sampled twenty-seven (27) tertiary government hospitals identified as Geriatric Centers and sixteen (16) health centers across all regions in the Philippines. We also reviewed the existing policies and guidelines related to HIS for OPs in the country.

Results:

Based on the existing guidelines, multiple agencies were involved in the provision of services for OPs, with several records containing health information of OPs. However, there is no existing HIS specific for OPs in the country. Only 14 (52%) of the hospitals while 4 (25%) of the health centers conduct comprehensive geriatric assessment (CGA). All tertiary hospitals and health centers are able to maintain medical records of their patients and almost all, 26 (96%) hospitals and all health centers, 16 (100%) have data on top causes of morbidity and mortality. Meanwhile, the presence of specific disease registries varied per hospitals and health centers. Challenges to HIS include inability to update databases due to inadequately trained personnel, use of an offline facility based HIS, unstable internet connection, and technical issues and non-uniform reporting of categories for age-group classification.

Conclusions:

Current HIS for OPs are characterized by fragmentation, multiple sources, and inaccessibility. Barriers to achieving appropriate HIS for OPs include inability to update HIS in hospitals and health centers and lack of standardization by age group and disease classification. Thus, we recommend a one-person, one-record electronic medical record system for OPs and the disaggregation and analysis across demographic and socio-economic parameters to inform policies and programs that address the complex needs of older persons. The conduct of CGA as a required routine procedure in all older persons and its integration to the existing HIS in the country is also recommended. Clinical Trial: Not applicable