CHAPTER I

INTRODUCTION

Background and Rationale

Hospitals are health care institutions that have an organized medical and professional

staff, members, inpatient facilities, and deliver services 24 hours per day, seven days per week.

They offer a varying range of acute, convalescent and terminal care using diagnostic and

curative services. Hospitals need to be organized around people’s needs, working closely with

other health and social care services and contributing to strengthening primary health care

(PHC) and public health services, to substantially contribute to Universal Health Coverage.

(World Health Organization)

Health has been acknowledged by the World Health Organization as “a state of

complete physical, mental and social well-being and not merely the absence of disease”.

(Research for Health: Policy Briefings by Council on Health Research for Development and

Global Forum for Health Research) The World Health Organization defines social determinants

of health as “The conditions in which people are born, grow, work, live and age, and the wider

set of forces and systems shaping the conditions of daily life.” (World Health Organization)

Some of the factors that contribute to health are Health Behaviors (20%), Social and Economic

Factors (40%), Physical Environment (20%) and Clinical Care (20%). (Health Research &

Educational Trust 2017, November). Although Clinical Care comprises only 20%, good medical

care still plays a major role in a person’s health status.

 Medical establishments in the Philippines have always faced a number of problems

including long waiting hours and inconvenient schedules. These are usually caused by a large

volume of patients, lack of proper queuing system, and the unavailability of more advanced

scheduling options. These complications may cause a delay in diagnosis thus, puttingthe lives

of the patients in danger. Another problem that may arise is the high possibility of infectious

diseases spreading if patients are in a crowded waiting room.

The healthcare system in the Philippines can be considered to be of a good standard,

despite the fact that the facilities may not be as impressive as those found in high-end US or

European hospitals. Medical practitioners in the Philippines are graduates from the top

universities in the country and most of them have studied in US medical schools. Additionally,

there are doctors that have practiced medicine in the US before sharing their expertise in the

Philippines. Filipino nurses are also trained by nursing schools that have excellent standards. In

fact, a large percentage of Filipino nurses go on to work in the US. (Allianz Care)

In its current decentralized setting, the Philippine health system has the Department of

Health (DOH) serving as the governing agency, and both local government units (LGUs) and

the private sector providing services to communities and individuals. The DOH is mandated to

provide national policy direction and develop national plans, technical standards and guidelines

on health. Under the Local Government Code of 1991, LGUs were granted autonomy and

responsibility for their own health services, but were to receive guidance from the DOH through

the Centers for Health Development (CHDs). Provincial governments are mandated to provide

secondary hospital care, while city and municipal administrations are charged with providing

primary care, including maternal and child care, nutrition services, and direct service functions.
Rural health units (RHUs) were created for every municipality in the country in the 1950s to

improve access to health care. The private sector, which is much larger than the public sector in

terms of human, financial and technological resources, is composed of for-profit and non-profit

providers that cater to 30% of the population. Although the private health sector is regulated by

the DOH and the Philippine Health Insurance Corporation, health information generated by

private providers is generally absent in the information system of the DOH. Regulation of health

science schools and universities is under the Commission on Higher Education, while the

regulation of health professionals is carried out by the Professional Regulation Commission.

PhilHealth introduced health technology assessment (HTA) in the early 2000s to examine

current health interventions and find evidence to guide policy, utilization and reimbursement. As

a third party payer, PhilHealth regulates through the accreditation of health providers that are in

16 compliance with its quality guidelines, standards and procedures. The Food and Drug

Administration (FDA) regulates pharmaceuticals along with food, vaccines, cosmetics and

health devices and equipment. At present, patients´ rights and safety are expressed under the

purview of the Penal Code and Medical Act of 1959 and health professional practice acts. The

lack of a gatekeeping mechanism in the health system allows patients to choose their

physicians. Patient empowerment, on the other hand, has remained more a concept than a

practice. The relationship of the health system with individuals, families and communities is still

largely one of giver to recipient. (Allianz Care)

Health care systems in the Philippines are divided into two: the Private Health care and

Public Health care systems. The private health sector caters to 30% of the population and is

based on North American medical models. Medical services in private hospitals are frequently

touted to be held to a higher standard, but that also means it comes at a higher price (Allianz

Care). The public healthcare system is delivered through public health and primary healthcare
centers linked to peripheral barangay (local town) health centers. Around 40% of the hospitals

in the Philippines are public. Doctors at public hospitals in the Philippines are well-trained, but

the technology and equipment used at public hospitals are not as good as private

ones. (Stramis document)

The usual medical appointment scheduling in the Philippines is primitive. Patients either

have to call their doctors or wait in line for their appointments. Time is wasted during long

waiting hours and there is a possibility for infection seeing that the waiting rooms or hallways

are packed with a large number of people who may initiate the spread of infectious diseases. In

order to address the issue, medical institutions in the Philippines would provide priority numbers

in order to prioritize those who came in early but still, it does not change the fact that people still

have to wait inside a crowded room, still uncertain of the flow of the medical procedure.

The Medical Appointment Scheduling System is a system designed to address those

issues which are common in the Philippines especially in health centers with out-patient

departments. It can provide a problem-free appointment scheduling and faster transaction

between patient and medical expert. It can also maximize the integration of technology even in

public health care centers. According to the management of Prince Charles Hospital, having an

efficient hospital queue management system at a health care institution is of utmost importance,

especially when the patients visiting the facility are either in pain or frail health, making it difficult

for them to queue for long periods of time until a medical practitioner is available to treat

them. (The Prince Charles Hospital Management, Chermside, Queensland)

 A web-based application will be designed entirely for the purpose of making medical

appointment scheduling faster and more convenient. The application can be accessed by any

user with the capability of using the web. The application software will allow the patient to log in

or sign up and enter the user’s basic information. It will then enable the user to select the body

part/s which is in need of medical treatment. After which, a series of symptoms will be provided

and the user is required to check the ones that fits his condition. If the symptoms felt are not

included on the list, the user may write it down on the space provided after the checkboxes. The

information will be sent to the doctor’s registry of patients and a reference number including the

estimated time for the appointment will be received by the user.

Objectives of the study

General Objectives

To design, construct, develop and test a Medical Appointment Scheduler System.

Specific Objectives

1. To design and construct a Medical Appointment Scheduler System that may be used to

replace the conventional way of scheduling in the Philippines by creating a web-based

application that is accessible to every user of different operating systems.

2. To create a software application that will perform the initial gathering of patient

information such as the name, age, gender, address, contact number and allow the

patient to check the symptoms applicable to them which is provided by the software

application.

3. To test and evaluate the effectiveness of the Medical Appointment Scheduler System.
Significance of the Study

Since the application is web-based, users can easily access it using any computer or

phone connected to the Internet using a standard browser. The transfer of information is also

easier and more accurate.

A large number of patients may be hard to accommodate thus, the system is useful in

minimizing the time and effort exerted by both the patient and the doctor. With the system, a

patient is not required to line up and wait for his turn given that he has a reference number

provided by the Medical Appointment Scheduler.

Medical Personnel. Inquiry about the patients regarding how they feel will be

unnecessary because the system will automatically summarize the symptoms previously

checked or provided by the patient himself. Thus, the attending doctor’s only responsibility is to

verify the summarized symptoms and provide the appropriate diagnosis including the suitable

medicine.

Patients. This is the biggest beneficiary of the proposed system since the main focus of

the study is the comfort of the patients. They can access the system using any device and any

operating system with internet connection. The application will also be user-friendly in order to

accommodate all kinds of patients with or without the knowledge regarding the usage of

applications. The reference number returned to the patient is also a huge help for a lot of time is

saved and a lot of necessary work can be done for the day instead of just waiting in line.
 The study will also help reduce the overcrowding in hospital or clinic hallways which

prevents the entry of other people with different appointments. Overcrowding may also

contribute to the transmission of diseases with epidemic potential such as acute respiratory

infections, meningitis, typhus, cholera, scabies, etc.

Scope and Limitations

The study is designed specifically to provide an efficient transfer of information from

patients to medical experts and not for self-diagnosis. It is limited to medical establishments or

clinics with the out-patient department. Majority of the respondents or the patients should also

have the means of connecting to the Internet to access the application.

The application is web-based thus it can be easily accessed by any user since it is

instantly available, easy to transfer files from one user to another and compatible with any

device including gadgets with lowers specifications.

The project is also designed for users of any age who are capable of operating the web

but children of younger age should be guided by a parent or guardian to ensure the veracity of

the information provided. It is also limited to regular check-ups or any clinic visit and not for

emergency purposes.