User-centered Approach to Developing Solutions for Electronic Medical

Records: Extending EMR Data Entry

Viktor Mikhael M. Dela Cruz, Christian E. Pulmano and Ma. Regina Justina E. Estuar

Ateneo de Manila Univeristy, Katipunan Avenue, Quezon City, Metro Manila, Philippines

Keywords:

Electronic Health Records, Health Informatics, Usability, User-centered Design.

Abstract:

The rapid advancement of technology presents the opportunity to digitize practice management. With a doctor

to patient ratio of 1:33,000, digitizing health records in the Philippines is seen as one solution in providing

more efﬁcient health care services. With the deployment of EMRs in the Philippines at its infancy, there is a

need to initiate studies on feasibility, usability and user perception. This paper reports ﬁndings on usability of

EMRs in a developing economy. Speciﬁcally, a system usability scale (SUS) was used to assess the usability

of an EMR and interviews were conducted to acquire user feedback. Results of the survey indicated an

overall mean SUS score of 70.76 with age and conﬁdence in technology being key deciding factors. Further

observations and future research to streamline the heavy task of encoding on an EMR during patient-physician

consultation are explained.

1 INTRODUCTION

The World Health Organization (WHO) suggests that

the desirable doctor-patient ratio is 1:1000 (Kumar

and Pal, 2018) but last 2008, a doctor to patient ratio

of 1:28,000 was reported in the Philippines (Villar Jr.,

2008). As of 2016, the country had further increased

its doctor to patient ratio to an alarming 1 doctor for

every 33,000 patients (Sandoval, 2016), a far cry from

the WHO recommended standard.

To curb the staggering proportion of doctors and

patients, the recently promulgated Universal Health

Care Act (UHC) aims to provide policies and in-

frastructure that improves the situations of both

health service provider and health-seeking individual

(Congress of the Philippines, 2018). The UHC law

also cites a number of government programs that aim

to increase human resources for health. These pro-

grams include the National Health Human Resource

Master Plan, scholarships, training programs, and a

return service agreement where graduates of health-

related courses who are recipients of government-

funded scholarships are required to work in the public

health sector for at least three years.

This study builds its foundation from section 36 of

the act which states that health service providers are

required to maintain a complete health information

system, a component of which is the electronic med-

ical record (EMR). To increase adoption to the tech-

nology, public health clinics who submit patient pro-

ﬁles and patient encounters to the Philippine Health

Insurance Corporation (PhilHealth) via EMRs are en-

titled to receive cash incentives. The EMR is also an

avenue for receiving incentives for clinics that provide

health care services that are of high priority by the De-

partment of Health including maternal care and new

born care.

This study zooms in on the crossroads Philip-

pine doctors ﬁnd themselves in through the Universal

Health Care Act. On one end, the continuously rising

number of Filipinos pushes the need for faster patient

turnaround times while the nation’s doctor-patient ra-

tio is being improved. On another end, physicians

are pressured to implement EMRs in their practice for

more efﬁcient facilitation of electronic claims.

As of date, there has been no comprehensive study

on the utilization of EMRs since its initial implemen-

tation in 2015. Implementing and deploying EMRs

without focus on users and usability has been proven

to hinder adoption and further development of the

technology (Force, 2011). Solutions and features cur-

rently being developed whether for existing EMRs

or as new software may be rendered ineffectual once

shipped out without being grounded in user feedback

and without including the user within the center of the

design process.

The challenge to adopt and adapt to new and un-

familiar technology in the face of high work demand

130

Dela Cruz, V., Pulmano, C. and Estuar, M.

User-centered Approach to Developing Solutions for Electronic Medical Records: Extending EMR Data Entry.

DOI: 10.5220/0008944201300137

In Proceedings of the 15th International Joint Conference on Computer Vision, Imaging and Computer Graphics Theory and Applications (VISIGRAPP 2020) - Volume 2: HUCAPP, pages

130-137

ISBN: 978-989-758-402-2; ISSN: 2184-4321

may be a task too heavy for any user and may be coun-

terproductive to the goals the UHC set out. This pa-

per describes an application of user-centered methods

to ideate and create solutions for EMRs. The surge

in EMR usage and adoption in the country brought

about by the UHC has presented an opportunity to

survey and acquire the feedback of the users of exist-

ing EMRs. In response, research materials such as a

demographics questionnaire and the system usability

scale were produced and modiﬁed for distribution to

EMR users. A research team conducted a week-long

survey that covered a number of clinics hundreds of

kilometers apart.

2 USABILITY AND

USER-CENTERED DESIGN

FOR EMRs

User-centered or Human-centered design is deﬁned

by the International Organization for Standardization

as an ”approach to systems design and development

that aims to make interactive systems more usable by

focusing on the use of the system and applying hu-

man factors/ergonomics and usability knowledge and

techniques (ISO Central Secretary, 2019).” Improved

productivity, enhanced user well-being, avoidance of

stress, increased accessibility, and reduced risk of

harm are some of the beneﬁts user-centered design

brings to systems (ISO Central Secretary, 2019). This

study takes inspiration from the goal of user-centered

design which is to optimize the user’s experience of a

system by including the user and the user’s perspec-

tive in all stages of the system’s development. De-

velopment of the research materials used in the study

were guided by user-centered design philosophy.

User-centered design highlights the importance of

and is heavily concerned with the subject of usabil-

ity. The Handbook of Usability Testing explains that

a product or a system is usable when users are able to

perform tasks they expect to be able to do without any

barriers or hindrances (Rubin and Chisnell, 2008). In

the scope of EMR usability, Belden et al. (2009) enu-

merated key methods in evaluating the usability of a

system by assessing its effectiveness, efﬁciency, and

satisfaction provided to users. Given how this study

deals with EMRs that have already been shipped for

production and distributed to the market, this study

focused on acquiring user feedback data to determine

if these systems were able to pass expected criterion.

Page and Schadler (2014) explored how to in-

crease the efﬁciency, effectiveness, and satisfaction

of the nursing interface of the University of Kentucky

Healthcare EMR. The study aimed to create systems

that made it easy to tell patient stories and reﬂect nurs-

ing practices through rapid iterative methods in de-

sign, prototyping, and user testing that spanned two

years segmented into 4 phases. A deﬁning factor in

the whole process was using iterative development

phases that was guided by cognitive nurse workﬂow,

tangible requirements from work teams, and future

state user workﬂow. Including the users within the

design motivates them to continue using the technol-

ogy and become part of what drives the technology to

be better.

Rose et al. (2005) examined the results manage-

ment module of the Longitudinal Medical Record

(LMR) web-based EMR through two qualitative stud-

ies conducted among the EMR’s users. The study

used task analyses and focus groups as its main

methodologies to address usability factors in the sys-

tem. Prevalent issues in both studies included infor-

mation overload and poor organization, disruptive ef-

fects to physician workﬂows, and lack of visual cues

and feedback. Focusing on the user’s workﬂow in

their busiest time was a key recommendation moving

forward. This supports the motivation behind meet-

ing users face-to-face in order to be able to personally

observe what they really need from a system.

With regards to the system usability scale,

Kavuma (2019) surveyed and scored EMR systems in

19 reviewed publications based on efﬁciency, effec-

tiveness, ease of learning, cognitive load, and user sat-

isfaction using a 5-point rating system inspired by the

usability evaluation criterion of the Healthcare Infor-

mation and Management Systems Society (HIMSS).

The study aimed to evaluate the usability of EMRs in

sub-Saharan Africa and to ﬁnd out how much usabil-

ity enabled or hindered EMR implementation in the

region. Findings showed that user satisfaction was

the key factor that pulled the general usability score

down. Moreover, it was observed that ease of learn-

ing was correlated to effectiveness as a number of sys-

tems simultaneously had high scores in both metrics.

The study recommended that EMR systems providers

pay special attention to user satisfaction when imple-

menting EMRs.

Furthermore, Shah et al. (2013) developed an

EMR system catered to palliative care providers in

low-resource areas of sub-Saharan Africa and eval-

uated its usability using the system usability scale.

The study aimed to provide palliative care to Africans

in response to rampant diseases such as HIV/AIDS,

tuberculosis, and cancer. The results from the sys-

tem usability scale showed a positive overall median

of 77.5, well above the accepted threshold of 70 to

be deemed usable. Participants, however, were con-

User-centered Approach to Developing Solutions for Electronic Medical Records: Extending EMR Data Entry

131

fused by the difference between ”agree” and ”strongly

agree” and likewise ”disagree” and ”strongly dis-

agree”. This may suggest the merging of the two pos-

itive and negative answers as the difference warranted

no signiﬁcant effects to the overall result.

EMR usability is a rising ﬁeld of study in many

nations and with the UHC, it is high time that EMRs

in the Philippines are also examined.

3 DATA COLLECTION

An open ended survey was constructed to measure

user experience including: what types of users are

there, how they perceive their EMR, how they use

their EMR, what features they like and dislike, what

their pain points are in using their EMR, what they

would like added or taken away, and what can be done

to improve their experience on their EMR. The SUS

was slightly modiﬁed to ﬁt the context of the research

without sacriﬁcing too much of the original essence.

Speciﬁcally, the word ”system” was replaced with

”EMR”, the verb tenses were changed from past tense

to present tense, and complex words such as ”cumber-

some” were replaced with simpler alternatives. Small

changes like these were also made by previous stud-

ies and had shown no signiﬁcant effect to the result

(Finstad, 2006; Bangor et al., 2009). Additionally, an

interview script was created to allow further elabora-

tion of answers and for the participants to be able to

fully express their opinion.

These materials were primarily distributed to the

users and clients of the SHINEOS+ EMR service as

an initial survey population. SHINEOS+ is a web and

mobile-based EMR service that caters to a network

of health establishments and health professionals in

the Philippines (The Secured Health Information Net-

work Exchange, 2019).

Data collection was performed during a ﬁve-

day trip that covered three provinces in the Western

Visayas region of the Philippines. A mixture of al-

lied health professionals including midwives, nurses,

doctors-to-the-barrios, and municipal health ofﬁcers

were asked to participate in a one-on-one session to

answer the research materials and be interviewed per-

sonally. Each session took an estimated 45 minutes

to an hour including the interview. Before each ses-

sion, compliant with modern ethical standards, partic-

ipants were oriented on details such as what the pur-

pose of the survey was, why they were asked to par-

ticipate, and if they could withdraw from interview

at any point. The survey proper started with the de-

mographics questionnaire, followed by a usability as-

sessment through the system usability scale, and con-

cluded with the interview.

The demographics questionnaire was created to

ﬁnd out what kind of users implement the EMR at

work. Occupation, gender, and age were the standard

questions asked while literacy and conﬁdence in tech-

nology were also assessed. Furthermore, participants

were also asked how long they have been using the

EMR, how often they use the EMR, and in what pe-

riod of a work day do they interact with the EMR the

most.

A version of the system usability scale was created

in order to attain a qualitative level of the usability of

the EMR based on its user’s perspective. The sys-

tem usability scale is a tool that yields a provisional

measure of a usability through a 10-item Likert-scale

questionnaire (Brooke et al., 1996). For the case of

this research, a total of 15 more items were added to

the SUS and the whole questionnaire was adapted to

ﬁt the EMR context. The extra items were included

to encompass other areas such as technology stress

but for the purpose of this study, only the items con-

cerning the baseline SUS will be evaluated. In to-

tal however, the participants were asked to score 25

statements based on the degree of which the statement

pertains to them.

An interview was held in order to allow users free

speech on their opinion of the EMR as well as to be

able to further expound on their answers. The par-

ticipants answered a total of 12 questions that were

carefully formulated such that they were structured to

keep the topic within bounds of the EMR conversa-

tion but without being too leading as to provoke spe-

ciﬁc answers. The participants were asked questions

in English but were given free reign to use whatever

language they were most comfortable speaking.

Interview questions as well as SUS items were

meticulously formulated to map to a speciﬁc aspect

of usability, whether efﬁciency, effectiveness, or sat-

isfaction. Through this, participant answers are more

tangible, the survey is more more organized and con-

sistent, and data acquired is easier to classify. Table

1 illustrates the mapping of interview questions and

modiﬁed SUS items to speciﬁc usability factors.

Each one-on-one session was conducted in a sep-

arate room in order to minimize noise and establish a

more private setting. In both written and oral surveys,

no identifying information were collected in order to

preserve user anonymity. The demographics ques-

tionnaire and modiﬁed system usability scale were an-

swered by the participants with a pen on paper. The

interview was recorded using the interviewer’s mo-

bile phone and the audio recordings were stored on a

privately hosted repository on the cloud. Interviewers

were also advised to take notes as backup and imme-

HUCAPP 2020 - 4th International Conference on Human Computer Interaction Theory and Applications

132

diate sources of information.

After completion of all one-on-one sessions, data

from the demographics questionnaire and system us-

ability scales were tallied on a Google Sheets spread-

sheet while transcription from the interviews were

collated on a separate spreadsheet. A coding man-

ual providing a mapping of ﬁelds to descriptions, data

types, and sample values was created for a more struc-

tured encoding and more readable results.

4 RESULTS AND DISCUSSION

4.1 Demographics Results

A total of 15 regional health units and clinics were

visited at the end of the trip. From these 15 estab-

lishments, 36 health professionals agreed to partici-

pate to the study. Almost two-thirds of the partic-

ipants were in the age range of 18 to 35 while the

other one-third was aged 35 to 55 with one partici-

pant being 55 and above. Furthermore, among the

participants, 62% or 22 of them were conﬁdent with

technology while 28% or 10 of them were somewhat

conﬁdent. The remaining 10% consisted of one par-

ticipant not conﬁdent and technology and other par-

ticipants who preferred not to say. It was observed

that there was no correlation between age and tech-

nology literacy since there were participants within

the ages of 18 to 35 that were somewhat or not conﬁ-

dent while there were participants within the ages of

35 and above who were conﬁdent. Lastly, 83% of the

participants use the EMR on a daily basis while the

remaining 17% use it either on a weekly or a monthly

basis. How frequent participants use the EMR was

observed to be not correlated to roles and most likely

be dependent on the strategy their respective clinics

implement with regards to EMR implementation.

4.2 SUS Score

Even though with an overall mode SUS score of 67.5,

participants rated the EMR with an overall mean SUS

score of 70.76 with a standard deviation of 10.54, just

slightly lying above the accepted passable score of 70

(Bangor et al., 2008). However, it must be noted that

the range of SUS scores ranged from as low as 40 to

as high as 90.

Findings showed that age was a factor in rating

the usability of the EMR as participants within the

age range of 18 to 35 provided an overall mean SUS

score of 71.75 while participants within the age range

of 35 to 55 had provided an overall mean SUS score

of 66.25 giving a huge 5-point difference. From here,

it can be said that the EMR appeared more usable to

younger participants compared to older participants.

It was also observed that conﬁdence in technol-

ogy was also a factor affecting the SUS score. Partic-

ipants who indicated that they were conﬁdent in using

technology and computers provided an overall mean

SUS score of 73.75 while participants who indicated

that they were either somewhat conﬁdent or not con-

ﬁdent at all using technology and computers provided

Table 1: Mapping of SUS items and interview questions to key usability factors.

Usability Factor SUS item Interview question

Efﬁciency

”I ﬁnd the EMR unnecessarily complex”,

”I ﬁnd the various functions in this EMR

are well integrated”, ”I think there is too

much inconsistency in this EMR”

”Which tasks take the longest to accomplish

using the EMR? What are the steps you take

to accomplish these tasks?”, ”Does the EMR

become unresponsive at times? What are the

steps you take when it does?”

Effectiveness

”I think that I need the support of a

technical person in using this EMR”,

”I imagine that most people can learn how

to use this EMR very quickly”, ”I ﬁnd the

EMR very unmanageable to use”, ”I need

to learn a lot of things before I can start

using this EMR well”

”How often do you encounter errors when

using the EMR? Which tasks are

error-prone?”, ”Have you had to change

any part of your workﬂow in order to ﬁt

using the EMR? Which part of your

workﬂow did you change and how?”

Satisfaction

”I want to use this EMR regularly”,

”The EMR is easy to use”, ”I feel

very conﬁdent in how I use the EMR”

”Would you prefer to have alternative

(e.g. paper and pen, record book) methods

in storing your medical records? Why,

or why not?”

User-centered Approach to Developing Solutions for Electronic Medical Records: Extending EMR Data Entry

133

an overall mean SUS score of 62.5. Computer liter-

acy and conﬁdence in technology proved to be a key

factor in assessing the EMR’s usability.

The roles played by participants within their work

did not however affect the SUS score. Encoders,

nurses, and municipal health ofﬁcers as groups pro-

vided overall mean SUS scores within the range of 70

to 73, all rating the EMR system as passable.

4.3 Interview Results

A total of 300 minutes worth of interviews were

recorded during the one-on-one sessions. Table 2 il-

lustrates a summary of ﬁndings from the interviews.

With regards to efﬁciency, most of the participants

agreed that there were no tasks intrinsic to the EMR

that took glaringly long to accomplish. Words such as

”easy” and ”responsive”, after translation to English,

were used by the participants to describe the system.

The tasks that did take long to accomplish were reliant

on required third-party service providers and a stable

internet connection. It is important to note that these

issues causing delays to the users’ workﬂow is the

technology required in order for physicians to receive

incentives speciﬁed in the Universal Health Care Act.

On the topic of effectiveness, participants state

that errors happen only on the tasks that concern sub-

mission for eClaims. Aside from these, participants

ﬁnd no other tasks error-prone. Furthermore, partic-

ipants also express that apart from the initial change

brought by learning how to use the system, the EMR

has caused no major change to their respective work-

ﬂows. The participants explain that they have been

able to adjust well to the requirements of the tech-

nology and ﬁnd that their original workﬂow is not as

different as their current process with the EMR. How-

ever, it was noted that the participants had to extend

work hours sometimes well beyond closing time as

their internet connection would only stabilize by af-

ternoon onwards. Albeit this change being the biggest

adjustment to the users’ workﬂows, it is an issue that

must be solved immediately as it deprives users of

regular work hours.

Finally, compared to traditional paper-based

records, participants were very satisﬁed with their

EMR but were more keen to the idea of implementing

an EMR while still keeping paper-based records for

the purpose of backup. As a response to intermittent

internet connection causing multiple downtimes dur-

ing the day, users adapt by using paper records ﬁrst

then encoding the records once connection is stable.

Table 2: Summary of responses to interview questions pertaining to key usability factors.

Usability Factor Question Findings

Which tasks take the longest to

accomplish using the EMR? What

are the steps you take to accomplish

these tasks?

There are no tasks that take long

to accomplish within the system,

Weak internet connection is the main

culprit when tasks take a while

Efﬁciency

Does the EMR become unresponsive

at times? What are the steps you take

when it does?

Long loading times caused by weak

and unstable internet connection

How often do you encounter errors

when using the EMR? Which

tasks are error-prone?

Errors happen not often and are

immediately solved by service

provider when brought to attention,

Tasks that are error-prone are data

entry to eClaims and patient

admission

Effectiveness

Have you had to change any part of

your workﬂow in order to ﬁt using

the EMR? Which part of your

workﬂow did you change and how?

Workﬂow did not change as same

processes are followed, Work hours

increased however due to availability

of internet

Satisfaction

Would you prefer to have alternative

(e.g. paper and pen, record book)

methods in storing your medical

records? Why, or why not?

A mix of electronic and paper records

is preferred

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134

5 DISCUSSION AND

RECOMMENDATIONS

Initial scoring on usability of SHINEOS+ EMR falls

short compared to global counterparts. EMR systems

such as the DataPall system in Africa which scored

77.5 Shah et al. (2013) and the NexTech system in

Florida which scored 82 Schumacher et al. (2010) are

ahead in terms of usability.

Based on results of the survey, SHINEOS+ EMR

achieved good reviews with regards to its efﬁciency,

effectiveness, and user satisfaction, all pillars of us-

ability. However, there are still more improvements

that can be made to improve the service. It is appar-

ent that the main issue users encounter are with avail-

ability due to internet and interoperability with third-

party services. A solution to this can be the use of the

ofﬂine version of SHINEOS+ EMR where data en-

tered is ﬁrst stored on local storage and is only saved

to the cloud once a connection to the internet is avail-

able. This innovation will allow users to be able to

work during the day without downtime which in turn

allows them to ﬁnish work within work hours.

Furthermore, it is also recommended that mem-

bers of the SHINEOS+ EMR team conduct more vis-

its to their users whether for the purpose of updating

them on what is new, or acquiring their feedback on

the current system, or checking on what makes the

work of their users harder and how the team can ad-

dress those issues. It is understandable how distance

can be an issue so a substantial visit every 6 months

can be a reasonable timeframe for this. A corner-

stone of user-centered design is the users themselves

and conducting a visit every once in a while not only

allows system makers to quickly and iteratively im-

prove their product but also gives users the opportu-

nity to participate in the development of the tools that

they use and more conﬁdence in their chosen EMR.

6 FUTURE RESEARCH

It was a common trend among all rural health units

to have a staggering number of patients as early as

8 A.M. At these times, it was normal for the receiv-

ing area of each building to be ﬁlled by individuals

that need care or by mothers with children suffering

from an illness. Given the large number of people at

such an early time, as well as having a limited number

of staff, and only having one doctor assigned to each

rural health unit, these establishments had adopted

unique strategies for attending to their patients. Fig-

ure 1 illustrates three observed strategies.

Strategy A utilizes a completely paper-based ap-

proach of recording until the information is handed to

an encoder for encoding to the EMR as well for pro-

cessing of the patient record for the extra provisions

speciﬁed in the Universal Health Care Act. Strategy B

involves a paper-based approach of proﬁling until di-

agnosis where a doctor writes the diagnosis on paper

while a nurse by the doctor’s side encodes the diagno-

sis to the EMR as the doctor states it. Strategy C uses

an all-EMR approach.

It is interesting to note that during the diagnosis

stage of the strategies, some doctors encode directly

onto the EMR while some doctors still write their di-

agnoses on paper. When the doctors who preferred

writing on paper were asked why so, the general con-

sensus was that it would take them longer to encode

than to write particularly due to slow typing speed

and intermittent internet connection. However, it was

stated by some nurses and encoders that they have a

hard time reading doctors’ notes and result to consult-

ing with the doctor about what they wrote before en-

coding to the EMR. Considering the high demand for

fast patient turnover especially in the most rural areas,

every minute is precious and doctors can not afford to

waste time dealing with their EMR.

Studies by Poissant et al. (2005) and Hill Jr et al.

(2013) have shown that electronic charting can take

signiﬁcantly longer compared to traditional handwrit-

ing. Furthermore, as of late, most EMRs only sup-

port typing input but Smelcer et al. (2009) explains

that many physicians still prefer to write on paper. A

challenge, then, is to ﬁgure out how to give doctors

another method of EMR data entry that is less cum-

bersome than manually typing through a computer.

Developing a solution for this will remove the extra

time taken to encode data from paper to an EMR and

will allow encoders to reallocate their time saved from

deciphering doctors’ notes to other tasks that may im-

prove overall rural health unit performance.

6.1 Handwriting Recognition

A possible solution and a continuation to this research

is to explore supporting handwriting as a method for

data entry to EMRs. This will be done by developing

a handwriting recognition interface and integrating it

to an EMR for testing, reﬁning through user feedback,

and iterative development. The SHINEOS+ EMR ser-

vice will be used to pilot the technology as a testbed

and for possible public use in the future.

Recognizing handwriting involves acquiring data

such as plane coordinates, time between strokes, and

pressure levels from a compatible digital surface that

accepts handwriting input. Examples of digital sur-

User-centered Approach to Developing Solutions for Electronic Medical Records: Extending EMR Data Entry

135

Figure 1: Observed strategies implemented in rural health units.

Figure 2: Sample handwriting recognition implementation.

faces are tablet computers and pen tablets used by

graphic designers. The JavaScript library MyScrip-

tJS will be used to abstract these functions and bring

handwriting recognition to SHINEOS+. Figure 2 il-

lustrates a sample implementation developed to test

the capabilities of MyScriptJS.

Once initial capabilities have been measured, aug-

mentations to the recognition algorithm will be ex-

plored in order to improve handwriting recognition

accuracy if needed. Furthermore, user-centered de-

sign philosophies will be employed to ensure that

the ﬁnal outcome is a solution that is usable and has

been developed with and for the users. After a de-

sirable state is achieved, the handwriting recognition

interface will be integrated to the SHINEOS+ EMR

as an additional option for data entry during patient-

physician consultation. Additional features such as

key clinical text extraction and automatic mapping to

EMR ﬁelds will also be developed to provide a seam-

less ﬂow of data from doctor handwriting to free-text.

7 CONCLUSIONS

This paper explored the situation of healthcare in the

Philippines, speciﬁcally in the context of the Uni-

versal Health Care Act and how health professionals

are now to manage their practice with the aid of an

EMR. Users of the SHINEOS+ EMR were surveyed

to acquire their feedback and usability of their cho-

sen EMR through carefully selected research meth-

ods and materials inspired by user-centered design

philosophies. Results of the survey were reported and

additional insights and solutions were discussed.

In the case of the Philippines, there is an apparent

need for the provision of more policies and infrastruc-

ture that will support the technologies required by the

UHC. At the end of the day, software can only go in-

sofar as the resources it needs are available.

Even though the EMR discussed proved to be

passable in terms of usability, this does not necessar-

ily mean that it is also acceptable. Different contexts

necessitate different strategies to overcome unique

problems and technology should be made as ﬂexible

as can be to accommodate the widest range of use

cases. In light of this, it is important that the users are

also included in the formulation and design process

of solutions. This assures that services and programs

truly do cater to the users needs and not just to the

assumptions of the provider.

HUCAPP 2020 - 4th International Conference on Human Computer Interaction Theory and Applications

136

ACKNOWLEDGEMENTS

The researchers express their gratitude to the Philip-

pine Department of Science and Technology and the

Ateneo School of Science and Engineering for fund-

ing this research through the DOST-ERDT grant and

SOSE Industry grant respectively. The researchers

would also like to acknowledge the support of the

Ateneo Center for Computing Competency Research

(ACCCRE).

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Fourteenth Congress of the Republic of the Philippines,

Second Regular Session.

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