1

CHAPTER 1

INTRODUCTION

Background of the Study

In the current time people can’t imagine their life without technology. The

technology sector has changed and developed many products. A computer is an example

of technology that helps people in many ways. People use computers to finish office

works, for business and also for entertainment. Computers helps us makes manual

process easier and efficient. Rural Health Unit (RHU) in the Philippines were established

to provide the preventive, regulatory, medical care services in the municipality including

general consultations, dental services, maternal health, family planning, nutrition,

immunization, simple laboratory Comprehensive Land Use Plan. One of its goals is to

eliminate and eradicate public health problems. To promote healthy lifestyle. To promote

the health nutrition of families and special populations.

Presently people are making appointments manually. This is a time-consuming

process; patient has to physically go to the clinic in order to make appointment. Some

clinics provide the opportunity to make appointments by placing a phone call. But in this

case, people are often left unattended. Hence, the researchers developed an online

appointment system for RHU-Pikit that aimed to let the patients to book an appointment

online.

Statement of the Problem

 2

RHU Pikit is a local health institution of Pikit committed to provide quality health

services among Pikitenos. Currently, they do not use a computer system for their patient

appointment. The patients commonly go to the RHU and fall in line and wait for their

turn to get an appointment. There are days that the number of patients is huge which

results to some patient not being entertained and not being given the medical assistance

they need. In the present, the Pikit RHU is still using manual way of completing their

paper works. It has always been a challenge for the workers from RHU Pikit to

accomplish their paper works considering the amount of data and information that they

need to acquire and secure. Some errors happen due to poor handwriting, ambiguous

abbreviations, and disorganized keeping of records. There are also instances when the

patients are not entertained due to the number of patients that requires consultation or

treatment in certain days. Producing reports is also a problem that they are currently

facing.

Objectives of the Study

Generally, the study aimed to design and develop an online appointment system

with SMS notification for Pikit RHU

Specifically, the study aimed to:

1. Develop a system where client can set an online appointment;

2. Develop a system that sends the user an SMS notification about their

appointment confirmation; and

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3. Develop a system that has an automatic time slot that will schedule the

appointment based on the availability of the slots given.

Scope and Limitation of the Study

The study focused on developing an online system for patient appointment for

RHU Pikit. Through the system, the patients will be able to set an appointment with the

RHU. The patients will be able to receive an SMS notification if their appointment was

moved or cancelled. The personnel in-charge will be able to approve the appointment

request. He or she can manage the data of the user. Prescription given by the doctors or

medical personnel during check-up is not included in the system. RHU’s do not ask

payment from its patients so payment and billing are not applicable in the proposed

system.

Significance of the Study

This study is intended to various set of people who could benefit in the

system. The result of this study could beneficial to the following:

Patients. An online appointment system allows patients to book appointments from the

comfort of their homes, without the need to visit the RHU or make phone calls. This can

save them time and effort. With an online appointment system, patients can book

appointments in advance, which helps reduce waiting times at the RHU. This can lead to

a more efficient and streamlined patient experience.

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RHU Pikit. An online appointment system allows the RHU to better manage its

resources, including staff, equipment, and supplies. This can help the RHU avoid

overbooking or under booking, which can lead to wasted resources or long waiting times.

An online appointment system can help the RHU keep better records of patient

appointments, including the date, time, and reason for the appointment. This can help

improve the quality of care provided by the RHU, as well as help with tracking and

reporting.

To the Future Researchers. The ideas presented may be used as reference data in

conducting new research. The outcome of the study will serve beneficial to neither

present researchers nor the future researchers for their cross-reference that will give them

background or an overview of the study.

Conceptual Framework

INPUT PROCESS OUTPUT

 Client
Information
RHU Pikit Online
 Date and time of Appointment System
appointment  View Scheduled
with SMS appointment
 Admin Notification
Username and  SMS Notification
password

Figure 1. Conceptual Framework

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In figure 1, it shows the conceptual framework of the study. Included in this

figure are the input required in making and completing the study such as the Client

Information, Date and time of appointment, Admin Username and password. The process

that the researchers has to go through in this proposed system. And lastly, the foreseen

output of the study which are the Scheduled appointment and SMS Notification which

show if the appointment is approved or disapproved.

Operational Definition of Terms

To provide better understanding to the readers of this paper, the following terms

are defined.

Appointment - an arrangement to meet someone at a particular time and place.

Data- A collected information that processed and stored in a computer. In this study,

it would be the details of the requester.

Database- A collection of a pieces of information that is organized and used on a

computer.

Client – a person who is receiving the benefits, services, etc., in this study, it is the

residents of the municipality of Pikit.

Manual – a task accomplished without the aid of a computer system.

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Personnel In-Charge – refers to the individual or group of individuals who are

responsible for overseeing and managing a specific area or function within an

organization. In this study, the person who handles the system.

RHU – rural health unit, it a place in a municipality where its residence go for medical

assistance for free.

SMS Notification- act as text message notifications that are sent in response to an event

or a transaction that has just occurred or is occurring somewhere else. SMS stands for

“Short Message Service.”

CHAPTER 2

REVIEW OF RELATED LITERATURE

This chapter presents some relevant concepts and information on the variables. It

focuses on studies that related to Online Appointment System.

An Empirical Investigation in the Context of an Online Clinic Appointment System

An online clinic appointment system (OCAS) is an example of health information

technology (HIT) innovation in the healthcare industry. An OCAS can help healthcare

organizations to improve the efficiency of information exchange for patients and

transform a clinic-centered practice into patient-centered practice. This research uses an

enhanced trust model to investigate the trust formation mechanism in the HIT context

using OCAS as a proxy. We collected survey data from young adults to study the
 7

patients’ perspectives and assess the proposed research model. The results support that

five trusting base constructs have a statistically significant influence on the development

of trusting beliefs in the use of OCAS, including situational normality, structural

assurance, cognitive trusting base, perceived ease of use, and self-efficacy. We discuss

theoretical contributions to trust formation in HIT and practical insights for healthcare

organizations to utilize in developing and implementing patient focused HIT (Xie et al.,

2020).

Features of Online Hospital Appointment Systems in Taiwan

In the Internet era, many web-based appointment systems for hospitals have been

established to replace traditional systems. Our study aimed to highlight the features of

online appointment systems for hospitals in Taiwan, where patients can visit outpatient

departments without a referral. Methods: All hospitals online appointment systems were

surveyed in October 2018. Features of first-visit registrations were analyzed and stratified

according to the hospitals’ accreditation levels. Results: Of the 417 hospitals, 59.7%

(249) had public online appointment systems. For first-visit patients, only 199 hospitals

offered the option of making appointments online from 7 to 98 (mean 38.9) days prior to

the appointment itself. Before appointments, 68 (34.2%) hospitals recommended

specialties for patients to choose according to their symptoms, and only 11 (5.5%) had a

function for sending messages to doctors. After appointments, 176 (88.4%) provided

links to real-time monitoring of outpatient service progress. Conclusions: More than half

of the hospitals in Taiwan have public online appointment systems. However, most of

these systems simply fulfill the function of registration, and rarely take the opportunity to

improve efficiency by gathering information regarding patients’ medical history or

 8

reasons for making the appointment. Nowadays, there are many means by which to

schedule a medical appointment. In the past, people used to make hospital appointments

with schedulers in person or via telephone. However, these approaches may negatively

influence patient satisfaction because they require verbal communication with real people

who sometimes make mistakes, such as filling in the wrong appointment date or time, or

sending the patient to the wrong health service provider (Yang et al., 2019).

Designing an Online Appointment System for Semiliterate Users

Information and Communications Technology (ICT) has revolutionized the

healthcare leading to provision of eHealth facilities remotely. During the peak time of

COVID-19, as the long queues at health care facilities can result in spread of the virus.

ICT can play an effective role especially for reducing the extended waiting time of

patients to consult a medical practitioner which is considered as a source of hazard during

the pandemic. However, in developing countries where majority population is

semiliterate so find difficulty when come into contact with appointment systems which

are not particularly designed keeping in consideration the requirements of semiliterate

users. It is extremely important to better understand how to design user interface which

allow semiliterate users to effectively perform the tasks. So there is a dire need to develop

a simple, effective, easy to learn user interface (UI) of an online appointment system for

the productive doctor-patient consultation. Therefore, this study aimed to providing an

effective user interface of web based online appointment system to semiliterate users

through User-Centered Design (UCD) methodology. To achieve this, a prototype was

designed to overcome issues in the existing appointment systems gathered through a field

study. The needs and expectation for semiliterate users were fulfilled by incorporating the
 9

requirements of UI development for the target users. A sample of forty-two semiliterate

users was used to evaluate the prototype. The evaluation results showed that semiliterate

users' performance measured using-- effectiveness, efficiency and satisfaction

significantly improved while interacting with the prototype as compared to existing

interfaces (chaud [Link].,2021).

Evaluating of hospital appointment systems in Turkey

Appointments services in all public hospitals in Turkey are managed by the

CPAS. This study showed that using CPAS successfully improved several assessment

metrics, including patient waiting time, effective outpatient services and access to

healthcare. However, considering the number of physician and outpatient clinic rooms

available in Turkey, it is not sustainable for the CPAS to effectively function. Since the

number of physicians cannot be increased in the short term, either the model The effects

of appointment registration systems have long been the subject of review in the literature.

In a study conducted at Xijing hospital in China, the use of WAS significantly increased

patient satisfaction with registration and effectively reduced the total waiting time.

Mardiash et al. proposed an effective appointment system model to reduce outpatient

waiting times in public hospitals in Indonesia. The CPAS showed a positive impact on

waiting times in Turkey (Küçük et al., 2021).

Web-Based Medical Appointment Systems

Traditionally, medical appointments have been made with schedulers over the

telephone or in person. These methods are based on verbal communications with real

people and allow for maximum flexibility in complicated situations However, because

these traditional methods require the intervention of schedulers, the ability to get a timely
 10

appointment is not only limited by the availability of appointment slots, but also by the

schedulers and phone lines Patients’ satisfaction with appointment booking is influenced

by their ability to book at the right time with the right health service providers, The

Internet has recently emerged as another means to make appointments. Web-based

appointment scheduling has been a popular research topic. Several studies conducted

satisfaction surveys and found that Web-based appointment scheduling is an extremely

important feature, and most patients would use the service again There are two major

types of Web-based medical appointment services, medical scheduling software as a

service (SaaS) and proprietary Web-based scheduling systems. Medical scheduling SaaS

has gained increasing prominence in recent years. These appointment systems are not

built up by health care practices themselves, but are provided and maintained by health

IT companies such as ZocDoc and InQuicker on a paid subscription basis The

appointment services are cloud-based and can be integrated into health care providers’

own management systems. The other type of appointment service is proprietary

appointment systems, which are integrated into patient portals on providers’ websites A

patient portal is a secured Web-based service that allows patients to access their health

information and communicate with their health care providers at any time In the United

States, the growth of patient portals has largely been spurred by meaningful will used

(Zhao et al., 2019).

Online Appointment Booking System

aThe system includes NodeJS for storing the number of requests, each of which

specifies a sequence of regions to be visited by a particular user. NodeJS server is used

for offering appointments at specified times, using the table to check for availability of
 11

operatives in specified regions at specified times, and for inserting new jobs in the routes

to reflect booked appointments. A scheduler periodically updates the routes e.g. by means

of a simulated annealing process, to generate a new set of appointments and prevents

duplication Firebase plays a vital role in fetching data for appointment scheduling that

helps to enhance application development effectively. It provides functionalities like

analytics, database, messaging, and crash reporting which helps in focusing the users

(Akshay et al., 2019).

A Mobile-Based Patient Surgical Appointment System Using Fuzzy Logic

The advent of artificial intelligence in medical field is playing a significant role in

improving healthcare services. In healthcare, there is always need for an intelligent

method to schedule resources and patients in order to reduce patient waiting time. The

treatment process of patients from their arrival to the starting time of consultation is

accompanied by uncertainties. Therefore, this study developed a fuzzy and a mobile-

based solution for patient surgical appointment system based on some relevant input

variables. The proposed system was simulated using MATLAB fuzzy inference system

with a triangular member function. The range of the fuzzy inputs was then fed into the

developed mobile-based application for an optimal patient surgical appointment system.

The evaluation findings revealed that the proposed framework is efficient in terms of

scheduling patient surgical consultations (Ayo et al., 2023).

Internet Based Intelligent Hospital Appointment System

In today’s competitive service industry, the technology in service systems is used

in a wide range of areas. The service companies are now providing service via internet or

via other computer-based systems in an increasing trend day by day. Expert systems are
 12

good examples of these applications. Today, expert systems are used in various fields

such as design, planning, imaging, diagnosis, etc. For practical use, the expert systems

are also used through internet. One of the most important service system institutions is

the hospital. Increasing the service quality level in hospitals, internet-based appointment

systems are used in several hospitals in Turkey. There are also several internets based

expert system applications today contributing the improvement of service levels in

several industries. In this study, an internet based expert system is created that is used in

outpatient department/polyclinic direction. The system architecture, algorithm and the

role of such an expert system are discussed in this paper. With the help of internet based

expert appointment system at hospitals, the queues in the hospitals decline, the number of

consultations decreases, the patients and doctors save time and finally the customer

satisfaction and quality level increases (Aktepe et al., 2017).

CHAPTER 3

METHODOLOGY
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The researchers used Rapid Application Development methodology in the

development of proposed system.

Work Breakdown Structure

ACTIVITY MONTH START FINISH

TASK

Requirement March 03/20/2023 03/30/2023

Gathering and
Analysis
Design April 04/20/2023 04/30/2023
Coding May-July 05/10/2023 07/30/2023
Testing August 08/10/2023 08/30/2023
Deployment September 09/10/2023 09/30/2023
Maintenance November 11/06/2023 11/30/2023
Table 1. Work Breakdown Structure

Table 1 presents the Work Breakdown Structure of the Development of the

System from the month of March, 2023 up to November, 2023.

Research Design

The method of research used in this study was descriptive. With the help of this

method, the researchers/developers were able to specify the needs of RHU and provide

solution to their problem. Descriptive Method allows the collection, analysis,

classification and tabulation of information from the RHU Pikit where developers based

their development of the said system

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Figure 2. Rapid Application Development

Figure 2 presents the Rapid Application Development methodology. The

developments of the system were time boxed, delivered and then assembled into a

working prototype. It shows the different phases in Rapid Application Development.

Requirement capture phase includes planning analysis phase. The quick design phase

consists of logical and the physical design phase.

Planning and Analysis

Planning and analysis phase determined based on the type of architecture that the

system was designed. The End-users suggestions were also being considered for the

better outcome and usability of the proposed system. In this phase, the researchers

conducted an interview and survey to the target beneficiary of the system. In conducting

a research interview and survey, the researchers provided tool such as questionnaire.
 15

Then followed by gathering data to identify the desired and needed features to be

included in the proposed system. After gathering data, the researchers analysed the

possible problem based on the needs and requirements of the user.

System Design

After all the Planning and analysis were met, the system design took place. The

researchers made sure that the Overall design and User Interface (UI) as prescribed by the

End-user were met. This part covers the physical and logical design of the developed

system.

Coding

The proposed system was constructed during this phase. The researchers

evaluated the system design and the data gathered during the data gathering stage. With

these data, the researchers made sure that the application met all the criteria as stated in

the objectives of the study. The researchers used PHP as the programming language and

MariaDB/MySQL for the backend or the database of the project.

Testing Phase

In this phase, the researchers performed series of testing to check for any possible

problems that may occur during implementation and operation of the software and if the

specification has been met.

Implementation
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During this phase, the system was implemented and tested at the Rural Health

Unit of Pikit, North Cotabato. Proper implementation procedure had imposed to ensure

system operability.

Maintenance

During the maintenance phase, errors or defects may exist, which would require

repairs during additional testing of the software. Monitoring the performance of the

software is also included during the maintenance phase.

Flowchart of the Developed System (Personnel In-charge)

START

Log in

No
RHU PIKIT ONLINE
Verify APPOINTMENT SYSTEM
WITH SMS NOTIFICATION
yes

Schedule for
Schedules Services
Today

Members

Log Out

STOP
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Figure 3. Flowchart of Personnel In-charge

Figure 3 illustrates the flowchart on the process of completing a task of the

personnel in-charge. Initially the in-charge is required to login using his or her username

and password. If the username and password is correct, the in-charge will be directed to

the dashboard of the system. From the dashboard, the in-charge can access the functions

of the system including Appointment approval, Managing the user’s data, sending SMS,

and more.

Flowchart of the Developed System (Patient User)

START

Register

Log in

No

Verify System Dashboard

yes

Set Appointment Schedule

STOP
Figure 4. Flowchart of the Patient User
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Figure 4 shows the flowchart on how the task for the user can be accomplished.

The user is required to login to the system using his or her username and password. If the

username and password is correct, the user will be navigated to the dashboard. From this,

the user can set-up an appointment, select the time and date that is convenient for him or

her. The user can receive an SMS if the appointment is approved or disapproved. The

user needs to logout from the system when he or she is done.

Use Case Diagram

Figure 5. Use Case Diagram

The use case diagram of the proposed study is illustrated in Figure 5. The diagram

shows two actors, the Personnel in-charge, and the Patient. For them to use the system,

they are required to login to the system using their username and password. The patient

must register first for him or her to be able to have login credentials. The patient can
 19

request for an appointment by selecting his or her preferred date and time. He or she can

also receive SMS notification if the appointment is approved or not. The personnel in-

charge can approve or disapprove an appointment request. He can also manage the data

of the users.

Architecture Design

Figure 6. Architecture Design of the System

Figure 6 shows the architecture design of the system. It shows the flow of the data

and information starting from the patient until it reaches the personnel in charge. It shows

the system hardware, the database, and the network environment. In this architecture, the

SMS is included since the patient can receive an SMS notification when his or her

appointment request is approved or disapproved.

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Context Diagram

Figure 7. Context Diagram

The study's context diagram is shown in Figure 7. According to the system's

context, in order for a patient or user to access the system, they must first register by

entering their login credentials. Additionally, he or she has the option to make an

appointment, which will be confirmed via SMS notification.

Respondents of the Study

The respondents of the study were the clientele and the personnel in-charge of the

Pikit RHU.

Location of the Study

The research was implemented and conducted at Pikit Rural Health Unit, Pikit

Cotabato.
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System Requirements

 Hardware Specification

Table 2 presents the hardware specification which will be important in developing

the system. The researchers utilized these specifications to ensure that the system

functions well and would not be compromised by its peripheral as well as to prevent

processing operations from being delayed.

Table 2. Hardware Requirements Specification

HARDWARE SPECIFICATION
Processor Intel r Pentium r CPU N3710
Memory 2.00 GB RAM
Hard Disk Storage 1 TB

 Software Specification

Table 3 presents the software specification. These software requirements must be

followed so that the system would be able to function well.

Table 3. Software Requirements Specification

SOFTWARE SPECIFICATION
Operating System Window 10
System Type 64-bit
Database MySQL
Programming Language PHP

CHAPTER 4
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RESULTS AND DISCUSSIONS

This chapter presents the results and discussion of the RHU Pikit Online

Appointment System with SMS Support. Generally, the study aimed to design and

develop an online appointment system with SMS notification for Pikit RHU

This study had three main objectives that were related to develop a system. These

are the following:

1. Developed a system where client can set an online appointment.

Figure 7. Online Appointment

Figure 7 shows the Online Appointment Page which enables the patient user to set

his/her appointment online.

2. Developed a system that will send the user an SMS notification about their

appointment confirmation
 23

Figure 8. Send an SMS Page

Figure 8 shows the page where the admin of the developed system can send an

SMS to the user by inputting the client’s message alongside with the corresponding

message if the schedules set was moved or cancelled.

3. Developed a system that has an automatic time slot that will schedule the

appointment based on the availability of the slots given.

 24

Figure 9. Priority Number Page

Figure 10. Confirmation Page

The patient user should select date of appointment and service offer that the

patient user would want to avail, as shown in figure 7. After clicking submit, the system

will generate a schedule by displaying a priority number that will be used as a guide by

the user on what hour does his/her schedule was set. As shows in figure 9, on the left side

of the screen, there are time slots displayed as numbers 1-8. After clicking yes, a thank

you notification will pop up on the dashboard of the user’s account as shown in figure 10.
 25

CHAPTER 5

SUMMARY, CONCLUSION, AND RECOMMENDATION

Summary

RHU Pikit is a local health institution of Pikit committed to provide quality

health services among Pikitenos. Currently, they do not use a computer system for their

patient appointment. The patients commonly go to the RHU and fall in line and wait for

their turn to get an appointment thus, the realized the development of RHU-Pikit Online

Appointment System to fully provide a quality health service to the Pikitenos.

Specifically, the study aimed to developed a system where client can set an online

appointment, developed a system that will send the user an SMS notification about their

appointment confirmation and developed a system that has an automatic time slot that

will schedule the appointment based on the availability of the slots given. Prescription
 26

given by the doctors or medical personnel during check-up is not included in the system.

RHU’s do not ask payment from its patients so payment and billing are not applicable in

the proposed system. The developed system was developed from March 2023 to

November 2023 at the Rural Health Unit of Pikit, North Cotabato.

Conclusion

Compared to the usual queuing method, the web-based appointment system could

significantly increase patient's satisfaction with registration and reduce total waiting time

effectively. However, further improvements are needed for broad use of the system.

Recommendation

The researchers of this project recommend the following based on their

observation for the researchers. These are the following recommendations:

1. Add payment gateway

2. The verification module should have a disapprove feature where the officer in

charge can directly disapprove the appointment

 27

CURRICULUM VITAE

1. Personal Data

Name: Fahad A. Sali

Address: Gli-gli, Pikit North Cotabato

Birthdate: February 5,1996

Civil Status: Single

Birthplace: Gli-gli, Pikit North Cotabato

Mobile #: 093528422222

Email Address: fahad020596@[Link]

2. Educational Qualifications

Elementary: Gli-gli Elementary School

Secondary: Pikit National High School

College: Cotabato Foundation College of Science and

Technology-Pikit Extension Unit

Course: Bachelor of Science in Information Technology

3. Seminars and Workshops

Capstone Project Making

Computer Hardware and Servicing

4. Scholarship: N/A

5. Membership in School Organization: N/A

 28

CURRICULUM VITAE

1. Personal Data

Name: Mujiahid K. Ali

Address: Batulawan, Pikit BARMM SGA

Birthdate: July 8,1996

Civil Status: Single

Birthplace: Gli-gli, Pikit North Cotabato

Mobile #: 09123223122

Email Address: mujiahidkali96@[Link]

2. Educational Qualifications

Elementary: Gli-gli Elementary School

Secondary: Silik National High School

College: Cotabato Foundation College of Science and

Technology-Pikit Extension Unit

Course: Bachelor of Science in Information Technology

3. Seminars and Workshops

Capstone Project Making

Computer Hardware and Servicing

4. Scholarship: N/A

5. Membership in School Organization: N/A

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 29

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APPENDICE