DIGITAL TRENDS IN HEALTH: THE ACCURACY OF EHATID

LGU APPLICATION OFFLINE FUNCTIONALITY ON

DATA SYNCHRONIZATION IN JUSTINIANO
R. BORJA GENERAL HOSPITAL

A Research Proposal

Presented to Faculty

of Cagayan De

Oro College -

PHINMA

Education

Alodino, Amnah E.

Damalan, Sheneen

Mama, Mohammad Sadick L.

Masota, Sharmaine

Mercado, Nick Laurence

Miquiabas, Mary Queen

Nasrodin, Norjanah

Paalisbo, Crystylle Shylla

Ms. Ivy Yañez, RN

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Introduction

In today's era of widespread internet access and dependability, it is imperative

to acknowledge that instances of internet connectivity issues still persist, particularly

in Cagayan de Oro City, Philippines. These interruptions hinder the smooth progress

of various activities, affecting individuals, especially in the transfer of electronic

health records between health care professionals and transactions within the

Department of Health sector. In line to this, The City Government of Cagayan de Oro

pushes forward with its response to the government’s call for Universal Health Care

with its Smarter and Integrated Local Health Information System for Cagayan de Oro

City (SmILHIS CDOC) Project. The SmILHIS CDOC Project will integrate the

eHATID LGU (eHealth TABLET for Informed Decision-Making of Local

Government Units) application, which will aid CDOC’s City-Wide Health System in

gathering and storing data from patients and generating reports for the Department of

Health and the Philippine Health Insurance (DOST, 2019).

Chan (2021) point out that “the main challenge in the implementation of EMR

is associated with very poor or intermittent internet connection. System lag and poor

connection due to weak LAN are two of the main issues identified by the medical

personnel. Lack of manpower and equipment also affects the overall process of

recording, archiving, and retrieval of patient’s records and vital information, medical

check-ups, prescription, and payment. The whole process is observed to be time

consuming and requires double the work, as not everyone is technologically literate”

(The Integration and Appraisal of Electronic Medical Records (EMR) in Cotabato

Regional and Medical Center, p.152). There are a lot of factors to consider on the
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implementation and efficacy of EMR and some of which are really relevant even up

to these days but the researchers mainly sees the important causing factor of its

efficacy are the limited resources to competent internet connection, unstable data

connection to certain network providers with limited data, and the flawed internet

connection with regards to the location and geographical areas of several outskirts of

populated areas with limited resources to electricity. According to Goking (Lack of

Cell Sites to Blame for Slow Internet, Sun Star Article, 2017), insufficient cell sites

and telecommunication infrastructure are causing slow internet connection in

Cagayan de Oro City.

When studying the effectiveness and dependability of the eHatid LGU

application's offline capabilities at Justiano R. Borja General Hospital, the focus is on

its smooth data synchronization upon connectivity restoration. This investigation

seeks to provide useful insights and recommendations for improving the precision and

reliability of eHatid LGU application transactions inside Rural Health Units and

Provincial Hospitals. The research attempts to give a complete knowledge of the

complicated dynamics at work by evaluating obstacles and variables generating

transaction delays. Beyond a simple evaluation, the study emphasizes the evaluation's

greater relevance in terms of helping local health authorities to make educated

decisions in the face of intermittent internet connectivity issues.

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Significance of the Study

The study will tackle the efficiency and accuracy of data synchronization from

1 LGU to the JR Borja General Hospital's database, thus covering the data

interoperability among involved agencies.

DOST: As the eHATID LGU system is from the Department of Science and

Technology, the findings of this research will encourage the need for improvement

and evolution as per the results demand.

DOH - The Department of Health, is the recipient of the eHATID system; thus, the

findings of this research would be very beneficial by using the results to improve

healthcare service and policies that will contribute to a better and more responsive

healthcare system across the country.

LGUs: The study will offer valuable insights on how well LGUs and JR Borja

General Hospital's databases synchronize their data. This will help LGUs identify any

issues or obstacles to data interoperability and make necessary improvements. By

ensuring smooth data exchange, LGUs can enhance the quality of healthcare services

provided to their constituents.

J.R. Borja General Hospital: The findings of the research study will highlight

potential for technology integration that can help to expedite healthcare processes

enhance service delivery. By leveraging the results gathered from the EHATID LGU

research study, J.R. Borja Hospital can address immediate healthcare requirements
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while also establishing a platform for continual improvement and responsiveness to

the changing health landscape of the local community.

Patients/Future Patients: The research findings will directly impact patients and future

patients. Efficient and accurate data synchronization will enable healthcare providers

to access complete and updated medical records, resulting in improved diagnosis,

treatment, and coordination of care. This can lead to better healthcare outcomes,

reduced medical errors, and increased patient satisfaction.

Future Researchers: Future researchers can use the findings as a foundation to further
explore the challenges and opportunities in data synchronization. The study can also
serve as a benchmark for future research in similar contexts, allowing for comparisons
and analyses of different approaches to data synchronization.

Statement of The Problem

The aim of this study is to evaluate offline functionality and the accuracy of

data synchronization between the LGU and JR BORJA General Hospital data bases.

The study will emphasize the many factors that impact data transfer, allowing experts

to make recommendations to help improve the system's quality. The researchers are

interested in the following responses:

1. What is the demographic profile of the respondents in terms of;

1.1 Educational Level

1.2 Length Time using The eHatid LGU System

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2. What are the primary challenges faced in the transfer of electronic health records

using the eHatid LGU System's offline functionality in terms of;

2.1 Accessibility

2.2 Data Synchronization

2.3 Geographical Location

2.4 Training and Familiarity

2.5 Performance

2.6 Internet Connectivity

3. What impact does the eHatid LGU System’s offline functionality have on the

overall efficiency work flow of health care practitioners in Justiano R. Borja

Hospital?

4. What are the specific protocols and mechanisms employed by Justiano R. Borja

Hospital to verify and validate the accuracy of data synchronized by the eHatid

LGU application, especially during periods of offline operation?

5. To what extent can the reliability of data synchronization be ensured during

periods of intermittent internet access in the implementation of the eHatid LGU

application?

Theoretical Framework

Information and Communication Technology Acceptance Model (ICTAM)

The modern healthcare sector is experiencing a transformational journey,

characterized by the common integration of information and communication

technologies. The Information and Communication Technology Acceptance Model

(ICTAM) appears as a vital theoretical framework in this digital era, when the
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acceptance of technical advancements is required. This essay goes into the

fundamentals of ICTAM, offering insights into its use in the ever-changing world of

healthcare.

The Information and Communication Technology Acceptance Model, rooted

in the broader context of Technology Acceptance Models (TAM), strives to

comprehend and elucidate the factors influencing the acceptance and adoption of ICT

in various domains, with a particular focus on healthcare. ICTAM, as an extension of

TAM, encapsulates the intricate interplay between perceived ease of use, perceived

usefulness, and behavioral intentions regarding the acceptance of ICT in healthcare

settings.

As the healthcare sector evolves digitally, the Information and Communication

Technology Acceptance Model emerges as a crucial lens for understanding the

complexities of ICT adoption among healthcare professionals. Recognizing the

intricate interaction between perceived ease of use, perceived utility, and behavioral

intentions in the context of nursing practice is critical for developing strategies that

promote the seamless integration of ICT tools. This theoretical framework provides a

detailed knowledge of the variables driving the technology environment in current

healthcare settings by digging into the basic pillars of ICTAM (Davis, 1989).

Technological Competency as Caring in Nursing

Nursing has changed over time, and the care that nurses give now needs to

adapt as well. New technologies are used everywhere in the world in which we

currently live. Despite these developments, nurses must maintain their commitment to

providing human care. The nursing profession cannot evolve into a purely technical
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one. The relationship between technological use and nursing care is framed by

Locsin's thesis of technological competency as caring in nursing.

It is believed that each individual receiving nursing care is special and requires

innovative approaches to care. Modern technology has produced creative approaches

to providing care for these individuals. Although Locsin does not define a human

being as being entirely natural, he does characterize a person as whole if they have

implants such as artificial limbs, insulin pumps, and cardiac pacemakers (Locsin R.,

2010).

The harmonious coexistence of technologies with nursing care is known as

technological competency. The integration of these ideas recognizes that they can

coexist and situates nursing practice within the framework of contemporary

healthcare. Technology helps the nurse and patient communicate more. On the other

hand, technology may potentially widen the gap that exists between nurses and

nurses. When people are continuously known through technology in the The nursing

process is lived at this very time.

Because this idea fosters a closer relationship between the nurse and the

patient, it is relevant to the study, which aims to determine the accuracy of data

synchronization in the context of offline and online data transmission from a local

government unit to the database of JR Borja General Hospital.

This theory serves as a solid foundation for the study, which addresses nursing

informatics and the integration of technology with regard to data interoperability.

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Conceptual Framework

Independent Variables Dependent Variables

 Educational Level
 Accessibility
 Length of Time using

eHatid System  Data Synchronization

 Training and Familiarity

 Performance
 Geographical Location

 Internet Connectivity

The different factors used in this study are addressed in this part of the paper.

The relationship between the variables is explained in this chapter.

As demonstrated in the provided diagram, performance and data

synchronization are directly impacted by educational attainment, time spent using the

eHATID LGU system, training, and familiarity, and also, it is true that having more

education increases a worker's chances of being hired to perform complex and

specialized work (Fulvio Castellacci, et al. 2019). The synergistic effect of the three

aforementioned variables highlights mastery, familiarity, and cognitive ability to use

the system, which can either improve or worsen performance and data

synchronization. This is because the eHATID LGU system's purpose is automatically

defeated if users lack the necessary cognitive ability and knowledge to operate it,

leading to questioned information and a delay in much-needed interventions. The

study found that self-efficacy increases with higher educational attainment and longer

work experience. The study also confirmed, via evaluation of variance, that employee
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self-efficacy differs according to length of employment and level of education

(Damianus Abun, et al., 2021).

The geographical location also has a significant impact on system accessibility

because internet connections can vary or even be scarce depending on one's location.

A location that benefits greatly from internet connectivity would have improved

system accessibility, which would improve performance and raise the likelihood of

accurate data synchronization; on the other hand, a location with limited internet

access would have the opposite effect, indicating a negative effect. Accordingly, even

though there are now more places with broadband available, there are still access

disparities, or the so-called "geographical digital divide." (Yoshio Arai, Sae

Naganuma, 2022) This simply indicates that regional differences in internet

connectivity still exist.

Given that an internet connection enables the transfer of data from one local

government unit to the JR BORJA General Hospital database, internet connectivity

would therefore have a significant impact on system accessibility, performance, and

data synchronization.

Hypotheses

Ho: The eHATID LGU system's information accuracy is not entirely reliable,

particularly in offline mode.

H1: The eHATID LGU system consistently provides accurate information, even when

operating in offline mode.

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Definition of Terms

eHatid LGU. eHealth TABLET for Informed Decision Making of LGU’s or also

know as eHatid LGU is one of the eHealth and Community Empowerment through

Science and Technology (CEST) projects of Philippine Council for Health Research

and Development (PCHRD) of the Department of Science and Technology (DOST)

with Ateneo De Manila University. It provides health Information system and

decision-making support to LGUs through an Electronic Medical Record (EMR) that

generates particular health reports for the Department of Health and the Philippine

Health Insurance Corporation (eHealth.) In this research, the eHatid LGU application

plays a crucial role in facilitating the exchange of client data among health care

professionals, even in the absence of internet access. Its efficiency in data information

transfer without relying on internet connectivity is a significant factor contributing to

streamlined communication within the health care sector.The application's seamless

functionality ensures that essential health information can be shared promptly and

securely, fostering improved collaboration among health care providers.

Interoperability. The ability of computer systems or software to exchange and make

use of information (Oxford Dictionary.) It is crucial in creating a connected and

integrated environment where various elements can communicate and collaborate

without encountering significant obstacles, particularly in the field of exchanging

health care records. Achieving interoperability ensures that health information

systems can seamlessly share data, promoting efficient and coordinated care. This
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interconnectedness facilitates a more comprehensive approach to patient health,

enhancing the overall effectiveness of health care delivery.

EMR. Are a digital version of the paper charts in the clinician's office (HealthIT.gov.)

It play a crucial role in modern health care by digitizing and organizing patient health

information. The importance of EMR lies in its ability to enhance the quality,

efficiency, and safety of health care services.

Health System. Comprising all the organizations, institutions and resources that are

devoted to producing health actions (WHO.) Health system emphasizes the

interconnectedness of these components, with the ultimate goal of improving health

outcomes, enhancing the quality of care, and promoting the well-being of individuals

and communities. Efforts to strengthen health systems often involve policy

development, strategic planning, and ongoing evaluation to address the evolving

healthcare needs of a population.

LAN. Collection of devices connected together in one physical location, such as a

building, office, or home (Cisco.) For data synchronization, a robust LAN ensures

seamless communication and sharing of information among different components of

the Health System. It supports the real-time exchange of data between devices,

servers, and other relevant systems.

Data Synchronization. The continual process of keeping a record type identical

between two or more systems (Workato.) In healthcare, accurate and up-to-date data

is essential for making informed decisions about patient care. Synchronization ensures
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that changes made in one part of the system are reflected consistently across all

connected devices and databases. It minimizes data discrepancies, reduces errors, and

enhances the overall efficiency and reliability of the Health System.

Universal Health Care. All people have access to the full range of quality health

services they need, when and where they need them, without financial hardship

(WHO.) Universal health care underscores the importance of ensuring that

synchronized health data is accessible and available to health care providers across the

entire healthcare system. It supports continuity of care, reduces duplication of efforts,

and contributes to a more comprehensive and patient-centric approach.

SmILHIS CDOC Project. The Smarter and Integrated Local Health Information

System (SMILHIS) is a Local Government Unit (LGU)-centric Local Health

Information Exchange (LHIE). It is being developed to allow seamless transfer of

data within the health service delivery network (eHealth PH.) This is beneficial in

responding to the advancement of the health care system in the Philippines. It makes

it easier for health care workers to efficiently facilitate client data while addressing

the challenges associated with geographical location and intermittent internet access.

The system aids in overcoming current issues, providing a more seamless and reliable

approach to health information management and ultimately contributing to enhanced

health care services in Cagayan de Oro City.

ICT. Refers to a varied group of technologies used for the capture, storage,

processing, and distribution of information. It refers to a wide variety of digital tools,

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systems, and applications that simplify communication, data management, and

information sharing.