An Assessment of Manual Medical Record System of Fr. Simpliciano Academy Inc. School Year 2018-2019

An Assessment of Manual Medical Record System of Fr. Simpliciano Academy Inc.
School Year 2018-2019
Chapter I
The Problem and Its Background
This chapter discusses the background of the study, theoretical and
conceptual framework, statement of the problem, hypothesis, significance of
the study, and scope and limitation. This usually leads into the research
problem which focuses on the problem. This chapter also leads the negative
and positive of the research. this is a general introduction to the topical area.
Introduction
According to Professor Dr. Phyllis J. Watson (2006) it is evident that a
majority of the country’s institutions still do not adopt the high technology in
today’s modern age where the computer has become a way of life. Daily clinic
transactions are still done on paper, particularly, in most medical clinic facilities.
Modern clinics are now operating at great pace striving to serve as many
patients as possible with the best of their abilities as we all know. The number of
patients has grown and various medical cases arise that the manual method of
managing patients’ records, prescriptions, billing and appointment schedule is no
longer practical as the years rolled by.
Medical health records form an essential part of a patient’s present and
future health care. Medical health records are used essentially for the present
and continuing care of the patient as a written collection of information about a
patient’s health and treatment. Doctors, nurses and other health care
professionals write up medical records so that previousmedical information is
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available when the patient returns to the health care facility. The medical record
must, therefore, be available. The patient may suffer if the medical record cannot
be located because the information could be vital for their continuing care. The
medical record system is not working properly and confidence in the overall work
if the medical record cannot be produced when needed for patient care.
Also, according to Dick RS, Steen EB, Detmer DE (1997) the patient
record is the principal repository for information concerning patient's health
care. The patient record affects virtually everyone associated with providing,
receiving, or reimbursing health care services in some way. The typical
patient record of today is remarkably similar to the patient record of fifty
years ago despite many technological advances in health care over the past
few decades. The health care system has become an organism guided by
misguided choices; it is unstable, confused, and desperately in need of a
central nervous system that can help it cope with the complexities of
modern medicine. Patient record improvement could make major
contributions to improving the health care system of this nation.
People nowadays rely more on technology to help them with their
current situations in the 21st Century. The researchers thought of applying
the technology somewhere else – the school. People at school who are in
charge of most of the medical paper works struggled to deal with their jobs.
The researchers used this intellect to research the modernized process of
arranging the school’s medical records. The researchers thought of helping
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the people in charge to organize the said records through computers so that
it is easier and more helpful to everyone.
In this study, the researchers hoped to develop a web-based
application that will minimize the manual records keeping and will give
patients more information about the clinic, therefore, allowing doctors and
staff ease in keeping track of patients, reducing patients’ waiting time and
increasing the number of patients served – a system that is fully automated,
user-friendly, time effective and efficient.
Background of the Study
According to Brad Justus (2011) each man, woman, and child has a
historyas simply virtue of being alive. In this technology-enabled age of the
quantified self, more and more people are taking an active interest in their
personal history - downloading apps to track calories and mood swings,
blogging about runs and test scores but arguably the most important record
is your medical record and for people born in the past century, that record
has advanced in both importance and technology.
Prior to 1900, there was no standard method for keeping medical
records. In fact, many doctors didn’t even touch their patients except to
check a pulse and many of their observations centered on studying the
patient’s complexion, urine, and other excretions. There wasn’t much to
write down so. Some more substantial narratives did exist; the ancient
Greeks wrote down advice for patients, lessons for doctors, and stories of
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particularly notable diseases. This practice was revived in the 14th century,
then again with a scientific revolution in the 16th century - marked by a
growing scholarly interest in the natural world and the inner workings of the
body - fueled the expansion of this practice and the publishing of medical
observations. Simon Forman and Richard Napier wrote one of the most
extensive surviving collections of medical records from this time. Other
doctors have kept account books, a list of patients along with their
payments for treatments and prescriptions.
Theoretical Framework
This study is anchored to the theory of PlacidePoba-Nzaou,several
governments in industrialized countries including the US, France, Germany
and the UK, are driving initiatives through regulations or financial incentives
so as to accelerate the adoption of Electronic Health Records by primary
care providers as well as hospitalsin order to cope with the unsustainable
rising costs of health care. Electronic Health Records are a growing
phenomenon that is considered the cornerstone of modern healthcare
systems of the current information age to the extent that, “failure to adopt an
EHR system may constitute a deviation from the standard of care”. In this
context, it is worth noting that there have been limited studies on EHR
implementation in hospital settings despite the fact that hospitals account
for a substantial share of total health care spending. In fact, they account for
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over one-third in the US and Canada and with at least 25% to 60% in the
EU depending on the country.
Electronic Health Record is defined as an electronic record of health-
related information on an individual that conforms to nationally recognized
interoperability standards and that can be created, managed, and consulted
by authorized clinicians and staff across more than one health care
organization. Electronic Health Records entail high potential benefits and
high likelihood of improving individual patients and populations health
outcomes (e.g. – clinical outcomes- reductions in medication errors,
improved quality of care; organizational outcomes- financial and operational
benefits; and societal outcomes- improved ability to conduct research,
improved population health, reduced costs that are often challenged by their
high level of risk that is persistent over time all along the Electronic Health
Record lifecycle as it is for other software packages. The failure of an
Electronic Health Record implementation or the poor management of
Electronic Health Record risk associated with its use may hamper a
hospital’s ability to generate potential benefits in addition to putting patients’
lives at risk and wasting scarce resources. In a broad sense, the poor
management of Electronic Health Record risk has resulted in a high level of
dissatisfaction of hospitals with their Electronic Health Record systems to
the extent that recent surveys have reported that about 20% of hospitals
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want to retire their current Electronic Health Record and switch to another
system.
In most industrialized countries, healthcare costs are rising so fast
that they will become unaffordable by mid-century without reforms. More
specifically, if present tendencies in health care costs prevail by year 2050,
nearly all OECD or Organization for Economic Cooperation and
Development countries will devote more than 20% of their GDP on health
care. And, by 2080 Switzerland and the United States will dedicate more
than 50% of GDP on health care, while by 2100 almost all OECD countries
will reach this level of spending.
This situation qualifies as being an unsustainable trend that needs to
be reversed and, the implementation of Electronic Health Records within the
concerned countries is seen as one of the most promising routes. However,
the implementation of an Electronic Health Record is highly risky.
As observed recently by several horror stories reported in trade press
publications, of Electronic Health Record risk factor occurrences at different
phases of systems’ lifecycles: hospitals forced to close; experienced
unprecedented operating losses; experienced unprecedented weak
operating performance due to Electronic Health Record costs or failure;
experienced costly data breach incidents.
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Conceptual Framework
INPUT PROCESS OUTPUT
 Proposed
 Paper-based  Survey
Computerized
records Questionnaire
System
 Medical  Interview
record folder
The table above shown the input-process-output (IPO) framework of the
manual medical record system.
This explained how the researchers’study is going to function. The
input indicated how the manual system was working. While the process
showed the way on how the researchers will makethe proposed
computerized medical record system possible,and the researchers gave out
survey questionnaires and interviewed chosenhigh school students of Fr.
Simpliciano Academy on how to generate better the medical record system
of the school and asked what were their opinions and suggestions about the
system. The output was the outcome of the researchers’ study, it is the
proposed computerized medical record system that the researchers’
assumed that it will be better than the manual medical record system.
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Statement of the Problem
Specifically, this study aimed to answer the following:
1.) What is the profileof the respondents in terms of:
1.1 Age
1.2 Gender
1.3 Grade Level
2.) What are the advantages/disadvantages of the manual
medical record system?
3.) What are the advantages/disadvantages of thecomputerized
medical record system?
4.) What is the extent of efficacy of the manual medical record
system?
5.) Is there a significant difference achieved between manual
medical record system andcomputerized medical record
system?
Hypothesis
 There is no significantdifference achieved inthe computerized medical
record system and manual medical record system.
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Significance of the Study
This study is significant to the following:
A. Nurses
The proposed system will make the nurses enhance the knowledge
about computers and at the same time it will lessen their work.
B. Patients/Students
The proposed system will make the students have easier access to
their medical files, records, and information.
C. Faculty
The proposed system willmake the faculty members have an easy
retrieval of the medical record, attendance, and profile of the student/s.
D. Administrative Officials
The proposed system will give the Administrative Officials a better
way to access through their medical records and student’s medical
records.
Scope and Delimitation
In general, the focus of this study was directed towards the design and
development of an online clinic management system about a medium-sized
medical clinic with its nurse, patients, faculty, staffs, and administrative
officials within Fr. Simpliciano Academy, Inc. area only from the school year
2018-2019. This study was largely dependent on the honesty, sincerity, and
integrity of the respondents.
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In this proposed system, records and files are computerized and
stored online for accessibility and portability. However, the proponents limit
the online feature of the system to parents, students, nurse, teachers, and
staff only. The system has a secure log-in for the selected people. Services,
contacts, and information are also included in this system.
The patients or students can sign-up the program in order to access
the computerized system. The nurse can also access the program in
monitoring and updating someinformation on the system.
Definition of Terms
Clinical Information -des laboratory results, medicines, referrals,
discharges and other clinical documents.
Clinical Reminders - helps caregivers deliver higher quality care to
patients for both preventive health care and management for chronic
conditions, and helps ensure the timely clinical interventions are initiated.
Data Process – the process of putting information into a computer so that
the computer can organize it, change its form, etc.
Data Display - is viewed by many disciplines as a modern equivalent of
visual communication.
Data Retrieval - obtaining data from a database management system such
as ODBMS. In this case, it is considered that data is represented in a
structured way, and there’s no ambiguity in data.
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Health Care – the prevention or treatment of illness by doctors, dentists,
psychologists, etc.
Hospital Care Efficiency - is a comparison of delivery system outputs,
such as physician visits, relative value units, or health outcomes, with inputs
like cost, time, or material.
Health Care Facilities - are places that provide health care.
Health Professional -is an individual who provides preventive, curative,
promotional or rehabilitative health care services in a systematic way to people,
families or communities.
Medical Record Worker - is someone who is responsible for accurately
transcribing and organizing patients' medical histories, symptoms and
diagnoses, as well as categorizing treatments and procedures for insurance
billing.
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Chapter II
Review of Related Literature and Studies
This chapter is the review of related literature and studies.A
literature reviewsurveys books, scholarly articles, and any other sources
relevant to a particular issue, area of research, or theory, and by so doing,
provides a description, summary, and critical evaluation of these works in
relation to theresearch problem being investigated.
Foreign Literature
According to Kohn et al (2000) healthcare is a unique and complex
domain and healthcare ISs have human safety implications and profound
effects on individual patient care. In fact, IS implementations are a
perturbation in any organization, whether it is a change in processes or in
organizational communication and learning. Chiasson & Davidson (2004)
Healthcare applications are technically complex, and the software and
hardware markets are considered to be less mature than the IT markets for
other industries and for medical technologies.
According to Karim (2008) interoperability concerning a specific task is
said to exist between two applications, when one application can accept data
from the other and perform the task in an appropriate and satisfactory manner
without need of extra operator intervention. One of the main challenges in
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introducing patient healthcare records is the development and use of systems
that advance communication and information sharing. Sharing information is
an essential aspect of communicating with colleagues and patients about
delivery of care. The absence of instant access to patient healthcare
information is the cause of one-fifth of medical errors.
According to Schreiweis& Heilbronn (2010) the background of HIS in
Public Hospital of Bangladesh mentioned that at the present world, hospital
information systems are a vital point of patient care. HIS provides best
information, to the right people and the right place. The world has shortage of
technical support in medical care. However, hospital information systems are
the solution of patient care, helps to make proper decisions. The computer has
become essential to health care system, driven in part by stimulated growth of
digital applications and communication technologies over the last two decades.
That is why HIS system is the new development of health care system.
According to Heller (1995) hospital information systems is very essential
for technological decade. HIS provides great efforts to Medical Information
System (MIS). Nowadays, HIS system is the new system which is spreading
throughout the world. So, in HIS system, there is one model which is called
Electronic Health Records (EHRs). HIS model has benefit to minimize the cost,
it is based on statement of Miller & West (2007). In HIS system, Electronic
Medical Records (EMRs) and Clinical Information System (CIS) which creates
a new model for improving patient safety, evolving coordination of care, and
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clinical decision making (Catherine et al., 2009). To concern HIS, there are two
model introduced under the HIS which are electronic Medical records (EMRs),
and Clinical Information System (CIS) where it would be helpful for patient
care, patient safety.
According to Hanseth et al (1996) many healthcare professionals work
autonomously, the deficiency of accessing vital healthcare information
segments and shared knowledge can produce duplicate clinical tests to be
arranged and leads to additional cost, pain and danger. Hence, connected and
unconnected electronic systems should be coordinated and interoperable i.e.
healthcare information is accumulated and stored into an electronic holding
place called as Data repository. All relevant data would be shared between
healthcare professionals in the same or different organizations.
According to Abdul (2008) indicates that one of the important issues in
paper-based records are, all the clinical information is written in free style, and
chances are high to miss or forget some important information, as this will lead
to serious effect on patient’s treatment and care. The case sheet is a hard
copy that can be accessed by one person at a time and needs physical
transfer for other physicians to access. Retrieving a record will be a hard task
given number of medical records present and missing a record won’t be a
surprise in a huge pile of paper based medical records. Moreover, with time,
information in paper records gets diminished of ageing paper and ink, even fire
accidents or natural disasters can ruin the archive of paper records. Based on
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the statement of Karim (2008) explains that all the above discussed issues can
be over-come by implementing EMR/EPR systems, it can not only solve the
problems but also improves the efficiency of healthcare by increasing
accessibility, and needs less resources to maintain records. EPR system can
be used as a resource of researchers, it will be a tool for disease surveillance,
which can be used for public health initiatives and for practicing Evidence
based medicine.
According to Lundgren (1989) maintaining accurate records that can be
retrieved is essential to the continuation of every business. Fast retrieval of
records has become so important that it is a major concern in business today.
For example, through automated processes, the United States Department of
State now has a capability to process and retrieve passport records more
rapidly than ever before. The department uses a combination of bar-coding
technology, high-speed microfilming, and computer assisted retrieval to
provide passport customers with the fastest possible response to requests for
information.
As cited in an online article paperap.com (2018) as consumers become
more informed, healthcare organizations re-examine their processes in order
to improve efficiencies and to position themselves as world-class
organizations. Med Central Health System, a health organization with two
Local Community Hospitals, 351 beds, and 2,600 employees in Mansfield, OH,
USA, is managing this with a system-wide, information technology-based
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initiative, Project Expert Care, geared to provide clinicians with reliable data, to
increase patient safety, and to decrease costs by optimizing operational
efficiencies.
Local Literature
According to Jonathan David A. Flavier (2011) the initial HRH plans
developed by the DOH focused exclusively on health workers employed
directly by DOH. The first truly national HRH plan, covering all government
employees of DOH and also health workers employed by the Department of
Education, the armed forces etc.; as well as those in private facilities, was
crafted in the 1990s, but its implementation was hampered by changes such
as migration of health workers, the increase in the number of nursing schools
and globalization. In 2005, the DOH, in collaboration with WHO-WPRO,
prepared a long-term strategic plan for HRH development. The 25-year human
resource master plan from 2005 to 2030, was to guide the production,
deployment and development of HRH systems in all health facilities in the
Philippines. The plan includes a short-term plan from 2005 to 2010 that
focuses on the redistribution of health workers as well as the management of
HRH local deployment and international migration. A medium-term plan from
2011 to 2020 provides for the increase in investments for health. A long-term
plan from 2021 to 2030 aims to put management systems in place to ensure a
productive and satisfied workforce. The DOH also created an HRH network
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composed of different government agencies with HRH functions to support
implementation of the master plan.
According to Kenneth Y. Hartigan-Go (2011) in the early 2000s, health
technology assessment was introduced by PhilHealth and a committee was
established to examine current health interventions and find evidence to guide
policy, utilization and reimbursement. The HTA committee works to identify
priority problems on the use of medical technologies needing systematic
assessment. It also conducts assessments on the use of medical devices,
procedures, benefit packages and other health-related products in order to
recommend to Phil health the crafting of benefit packages. In addition, HTA
capabilities are due to be strengthened through the new health technology unit
of the FDA recently reinforced by legislation.
According to David (2011) health status has improved dramatically in the
Philippines over the last forty years: infant mortality has dropped by two thirds;
the prevalence of communicable diseases has fallen and life expectancy has
increased to over 70 years. However, considerable inequities in health care
access and outcomes between socio-economic groups remain.
According to Lagrada (2010) in its current decentralized setting, the
Philippine health system has the Department of Health serving as the
governing agency, and both local government units and the private sector
providing services to communities and individuals. The DOH is mandated to
provide national policy direction and develop national plans, technical
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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. 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 were created for every
municipality in the country in the 1950s to improve access to health care.
According to Flavien (2012) in the early 2000, the DOH embarked on
setting the standards of the referral system for all levels of health care. While
this system was promoted to link the health facilities and rationalize their use,
in practice adequate referral mechanisms were not put in place, and the
people’s health-seeking behavior remains a concern. In general, the primary
health care facilities are bypassed by patients. It is a common practice for
patients to go directly to secondary or tertiary health facilities for primary health
concerns, causing heavy traffic at the higher-level facilities and corresponding
over-utilization of resources. Based on the statement of the Department of
Health (2010) hospital admissions from the data of PhilHealth reimbursements
show that highly specialized health facilities continuously treat primary or
ordinary cases. Dissatisfaction with the quality of the services and the lack of
supplies in public health facilities are some of the reasons for bypassing (DOH,
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2005). This is aggravated by a lack of gatekeeping mechanisms, enabling
easy access to specialists.
According to Kyle Mckinley (2006) the companies saved money by
making or purchasing a computerized system by reducing paper usage and
employee overtime. Since employees did not have to spend their time doing
paper work, they could do their jobs faster and more efficient.
According to Lolita Blue (2011) the adoption of computer processing
simplifies management's tasks in direction current business activities, provided
management play it0s role in the development of the processing system. In the
application areas turned over to the computer, management policies are
carried through automatically because they are embodied in the processing
system. In addition, the management information system incorporated in the
processing structure provides timely information in useful form these two arms
of HIS are also referred to as integrated Local Community Hospitals
information processing systems (IHIPS).
According to Luke Hemsworth (2010) Local Community Hospitals
information technology and Local Community Hospitals management software
programs are synonymous aiming to meet all demands and needs of medical
staff, surgical teams and patients. The two systems ensure that all billing,
tracking, patient care, bed management, pharmacy, counselling and
recruitment as well as rotation of surgical teams is on schedule. The presence
of automation and software as the mainframe of a Local Community Hospitals
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administration means that all information has to be processed onto two or
three hard disks. In case of any malfunction or crash, the data is still available
in another disk. Usually, Local Community Hospitals keep two to three 'mirror'
disks - one in the archives and one under the scrutiny of management
personnel. Remote data backup as well as control processing and tracking
automated systems ensure the smooth non-stop functioning of these systems
(Local Community Hospitals Information Systems - Customized to Meet all the
Management Needs of a Local.
According to Hodge & Hodgson (1969) from the book "Management and
the Computer in Information and Control Systems" information is the essential
factor within which organizations work effectively. At the planning level,
information is required to convert strategy into tactics (detailed plans and
schedules and their evaluation). At the operational levels of information is
required to carry out production of refining or marketing plans. Finally, even the
simplest loop controller in a process unit requires information from process
sensors to produce their limited control.
According to Terry D. Lundgren and Carol A. Lundgren (2012) records
management, then, is planning, staffing, organizing, directing and controlling of
records and those processes associated with records. Records management
is organized around the life cycle of a record and ends with the permanent
storage or destruction of record.
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According to Amansharma (2008) computerization in the small business
has very many advantages. First, the time taken in updating the financial
records is reduced. Secondly, some routine jobs like invoicing of cash
collections. Adding and deleting of information/transactions is speeded up. The
risk of clerical errors while making calculations and transferring data between
records is also reduced. Any up to- date record on the financial position is
always available.
According to Sanguini (2007) clinical productivity depends on rapid
access to information, seamless data flow, and reliable clinical networks.
Reducing complexity results in higher efficiency. That's why our eHealth
Solutions provide you with a global IT infrastructure for integrated healthcare
based on both clinical and IT security expertise. We focus on Integrated Care
Solutions that improve processes along the healthcare continuum and clinical
pathways, e.g. by featuring an electronic health record. Our Identity Solutions,
in turn, enable secure access and efficient administration. This adds up to
effective cooperation for healthcare providers and a better quality of patient
care at reduced costs - giving relevant answers to the demands of integrated
healthcare.
According to Gustav (2007) an efficient revenue cycle - which includes
scheduling, billing and managing supplies - is essential to the operational
success of any Local Community Hospitals. The Local Community Hospitals’
leadership worked closely with CSC to diagnose where the operating room
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revenue cycle was deficient and what needed to be changed. This review
concluded that the Local Community Hospitals should make improvements in
a number of areas, including charge coding, materials management and
supply contracts. CSC's team, bolstered by its experience in healthcare
systems management, successfully transformed the Local Community
Hospitals’ billing process as part of a multifaceted program that has led to
significant operational improvements at the Local Community Hospitals.
According to Fluvia(2008)another article on the internet "Brazilian
Patient Monitoring Market - Moving Towards Next Level of Competition" crucial
movements brought the Brazilian Patient Monitoring to a next level of
competition, challenging the approach and strategies of companies," explains
Daniela Putti, Industry Analyst at Frost & Sullivan. "To be able to sustain or
raise their positions, competitors will need to anticipate market needs and
reinforce their competitive advantages offering complete solutions to public
and private Local Community Hospitals. The greatest impacts are expected to
be felt by end-users, the most benefited ones from these movements, bringing
new and remarkable market dynamics.
According to Kauka (2005) the article of Michael R. Kauka, people
started talking about something called the electronic health record in the 60s.
But computers were practically nonexistent. Then, in 1991, a report by the
Institute of Medicine introduced a more precise concept of the computer-based
patient record and its importance to future medicine. It was the first report to
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pioneer the idea of a computer-based, longitudinal, life-long, integrated patient
record including entries from all healthcare providers. The benefits of an
electronic patient record became immediately obvious.
According to John Mello (2011) "It's one of the fastest-growing segments
of IT." there are two major applications: PACS and electronic patient records."
PACSs or picture archiving and communications systems store cardiology and
radiology tests, magnetic resonance imaging or MRI results, and other large
files. Still, Mello says healthcare is a late adopter of technology, claiming that
only about 5 percent of healthcare firms have sophisticated electronic storage
systems. He says that most large Local Community Hospitals already have
them, while smaller and midsized facilities plan to implement them soon.
Foreign Studies
According to Gautham et al. (2014) developed the clinical guidance
system with the use of mobile technology to enhance the quality of health care.
The developed system provides guidance to manage various diseases. The
application was tested on 128 patients by 16 service providers in rural area of
Tamil Nadu, India. The application was found suitable for both patients as well
as for service providers.
According to Subhagata et al. (2015) suggested a new framework for
smooth working of telemedicine services in Manipal, India. To design new
framework, a systematic survey exploring the feasibility at individual and
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organizational levels has been planned. The collected data from questionnaire
was mathematically analyzed to examine the satisfaction health services. The
results showed that there is lack of ICT support to provide health care services
and organizational must adopted proper measures.
According to Ravin et al. (2015) conducted a survey to analyze the
challenges faced in delivering of e-health care services in selected rural areas
of Madhya Pradesh and Maharashtra. The study concluded that village health
workers play crucial role in generating awareness about e-health service and
act as mediator between village and the e-health center. The e-health care
through ICT offers a new platform for the treatment of patients residing in rural
and remote areas. 24
According to Sumninder et al. (2015) conducted a survey to examine the
awareness level among people of Punjab regarding health insurance. On the
basis of 600 respondents it has been observed that there is low level of
awareness and willingness among people regarding health insurance. Other
key factors responsible for less coverage are paucity of funds, lack of
intermediaries, lack of awareness, limited policy options, less coverage and
limited viability of services.
According to Renuka et al. (2015) analyzed the current position of
Foreign Direct Investment (FDI) in Indian health care sector. Various
opportunities and challenges regarding such investment have been identified.
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It has been suggested that FDI must create necessary infrastructure as well
enhance awareness level to provide qualitative health care services. FDI funds
can also be utilized to increase the physical capacity and development of
specialty and super-specialty centers, up gradation of new technology like e-
health services.
According to Udita et al. (2014) identified critical success factors that
influenced the success of e health services in India. These critical success
factors were data warehousing and mining, decision support system, data
access control, biomedical engineering technology, telecommunication
infrastructure, government policies, consumer mindset, health care providers
mind set, literacy level and health insurance. It has been emphasized that the
success of e health care depends not only on technological factors but also on
psychology factors. Another study on similar telemedicine-based factors has
also been conducted for state Uttaranchal, India
According to Radha et al. (2014) conducted a pilot study in rural primary
hospitals of India and reviewed the record keeping system. The study focused
on the issues related to portability of patient’s records. The records of geriatric
cohort and maternal cohort of 308 participants were considered for portability
during a period of nine month. The information shared among patient through
short messaging service (SMS) and USB based memory card were also
supplied with information to 135 randomly selected patients. The study
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concluded that health data seeking behavior as another dimension that can
motivate people to adopt telemedicine services.
According to Nishith et al.(2014) underlined many positive implications
of FDI. In order to expand access to health care services, develop
infrastructure, avail diagnostic facilities, upgrading technology and creating
employment, huge funds are required. According the financial report, 2012
Indian hospital industry was estimated to be USD 280 billion and by 2020 it will
be USD 280 billion. For the success of telemedicine services, it is advised that
in tier II and tier III locations the cost of providing health care services should
be maintained low. These locations consist of primary health care units with
less population as compared where qualitative services can be provided
through telemedicine. Therefore, for investing in to these hospitals commercial
strategy is needed.
According to Shahid and Kolomeyer (2012) analyzed economical
position of USA economy and addressed usefulness of telemedicine care
system. The telemedicine ophthalmic remote health screenings were
performed on community-based groups to detect vision threatening disease.
The study concluded that the comprehensive and community based remote
screenings can provide more sensitive detection of vision-threatening disease.
According to Bhatia et al. (2014) concluded that the optimistic sway of
Telemedicine services depends upon socio-political factors in addition to the
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accessibility, acceptance, execution, and implementation of such technologies.
The study highlighted three considerable technical components of
Telemedicine: Infrastructure, Human resource Readiness and Health care
Readiness. For successful recognition of Telemedicine 26 abilities, there is
need to digitalize data at fast speed along with maintaining its safety and
security. It is the most vital pre-requisite that facilitate the medical staff for fast
examination of any medical problem. High bandwidth of telecommunication
network will improve the quality of services being provided by providing ease in
fast uploading of patient’s data and images. High speed network will also
facilitate uninterrupted live video conferencing that will help in quick decision
making. Indian government has taken initiative to provide higher bandwidth
connectivity by launching project National Optical Fibre Network (NoFN). It will
connect all panchayats of a country under the network providing bandwidth of
10-100 mbps. The major challenges addressed by the study are the
complexities involved in technologies, requirement of trained professionals,
high operating and maintenance cost etc.
According to Carlos et al. (2014) has developed an ICT based follow up
and monitoring Telemedicine model called Oral Anticoagulant Therapy (QAT)
for the anticoagulant patients. It is concluded that the amount of
anticoagulation control does not differ considerably from that have realized
with the conventional procedure. It has not only improved acceptability of self-
monitoring system but also has reduced systematic loss suffered by patients
` 27
under self-management procedure. Patients can avoid number of
consultations with doctors and reduce further anxiety by adjusting time and
place of determinations as per their necessity. The patient can get benefit of
reduced cost for follow up and monitoring system.
According to Kapoor et al. (2014) discussed the various problems faced
while implementing Telemedicine technologies. The study revealed that these
problems are not linked with technical problems but are linked with funds,
behavior and attitude of doctors, lack of awareness etc. The other type of
problem discussed was the availability of doctors at super specialty hospitals
in remote areas.
According to Pal et al. (2014) have discussed the scenario of providing
health care services to rural population and have mentioned various funding
agencies that sponsored different projects across the country for providing
telemedicine services. The role of private 27 telecommunication companies
was also highlighted to participate in success of such technology. The study
further recommended various initiatives to be taken to create awareness and
improve accessibility among the rural population.
According to Singh et al. (2013) studied the utility of Telemedicine
services for children on the basis of data collected from secondary sources
provided by PGI, Chandigarh. The findings showed that even newly born
babies in villages can be examined and treated under Telemedicine by
` 28
connecting super specialist either through video conferencing or by getting
consultations by transmitting information and images electronically.
According to Bhatia (2013) conducted a survey to determine the socio-
political variables influencing the popularity of Telemedicine. The study was
based on the data collected through questionnaire which was later analyzed
and tested by applying statistical tools like reliability, validity and regression.
The results of the survey concluded that collective efforts were required from
the users, government, technologists, economists, physicians, clinicians,
nurses and other service providers to make adoption of Telemedicine a great
success.
According to Wani et al. (2013) conducted the research to examine the
status, problems, quality of e health services provided in India and also
compared Indian health system with other nations. The study was based on
secondary data collected from different sources provided by Health care
departments of India. The findings of the study revealed that Indian health care
services are at infant state as compared to developed nations. There are
ample of unexploited resources in India that hinders the growth and quality of e
health care services.
According to Apter (2007) in the committee of nations, Nigeria often
denotes fraud and corruption. The extent of involvement of fraud perpetuators
in Nigeria and those operating outside the shores of the country is
` 29
unquantifiable. Apter stated that fraudulent practices range from online identity
theft, marketing of non-existent goods, prosperity churches, false non-
governmental organizations soliciting funds from foreign donors, to outright
imposition by persons as government officials awarding bogus contracts. The
activities of corrupt elements in society have tarnished the social and corporate
image of the nation, causing a drought of foreign investment in the country.
Corruption exists in every facet of life in Nigeria, and has negatively affected
the willingness of international investors to do business in Nigeria. The
engagement of the larger society in corruption occurs by ambivalent
complicity. Sustained aiding and abetting of corruption in the Nigerian society
makes it Nigerian impossible for the nation to rise above mediocrity in almost
every area of socioeconomic endeavor including health care.
According to Ayo (2008) in a study of the framework for implementation
of ecommerce in Nigeria decried the abysmally law internet-access in the
country. Internet connection enables affected data management system,
picture archival, and communication system and specifically important for
running radiological information system and teleradiology. Other requirement
includes well-trained health care workers and information system
administrator.
According to Benham-Hutchins (2009) because of challenges involved
in integrating new hospital information systems with old paper documentation
and record systems, clinicians, and other health care practitioners may
` 30
become encumbered with multiple and conflicting sources of patient
information. Multiples of paper and electronic documentation may disrupt a
seamless workflow and influence the quality and efficiency of service delivery.
These circumstances also have the potential to cause new types of medical
errors resulting from poor harmonization of patient information. Understanding
these concerns requires examination of human factors in the design of
technology that is able to adapt to the way health care providers do their job.
The delivery of patient-friendly services demands that health care providers
continue to work toward improvement in the method of care pathways and
processes.
According to Ford, Menachemi and Phillips (2012) in 2006 the Institute
of Medicine (IOM) issued a report calling for paperless health record system
within 10 years. This visionary call fell short media attention. Scholarly and
government was support also deficient compared to other by the IOM. The
consequences are that integrating electronic health record system into the
workplace health care, critical care, and the ambulatory setting does not
equate other areas of medical care. Davies (2006), report that the America is
ranked 66th among 100 countries with top class health care infrastructure and
system recent studies indicate that whereas 4% to 6% of United States
hospital and health care organization have achieved full implementation of
hospital information system, 1-6% have partial adoption of some forms of
hospital information system Moore, 2009, Simon et al., 2008: Ward et al.,
` 31
(2006). The high cost of implementation of electronic health systems of Lowa
Hospitals, found an 80% adoption rate for urban financial capabilities of urban
hospital as the reason for the disparity Furukuwa, et al. in their analysis of
disparity in adoption Nigerian Hospital Information System.
According to Garets and Horowits (2008) clinicians should engage in
evaluation of hospital information system technologies because information
system will become repositories of clinical data. Electronic medical records
system and other information system will attain commonplace application in
hospitals and other health care centers in the incoming decade. President
Bush set a target of developing electronic health care records for all Americans
by 2014.
According to Jantz (2009) the emergence of computers-based
information system has changed the world a great deal, both large and small
system have adopted the new methodology by used of personal computers, to
fulfil the several roles of productions of information therefore computerizing the
documentation of patients record to enable easier manipulation of input
process and output will bring us to this existing new world of information
system. Patient’s records and disease pattern documentation from patients
and their particular health system in order to function properly. If this
information is not documented perfectly causing some data to get misplaced,
the health system will not be efficient.
` 32
According to Priyanka Pandey (2012) Online Eye Center Management
System helps to maintain the patients’ record, doctors’ record, time scheduling
management of an eye care clinic. At the same time, it can handle the
accounts of the daily transaction. This software is very useful and it makes all
the manual works replaced with the use of the computerized system. It saves a
lot of time and money. Manual data recordings become a cumbersome job and
it can also lead to errors even after repeated cross checks. But the use of this
system will able to avoid all these and it can give 100 % accurate results.
Moreover, this software application will organize the data in such a way that it
can help the user while searching a specified document or details. The idea of
Online Eye Care System project is to develop which focuses on some modules
of management of the Eye care clinic. It allows users to maintain the records of
the patients and also it allows doing the manual operations in an automated
form. It provides details on treatment, facilities, eye care products and
customers record.
According to Sarals Solution Foresight (2009) a completely integrated
practice management system for ophthalmologists that allow you to take
command of practice development, management control, and patient care.
Friendly and intuitive, Foresight has been carefully designed to put your
practice information at your fingertips in a logical, predictable, and easy-to-
understand manner in a single or multi-user environment. The system is
flexible and designed to grow with you as your practice grows. Its features
` 33
include: Patient Demographics Ocular and Medical History Daily activity
register Patient Bills and payments Operation theatre scheduling Appointment
management Procedure tracking IPD Patients LASIK Details Patient Visit
Details - Fundus examination, findings, refraction, complaints, diagnosis, slit
Lamp exam, Glaucoma exam, User defined Custom Screens, Contact Lens,
Lasik Details, A-scan, Prescriptions, Treatment, Advice Digital Imaging - Direct
image and video capture, Send documents as email attachment, Creates
ready-to-print photo albums , Import images from digital camera, Compare
before and after treatment images Reports - Check-up printout Patient,
Receipt printing. Referral letters, Appointments, Visit listings, Practice analysis,
New Patients, Customized Reports Address Book, and Reminders
Correspondence and email Show-me-how video tutorials for quick staff
training. Foresight allows you to reduce administrative time, streamline
communications, improve the quality of your clinical documentation and ensure
nothing is ever lost or forgotten. Having Eye clinic management system can
help the clinic to manage their daily activity. System help reduce the problems
occur when using the manual system, enables doctors and clinic assistant to
manage patient records, medicine stock, and appointment and produce
reports, in order for companies and organizations to carry out their daily tasks
successfully, they follow certain processes. Eye Clinic Management systems
are responsible for maintaining those processes based on the statement of
` 34
British standards institution (2012). They are present in almost every aspect of
our daily lives like banks, movie theatres and shopping centers.
Local Studies
According to Dr. Sy (2012) in the past, health center staff members sort
through a roomful of envelopes containing patient records, which takes an
average of four to five minutes depending on the availability of the record.
When the record is not found, a new record will be made for which the patient
will have to pay an extra cost. With CHITS, searching for a patient's record
upon admission takes just a few seconds to retrieve. Records in the form of lab
requests, results, and reports or daily service reports, census for number of
vaccinations, supplies, etc.; can be generated automatically.
According to National Telehealth (2017) an electronic medical record
specifically designed for the community health centers in the Philippines, was
developed through a collaborative and participative process involving health
workers and the Information and Communication Technology community,
using the primary health care approach and guided by the open source
philosophy.
` 35
Chapter III
Research Methodology
This chapter presents the methods to be used in the study. It also
describes the subjects of the study, the instruments used, the procedure of
data gathering, and the statistical treatment of the data.
Research Method
The researchers used the qualitative method of research. The qualitative
research is a process of naturalistic inquiry that seeks an in-depth understanding
of social phenomena within their natural setting. It focuses on the "why" rather
than the "what" of social phenomena and relies on the direct experiences of
human beings as meaning-making agents in their everyday lives.
Specifically, the IPO method of research. The input–process–output (IPO)
model, or input-process-output pattern, a widely used approach in systems
analysis and software engineering for describing the structure of an information
processing program or another process. In the IPO model, a process is viewed
as a series of boxes (processing elements) connected by inputs and outputs.
Description of the Respondents
The researchers chose the institution, Fr. Simpliciano Academy, and they
chose the respondents of the high school students. Specifically, from Grade 7 to
Grade 10 high school students of Fr. Simpliciano Academy. There were 81
` 36
number of students in Grade 7, 73 in Grade 8, 59 in Grade 9, and 79 in Grade
10. Overall, there were 292 total number of high school students in a mixture of
male and female at an approximate age of 12-16 years of age in the chosen
institution.
Population and Sample
To get the sample of respondents from the total number of
respondents, the researchers used the Slovin Formula to get the number of
samples from the respondents. The Slovin formula is:
𝑁
n=
1+𝑁𝑒 2
Where N was the population or the total number of our respondents,
then n was the sample number from our respondents, and the e was the margin
of error.
N = 292
e = 5%
The chosen high school students of Fr. Simpliciano Academy werethe
population and 5 percent wasthe margin of error.
292
n=
1  292(0.05) 2
` 37
292
n=
1  292(0.0025)
292
n=
1  0.73
292
n=
1.73
n = 169
In conclusion, the researchers got 169 total respondents as their
sample.
Sampling Technique
The researchers used the simple random technique wherein they
randomly picked the respondents by using of random numbers. The use of
random numbers is an alternative method that also involves numbering the
population.
Simple random sampling is a sampling technique where every item in the
population has an even chance and likelihood of being selected in the sample.
Here the selection of items completely depends on chance or by probability and
therefore this sampling technique is also sometimes known as a method of
chances. The sample size in this sampling method should ideally be more than a
few hundred so that simple random sampling can be applied in an appropriate
` 38
manner. This method is theoretically simple to understand but difficult to
practically implement, working with large sample size isn’t an easy task and it
can sometimes be a challenge finding a realistic sampling frame.
The researchers randomly picked 169 survey papers from the total
population of high school students in Fr. Simpliciano Academy, Inc. There were
292 survey papers in total and by having the Slovin’ Formula, the researchers
got the sample of 169 from the total population of the high school students with
an error’s margin 5%.
Research Instrument
The researchers used the survey questionnaire as their research
instrument. A survey is defined as the measure of opinions or experiences of a
group of people through the asking of questions. This is opposed to a
questionnaire, which is defined as a set of printed or written questions with a
choice of answers, devised for the purposes of a survey or statistical study.
The first part of the survey questionnaire was about the profile of the
respondents including the name, gender, age, and grade level. At the second
part, the yes or no questions, the questions that were being asked focused on
the advantages and disadvantages of the manual medical record system and
computerized medical recordsystem. While in the third part of the survey
questionnaire, the Likert scale, it focused on how the manual medical record
system was useful to the people that limited the system and how the
` 39
computerized medical record system will be beneficial to the people that will limit
the system.
Sources of Data
The main source of data of the researchers was their respondents.
Specifically, from Grade 7 to Grade 10 high school students of Fr. Simpliciano
Academy. There are 81 number of students in Grade 7, 73 in Grade 8, 59 in
Grade 9, and 79 in Grade 10. Overall, there is 292 total number of high school
students in a mixture of male and female at an approximate age of 12-16 years
of age. It covers up the whole high school students of Fr. Simpliciano Academy
in a mixture of male and female at an approximate age of 12-16 years of age in
the chosen institution.
The overall respondents had a total number of 293 and had a sample of
about 169 total respondents.
Data Gathering Procedures
Data gathering procedure is the process of gathering and measuring
information on targeted variables in an established system, which then enables
one to answer relevant questions and evaluate outcomes.
This shown our data gathering procedure:
 Wrote a formal letter and addressed to the principal asking for the
permission to have a survey in the school.
` 40
 The researchers went to the classroom one by one and disseminated the
survey questionnaires to the students.
 The students were given 10 minutes to answer the survey questionnaire
given by the researchers.
 Afterward, the researchers collected the survey questionnaire.
After collecting all the datawith the help of the statistician, the researchers
tabulated and tallied the survey. The result would hopefully be the basis for the
assessment of the manual medical record system of the school.
Research Locale
It was in the year 1991 when Mo. Flora Zippo, SFSC one of the first five
Italian Missionaries of the Congregatzione Delle Source Francescane Dei Sacri
Cuori (SFSC) or Franciscan Sisters of the Sacred Heart opened up the second
school in Barangay Don Bosco, Paranaque City. While the first building of the
school was still under construction, children were in Immaculate Heart of Mary
School (not college yet). When the school was completed, it was named as St.
Francis School since it was intentionally and particularly built for the children of
the poor. In 2003 during Ash Wednesday, the school was burned and the
elementary pupils were temporarily transferred to the Drop-in Center of Father
Simpliciano Foundation. The school was rebuilt in the same place and year.
The sisters opened up a High School building. A new four-storey building was
built with the help of generous benefactors from Italy and thus the new building
` 41
has various facilities like the High School Library, Science Lab, AVR Room, TLE
Room, Faculty Room, Principal Office, Guidance Office, and Clinic.
Statistical Treatment
The researchers used the percentage frequency distribution as their
statistical treatment.
A percentage frequency distribution is a display of data that specifies the
percentage of observations that exist for each data point or grouping of data
points. It is a particularly useful method of expressing the relative frequency of
survey responses and other data.
The process of creating a percentage frequency distribution involves first
identifying the total number of observations to be represented; then counting the
total number of observations within each data point or grouping of data points;
and then dividing the number of observations within each data point or grouping
of data points by the total number of observations. The sum of all the
percentages corresponding to each data.
Formula:
` 42
Where:
% = Percent
f = Frequency
N = Number of cases
` 43
Chapter IV
Analysis, Interpretation and Presentation of Data
This chapter includes the summarization of the collected data and the
statistical treatment, and/or mechanics, of analysis.
Table 1.1 Profile of the Respondents in terms of Age
Age Frequency Percentage
12 21 12.43%
13 43 25.44%
14 41 24.26%
15 43 25.44%
16 21 12.43%
TOTAL 169 100%
The table 1.1 showed the age of subjects who took part in the completion
of the questionnaires.
The table also showed the sample of 169 chosen high school students of
Fr. Simpliciano Academy Inc. 21 or 12.43% of the total respondentswere 12
` 44
years old; 43 or 25.44% of the totalrespondentswere 13 years old; 41 or 24.26%
of the total respondentswere 14 years old; 43 or 25.44% of the total
respondentswere 15 years old; and 21 or 12.43% were 16 years old.
Therefore, the researchers concluded that the highest number of ages
was on 13 and 15 with a frequency of 43, and a percentage of 25.44% of the
total respondents.
Table 1.2 Profile of the Respondents in terms of Gender
Gender Frequency Percentage
Male 90 53%
Female 79 47%
TOTAL 169 100%
The table 1.2 showed the gender of subjects who took part in the
completion of questionnaires.
Fr. Simpliciano Academy Inc. Accordingly, 90 of the respondents were male
which constituted 53% of the total respondents and 79 were female which
constituted 47% of the total respondents.
` 45
Therefore, the researchers concluded that the highest number of
genders was male with a frequency of 90, and a percentage of 53% of the total
respondents.
Table 1.3 Profile of the Respondents in terms of Grade Level
Grade Level Frequency Percentage
7 54 31.95%
8 41 24.26%
9 45 27.63%
10 29 17.15%
TOTAL 169 100%
The table 1.3 showed the grade level of subjects who took part in the
completion of questionnaires.
Fr. Simpliciano Academy Inc. 54 or 31.95% of the total population were from the
Grade 7; 41 or 24.26% of the totalpopulation were from the Grade 8; 45 or
27.63% of the total population were from the Grade 9; and 29 or 17.15% of the
total population were from the Grade 10.
` 46
Therefore, the researchers concluded that the highest number of grade
levels was in the Grade 7 with a frequency of 54, and a percentage of 31.95%
of the total respondents.
Table 2.1 Advantages of the Manual Medical Record System
Questions Yes No
safety/reliability 126 43
confidentiality 114 55
accuracy 100 69
productivity 117 52
consistent 87 82
The table 2.1 showed the advantages of the manual medical record
system based on the survey questionnaires given to the respondents.
The table showed that 126 of the students of Fr. Simpliciano Academy
Inc. answered yes on the question regarding with the safety/reliability of the
manual medical system because they think it was more reliable based on
safety but 43 other students ought to differ. In the privacy of handling medical
records, 114 students thought that it was best to use the manual medical
record system and 55 other students beg to differ. Going into the accuracy of
` 47
handling medical records, 100 students answered yes as to being an
advantage ofthe manual medical system and 69 answered no. As to
productivity, 117 students thought that the manual medical record system was
productive in terms of handling medical records and 52 other students said
no. While 87 students answered yes to the manual medical system being
consistent and 82 others said no.
Therefore, the researchers concluded that the manual medical record
system was safety, confidential, accurate, productive, and consistent based
on the respondents’ responses.
Table 2.2 Disadvantages of the Manual Medical Record System
Questions Yes No
time consuming 127 42
inconsistency 101 68
prone to danger 119 50
complicated 118 51
space-consuming 100 69
` 48
The table 2.2 showed the disadvantages of the manual medical record
system based on the survey questionnaires given to the respondents.
The table showed that 127 of the students of Fr. Simpliciano Academy
Inc. answered yes on the question regarding with how the manual medical
system consumes time but 42 of the respondents says it does not. In the
inconsistency of data entry, 101 students thought that the manual medical
system is indeed inconsistent with the dataand 68 other students ought to
differ. Going into the vulnerabilityof the manual medical system, 119 students
of the school answered yes as they agree to the manual system being prone
to damage and can be misplaced easily and50 answered no. As to making
changes, 118 students thought that the manual medical system is
complicated in terms of altering the data and 51 others thought the other way.
The system being space consuming, 100 students thought that the manual
medical system was more space consuming than the computerized medical
system, which 68 other students thought was not as space consuming.
system was time-consuming, inconsistent, prone to danger, complicated and
space-consuming based on the respondents’ responses.
` 49
Table 2.3 Advantages of Computerized Medical Record System
Questions Yes No
security 125 44
accuracy 107 62
convenience 137 32
efficiency 130 39
compression 123 46
The table 2.2 showed the advantages of the computerized medical
record system based on the survey questionnaires given to the respondents.
The table showed that125 of the students of Fr. Simpliciano Academy
Inc. think that they are secured with the use of computerized system while 44
students disagreed. The system being accurate, 107 people agreed while 62
chose the latter. 137 people said that the proposed system is convenient
while 32 others said no. As to efficiency, 130 people agreed while 39 others
disagreed. Going into the organization of the proposed system, 123 people
said yes and 46 despise.
` 50
Therefore, the researchers concluded that the computerized medical
record system would be secured, accurate, convenient, efficient, and
compressed based on the respondents’ responses.
Table 2.4Disadvantages of Computerized Medical Record System
Questions Yes No
inaccuracy 90 79
unfamiliarity 108 61
acquire virus 139 30
easily hack 128 41
costly 104 65
The table 2.4 showed the disadvantages of computerized medical
record system based on the survey questionnaires given to the respondents.
The table showed that 90 students of Fr. Simpliciano Academy Inc.
answered yes referring to the inaccuracy of the proposed system while 79
others differ. As for unfamiliarity, 108 people are unfamiliar with the proposed
system while 61 others are familiar with it. 139 people worry that the proposed
system may acquire virus and 30 more people begged to differ. 128 people
thought that the proposed system might easily get hacked and 41 thought it
` 51
won’t get hacked that easy. 104 people said that it may cost a lot of money and
65 thought it’s on the budget.
Therefore, the researchers concluded that the computerized medical
record system would be inaccurate, unfamiliar, costly and can acquire virus and
easily hack based on the respondents’ responses.
Table 3.1 The Efficiency of Manual Medical Record System and
Computerized Medical Record System
5 4 3 2 1
Questions
Strongly Agree Neutral Disagree Strongly
Agree Disagree
Q1. Efficiency of 50 59 47 8 5
the Manual
System (29.59%) (34.91%) (27.81%) (4.73%) (2.96%)
Q6. Efficiency 22 49 54 31 13
ofthe
Computerized (13.8%) (28.99%) (31.95%) (18.34%) (7.69%)
System
The table 3.1 showedthe efficiency of the manual medical record system
and the computerized medical record system.
` 52
In the manual medical record system, 50 people strongly agreed that the
system was efficient which constituted 29.59% of the respondents. 59 or
34.91% of the respondents agreed that the system was efficient. While, 47 or
27.81% of the respondents were neutral as what the respondents observed in
the system. Then, 8 or 4.73% of the respondents disagreed that the manual
system was efficient and 5 or 2.96% of the respondents strongly disagreed.
Whilst in the computerized medical record system, 22 or 13.8% people
strongly agreed that the system was efficient and 49 or 28.99% agreed that the
system was efficient. While, 54 people answered that the system was neutral
which constituted 31.95% of the respondents. 31 or 18.34% of the respondents
disagreed that the system was efficient and 13 or 7.69% of the respondents
strongly disagreed.
system was more efficient than computerized medical record system based on
the total respondents’ responses.
` 53
Table 3.2 The Conveniencyof Manual Medical Record System and
5 4 3 2 1
Questions
Agree Disagree
Q2. 28 60 53 20 8
Conveniency
of the Manual (16.57%) (35.50%) (31.37%) (11.83%) (4.72%)
System
Q7. 30 50 54 22 13
Conveniency
of the (17.76%) (29.59%) (31.96%) (13.02%) (7.69%)
Computerized
System
The table 3.2 showed the conveniency of the manual medical record system
and computerized medical record system.
In the manual medical record system, 28 people or 16.57% of the
respondents strongly agreed that the system was convenient. While there are
60 people or 35.50% of the respondents agreed to the conveniency of the
system. 53 people or 31.37% of the respondents were neutral towards the
conveniency of the system. There were 20 people or 11.83% who disagreed
about the convenience of the system and 8 people or 4.72% of the respondents
strongly disagreed that the system was convenient.
` 54
Whilst in the computerized medical record system, 30 people that
constituted 17.76% of the respondents strongly agreed that the system was
convenient. 50 people or 29.59% of the respondents agreed that the system
was convenient while there were 31.96% of the respondents or 54 people who
were neutrally okay with the system. 22 people or 13.2% disagreed to the
conveniency of the system. While there were 13 people or 7.69% of the
respondents who strongly disagreed that the system was convenient.
system and computerized medical record system had no significant difference
regarding the conveniency of both systems based on the total respondents’
observations.
Table 3.3 The Familiarityof the Manual Medical Record System and
Computerized Medical Record System to the Respondents
5 4 3 2 1
Questions
Agree Disagree
26 50 67 13 13
Q3.Familiarity
to the (15.38%) (29.59%) (39.64%) (7.69%) (7.69%)
Manual
System
` 55
Q8. 70 30 29 31 9
Familiarity to
(41.42%) (17.75%) (17.16%) (18.34%) (5.32%)
the
Computerized
System
The table 3.3 showed the familiarity of the manual medical record system
and the computerized medical record system to the respondents.
In the manual medical record system, there were 26 people strongly agreed
that they were familiar with the system which constituted 15.38% of the
respondents, while 50 or 29.59% of the respondents agreed. 67 or 39.64% of
the respondents were neutral towards the familiarity of the system and there
were 13 people disagreed and also 13 people strongly disagreed as they were
not familiarwith the manual system which constituted 7.69% of the respondents.
Whilst in the computerized medical record system, 70 people or 41.42% of
the respondents strongly agreed that they were not familiar with the system,
and 30 people or 17.75% of the respondents agreed. While, 29 people were not
that much familiar with the computerized system which constituted17.16% of
the total respondents and 31 people or 18.34% of the respondents disagreed
with the familiarity of the system. 9 people or 5.32% of the total respondents
strongly disagreed with the familiarity to the system.
` 56
Therefore, the researchers concluded that the computerized medical record
system was more familiar to the total respondents than manual medical record
system based on the total respondents’ answers.
Table 3.4 The Accuracyof Manual Medical Record System and
5 4 3 2 1
Questions
Agree Disagree
Q4. Accuracy 40 39 55 26 9
of the Manual
(23.67%) (23.08%) (32.54%) (15.38) (5.33%)
System
77 60 19 10 3
Q9. Accuracy
of the (45.56%) (35.50%) (11.24%) (5.92%) (1.77%)
Computerized
System
The table 3.4 showed the accuracy of manual medical record system and
computerized medical record system.
In the manual medical record system, there were 40 people or 23.67% of
the respondents who strongly agreed that the system was indeed accurate. 39
people or 23.08% of the respondents who agreed that the system had
` 57
beenaccurate. While 55 people or 32.54% of the respondents neutrally believed
that the system was accurate. 26 people or 15.38% of the respondents begged
to disagree that the system was accurate. There are 9 people or 5.33% of the
respondents strongly disagreed that the system was accurate.
Whilst in the manualmedical record system, 77 people or 45.56%
strongly agreed that the system was accurate. While there were 60 people or
35.50% of the respondents who agreed to the system had been accurate. There
were 19 people or 11.24% of the respondents thought that the system was
neutrally accurate. There were 10 people or 5.92% of the respondents who
disagreed to the system was accurate and there were only 3 people or 1.77% of
the respondents who begged to strongly disagreed an accurate system.
Therefore, the researchers concludedthat the computerized medical
record system would be more accurate in the future than manual medical record
system based on the total respondents’ beliefs.
Table 3.5 The Satisfactionof the Manual Medical System and
Computerized Medical System to the Respondents
5 4 3 2 1
Questions
Agree Disagree
` 58
33 66 50 14 6
Q5.
Satisfactionto (19.33%) (39.55%) (29.59%) (8.28%) (1.77%)
theManual
System
74 54 31 7 3
Q10.
Satisfaction (43.79%) (18.34%) (18.34%) (4.14%) (1.78%)
to the
Computerized
System
The table 3.5 showed the satisfaction of the manual medical record system
and computerized medical system to the respondents.
In the manual medical record system, 33 people or 19.33% of the total
respondents strongly agreed that they were satisfied with the system and 66
people agreed that they were also satisfied with the system which constituted
39.55% of the total respondents. While, 50 people or 29.59% of the total
respondents were neutrally satisfied with the system.There were 14 people or
8.28% of the total respondents disagreed as they were not satisfied with the
system and there were 6 people or 1.77% of the total respondents strongly
disagreed as they were not really satisfied with the system.
Whilst in the computerized medical record system, 43.79% of the total
respondents or 74 people strongly agreed as they considered that the system
will satisfy them and 54 people or 31.95% of the total respondents agreed as
they also considered that the system will satisfy them in the future. 31 people or
` 59
18.34% of the respondents believed that the system will neutrally satisfy them.
While, there were 7 people or 4.14% of the total respondents disagreed as they
considered that the system will not satisfy them and 3 or 1.78% of the total
respondents strongly disagreed as they also considered that the system will not
really satisfy them in the future.
Therefore, the researchers concluded that the computerized medical record
system would be having more satisfaction to the people that limits the
researchers’ study than manual medical record system based on the total
respondents’ responses.
` 60
Chapter V
Summary of Findings, Conclusions and Recommendations
This chapter presents the summary of the findings, so conclusions written
form the findings and the corresponding recommendations.
This study was taken with the general objective of the assessment of
manual medical record system of Fr. Simpliciano Academy Inc. School Year 2018-
2019.
Summary of Findings
The following findings were offered based on the data that had been
collected by the researchers from the previous chapter.
1. The total population of the respondents was 292 students from the
chosen institution, Fr. Simpliciano Academy Inc.
2. Using the Slovin’ Formula, the researchers got the sample of 169.
3. 21 or 12.43% of the total respondents were 12 years old; 43 or 25.44%
of the total respondents were 13 years old; 41 or 24.26% of the total
respondents were 14 years old; 43 or 25.44% of the total respondents
were 15 years old; and 21 or 12.43% were 16 years old.
4. 90 of the respondents were male which constituted 53% of the total
respondents and 79 were female which constituted 47% of the total
respondents.
` 61
5. 54 or 31.95% of the total population were from the Grade 7; 41 or
24.26% of the total population were from the Grade 8; 45 or 27.63% of
the total population were from the Grade 9; and 29 or 17.15% of the total
population were from the Grade 10.
6. The researchers collected a total answer of yes with the frequency of
544, and atotal answer of no with the frequency of 301 regarding the
advantages of the manual medical record system.
565, and a total answer of no with the frequency of 280 regarding the
disadvantages of the manual medical record system.
advantages of the computerized medical record system.
disadvantages of the computerized medical record system.
10. The manual medical record system had a 109 total of agrees/strongly
agreeswhich constituted 64.50% of the total respondents while the
computerized medical record system had a 71 total of agrees/strongly
agrees which constituted 42.01% of the total respondents regarding the
efficiency of both systems.
` 62
11. The manual medical record system had an88 total of agrees/strongly
agrees which constituted 52.07% of the total respondents while the
computerized medical record system had an80 total of agrees/strongly
conveniency of both systems.
familiarity of both systems to the respondents.
accuracy of both systems.
satisfaction of both systems to the respondents.
Conclusions
` 63
Based on the findings derived from this study, the following conclusions
were written.
1. The researchers concluded that the highest number of ages was on 13
and 15 with a frequency of 43, and a percentage of 25.44% of the total
respondents.
2. The researchers concluded that the highest number of genders was
male with a frequency of 90, and a percentage of 53% of the total
respondents.
3. The researchers concluded that the highest number of grade levels
was in the Grade 7 with a frequency of 54, and a percentage of
31.95% of the total respondents.
4. The researchers concluded that the manual medical record system
was indeed safety, confidential, accurate, productive, and consistent
based on the respondents’ responses.
was indeed time-consuming, inconsistent, prone to danger,
complicated and space-consuming based on the respondents’
responses.
6. The researchers concluded that the computerized medical record
system would be secured, accurate, convenient, efficient, and
compressed based on the respondents’ responses.
` 64
7. The researchers concluded that the computerized medical record system
would be inaccurate, unfamiliar, costly and can acquire virus and easily
hack.
was more efficient than the computerized medical record system.
and computerized medical record system had no significant difference
regarding the conveniency of both systems.
10. The researchers concluded that the computerized medical record
system was more familiar to the total respondents than the manual
medical record system.
would be more accurate in the future than the manual medical record
system.
would be having more satisfaction to the people that limits the
researchers’ study than the manual medical record system.
Recommendations
The following recommendations were offered based on the findings and
conclusion of the study.
` 65
1. The health care nurse and the school should adopt the computerized
medical record as the standard for medical and all other records
related to patient care.
2. Computerized medical record facilitate cost-effective access to more
complete, accurate health data with which providers can make better
decisions about patient care.
3. Computerized data processing techniques can enable the managed
care providers/nurses and the researchers to conduct more
sophisticated analyses of health care utilization and outcomes.
4. Computers were being accepted as a tool for enhancing efficiency in
virtually all facets of everyday life, so the researchers recommended
the proposed system.
5. The researchers recommended the proposed system based on the
collected data, statistically stating that the computerized medical
record system was more familiar, would be more accurate and would
be having more satisfaction to the people that limits the system.
` 66

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An Assessment of Manual Medical Record System of Fr. Simpliciano Academy Inc.

School Year 2018-2019

The Problem and Its Background

This chapter discusses the background of the study, theoretical and

conceptual framework, statement of the problem, hypothesis, significance of

According to Professor Dr. Phyllis J. Watson (2006) it is evident that a

managing patients’ records, prescriptions, billing and appointment schedule is no

longer practical as the years rolled by.

Medical health records form an essential part of a patient’s present and

and continuing care of the patient as a written collection of information about a

professionals write up medical records so that previousmedical information is

record is the principal repository for information concerning patient's health

receiving, or reimbursing health care services in some way. The typical

patient record of today is remarkably similar to the patient record of fifty

misguided choices; it is unstable, confused, and desperately in need of a

modern medicine. Patient record improvement could make major

contributions to improving the health care system of this nation.

People nowadays rely more on technology to help them with their

current situations in the 21st Century. The researchers thought of applying

The researchers used this intellect to research the modernized process of

arranging the school’s medical records. The researchers thought of helping

it is easier and more helpful to everyone.

In this study, the researchers hoped to develop a web-based

increasing the number of patients served – a system that is fully automated,

user-friendly, time effective and efficient.

Background of the Study

historyas simply virtue of being alive. In this technology-enabled age of the

personal history - downloading apps to track calories and mood swings,

has advanced in both importance and technology.

Prior to 1900, there was no standard method for keeping medical

check a pulse and many of their observations centered on studying the

patient’s complexion, urine, and other excretions. There wasn’t much to

then again with a scientific revolution in the 16th century - marked by a

extensive surviving collections of medical records from this time. Other

payments for treatments and prescriptions.

This study is anchored to the theory of PlacidePoba-Nzaou,several

governments in industrialized countries including the US, France, Germany

so as to accelerate the adoption of Electronic Health Records by primary

care providers as well as hospitalsin order to cope with the unsustainable

rising costs of health care. Electronic Health Records are a growing

phenomenon that is considered the cornerstone of modern healthcare

implementation in hospital settings despite the fact that hospitals account

EU depending on the country.

Electronic Health Record is defined as an electronic record of health-

related information on an individual that conforms to nationally recognized

interoperability standards and that can be created, managed, and consulted

organization. Electronic Health Records entail high potential benefits and

high likelihood of improving individual patients and populations health

outcomes (e.g. – clinical outcomes- reductions in medication errors,

improved quality of care; organizational outcomes- financial and operational

benefits; and societal outcomes- improved ability to conduct research,

Record lifecycle as it is for other software packages. The failure of an

Electronic Health Record implementation or the poor management of

hospital’s ability to generate potential benefits in addition to putting patients’

management of Electronic Health Record risk has resulted in a high level of

dissatisfaction of hospitals with their Electronic Health Record systems to

In most industrialized countries, healthcare costs are rising so fast

that they will become unaffordable by mid-century without reforms. More

specifically, if present tendencies in health care costs prevail by year 2050,

nearly all OECD or Organization for Economic Cooperation and

will reach this level of spending.

This situation qualifies as being an unsustainable trend that needs to

be reversed and, the implementation of Electronic Health Records within the

concerned countries is seen as one of the most promising routes. However,