RevisionPaper (Capstone)
RevisionPaper (Capstone)
By:
Codeno, Denalyn H.
Baloran, Joshua B.
Eustaquio, Gina C.
Sampayan, Efren B.
Umayam, Frances C.
June 2023
Chapter 1
INTRODUCTION
To address the need, this study aims to develop a project “Medical Information
Management System” for Nolasco Memorial Hospital to be used by the hospital
management. The project would ensure that relevant data and information of patients are
collected, stored and accessed systematically. It shall enable MIMS procedures to be done
This part presents the literatures and studies from foreign and local researches as well
as related readings, which bearings on the research.
A study by Dhull and Singla (2016), found that HIMS helps to improve the quality of
patient care by providing accurate and timely information. It also improves communication
between departments, reduces errors, and saves time.
In a study conducted by Villanueva et al. (2020), the authors assessed the effectiveness
of HMIS in improving the quality of healthcare services in a tertiary hospital in the
Philippines. The study found that the implementation of HMIS has improved the quality of
healthcare services, including patient safety, clinical outcomes, and patient satisfaction.
In another study by Roque and Barrameda (2019), the authors evaluated the impact of
HMIS on the hospital management process in a government hospital in the Philippines.
The study found that the implementation of HMIS has significantly improved the hospital
management process, including patient registration, appointment scheduling, and billing
processes.
It says that this study shows the system and information quality are significant factors
influencing perceived ease of use of HIS, while information and service quality are the key
factors affecting perceived usefulness of HIS. Results indicate that perceived usefulness
and perceived ease of use significantly affect HIS acceptance (R2=0.545) from the
physician's perspective. The findings of this study can help the managers understand the
key considerations affecting HIS development and use and provide important reference
material for system improvement, (Chen et al., 2016).
Khalifa and Abdelrazek (2019), concluded that HIMS can improve the quality of care,
reduce medical errors, and increase patient satisfaction. It also enhances resource
utilization, reduces costs, and improves decision-making.
A study by Marasigan and Ferrer (2019), assessed the factors influencing the adoption
of HMIS by healthcare providers in the Philippines. The study found that factors such as
perceived usefulness, ease of use, and compatibility with existing systems had a significant
impact on the adoption of HMIS.
According to Fernando (2022), this study had emphasized the critical aspects of the
digital healthcare and its application in healthcare settings. The current state and the issues
and challenges associated with the technologies were also identified in this study. It was
also found that they are still relatively new, with issues still focused on accuracy, design,
and security and privacy. Nevertheless, the good thing about the issues and challenges in
digital healthcare is that they can be managed and resolved by several emerging
technologies: security and privacy through blockchain and cloud computing, accuracy
through the use of AI techniques, and lastly, design through the use of UI/UX, and
progressive web applications (PWAs). And with already a variety of types, it is essential to
note that implementing the tools in digital healthcare is not anticipated to replace medical
professionals but instead to complement the existing systems through support in the
medical interventions.
K. Klassen (2015), it is shown that, in general, appointment slots should be shorterand pushed later in
the session. Conversely, as interruptions rise, appointments in the middle of the session should be
longer. The purpose of this paper is to design appointment systems that reduce waiting
times ofthe patient while maintaining utilization of the physician at a high level. In this article, a system
that reduce waiting times of the patient while maintaining utilization of the physician at a high level.
In this study, Bukenya et al. (2021), sought to assess the different records management
practices at the Masaka Regional Referral Hospital. The objectives of the study were: to
find out the existing infrastructure for the management of patient medical records, assess
how medical records management affects the quality of health service delivery at the
Hospital, assess the availability of capacity for electronic records management in terms of
human resources. The findings showed that the Masaka Regional Referral Hospital uses
manual records management system in the creation, maintenance and usage of records as
well as retrieval and disposal of medical records. The study also discovered that the time
spent in the retrieval of patient folders was also long due to the manual nature of the
hospital records management system. The use of this electronic records management
system is believed to be efficiently and effectively promoting easy accessibility, retrieval
of patient medical records and allows easy communication amongst the healthcare service
institutions and healthcare providers.
Ardiani et al. (2022), it assessed that the Health Information System was developed
primarily to support the health management. This system used is more focused on a
computer-based information system supported by a medical record unit. Electronic
Medical Record is the use of information technology devices for collecting, storing,
processing and accessing data stored in patient medical records in hospitals in a data-based
management system that collects various medical data sources. In managing the health
information system, providing access to patient data in digital format, it is hoped that it
will make it easier for medical officers to track patient data from time to time, making it
easier to obtain patient health information. This serves to improve the quality of
comprehensive health services to patients and medical personnel in helping to provide
better health services. In the integrated patient health information system management
model, it must provide access to patient health information and allow the exchange of data
managed by several medical officers, patient data managers and other hospitals.
A study by Dacillo and Ermino (2019), examined the factors influencing the use of
HMIS by healthcare providers in the Philippines, the study found that factors such as
perceived usefulness, ease of use, and compatibility with existing systems have a
significant impact on HMIS adoption.
Estinar, et al. (2018) with the system created, the researchers were able to create a system that not only
allowed them to provide relevant health services, but the system created also acts as a platform to create,
store, and consolidate important medical data, which acts as a data backbone and have great use for future
clinical purposes. In relation to this study, acquiring valuable and timely data and processing them in order
to provide relevant health services seems to be an obstacle; so with the system created, the researchers were
able to create a system that not only allowed them to provide relevant health services, but the system
created also acts as a platform to create, store, and consolidate important medical data, which
acts as a data backbone and havegreat use in different kinds of businesses.
According to Ian Paul Valeza Alberto (2015) , Nowadays, most of the businesses and institutions are
still using an old system of recording, which is done manually. The staff/assistant are still experiencing an
old tradition of recording where it consumes more space, time, paper and other problem to find/store the
patient’s information. One of the most vital institution that need a computerized recording
are clinics. The clinic management system is divided into two, where the admin and user can be logged
in separately. The admin is the one that can add, delete and change about the user’s information and also
about the patient’s information. In relation to this article, recording data consumes space, time, paper and
other problems to find or store the patient’s information; one of the most vital institution that need a
computerized recording using systems.
Francis Donn T. Mendoza (2015), states that Manual Recording System provides an effective and
usefulway to record and deliver an efficient information system but it lacks the ability to auto-sort the
records. Other concerns are paper record which does not last permanently. The Clinic Management
System isdesigned to guarantee the removal of various problems or to eliminate the problem of redundancy
thatincreases the inefficiencies in data to be retrieved. In relation to this article, recorded data is
important and there are problems in manual systems which is dataredundancy and paper record
that does not last. Clinic management features the removal of those problems, Auto-sorting and
preservation of data.
Cortez, J. (2023), Health Information Systems (HIS) are vital in making or developing
the policies of health programs in the Philippines. The HIS is broadly defined as a system
that integrates data collection, processing, reporting, and use of the information necessary
for improving health service effectiveness and efficiency through better management at all
levels of health services. This study is conducted to visualize the current situation of the
health information system users in public health facilities in the Province of Bataan. It
endeavors to answer on how the health facilities in the Province are described based on
their report platform, the number of personnel, trained and untrained per facility, and the
needs of the facilities when it comes to the training of the encoders. The capability training
in each health information system used is proposed. In conclusion, the Province of Bataan
is supporting the implementation of the use of health information systems (HIS) by
designating encoders for every public health facility.
P. Handayani (2018), this study reviews the literature on the most important acceptance
factors associated with Hospital Information Systems (HIS) and related technologies based
on user groups’ perspectives (medical staff, hospital management, administrative
personnel, patient, medical student, and IT staff), which can assist researchers and hospital
management to develop suitable acceptance models to improve the quality of HIS.
In a study conducted by Cruz and Ebonia (2017), the authors assessed the impact of
HMIS on the quality of health care services in a private hospital in the Philippines. The
study found that HMIS implementation significantly improves the quality of healthcare
services, including patient safety, clinical outcomes, and patient satisfaction.
Zayyad and Toycan (2016), conducted a study on the challenges and benefits of HIMS
implementation in developing countries and found that while HIMS has many benefits. It
is used to facilitate the gathering of information and also to not consume time in obtaining
the patient's information.
Ahmadian, L. et al. (2014), Hospital information systems (HIS) are often implemented
to enhance the quality of care, as well as to improve the efficiency and safety of health care
services. However, there are various barriers for their successful implementation. This
study is to prioritize these barriers. The findings of the study revealed that lack of powerful
information networks, error in data entry, technical problems related to system design, lack
of organizational training, lack of users’ knowledge about system and working with it, and
negative attitudes of providers and patients toward systems are the most important barriers
of HIS implementation. Prioritizing of these barriers helps policy makers to decide what to
do when planning for HIS utilization.
Liang, C. et al. (2017), the relationship between a doctor and a patient plays an
important role in patient satisfaction with health-care services. It has become an important
and contentious issue in China’s health-care reform. This study uses service fairness as a
theoretical lens to investigate the influence an implementation of a patient-accessible
hospital information system (HIS) has on doctor–patient relationships and patient
satisfaction. The results of this study show that patient-accessible HIS promotes patients’
perception of service fairness, improves doctor–patient relationships, and increases patient
satisfaction.
Shaikh, B. T., & Rabbani, F. (2005), The health management information system
(HMIS) is an instrument which could be used to improve patient satisfaction with health
services by tracking certain dimensions of service quality. The objective of the HMIS
would be to record information on health events and check the quality of services at
different levels of health care. The importance of patient assessment is a part of the concept
of giving importance to patient's views in improving the quality of health services.
Expected benefits include enhancing patient satisfaction through improved
communication; greater provider sensitivity towards patients; enhanced community
awareness about the quality of services; and overall better use of services in the health
system.
To the recent research conducted by Zaid Nasralla (2013), from the Universityof Leeds,
the use of new and emerging technologies in fields of telecommunication has been widely
used in healthcare sectors. The Electronic Patient Record Management System (EPRMS) is
a system which had acentralized database that contains the patient records including the
basic personal information, department lies-in, physician, doctors, tours, treatment and lab
results.
Adler-Milstein (2013), stated that the potential benefits of using IT in the healthcare
field, including efficiency and quality gains, will only be possible if the hospitals and
clinics promote organizational changes, including greater autonomy for the individuals in
the decision-making process and an increase in training programs. This situation is similar
to that recommended by Gold Zweig (2013), who concluded that the impact of the
Handayani, P. W. et al. (2013), hospitals are required to improve their quality of health
services to meet the higher standards. This improvement is supported by Ministry of
Health which has launched electronic health (e-health) program. The hospitals are required
to have Hospital Information System (HIS) for healthcare. However, to date only a few
hospitals have implemented an integrated HIS. The purpose of this research is to asses the
Information Technology (IT) maturity of a teaching hospital in implementing HIS. This IT
assessment observes from four layers namely business process, Information System (IS),
Information Technology (IT) and IS/IT management and organization. The result of this
research is that teaching hospitals should prepare a plan to restructure their network with
adequate infrastructure, create IT blue print and policy, IT organization restructuring, IT
staff competency development and build integrated HIS.
In a study conducted by Dizon, et al. (2018), the authors analyzed the impact of HMIS
on the financial performance of hospitals in the Philippines. And the study found that the
implementation of HMIS improves the financial performance of hospitals, including
increased revenue, reduced costs, and improved efficiency. It can also be seen that HMIS
better ensures the safety of confidential information of patients.
Lavin, M. A. et al. (2015), The electronic health record (EHR) is a documentation tool
that yields data useful in enhancing patient safety, evaluating care quality, maximizing
efficiency, and measuring staffing needs. Although nurses applaud the EHR, they also
indicate dissatisfaction with its design and cumbersome electronic processes. In this article
describes the views of nurses shared by members of the Nursing Practice Committee of the
Missouri Nurses Association; it encourages nurses to share their EHR concerns with
Information Technology (IT) staff and vendors and to take their place at the table when
nursing-related IT decisions are made. In this article, we describe the experiential-
reflective reasoning and action model used to understand staff nurses' perspectives, share
committee reflections and recommendations for improving both documentation and
documentation technology, and conclude by encouraging nurses to develop their
documentation and informatics skills. Nursing issues include medication safety,
Over the years, various innovations have been introduced into healthcare organizations
in order to incorporate better use of technology, to reduce medical error, to decrease costs,
to aid decision making, and to facilitate the search for medical solutions. This allows
integration between experts in the medical field either throughout the organization or
globally (Ahmadi et al., 2015, Sepucha et al., 2016).
According to Wagenaar, et al. (2016), routine health information systems (RHIS) are in
place in almost every country and provide regularly collected records of full coverage at all
levels of service delivery of the health system. However, these rich sources of data are
routinely overlooked for evaluating the causal effects of health programs due to concerns
about completeness, timeliness, representativeness and accuracy.
According to Carvalho, J. et al. (2019), in the last five decades, the maturity models
have been introduced as guides and reference frameworks for information system
management in organizations within different industries and sectors. This models have also
been used to address a wide variety of challenges, complexities and the high demand for
hospital IS (HIS) implementations.
This system is a crucial tool in maintaining accurate and up-to-date patient data to assist
healthcare professionals in making informed decisions and it is also to improve the quality of
patient care by enabling healthcare providers to access the medical records of the patient
accurately and instantly. It serves as a centralized platform to maintain, access and manage
patientdata collected by the healthcare providers.
ISO 25010:2011
Software Quality
Standards
Feedback
The processes involved are the analysis on the practices, procedures, problems, gaps and
needs in data collection, storage and retrieval of the patients record at the Nolasco Memorial
Hospital, design and development of the Medical Information Management System of
Nolasco Memorial Hospital using the Dynamic System Development Method, and the
assessment and evaluation of the developed system.
The output of the study is the application system developed to automate the vital
processes of the MIMS designate in data entry, access and retrieval with the system capable
of printing reports and other related documents.
Start
Patient
Registration
Test Yes
Record Health
Diagnostics
Condition
Medical
Treatment
Assign patient to
the Doctor
Give patient
Need prescription and
medication / arrange the
follow up? appointment for the
Yes follow up
No End
Login Form
Home
Nurses’ Medicines/
Laboratory Supplies
Progress Notes Findings
Discharge
History Sheet Summary
1. What are the practices and procedures of the Medical Information Management System
of Nolasco Memorial Hospital in the collection and storage of patients records?
2. What are the problems, needs and gaps in the existing records collection and storage
practices and procedures of the Medical Information Management System of Nolasco
Memorial Hospital?
3. What system can be developed to solve the problems and needs in the existing records
collection and storage practices and procedures of the Nolasco Memorial Hospital?
4. What is the extent of compliance of the developed application to ISO 25010 Software
Quality Standards in terms of:
i. functional suitability,
ii. performance efficiency,
iii. compatibility,
iv. usability,
v. reliability,
vi. security,
vii. maintainability, and
viii. portability?
5. What enhancements can be done to enhance the developed system?
The proposed system shall cover the preparation of medical reports and other related
documents as determined by the Hospital Staff/Admin.
Participants shall be limited to the Hospital Staff/Admin and IT professionals who shall
later evaluate the developed system.
Nolasco Memorial Hospital. This study would benefit the institution particularly the
MIMS office as this would mean efficiency in the manipulation of patients’ information and
productivity in the preparation of medical reports and other MIMS-related documents. The
implementation of the system will ease the tasks of the MIMS staff therefore greatly
reducing chances of producing incorrect reports. The Staff/Admin shall also benefit from the
use of the system as they would need less time in waiting for patients’ document due to the
effectiveness and efficiency of the system in generating documents.
The Researchers. The researchers would find the study as an avenue to showcase their
potentials of merging IT as an innovative tool in office administration. Engaging with
hospital staff shall advance the skills and research potentials of the researchers.
Future Researchers. Considering that the study may have been the same in other
disciplines, future researchers may benchmark on the results of the study towards the
development of a more concrete solution to related studies on office automation. Further,
areas not covered in the study may serve as an opportunity for future researchers to explore.
Definition of Terms
To ensure optimal understanding of the concepts of this study, the following terms are
provided with operational definitions:
Functional Suitability. It is the characteristic that represents the degree to which the
proposed system provides functions that meet stated and implied needs when used under
specified conditions.
Satisfaction. It is the degree to which the proposed system would provide customer
level approval when comparing the system’s perceived performance with his or her
expectations. In particular, the users and/or experts being fulfilled with that the system could
offer meeting their required outputs.
Security. It is the degree to which the proposed system protects information and data
so that persons or other products or systems have the degree of data access appropriate to
their types and levels of authorization.
Usability. It is the degree to which the proposed system application as used by users
achieve their quantified goals with effectiveness, efficiency, ease of use and learnability of
utilizing the system.
This chapter includes the project design, locale of the study, participants of the study,
instrumentation, data gathering procedures, and data analysis tools to be used in the study.
These parts provide justification to the researchers’ methods of collecting and analyzing the
data.
Project Design
This study shall employ the descriptive and system development method using
Dynamic System Development Method. The descriptive method will be used in
understanding the practices, procedures, problems, needs and gaps in data collection, storage
and retrieval of the patient data at the MIMS of Nolasco Memorial Hospital office. DSDM
shall be used with the ultimate goal of developing a Medical Information Management
System of Nolasco Memorial Hospital at Centro Sur, Gattaran, Cagayan.
In this study, DSDM shall focus on the delivery of an office solution, Medical
Information Management System of Nolasco Memorial Hospital. Prototyping shall be used
to ensure that the user have a clear picture of all aspects of the system. DSDM is rooted in
the software development community, but the convergence of software development,
process engineering and business development projects has changed the DSDM framework
to become a general framework for complex problem-solving tasks. The DSDM framework
is implemented for agile and traditional development processes.
System Architecture
Figure 2 shows how the Medical Information Management System of Nolasco
Memorial Hospital shall work. Data sources include patients’ data as inputs. Through the
Medical Information Management System processes, these inputs shall be stored as
patient’s medical information from which the outputs and deliverables of the system are
produced. These are results of individual patients’ documents.
Process Input
Output Information
The next figure (Figure 3) is the graphical representation of the proposed system.
The system administrator who is also the user is the designated Staff/Admin of Nolasco
Memorial Hospital who has all the capabilities of the system.
User Management
Patients’
Admin/ Information MIMS
User Management
User Management
Process
Manage User
Data
Input patients’
data
View patients’
data
Manage patients’
data
Manage patients’
document
Prepare printed
medical record
Database Schema
Sample Output
The study will be conduct at the Nolasco Memorial Hospital at Gattaran, located at
Centro Sur, Gattaran, Cagayan.
1. The Medical Staff/Admin of Nolasco Memorial Hospital will be the main informant
and source of major inputs to the system such as the needs and gaps in the existing
records collection and storage practices of the Medical office.
2. Panelists and evaluators who are IT professionals shall evaluate the features and the
performance of the developed system vis-a-vis software quality standards.
The following were the research instruments used in gathering the needed data for the
study:
Key Informant Interview. Using an interview guide, formal interview with the
Nolasco Memorial Hospital medical officer shall be done to elicit information as regards the
problems, needs, and gaps in the data collection, storage and retrieval of patients’ data at the
Medical Information Management System of Nolasco Memorial Hospital office. Moreover,
the information as regards the needed reports and deliverables of the proposed system shall
be asked in the interview.
Documentary Analysis. The existing reports prepared by the MIMS office shall be
determined through documentary analysis. Sample reports and documents shall be requested
and analyzed to provide useful information in the design of the proposed system.
1. Seek approval from the Hospital Admin/Staff for conducting of the study at the Nolasco
Memorial Hospital, at Centro Sur, Gattaran, Cagayan.
2. Send a request letter to the Admin/Staff of Nolasco Memorial Hospital for the conduct
of an interview to gather the data as specified in the objectives of the study.
Data Analysis
The answers to be obtained from the participants in the interviews shall be recorded
and studied. The interviewee’s responses shall be noted and from there interesting points
related to the interview questions shall be stressed to helped in the analysis of the responses.
Mean shall be used to analyze the rating of the IT experts with respect to the
compliance of the application which will be developed in this study in relation to ISO
standards. The extent of compliance of the system shall be rated using the following matrix:
Table 2. Likert Scale for the Measurement of the Extent of Compliance to ISO 25010:2011
Software Quality Standards
Descriptive
Mean Range Interpretation
Equivalent
4.20 – 5.00 Very Great Extent The measure described in the item is compliant to
the very high extent or OUTSTANDING.
3.40 – 4.19 Great Extent The measure described in the item is compliant to a
high extent or VERY SATISFACTORY.
2.60 – 3.39 Moderate Extent The measure described in the item is compliant to
the moderate extent or SATISFACTORY.
1.80 – 2.59 Low Extent The measure described in the item is compliant at
low extent or FAIR.
1.00 – 1.79 Very Low Extent The measure described in the item is compliant at
Chapter 3
I. Practices and procedures of the Nolasco Hospital in the collection and storage of
patients’ records
Nolasco Hospital is currently use a manual system for the management and
maintenance of critical information.
II. Problems, needs, and gaps in the existing records collection and storage
practices and procedures of the Nolasco Hospital
The Nolasco Medical Information System existing manual practices and
procedures, the Nolasco designate consumes a lot of time to store and locate patients'
information, especially when they writing the patients’ to admit, they need to take down
the information of the patient before they admit it.
These issues suggest the need for a computer application capable of storing
electronic copies of patient records, printing stored files, and conveying real-time data and
information to the user. The use of such an application would mean more productivity in
the hospital as efficiency in document manipulation is ensured.
IV. The extent of compliance of the developed application to ISO 25010 Software
Quality Standards
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