The Computing And Information Systems

Published Date: 02 Nov 2017

Project Report

Submitted by

Siti Nur’afifah binti Sait

In partial fulfilment for the award of the degree of

BSc. in Internet Computing

Computing and Information Systems

Faculty of Business and Computing

May, 2013

Table of Contents

Section No.

Section Name

Page

Abstract

ii

Declaration

iii

Acknowledgment

iv

1

Introduction

1

ICT in Health Care

1

Intelligent Technology for Health Care

2

3.1

Web Based Technology

3

3.2

Mobile Android Technology

6

3.3

Near Field Communication Technology

6

4

Implementation of Technology

7

4.1

Mobile Android Technology Based Scheduling System

7

4.2

NFC Technology Based Queuing System

4.3

Web based Technology Based Confirmation System

5

Conclusions And Future Work

6

References

Lists of Figures

Section No.

Section Name

Page

Abstract

ii

Declaration

iii

Acknowledgment

iv

Abstract

The standard operating procedure (SOP) of outpatient clinic represents a complex structure system in healthcare are lacking in many ways. This critical component in this system includes appointment scheduling and outpatient waiting times, which are somehow time-consuming, and establish a great stress in both patients and operating staff. Many studies and technologies have adapted towards making an effective operation. However, these systems still got some drawbacks such as facilities towards prioritizations, no reminder system for patient appointments and no check-in system to alert outpatient staff. This paper describes the development of improving the performance which focuses on the critical components by introducing the technology of Near Field Communication (NFC) for automatic alert system for check-ins and prioritization; and simplified Android Mobile application for patient appointments. Refine standard of procedures, appointment reminders, adjustments in appointment procedures and automatic check-in system to monitor patients are some of the systems that can help in reducing outpatient waiting times and hence will reduce the incompetency, improve the quality and productivity of service provided, especially for outpatient clinic.

Keywords: NFC, Android, MySQL, Healthcare, ICT.

Declaration

I hereby declare that this Project Report does not incorporate without the acknowledgement of any material submitted for degree or diploma in any university; and to the best of my knowledge it does not contain any material previously published or written by another person accept where due reference is made in the text.

Date: [SITI NUR’AFIFAH SAIT]

Acknowledgement

Indeed, without the assistance of key individuals, I would not have been able to finish this project report. Thus, I must take time to send regards to those who have assisted in countless ways.

Firstly, I would like to thank my creator, Allah for giving me strength, knowledge and ability to have been able to pursue my dreams and blessing me by surrounding me with really special people.

Great thanks to the following people for their guidance and contributions towards the completeness of this project:

Miss Yeo Symey – Project Supervisor

Professor (Dr.) Suresh Sankaranarayanan – Associate Professor

Sir Syed Hassan Bilal, for teaching me the concept of Radio Frequency devices.

Musa bin Haji Pinne – Hearing Therapist, RIPAS Hospital, for contributing ideas and general operations in healthcare.

All CIS staff and all close friends from Bachelor Science in Internet Computing, who has supported me throughout this project.

Not forgetting, my dearest family who has giving me hopes and supports during rough times.

Introduction

Although healthcare provides appointment scheduling service, especially in the outpatient department, the number of patient waiting in for consultation still keeps on increasing and has never been empty. Much of the time spent waiting for their name to be called, often under conditions which does not permit the time being usefully occupied. This has been an agenda as it as well means a loss of working time.

The key components of outpatient management clinic are patient health records, appointment slots management and check-ins with prioritization order are all very crucial in order to maintain the overall level of healthcare organisation in the country. However, to aim the level of efficiency and effectiveness, there are certain areas which need a proper time management and quality performance. As such, most complaint issues recorded are the dissatisfaction in the length of time spent between patient arrival and actual starting time of consultation (Hitti, 2007). According to Clinic Audit (2012), Brunei Darussalam has recorded an average of 2,710 general cases in outpatient department with the mean waiting time of 58 minutes per sessions. Furthermore, it has been reported that appointments slots are not organise that patient are not able to schedule an appointment within a week or be changed into later date for more than once. Patients are dissatisfied by the inconveniencies and unavailable time of appointment slots, especially for patients with urgent needs. This is resulted from the lack of adequate information and managerial flow in standard operating procedure (SOP) which arises in delayed management of report updates, and an elevated delay in outpatient consultations.

Figure 1.1 describes the general patient flow through the outpatient services up to the moment of consultation (Cayirli & Veral, 2003). Typically, patient will contact the healthcare administrator to schedule an appointment and waits for any replies towards confirmations which usually takes days or even months (i.e. Access time). Once appointment is confirmed, patients must first fill in registration forms upon arrival. Then between registration process and consultation, the total patient waiting time is divided into

Patient’s earliness – Time recorded between early arrival and scheduled appointment time.

Internal waiting time – Period between scheduled time and the actual starting time of consultation.

Traditional System (Paper-based)

The current procedure in outpatient department is depending on first-come, first-served basis, whereby there are two ways of having a professional consultation:

Walk-in appointment where patients are required to fill in registration forms or presenting identification card to the registration staff which will then be given a less complex registration form. However, most of the time, this procedure is repeated for every outpatient visits. Hence, it will result in more paper-based forms and less organised management.

Scheduling an appointment beforehand in which patient has to call in, ask for any available dates and waits for the response from the administration staffs. In other cases, appointments are made by the doctors, only for patient with frequent monitor.

The average waiting time for walk-in patients yearly has increased to 45 minutes per patient. During these two procedures, there are no prioritization made and paper work needs to be done in order to register a visit (Hylton & Sankaranarayanan, 2012).

Following the challenges faced by the hospital staff, a great deal of work need to be done to handle a huge stack of patient files and records for health history, provider notes, appointment records, admission and discharge information, laboratory and radiology report information, index of summary and patient hospital visits. So taking these challenges, there has been a vast amount of technological advancement adapting the outpatient department aimed to refine the work flow of standard operating procedure (SOP).

ICT in healthcare

For the last two decades, Information and Communication Technology (ICT) has made such innovation that it becomes accessible to worldwide organisation and individuals, including healthcare industry. In the last few years, there are major improvements in healthcare industry to ensure the quality of performance and effective standards of medical care and services. Goldsmith (2000) stated that the Internet, in general, has a great impact in transforming both the structure and standard of procedures (SOP) of healthcare than any technology been adapted few years ago. However, due to the resistance associated from protecting the patient records confidentiality cease the full potential of Internet in healthcare.

Online registration and scheduling appointment has been one of the options for the patients to avoid the hassle of queuing and filling out registration forms. It also gives the advantage for administrator to monitor and easy searching of any medical records or personal information as it is available online. However, it becomes inefficient as the transfer of data can be in filtered and accessible online and hence, the risk of online hacking is very huge. In addition, prior to online registration and appointment scheduling, there has no advancement which provides any prioritization facility and so there is still a delay in entertaining them before they are being called for outpatient consultation. Last but not least, there is no reminder system on any platforms for appointments which has been confirmed by the healthcare administrators (Yi Wan and Yong Xu, 2011).

BruHIMS (Brunei Health Information System) has also made an attempt in acquiring the needs of healthcare management system by introducing an interactive scheduling for appointments and automatic transfer of prescription form from doctors to pharmacists. Moreover, the system also provides prioritization categories which are entered manually to the system. However, even though patient registrations are to be inserted onto a dedicated server, patient still required to fill in a complex registration forms. Appointment management are still be made manually, whereby patients have to called in to schedule an appointment.

In addition, with the realisation in collaborating ICT in healthcare, outpatient staffs are able to access to patient medical records, and making a quicker decision to lower the outpatient waiting times rate as it may reduce steps in procedures with consistent management.

Technology integrated in healthcare

It is now well recognized that Internet has not only connect people and data, but also objects in general. Radio Frequency Identifier (RFID) and Near Field Communication (NFC) are expanding significantly as they have been applied to various areas including healthcare industry (Wikipedia, 2012). According to 2012 World Economic Forum, many industries now rely on integrated information technology (IT) systems and infrastructure to monitor, control, manage and deliver their services (Briggs, P., 2012).

Based on the above statement, an "Application of Intelligent Agents in Hospital Appointment Scheduling System on Android handset" (Hylton, A. & Sankaranarayanan, S., 2012) was developed in order to eliminate the need of healthcare staff in performing similar tasks and admission activities repeatedly. The project aims to improve the speed of processing any unscheduled appointment and take prioritization level towards making an appointment into account. The system also provides a mobile appointment lists which facilitates in sending confirmations. However, it has also possessed some drawbacks as no alert and reminder system for patient or doctors towards upcoming appointments.

By combining technology and ICT for healthcare industry, this paper will focus on developing NFC Technology and Mobile Android Application which aims to refine the core management of Standard Operating Procedures (SOP) and is organised as follows: Section 2 discusses on describing the existing works and technologies which has impacted the healthcare industry, section 3 and 4 discusses about NFC technology and architecture of project system, section 5 discusses on data gathered in implementation of project and section 6 provides concluding remarks and future works.

Background Work

Before considering technology advancement for healthcare industry, we must understand what healthcare Standard Operation Procedure (SOP). It is a written set of instructions that healthcare staff should follow to complete a job safely, with no adverse effect on personal health or the environment, and in a way that maximizes operational and production efficiency. SOP in outpatient clinic includes registration procedure and appointment scheduling process, which currently paper-based. Files and patient’s health records are stored in physical storage, and will be transferred by nurses’ or administrator to the doctor’s office for consultation. This system is obviously inefficient and time-consuming, and the risk of misplacing records is transparent.

Registration process using paper-based system mostly requires patients to fill up the forms and submit to the registration table or they could simply place their identification card or appointment card in the box provided and wait for their name to be called. The question is what if the card is misplaced or taken by any unauthorised personnel? One of the issues being presented is that If patient’s records are not to be found or unregistered patient, the current admission staff will delay his/her consultation time. Based on the survey report in 2007 (LaGanga & Lawrence, 2008), the most complaint issues are the time spent in the waiting room and 19% of the patients complained that they could not get an appointment within a week time. In addition, thousands of patients’ appointments are changed to the later date for more than once (National Health Service Survey, 2012). Outpatient satisfaction with healthcare procedures was not only associated with waiting times but over one-third chose to not fulfil the appointment schedule as they expected to have to wait for long periods. This issue still remain a challenge to healthcare industry worldwide.

Applications

One of the applications being introduced is online scheduling and registering system (RegisterPatient.com). This is a 24 hours and 7 days per week system whereby healthcare administrator is notified automatically on upcoming appointments and registered patient via online system. It allows patient to complete registration forms at their own convenience without having to queue. Once it has been completed, the patient will be notifies with a map to the nearest healthcare facility. However, there are some consequences towards this system. Firstly, registration required patients to fill in important data such as credit card number, identification card number and etc. Since the system is web-based, these numbers can be hacked by impersonation of websites. Secondly, most of the online registration and scheduling appointment system requires payment to the provider per month. Third, online scheduling system are only limited to less diagnosed symptoms such as abdominal pains, nausea, vomiting, diarrhoea and etc. So if there are symptoms which are not included on the list, patient has to call in for any available appointment slots and wait for confirmations. For such cases of emergency and urgent need of consultation, this inefficiency may lead to problems for both patients and healthcare staff. Finally, this system does not provide any prioritisation towards scheduling the appointments.

NFC Technology

Types of NFC tags

Radio Frequency

Application Frameworks

Major Features

Architecture and Design

Application

Near Field Technology

Mobile Android Application

Web Application

Usability

Initial User-Interface design process

An Iterative Design Example

Final User-Interface Application Design

Conclusions and Future Works