Using Mobile Application to Improve Doctor-Patient Interaction in Healthcare Delivery System

The use of mobile applications for healthcare has become a focal point of innovation that could aid patients in their everyday healthcare management. Mobile applications can contribute to increasing the effectiveness and reduc-ing the costs of healthcare delivery as well as preventing illnesses through behaviour change. This paper presents model of an interactive mobile healthcare application that facilitates the needs between doctors and patients. The proposed mobile application will provide optimal communication to several parties in the healthcare sector such as patients, doctors and pharmacists for better healthcare services and delivery. The software development methodology adopted was Object Oriented Analysis and Design Methodology (OOADM). Our mobile application is developed for Android platform and HTML, CSS and JS were used at the front-end while Angula JS, PHP and MYSQL powered the back-end.


Introduction
Healthcare is an environment that has been experiencing dramatic progress in computing technology in order to process and distribute all relevant patient information electronically and overall to improve the quality of care. In particular, mobile e-health involves a spectrum of information and telecommunication technologies to provide healthcare services to patients who are at some distance from the provider and also provide supporting tools for the mobile healthcare Mobile healthcare has huge potential to improve efficiency, improve healthcare quality, enable doctors to monitor their patient's health, enable patients to manage their heath more comfortably out of the hospital, allow home care providers to provide better healthcare quality to seniors, and reduce the cost of care by allowing patients to make fewer visits to their doctor [2]. A new study suggests that patients who read their e-health records are more likely to understand their medical issues better and to take their medications as prescribed [3]. It is believed that e-health applications also make patients feel more in control and less confused, increase devotion to medications [3], improve relationships between doctors and patients, help patients to ask more informed questions and ease anxiety and confusion without extra work for health providers [4]. Additionally, [5] quoted Dr. Jonathan Pell, an assistant professor at the University of Colorado in Denver as saying "The hope is that increased transparency achieved by sharing electronic medical records with patients while they are in the hospital would make them more engaged in their care, more satisfied, and more likely to ask questions and catch errors". However, some experts think that too much information can cause panic for the patient. It is also thought that patients with less education may need more work to explain health issues to them; while educated patients may have an easier time understanding their health records [5].

Statement of the Problem
In Nigerian culture, doctor-patient interaction is dominated by the doctor and culture of "not questioning the doctor". Due to social and educational barriers, doctors feel there is no point in attempting to explain tests and test results to patients as they would not understand anyway. The level of communication is placed in the hands of the physician where they are the communicator and patients are the listeners. Doctors were once seen as god-like in the society, the popular belief that they can treat and cure any condition. Hence, patients used to leave their full confidence of their health outcome to them. However, over the past decade, doctors are often criticized for not providing adequate considerations to the patients' feeling or desires regarding the illness or conditions being treated. The patients on the other hand, often assume a doctor may know things about his/her condition when he or she actually does not. These are complex problems that arise when the communication gap between doctors and patients is wide. Moreover, patients or family members often sign consent forms without really understanding what they are consenting to. Such one-way communication and decision making disempowers patients who, as a result, rarely participate in their own care. Poor communication is linked with less accurate diagnoses, suboptimal patient compliance, over-treatment, under treatment and "mistreatment" [6].

Aim and Objectives of Study
The aim of this work is to develop a mobile application that provides optimal communication among patients, doctors and other stakeholders for better healthcare services and delivery. It will help them to communicate with each other for appointment, prescription management and patient data management at any time using mobile with the internet. The objectives of the research are: 1) To create an application that will be easy for use without learning any additional skills.
2) To develop an application that focuses on how to enhance users' awareness and knowledge about medication and its management.
3) To create the framework that will enable more citizens to receive healthcare services whenever needed.

4)
To provide mobile platform that will deliver services that are cost-effective and meet certain pre-established standards of quality.

Significance of Study
The major significance of this work is to provide a mobile healthcare app service with the potential to achieve the key attributes of mobile technology: 1) Access: patients, doctors and other stakeholders will access electronic mobile records for viewing and entering real time data anytime and anywhere. It will provide them easy access for real time communications, information sharing, collaboration and consultation.
2) Insight: the app will facilitate the availability of "interpreted" information using clinical documentation, test results, image data and communication for more efficient collaboration between patients and other stakeholders making faster, more accurate judgments and decisions.
3) Convenience: this app when connected is always on, and "in hand", for the task at hand. This convenience reduces time spent "managing" records, improves data capture, reduces errors, and enables health care providers to have higher quality interactions with patients.

Literature Review
Many Medication Systems have been developed based on different platforms and concepts. The use of healthcare-related apps is growing but there are many issues related to their functionality. In this section, we reviewed some of the E-Health Telecommunication Systems and Networks literatures and applications that are related to our work.

1) Epocrates
Epocrates enables patient care by delivering the right information, when it is needed. It has features such as; find providers for consults and referrals in the Provider Directory, review drug prescriptions and safety information, check for potentially harmful drug interactions, access timely medical news and research information, disease information, alternative medications, lab guides, and more clinical tools [7].
2) Doctor at Work This application manages patient records, appointments, patient visit notes, bill patients, track customer payments and balance due. This app can be useful for medical professionals and students that visit patients every now and then. It also helps the patients to get the appointments with doctors and sends the reminder through SMS or by email, creates itemized bills for patients to track the due amount, maintains the visit history of the patients, etc. [7].
3) Diagnotes This mobile application is web-based and provides healthcare practitioners the tools to enhance doctor interaction with their patients and other support staff. The user is expected to first create his account to enable him have access to all the functionalities the application. It routes phone calls and text, supports documentation of every encounter for continuity of patient care (Google Play, 2015).
All the existing applications discussed above are kind of more commercial and money making, but this our proposed system cares more for patient-centered approach, and provides an optimal communication between doctors and patients. This app is helpful to patients to ask questions and state their concerns to doctors regarding their health condition. This app will facilitate the patients to interact with doctors without making any physical appointments.

Proposed System
The proposed system is a mobile application that can accommodate the communication needs between doctors and patients. The application must be able to handle processes ranging from the doctor's search process, check registration, queue number settings and notifications, easy-to-access medical records, and chats between doctors and patients. This, therefore, helps in making critical information more readily available for review on an individual basis.
These changes will be more than automated and more efficient versions of what we already do. There will be new ways to support and even provide healthcare: replacements and refinements for existing processes, procedures, and work habits that will improve outcomes. Other benefits of the proposed new system are:

Methods and Design
The development of any software requires following certain procedures in order to achieve set objective. There are many methodologies that are adopted by software developers to provide pleasant software development based on the project needs. For the software development of the proposed system, Object Oriented Analysis and Design Method (OOADM) were used.

System Requirements
Hardware Requirements:  Laptop.    Overall management of the system. Some of the inputs to the system are as shown: In Figure 2, the doctor logs in with his user name and password to access his account in the app but a new doctor must create an account to be able to log into the app.
In Figure 3, the patient will follow the same steps to gain access as the doctor.  In many cases, output is the main reason for developing the system and the basis on which the usefulness of the system is evaluated. In this work, the following are some of the outputs.

Module Description
The coding phase deals with transforming the user requirements into a form that is implementable using programming language. The programming languages used to develop the front-end are JAVA and HTML while the back-end prescription ready.  The pharmacist shall be able to view and update the information of the patient's payment status.
Administrator module:  The admin shall be able to login with his user name and password; and he shall be able to logout.  The admin shall be able to search for a user (patient, doctor, nurse, and pharmacist) by user name, SIN and DOB to view the user's information.  The admin shall be able to edit the user account.  The admin shall be able to check the retrieved update.
 The admin shall have overall management of the system.

Conclusions
The application works for the benefits of the society and provides an interactive interface between the patient and the doctor. This paper proposed a mobile healthcare application that provides both healthcare providers and patients access to accurate and up-to-date information with less time and effort as well as improved efficiency of the information flow. The main advantage of this application is that doctors will be provided with full history of their patients' health status and patients will hold their data wherever they go. The proposed system will also help Medical Doctors to speed up diagnosis and treatment of patients through the advice and interaction with the patient.
The system is portable and can easily be installed and used on any mobile phones supporting Android OS. The use of this system can result in a reduction in number of hours spent searching for doctors and contacting them at the time of need. It also provides an interface that is easy to understand by the users and greatly helps in adapting to the use of this system.

Future Work
This application can be improved in the future by adding the following functionalities:  Supporting video calls to discuss the problems with doctors.
 Implement hardware for monitoring status of the patient.
 Patients reports can be stored in encrypted form.
 The system can also be enhanced by using voice recognition feature of the Android.