Discuss About The Patient Reported Outcome Measures Practice

Introduction to Doctor Web Appointment System

Discuss About The Patient Reported Outcome Measures Practice.

The Doctor Web Appointment System is an online portal through which  the patients can make the appointment with specific doctor. The system can be used by the users after the registration (Tieu et al. 2015). The registered users can be reached to the particular doctors who are registered in the portal. There is a annual charge for the registration.  The charges for the registration are different for the patients and the doctors. 

There are certain problems regarding the Doctor Web Appointment system.

• The patient records are not properly updated electronically.
• Most of the doctors are not interested about using this system.
• The graphical interface of the system is not user friendly.
• There is a lack of security during the transaction of money through the system.
• The portal has no different divisions for different specialist .
• Queue disciplines of the patients are not maintained properly in the portal.
• Scheduling on the emergency basis cannot be done through the system.

Certain opportunities can be seen in the web based appointment system.

• The application of the advanced technology will help the web portal to be more specific and effective.
• The effective system can attract more doctors to join in the web based appointment system.
• The different division mentioning the specialist doctors will help the patient to choose doctors more specifically.
• Additional portal for keeping the track of patient’s medicine and other medical details along with the prescription can help the patient during the treatment process.
• The graphical user interface of the system can be developed into a user friendly so that the naive users can use the system easily.
• Advanced security protocols can be used in the transaction gateway so that the transaction of money through the portal can be more secured.
• The scheduling issues on the priority basis can be implemented, so that the patient with emergency can get appointment easily.
• The movement of the waiting queue can be improved.

There are some mandates which  are needed to be present in order to implement the system.

• The data stored in the system needs to be secured and safe. The individual users only can access respective individual records.
• The whole Web based appointment system is needed to be maintained by a particular software service providing organization.
• The doctors who are interested to register in the portal are needed to submit their proof of qualification to the authorized body associated with the web based appointment system.
• The money collected for the registration purpose through the online transaction will provide an automatically generated invoice.
• The system will only store the necessary information about the patient with the permission of the patient. Other confidential information such as the user’s debit or credit card number will not be stored by the system.
• The system will show the right information regarding availability of doctors and the tight appointment time available.
• The system should maintain the transparency the providing the services.

There are two success factors in this case.

• Success factors related to the process and the system: The discussed system is the web based doctor appointment system. Te users can login through the portal by their registration ID and can make appointment with the doctors they need (Aminpour, Sadoughi and Ahamdi  2014). The interested doctors can also register themselves in the portal. The whole process from the registration to appointment making will be done online (Naimark,  Madar and Shahar  2015). This online appointment system will save the cost and the time as the users can make appointment with a single click and they can choose their own time to make the appointments. All available slots will be shown to the users so that they can make their own choices (Dalal et al. 2015). The portal will also keep the medical record of the patients. This process will eliminate the chances of human error along with that the chances of misplacement of the reports can be reduced (Nelson et al. 2015). The automation in the different processes in the system such as generation of the report along with keeping the appointment details of the patients electronically will help to reduce the human error.

The record stored in the individual’s portal in the system can be shared with the other health providers with the permission of the patients, if it is necessary.

• Success factors related to project:

1. Involvement of users: During the whole development process the opinions of all the stakeholders related to the web appointment system is heard and the modifications are made on the basis of these opinions.
2. Project planning: The project planning is needed to be done wisely by the team leaders so that the team members do not miss any essential requirements or the steps of process during the development phase.
3. Support after the delivery of the system: A dedicated team will provide technical support through online, to the users of the system. In case, if there is any technical glitch happens , the support team will resolve that.
4. Selection of right team: The right team selection is important in order to deliver the system with the desired requirements and the modifications.

The Web based doctor appointment system has developed first in 2009. It was initially used by the group of hospitals on the experiment basis. The development team has requested those hospitals to give the review on the given system. On the basis of certain review the web development system is modified and reintroduced in 2011 (Arora et al. 2015). Earlier the system was a standalone system. After he modification the system conducts operations online. The system gains popularity after sometimes. Currently the users are using the Web based appointment system 2.0, where the registrations can be made by the users and doctors (Wen  and Zhang  2015). All the information are stored in the secured database which is maintained centrally. The account section provides all the reports and all appointments details of the patients. Patients can download the reports from the download sections.

• There is no need for the already registered users to register into the system.
• The new users have to click on the “register “tab.
• The details of the users are needed to be provided along with their unique identification number.
• The users need to choose the subscription timeframe. There are two options available- registration for 6months and registration for 1 year.
• After the submission of the details, the page will lead to the payment gateway. The user has to make the payment using debit or credit card or net banking.
• After the payment, the respective individual accounts of the users are created.

• The doctors who are interested to register themselves i the portal are needed to register by clicking “doctor registration” tab.
• The doctors are needed to be provided the details along with the identification number.
• The next page will require the qualification details of the doctors, where they have to submit scanned copy of their academic certificates.
• The one time registration fee, which is minimal, has to be given by the doctors through the payment gateway.
• After the payment doctor’s account will be created.

• The patients will make appointment through their account.
• Before making the appointment the patients have to fill the columns regarding their problem and doctor specification and the time slot they want.
• Basis on the entered data the available slots are shown to the patients.

• Data is stored in the sql server which is maintained centrally.
• The user can view all the data related to his or her medical conditions.
• The reports can be downloaded from the portal by the users.

• SQL data server
• Firewalls`
• Computers , which are working as servers.
• Security protocols.

In case of defining the tangible benefits, there factors an be considered:

• Cost savings: In order to modify the current system, certain amount of money is needed to be invested. However, the modification will help to run the system in a cost effective manner. The money invested in this case can be considered one time investment.
• Time savings: The current web based appointment system reduces the time for making the appointment. However, the newly modified system will not contribute largely in the time reduction as it has been already served by the previous version of the system.
• New products and services: The modified system will introduce certain services like – the advanced scheduling and the update about the movement of the patient waiting list (Silver 2015). The modification of the scheduling will help to prioritise the energy condition of the patient and the update about the movement of the waiting list will inform the patient about their waiting list number. The newly imposed security protocol in the payment gateway will improve the security of the transaction gateway and the users can be assured that their card details and money are in safe position.

• The main purpose of the web based doctor appointment system is to organize the appointment making system in a composed and organized way through online. The earlier version served this purpose quite effectively. However, certain issues related to the appointment making system were not well managed in the previous system (Ahmadi-Javid,Jalali and Klassen 2017). The main benefit of the new process is that the portal has certain controls over various important process like scheduling and security in the money transfer.
• The new version of the web based appointment system provides the better communication process between the stakeholders of the process such as patients, doctors and online support team (Dimitrov 2016). In case, if a user faces any problem while using the system he or she can ask assistance from the online support team.
• The new version of the system helps to resolve some ethical problems those can be happened with the use of this kind of system(Mishra, Kumar and Bhasker 2015) . In case, if any appointment is missed or denied by the user the matter can be resolves by the stored appointment data in the portal (Kruse et al.2015).  The transparency about the waiting list can also be maintained as the patients are updated about the movement of the list.

• The main advantage in this system is that using cloud storage will provide the large storage space that cannot be provided by SQL server.
• The data can be more secured.
• The cost of maintaining data in new system can be reduced, as the cloud architecture will be maintained by the third party cloud provider.
• The data can be accessible from any places.
• The storage system can be flexible to adopt any certain changes.

• The initial cost of the migration of data can be costly.
• The handling of data in cloud is needed to be done by the experts, otherwise there are chances of technical glitches.
• There are different layers of the cloud, so it can be difficult for the developers to decide which layer to be used.
• The security is the major concern about cloud architecture, as without proper security regime the data can be accessed illegally form the cloud.
• The cost has to be paid in order to modify the whole infrastructures which can compatible with cloud architecture.

• Most of the people are now using mobile to do various important tasks. In case, if the web based doctor appointment system has its own dedicated mobile application, it will be more user friendly.
• Instead of changing the way of storage , if the convention server storage system is modified, the cost will be reduce as well as the system will be modified.
• The keeping of the conventional storage system will not require the experts to handle the system.
• Modification of the conventional system will not require the cost for the up gradation of the whole technical infrastructure.

• The making of the mobile application requires a good amount of resources.
• The individual mobile application needs the special maintenance. In order to do this a dedicated mobile application development team will be needed, which is not a cost effective option.
• The use of conventional sever can be problematic after certain point of time, as it does not provide the required flexibility of data storage.

• No modification is required in the system.
• The cost and time can be saved.
• No training is needed to be required as the system is a known system.

• The current system has no transparency in maintaining the queue of the patient and scheduling of the appointment.
• The current system does not provide a strong security encryption during the transaction of the money.
• The current system uses conventional database, which may not be sufficient for this kind of system.

The above alternatives of the modification of the web based doctor appointment booking system indicate the various advantages and disadvantages of all the alternatives.

In case of the migration of data from the conventional system to the cloud storage can be beneficial as it will have the capacity to store the large amount of data. The initial implementation may take much resource, but in long run this modification can be cost effective solution of maintaining the data (Gordon and Hornbrook 2016). There are other issues regarding the storage in cloud architecture like it needs expert man power to handle the system and provides a niche technology in the modification of the system.

Problems with Doctor Web Appointment System

Another alternative of the modification of the current system is to use the conventional system and inventing a dedicated application for the system. This will help the system to reach to the customers more effectively (McInnes et al. 2014). As, the conventional system is being used for storing the data, there is no need for the experts to handle the system (Vashist, Schneider  and Luong  2014). This helps to save the cost.

In case, if no action is taken for the modification of the system, there will be certain advantage as, well as the disadvantage (Boulos et al. 2014).  The cost and time saving will be the advantage, but keeping the old system will not solve the current problems in the system.

RECOMMENDATION: It can be recommended from the discussion that in order to modify the system, cloud storage can be taken as substitute to replace the conventional system. Along with this modification of the storage system, the dedicated mobile app of the system can be done , so that the users will find it more easy to use the system.

References

Ahmadi-Javid, A., Jalali, Z. and Klassen, K.J., 2017. Outpatient appointment systems in healthcare: A review of optimization studies. European Journal of Operational Research, 258(1), pp.3-34.

Aminpour, F., Sadoughi, F. and Ahamdi, M., 2014. Utilization of open source electronic health record around the world: a systematic review. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 19(1), p.57.

Arora, S., Burner, E., Terp, S., Nok Lam, C., Nercisian, A., Bhatt, V. and Menchine, M., 2015. Improving attendance at post–emergency department follow?up via automated text message appointment reminders: A randomized controlled trial. Academic emergency medicine, 22(1), pp.31-37.

Boulos, M.N.K., Brewer, A.C., Karimkhani, C., Buller, D.B. and Dellavalle, R.P., 2014. Mobile medical and health apps: state of the art, concerns, regulatory control and certification. Online journal of public health informatics, 5(3), p.229.

Dalal, A.K., Dykes, P.C., Collins, S., Lehmann, L.S., Ohashi, K., Rozenblum, R., Stade, D., McNally, K., Morrison, C.R., Ravindran, S. and Mlaver, E., 2015. A web-based, patient-centered toolkit to engage patients and caregivers in the acute care setting: a preliminary evaluation. Journal of the American Medical Informatics Association, 23(1), pp.80-87.

Dimitrov, D.V., 2016. Medical internet of things and big data in healthcare. Healthcare informatics research, 22(3), pp.156-163.

Gordon, N.P. and Hornbrook, M.C., 2016. Differences in access to and preferences for using patient portals and other eHealth technologies based on race, ethnicity, and age: a database and survey study of seniors in a large health plan. Journal of medical Internet research, 18(3).

Kruse, C.S., Argueta, D.A., Lopez, L. and Nair, A., 2015. Patient and provider attitudes toward the use of patient portals for the management of chronic disease: a systematic review. Journal of medical Internet research, 17(2).

McInnes, D.K., Petrakis, B.A., Gifford, A.L., Rao, S.R., Houston, T.K., Asch, S.M. and O’Toole, T.P., 2014. Retaining homeless veterans in outpatient care: a pilot study of mobile phone text message appointment reminders. American journal of public health, 104(S4), pp.S588-S594.

Mishra, R., Kumar, P. and Bhasker, B., 2015. A web recommendation system considering sequential information. Decision Support Systems, 75, pp.1-10.

Naimark, J.S., Madar, Z. and Shahar, D.R., 2015. The impact of a Web-based app (eBalance) in promoting healthy lifestyles: randomized controlled trial. Journal of medical Internet research, 17(3).

Nelson, E.C., Eftimovska, E., Lind, C., Hager, A., Wasson, J.H. and Lindblad, S., 2015. Patient reported outcome measures in practice. Bmj, 350, p.g7818.

Silver, M.P., 2015. Patient perspectives on online health information and communication with doctors: a qualitative study of patients 50 years old and over. Journal of medical Internet research, 17(1).

Tieu, L., Sarkar, U., Schillinger, D., Ralston, J.D., Ratanawongsa, N., Pasick, R. and Lyles, C.R., 2015. Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study. Journal of medical Internet research, 17(12).

Vashist, S.K., Schneider, E.M. and Luong, J.H., 2014. Commercial smartphone-based devices and smart applications for personalized healthcare monitoring and management. Diagnostics, 4(3), pp.104-128.

Wen, C. and Zhang, J., 2015. Design of a microlecture mobile learning system based on smartphone and web platforms. IEEE Transactions on Education, 58(3), pp.203-207.