Developing Electronic Medical Record Based on NFC Noor Cholis Basjaruddin Edi Rakhman
Kuspriyanto Mikhael Bagus Renardi
Department of Electrical Engineering, Politeknik Negeri Bandung Jl. Gegerkalong Hilir, Ds.Ciwaruga, Bandung, Indonesia +62817202982
School of Electrical Engineering and Informatics, Institut Teknologi Bandung Jl. Ganesha 10 Bandung, Indonesia
[email protected] requirement is difficult to meet due to its reliance on internet connection and the availability of server services where EMR is stored. Internet connections are often problematic so that medical record access can be disrupted especially in Indonesia internet connection is not evenly distributed. The availability of server services is also sometimes disrupted due to several reasons such as repair, maintenance, operating failure of server computers, and disrupted power supplies.
ABSTRACT Internet-based electronic medical records have dependencies on the availability of internet access and server services. In most areas of the world it is a problem because the average level of internet service availability is low. Required technology that enables the exchange of data offline but still secure and at certain times the data can be synchronized with the data on the server using internet. Near Field Communication (NFC) technology enabled mobile phones to store important data with secure and reliable. The data can be sent to another phone equipped with NFC or read by NFC reader without internet. Through special applications the data can also be added, subtracted, or modified. In this research has been developed medical record system based on Near Field Communication (NFC). NFC-based electronic medical record (EMR) is expected to replace conventional medical records and improve the function of internet-based EMR. The advantage of NFC-based EMR is that it takes less time in usage, is not dependent on internet access, and the ease of delivering EMR to those in need.
The retrieval and processing of data stored on the server can only be done online through the internet or intranet network. It is therefore necessary that technology allows the capture and processing of data off-line and under conditions that allow data stored on mobile devices to be sent to the server for wider purposes. Technology that can answer those needs is NFC. Through NFC data can be retrieved and processed off-line, but at the moment allowing such data can be sent to the server for wider purposes [1] and [2]. In addition, NFC-based medical records also allow medical record data to be used by health care wherever independent of where the first medical record is made.
CCS Concept Information systems ➝ Mobile information processing systems
Electronic medical records research, among others, performed by [3], [4], and [5]. In [3] we investigated the benefits of EMR that facilitated administrative personnel in patient information retrieval, whereas at [4] and [5] it was suggested that EMR was beneficial for patients because it increased efiesiensi in the process of health care.
Keywords NFC; Near Field Communication; Electronic Medical Record
1. INTRODUCTION The development in medical record in the information age is the emergence of electronic medical record (EMR) that is medical record that utilizes server as storage place, web as media for reading and updating data, and internet as communication media between server and web based application. The completeness and accuracy of medical record data on EMR can be better than conventional medical records. A well-built EMR meets at least some of the most important electronic data storage elements privacy or confidentiality, integrity, authentication, access control and non-repudiation, but it is very difficult to meet availability. Medical record data that has been entered in EMR should be accessible whenever and wherever as needed. This availability
The development of smart card-based medical records was developed by [6], [7], and [8]. These three studies use RFID cards to store medical record data. The development of electronic medical records further exploits the NFC as performed by [5] and [9]. In addition to medical records the researchers also developed an NFC-based health care system such as [10] and [11].
2. RESEARCH METHOD Medical record activities based on Guidelines for Medical Record & Procedure of Hospital 2006 include: [12] 1. Acceptance of patient (recording of patient's social data) 2. Recording of service data 3. Data management 4. Reporting 5. Storage / Retrieval of data Such activities shall be eligible for the implementation of privacy or confidentiality, integrity, authentication, access control, nonrepudiation, and availability.
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The development of NFC-based medical record that will be conducted covers all media recording activities as well as qualified in the implementation of such activities. The preferred approach in solving this problem is a system approach with high
DOI: https://doi.org/10.1145/3168390.3168420
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levels of security, accuracy, and reliability. Through this approach can be realized eligible system in the implementation of medical records.
patient's phone can be copied to the doctor's phone using NFC. The delivery process of EMR uses NFC so it does not depend on internet network.
This research begins with literature studies on medical records [12], electronic medical records, NFC [13] & [14], communication protocols [15], encryption [16], and applications in the android operating system environment . This literature study produces some information about aspects of medical record and NFC based system that can be used as base in determining the requirement and system specification. Based on the specifications and then designed the system with the beginning of the development of NFC-based medical record system architecture [17]. Applications developed based on the architecture that has been developed with attention to the level of data security whether stored, read, or modified .
3.3
Application Views
The initial appearance of the application and EMR insert form can be seen in Figure 3.
3. RESULTS AND ANALYSIS 3.1 Architecture The NFC-based EMR architecture can be seen in Figure 1. The EMR application on the doctor's phone can be used to read and change the EMR content, while the EMR application on the patient can only be used for reading. When the patient first comes to the doctor and the doctor does not have the patient’s EMR then the doctor needs to copy the EMR from the patient’s phone by tap between the patient's phone and the doctor’s phone. Upon medical examination of the patient then the doctor will renew the EMR and keep it. Patients will get the latest EMR from a doctor using NFC. This architecture also allows one phone to be used to store multiple EMR from different people. Confidentiality is maintained with the use of autotentication in developed application. Figure 2. Use case.
Figure 1. NFC-Based EMR Architecture.
3.2
Use Case
The developed application consists of two parts: the first part is used by the doctor and the second part is used by the patient. Figure 2 shows the use case of the developed application. Patients are not entitled to add or change EMR, whereas doctors may add or change EMR.
Figure 3. The front page and MR page of the NFC-based EMR application.
Users of EMR application both a doctor and a patient must register on the application before using the EMR facility. After enrolling a doctor or patient can use the application after performing the autontication. Doctor use the application to create a new EMR or update an existing EMR. The latest EMR that has been made by the doctor is then sent to the patient via NFC by tap. If the patient visits another doctor, then the EMR stored in the
3.4
Sequence Diagram
The sequence diagrams for EMR sending can be seen in Figure 4 and Figure 5. Figure 4 shows sending process an EMR by patient’s phone to doctor’s phone, while Figure 5 shows sending
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process an EMR by doctor’s phone to patient’s phone. EMR delivery process takes only a few milliseconds so it is very efficient when used. Generally the data size of an EMR is 100 KB
so using the transfer speed of 424 kbit/s only required a few seconds for the delivery of an EMR file.
Figure 4. Sequence diagram on the medical record sending by patient to doctor.
Figure 5. Sequence diagram on the medical record sending by doctor to patient. Based on the consideration of security and confidentiality then the developed application is made into two separately. Application for doctors are distributed on a limited basis and will be developed with a registration system before doctors download the application. The application for the patient will be distributed freely through the application store.
3.5 Comparison of Applications and Requirements The comparison of developed application and requirements can be seen in Table 1. The developed application must meet the demand set at the beginning of the design. Table 1 shows that the developed application meets all the predefined requirements.
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In the initial version the requirements is set based on the minimum basic functionality that must exist in an EMR application. The next stage of application will be developed by setting new requirements to meet aspects of reliability, usability, efficiency, maintainability, and portability.
a material improvement in application development. Through the beta test is expected to know how far the usability level of application by doctors and patients. Questionnaires will be used in beta test implementation.
Table 2. Alpha test result Table 1. Comparison of applications and user requirements No.
Application Properties
1
The application provides a form for filling in the patient's personal data
2
Application provides form for physician's selffilling data
3
Application enables the transfer of patient data to doctor's cell phone via NFC
Requiments Description
Remarks
Patient can fill in the data self
Charging data only once and can be used to manufacture EMR in any doctor.
Doctor can fill in the data self
Charging data only once and can to serve patients in large numbers.
Doctor can copy patient's self data via NFC
Through tap (closer two phones), patient data can be copied to doctor's phone.
4
Patients can view their EMR through the View EMR menu.
Patients can view their EMR.
Through View menu, patient can view their EMR.
5
Medical personnel may create a new EMR or edit an existing EMR.
EMR is visible and modified by medical personnel
Only medical personnel can add and edit patient EMR
EMR made by medical personnel can be copied to the patient's cell phone via Send MR
EMR can be copied from the mobile phone medical officer to the patient's mobile phone via NFC
EMR which has been made medical officer can be copied to the patient's mobile phone.
EMR of the patient can be copied to mobile phone medical officer via Send MR
EMR on patient's mobile phone can be copied to mobile phone medical officer through NFC
If patient went to another doctor then EMR can be copied to new doctor's phone.
6
7
3.6
Function
Scenario
Actual Result
Status (pass/fail)
Patient Registration
The researcher tried to enter a new patient data into the patient application
The new patient data added
pass
Doctor Registration
The researcher tried to enter a new doctor data into the doctor application
The new doctor data added
pass
Sending patient’s data to doctor’s phone
The researcher tried to sent a patient data from patient’s phone to doctor’s phone using NFC
Patient data sent to doctor’s phone
pass
Insert New EMR
An EMR insert to doctor’s phone
An EMR added in doctor’s phone
pass
Update EMR
An EMR in doctor’s phone is updated
An EMR in doctor’s phone is updated
pass
Sending an EMR data from patient’s phone to doctor’s phone
Using two phones, the researcher tried send a EMR from patient’s phone to doctor’s phone
An EMR sent to doctor’s phone
pass
Sending an EMR data from doctor’s phone to patient’s phone
Using two phones, the researcher tried send a EMR from doctor’s phone to patient’s phone
An EMR sent to doctor’s phone
pass
4. CONCLUSION The design of NFC-based electronic medical record application has been implemented. The application allow a doctor to add, change, and view patient's EMR. The patient can only see his EMR and the EMR data is protected by the authentication system. The developed application also allows the sending of personal data and EMR of the patient to the medical officer. In contrast, EMR written by medical officers also allow to be sent to the patient's phone via NFC. NFC-based EMR has a higher level of service availability than internet-based EMR because it does not depend on internet access.
Alpha Test Result
Alpha test is used to test whether the entire application function can work properly or not. The test is done by using dummy data and the results can be seen in Table 2. The alpha test results show that the application can work in accordance with the requirements that has been set. The next test to be performed is a beta test. In this test some doctors and patients will be involved. The beta test results will be
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5. REFERENCES
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