CAGAYAN STATE UNIVERSITY AT LAL-LO 1

MEDICAL INFORMATION MANAGEMENT SYSTEM

OF NOLASCO MEMORIAL HOSPITAL

In Partial Fulfillment for the Academic Requirement for the degree

Bachelor of Science in Information Technology

By:
Codeno, Denalyn H.
Baloran, Joshua B.
Eustaquio, Gina C.
Sampayan, Efren B.
Umayam, Frances C.

June 2023

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Chapter 1
INTRODUCTION

The Problem and Its Background

In today’s society, Information and Communication Technologies (ICT) play an

important part in almost every area. This ICT has the potential to promote the patient-
centered health care at a lower cost, it can increase the quality of care and sharing of
information, also educate the health professionals and patients and lastly, it can stimulate
other forms of interaction to patients and health providers. This can also help to access
easily the patients’ medical record by collecting of the patients’ data because it is one of
the most important aspects in the medical field. The medical data is one of the essential for
doctors to analyze the patient’s situation and illness and then to find a possible cure for it. In
the past, the patient records used to create a large amounts of paperwork because everything
was on paper and pen. In accessing the past records was troublesome. However, with the
development of digitalization, the medical information of patients can be keyed into a
digitized system. These has provided the extraordinary ease for doctors and patients to
access with a click of a button, from anywhere at anytime.

Medical records, also referred to as patients' records, are scientific compilations or

documentations of a person's healthcare data through time and within the scope of a
certain healthcare provider. Biographical details, medical histories, surgical and treatment
histories, etc. are all included in this data. To have a good influence, it would be beneficial
to undertake a thorough analysis of the facility's record-keeping and management
procedures or systems, as well as the security issues with the current system. The manual
technique of managing patient health records is restrict by a number of issues, including
slow and laborious manual processing, increased patient wait times, lack of proper
security of patient information and more importantly, a lack of backup for the records that
are already available could, if ignored, lead to medical-legal issues and a violation of trust
on the side of the hospital management.

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Jeyakumar T. et al. (2021) Health Information Systems have been proposed as a

solution in a complex organizational approach to transforming the quality of care
delivered, increasing patient safety, and reducing health care costs. An HIS is defined as a
system designed to integrate data collection, processing, and reporting and the use of
health information to influence policy making and improve health service effectiveness
and efficiency. This enables the facilitation of health information sharing among multiple
authorized custodians across the health care persistence in support of clinical efficiency
and optimal quality care. The aim of this is to understand the most effective strategies and
approaches to enable the health care providers to optimally use an health information
system.

The Medical Information Management System of Nolasco Memorial Hospital

currently uses a manual system to manage medical records. This type of technology,
typically lacks any backup and offers nonexistent protection for patient medical data. This
new role in medical records strategy adds significant changes to the MIMS function and to
the professionals in an organization. In fact, the major goals of medical records in the
organizations enables health practitioners to store and retrieve data relating to a patient's
medical records. It also enhances the communication of patient information through a
legible format that anyone can use. As a result, it reduces the chance of medication errors.

The Medical Information Management System of Nolasco Memorial Hospital is an

organizational unit that has identified the need for a computerized system to be used to
better ensure that the hospital procedures are performed in a systematic manner resulting in
a streamlined work of medical records. Moreover, managing the records of the patients
will be done more effectively and efficiently using such a tool. It will also ensure the
effective use of medical records and enable proper communication and timely access to
accurate information to those who need medical information.

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

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efficiently and effectively thus resulting to the generation of accurate information.

Moreover, the use of the developed system shall ensure the availability of information
which at times are needed in hospital decision-making and reporting needs.

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Related Literatures and Studies

This part presents the literatures and studies from foreign and local researches as well
as related readings, which bearings on the research.

This conducted a systematic review on the effectiveness of HIMS in improving

healthcare processes and outcomes. They found that HIMS improved patient safety,
clinical decision-making, and communication between healthcare providers, (Shahmoradi
et al., 2017).

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).

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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.

According to Charles Southey (2016), clinic management can maximize the

productivity and profitability of medical practices. The most important segment that will
be use in the systemis the “medical record”. Medical record is an important compilation of
facts about the patient’s life and health.

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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.

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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.

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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.

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Fan, K. et al. (2018), with the development of electronic information technology,
electronic medical records (EMRs) have been a common way to store the patients’ data in
hospitals. They are stored in different hospitals’ databases, even for the same patient.
Therefore, it is difficult to construct a summarized EMR for one patient from multiple
hospital databases due to the security and privacy concerns. They proposed a blockchain-
based information management system, MedBlock, to handle patients’ information.

Ekblaw, A. et al. (2016), A long-standing focus on compliance has traditionally

constrained development of fundamental design changes for Electronic Health Records
(EHRs). We now face a critical need for such innovation, as personalization and data
science prompt patients to engage in the details of their healthcare and restore agency over
their medical data. The purpose of this study is to expose, in preparation for field tests, a
working prototype through which we analyze and discuss our approach and the potential
for blockchain in health IT and research.

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.

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Hospital Information System (HIS) is a comprehensive, integrated information system
designed to manage the administrative, financial and clinical aspects of a hospital. This
study is to describe those aspects of the implementation of hospital information system in
three tertiary hospitals in Klang Valley; Serdang Hospital, Selayang Hospital and
University Kebangsaan Malaysia Medical Centre (UKMMC). There were differences in
hospital information system development and implementation in the three hospitals. Each
system has its own strengths and weaknesses that make it unique. In developing HIS, its
important to ensure the system can work effectively and efficiently. Quality human
resource, good support system, user-friendly and adequate training of the end-user will
determine the success of implementation of HIS. Upgrading of hardware and software as
needed is the basis to keep up with the pace of technology advancement and increasing
number of patients. It is hoped that HIS will be implemented in all other hospitals with
effective integration and networking, (Ismail, A., 2010).

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.

Imus, et al. (2018), Management Information System provides an efficient and

effective way to record andmanage information that is needed of every barangay. A
Barangay Management Information System is a program which contains features that
records and manages information and at the same time can senddocuments from barangay
hall to the city hall. In relation to this article a system that provides an efficient and
effective way to record and manage information.

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According to Masoud Hussein Mahundi (2018), The need for integration of health
information systems as realized in the 90s by the developing countries resulted into
deliberate standardization initiatives. Software systems, human resources, procedures, and
data collection tools were all subjected to standardization. This standardization, however,
has been so absolute that the local and permanent variations were not taken
intoconsideration.In relation to this study, it provides the data to identify non-performing
areas and leads to better business productivity and efficiency.

According to Urs Saas, the advancement and improvement of Information Technology

provides a lot more convenience in terms of recording, storing and keeping large scales of
different types of records. To be able to make use information, scientific controls are
beingapplied. A Record Management System has been developed to manage recording
more efficient and more convenience.

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.

According to The Indian healthcare industry is growing at a phenomenal rate, with

private hospitals, government funds and foreign aid in the public health program steering
this growth. The combination of high quality service at low cost is also making India a
destination of health tourism as this mixes fun and leisure with necessary medical
attention. The positive effects of all these endeavors is that the life expectancy of an
average Indian has increased, however this is not a reason to be satisfied as figures are still
very modest when compared globally. (Mukherjee et al., 2015)

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

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implementation of HIS depends on the context of the implementation and applications, as
well as on the clinical problems and the patient population.

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,

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documentation and standards of practice, and EHR efficiency. IT concerns include
interoperability, vendors, innovation, nursing voice, education, and collaboration.

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).

Bouayad L. et al. (2017), a new generation of user-centric information systems is

emerging in health care as patient health record (PHR) systems. These systems create a
platform supporting the new vision of health services that empowers patients and enables
patient-provider communication, with the goal of improving health outcomes and reducing
costs. This evolution generates new data sets and capabilities, providing opportunities and
challenges at the user, system, and industry levels.

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.

It is an authentication of medical data and reports is a significant issue for preparing,

editing, and transmitting the patient report. (S. Samanta, et al., 2016), the medical
information transfer requires communication technologies in order to offer health care
services. This achieves mutual availability of therapeutic case studies among different
diagnostic hospitals or centers which are very widespread.

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.

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In summary, the medical information management system lies in improving the quality,
efficiency, and effectiveness of the healthcare services and it is important because it is one of
the documentation tool that yields the data useful in enhancing patient safety, evaluating care
quality, maximizing efficiency, and also measuring the staffing needs.

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.

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Conceptual Framework
INPUT PROCESS OUTPUT
Practices and Analyses on the Medical Information
procedures of MIMS practices, procedures, Management System of
of Nolasco Memorial problems, gaps and Nolasco Memorial
Hospital office in the needs in data collection, Hospital
collection and storage storage and retrieval of
of patients information the patients record at
Patients’ e-Portfolio
the MIMS-NMH
Problems, needs and Patient Information
gaps in the existing System Development Physical Examination
Laboratory Findings
records collection and using DSDM History Sheet
storage of the MIMS- Doctor’s Orders
NMH office Assessment of the Medication and Treatment
Sheet
System on the Extent of Nurses’ Progress Notes
Patients’ Personal Compliance to ISO Medicines/Supplies
Information (PDS data) 25010:2011 Software Discharge Summary Sheet
Quality Standards
Patients’ documents
Patient Information
Physical Examination
Laboratory Findings
History Sheet
Doctor’s Orders
Medication and
Treatment Sheet
Nurses’ Progress Notes
Medicines/Supplies
Discharge Summary
Sheet

ISO 25010:2011
Software Quality
Standards

Feedback

Figure 1. Conceptual Framework

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The conceptual framework followed the input-process-output diagram with a feedback
mechanism. The elements of the input were the identified needs, problems, gaps and
practices of the MIMS office of Nolasco Memorial Hospital. Personal information of
patients as reflected in their Personal Data Sheets were also inputs as well as digitized
copies of their pertinent documents. Moreover, the assessment tool for software quality
standards shall be used to evaluate the system to be developed.

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.

A feedback mechanism is incorporated to help in the holistic development and

improvement of the system.

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Flow Chart

Start

Patient
Registration

Availability Ask for nurse

of Doctor recommendation
No

 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

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Hierarchical Input-Process-Output Diagram

Login Form

Home

Patient Doctor’s Physical Medication

Orders Examination and Treatment

Nurses’ Medicines/
Laboratory Supplies
Progress Notes Findings

Discharge
History Sheet Summary

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Statement of the Problem

The project aims to develop a Medical Information Management System of Nolasco

Memorial Hospital.

Specifically, it seeks to answer the following questions:

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?

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Scope and Limitations
This study will focus on the design, development and evaluation of a Medical
Information Management System of Nolasco Memorial Hospital. The data and information
shall be limited to the MIMS of Nolasco Memorial Hospital office where the information
shall be obtained.

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.

Significance of the Study

This study would be essential in the Medical department of Nolasco Memorial Hospital
at Centro Sur, Gattaran, Cagayan and all the people who will having an access in this
project. They help provide a better care to patients by enabling quick access to patient
records resulting in more efficient care and also automate a different variety of task that
meet the user and patients needs. Enabling the providers to improve efficiency and meet
their business goals. The system will save time and speed up the work, provide and satisfy
the patients. The outcome of this study would provide the greater benefits to the following:

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.

IT Practitioners. As the role of IT is emerging, IT practitioners would likewise benefit

from this study by looking at the potential role of a more challenging integration of

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information technology in the field of office administration. The knowledge gained from
involving IT in various fields would somehow urge the emergence of IT experts in the
society.

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:

Compatibility. It is the degree to which the proposed system can exchange

information with other products, systems or components, and/or perform its required
functions, while sharing the same hardware or software environment.

Efficiency. It is the quality of the proposed system of being able to do a task

successfully without exerting too much effort, saving time and costs towards the production
of necessary information.

Functionality. It is the summary or any aspect of what the proposed system

application can do for the user meeting its required outputs without fear of generating or
manipulating the system. It includes the ability to perform the task or function as per
requirement.

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.

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Information System. It is a software solution used for data entry, data tracking and
information management.

Maintainability. It is the extent of which the proposed system or the software

application is understood, repaired, or enhanced. With less or no intervention from the
developers, it would include the ability for the organization to sustain the utilization of the
system in place.

Medical Record. It is a comprehensive and systematic documentation of a patient’s

medical history, diagnosis, treatments, and outcomes over time.

Performance Efficiency. This characteristic of the proposed system which represents

its performance relative to the amount of resources used under stated conditions.

Portability. It is the extent of the proposed system to be used in an operating system

other than one in which it was created without requiring major assistance or rework. It is the
ability of the system to run and execute smoothly in a new environment.

Record. It is thing constituting a piece of evidence about the past, especially an

account of an act or occurrence kept in writing or some other permanent form.

Reliability. It is the degree to which the proposed system could be relied on or

depended on, as for the accuracy, quality, yielding the same results based on requirements.

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.

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Chapter 2
METHODS AND PROCEDURES

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.

Figure 1 shows the concept of Dynamic Systems Development Method (DSDM) as

an agile project delivery framework, primarily used as a software development method
which shall be used in the development of the system. The framework consists of seven (7)
phased steps which are organized and embedded in set of roles and responsibilities and are
supported by several core techniques. The phases are Pre-Project, Feasibility Study,
Business Study, Functional Model Iteration, Design & Build Iteration, Implementation, and
Post-Project.

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Figure 1. Dynamic System Development Method (DSDM)

Source: https://www.google.com/url?sa=i&url=https%3A%2F
%2Fwww.codeproject.com%2FArticles%2F5097%2FWhat-Is-
DSDM&psig=AOvVaw1hRoriD9eRoFdFcm4BWuyV&ust=1686660041646000&source=ima
ges&cd=vfe&ved=0CBEQjRxqFwoTCNCD-OGpv_8CFQAAAAAdAAAAABA3

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.

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User Admin Data

Process Input

Output Information

Figure 2. System Architecture of the Project

Context and Data Flow Diagram

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

Figure 3. Context Diagram of the project

Use Case Diagram

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The Use case diagram (Figure 4) describes the actual flow of usage of the system
from the user (actor). The user is the Hospital Admin/Staff of Nolasco Memorial Hospital.

Manage User
Data

Input patients’
data

View patients’
data

Manage patients’
data

Manage patients’
document

Prepare printed
medical record

Figure 4. Use Case Diagram (User/Admin)

Database Schema

Entity Relationship Diagram

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Wireframes ( User Interface)

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Sample Output

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Locale of the Study

The study will be conduct at the Nolasco Memorial Hospital at Gattaran, located at
Centro Sur, Gattaran, Cagayan.

Participants of the Study

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The participants to this study as presented in Table shall be composed of the
following:

Table 1. Participants of the Study

Participants Number
Admin 1
IT professionals as panelists 5
IT professionals as system evaluators 3

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.

Data Gathering Tools

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.

Data Gathering Procedure

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Prior to data gathering and collection, the researchers shall perform the following
steps:

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

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the lowest extent or POOR.

Chapter 3

RESULTS AND DISCUSSION

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This chapter includes the presentation of the data, their analyses, and a discussion on
the processes.

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.

III. The developed system,

IV. The extent of compliance of the developed application to ISO 25010 Software
Quality Standards

V. Enhancements that can be made to the developed system

REFERENCES

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Ahmadi, H., Nilashi, M., Shahmoradi, L., & Ibrahim, O. (2017). Hospital Information
System adoption: Expert perspectives on an adoption framework for Malaysian public
hospitals. Computers in Human Behavior, 67, 161-189.

Ahmadian, L., Khajouei, R., Nejad, S. S., Ebrahimzadeh, M., & Nikkar, S. E. (2014).
Prioritizing barriers to successful implementation of hospital information systems. Journal
of medical systems, 38, 1-6.

Akkoc, T.V. (2019), “Self-reported management of pain in hospitalized patients: link

between process and outcome”, American Journal of Medicine, Vol. 117 No. 8, pp. 569-
574.

Bradley H Wagenaar, Kenneth Sherr, Quinhas Fernandes, Alexander C Wagenaar, Using

routine health information systems for well-designed health evaluations in low- and middle-
income countries, Health Policy and Planning, Volume 31, Issue 1, February 2016, Pages
129–135,

Bouayad, L., Ialynytchev, A., Padmanabhan, B.: Patient health record systems scope and
functionalities: literature review and future directions. J. Med. Internet Res. 19(11), e388
(2017).

Cortez, J. E. M., J. K. G. Ishii, A. M. R. Ongkiko, C. R. Ortega, B. P. Malang, and F. G.

Vigonte. “Health Information System Users in Public Health Facilities: A Descriptive
Analytics”. International Journal of Multidisciplinary: Applied Business and Education
Research, Vol. 4, no. 1, Jan. 2023, pp. 156-73, doi:10.11594/ijmaber.04.01.15.

Ekblaw, A., Azaria, A., Halamka, J. D., & Lippman, A. (2016, August). A Case Study
for Blockchain in Healthcare:“MedRec” prototype for electronic health records and
medical research data. In Proceedings of IEEE open & big data conference (Vol. 13, p. 13).

Ismail, A., Jamil, A. T., Rahman, A. F. A., Bakar, J. M. A., Saad, N. M., & Saadi, H.
(2010). The implementation of Hospital Information System (HIS) in tertiary hospitals in
malaysia: a qualitative study. Malaysian Journal of Public Health Medicine, 10(2), 16-24.

COLLEGE OF INFORMATION AND COMPUTING SCIENCES

 CAGAYAN STATE UNIVERSITY AT LAL-LO 3
6
Kai Fan, Shangyang Wang, Yanhui Ren, Hui Li & Yintang Yang Journal of Medical
Systems volume 42, Article number: 136 (2018).

Lavin, M. A., Harper, E., & Barr, N. (2015). Health information technology, patient
safety, and professional nursing care documentation in acute care settings. Online Journal of
Issues in Nursing, 20(2).

Liang, C., Gu, D., Tao, F., Jain, H. K., Zhao, Y., & Ding, B. (2017). Influence of
mechanism of patient-accessible hospital information system implementation on doctor–
patient relationships: A service fairness perspective. Information & Management, 54(1),
57-72.

Putu Wuri Handayani, Achmad Nizar Hidayanto & Indra Budi (2018) User acceptance
factors of hospital information systems and related technologies: Systematic review,
Informatics for Health and Social Care, 43:4, 401-426, DOI:
10.1080/17538157.2017.1353999.

Shaikh, B. T., & Rabbani, F. (2005). Health management information system: a tool to
gauge patient satisfaction and quality of care. Eastern Mediterranean health journal = La
revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit,
11(1-2), 192–198.

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