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. Health information system (HIS) that maintains “one person, one record” facilitates efficient provision of services for older persons (OP) and the use of HIS at the point of care have shown positive impacts on clinical processes and patient health in multiple settings of care.

Objective:

Objectives 1. To review the existing policies and guidelines related to health information system (HIS) for older persons (OPs) in the Philippines 2. To determine the proportion of select hospitals and health centers that conduct comprehensive geriatric assessment (CGA). 3. To describe the status and challenges related to health information system in select tertiary hospitals and health centers.

Methods:

The study utilized a cross-sectional study design. Data derived from the findings of the Focused Interventions for Frail Older Adults Research and Development Project (FITforFrail). A facility-based listing of services and workforce specific to geriatric patients was conducted in twenty-seven (27) tertiary hospitals identified as Geriatric Centers across all regions and sixteen (16) health centers within their catchment area. Policies and existing literature on HIS were also reviewed.

Results:

Based on the existing policies, there were multiple agencies involved in the provision of services for OP, with multiple records containing health information and status of OPs. There is no system to integrate or enable interoperability of data systems of OPs at primary, secondary or tertiary levels of care. Hence, a provider for an OP would be unable to access medical, social or insurance information in a single record. Geriatric syndromes including frailty, malnutrition, dementia, incontinence, polypharmacy, and others were not regularly reported as part of the National Health Data Dictionary. Furthermore, reporting based on age group classification is not uniform across facilities. Only 14 (52%) of the hospitals identified as Geriatric Centers while 4 (25%) of the health centers conduct CGA. All tertiary hospitals (27) and health centers (16) are able to maintain medical records of their patients. The tertiary hospitals have better registries on diseases such as CVD, stroke, heart attack, cancer, and mental disorders while health centers have better registries on risk factors such as hypertension, diabetes, but are also able to capture respiratory diseases and disabilities. The updating of databases is not regularly done. Reasons for this include inadequately trained personnel, limited offline facility based HIS, unstable internet connection, and technical issues.

Conclusions:

Current HIS for OPs are characterized by fragmentation, multiple sources of health information and inaccessibility. Barriers to achieving appropriate HIS for OPs include inability to update HIS in hospitals and health centers and lack of age group and disease standardization. A one-person, one-record electronic medical record system for OP is recommended to address their complex needs and extract data to inform policies and programs. Furthermore, the data on OP shall be disaggregated and analyzed across geographic and social parameters in order to identify gaps in programs and provision of services. Lastly, we recommend the conduct of CGA in all older persons and integrate it in the existing HIS in the country. Clinical Trial: Not applicable