Health Monitoring System in Palo-Alto Health Center Using Machine Learning

Algorithm

Briones Lyka Jhonadel U.

Concepcion Jomar C.

Dimapilis Jan Xyzo

Imperial Juan Miguel

 Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents the basis for theoretical framework of the study. This covers a
review of related literature and studies that will give researcher sufficient background in
the conceptualization of the present paper and a deeper insight of what to look into study.

2.1 Theoretical Frame work

The Health Monitoring System uses model, software and different platform such as
Client and server and computing as model, JavaScript, PHP, CSS and MySQL for the
database.

Aside from the theories above, Health Monitoring System will also use Medical
Records, Baby forms for vaccination. Health Monitoring System will also use Machine
Learning Algorithm.

Figure 2.1 Health Monitoring System in Palo-Alto Health Center Using Machine
Learning Algorithm Theoretical Framework

Health Monitoring System in

Palo-Alto Health Center Using
Machine Learning Algorithm

IT Theories Non- IT Theories

JavaScript
 Medical Record
PHP  Baby Forms
(Vaccination records)
CSS  Maternal Record
 Family Planning Record
MySQL  Individual Treatment
Record (ITR)
Machine Learning
 Target Client List (TCL)
Algorithm
2.1.1 IT Theories

2.1.1.1 JavaScript

JavaScript is a programming language commonly used in web

development. It was originally developed by Netscape as a means to add dynamic
and interactive elements to websites. While JavaScript is influenced by Java,
the syntax is more similar to C and is based on ECMA Script, a scripting language
developed by Sun Microsystems.

JavaScript is a client-side scripting language, which means the source code is

processed by the client's web browser rather than on the web server. This means
JavaScript functions can run after a webpage has loaded without communicating
with the server. For example, a JavaScript function may check a web form before it is
submitted to make sure all the required fields have been filled out. The JavaScript
code can produce an error message before any information is actually transmitted
to the server.

Like server-side scripting languages, such as PHP and ASP, JavaScript code
can be inserted anywhere within the HTML of a webpage. However, only
the output of server-side code is displayed in the HTML, while JavaScript code
remains fully visible in the source of the webpage. It can also be referenced in a
separate .JS file, which may also be viewed in a browser. [TECH2019]
Figure 2.2 JavaScript
2.1.1.2 PHP

"Hypertext Preprocessor" (It is a recursive acronym, if you can

understand what that means.) PHP is an HTML-embedded Web scripting language.
This means PHP code can be inserted into the HTML of a Web page. When a PHP
page is accessed, the PHP code is read or "parsed" by the server the page resides on.
The output from the PHP functions on the page are typically returned as HTML code,
which can be read by the browser. Because the PHP code is transformed into HTML
before the page is loaded, users cannot view the PHP code on a page. This make PHP
pages secure enough to access databases and other secure information.
A lot of the syntax of PHP is borrowed from other languages such as C, Java and Perl.
However, PHP has a number of unique features and specific functions as well. The
goal of the language is to allow Web developers to write dynamically generated
pages quickly and easily. PHP is also great for creating database-driven Web sites. If
you would like to learn more about PHP, the official site is PHP.net. [TECH2019]
Figure 2.3 PHP

2.1.1.3 CSS

Stands for "Cascading Style Sheet." Cascading style sheets are used to
format the layout of Web pages. They can be used to define text styles, table sizes,
and other aspects of Web pages that previously could only be defined in a
page's HTML.
CSS helps Web developers create a uniform look across several pages of a Web site.
Instead of defining the style of each table and each block of text within a page's
HTML, commonly used styles need to be defined only once in a CSS document. Once
the style is defined in cascading style sheet, it can be used by any page that
references the CSS file. Plus, CSS makes it easy to change styles across several pages
at once. For example, a Web developer may want to increase the default text size
from 10pt to 12pt for fifty pages of a Web site. If the pages all reference the same
style sheet, the text size only needs to be changed on the style sheet and all the
pages will show the larger text.

While CSS is great for creating text styles, it is helpful for formatting other
aspects of Web page layout as well. For example, CSS can be used to define the cell
padding of table cells, the style, thickness, and color of a table's border, and the
padding around images or other objects. CSS gives Web developers more exact
control over how Web pages will look than HTML does. This is why most Web pages
today incorporate cascading style sheets. [TECH2019]

Figure 2.4 CSS

2.1.1.4 MySQL

MySQL is an Oracle-backed open source relational database

management system (RDBMS) based on Structured Query Language (SQL). MySQL
runs on virtually all platforms, including Linux, UNIX and Windows. Although it can
be used in a wide range of applications, MySQL is most often associated with web
applications and online publishing.

Today, MySQL is the RDBMS behind many of the top websites in the
world and countless corporate and consumer-facing web-based applications,
including Facebook, Twitter and YouTube. [SEAR2018]

Figure 2.5 MySQL

2.1.1.5 Machine Learning Algorithm

Machine learning is an application of artificial intelligence (AI) that provides

systems the ability to automatically learn and improve from experience without
being explicitly programmed. Machine learning focuses on the development of
computer programs that can access data and use it learn for themselves.

The process of learning begins with observations or data, such as examples,

direct experience, or instruction, in order to look for patterns in data and make
better decisions in the future based on the examples that we provide. The primary
 aim is to allow the computers learn automatically without human intervention or
assistance and adjust actions accordingly. [EXPE2019]

2.1.2 Non-IT Theories

2.1.2.1 Medical Records

Medical records technicians document patients' health information,

including the medical history, symptoms, examination and test results, treatments,
and other information about health care provider services. Medical records and
health information technicians' duties vary with the size of the facility in which they
work.

Although medical records and health information technicians do not provide direct
patient care, they work regularly with physicians and other healthcare
professionals. They meet with these workers to clarify diagnoses or to get additional
information to make sure that records are complete and accurate. [RMCH2019]

2.1.2.2 Baby Forms (Vaccination records)

Baby Forms (Vaccination records) sometimes called immunization

records. Provide a history of all the vaccines you or your child received. This record
may be required for certain jobs, travel abroad, or school registration. [CDCG2019]

2.1.2.3 Maternal Record

This provides the information of the monthly pre-natal check-up and

monthly vaccination of pregnant women. Nurse Coordinator/Midwife or staff on
Duty accommodated client and logs pertinent data on the Maternal Record.

2.1.2.4 Family Planning Record

Family Planning is having the desired number of children and when

you want to have them by using safe and effective modern methods. Proper birth
spacing is having children 3 to 5 years apart, which is best for the health of the
mother, her child, and the family. This has a record of number of current user
beginning and total new acceptors every month. [DOHG2019]

2.1.2.5 Individual Treatment Record (ITR)

The fundamental building block or foundation of the Field Health Service

Information System is the INDIVIDUAL TREATMENT RECORD. This is a document,
form or piece of paper upon which is recorded the date, name, address of patient,
presenting symptoms or complaint of the patient on consultation and the diagnosis
(if available), treatment and date of treatment. This record will be maintained as
part of the system of records at each health facility on all patients seen. [UHMI2011]

2.1.2.6 Target Client List (TCL)

The Target Client Lists constitute the second “building block” of the FHSIS
and are intended to serve several purposes. First is to plan and carry out patient
care and service delivery. Such lists will be of considerable value to
midwives/nurses in monitoring service delivery to clients in general and in
particular to groups of patients identified as “targets” or “eligibles” for one or
another program of the Department. The primary advantage of maintaining the
Target Client Lists is that the midwife/nurse does not have to go back to individual
patient/family records as frequently in order to monitor patient treatment or
services to beneficiaries.

The second purpose of Target Client Lists is to facilitate the monitoring and
supervision of service delivery activities. The third purpose is to report services
delivered. Again, the objective is to avoid having to go back to individual
patient/family records in order to complete the FHSIS Reporting The fourth purpose
of the Target Client Lists is to provide a clinic-level data base which can be accessed
for further studies. [UHMI2011]
2.2 Related Literature and Studies

2.2.1 Foreign Literature

2.2.1.1 Automatic Wireless Health Monitoring System for Patients Circuit and
Working

According to Tarun Agarwal (2019) in the article “Automatic Wireless Health

Monitoring System for Patients Circuit and Working” this device namely
wireless health monitoring system used to overcome this problem like easy to use,
small in size, light weight and portable. This device uses a heartbeat sensor to track
the patient’s heart beat count and also abnormalities.

The main goal of this project is to design a wireless system project, namely
automatic wireless health monitoring system. The main goal of this project is to
monitor the temperature of the patient’s body and display the same to the doctor
using RF technology. In hospitals, the temperature of a patient’s body need to be
monitored constantly which is generally made by the staff members of the hospital.
They notice the temperature of the patient’s body constantly and keep a record of it.

The block diagram of the automatic wireless health monitoring

system mainly includes transmitter section and receiver section. In the TX section,
the temperature sensor is used to detect the temperature of the patient’s body and
the data which are sensed by the sensor is sent to the microcontroller.
The transmitted information can be encoded into serial data over the air
through RF module and the temperature of the patient’s body values is displayed on
the LCD display using an antenna arranged at the end of a transmitter and the data
from the transmitter is transmitted to the receiver end. [ELPR2019]

2.2.1.2 Personal Health Records: A Systematic Literature Review

According to Gunther Eysenbach (2017) in the journal “Personal Health

Records: A Systematic Literature Review” information and communication
technology (ICT) has transformed the health care field worldwide. One of the main
drivers of this change is the electronic health record (EHR). However, there are still
open issues and challenges because the EHR usually reflects the partial view of a
health care provider without the ability for patients to control or interact with their
data. Furthermore, with the growth of mobile and ubiquitous computing, the
number of records regarding personal health is increasing exponentially.

This movement has been characterized as the Internet of Things (IoT),

including the widespread development of wearable computing technology and
assorted types of health-related sensors. This leads to the need for an integrated
method of storing health-related data, defined as the personal health record (PHR),
which could be used by health care providers and patients. This approach could
combine EHRs with data gathered from sensors or other wearable computing
devices. This unified view of patients’ health could be shared with providers, who
may not only use previous health-related records but also expand them with data
resulting from their interactions. Another PHR advantage is that patients can
interact with their health data, making decisions that may positively affect their
health. [NCBI2017]

2.2.1.3 Machine Learning Algorithms: A Review

According to Ayon Dey (2016) in the journal “Machine Learning

Algorithms: A Review” Machine learning is used to teach machines how to handle
the data more efficiently. Sometimes after viewing the data, we cannot interpret the
pattern or extract information from the data. In that case, we apply machine
learning [1]. With the abundance of datasets available, the demand for machine
learning is in rise. Many industries from medicine to military apply machine
learning to extract relevant information. The purpose of machine learning is to learn
from the data. Many studies have been done on how to make machines learn by
themselves [2] [3]. Many mathematicians and programmers apply several
approaches to find the solution of this problem. All the techniques of machine
learning are explained includes in this paper. Supervised Learning, the supervised
machine learning algorithms are those algorithms which needs external assistance.
The input dataset is divided into train and test dataset. The train dataset has output
variable which needs to be predicted or classified. All algorithms learn some kind of
patterns from the training dataset and apply them to the test dataset for prediction
or classification. Three most famous supervised machine learning algorithms have
been discussed here. 1) Decision Tree: Decision trees are those type of trees which
groups attributes by sorting them based on their values. Decision tree is used
mainly for classification purpose. Each tree consists of nodes and branches. Each
nodes represents attributes in a group that is to be classified and each branch
represents a value that the node can take. 2) Naïve Bayes: Naïve Bayes mainly
targets the text classification industry. It is mainly used for clustering and
classification purpose [6]. The underlying architecture of Naïve Bayes depends on
the conditional probability. It creates trees based on their probability of happening.
These trees are also known as Bayesian Network.

3) Support Vector Machine: Another most widely used state-of-the-art machine

learning technique is Support Vector Machine (SVM). It is mainly used for
classification. SVM works on the principle of margin calculation. It basically, draw
margins between the classes. The margins are drawn in such a fashion that the
distance between the margin and the classes is maximum and hence, minimizing the
classification error.

B. Unsupervised Learning, the unsupervised learning algorithms learns few features

from the data. When new data is introduced, it uses the previously learned features
to recognize the class of the data. It is mainly used for clustering and feature
reduction.

The two main algorithms for clustering and dimensionality reduction techniques are
discussed below.

1)K-Means Clustering: Clustering or grouping is a type of unsupervised learning

technique that when initiates, creates groups automatically. The items which
possesses similar characteristics are put in the same cluster. This algorithm is called
k-means because it creates k distinct clusters. The mean of the values in a particular
cluster is the center of that cluster. 2) Principal Component Analysis In Principal
Component Analysis or PCA, the dimension of the data is reduced to make the
computations faster and easier. To understand how PCA works, let’s take an
example of 2D data. When the data is being plot in a graph, it will take up two axes.
PCA is applied on the data, the data then will be 1D.

C. Semi - Supervised Learning Semi – supervised learning algorithms is a technique

which combines the power of both supervised and unsupervised learning. It can be
fruit-full in those areas of machine learning and data mining where the unlabeled
data is already present and getting the labeled data is a tedious process. There are
many categories of semi-supervised learning. Some of which are discussed below: 1)
Generative Models: Generative models are one of the oldest semi-supervised
learning method assumes a structure like p(x,y) = p(y)p(x|y) where p(x|y) is a
mixed distribution e.g. Gaussian mixture models. Within the unlabeled data, the
mixed components can be identifiable. One labeled example per component is
enough to confirm the mixture distribution. 2) Self-Training: In self-training, a
classifier is trained with a portion of labeled data. The classifier is then fed with
unlabeled data. The unlabeled points and the predicted labels are added together in
the training set. This procedure is then repeated further. Since the classifier is
learning itself, hence the name self-training. 3) Transductive SVM: Transductive
support vector machine or TSVM is an extension of SVM. In TSVM, the labeled and
unlabeled data both are considered. It is used to label the unlabeled data in such a
way that the margin is maximum between the labeled and unlabeled data. Finding
an exact solution by TSVM is a NP-hard problem. D. Reinforcement Learning
Reinforcement learning is a type of learning which makes decisions based on which
actions to take such that the outcome is more positive. The learner has no
knowledge which actions to take until it’s been given a situation. The action which is
taken by the learner may affect situations.

E. Multitask Learning Multitask learning has a simple goal of helping other learners
to perform better. When multitask learning algorithms are applied on a task, it
remembers the procedure how it solved the problem or how it reaches to the
particular conclusion. The algorithm then uses these steps to find the solution of
other similar problem or task. This helping of one algorithm to another can also be
termed as inductive transfer mechanism. If the learners share their experience with
each other, the learners can learn concurrently rather than individually and can be
much faster. F. Ensemble Learning When various individual learners are combined
to form only one learner then that particular type of learning is called ensemble
learning. The individual learner may be Naïve Bayes, decision tree, neural network,
etc. Ensemble learning is a hot topic since 1990s. It has been observed that, a
collection of learners is almost always better at doing a particular job rather than
individual learners. Two popular Ensemble learning techniques are given: 1)
Boosting: Boosting is a technique in ensemble learning which is used to decrease
bias and variance. Boosting creates a collection of weak learners and convert them
to one strong learner. A weak learner is a classifier which is barely correlated with
true classification. On the other hand, a strong learner is a type of classifier which is
strongly correlated with true classification. The pseudo code for AdaBoost (which is
most popular example of boosting).

2) Bagging: Bagging or bootstrap aggregating is applied where the accuracy and

stability of a machine learning algorithm needs to be increased. It is applicable in
classification and regression. Bagging also decreases variance and helps in handling
overfitting.

G. Neural Network Learning The neural network (or artificial neural network or
ANN) is derived from the biological concept of neurons. A neuron is a cell like
structure in a brain. To understand neural network, one must understand how a
neuron works. A neuron has mainly four parts. They are dendrites, nucleus, soma
and axon.

An artificial neural network behaves the same way. It works on three layers.
The input layer takes input (much like dendrites). The hidden layer processes the
input (like soma and axon). Finally, the output layer sends the calculated output
(like dendrite terminals). There are basically three types of artificial neural
network: supervised, unsupervised and reinforcement. 1) Supervised Neural
Network: In the supervised neural network, the output of the input is already
known. The predicted output of the neural network is compared with the actual
output. Based on the error, the parameters are changed, and then fed into the neural
network again. Supervised neural network is used in feed forward neural network.

2) Unsupervised Neural Network: Here, the neural network has no prior clue about
the output the input. The main job of the network is to categorize the data according
to some similarities. The neural network checks the correlation between various
inputs and groups them.

3) Reinforced Neural Network: In reinforced neural network, the network behaves

as if a human communicates with the environment. From the environment, a
feedback has been provided to the network acknowledging the fact that whether the
decision taken by the network is right or wrong. If the decision is right, the
connections which points to that particular output is strengthened. The connections
are weakened otherwise. The network has no previous information about the
output.

H. Instance-Based Learning In instance-based learning, the learner learns a

particular type of pattern. It tries to apply the same pattern to the newly fed data.
Hence the name instance-based. It is a type of lazy learner which waits for the test
data to arrive and then act on it together with training data. The complexity of the
learning algorithm increases with the size of the data. Given below is a well-known
example of instance-based learning which is k-nearest neighbor.

1)K-Nearest Neighbor: In k-nearest neighbor (or KNN), the training data (which is
well-labeled) is fed into the learner. When the test data is introduced to the learner,
it compares both the data. k most correlated data is taken from training set. The
majority of k is taken which serves as the new class for the test data. [IJCS2016]
2.2.1.4 Records Management or Information Governance?

According to William Saffady (2015) in the article “Records

Management or Information Governance?” stated that record management is a
specialized discipline that concerned with the systematic analysis and control of
information created, received, maintained or used by an organization pursuant to its
mission, operation, and activities. By definition, record management is concerned
with information that is recorded or “written down” as opposed merely memorized
or exchange verbally.

A comprehensive record management program includes policies, procedures,

and processes that addresses significant record keeping issues specifically:
Determining how long recorded information needs to be kept to satisfy an
organization’s requirements, Ensuring compliance with record keeping laws and
regulations in all locations where an organization has business operations,
Managing inactive records in a cost-effective manner, Organizing active records for
retrieval when needed, Protecting recorded information that supports mission-
critical business operations.[QUES2015]

2.2.1.5 Medical Records Management: Conquering Piles of Paper

According to Audrey Thomas (2016) in the article “Medical Records

Management: Conquering Piles of Paper” good medical record management system
could mean the difference between life and death for some individuals. The first
components you will need to set up your medical record management system are 3-
ring binders. Using categories or tabs for the following information will help a
person to locate things quickly within medical records management file: Current
medication, Immunization, allergies, health history, Test/Lab results.

It is a good idea for each family member to have own medical records
management binder. Anytime you move more or switch to a new health care
provider have this important information at your fingertips. [SMEA2016]
2.2.2Foreign Studies

2.2.2.2.1 Intelligent health monitoring system based on smart clothing

Figure 2.6 Intelligent health monitoring system based on smart clothing

In this study proposed an intelligent health monitoring system based on

smart clothing. The system consisted of smart clothing and sensing component, care
institution control platform, and mobile device. The smart clothing is a wearable
device for electrocardiography signal collection and heart rate monitoring. The
system integrated our proposed fast empirical mode decomposition algorithm for
electrocardiography denoising and hidden Markov model–based algorithm for fall
detection.

Figure 2.7 Architecture of the proposed intelligent health monitoring

system
 The architecture of smart clothing and sensing component is shown in Figure
2. The design details of the smart clothing are illustrated in Figure 3. The smart
clothing was made of conductive fiber. The four electrode patches on the smart
clothing were used for collecting analog ECG signals, which were sent to the sensing
component. The analog-to-digital converter (ADC) of the sensing component
converted the analog ECG signals into digital signals with a sampling frequency of
250 Hz. The digital ECG signals were analyzed by the MPU of the sensing component
to obtain the health data, which were sent as broadcast packets in a frequency of
1 Hz through BLE.

Figure 2.8 Smart clothing and sensing component.

Figure 2.9 Design details of the smart clothing.

 The proposed intelligent health monitoring system provided the following
eight kinds of services (Table 1):

1. Surveillance of signs of life. The heart rate of the elderly is detected at any
time, and alert is triggered when the heart rate is above 140 Hz or lower than 50 Hz.
2. Tracking of physiological functions. Using the collected data of step number,
monthly and daily step number variation is analyzed. For a specific physical state, it
is determined whether the amount of exercise corresponding to the physical state is
achieved.
3. Monitoring of the activity field. The position of the elderly in the care
institution is recorded regularly and analyzed to track whether the position is
varied or whether the elderly stays indoors.
4. Anti-lost. It is detected by indoor positioning whether the elderly gets close
to the alert area defined by the care institution. The system is capable of detecting
up to 10 m.
5. Fall detection. Falls are detected at any time. On detecting a suspected fall
incident, an emergency call for help packet will be sent immediately.
6. Emergency call for help. The sensing component has an emergency call for
help button, which can be used for real-time call for help when the body is found to
be abnormal.
7. Device wearing detection. If there is no sensing component within the system
architecture, the required service cannot be reached, so it is important to detect
whether the elderly wears the sensing component.
8. Device low battery warning. For the same reason as (7), it is necessary to
detect whether the sensing component is in low battery.

Eight kinds of services were provided by the system, including surveillance

of signs of life, tracking of physiological functions, monitoring of the activity field,
anti-lost, fall detection, emergency call for help, device wearing detection, and
device low battery warning. The performance of fast empirical mode decomposition
and hidden Markov model were evaluated by experiment I (fast empirical mode
decomposition evaluation) and experiment II (fall detection), respectively. The
accuracy and sensitivity of R-peak detection using fast empirical mode
decomposition were 96.46% and 98.75%, respectively. The accuracy, sensitivity,
and specificity of fall detection using hidden Markov model were 97.92%, 90.00%,
and 99.50%, respectively.

The system was evaluated in an elderly long-term care institution in Taiwan.

The results of the satisfaction survey showed that both the caregivers and the elders
are willing to use the proposed intelligent health monitoring system. The proposed
system may be used for long-term health monitoring.

2.2.2.3 Health Monitoring System using Raspberry Pi and IOT

Figure 2.10 .Health Monitoring System using Raspberry Pi and IOT

Health monitoring system using IOT describes the collection and

interoperation of Patient data collected from the sensors from the hospitals through
IOT Technology. The collected sensor data will support the doctor in the emergency
situation for the betterment and improvement of Patient health. The hardware
platform to implement the project consists of a sensor and Raspberry Pi 3 Model B
equipped in a way to communicate with a doctor through the Internet and Smart
Phone. This proposed idea will help doctors to know about the state of patient
health and monitor anywhere in the world. In this proposed idea the sensors gather
the medical information of the patient that includes patient’s heart rate, blood
pressure, and pulse rate.

Then using the camera the patient is livelily monitored through the
Raspberry kit and this information is sent to the Internet and stored in a medical
server. The doctor and patient can monitor the patient data from any place of the
world through the provided IP server address anytime. The emergency alert is sent
to the patient if the sensor value is exceeded by the threshold data. Thus the
patient's health parameters are watched lively and regular monitoring through the
medical server to a doctor will help to make an effective diagnosis and almost
accurate care can be given. The data collected through the IOT will help the patient
to recover easily and also enhanced medical care can be given to the patients at a
low cost.

The kit implementation for Health Monitoring System is shown in figure 10.
The Mouse and Keyboard connected to the USB port of Pi and the Monitor
connected to the HDMI video port. The sensors connected to the GPIO pin through
which the data from the Pi is transferred to the server and the patient can monitor
the data on the monitor.

Figure 2.11 Kit implementation for Health Monitoring System

 Figure 10 shows the display of the health monitoring system on the patient’s
monitor. After the use of the pulse rate, blood pressure and heart sound sensor, the
digital output from the sensor through the Pi is displayed on the Monitor.

Figure 2.12 Display on Monitor after Execution

The Pi camera output is displayed on the server, the IP address of the server
is the same as the IP address of the raspberry pi. The camera output is shown in
figure 11.

Figure 2.13 Pi Camera Output

 IoT Technology is an integration of various technologies which enables
different devices and objects to interact with each other and use different network
technologies. The proposed system gives better and effective health care services to
patients and the information collected is networked worldwide through internet
and communication devices in turn connected to cloud services and doctors can use
this data and provide a quick and effective solution.

The proposed model is a well-equipped system where the doctor can check
his patient anywhere, anytime. Emergency alert e-mail is sent to the patients if the
threshold value is reached that to consult the doctor. This system is helpful for
patients who are advised for the complete bed rest and the paralyzed patients,
where the doctor can physical monitored the patient from the home with the help of
the Pi camera which is used in the system. The aim of the proposed framework is to
adopt a new production of medical systems that can provide health care services for
high quality and low-cost patients using this combination of large data analysis,
cloud computing, and computing technologies. The enhancement for the designed
system will connect more sensors and connect all the objects to the Internet for
quick and easy access. Further enhancement of existing model can also be deployed
as a mobile application in order to become easy to access the model around the
world.

The mobile application can be enhanced with the ambulance services,

doctor’s list, nearby hospitals. The patients who are advised for the complete bed
rest and the paralyzed patients can also be monitored and given precautions by the
doctors by visual and audio by using the pi camera. The system is implemented for
one-to-one access, which can be implemented for many by giving unique id for each
member/patient in the home or the hospital.

In the project, Raspberry Pi is used as a data aggregator as well as a

processor. The patient and doctor smartphone/ computer are used as a monitoring
system. The Pi camera output is displayed on the server, the IP address of the server
is the same as the IP address of the raspberry pi. [COMPU2019]
2.2.2.4 Utilisation of Electronic Health Records for Public Health in Asia: A
Review of Success Factors and Potential Challenges

Figure 2.14 Utilisation of Electronic Health Records for Public Health in

Asia: A Review of Success Factors and Potential Challenges

Electronic health records offer a valuable resource to improve health

surveillance and evaluation as well as informing clinical decision making. They have
been introduced in many different settings, including low- and middle-income
countries, yet little is known of the progress and effectiveness of similar information
systems within Asia. This study examines the implementation of EHR systems for
use at a population health level in Asia and to identify their current role within
public health, key success factors, and potential barriers in implementation. A
systematic search process was implemented. Five databases were searched with
MeSH key terms and Boolean phrases. Articles selected for this review were based
on hospital provider electronic records with a component of implementation,
utilisation, or evaluation for health systems or at least beyond direct patient care. A
proposed analytic framework considered three interactive components: the content,
the process, and the context. Tirtytwo articles were included in the review. Evidence
suggests that benefts are signifcant but identifying and addressing potential
challenges are critical for success. A comprehensive preparation process is
necessary to implement an effective and flexible system. Electronic health records
implemented for public health can allow the identification of disease patterns,
seasonality, and global trends as well as risks to vulnerable populations. Addressing
implementation challenges will facilitate the development and efficacy of public
health initiatives in Asia to identify current health needs and mitigate future risks.

Material and Methods

2.1. Analytical Framework. The analytical framework for this review was adapted
from studies examining the impact of EHR in medical office settings and a
conceptual framework for data visualization using EHR. In order to examine the
content for utilization in public health, one needs to consider it along with two other
interactive components: the context and process. The context can be further
classified as internal and external. For the purposes of this review, the internal
context refers to the structure, culture, and resources of the organization utilizing
the EHR. The external context refers to the larger socioeconomic and political
environment in which the organization operates. For this review, “process” is
classified into the input process and output process. The input process considers all
factors related to data entry, which may consider cultural factors or available
resources. Output process considers all factors related to data visualization and its
output.

2.2. Search Strategy. A systematic search process was completed to identify relevant
articles related to utilization of EHR for public health in Asia. Specifically, articles to
be included must full two key components: (1) The article must (a) be based on
hospital/service provider electronic records AND (b) have a component of
implementation, utilization, OR evaluation (2) The article must be related to public
health by fulfilling one of the following criteria: (a) Going beyond direct clinical or
patient care OR (b) Being health systems related Electronic records or systems not
related to public health as well as summary or opinion papers, abstracts, news
articles, and reviews were excluded. Medical Subject Headings (MeSH) were
identified and used as search terms including “information systems,” “database
management systems,” “medical record systems,” “hospital information systems,”
“information technology,” and “software, software design, and software validation.”
MeSH keywords fitting outcomes of interest included “decision making,” “health
planning,” “health policy,” “public health,” “systems integration,” and “organizational
culture.” Finally, these terms focused on Asia with articles published from January
2008 to May 2019. A total of five databases were searched: CINAHL, EMBASE,
Medline, Web of Science, and PubMed. For each study, we extracted its current
content and utilization in public health and key information including its aim,
methods, findings, and limitations as identified by the original authors of the
studies. Key success factors and barriers to implementation as identified by the
original authors were extracted.

Relevant information from Search Outcomes

Following searches in all the named databases, a total of 465 articles were
identified. To ensure identification of all relevant articles, the initial search focused
on all articles including EHR and/or Asia and/or public health related activities.
Specific details have been summarized in Figure 2. Four researchers (LD, WJ, AH,
and CA) performed the abstract reviews and assessed the full texts. Six researchers
(LD, WJ, KP, AH, ND, and CA) were responsible for data extraction of the included
reviews. In addition to following the analytical framework outlined above, each
paper was examined for common themes associated with challenges and good
practice. A thematic analysis as guided by the framework was applied and
performed by three investigators (LD, AH, and CA), with extracted data compiled
and analyzed using NVivo 12 (QSR International, Don caster, Victoria, Australia).

Figure 2.15 Role and benefits of electronic health records to public health in

Asia.
Role and Benefits of Electronic Health Records to Public Health

It was clear from several of the studies that—while recognizing difficulties in

integration and development of EHR within Asia—there were also significant
benefits. The benefits of leveraging electronic systems focused primarily on disease-
, patient-, or situation-specific interventions as well as improvement of “systems-
level” functioning, or both. A key element of public health in Asia is the utilization of
EHR for disease surveillance and monitoring systems. EHR have the ability to help
identify and predict seasonal outbreaks and high risk areas and prevent infections
or diseases as well as assisting in the coordination of demographic information and
community profiles, which are invaluable in the current public health climate.
However, concerns about confidentiality were noted. Another key utilization of EHR
is their implementation to improve health care systems. The identification of risk
factors through electronic health systems allows health professionals to recognize
and track them over time, helping both in clinical decision making, planning for
outbreaks, and identifying transmission of diseases. For example, a study of cancer
patients allowed the tracking and analysis of diagnostic patterns, the number of
investigations completed by physicians, and transfer of information as well as
factors for the diagnoses.
 The progress and capacity of EHR systems is far-reaching and effective.
Understanding broader and local contexts, access to available resources, addressing
organizational challenges, and implementing well thought-out approaches in the
development of EHR projects should go a long way to address potential barriers to
EHR implementation. The values of EHR are significant and go beyond individual
clinical decision-making in its ability to identify disease patterns, seasonal and
global trends, and the potential risks to vulnerable populations as well as to
strengthen coordination of care between different sectors. Understanding the
potential capabilities and preparing for potential challenges of EHR as highlighted in
this study will help facilitate the development and implementation of public health
initiatives in Asia to address current needs and identify future risks. [HIND2019]

2.2.2.5 A cross‐case analysis of the effects of EMR deployment on Antenatal

Care Services in Rural Health Centres in Malawi

Figure 2.16 A cross‐case analysis of the effects of EMR deployment on

Antenatal Care Services in Rural Health Centres in Malawi

Implementation of Electronic Medical Record (EMR) systems within

developing contexts has been increasing, as part of efforts to monitor and facilitate
attainment of health-related Millennium Development Goals (MDG). However, these
efforts have been concentrated in urban hospitals. This research was therefore
conducted to understand how EMR systems can be developed for use in rural
primary care settings in order to support attainment of the Millennium
Development Goal of improving Maternal health. The empirical material has been
obtained through an Action Research study conducted in Malawi from 2009 to 2013.
Two Antenatal care EMR systems were implemented in two rural health centres. A
central objective was to understand the form of user participation that takes place
when developing EMR systems in Developing country settings.

The aim of the research project was to implement EMR systems that would
support health workers in the provision of Antenatal care services. Based on
findings from a situation analysis of the services, and discussions with various
stakeholders, system requirements for the health centres were developed. The
functional requirements for the proposed ANC system were specified as: registering
ANC clients; capturing and validating client’s antenatal care data; providing alerts
and reminders for patient care based on the patient data entered; reviewing client’s
ANC data captured; scheduling ANC appointments; ending ANC service for the
pregnancy; producing statistical reports; and reviewing a client’s ANC history for
previous pregnancies (i.e. if the previous pregnancy was captured in the system).
The specific designs and functionality of the two EMR software applications are
described later in this section.

Figure 2.17 Touchscreen workstation with printer and barcode

scanner at Health Centre A
 Figure 2.18 Touchscreen workstation with printer and barcode
scanner a tHealth Centre A

The target health facilities had no electricity; therefore the type of hardware
infrastructure was of concern. The research team decided to implement the
solutions based on ABC hardware technologies as they had proved to work in
rural health centres using renewable sources of energy. This infrastructure
consisted of an energy solution based on solar power and low power consumption
hardware (similar to what is described in another paper). The technical 8 design
adopted a server-client setup with several workstations at different points of care.
Each health centre had a server on site which hosted the EMR application. A Local
Area Network was also installed at each health centre. The main component of the
workstation was a touchscreen computer. In Health Center A, the workstation also
had a thermal printer and a barcode scanner; whilst in Health Center B, the
workstation had a keyboard and mouse.

Figure 2.19 Blood Pressure screen 1

 Figure 2.20 Blood Pressure screen 2

Figure 2.20 Health passport with a Barcode sticker

At patient care level, the ABC EMR software functionality consisted of: client
registration; capturing ANC information, and reviewing the ANC service history.
Client registration involved capturing of basic demographic data consisting of the
client’s name, age/date of birth, place of residence, mobile number, and occupation.
The sex of the client was automatically indicated as female since it was for antenatal
care clients only. At the end of the registration process, the system automatically
printed out a sticker that had the patient name, birthdate, place of residence, patient
identifier number and a barcode representation of the ID number. The sticker could
be affixed on the client’s health passport, as shown in figure 5. The barcode is used
to search/retrieve a client’s record in the system using the barcode scanner.
 Once the client was registered, different types of information could be
captured into the system. The system had a patient dashboard which provided links
for entering Antenatal care data and for viewing the data that had been captured for
that particular client. For entering the data, the dashboard provided links to two
kinds of data, patient history data and current visit data. The patient history was
collected once, during the first visit. The history data was organized into four
categories - obstetric history, medical history, social history and surgical history,
with each of these categories having a set of data elements (i.e. questions) that had
to be entered. For instance, under obstetric history, the number of pregnancies
(Gravida), deliveries, abortions were collected as well as the specific details of each
delivery and abortion. All the questions in a selected category had to be
answered/entered before the data could be saved in the system. The patient history
could be printed on the label stickers and affixed in the health passport.

To capture the current visit details, the current visit option on the patient
dashboard provided links to several categories of visit data namely: vitals, lab
results, ANC physical examination results, current pregnancy details (i.e. data
captured once during the pregnancy such as LMP), scheduling the next visit, drug
prescription and any other outcomes. The captured visit data could be printed on
the label sticker and affixed to the health passport.

Figure 2.21 Obstetric history sticker and lab results sticker (right side) placed in a
health passport
 Figure 2.22 A detailed obstetric history sticker placed in a health passport

To capture the current visit details, the current visit option on the patient
dashboard provided links to several categories of visit data namely: vitals, lab
results, ANC physical examination results, current pregnancy details (i.e. data
captured once during the pregnancy such as LMP), scheduling the next visit, drug
prescription and any other outcomes. The captured visit data could be printed on
the label sticker and affixed to the health passport.

Figure 2.23 Current visit dashboard in ABC EMR system

Figure 2.24 Current visit dashboard in ABC EMR system

 The data entered in the system could be viewed from various tabs on the
patient dashboard. The tabs were colour coded to show the status of the data
(Figure 10). A yellow colour indicated the data had not been entered, red colour
indicated there was a danger sign or highrisk factor within that group of data, and
black indicated the data had been entered and there was no high-risk factor.

Figure 2.24 A sample patient dashboard

To correct the Antenatal care data entered, firstly the wrong data had to be
deleted which was done from the patient dashboard. After this, the data could be re-
entered. This implied deleting and re-entering all the data in that category, e.g. the
obstetric history. However, for the demographic data, it was possible to update the
specific data element (e.g. name or address) directly and print a new sticker. The
system also provided statistical information on the services provided in two ways.
Firstly, the system dashboard displayed a summary of clients registered and
number of clients who had received a particular type of care, such as the number of
clients registered and the number of clients whose obstetric history had been
entered in a day. Secondly, the system could produce ANC monthly cohort reports
for the facility.
 Figure 2.25 A sample patient dashboard

To correct the Antenatal care data entered, firstly the wrong data had to be
deleted which was done from the patient dashboard. After this, the data could be re-
entered. This implied deleting and re-entering all the data in that category, e.g. the
obstetric history. However, for the demographic data, it was possible to update the
specific data element (e.g. name or address) directly and print a new sticker. The
system also provided statistical information on the services provided in two ways.
Firstly, the system dashboard displayed a summary of clients registered and
number of clients who had received a particular type of care, such as the number of
clients registered and the number of clients whose obstetric history had been
entered in a day. Secondly, the system could produce ANC monthly cohort reports
for the facility.
 Figure 2.25 A sample patient dashboard

In order to retrieve a person’s record, search functionality was provided.

Different criteria could be used to search including the name or identifier. The client
record could also be retrieved by looking through a list of all the clients registered at
the facility.

Figure 2.26 A sample patient dashboard

Once the client was registered, she could be enrolled into the ANC program.
The enrolment required specifying the date of the first ANC visit and the LMP date.
The system then automatically calculated the visit dates for all the subsequent visits
based on the 14 recommended gestation periods in the FANC protocol. The visits
were displayed as color-coded boxes to show the status of the visit. Green was used
to indicate the visit had been completed, purple indicated the visit was incomplete
(but had some data), red indicated the visit was overdue, and yellow meant the visit
was scheduled in the future. The visit dates could be modified in a separate tab,
labelled ‘Modify due/visit.
 Figure 2.27 A sample patient dashboard

The client data for the visit could be entered by firstly selecting the
visit and then specifying the actual visit date, which was indicated as the report
date. Once the report date was specified, the data entry form for the visit was
displayed. Once the data had been captured on the form, it could be validated based
on validation rules configured during customisation. It was also possible to mark the
form as ‘completed’ which indicated that data entry for that visit had been
completed. The XYZ system also had functionality for generating an ANC program
summary report for a particular period. This provided a summary of the clients
registered during the period and the status of their visits. [MNUI2014]

2.2.3Local Literature
2.2.3.1 DOH, DOST to improve access to health information

According to Rapper (2014) in the article “DOH, DOST to improve

access to health information” the Philippine Health Information Exchange will store
health-related data in the country and can be viewed by authorized health care
providers. Health Secretary Enrique Ona explained that having a centralized health
information will help policy makers and health managers formulate better health
programs.
 Meanwhile, DOH Usec Teodoro Herbosa believes that having a system for
shared information will be helpful especially to patients living in rural areas who do
not have access to health services.

“It will provide a single unified view of patients’ data records across and
between facilities, whether hospitals or clinics, to an interface that is accessible
anywhere and anytime. Maybe even in your smartphones,” Herbosa added.

One of the main concepts of the Philippine Health Information Exchange is

having a standard for all health data. “What the country has at the moment are
independent information systems that are unfortunately still subpar to developing
international standards,” Ona said.

Another project in the health sector is the RxBox, a portable telehealth device
equipped with sensors that allows patients to consult with health care specialists by
simply measuring their vital signs and then transmitting them through a wireless
connection. Others, the android run e-tablet and e-hatid, which allow real-time
access to health information for LGUs and health specialists, are also part of the
initiatives in the health sector.

"Having these smarter technologies for better healthcare services and the
capability to connect health information, we can now guarantee that our health
specialists, policy makers and stakeholders will be smarter in formulating policies,
and programs for the benefit of Mang Juan and Aling Maria," Science & Technology
Secretary Mario Montejo said.

In privacy issues, having a system that will house all health information in
the country, privacy becomes one of the concerns of people.
Ona assured that the system will only consist of information such as the number of
people having a particular disease and their age, among other things and will not
reveal their identity.

"We’ve also created a group that [would] also create our standards for privacy in
terms of sharing of patient information and patient health data," Herbosa added.
[RAPP2014]

2.2.3.2 Dentists now have a new buddy in Medix, helps clinics keep patient
records online

According to Phoebe Magdirila (2014) in the article “Dentists now

have a new buddy in Medix, helps clinics keep patient records online” keeping tons of
records on paper is almost a thing of the past for most businesses. Record-keeping
software – or simple web tools like Google Docs or Evernote – has largely taken
over. However, many dentists are still far from the computer age. That’s why
Philippine startup Medix wants dentists to put its patients’ records on its web
platform. Dentists have a responsibility to keep their patients’ information, together
with their dental history. Every dentist does this. However, many still rely on paper-
filing methods.

Medix, a cloud-based clinic management service, could possibly make record-

keeping more seamless. It allows dentists to keep their patients’ details and dental
history online. It also gives dentists the capability to upload digital before-and-after
images of their patients for future reference. The web dashboard also shows a
dentist’s upcoming appointments. Medix founder Marc Medina says that Medix cuts
out time wasted in maintaining records and allows dentists to focus more on
attending to their patients. [TECH2014]

2.2.3.3 Capacity Building for Health Care Provision RESULT AREA 3 Changing
Systems for Saving Lives
 According to the article “Capacity Building for Health Care Provision RESULT
AREA 3 Changing Systems for Saving Lives” (2015) stated that electronic medical
record system for use by the rural health units and/or barangay health stations. The
system aims to automate the registration, consultations and monitoring of patients.
iClinicSys generates a digital copy of the traditional paperbased medical record of an
individual, and provides the required data for submission to the national health data
reporting, Philippine health information exchange, and for meeting the Philhealth
electronic claims and benefits’ requirements. It supports the Universal Health Care’s
thrust to establish a modern information system that shall provide evidence for
policy and program development, and support for immediate and efficient provision
of health care and management of province wide health systems.

Integrated Clinic Information System (iClinicSys) is the reference model for

electronic medical record system in support of the Department of Health’s national
health data reporting, Philhealth’s Primary Care Benefits and other eHealth
initiatives. In the system integration framework, iClinicSys is visualized as a mother
system where different DOH information systems will be integrated like Maternal
and Neonatal Death Reporting, Tuberculosis system, Injury reporting, Chronic Non-
communicable diseases and stock inventory. This will be facilitated through a single
sign-on wherein health facilities will log-in on iClinicsys account and they will be
able to access different modules and systems. iClinicsys also allows submission and
sharing of reports between other government agencies like Philhealth and
Department of Social Welfare and Development (DSWD) through the web service
feature. [WPRO2015]

2.2.3.4 Clinical Decision Support System

According Tricia (2015) to the article “Clinical Decision Support System” said
that as part of improving the delivery of health care system, there should be enough
features that will provide the users, particularly the health care providers, enough
details that will aid them in decisions when it comes to patient care. One of the key
features a system would have is the Clinical Decision Support System. In literature, it
is defined as a software or features that enables the patients or the clinicians with
mapped clinical knowledge and patient-related information, appropriately
organized, filtered and presented to generate data that would influence health
decisions and choices to enhance patient care. To maximize the reliability of the
system, there would be a need for the following: Clinical Knowledge that is currently
up to date and accurate, Patient information encoded in the EMR should be
complete, accurate and updated by the Health Care Provider, and Annual or periodic
reviews of the content against current practice

The three items are important since the Health Care Providers rely on the
information and the generated advises. However, people should take note as well
that CDSS does not replace the clinicians when it comes to decision-making. It only
aids the clinicians to come up a better diagnoses and individualized patient care.

In the Philippines, we have a system called Community Health Information

Tracking System or CHITS. This EMR system has been deployed to different Rural
Health Units for the purpose of automation of the patient information on site. The
features that would improve health service delivery in using EMRs such as CHITS
are data entry, data review, assessment and understanding triggered by user tasks.

Furthermore, people should take note as well the 5 Rights CDSS should have
the right information, to the right people, though right channels, in the right
intervention formats and at the right points in workflow. [THES2016]

2.2.3.5 eHealth

According to Govph (2015) to the article “eHealth” guided by the PeHSP for
UHC, one of the identified critical eHealth projects to address the above situational
health condition is the development and implementation of the Philippine Health
Information Exchange (PHIE). The PHIE is a platform for secure electronic access
and efficient exchange of health data and/or information among health facilities,
health care providers, health information organizations, and government agencies
in accordance with set national standards in the interest of public health. The PHIE
is envisioned to become an integral component of the health care delivery system as
part of health services available to all patients. It shall integrate and harmonize
health data coming from different electronic medical record systems and hospital
information systems. It shall provide an infrastructure for data/information sharing
between health care providers, and support access to patients records across
providers in all geographic areas of the country; thereby, improving efficiency and
reliability of communication among participating health care providers. In general,
its implementation shall promote public health, improve total patient care and
better decision making, while safeguarding the right to privacy of every individual.

From the viewpoint of business process owners, the PHIE aims to achieve
integrated healthcare services and delivery that is also seamlessly responsive,
efficient, cost-effective, and real-time. Specifically, the system will aid in Enabling
secured data sharing between authorized healthcare providers and consequently,
supporting protected access to clients health data record across providers in many
geographic areas of the country; Providing a single unified view of clients health
data record across health facilities whether a hospital or clinic through an interface
that is accessible anywhere and anytime; thereby, enhancing client care
collaboration; Facilitating aggregation of health data into a longitudinal electronic
medical record; and Generating accurate and real-time health statistical reports for
monitoring and evaluation, with subsequent development of appropriate
interventions, policies, and protocols.

Point of service applications, i.e. the systems used by the health facilities such
as hospitals, rural health units, and clinics to access and update the clients records
interact with the PHIE. Examples of these are the DOHs Integrated Hospital
Operations and Management Information System (iHOMIS), and Integrated Clinic
Information System (iClinicSys) used by government hospitals and rural health
units, respectively, for recording and updating a clients medical record. One of the
essential end-products of this component is a unified client-centric electronic
medical record that can be securely shared among healthcare providers.
[EHEA2015]
2.2.4 Local Studies

2.2.4.1 COMPUTERIZED INFORMATION SYSTEM IN BARANGAY

POBLACION, DANAO CITY, CEBU - CAPSTONE PROJECT

Figure 2.28 COMPUTERIZED INFORMATION SYSTEM IN BARANGAY

POBLACION, DANAO CITY, CEBU - CAPSTONE PROJECT

The main goal of the study is to develop a Computerized Barangay

Information System that can automate the record-keeping process in order to
produce efficient and accurate reports and proper automated files management.
Furthermore, the system will be able to secure residents confidential records, to
easily update resident‟s profile, provides backup database of all records and to issue
certificates/permits and other related records. In addition, the software product is
compiled using Windows XP operating system and is written in visual basic 6.0; a
member of Microsoft Integrated Development Environment applications.

The software product supports Windows XP, Vista, 7, 8 and 10. Features
Below are the main features of the proposed system. Login is the procedure used to
get access to an application and this would ask for the username and password.
Files Button contains the data that are being recorded especially for official
purposes. E.g. Certificates, Permits and other Barangay Issuance. Backup and
Restore Button, backup refers to the copying of files or databases to a secondary site
for preservation in case of equipment failure or other catastrophe; restore refers to
bring back the files and to put back into a former or in an original state. Quick
Search Button is a search engine that operates on material stored in a digital
database and it allows to search the recorded data in the database.

Figure 2.29 User Account

User Account Button is a location in a database used to store a username,

password, and other information, that can be used in logging in the system.
Temporary Lock Button will allow the end user to be temporarily locked from
his/her current work without logging-out. To resume from his/her current work,
end user must enter his/her password. Print is a process for reproducing text and
images using a master form or template; this allows printing files like certificates,
permits and other barangay issuance. Saved Button is to copy data from a
temporary area to a more permanent storage. Furthermore, all the data will be
stored in a single string which will be put back into the database. Purok Button
displays how many purok are there in the barangay and displays also the registered
residents in every purok. Organizational chart and list of employees displays the
current names of the barangay officials and it contains their specified position.
 Figure 2.30 Load Event

Load Event is the part of an application that is responsible for loading

preferences and also responsible for preparing the database to connect to the
application. Limitations The system will only cover records like certificates, permits
and other barangay issuances. Product Characteristics, the barangay information
system consist of the following characteristics: Maintainability The software can be
easily maintained. End users may run an antivirus for the computer where the
software product is running. Furthermore, the software product requires a running
and updated OS. In addition, trained personnel who can handle the software product
is highly recommended. Thus, the program has the ability to maintain security of the
database. Dependability It will help the user in making their job easier and can
lessen their time. The end users can secure the files by putting credentials where
only the authorized personnel can access.
 Figure 2.31 Main Menu

Main Menu Description: It opens when success of loading the Main Menu a window
shows, main menu is a type of user interface which allows the user to interact with a
computer through a metaphor of direct manipulation of graphical images or icons.
Date: December 1, 2016 Owner: Lado, Mark John, Maloloy-on Monica, Perez Gladys,
Rizaldo, Philip Keven and Tacocong Stephanie Acceptance Requirement: The system
should able to display the icons category. Number of test cases: 6 Decision:
Accepted. In all cases, the system will be able to open the respective form that
indicates the correct form.

Figure 2.32 Files

Files Description: The files are a collection of records. In this form, it displays
buttons that are related to the software product. This contains related barangay
issuances. After filing succeeds the data is stored in the central database. Date:
December 10, 2016 Owner: Lado Mark John, Maloloy-on Monica, Perez Gladys,
Rizaldo, Philip Keven, and Tacocong Stephanie Acceptance Requirement: The
system should be able to display the buttons category that contains data like
certificates, permits and other barangay issuances. Number of test cases: 12
Decision: Accepted. In all cases, the system will be able to open the record- keeping
that indicates the certificates, permits and other Barangay issuance.

Figure 2.33 Residents

Residents Description: Clicking Residents, this will show the registration form. A
person who lives somewhere permanently or on a long-term basis should fill-in.
When registrant is already done, clicking “Register” will automatically save the data.
Date: December 15, 2016 Owner: Lado Mark John, Maloloy-on Monica, Perez Gladys,
Rizaldo, Philip Keven and Tacocong Stephanie Acceptance Requirement: The system
should able to add new data as a resident and should able to display the registration
form. Number of test cases: 6 Decision: Accepted. In all cases, the system will be able
to add new registrant which also displays the registration form.
 Figure 2.34 Back – up and Restore

Back – up and Restore Description: This system will allow users to create backups
and restoration of the current database. Back-up and restore is a secure place to
prevent losing the data. In no event, an unauthorized person is not granted in
accessing this panel. When Back-up and restore succeeds you need to re login for
the security. Date: January 6, 2017 Owner: Lado Mark John, Maloloy-on Monica,
Perez Gladys, Rizaldo Philip Keven and Tacocong Stephanie Acceptance
Requirement: The system should able to copy the current database to another disk
as a backup in case of system failure and can still restore the database. Number of
test cases: 9 Decision: Accepted. In all cases, the system will be able to copy the
current database to another disk as “back up” and can perform a “restore” in which
to bring back the files to its original state.
 Figure 2.35 Search

Search Description: By clicking its category, search shows the complete

information.A search is the organized pursuit of information. Date: January 10, 2017
Owner: Lado Mark John, Maloloy-on Monica, Perez Gladys, Rizaldo Philip Keven and
Tacocong Stephanie Acceptance Requirement: The system should be able to display
real-time searching results and display all records of the registered residents.
Number of test cases: 5 Decision: Accepted. In all cases, the system executes
successfully and runs well. It searches initially when you enter key letters and
displays real-time searching results.
 Figure 2.36 Purok

Purok Description: This will display the registered residents in every purok. Date:
January 17, 2017 Owner: Lado Mark John, Maloloy-on Monica, Perez Gladys, Rizaldo
Philip Keven and Tacocong Stephanie Acceptance Requirement: The system should
be able to organize all the residents in its Purok. This should be done by using six
command buttons. Number of test cases: 3 Decision: Accepted. In all cases, the
system will be organized by purok. It shows the different purok, clicking them
contains records.
 Figure 2.37 Search

User Accounts Description: This enables the user to add new user account that can
be used in accessing the system. To complete the registration, you need to answer
the security questions and set the privilege for full security. Date: January 19, 2017
Owner: Lado Mark John, Maloloy-on Monica, Perez Gladys, Rizaldo Philip Keven and
Tacocong Stephanie Acceptance Requirement: This system should be able to add
credentials for the authorize person and also deletes credentials. Number of test
cases: 3 Decision: Accepted. In all cases, the system is able to add credentials and
delete added credentials, as well.
 Figure 2.38 Organizational chart

Organizational chart and list of employees Description: In this form, it's able
to show the organizational chart of Barangay Poblacion and also the list of
employees. Date: January 25, 2017 Owner: Lado Mark John, Maloloy-on Monica,
Perez Gladys, Rizaldo Philip Keven and Tacocong Stephanie Acceptance
Requirement: The system should be able to access the organizational chart and list
of employees. Number of test cases: 3 Decision: Accepted. In all cases, the system
will be able to show the names and their respected positions.
 Figure 2.38 Print

Print Description: In releasing Barangay issuances, you need to print it as a hard

copy, as secondary copy to the requestor. Date: February 8, 2017 Owner: Lado Mark
John, Maloloy-on Monica, Perez Gladys, Rizaldo Philip Keven and Tacocong
Stephanie Acceptance Requirement: The system should be able to print all
documents like Summon-Lupon Record, Write Barangay Clearance and Write
Summon-Punong Barangay. Number of cases: 5 Decision: Accepted. In all cases, the
system will be able to show the print preview of the document which can be done by
clicking the print button.

The software is designed by the researchers that it can achieve the required
needs of the end users. It can save time in record retrieval, filing and other
processes. It is faster and dependable than doing the manual recording. User-
Friendly, the software is designed for the end users to be able to understand easily,
effectively and efficiently without deep instructions. Significance of the Study The
significance of the study is very timely for wherein technology is getting bigger and
in demand. The proposed system will have a significant effect on both the residents
of the barangay and barangay employees who manage the system as well as the
barangay itself. The implementation of the system will change the methods and
process that the barangay is accustomed to for keeping their files. This will also
ensure that all the records will be intact and updated. The system will also create a
census-based environment to monitor the population of the locale. The barangay
will also be assured that the file will be protected and safe for it will require
authorization before someone can access the system. [SLID2017]

2.2.4.2 Pampanga’s Barangay Health Information System (PBHIS) : A Decision

Support & Health Information System for Rural Health Unit 1

Figure 2.39 Pampanga’s Barangay Health Information System

(PBHIS) : A Decision Support & Health Information System for

Rural Health Unit 1

Pampanga’s Barangay Health Information System (PBHIS) was developed as

a decision support and health information system to specifically cater to the Rural
Health Unit I of San Fernando City in providing relevant health programs it its
citizens. It has 5 main modules: (1) System Users Module, (2) EMR Module, (3)
Reports Generation Module, (4) Analytics Module, and (5) Program Proposal
Module. The modules were defined through benchmarking that best fit as solutions
to the problems identified.

Figure 2.40 Screenshot of EMR Module

The first module focuses on the registration of the users of the system who
have different levels of access which corresponds to their respective responsibilities
from maintaining the system, encoding data, and generating reports.

The second module, EMR Module, focuses on the recording and tracking of
patient health information which includes patient data, health details and
consultation records. It was identified that the client used paper records, which was
one of the sources of the problems. Therefore, this module was built as a central
document repository for the RHU, moving towards their goal of being paperless.
Digitized patient records allowed for a faster and efficient retrieval of data which
had been previously performed by a nurse sifting through the documents of the
entire health center. This module is a vital part of the system as the data collected is
also utilized in other modules. With the EMR module, the client can now collect and
track patient data. See Figure 1 below for the now electronic Individual Treatment
Record:

The third module, reports module, allowed the RHU and BHCs to generate
and print mandated reports requested by the Department of Health and PhilHealth.
This module addressed the difficulty in Presented at the DLSU Research Congress
2018 De La Salle University, Manila, Philippines June 20 to 22, 2018 processing and
generating reports which cause delays in report submission of the RHU to the
respective health agencies. With the reports module, the clients were able to have
more time in providing health services to constituents rather than having spent time
creating reports.

The fourth module is composed of descriptive and prescriptive analytics that

is capable of handling and manipulating EMR. The major function is to present data
in a way that can assist in program proposals and decision-making by helping
prioritize programs to deliver, diagnosis to tackle, and define targets. It is achieved
by presenting data with the context of data visualization, system prompts, and
customized reports, as well as suggestions for a program proposal from the system
based on previous evaluated programs. The feature of this module is mainly seen
embedded with the program proposal module.

The last module focuses on program proposal for use in the RHU and
evaluation of accomplished programs for future use as historical data. Being
integrated with the analytics module, it provides alerts and recommendations which
will be used as sufficient evidence and cause to propose and plan a program in
response to cases of concern. The analytical capabilities of the system can be
generalized into two parts: (1) targets recommendation and (2) programs
recommendation.

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.
[DLSU2018]

2.2.4.3
2.2.4.4

Figure 2.

2.2.4.5

Figure 2.