University of Wollongong Thesis Collections University of Wollongong Thesis Collection University of Wollongong Year  Design of a web service based prototype appointment system for improving the patient access to primary health care service Hongxiang Hu University of Wollongong Hu, Hongxiang, Design of a web service based prototype appointment system for im- proving the patient access to primary health care service, Master of the Information and CommunicationTechnologybyResearchthesis,SchoolofInformationSystems&Technology -FacultyofInformatics,UniversityofWollongong,2010. http://ro.uow.edu.au/theses/3138 ThispaperispostedatResearchOnline. School of Information System and Technology Design of a Web Service Based Prototype Appointment System for Improving the Patient Access to Primary Health Care Service Hongxiang Hu This thesis is presented as part of the requirements for the award of the degree Master of the Information and Communication Technology by Research From University of Wollongong March 2010 i DECLARATION I, Hongxiang Hu, declare that this thesis, submitted in fulfilment of the requirements of the award of Master of Information and Communication Technology by research, in School of Information Systems and Technology, University of Wollongong, is wholly my own work unless otherwise referenced or acknowledged. The document has not been submitted for qualification at any other academic institution. Signature: _________________ Date: _________________ ii ACKNOWLEDGEMENTS I feel deepest appreciation and gratitude to a number of people and organisations who have contributed to the research undertaking and thesis preparation in many forms. First, I thank my supervisor Dr Ping Yu, for her continuous support and constant encouragement, guidance and insightful feedback during all these years of my study. Ping was always there to listen and to give advice. She taught me how to gather raw materials, ask questions and express my ideas. She showed me different ways to approach a research problem and the need to be persistent to accomplish any goal. I also thank my co-supervisor, Dr. Jun Yan, who guided my study of web services and the give me precious advice in composing my research thesis. Special thanks go to my industry supporter Dr. M.K. Rashid, CEO of the Centre Health Complex in Shellharbour, for allowing me to conduct my field study in the clinic. I am also greatly indebted to people who facilitated and organised the experiments and discussion in the study: Dr Niraj Gouveia, Mrs. Violeta Kuzmanoska, Dr Naveed Shaukat, Dr. Vicki Angwin, Miss. Susan Zhou, and et al. These people helped me to understand the practice of primary health care in Australia. Besides my advisors, I would like to thank Mr Xiaojun Zhang, who helped me from the very beginning of this project. He helped me to analyse the workflow and IT infrastructure in CHC and provided me very valuable advices for my design and system prototyping. iii I’m thankful also to Dr. Carole Alcock for her help in editing and proof-reading the manuscript of my thesis, and Dr. Andrew W. Knight for his generous help in extending my understanding of Advanced Access model. Most importantly, I thank my parents and my fiancée, for your enduring support and encouragement throughout the research, for your love, patience, and confidence in me at all time. iv ABSTRACT Research Aim and Questions: This research aims to develop a computer-based appointment system, which could integrate with the existing clinical information system and improve the patient access to the services offered by both General Practitioners (GPs) and Allied Health Professionals (AHPs) in a primary health care clinic Centre Health Complex (CHC). To achieve this requires the development of an understanding of the features and processes of patient booking in the primary health care environment; the identification of the gaps of the existing patient booking system; and a scheme of an improved system, which could fill these gaps. The output of this project is a prototype of patient appointment system built on web service technology. Research background: To acquire a routine appointment from a GP or an AHP, a patient may need to wait more than several weeks in CHC. Patient's long waiting time is always accompanied with some series access problems such as missed appointments in the practice. Consequently, some patients are driven from primary health care to Emergency Department (ED) and add pressure to the overburdened hospital system. The patient’s access problem is initiated by the traditional appointment system, which is based on a basic fixed schedule for booking patients. It does not record a patient request if the request is not met; therefore, it has missed the essential baseline data about the patient’s actual demands. Without this information, the practice could not plan effectively to fully meet the demands of the patients for primary care services. Research Methodology: This research followed a standard software development process – waterfall model. Three phases of study were carried out, including (1) requirement analysis, (2) system design, and (3) prototyping and unit testing. First, a filed study was conducted in the CHC to collect information about the features and processes of patient booking and the IT infrastructure in the clinic. The weakness of the practice workflow and the IT infrastructure were identified. Then the design of the new appointment system was proposed to plug these gaps. Finally, a prototype of the proposed appointment system was built. v Result and Conclusion: This design and prototype appointment system was influenced by the general idea of the Advanced Access (AA) model. Its workflow was developed following the general process of AA: (1) setting up the access target; (2) monitoring the patient’s demand; and (3) planning the provider’s supply to meeting patient’s demand. The proposed appointment system was composed of four modules as: Request module, Schedule module, Performance module and Strategy module. The role of each module was to manage patients’ appointment requests, manage the providers’ supply, monitor practice performance and provide clinic recommendations for taking appointments respectively. In order to be compatible with the existing IT infrastructure, this appointment system was built on web services technology, so that both GPs and AHPs could benefit from the inventive management process and integrated interface. Future Direction of This Project: Due to the time limit, the implementation and evaluation were not conducted for this project. The prototype appointment will be implemented in CHC in the future, when the new features we have designed for this appointment system for improving patient access will be tested and justified. vi PUBLICATIONS Hu, H, Yu, P & Yan, J 2010, Design an Automatic Appointment System to Improve Patient Access to Primary Health Care. Proceedings of the Fourth Australasian Workshop on Health Informatics and Knowledge Management (HIKM 2010), Brisbane, Australia, ACSW vii TABLE OF CONTENTS DECLARATION .......................................................................................................... i ACKNOWLEDGEMENTS ......................................................................................... ii ABSTRACT ................................................................................................................ iv PUBLICATIONS ........................................................................................................ vi TABLE OF CONTENTS ........................................................................................... vii LIST OF FIGURES .................................................................................................... xi LIST OF TABLES .................................................................................................... xiv LIST OF ACRONYM ................................................................................................ xv 1. INTRODUCTION ............................................................................................... 1 1. 1 Background .................................................................................................. 1 1. 2 Statement of the Problem ............................................................................. 2 1. 3 Research Objectives ..................................................................................... 3 1. 4 Significance of the Research ........................................................................ 4 1. 5 Research Methodology and Research Design .............................................. 5 1.5.1 Phase 1: Requirement Analysis ................................................................ 5 1.5.2 Phase 2: System Design ........................................................................... 5 1.5.3 Phase 3: Prototyping and Unit Testing .................................................... 6 1. 6 Thesis Outline .............................................................................................. 6 2. LITERATURE REVIEW..................................................................................... 7 2. 1 Introduction .................................................................................................. 7 2. 2 Health Care System in Australia .................................................................. 7 2.2.1 Health Care Providers .............................................................................. 7 2.2.2 Health Care Insurance .............................................................................. 9 2. 3 The Need for Collaboration ....................................................................... 10 2. 4 Problems of Patient Admission in Primary Health Care ............................ 15 2. 5 A Revolutionary Model of Patient Admission in Primary Health Care..... 17 2. 6 Important Issues for Designing an Appointment System .......................... 21 2.6.1 Revealing Patients Demand ................................................................... 21 2.6.2 Measuring Service Performance ............................................................ 22 2.6.3 Balance Demand and Supply ................................................................. 25 2. 7 Summary .................................................................................................... 26 3. METHODOLOGY ............................................................................................. 28