CHAPTER 2

CONCEPTUAL FRAMEWORK

2.1

Review of Related Literature and Studies

The development and implementation of e-Health for Pagamutang Bayan ng

Carmona is vital to the success provision of better medical services to the public. Various
related studies and system development undertakings had been adapted and used as bases
in the development and implementation of e-Health for Pagamutang Bayan ng Carmona
in pursuance with transforming current resources and technology of the hospital into
more efficient, effective hospital record and information system that would provide better
and faster services to the public specifically the patients of the said hospital.
In this chapter, overviews of some medical record management systems which have
clear relation to this study are presented.

2.1.1 Foreign Literature

2.1.1.1 Delivering e-Health to Australia, The Royal Australian College of
General Practitioners

Figure 2.1 Homepage of the Royal Australian College of

General Practitioners Website

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The future of quality, safe, and efficient patient care will include a large
dependency on electronic products, services and tools. This is why the
RACGP is very excited to be at the forefront of e-health.
e-Health is the electronic collection, management, use, storage and sharing
of healthcare information. This information can include individual items such
as referrals, test results, discharge summaries, vaccination history, medication
history and diagnoses, to comprehensive medical records.
e-Health systems that can securely and efficiently exchange data can
significantly improve how clinical and administrative information is
communicated between healthcare providers. As a result, e-health systems
have the potential to unlock substantially greater quality, safety and efficiency
benefits. e-health has the capacity to benefit all Australians individual
consumers, healthcare providers and organisations.
Benefits of e-health
The benefits of a national e-health system are far reaching for patients,
GPs and practice staff and other healthcare providers.
Patients

Improved quality of patient care

More patient focused integrated care

Improved cost effectiveness of care

Improved patient safety

Improved access to healthcare

Improved continuity of care

Close the gap between rural and remote healthcare providers and patients

Lives saved through better decision support, increased access to

information, and reduced adverse events.

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GPs and Practice Staff

Improved access to reliable health information when and where it is

needed

Improved healthcare planning by ensuring resources are directed to where

they are needed most

Enhanced shared care for complex medical problems and chronic disease

Encourage innovation to deliver improvements in health sector

productivity

Reduced burden on Australia's health sector through better health

management (e.g. reduced duplication of tests, visits and procedures).

The role of the RACGP in e-health
General practice is in an ideal position to be at the forefront of e-health.
There are over 125 million GP consultations taking place in Australia
annually and computers are now used by 96% of GPs for clinical purposes.
This demonstrates that GPs are increasingly reliant on computers for patient
care and there are clear benefits that would arise from the Australian health
sector operating as an inter-connected system, avoiding duplication and
reducing errors. The manner in which data is collected, stored, and managed
has to be agreed on by the general practice community given its understanding
of the key drivers of privacy, confidentiality, safety, quality, ethics and
accuracy. The secondary use of this data for health service planning and
research must be governed with respect and due diligence.
The College is investing in e-health and will ensure that e-health
initiatives are profession-led to better enable GPs and their practice teams to
improve health outcomes for patients in the long term. e-health and
information technology supports GPs' work and connects them with the
extended primary healthcare team, public health, mental health and
subspeciality services.

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The future of modern healthcare services will be supported by GPs' ability

to adapt to new technology. The RACGP believes that web based technology
will be the future for GPs delivering efficient, high quality and safe healthcare
to the community.
e-Health will have significant impacts on the manner in which GPs
practice in the coming decade. The fundamental aim of the RACGP's
commitment to e-health is to see a healthcare system which is based on the
principles of interconnectivity and interoperability, and one which is simple
and intuitive.
RACGP initiatives
The Royal Australian College of General Practitioners (RACGP)
recognizes that telehealth provides considerable opportunities to improve
health outcomes for patients in outer metropolitan, regional, rural and remote
communities and is committed to supporting the profession during the
telehealth rollout. [RACG2011]

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2.1.1.2 Quintegra Hospital Management and Information System (HMIS)

Figure 2.2 Homepage of Quintegra Hospital Management

and Information System (HMIS)

Quintegra HMIS is a hospital management system (HMS) being used

internationally. It has worldwide presence in different countries like India,
United Kingdom, USA, Germany, Malaysia and Singapore. This system was
developed in 1994 by Quintegra Solutions Limited. Like other HMS, it has
various modules like Patient Administrations, laboratory, nursing, ward,
billing, and integrated with the financial and human resource system.
In the evaluation of the system, Quintegra highlights the following
features such as patient-centered approach, user-friendly, easy to use and webenabled applications, multi-level distributed hospital information system,
security

and

privacy

(authentication,

authorization,

privacy

policy),

robustness, reliability and scalability. They also highlighted that Quintegra

HMIS is powered by SAP Netweaver and Oracle.
In contrast, the e-Health for Pagamutang Bayan ng Carmona utilizes
MySQL database server as the database management system server for the
reason that MySQL is an open source and free software.

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Feature wise, the system contains the same security features with regards
to policies, authorization and authentication. Same platform, the browser
based application is also implemented in the system.

2.1.1.3 Outsource2indias EMR System

Figure 2.3 Homepage of Outsource2indias EMR System

Outsource2india has been offering a large number of healthcare
automation solutions to help global healthcare organizations improve their
medical practices performance. One such healthcare automation solution that
Outsource2india offers, is the Electronic Medical Records (EMR) system.
Their EMR system can help provide better patient care and has the latest
clinical productivity tools. With consistent procedures, logical workflows and
specialty-specific templates, their EMR system can help automate all the
aspects of patient documentation process.
The EMR software solution that they offer can be joined to ones practice
management software and medical billing software to provide them with a
fully-integrated healthcare solution.
The EMR system that they offer has features and functionalities that
specifically address the needs of office administrative staff, nurse

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practitioners, medical assistants and doctors. By using our EMR system, you
can:

Maintain daily appointment schedules that can be easily accessed by your

physicians or administrators

Ensure the consistency of treatment and activities by listing physician

tasks

Manage office documents for distribution and further processing

Create reminders and electronic messages

With the help of their EMR system, physicians can use the most proficient

data capture tools to ensure that data is entered quickly with minimized
computer interactions. Each of your physicians can use the templates and
treatment plans options to customize their favorite protocols. Physicians can
use this feature to provide patient information, create lab/pharmacy orders or
record common ailments.
Features and functionalities of Outsource2indias EMR system

Office workflow management: This feature can help you manage your
patients flow from check-in to check-out.

Coding assistance: This feature uses CMS guidelines to evaluate medical

notes and suggest the appropriate E & M code for each encounter.

Chart notes: These specialty-specific templates can help you simplify the
patient examination, evaluation and documentation process.

Prescription assistant: Features such as templates, cross-checks and

pharmaceutical databases ensure fast and accurate medication prescribing.

Document managing and imaging: This feature helps users scan, index,
archive or distribute patient documents. Users can also email/fax
documents through an interface to third-party systems.

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HL7 interfaces: Our EMR system adheres to industry-approved HL7

(Health Level Seven) ANSI standards.

EMR system has several automated processes that help to increase

productivity. These include:

Workflows that can be customized to match your offices needs

Recommendations about preventative healthcare

Detailed documentation of the encounter details of each patient

Completed demographic data and schedule information for every patient

Comprehensive electronic medical charts that have an easy-to-use format

Pre-defined treatment plans for common ailments

Recommendations about drug dosages

Alerts about interactions and allergies

Electronic transmission of results/lab orders through lab interfaces

E-prescription for medicines by using online pharmacy services

Benefits of choosing Outsource2indias EMR system

Improved patient processing is achieved by speeding up the check-in

procedure, improving the accuracy of patient data and reducing
paperwork;

Establishment of clinical best practices and workflow management in your

office;

Every patients medical history is stored in the EMR system for quick
review by your physicians or clinical staff;

The knowledge base feature provides informative updates for the

diagnoses and treatments based on national guidelines;

The pharmaceutical module in the EMR system contains the latest

medications and dosage data to help you avoid difficult drug interactions.
[OUTS2010]

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2.1.1.4 Integrated Hospital Management System (IHMS), Lions Aravind

Institute of Community Ophthalmology (LAICO), Madurai, India
LAICO had initiated software development project with an intention to
support voluntary hospitals by providing software solutions for hospital
management. The project was started in September 1999 with funding from
CBM. LAICO with its 15 years of experience in using computers for various
applications at Aravind Eye Hospitals took responsibility to define the
software requirements and system design. This system was completed in
April 2001 and evaluated for six months before its full implementation in
December 2001.
IHMS is an integrated system that covers different aspects of patient care
and administration in hospital management. The patient care domain like outpatient registration and billing, in-patient reservation, admission and
discharge,

ward

management,

appointments

and

medical

records

managements are some of the functionalities of the IHMS.

Microsoft SQL Server is used at the backend for data management, since
they consider its powerful features and data managements to access the data
efficiently. The system was designed for Microsoft Windows environment.
IHMS also employs the International Classification of Diseases (ICD)
Standard to build up the data for medical records.
In comparison,

the e-Health for Pagamutang Bayan ng Carmona also

uses the ICD Standard for medical records. It has all the modules for patient
care and management stated in the IHMS. On the other hand, the system is
also implemented in a browser-based and web-based environment.

2.1.1.5 VESALIUS Integrated Hospital Management System, St.

Andrews Community Hospital, Singapore
As a community hospital, St. Andrews Community Hospital (SACH)
manages elderly patients who have been transferred there from acute hospitals

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after initial stroke or lower limb fracture has been treated. SACH is a nonprofit organization that provides excellent care that is compassionate and
holistic.
The hospital uses VESALIUS Health Management System customized
according to SACHs particular needs and operations. VESALIUS contains
different modules such as outpatient management, inpatient management,
pharmacy, purchase order, inventory management, billing, interface with
financial system, regulatory submissions (Central Claims Processing System).
Based on the experience of St. Andrews Community Hospital, with the
introduction of VESALIUS, valuable resources are rechanneled from manual
tracking of stock levels to other critical pharmacy areas.

Stocks are

automatically deducted upon dispensing or transfer and re-ordering alerts are

pre-defined. The computerization of inpatient medication records also leads
to a more efficient workflow comprising online patient listing, medication
management and dispensing by pharmacy staff. This new system replaced the
formerly labor-intensive tack of manually submitting subsidy claims to the
government. Overall, the system has improved the hospitals efficiency as
manual and administrative works are minimized.
Similarly, the e-Health for Pagamutang Bayan ng Carmona also envisions
of improving the efficiency of hospital administration and minimizing tedious
works. Upon reviewing this literature, a clear idea on how to accurately
implement and integrate the inventory module to the core modules of health
care management system is obtained.

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2.1.1 Local Literature

2.1.2.1 Accent Hospital Management System (AHMS)

Figure 2.4 Page Lay-out of Accent Hospital Management System

(AHMS) Main Menu

Accent HMS is a hospital system developed locally by Associated

Computers and Communication Enterprise. This system covers all aspects of
hospital management and day-to-day operations of a hospital.
It is the first mid-segment hospital management system in the Philippines.
In the evaluation of the system, the following features were seen by the
proponent such as; easy to learn and operate, highly modular, multiple tier
server architecture. Accent highlighted that several benefits will be realized
with the implementation of system. Like other HMS, foreign or local, modules
such as Inpatient module, Outpatient module, Billing and reports are
integrated in the system. Access control is also integrated to secure the
system. AHMS was developed in Visual Basic 6.0 and using MS SQL Server
2005 to support its database management system with Seagate Crystal Report
for reporting purposes.
This is significant to the study in the sense that all modules are also
presented in the e-Health for Pagamutang Bayan ng Carmona.

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2.1.2.2 Community Health Information Tracking System (CHITS),

Department of Health

Figure 2.5 Page Lay-out Community Health Information Tracking

System (CHITS)

CHITS is a software for the health centers that combines the features of an
electronic health record and clinic appointment system while also integrating
modules for different national health programs. It is an extensible, modular
system that leverages existing routine health information systems in public
health to serve as a starting point for implementing comprehensive
information system integration.
Through CHITS, community-based health information is made available
not only to public health agencies requiring community level information but
also to the community itself that generates information.

It enables the

community to use this information for local decision making.

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CHITS is in use in forty eight (48) health centers in two cities and two
provinces. Pasay City is also planning to adopt this system for citywide
implementation.
CHITS has different modules such as Patient Module, Consults Module,
Libraries or Master File, Reports Module and Content Module for content
management system.
The different open source software used to develop CHITS were: Linux
operating system, PHP scripting language, Apache web server, MySQL as the
database management system tool. In addition, a generic architecture for
modular enterprise (GAME) was also developed to make further expansion of
the CHITS easy, for any developer with a modicum of training in scripting
language. This GAME architecture is the native framework for CHITS used
by the programmers instead of using readily available framework that can be
downloaded in the internet for free.
CHITS is found to be useful in terms of reports generation and deeply
understand the national and international standards set by health governing
bodies (DOH, WHO) like the classification of diseases (International
Classification of Diseases or ICD). The ICD is the international standard
diagnostic classification for all general epidemiological and health
management purposes.
In contrast, CHITS concentrated in community health information system
while the PBC-HMS concentrates more in hospital setting.

2.1.2 Foreign Studies

2.1.2.3 Hospital Management Information System: The Aceh Experience,
Indonesia
The Aceh province in Northern Sumatra, Indonesia was devastated by the
Indian Ocean Tsunami on December 26, 2004. The disaster brought immense
destruction and took about 220,000 lives throughout the province.

The

provincial health sector suffered in affected health facilities the lost of up to

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30 & of its workforce and immense infrastructural damages. The German

government offered assistance to the Indonesian government through various
German aid and development cooperation agencies in the framework of the
Aceh Reconstruction and Rehabilitation Programme (ARRP). Part of the
assistance is to develop a hospital management system.
This study is aimed to improve the capacity to efficiently manage the
public health sector and the public health services and improve the health
status of the population, in particular of vulnerable groups through better
health service management. The system used by the Aceh Province was
outsourced from a private company in Indonesia.
During the analysis of the current situation, several problems like time
consuming and delays, inaccuracy, resource intensive works and redundancy
were enumerated. Rapid assessment of existing system was also done. With
the gathered data and information, some considerations were enumerated to
form a strategy in the acquisition of hospital management system. Time,
costs, funds and risks were some of the considerations in the said endeavor.
During the procurement process, user and software requirement were also
gathered before implementation was done.
The study stipulated the implementation outcome of the said project which
will be significant in the implementation of the e-Health for Pagamutang
Bayan ng Carmona since the experience of Aceh is similar with the
proponents experience in terms of project management and implementation.
Some of the challenges faced during the implementation are uncooperative
users, busy schedule, and passive resistance.

Some users systematically

avoided meetings, and when they do attend, provided more problems rather
than solutions. Some users appear cooperative and well during interaction
with the implementation team but would not use the system when it went live.
These problems mentioned were solved by getting the cooperation of the top
level managers to control staffs and apply pressure on them to cooperate.

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In the conclusion of the study, lessons learned were specified. They are the
following:
1. A common mistake is to take HMIS implementation as an exercise to
procure and deliver hardware, software and conduct few training sessions
before achieving objectives. This works for routine automation software
such as Microsoft Office but HMIS implementation effort is much more
than that.

It involves meticulous planning, improvement of work

processes, changing organization culture and long term coaching, and

maintenance.
2. The efforts involved in implementing HMIS and the difficulties involved
should not be underestimated. Funding availability and technical capacity
should be used to evaluate ambitions and scope. External elements such
as possible changes in partner organization and governing policies should
also be considered in making decisions.
3. Partners should not be kept in the electronic Stone Age by further
advocating manual processes while other industries such as banking and
finance has adopted Information and Communication Technology (ICT)
since 30 years. Partners capabilities shouldnt be discounted and used as
reason why projects should not adopt management improvements through
computerization and information systems.
4. Failures in hospital and health information systems implementation are
commonly heard and widely documented. However, HMIS should be
given a chance as it is the only mean of evidence based management.
Obstacle in the implementation can be overcome through meticulous
planning, adoption of suitable implementation strategies and appropriate
technical expertise in project management, continuous coaching and
regular exposure to own HMIS generated data. The confrontation with
poor data outcome is the best challenge/motivation to improve existing
HMIS.

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5. The objective of a functioning HMIS should always be in the center of all

HMIS development and modifications: to solve operational problems and
improve the health service conditions.

The technologically advanced

solution is not necessarily the best solution.

In this study, several steps in implementing the HMIS system was done,
the outcome was documented and lessons learned were enumerated.
These steps are significant to the study since expectations during the
implementation stage of the PBC-HMS are critical. This related study is
also significant in the whole project management process since some
information in the actual implementation was given enough attention and
advices on how to overcome certain issues and problems.
Another
2.1.3

Local Studies
2.1.4.1 Purisimo Lorenzana Tiam (PLT) Hospital Management
Information System, Bascaran, Solano, Nueva Vizcaya
The main concern of this study is to develop an electronic medical
recording system and billing system for the PLT Hospital. This hospital is
a private hospital located in Nueva Ecija, a tertiary level hospital which
offers various medical services to community.
In this study, the researcher identified problems encountered in the
existing medical record keeping and billing system of PLT Hospital,
identified the processes that needs to be automated along with medical
record-keep and billing and determine a suitable security measures to
protect the integrity of data.
The researcher of this study follows research procedures in order to
come up with a comprehensive approach in developing the required
system needed by the hospital. Data gathering techniques and different
sources of data was presented and proper respondents were identified in
this study.

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With necessary data and information, the researcher comes up to a

solution of providing the PLT Hospital a computerized hospital
management information system.
This study may be helpful in recognizing other features that may be
included in the e-Health for Pagamutang Bayan ng Carmona. Proper steps
in collating and handling captured data can also be learned in this related
study.
In contrast, the PBC-HMS also integrates other features such as
laboratory, pharmacy, central supply stocks and emergency module.

2.2 Conceptual Model of the Study

This section sets out the conceptual model of this project. The conceptual model used
in this study is the Input-Process-Output Model. In IPO Model, a process is viewed as a
series of boxes (processing elements) connected by inputs and outputs. Information or
material objects flow through a series of tasks or activities. What goes in is the input;
what causes the change is the process; what comes out is the output [IVYT2008]. Figure
2.4 illustrates the basic IPO model. The concept stipulated in the IPO model in this study
provided the general structure and guide in development of the system.
To facilitate the development of the system, the conceptual model provided a birdseye view on what are the inputs in the system, the processes carried out based on the
inputs, and the output that will solve the issues in the hospital.

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Figure 2.6 Conceptual Model of the Study (IPO Model)

The data requirements which served as inputs to the system are patient information,
patient vital signs, chief complaints, requirements and policies from national government
agencies, and international standards in classifying diseases (ICD10). The software
requirements used to perform the development of the system are PHP and Java scripting
languages, MySQL as the DBMS software, web browser to access the application,
xHTML which is required to display the markup language output of the PHP, and other
plug-ins. Client and server computers, intranet connection (LAN) and printers are the
hardware utilized to complete to input requirements of the system.
Different stages were involved in the process juncture which caused changes in the
system. The requirements planning stage which involves all the concerned people that
affects the system like the nurses, medical technologists, doctors and other medical staff
of the hospital. The requirements definition engrosses analysis of the existing system and
defining the problems that needs to be resolved. The user design stage includes the
design and presentation of prototype of the system which involves continuous
communication with all levels of the users to ensure that solutions agreed will truly
resolve the issues identified. The construction stage focuses in the actual development of
the application that continuously seeks the participation of the users in the changes and
improvement of the system. The cutover stage involves the actual implementation of the

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system which entails application testing, change management, user training and system
deployment.
These processes brought changes in the current system which yields the output of the
system. The main output is the e-Health for Pagamutang Bayan ng Carmona that aimed
at implementing efficient and effective electronic medical record and information system
that would provide faster and better services to the public of Carmona, particularly to its
patients.

2.3 Theoretical Framework of the Study

2.3.1 IT Theories

2.3.1.1

Browser-based Application

A browser-based application is an application that runs on a web browser

such as Firefox, Internet Explorer or Chrome. These applications only require
an Intranet connection and a web browser to run properly regardless of the
operating system being used on the computer.
One of the main benefits of browser-based applications is that there are no
downloads necessary to make the application run. This means that even users
behind firewall can benefit from using these types of applications.

2.3.1.2

Client-Server Computing

The client-server model of computing is a distributed application that

partitions tasks or workloads between the providers of a resource or service
called server, and the service requesters called clients. Clients and servers
communicate over a computer network on separate hardware, but may both
reside in the same or different system. A server machine is a host that is
running one or more server programs which share their resources with clients.
A client does not share any of its resources, but requests a servers content or
service function. Clients therefore initiate communication sessions with servers
which await incoming requests [WIKI2011].

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Figure 2.7 Client-Server Model

2.3.1.3 MySQL: Open Source Database Management System

MySQL, developed by Swedens MySQL AB, now owned
by Oracle, is a free, open-source database that offers real
advantages and limitations. It is a relational database management
system that runs as a server providing multi-user access to a
number of databases [WIKI2011].
MySQL can be accessed in almost any programming
languages available such as C, Java, .NET, PHP, Python and Perl.
PHP is the most popular partner of MySQL since this database is
being used for web databases. With its robust capabilities, it has
been chosen by many popular sites and companies such as Yahoo,
Google,

Walmart,

Swedish

National

Police,

McGraw-Hill

Education, to mention a few.

MySQL is faster, more reliable, and cheaper than any other
database system.

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2.3.1.4 Object Oriented Programming (OOP)

Object oriented programming is a type of programming in
which programmers define not only the data type of a data
structure, but also the types of operations (function) that can be
applied to the data structure.

In this way, the data structure

becomes an object that includes both data and functions.

In

addition, programmers can create relationships between one object

and another. For example, objects can inherit characteristics from
other objects.
One of the principal advantages of object-oriented
programming techniques over procedural programming techniques
is that they enable programmers to create module that does not
need to be changed when a new type of object is added.

programmer can simply create a new object that inherits many of

its features from existing objects.

This makes object-oriented

programs easier to modify [WEBO2011].

2.3.1.5 NetBeans IDE

Figure 2.8 NetBeans IDE

NetBeans is a free, Multilanguage IDE available from
NetBeans.org.

Though NetBeans began life as a Java IDE,

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versions exist for Python, Ruby, Javascript, Groovy, C/C++, and

PHP. The IDE is Java-based, and it will run on Windows, Mac OS
X, Linux and Solaris.
The NetBeans IDE interface is a collection of dockable
windows, arrange in the familiar explorers on the left, editors to
the right format.

The explorers include a typical project

navigator, a file system navigator and a database explorer. To this

trio, NetBeans adds a web service.
Because NetBeans PHP includes Javascrips editing
capabilities, it will recognize the embedded Javascript in the
HTML portion of a PHP source file and provide context aware
code completion of Javascript elements.
For PHP debugging, NetBeans uses Xdebug. The IDE can
also

debug

client-side

Javascript using NetBeans-supplied

Javascript debugger [TECH2011].

The researcher used this IDE during the development of the
system.

2.3.2

Non-IT Theories
2.3.2.1 Medical Records Management
Medical records management refers to the planning,
controlling, directing, organizing, training, promoting and other
managerial activities related to the creation, maintenance and use,
and disposition of medical records to achieve adequate and proper
documentation of a health care organizations policies and
transactions.
The medical record has four major sections:
1. Administrative, which includes demographic and
socioeconomic data such as the name of the patient,

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sex, date of birth, place of birth, patients permanent

address and medical record number.
2. Legal data including a signed consent for treatment by
appointed doctors and authorization for the release of
information.
3. Financial data relating to the payment of fees for
medical services and hospital accommodation; and
4. Clinical data on the patient whether admitted to the
hospital or treated as an outpatient or an emergency
patient.
Better medical record management is essential for the
present and continuing care of the patient.

2.3.2.2 Health Information System or Health Informatics

Health informatics is a discipline at the intersection of
information science, computer science, and health care. It deals
with the resources, devices, and methods required tooptimize the
acquisition, storage, retrieval, and use of information in health and
biomedicine. Health informatics tools include not only computers
but also clinical guidelines, formal medical terminologies, and
information and communication systems (ICT). It is applied to the
areas of nursing, clinical care, dentistry, pharmacy, public health,
occupational therapy, and (bio) medical research [WIKI2011].
HIS is a standardize tool to design, monitor and evaluate
public health programs. The aim is to improve the health status of
people, through evidence-based policy formulation, improved
management of health programs and direct actions that improve
public health [UNHC2011].

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2.3.2.3 Electronic Health Record (EHR)

The Electronic Health Record (HER) is a longitudinal
electronic record of patient information generated by one or more
encounters in any care delivery setting.

Included in this

information are patient demographics, progress notes, problems,

medications, vital signs, past medical history, immunizations,
laboratory data, and radiology reports. The HER automates and
streamlines the clinician workflow. It has the ability to generate a
complete record of a clinical patient encounter, as well as
supporting other care-related activities directly or indirectly via
interface including evidence-based decision support, quality
management, and outcomes reporting [NIH2006].
An electronic record may be created for each service a
patient receives from ancillary departments, such as radiology,
laboratory, or pharmacy, or as a result of an administrative action.
Registration, admissions, discharge, and transfer (RADT)
data are key components of EHRs. These data include vital
information for accurate patient identification and assessment,
including but not necessarily limited to, name, demographics, next
of kin, employer information, chief complaint, patient disposition,
etc. The registration portion of an EHR contains a unique patient
identifier, usually consisting of a numeric or alphanumeric
sequence that is unidentifiable outside the organization or
institution in which it serves. RADT data allows an individuals
health information to be aggregated for use in clinical analysis and
research.
This unique patient identifier is the core of an HER and
links all clinical observations, tests, procedures, complaints,
evaluations, and diagnoses to the patient.

The identifier is

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sometimes referred to as the medical record number or master

patient index (MPI). Advances in automated information systems
have made possible for organizations or institutions to use MPIs
enterprise wide, called enterprise-wide master patient indices.

2.4

Summary
The conceptual framework was used in this research to outline possible
courses of action and present a preferred approach to an idea. This chapter
started with the review of foreign and local literature, foreign and local studies,
and IT and Non-IT theories that will contribute in the development of e-Health
for Pagamutang Bayan ng Carmona.
The related foreign literatures presented have significant relationship
with the study since all of them are providing healthcare to communities. The
Integrated Hospital Management System (IHMS), Lions Aravind Institute of
Community Ophthalmology (LAICO), Madurai, India and the VESALIUS
Integrated Hospital Management System of St. Andrews Community Hospital,
Singapore were chosen because they adopt the same features and functions of
the system.
Also, the related local literatures reviewed in this study are also
significant in the sense that it was developed in the Philippines setting. The
Community Health Information Tracking System (CHITS) of Department of
Health that was implemented in some parts of the country also used PHP and
MySQL in the development of the system. PHP and MySQL were highly
considered because of their cost and efficiency and its proven track of record in
the development of browser-based and web-based systems.
The related foreign studies included have significant relationship since
it focused in the implementation strategy, presented all problems and solutions
done, and tackled the lessons learned in implementing the hospital management
system.

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The conceptual model of the study served as guide in the development

of the system. The summary of inputs and processes in the development steered
the researcher in developing the e-Health for Pagamutang Bayan ng Carmona.
IT and Non-IT theories reviewed and presented clearly illustrated that
the study is well guided and well acquainted with specific disposition or
viewpoint during the analysis of the system.
Finally, the definition of terms enumerated will clarify vague
terminologies used in this study.

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