Chapter 1

The Problem and Its Background

Introduction

With the advent of the information age in the 21st century, devices such as

computers and mobile phones were vastly improved in terms of processing capability

and functionality. With the passing of time, the integration of these devices into the

different aspects of society continue to go deeper. In particular, the healthcare industry

has seen in recent times the creation of information systems within electronic devices

designed to augment the provision of care to patients by healthcare providers and

medical practitioners.

Medical records are information about a patient’s medical history, usually

containing data regarding previous diagnosis, treatments, pre-existing conditions, and

such that are relevant to healthcare. These are used by professionals to provide

informed and quality care designed specifically for a patient’s unique circumstance.

Medical records usually exist in written form, using papers to document information

about a patient. However, the traditional method of recordkeeping involving paper poses

issues such as the incompleteness, inaccuracy, and illegibility of data (Charnock, 2019).

There are three types of medical records in digital form: electronic medical

records (EMRs), electronic health records (EHRs), and personal health records (PHRs).

The two former types of medical records share similarities in functionality, such as the

documentation of important patient data; the main distinction between the two is that
EMRs are designed to record patient data that are accessible exclusively to a single

healthcare institution (i.e. a hospital or a clinic), wherein EHRs allow multiple healthcare

institutions to access and modify medical records of a patient.

Background of the Study

While EMRs and other forms of digital medical records become more prevalent in

the healthcare sector, a considerable percentage of clinics and hospitals still use the

traditional method of recordkeeping. Several factors, such as the lack of standardization

of digital records, lack of access to software specifically designed for particular

institutions, and lack of budget and resources to install and maintain hardware and

software, bar these systems from being the standard in most hospitals and clinics.

In the Philippines, there are several health information systems (HIS) being used

in settings such as barangay health centers. One of these is the Community Health

Information Tracking System (CHITS), which, according to the National Telehealth

Center (NHTC), is an “electronic medical record system developed by NTHC to improve

health information management at the rural health unit (RHU) level”. Several

With that in mind, this research aims to test the effectiveness of an EMR

prototype software designed according to the needs of a school clinic. This software

contains functionalities that will help in the recordkeeping aspect of the clinic, such as

collection, recording, and consolidation of students’ medical data.

Theoretical Framework

The Technology Acceptance Model (TAM) Theory attempts to explain the

process of people accepting and using a particular technology. The theory posits that

there are factors affecting users’ acceptance and reception of new technology. The first

factor, perceived usefulness, is defined as "the degree to which a person believes that

using a particular system would enhance his or her job performance. Another notable

factor, perceived ease of use, refers to "the degree to which a person believes that

using a particular system would be free of effort." (Davis, 1989). This particular theory is

relevant to this study due the intent of determining how the proposed electronic medical

record system will be received by the beneficiary in terms of practicality and reduction of

applied effort.

Another theory relevant to this study is the Task-Technology Fit (TTF) Theory.

This theory posits that a technology would bring about more positive benefits if the

characteristics of said technology match the tasks that need to be fulfilled by the user.

Task-technology fit is measured according to the following factors: quality, locatability,

authorization, compatibility, ease of use/training, production timeliness, systems

reliability, and relationship with users (Goodhue and Thompson, 1995). The TTF theory

is relevant to this study due to the study’s intent to assess the proposed EMR system

according to the characteristics it possess and how fit they are for their designated

tasks.

1 Task-Fit Technology (Goodhue and Thompson, 1995)

Conceptual Framework
Input
1. Information regarding
school clinic procedures
and guidelines
a. Student Medical
Record Guidelines
b. Clinic Admission
Process
2. Data regarding
problems of current
system
a. Efficiency
b. Storage
3. Framework of the
system to be
incorporated to the
software
a. Features
b. User Interface
Through the use of the Input Process Output (IPO) model, the study is divided
sequentially into four steps. In the Input stage, the data necessary for the EMR system
prototype are indicated. Certain guidelines must be taken into account as they are
Process Output
1. Develop a framework
containing information
regarding school clinic
procedures and
guidelines.
2. Identify the problems
of the existing system
based on interviews, Electronic Medical
surveys, and Record System
observation. Prototype for Morong
a. Formulate possible National High School’s
solutions to said School Clinic
problems.
3. Develop a software
using tools that are
appropriate for the
task.
Evaluation
1. Evaluate if the
desired output is
achieved.
a. Assess the
software’s
functionalities and
interface.
b. Conduct a test for
implementation.
operational standards and must be met by the institution. In the Process stage, analysis

of data and conceptualization of the system take place. The characteristics of the

software must be fit for the tasks they are supposed to perform in order for the proposed

system to improve the current system, as stated in the Task-Fit Technology Theory.

Evaluation is a continuous step to be performed throughout the duration of the study.

Statement of the Problem

This study aims to answer the following questions posed in accordance with the

conceptual and theoretical framework used:

1. What are the implications of an electronic medical record system in a public school

clinic?

1.1. How will the proposed EMR system improve the status quo in collecting,

storing, consolidating, and exporting students’ medical records?

1.2. What are the consequences in using the proposed EMR system?

1.3. How is the proposed EMR system perceived by the user in terms of usefulness

and ease of use?

1.4. Are the characteristics of the technology fit for the tasks they are designated to

perform?

2. How can the results of the study be used in future EMR-related researches?

2.1. Is a digitized method of medical record system feasible as a standard for every

healthcare institutions in the Philippines?

 2.2. How can future researchers improve the current design and functionality of the

EMR system?

2.3. Can the study be used as a stepping stone for developing an electronic health

record system?

Hypothesis

The proposed electronic medical record system is an improvement on the current

system implemented by the school clinic of Morong National High School. It will

eliminate problems such as incompleteness, inaccuracy, and illegibility of data that

traditional method of recordkeeping poses. The input, storage, consolidation, analysis,

and exportation of data will also be easier through the use of the system.

Scope and Limitation

This study focuses on the development of an electronic medical record system to

be used within the confines of Morong National High School and its school clinic. It

follows a developmental research approach as it seeks to describe and analyse the

development process of a product.

Definition of Terms

Healthcare – the maintenance or improvement of health via the prevention,

diagnosis, and treatment of disease, illness, injury, and other physical and mental

impairments in people

Information system – an integrated set of components for collecting, storing, and

processing data and for providing information, knowledge, and digital products.

Medical record – includes a variety of types of “notes” entered over time by

healthcare professionals, recording observations and administration of drugs and

therapies, orders for the administration of drugs and therapies, test results, x-rays,

reports, etc.

Electronic medical record – a digital version of the paper charts in the clinicians’

office; contains the medical and treatment history of the patient in one practice

Electronic health record – the systematized collection of patient and population

electronically-stored health information in a digital format; these records can be shared

across different health care setting.

Personal health record – a health record where health data and other information

related to the care of a patient is maintained by the patient

Health information system – a system designed to manage healthcare data