Recoletos de Bacolod Graduate
PhD-Business Management
University of Negros Occidental-Recoletos
Bacolod City
Business Research
NAME: Evans B. Sansolis

Acceptability of a Low-Cost Medical Diagnostic Test System in Philippine Barangay Health Centers

CHAPTER I
INTRODUCTION

Project Context The Philippines is a third world country wherein a large number of its citizens living in urban and rural areas subsist below the poverty line. Millions of people are unemployed, and countless citizens earn an income below Php 5,000 a month. In fact, a lot of families in the country have been struggling to survive. According to the book, "Poverty in the Philippines" published by Asian Development Bank, "Economic growth has gone through boom and bust cycles, and recent episodes of moderate economic expansion have had limited impact on the poor. Great inequality across income brackets, regions, and sectors, as well as unmanaged population growth is considered some of the key factors constraining poverty reduction efforts.” This idea tells us that a lot of families in the country are suffering from extreme poverty which eventually affects their health and medical needs. Thus, our government is lacking in an adequate, systematic, elaborate collection and storage of medical data for our underprivileged countrymen. In light of this, open-source hardware that is open for modification can easily be converted to form a new machine, gadget, or instrument, wherein its hardware schematics and integrated circuit layout can easily be obtained and redeveloped, is everywhere nowadays. Obtaining such hardware is easy since the internet is crowded by online shops which offer it for an affordable price. A few clicks of our mouse button allows us to ship this open source hardware anytime, anywhere. With this emerging new technology, inexpensive yet competitively efficient medical sensors and hardware are becoming more prevalent. This gives engineers and software programmers a privilege to consider an affordable medical diagnosis in contrast with the existing more expensive medical standardized laboratory diagnosis. So with that, these open source machines will revolutionize the collection of medical data and diagnosis of medical condition of our underprivileged countrymen in both remote urban or rural areas.

Purpose and Description
Currently, some of the even prestigious barangay health centers in cities have few medical personnel to cater their constituent’s health. Some has only one midwife who tends to the medical needs of its residents; and some managed to have a mini medical laboratory that provides services on CBC, spectrum, urine and fecalysis. But those prestigious barangay health centers are few. Thousands of barangay health centers failed to provide the necessary health monitoring services to its constituents because of an expensive medical diagnostic tools with which a barangay center could not afford to purchase.
The effect of this failure of service is tremendous in medical monitoring for epidemic prevention. Therefore, there is a need for a Low-cost Medical Diagnostic Tests System. This system will be of great assistance to the barangay health centers. Hence, the above knowledge gave rise to this study-- efficiently and reliably utilize a system comprise of a medical software with backend database and interfaced by the nine (9) low-cost, readily available, open source medical diagnostic test sensors that yields ten (10) medical diagnostic tests data. This medical software will aid in the monitoring and detecting of various health conditions of the constituents of a barangay. This system shall be named as "Low-Cost Medical Diagnostic Test System" or LcMDT System. Low-cost Medical Diagnostic Tests System has three components to efficiently collect, manage and store constituent’s medical data. First, the hardware component which is composed of nine (9) Medical Sensors that are needed for the diagnostic test of Heart rate and Pulse, Body Temperature, Respiration Rate, Blood Pressure, Glucometer, Electrocardiogram (ECG), Oxygen in blood (SPO2)/Pulse Oximetry, Galvanic skin response/ Skin Conductance, Eletromyography (EMG) and Patient position; second, the system software (LcMDT System Software) that serves as the software platform of the nine (9) medical sensors; and third a database (LcMDT System Database) for efficient storage of the constituent’s medical data.

General Objective The main objective of this study is to implement and utilize "Low-Cost Medical Diagnostic Test System" which is a system comprised of a medical software with backend database necessary for saving and retrieving of medical data of the constituents of all barangay health centers in the Philippines. This system will also control the nine (9) medical sensors needed for the medical data gathering of ten (10) medical diagnostic tests.

Specific Objectives The specific objectives of the study are as follows: 1. To determine the need of the constituents of barangay health centers in the Philippines with regards to the utilization of a Low-Cost Medical Diagnostic Test System which includes a medical software with backend database interfaced with nine (9) medical sensors. 2. To determine the effectiveness of Low-Cost Medical Diagnostic Test system which includes a medical software with backend database interfaced with nine (9) medical sensors in medical data gathering, data saving, and data retrieving by the barangay health workers;

Scope and Limitation of the Study This study is limited to determination of the need of the said system of barangay constituents; and to the determination of effectiveness on the implementation and utilization of the Low-Cost Medical Diagnostic Test System which is composed of a medical software with backend database, interfaced with nine (9) low-cost health sensors in medical data gathering, medical data saving, and medical data retrieving of the constituents of certain barangay.

Significance of the study This study will help the constituents of barangays in conveniently knowing their current health condition so to meet their health needs. This will also provide them in getting an access to easy retrieval of their medical data for further medical analysis by the Barangay Health Physician. The Low-Cost Medical Diagnostic Test System can be used by barangay health centers as an alternative tool to gather medical data and to organize those medical data in its appropriate categories. With an organized medical data, medical information of the constituents can then be easily accessed for later analysis. This would greatly benefit the barangay health centers in their pursuit for efficient, organized collection of medical data. This study has enlightened the researcher to develop a medical system that will meet the health needs of a barangay constituent, thereby helping him know his current health condition. Developing this system will improve the researcher’s programming and analytical skills. Future researchers can make this study as a reference. This will guide them for farther development of a system pertaining to the improvement of the quality of life.

Definition of Terms
For clarity and common understanding, the key words used in this study are defined as follows: Medical Diagnostic Tests- These are wide range of medical tests done manually by a medical personnel or though medical sensors for automated completion that can determine the nature and cause of a diseases. In this study, the medical diagnostic test were referred to the diagnostic test of Heart rate and Pulse, Body Temperature, Respiration Rate, Blood Pressure, Glucometer, Electrocardiogram (ECG), Oxygen in blood (SPO2)/Pulse Oximetry, Galvanic skin response/ Skin Conductance, Eletromyography (EMG). Medical Sensor- These are hardware components that use electrical current, infrared, colorometry etc. to measure physiologic and biologic values of a medical patient. In this study, the medical sensors were referred to the (9) Medical Sensors namely, Temperature sensor, Pulse Oximeter sensor, KODEA digital Blood Pressure, ECG sensor, EMG sensor, GSR sensor, Body Position (Accelrometer), Glucometer sensor and Airflow sensor . Medical Software- This is an interface for handling and controlling the medical diagnostic sensors as well as for collecting, organizing, and processing medical data for printouts or information promulgation. In this study, the software was referred to as proposed LCSYS 10MDT.

CHAPTER II
REVIEW OF RELATED LITERATURES

This chapter presented the review of related literature and studies gathered by the researcher in relation to the study of utilization of Low-Cost Medical Diagnostic Test System in Philippine’s barangay health centers, a system for monitoring health condition. Theoretical framework of the study is also shown here.

The Medical Record W. Osler (1998) famed clinician, W. Osler' teachings was followed by physicians all over the world. His teachings are linear and simple-- study and learn from patients and their medical records in order to advance the study of diseases. Nowadays, just like the 1900s, physicians carry on to start this learning process by collecting a history of the patient’s medical problems, carrying out medical tests, and then recording the medical data in the patient’s medical record. Physicians direct the patients for preferred medical tests and medical procedures that are usually comprised of clinical laboratory, and other medical services to approve a preliminary diagnosis and remove other possible diagnoses. Then, physicians generally reach at a more valid diagnosis after analyzing the information received from these medical services and by then, prescribe the right treatment. For a complicated or an uncommon medical problem, physicians may assign the patient to rightful medical specialists, and may also research on applicable therapies by checking appropriate medical books, journals, and other bibliographic references.

The Electronic Medical Record Lehmann and Meyer (2010) discussing about Electronic Patient Record, they have stated that the collection of documents concerning a patient from different sources and created at different times to a patient-related document collection is termed a patient record. The main goal of a patient record is to put into record the when, with whom, why, which the diagnosis and medication was given, by whom, with what result, and with which argumentation. It should be hypothetically possible to follow each step of medical treatment.
Also, they have stated that medical documentation is usually executed by forms and free-text notes. Additionally, medical-technical documents like ultrasound results, cardiograms, and x-rays are adjoined to the patient medical record. According to Lehmann and Meyer zu Bexten, the main medical data and information saved in a patient medical record is outlined as follows: * Personal data: e.g. name, address, date of birth, sex, age * Administrative data: e.g. health insurance data, general practitioner, case number * Medical history: e.g. ailment, severity of symptoms * Medical findings: e.g. laboratory values * Diagnosis: e.g. admission diagnose, main diagnose, secondary diagnosis * Therapies: e.g. medication, surgeries * Nursing documentation: e.g. lustration, bedding * Course of treatment: e.g. chronological illustration of a patient’s condition * Discharge note: e.g. recapitulating review and interpretation of medical history * Special documentation: e.g. clinical trial According also to the authors, in recent years, certain endeavors were made to transpose the traditional patient medical record by an electronic medical patient record. The advantages of electronic medical patient record systems over traditional patient medical records are complex. One of these is no local restriction of usage, fast and varied processing and retrieval capabilities or user-oriented presentation of data. However, contrasting hazards and disadvantages may happen. Aside from issues like financial costs and time to let users adapt with the technical part of an electronic medical patient record system, notably the high costs for failsafe IT-solutions, and data security are integral aspects of each electronic medical patient record system. Commonly, an electronic medical patient record system is fixed in a Medical Information System. The embedded system assigns each patient unique patient identifier which is an important condition to satisfy reliable and unique data recording. Patient-related information in health care is very sensitive. With the existence of the electronic patient’s record, information contains a huge degree of transparency. Thus, protection and safeguard of data privacy in the electronic patient’s record is of great challenge.

The Modern Medical Monitoring System Mansoor Baig (2014) In a paper Vital Signs Monitoring Systems – Patient’s Acceptability, Issues and Challenges, Mansoor Baig, et al stated that-- to determine basic health issues and initiatory health condition, vital signs are often treated as important information. It can help in early detection, early diagnosis, and reduces risks of fatal medical incidents. Today’s advanced monitoring systems merge the stable solution of technological and medical condition to permit contemporary healthcare outcome. Medical vital sign monitoring systems are becoming the center of today’s healthcare objectives. Also, according to this study, this kind of model is changing from traditional and manual data gathering, recording and saving into an electronic computer based records and further to smartphone. These high tech medical data recoding are both versatile and innovative in medical healthcare monitoring systems. They havc also classified vital signs monitoring systems as wearable, wireless, and mobile monitoring systems. Patient acceptability of some of these systems has been evaluated using 30 participants. However, a complete review of related literature in the background of acceptability, efficiency, mobility, reliability of vital signs monitoring systems in medical healthcare delivery and handling medical physiological data states that the outcome of their study indicated a few limitations disclosed by medical personnel and patients. Nevertheless, these systems should be more reliable and simple to operate. They should be accessible to medical personnel and professionals.

The Open-sourced Medical Sensors According to Ch Srikanth (2014) In an entry in International Journal of Engineering Trends and Technology (IJETT) Smart Embedded Medical Diagnosis using Beaglebone Black and Arduino, Ch Srikanth et al stated that electronics technology has entered almost in all aspects of day-to-day life. They have seconded that even the medical field is not an exception. They have also stated that the need for a well-equipped hospitals and diagnostic centre is increasing day by day as the people are becoming more conscious about their health conditions. So in connection with this, they have discussed about the use of an Arduino board connected to open sourced medical sensors for the collection of medical data. According to them, as the technologies are advancing it has become feasible to design a low-cost vital sign monitoring system to display, record, and transmit signals from the human body. This paper discusses the bearing of acquiring medical sensors for reading medical physiological data like Pulse, SPO2, Airflow (breathing), Body Temperature, ECG, Glucometer, Galvanic Skin Response, Blood Pressure, Patient Position, Muscle/Electromyography sensor (EMG) and connecting it to a database backed medical software. They have speculated that this system is expected to monitor patients conveniently and accurately.

Synthesis:
These studies are related to the present study with which the purpose is to provide the constituents of barangays a cost-effective system to meet their health needs through the utilization of a Low-cost Medical Diagnostic Tests System. Insights on their projects have guided the researcher in the preparation and development of the LcMDT System.