Field Health Services Information System

Reference

Nies, M., McEwen, M. (2020). Field Health Service Information System. In Community and Public Health Nursing (2nd Philippine ed., pp. 403-411). C&E Publishing, Inc.

A Health Information System (HIS) has four primary functions: data generation, compilation, analysis & synthesis, and communication & use. This system collects data from the healthcare and other pertinent sectors; analyzes gathered data; ensures overall data quality, relevance, and timeliness; and, converts the data into information imperative for health-related decision-making (WHO, 2008b).

The Field Health Services Information System (FHSIS) is the HIS utilized in the Philippine context, serving as the official reporting and recording system of the Philippine Department of Health (DOH). It is a facility-based and data-generated system from the Barangay Health Stations (BHS) and Rural Health Units (RHU) to the national level. The current FHSIS (version 2012) primarily aims to:

1. Provide raw and summary data on health service delivery and selected health program accomplishment indicators;
2. Provide a standardized, facility-level data base for program monitoring and evaluation purposes.
3. Provide more evidence-based data for research purposes, policy formation and basis for health system interventions; and
4. Minimize documentation burden at the service delivery level in order to allow more time for patient care and health promotion activities.

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Components of the FHSIS

There are two primary types of tools utilized by the FHSIS:

1. Recording Tools: detailed, day-to-day, facility-based documents on the health services rendered to patients/clients in the rural health facilities.
2. Reporting Tools/Forms: summary data transmitted or submitted on a monthly, quarterly, and annual basis to higher organizational levels of the healthcare delivery system. These are based on the Summary Table (ST) and Monthly Consolidation Table (MCT) recording tools.

Recording Tools

1. Individual Treatment Record (ITR): the primary building block of the FHSIS. This is a basic patient consultation record containing a date, name, address of the patient, height, weight, chief complaint, presenting signs and symptoms, diagnosis (if available), and treatment. Examples of ITRs include immunization records or national tuberculosis program treatment record.
2. Target Client List (TCL): the secondary building block of the FHSIS. This is a list of eligible clients for a particular health program. It facilitates the monitoring and supervision of service delivery activities and determines the client’s compliance to a particular program. Health programs to be maintained under FHSIS version 2012 are: Prenatal Care, Post-Partum Care, Nutrition and Expanded Program for Immunization, Family Planning, and Sick Children. This tool provides a clinic-level data for population-based research.
3. Summary Table (ST): a form with 12 columns for a monthly tally of the number of clients in the barangay health facility in terms of health program accomplishments (all TCL data) and morbidity diseases.
4. Monthly Consolidation Table (MCT): a form filled up by the Public Health Nurse (PHN) to collate data report by all midwives of the city or municipality. It is essentially the output table of the RHU, consisting of the reported data per indicator by each Barangay Health Station or public health midwife. This record will serve as the source document for the public health nurse for the Quarterly Forms.

Reporting Forms

It will be important to memorize each report’s alias!

1. Monthly Forms:
   • Program Report (M1) contains selected indicators categorized as maternal care, childcare, family planning, and disease control; the same indicators found in the TCL and ST. This is report is submitted by the midwife.
   • Morbidity Report (M2) contains a list of all diseases by age and sex. This report is submitted by the midwife.
2. Quarterly Forms:
   • Program Report (Q1)
   • Morbidity Report (Q2)
3. Annual Forms:
   • Report on demographic, environmental, natality, and mortality. (A1)
   • Report on all diseases according to age and sex. (A2)
   • Report on all mortality cases or deaths according to age and sex. (A3)

Summary of Responsible Persons and Schedules for FHSIS Tools

Office	Person	Recording Tools	Reporting Tools	Schedule
BHS	Midwife	ITR, TCL, ST	M1, M2	Every second week of the succeeding month
		-	A-BRGY Form	Every second week of January
RHLI	PHN	ST, MCT	Q1, Q2	Every third week of first month of succeeding quarter
			A1, A2, A3	Every third week of January
PHOiCHO	Prov/City FHSIS Coordinator	-	Q1, Q2	Every fourth week of first month of succeeding quarter
			A1, A2, A3	Every fourth week of January
CHD	Regional FHSIS Coordinator	-	Q1, Q2	Every second week of second month of succeeding quarter
			A1, A2, A3	Every second week of March

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Standards of Documentation in Public Health

1. Contents of a medical record must meet all regulatory, accrediting, and professional organization standards. Some examples include nursing assessment and care provided; informed consent; teaching provided; response and reaction to teaching; etc.
2. Use black permanent ink for all entries.
3. Date, time, and sign all entries. Use first initial, last name and title.
4. Entries are to be legible with no blank spaces left on a line. If space is left on a line, draw a line through the space to the end of the line. Diagonal lines may be used for large spaces.
5. Strikethrough errors (like this), write ERROR, initial, and date the line. Do not erase, obliterate, or “white out” the error.
6. Entries are to be factual, complete, accurate, contain observations, clinical signs and symptoms, client quotes when applicable, nursing interventions, and patient reactions. Do not give opinions, make assumptions, or enter vague, meaningless statements e.g. “is a good parent”. Be specific.
7. Use correct grammar, spelling, and punctuation.
8. Write the client’s name and other identifying information on each medical record page.
9. Be sure to use only those abbreviations approved by your agency/facility.
10. Always record a client’s non-cooperative/non-compliant behavior.
11. Never document for someone else or sign another nurse’s name in any portion of the medical record.
12. Documentation should occur immediately after care given. Note problems as they occur, resolutions used and changes in client’s status.
13. When leaving messages, document time, name, and title of person taking message, and telephone number you called.
14. Record client assessment before and after you administer medications or other treatments.
15. Document any discussion of questionable medical orders, and the directions the physician gave. Include the time and date of discussion and your actions as a result of the discussion and consequent directions given.
16. Chart an omission as a new entry. Do not backdate or add to previously written entries.
17. When an unusual incident occurs, document the incident on a special incident or occurrence report form. Do not write “incidence report” filed in the medical record. Do write what happened to the client and actions taken to assure the client’s wellbeing in the medical record.
18. Record only your own observations, actions. If you receive information from another caregiver, state the source of the information.
19. Record the date, time, and content of all telephone client-related communications.
20. If you did not document it, it did not occur.