Online patient scheduling in 40 characters

ONLINE PATIENT SCHEDULING SYSTEM
Acknowledge
My sincere gratitude to my Supervisor Mr. Debashish Das for guiding me throughout the planning
and development phase of the system. Without his strategic guideline and counselling I would not
have reached the final stage of the development. I would like to thank Mr. Dhason for briefing the
student regarding the Final Year Project. Mr. Dhason’s sincere guidance and always cooperating
nature has provided us with proper knowledge and directions on how to prepare for the final
documentation.
I would like to thank my close peers and my classmates for being supportive and encouraging
throughout my three-year journey here in Asia Pacific University. My sincere gratitude goes to
Asia Pacific University for providing the platform where I was able to cherish and nurture my
compassion and improve my technical skills. Much appreciation to APU for great support and all
necessary academic materials that has taught me great helpful academic as well as life lessons.
Finally, yet importantly, I would like to thank my family. Their endless support has been
unconditional. Their hopes and faith on me had me keep going even when days were challenging.
SAMIHA TABASSUM HAQUE (TP034305) 1

Table of Contents
Acknowledge .................................................................................................................................. 1
Chapter 1: Introduction to the Study
1.1 Background to the Project ....................................................................................................... 11
1.2 Problem Context ..................................................................................................................... 12
1.3 Rationale ................................................................................................................................. 14
1.4 Potential Benefits .................................................................................................................... 14
1.4.1 Tangible benefits ............................................................................................................................ 14
1.4.2 Intangible benefits ......................................................................................................................... 15
1.5 Target Users ............................................................................................................................ 15
1.6 Scope and Objectives .............................................................................................................. 15
1.6.1 Aims................................................................................................................................................ 16
1.6.2 Objectives....................................................................................................................................... 16
1.7 Deliverables –Functionality of the proposed system .............................................................. 16
1.8 Nature of Challenges............................................................................................................... 17
1.9 Overview of this report and Project Plan ................................................................................ 17
Chapter 2: Literature Review
2.1 Introduction ............................................................................................................................. 18
2.2. Domain Research: .................................................................................................................. 19
2.3 Technical Research: ................................................................................................................ 23
2.3.1 Similar Systems: ............................................................................................................................. 24
2.3.2 Architecture of Similar Systems ..................................................................................................... 28
2.4 Conclusion .............................................................................................................................. 33
Chapter 3: Development Methodology
3.1 Identification of Chosen Methodology: Agile ........................................................................ 34
3.2 Justification to Agile Approach .............................................................................................. 34
3.3 Description of the System Development Methodology: ......................................................... 35
3.3.1 Agile Manifesto .............................................................................................................................. 36
3.4 Agile Methodologies............................................................................................................... 38
3.4.1 Scrum Approach for Online Patient Scheduling ............................................................................. 38
3.5 Scrum Implementation:........................................................................................................... 40
3.6 Conclusion: ............................................................................................................................. 42

Chapter 4: System Architecture

4.1 Introduction ............................................................................................................................. 43
4.2 Abstract Architecture .............................................................................................................. 44
4.3 System Design ................................................................................................................... 45
4.3.1 Use Case Diagram: .................................................................................................................. 45
4.3.2 Use Case Specification ............................................................................................................ 49
4.3.3 Class Diagram .......................................................................................................................... 52
4.3.4 Activity Diagram ...................................................................................................................... 54
4.3.5 Sequence Diagram .................................................................................................................. 54
4.3.6 Entity Relation Diagram .......................................................................................................... 59
4.3.7 Database Table Structure ........................................................................................................ 60
4.4 User Interface ..................................................................................................................... 64
4.5 System Development ......................................................................................................... 68
4.5.1 Programming Language: ................................................................................................................ 68
4.5.2 IDE: ................................................................................................................................................. 69
4.5.3 Database Management System: .................................................................................................... 69
4.5.4 Operating System: .......................................................................................................................... 71
4.5.5 Web Server:.................................................................................................................................... 71
4.5.6 Web Browser: ................................................................................................................................ 71
4.5.7 AES Encryption for Security Code: ................................................................................................. 72
4.5.7.1 Justification to AES Encryption ............................................................................................... 73
Chapter 5: Requirement Validation
5.1 Introduction ............................................................................................................................. 75
5.1.1 Questionnaires ............................................................................................................................... 75
5.1.2 Interview ........................................................................................................................................ 77
5.2 Analysis of Data collection through Questionnaire: ............................................................... 77
5.2.1 Analysis of the Data gathered through Questionnaire: ................................................................. 85
5.3 Conclusion: ........................................................................................................................................ 86
5.4 Analysis of Data through Interviews: ..................................................................................... 86
5.4.1 Conclusion from the Data collected through Interview: ............................................................... 90
Chapter 6: Implementation
6.1 Screenshots ............................................................................................................................. 91

6.1.1 Home page ..................................................................................................................................... 91
6.1.2 About page ..................................................................................................................................... 92
6.1.3 Events page .................................................................................................................................... 93
6.1.4 Partners page ................................................................................................................................. 93
6.1.5 Login page ...................................................................................................................................... 93
6.1.6 Register new account page ............................................................................................................ 94
6.1.7 My account page ............................................................................................................................ 95
6.1.8 New appointment page ............................................................................................................. 95
6.1.9 Appointment Update Page: ........................................................................................................... 96
6.1.10 Make payment page .................................................................................................................... 97
6.1.11 My appointment page ................................................................................................................. 98
6.1.12 Consultation rating page .............................................................................................................. 99
6.1.13 Doctor record page ...................................................................................................................... 99
6.1.14 Patient record page .................................................................................................................... 100
6.1.15 System record page ................................................................................................................... 100
6.1.16 Register new staff page.............................................................................................................. 101
6.1.17 Encryption .................................................................................................................................. 101
6.1.18 Password strength checker ........................................................................................................ 102
6.2 Sample codes ........................................................................................................................ 102
6.2.1 Login page .................................................................................................................................... 103
6.2.2 Register new account page .......................................................................................................... 104
6.2.3 My account page .......................................................................................................................... 104
6.2.4 Doctor record page ...................................................................................................................... 105
6.2.5 New appointment ........................................................................................................................ 105
6.2.6 Make payment ............................................................................................................................. 107
6.2.7 Automatic notification email ....................................................................................................... 108
6.2.8 Consultation rating ...................................................................................................................... 109
6.2.9 Security features .......................................................................................................................... 110
Chapter 7: System Validation
7.1 Unit Testing: ......................................................................................................................... 112
7.2 Integration Testing: ............................................................................................................... 117
7.3 System Testing: ..................................................................................................................... 120

7.4 User Acceptance Test: .......................................................................................................... 121

7.5 Conclusion: ........................................................................................................................... 126
Chapter 8: Reflection & Conclusion
8.1 Personal Reflection and Critical Evaluation: ........................................................................ 127
8.2 Conclusion: ........................................................................................................................... 128
References ................................................................................................................................... 130
APPENDIX ................................................................................................................................. 135
Table of Figures
Figure 2: System flow chart for online appointment registration. (Zhan, X. and Liu, X. (2013)) 24
Figure 3: System flow chart for online appointment registration. (Zhan, X. and Liu, X. (2013)) 24
Figure 4: HSC Medical Center Appointment System interface. (http://www.hsc.com.my) ........ 25
Figure 5: Takaful Appointment System. (https://www.takaful.com.my) ..................................... 26
Figure 6: Xpert Appointment System. (http://www.getacoder.com) ............................................ 27
Figure 7:Signing up process for simplybook.me (https://simplybook.me)................................... 27
Figure 8: System Configuration proposed by MD Zahidur Rahman. (Rahman, M. (2015)) ....... 30
Figure 9: Doctors’ Interface Output. (Rahman, M. (2015)) ......................................................... 30
Figure 10: Management Interface Output. (Rahman, M. (2015))................................................. 30
Figure 11: Simplybook.me interface for medical center. ............................................................. 31
Figure 12: Patient Interface. (Mypatientscheduler.com. (2016)) .................................................. 31
Figure 13:Front Desk Interface. (Mypatientscheduler.com. (2016)) ............................................ 32
Figure 14: Admin log in interface. (Mypatientscheduler.com. (2016)) ........................................ 32
Figure 15: NHIS Online Appointment System Architecture. (Idowu, A., Adeosun, O. and
Williams, K. (2014)) ..................................................................................................................... 32
Figure 16: User case diagram for the proposed NHIS system. (Idowu, A., Adeosun, O. and
Williams, K. (2014)) ..................................................................................................................... 33
Figure 17: Agile overall Process. (www.tutorialspoint.com, (2016))........................................... 35
Figure 18: Agile Manifesto Model. (AGILE MODELING AND PROTOTYPING. (n.d.)) ....... 36
Figure 19: Agile Basic Principles. (AGILE MODELING AND PROTOTYPING. (n.d.)) ......... 37
Figure 20: Scrum Methodology Overview. (COHEN, D., LINDVALL, M. and COSTA, P. (2004))
....................................................................................................................................................... 38

Figure 21: Scrum Methodology Simplified. (Sharma, S., Sarkar, D. and Gupta, D. (2012))....... 39
Figure 22: Sample of a Sprint Burn-down Chart. (Williams, L. (2007))...................................... 39
Figure 23: Brief picture of Scrum Process. (Williams, L. (2007)) ............................................... 40
Table 1: Scrum Implementation Table ......................................................................................... 41
Figure 23: Simple Patient Scheduling Architecture...................................................................... 44
Figure 24: 2-tier Online Patient Scheduling System Architecture. (S, N. and Sarda, E. (2014)) . 45
Figure 25: Previous Version of Use Case Diagram. ..................................................................... 46
Figure 26: New Version of Use Case. .......................................................................................... 47
Figure 27: Use Case Diagram for Patient. .................................................................................... 48
Figure 28: Use Case for Doctor/Staff and Admin Login. ............................................................ 49
Table: Use Case Specification for Login. ..................................................................................... 49
Table: Use Case Specification for Admin .................................................................................... 50
Table: Use Case Specification for Patient Register ...................................................................... 50
Table: Use Case Specification for Manage Appointment............................................................. 51
Table: Use Case Specification for System Log. ........................................................................... 51
Figure: Use Case Specification for Post Review. ......................................................................... 52
Figure 29: First Version of Class Diagram. .................................................................................. 52
Figure 30: New Version of Class Diagram. .................................................................................. 53
Figure 31: Showing Base Cases. ................................................................................................... 53
Figure 32: Activity Diagram for Online Patient Scheduling System. .......................................... 54
Figure 33: First Version of Sequence Diagram. ........................................................................... 55
Figure 34: Sequence Diagram for Login. ..................................................................................... 56
Figure 35: Sequence Diagram for New Account Register............................................................ 57
Figure 36: Sequence Diagram for Register New Staff. ................................................................ 57
Figure 37: Sequence Diagram for Patient Manage Appointment. ................................................ 58
Figure 38: Sequence Diagram for System logs............................................................................. 58
Figure 39: Previous Version of ERD Online Patient Scheduling. ................................................ 59
Figure 40: New Version of Entity Diagram. ................................................................................. 60
Table: Database table for Account ................................................................................................ 61
Table: Database table for Appointment ........................................................................................ 61
Table: Database table for Credit Card. ......................................................................................... 61

Table: Database table for Doctor .................................................................................................. 62

Table: Database table for Hospital. ............................................................................................... 62
Table: Database table for Specialty. ............................................................................................. 62
Table: Database table for Rating................................................................................................... 63
Table: Database table for Payment. .............................................................................................. 63
Table: Database table for Staff. .................................................................................................... 64
Table: Database table for System Email ....................................................................................... 64
Figure 41: Home Page Online Patient Scheduling ....................................................................... 64
Figure 42: Patient Login ............................................................................................................... 65
Figure 43: Department List ........................................................................................................... 65
Figure 44: Specialize Doctor Selected .......................................................................................... 66
Figure 45: Booking an appointment ............................................................................................. 66
Figure 46: Physician Login Interface ............................................................................................ 67
Figure 47: Physician Activity Interface ........................................................................................ 67
Figure 48: Admin/ Staff Login ..................................................................................................... 68
Figure 49: Staff Activity Interface. ............................................................................................... 68
Figure 50: Data Flow of Online Patient Scheduling. .................................................................... 70
Figure 51: Chrome Architecture. (Burstyn, J., Barleta, K., Berk, L., Cole, P. and Franzon, T.
(2009))........................................................................................................................................... 72
....................................................................................................................................................... 74
Figure 52: Question 1.................................................................................................................... 78
Figure 53: Question 2.................................................................................................................... 78
Figure 54: Question 3.................................................................................................................... 79
Figure 55: Question 4.................................................................................................................... 79
Figure 56: Question 5.................................................................................................................... 80
Figure 57: Question 6.................................................................................................................... 80
Figure 58: Question 7.................................................................................................................... 81
Figure 59: Question 8.................................................................................................................... 81
Figure 60: Question 9.................................................................................................................... 82
Figure 61: Question 10.................................................................................................................. 82
Figure 62: Question 11.................................................................................................................. 83

Figure 63: Question 12.................................................................................................................. 83

Figure 64: Question 13.................................................................................................................. 84
Figure 65: Question 14.................................................................................................................. 84
Figure 66: Question 15.................................................................................................................. 85
Table: Interviewee 1 Table. .......................................................................................................... 86
Table: Interviewee 2 Table ........................................................................................................... 88
Table: Interviewee 3 Table ........................................................................................................... 89
Figure 67: Screenshot for “Home” page. ...................................................................................... 92
Figure 68: Screenshot for “About” page. ...................................................................................... 92
Figure 69: Screenshot for “Events” page. ..................................................................................... 93
Figure 70: Screenshot for “Partners” page.................................................................................... 93
Figure 71: Screenshot for “Login” page. ...................................................................................... 94
Figure 72: Screenshot for “Register new account” page. ............................................................. 94
Figure 73: Screenshot for “My account” page. ............................................................................. 95
Figure 74: Screenshot for “New appointment” page. ................................................................... 96
....................................................................................................................................................... 96
Figure 75: Select Appointment Record to Update. ....................................................................... 96
Figure 76: Appointment Update Page........................................................................................... 97
Figure 77: Appointment Successfully Updated ............................................................................ 97
Figure 78: Screenshot for “Make payment” page. ........................................................................ 98
Figure 79: Screenshot for “My appointment” page. ..................................................................... 98
Figure 80: Screenshot for “Consultation rating” page. ................................................................. 99
Figure 81: Screenshot for “Doctor record” page. ......................................................................... 99
Figure 82: Screenshot for “Patient records” page. ...................................................................... 100
Figure 83: Screenshot for “System record” page. ....................................................................... 100
Figure 84: Screenshot for “Register new staff” page.................................................................. 101
Figure 85: Encryption for security code. .................................................................................... 101
Figure 86: Password strength checker. ....................................................................................... 102
Figure 87: Objects in the system. ................................................................................................ 103
Figure 88: Sample code for “Login” page. ................................................................................. 103
Figure 89: Register new account page. ....................................................................................... 104

Figure 90: Sample code for update account details. ................................................................... 105
Figure 91: Sample code for doctor record page. ......................................................................... 105
Figure 92: Sample code for new appointment past date validation. ........................................... 106
Figure 93: Sample code for appointment 7 days’ advance rule. ................................................. 106
Figure 94: Initial status of a new appointment............................................................................ 106
Figure 95: Sample code to validate credit card details. .............................................................. 107
Figure 96: Sample code to validate credit card. .......................................................................... 107
Figure 97: Sample code for update appointment status. ............................................................. 108
Figure 98: Sample notification email. ......................................................................................... 108
Figure 99: Sample code to send appointment confirmation email. ............................................ 109
Figure 100: Rating scale for consultation session....................................................................... 109
Figure 101: Sample code for rating point. .................................................................................. 109
Figure 102: Sample code to insert rating record. ........................................................................ 110
Figure 103: Sample code for encryption..................................................................................... 110
Figure 104: Sample code for decryption..................................................................................... 111
Figure 105: Sample code to implement password strength checker. .......................................... 111
Figure 106: Unit Testing Process of Registration Sprint of the Online Patient Scheduling. ...... 112
Table: Unit Testing for Login. .................................................................................................... 113
Table: Unit Testing for “Register”. ............................................................................................. 113
Table: Unit Testing for “Update Personal Information”............................................................. 114
Table: Unit Testing for “Make New Appointment”. .................................................................. 115
Table: Unit Test for “Update My Appointment”. ....................................................................... 115
Table: Unit Testing for “Make Appointment”. ........................................................................... 116
Table: Unit Testing for “Consultation Rating”. .......................................................................... 116
Table: Unit Testing for “Doctor Record”. .................................................................................. 116
Table: Unit Testing for Patient Record for Staff Only. .............................................................. 117
Table: Unit Testing for “Register New Staff”. ........................................................................... 117
Table: Integration for Register Account and Account Login. .................................................... 118
Table: Integration for New Appointment and My Appointment Page. ...................................... 119
Table: Integration for My Appointments and Make Payment. ................................................... 120
Table: System testing for all the functions. ................................................................................ 121

Table: User Acceptance Test for GUI. ....................................................................................... 122

Table: User Acceptance Test for Human Computer Interaction. ............................................... 122
Table: User Acceptance Testing for overall System................................................................... 123

Chapter 1: Introduction to the Study

1.1 Background to the Project
Information System has become an important aspect for any developing business in recent years.
As the growing business needs to have accurate information and necessary technology for solving
problems and to catch up with ever growing customer needs, Information System Technology has
been a key force for organizations to determine their business criteria. Businesses today use
information system and use the available technologies because they understand the importance of
maintaining and updating data electronically (Davis and Yen, 1998)
Using Information System for managing information in the health care such as patient record,
patient appointment system, patients scheduling appointment and doctor schedule is not only a
simpler way to save time and reduce cost, but also a way to support and improve the health care
information to be more accessible and flexible (modifying, saving, deleting, updating) for system
users and storing data efficiently. In addition, it improves the quality of data control (Liu and Zhu,
2007).
Enhancing patient care management is one of the major aims of healthcare industry today to
improve the healthcare system worldwide. This goal is to be equally if not more important as the
other keys of improving the health of the population and managing per capita cost of care.
(Berwick et al, 2008) As the population continues to grow, so too does the need for healthcare
services and options. (The Benefits Of Online Appointment Scheduling. 1st ed) Health Care
Service providers globally are experiencing an increase in pressure to concurrently reduce cost and
improve accessibility and quality of care they deliver especially resolving long waiting times,
delays and queue of patients. (Mardiah, F. and Basri, M. (2013)) Thus a Patient Scheduling
System is launched as an important component of scheduling and managing appointments.
Especially online scheduling software has simplified and automated the process of hospital
management for all size of organizations.

This project aims to introduce a Patient Scheduling Online Service for health care institutions
that would ease off the appointment-scheduling journey for users and pave the path of a better
doctor-patient experience. The proposed system advances with online facilities that eliminate the
chaos of traditional appointment services. This system offers online appointment booking, to view
doctors list, to cancel and update appointments with an administrative portal to manage all the
sections. It provides advanced functionality to streamline the process thus easy access to personal
hospital services that help organizations to stay connected with their customers, clients and most
importantly patients and can result in significant time and monetary savings In to order to develop
a successfully running online Patient Scheduling, the system is required to interact with system
database, scheduling module and the administrative module for example, to achieve the best
implementation, the scheduling system would be able to interact with several medical health care
staff such as physicians, nurses admin staff and patients.
1.2 Problem Context

Online Patient Scheduling also commonly known as Online Appointment booking system an
optimized phase of medial healthcare service to improve patient healthcare journey in hospitals
and clinics. Motivated by the rising popularity of electronic appointment booking system, this
project aims to develop an appointment-scheduling model that takes into account the patient
preferences regarding when they would like to be seen. Currently, it is rational to establish the fact
that, very few hospitals provide online scheduling doctor-patient session. In fact, majority of the
medical centers in Kuala Lumpur provide traditional patient scheduling routines. In traditional
appointment scheduling process, patients are scheduled for a future appointment time and the
number of patient granted an appointment has an upper limit each time period. The appointment
lead-time could be very long for example, several weeks or a month in advance, which could result
in a high number of no-show. [Dai, X. (2013). Online Clinic Appointment Scheduling. 1st ed.]
According to a case study by the Commonwealth Fund Commission on a High Performance Health
System, six attributes were identified for an ideal health care delivery system. The report
determined and examined the problems engendered by fragmentation in the health care system and
offered policies to stimulate greater organization for high performance. (Mccarthy, D., Mueller,
K. and Wrenn, J. (2009))

The Six Attributes of an Ideal Heath Care Delivery System are discrete guidelines for a better
health care organizational structure and customer satisfactory. The Six Attributes are:
 Information Continuity: Patients’ clinically relevant information is accessible to the
health care providers at the point of care and to patients through the Online Website.
 Care Coordination and Transition: Patient care is coordinated among different
departments and transitions across care setting are actively managed.
 System Accountability: The clear accountability for the Patient Scheduling System is
defined with care coordination.
 Peer Review and Teamwork for High-Value Care: Physicians, nurses and other
members of the health care team among departments have accountability to each other to
reliably deliver high quality care.
 Continuous Innovation: The Appointment Scheduling system is continuously innovating
in order to improve the quality of patient experiences of health care delivery.
 Easy Access to Appropriate Care: The Patient Scheduling System allows patients to have
easy access to appropriate care and information at all information. (Mccarthy, D., Mueller,
K. and Wrenn, J. (2009))
In many ‘Open Access Appointment Scheduling’, the number of patients request is selected in
random. A patient is assigned to a time bucket within a relatively short time period such as one or
two day in advance from the time requested. Though the theory behind this process is to reduce
no-show probability, patient inconvenience and waiting time, communication error still holds back
the facility. In classical systems, patients are to go to the hospital and wait in the queue to make a
reservation and get an appointment. [Sherly, I. (2016). Online Appointment Reservation and
Scheduling for Healthcare- A Detailed Study. 2nd ed.] This process is time-consuming where
generally patients end up waiting for very long time intervals. Even though the patient might
choose to fix an appointment, this option is infeasible at all times and does not likely work well
for general public involved in the system. Online scheduling facilitates patients with quick
response service and convenient and accessible time.

1.3 Rationale
When on Online Patient Scheduling System is replaced with traditional appointment reservation
service, patients are the prime benefit holders. Hospitals and medical centers would definitely have
a better appointment management process as well as sophisticated control over doctors’ schedule
and employee productivity. The advantages will be time saving for both patients and doctors and
much convenient for the administrative staffs to manage all the appointments and paper work.
Online appointment scheduling would reduce the workload of the administrative staff and provide
much better customer satisfaction.
1.4 Potential Benefits

Online Patient Scheduling has its tangible and intangible benefits to both users who would book
appointments and the hospital management including doctors and staffs.
1.4.1 Tangible benefits
 Flexibility: Online scheduling features advanced functionalities that are automated and
improve the appointment reservation process and provide customers a simple healthcare
flow. For example, time-saving.
 Security: Maintains patient confidentiality and provide information protection. For
example, protected health information are not shared or discussed within even hearing
distance of other patients.
 Connectivity: Keeps organizations better connected with their customers and patients. By
staying connected with their customers, institutions get a better view of their management
process. For examples, reviewing and rating doctor-patient experience flow that helps the
hospital management to overview doctors’ average performance.
 Monetary Savings: Automated scheduling benefits large-scale medical centers monetary
savings. It lifts the burden of assigning staff members to manage scheduling appointments
and reduce employee pay in the form of over-time or hiring new staff.
 Accessibility: Online scheduling software is accessible for all type of users. All that’s
required is an Internet connection and users can access a vast range of facilities.

1.4.2 Intangible benefits

 Patients are able to schedule for various medical procedures and treatments.
 Daily, weekly and monthly patient scheduled are easily viewed.
 Patient records and Appointments reports are created.
 Helps to track Patient Flow based on arrival, visit and departure time.
 No-show, missing, over-booking patients and other conflicts can be avoided.
 All appointments are assembled from the website.
1.5 Target Users

The targeted users range from the population having internet access and are familiar with various
online services available. This group of targeted users are eager to ease out their daily life through
online facilities provided by various online organizations.
The developer has targeted 4 types of users:
 General Users who are seeking online service to avoid the chaos of traditional appointment
booking system.
 Physicians working with large scale medical organizations who attend a large number of
patient every day.
 Physicians running independent small scale clinic in suburban areas.
 Large scale healthcare institutions who are looking for simple cost-effective appointment
scheduling.
1.6 Scope and Objectives

Patient growth certainly is beneficial for healthcare business but it also creates challenges for
facility admins and staff. Procedures that were previously adequate may no longer be effective in
handling a rise in new patients. (The Benefits Of Online Appointment Scheduling. 1st ed.) The
appointment process especially in large organizations is challenging. It is often burdensome task
that requires significant time and staff resources to manage. The proposed patient scheduling
system replaces traditional booking chaos with online facility in addition with automated e-mail
and text message reminders. Patient scheduling system allows the users the power to book their
own appointments with respective doctors online that benefits organizations to manage a

tremendous amount of time that would otherwise have been spent answering phone, responding to
e-mails and voice messages. This online platform improves flexibility of healthcare service with
customized reporting and security features.
1.6.1 Aims
The aim of patient scheduling service is to provide patients full access to manage their hospital
appointments which, facilitates with an online service for appointment reservation, updating and
canceling management minimizing customer inconvenience and assuring a better healthcare.
1.6.2 Objectives
 To develop a system that allows users to have control over their appointment making
service.
 To facilitate the patients with real time healthcare scheduling.
 To manage staff resources needed for managing appointments.
 To maximize operation hours.
 To make the use of online platform for less customer inconvenience and high productivity
among staff.
 To optimize time savings and monetary savings as both staff time and services translate
into expenses and revenue.
1.7 Deliverables –Functionality of the proposed system

The intelligent Online Patient Scheduling System aids simple and easy appointment reservation
online as long as the specific device is connected to the Internet. This service will minimize patient
waiting time as well as the chaos of managing tons of appointments everyday by hospital
management. Once a patient has booked a schedule, he or she would also be allowed to make
changes, even cancel their appointment according to their convenience. The website should view
list of doctors with their respective specializations where users are able to select their certain
physician. The system also consists of an administrative panel where the system admin is able to
monitor the number of patient attended by the doctors daily, weekly and monthly. The core
functions of the system are listed below:
 Allows end-users to register, login and logout from the system.

 Allows users to view doctors list according to departments as well as doctors’

specifications.
 Allows users to book update and cancel their appointments.
 Allow the doctors to view the number of patients to be attended for the day.
 Allows respective management staff to be updated about the day’s activities.
 Allow patients to review and rate their experience with the respective doctors.
 Once an appointment is booked, the system notifies the users by email one day prior to the
appointment.
 Patient will be able to make Online Payment for their appointment. (Stimulation Only)
1.8 Nature of Challenges

To initiate the first phase of this project, I need to master web-developing concepts and user
browsing experience. Different screen-resolutions for different types of devices are to be
understood. As for selecting the programming language, I need to make a choice between using
java or ASP.net since I do not have brief knowledge about ASP.net. While developing the web-
application, security of the website would definitely be considered since I would like to add Online
payment transaction as an extra feature. Not only that other security measures such as prevention
from SQL Injection, Encryption of patient information are to be taken under consideration.
1.9 Overview of this report and Project Plan

The proposed system aims to deliver an online patient scheduling facility for clinics and hospital
management. This case study provides a brief research on various factors and hypothesis of Online
Patient Scheduling. Chapter 2 would thoroughly evaluate literature review of the case, Chapter 3
would draw a guideline on the Agile Methodology and how the Agile approach has guided the
developer during the development of the system. Chapter 5 is designed with primary research tools
such as Questionnaires and Interviews. Chapter 6 would describe the system implementation and
system screenshots. In Chapter 7, integration testing, unit testing plan and user acceptance testing
is formatted according to the Agile approach. At last, the documentation ends with conclusion and
personal reflection of the developer in Chapter 8.

Chapter 2: Literature Review

2.1 Introduction
Appointment scheduling has become a complex task especially for healthcare professionals in
hospitals and clinics. Few reasons that could cause these complications range from a heavy flow
of patient traffic to a physician that practices in a number of clinic and moves from one medical
facility to others. An ineffective appointment management could also cause overlapping
appointments, rise in number of no-shows, patient dissatisfaction in general and revenue loss for
healthcare institutions.
In recent days, many medical institutions use a combination of phone-based scheduling and
computerized appointment scheduling. Even though this combo along with out-sourcing services
make a better efficient system, few gaps for technical and human error still remains.
This online facility is an effective add-on to any hospital or clinic’s website. It lightens the hard
work associated with managing a medical facility. More time on hand to commit to patient care,
better patient compliance and fiscal viability are other rewards. (NIMS Institute of Management
& Computer Sciences, (n.d))
The key mission of an efficient online patient scheduling is to reflect patient satisfaction and
revenue gains. An active appointment scheduling a bridge that connects efficient healthcare
services and timely access to the services. The proposed Patient Scheduling system aims to even
out workflow and reduce the thronging of people in waiting rooms.
Any medical center that handles patients’ scores and healthcare responsibilities are at risk of
wasting too much time and money on patient scheduling. Especially small size clinic where
physicians manage their own medical office, it is not worthwhile to continue with primitive paper
based scheduling system. Since appointment books are limiting and time consuming, the more
cancellations and scribbles the more this process confuse and frustrate the staff who are managing
these. In comparison to paper-based appointment scheduling, web-based patient scheduling is
faster that allows multiple user access at any given time. Web-based appointment scheduling
enables to generate appointment reports and email appointment reminders and minimizes no-
shows.

2.2. Domain Research:

Outpatient Management:
The combination of time, technology and the rapid increase in population has been the drive force
to introduce an online patient scheduling. Outpatient management is one key factor that has been
influential for developing an online appointment system. Outpatient services have become an
essential component of healthcare industry. The objective of outpatient scheduling is to provide
an appointment system service that measures optimized performances in a clinical environment.
 Waiting Time:
Long waiting times are an alarming problem for patients using urban health centers in developing
countries. According to a case study conducted for NHIS Outpatient in Nigerian teaching hospitals,
a bock appointment system was introduced and evaluated in a large South African health center.
Waiting times of patients were measured over one-week period during the research before and
after the implementation of appointments. Groups and individual interviews were conducted with
management staff and patients. After launching the appointments system, patients with acute and
chronic illnesses and having appointments had significantly shorter waiting time than similar
patients without appointments. (Idowu, A., Adeosun, O. and Williams, K. (2014))
Research carried out based on patient health care service requirements appointment could be
divided into three major sections such as Primary Care Clinic, Specialty Clinic and Surgery
Appointment Scheduling. (Gupta & Denton, 2008)
 Primary Care Clinic Appointment:
This section falls under the initial care fields that are provided by a single physician or a group of
physicians running a medical facility. One prime example under this section is small size clinics.
For wider scale clinics running by multiple physicians and multiple departments, patients prefer
time slots and physicians’ availability. Efficiency in clinic and patient satisfaction could be
improved by assigning a patient to a preferred time slot and a physician who is familiar with the
patient’s medical issues. The number and length of available appointment time slots are settled
based on the type of service request, medical urgency and provider’ panel.
 Specialty Care Clinic Appointment:
This section focuses on diagnoses, treatment and recovery for certain specialties such as
neurosurgery, cardiology, and Endocrinology etc. particular related tests could be provided to

complete the diagnoses. Sometimes specialists require a referral from a primary care physician for
patients’ first appointment. The length of available appointment time slots are fixed for these
services and the availability for examination facilities such as X-rays, Scans are taken into
consideration.
Considerations of Patient Scheduling:
The major aim of patient scheduling is to provide an optimal policy and to gain a positive balance
between patients’ satisfaction and the performance of medical institutions. Generally certain
factors influence on the performance of an appointment such as urgency of patients, punctuality,
no-shows and cancellations and service processes. These criteria are taken a base line while
developing a well-designed web-based appointment system. (Cayirli & Veral, 2003).
 Unpunctuality:
Difference between patient arrival time and actual appointment time lead to a dysfunctional clinic
management. Nuffield Trust studies (1955) implied that more than half of 8 the patients arrive
early, which could cause the congestion of the patient’s waiting room and increase patients’
waiting time. Wijewickrama & Takakuwa (2008) discussed how the impact of no-shows on
patients’ waiting time is higher than that of punctuality. Moreover, some studies also show, the
impact of physicians’ unpunctuality where the physician caused delay for the appointment. Vissers
(1979) pointed out patients’ waiting time and physicians’ idle time were affected by the
unpunctuality of both patients and physicians.
 No-show and Late Cancellations:
This section prioritized who are late and miss their appointments. This results in no-show problems
that increase under-utilization of clinic capacity. Generally, 5-30% is used as a no-show probability
in past studies (Ho and Lau, 1992 & 1999; Klassen and Rohleder, 1996; Yang, Lau and Quek,
1998; Cayirli, Veral, and Rosen, 2006 & 2008; Kaandorp and Koole, 2007). Certain papers
analyzed real data from clinics and pointed out that patients with relatively high no-show
probability are younger, male, unmarried, uninsured, with psychosocial problems, of lower
socioeconomic status, divorced or widowed and have a history of missed appointments (Neal,
Hussain-Gambles, Allgar, Lawlor, and Dempsey, 2005). Daggy et al. (2010) pointed out
transportation and appointment lead time affected the no-show probability as well.
Some papers implied that long appointment lead times increase the no-show rate. Dove and
Schneider (1981), Lee et al. (2005) and Gallucci et al. (2005) reported that no-shows were the most

influential factor on performance of Appointment Scheduling among three environmental factors

reviewed (Ho and Lau, 1992). To reduce no-show probability, changing patient behavior or
applying overbooking and short lead-time scheduling are suggested. (Daggy, etal. 2010)
 Patient Preference:
Few case studies states that accommodation of patients’ preferences could help to ensure the
quality of services provided by primary clinic physicians and increase clinics’ revenues. (O’hare
and Corelett, 2004) No-show rates could also be reduced if patients’ preferences are matched.
 Arrival Characteristics:
Size of arrival units are important for clinic-patient management success. A single arrival is taken
as only one unit, the smallest number handled that arrive at the system and wait for services. This
is typically a single patient.
A group arrival is said to be several unit entering the system at the same time. In such scenario,
the time between successive arrivals of the groups could be probabilistic as well as the number of
patients in the group. (Dai, X. (2013))
 Service Characteristics:
Number of Services:
There are two types of queuing process for the number of service provided by any medical center.
Single stage queuing means when only one type of service is requested at the patient arrival. Multi
stage queuing refers to a series of branched services that are requested in the whole service process.
Number of Physicians:
According to queuing theories, queuing system are two kinds: single server and multiple server
systems. In a doctor-patient scenario, physicians are servers. In primary multi-physician clinics,
doctors have their own panels as a result, patients are able make appointments to different
physicians based on their different specializations. In such cases, appointment systems are multi-
server systems. When studying the performance of an appointment system, multi-server systems
are taken into consideration in some papers such as Wijewickrama & Takakuwa, (2008) and Chao
et.al (2003).
Service Time:
Service times could be random or constant. Majority of the time, it could be assumed that the
service time of routine appointment at primary care clinics is constant.
Queue Discipline:

This process determines the priority order for patients to be scheduled for an appointment.
According to general queuing theory, queue discipline is divided into four main classes, first come,
first serve, last come first served, service in random order, and priority ranking. In the appointment
scheduling problem, it is assumed that patients are served FCFS in most of papers. In the real
world, some clinics apply a priority ranking discipline when they scheduling appointments. For
example, clinics give the first priority to emergent patients and second priority to readmission
patients. Walk-in patients are usually given to the lowest priority. (Dai, X. (2013))
Measurements of an Appointment System Performance:
A case study provided by Cayirli and Veral (2003), patient scheduling’s performance are measured
according to patients’ waiting time, providers’ overtime and idle-time and cost of the management.
 Cost-Based:
There are three factors that are to be considered: cost of patients’ waiting time. Physicians’ idle
time and overtime. In most of cases, costs of patients’ waiting time and physicians’ idle time are
the main considerations, such as in Vanden Bosch, Dietz and Simeoni (1999), Lau and Lau (2000),
Robinson and Chen (2003). Few of studies focus on minimizing appointment cost based on these
three factors.
 Time-Based:
The three factors mentioned above are measured in terms of mean, maximum, variance and
frequency distribution. Patients’ waiting is the difference between the scheduled appointment time
and patients’ actual service time and waiting time due to early arrival is not counted. Doctors’ idle
time defines the waiting time caused by no patients waiting to be seen. Overtime is the difference
between actual and planned finish time of consults. O’Keefe (1985), Walter (1973), Vissers and
Wijingaard (1979) have submitted papers on appointment system problem with time-based
measurements.
 Fairness:
Fairness is measures by the uniformity of performance of a patient scheduling system. By
evaluating the mean waiting time of patient according to their place in the queue (Bailey, 1952),
variance of waiting time and queue size (Blanco Whit and Pike, 1964, Fetter and Thompson, 1966,
Yang, Lau and Quek, 1998), any patient scheduling system’s fairness is determined.
 Developing Algorithm:

After a gathering a brief understanding on the issues and factors mentioned above, the final phase
is to develop an algorithm for the proposed patient scheduling system.
Robinson and Chen (2003) tried to balance waiting time and idle time using Monte Carlo
integration, solved the problem approximately as a stochastic linear program and developed a
theoretic closed-form heuristic policy. Mancilla and Storer (2012) developed a stochastic
scheduling problem considering waiting and idle time and overtime cost for operation room and
surgery scheduling. A multi-stage stochastic integer program using sample average approximation
was applied to solve this problem.
2.3 Technical Research:

During this stage of research, more technical information and requirements are gathered about the
proposed system.
System Requirement Analysis:
For any software development, the initial phase is to conduct a demand analysis. Demand analysis
is the process of discovery, refinement, modeling, specification and review. The process is directly
related to the quality of the software and subsequently studies significant impacts on the design
and implementation. For this analysis, functional requirements and technical requirements are
analyzed.
Another way of gathering system requirements is to analyze the Demand versus Capacity study.
This study helps to understand whether the right number of appointments are offered, the suitable
mix between same-day and pre-bookable and to check whether these components are spread
correctly across the week. (Improving access, responding to patients. (2016))
Functional Requirements:
Based on the research conducted for the proposed system, there are two sets of functions for an
online appointment system. The first set of functions is online registration including sign up and
log in, selection of department, date, physician and other online booking registration functions.

Figure 1: System flow chart for online appointment registration. (Zhan, X. and Liu, X. (2013))
The next set of functions is data management that allows the database administrator to add, delete,
modify and back up the data. Data addition, deletion and modification are the basic functions that
are to be effectively maintained the consistency of the database to meet actual requirements. Data
restore and back up are the system’s security enhancer.
Figure 2: System flow chart for online appointment registration. (Zhan, X. and Liu, X. (2013))
Technical Requirement Analysis:

In software development, system architecture is built according to the functions of the system. The
system architecture determines system development model development environment and tools.
Taking into account the system security and simplicity, Windows 10 would be used as operating
system, Visual Studio 2015 as developing environment, C#.Net as developing platform. As the
back-end database, Microsoft SQL Server will be used.
2.3.1 Similar Systems:
HSC Medical Center Appointment System:
Nowadays the need to queue up for a long time to consult a medical officer has minimized by
technological facilities available over the Internet. One such organization that has adapted the
recent technological era is HSC Medical Center. The appointment system used by HSC Medical

Center does not require any ID and password to log-in before making any appointment and the
appointment is valid within 24 hours only. The users are required to complete a form and click the
submit button to finalize the appointment.
Figure 3: HSC Medical Center Appointment System interface. (http://www.hsc.com.my)
Takaful Appointment System

Takaful Insurance provides an Online Appointment System. It was developed to decrease the
higher cost by using phone and impractical. In this system, the user is able to enter the time of the
appointment at any-time. There is no ID and password required for this system, the user only has
to provide his/her details and submit the form. (Abd Wahab, M., Hassan, N., Wali Mohd, Z. and
Hanaf, H. (2009))

Figure 4: Takaful Appointment System. (https://www.takaful.com.my)
Xpert Fitness Center Appointment System

Xpert Fitness Center has a similar appointment scheduling system to make an appointment with
the trainers. This system offers an interactive environment especially during the time and date
selection for each session in a week. This weekly schedule would respond depending on the
calendar selected by the user. Clients would have to log in before allowing to use the system, so
the ID and password is required.

Figure 5: Xpert Appointment System. (http://www.getacoder.com)
Online Appointment for Medical Services by MD Zahidur Rahman

This is a proposed researched system by MD Zahidur Rahman. The proposed system is designed
to save effort, time and money of patients from waiting to make appointments as well as to reduce
the work of the doctor and the hospitals and clinics to manage appointments easily.
Simplybook.me
This is an online booking system for various service providers such as medical services, hair and
beauty salons, repair services, event planners, rental agencies, government agencies, educational
services and many more.
The system does require users to sign up to enjoy a vast range of services that they provide.
Figure 6:Signing up process for simplybook.me (https://simplybook.me)

For medical facilities, the system specifically asks users such as physicians to provide detailed
information about available time slots and consultations. This system also allows users to group
related services under categories such as diagnostic, therapy, prophylaxis etc. (Mike Benkovich,
C. (2016))
MyPatientScheduler:
This is also an online appointment scheduling, appointment confirmation, reminder and automated
recall system.
This system offers flexible appointment templates, procedures that are code driven and powerful
patient control. The system is designed to increase appointment confirmation rates while
decreasing labor costs with their automated appointment confirmation tools such as email, phone
call and SMS. The proposed facility also offers flexible recall system with fully customizable
automated reminders to patient when it is time for their appointment. (Mypatientscheduler.com.
(2016))
DEPENDABLE ONLINE APPOINTMENT BOOKING SYSTEM FOR NHIS

OUTPATIENT IN NIGERIAN TEACHING HOSPITALS
This research based system is consist of Patient registration menu, patient activity menu, weekly
calendar, patient appointment menu, patient report menu and administration login menu. The
system offers a user-friendly interface for capturing valid registration code, username and
password. In each patient account, data pertain to the patient and available doctor are entered and
appointment booked are submitted. All this captured information is stored in the database.
2.3.2 Architecture of Similar Systems
HSC Medical Center Appointment System:
This is web-based appointment automation system that does not require ID and password prior to
making appointments.
 Owner Side’s Server:
Appointment automation system server is developed to operate the system. The server is running
the system.
 Web-server:
The web-server is to deliver contents such as web pages, using HTTP over the WWW

 Desktop Computer:
This tool is for user interact the appointment automation system GUI or interface. Users done all
the process of appointment automation system with communicate and interact with GUI or
interface provided by the system.
 Client-Side Web Browser:
Client side requires a desktop with web browser to access the appointment automation system
GUI.
 Internet Access:
Client side is required to have internet access to connect with web server and application of
appointment automation system. Internet is a bridge to connect the client and the appointment
automation system. (EssayMonster.net - essays, research papers, dissertations & etc. (2016))
Online Appointment for Medical Services by MD Zahidur Rahman
This system contains three modules:
 Patient: Can easily view the schedule to make any appointment.
 Doctor: Are able to view number of patients to be attended. To view patient details, to
update doctor specification details, to view appointment records, to update appointment
record. Example: status of appointment from “New” to “Completed”.
 Management: To register new user in the system: Doctor, Nurse & staff. Update system
control records (Example: Email address of the system to send automatic Emails).
System Implementation:
Web Forms Application is developed using HTML, CSS, JavaScript, jQuery. PHP is chosen as a
programming language and MySQL for the database management.

Figure 7: System Configuration proposed by MD Zahidur Rahman. (Rahman, M. (2015))
Figure 8: Doctors’ Interface Output. (Rahman, M. (2015))
Figure 9: Management Interface Output. (Rahman, M. (2015))

Simplybook.me Interface:
Figure 10: Simplybook.me interface for medical center.
MyPatientSchedule Interface:
This system offers three interfaces for patients, reception and management interface.
Figure 11: Patient Interface. (Mypatientscheduler.com. (2016))

Figure 12:Front Desk Interface. (Mypatientscheduler.com. (2016))
Figure 13: Admin log in interface. (Mypatientscheduler.com. (2016))
DEPENDABLE ONLINE APPOINTMENT BOOKING SYSTEM FOR NHIS

OUTPATIENT IN NIGERIAN TEACHING HOSPITALS
Figure 14: NHIS Online Appointment System Architecture. (Idowu, A., Adeosun, O. and Williams, K. (2014))
MySQL is deployed as the database for this system. MySQL in wampserver is used to create and
populate the database. The system is implemented using dream weaver and PHP. Apache is used
as the server to provide basic functionality of the web GIS. PHP is used as a scripting language to
program the server side to manipulate knowledge in the database.

Figure 15: User case diagram for the proposed NHIS system. (Idowu, A., Adeosun, O. and Williams, K. (2014))
2.4 Conclusion
The adaptability of an online patient scheduling structure enhances services provided by medical
institutions. This is a great way of assembling all the appointments from website. It delivers
flexibility and simplicity to patients, that’s the reason online appointment systems are becoming
popular these days. During the research process, various articles and similar systems have been
analyzed. Based on the content found during the research, a new Online Patient Scheduling System
has been proposed in the following chapters.

Chapter 3: Development Methodology

3.1 Identification of Chosen Methodology: Agile
During a system development lifecycle, there are two main factors that are considered: to
emphasize on process and the quality of the software and process itself. (Sharma, S., Sarkar, D.
and Gupta, D. (2012)) Since software development is a complex filed that contains countless
variables impacting the system, any develop would always seek for an organized structure that
could be used as a base for developing a system. All software systems are imperfect because they
cannot be built with mathematical or physical certainty. Thus, system development methods are
introduced in order provide developer a base line of processes and sequences to follow while
building a system.
Different software developing methods have different characteristics of processes to reach
completion of a system. Based on the research carried out and analysis of system requirements for
the proposed Online Patient Scheduling System Agile Method is selected by the developer. In
general terms, Agile process is an iterative approach that prioritizes customer satisfaction and
customers have direct involvement evaluating the software. Agile method follows the Software
Development Lifecycle that includes requirement gathering, analysis, design, coding and testing.
As a result, the approach delivers a partially implemented software and waits for customer
feedback.
3.2 Justification to Agile Approach

Agile Method is programming centric. While other methodologies are mainly based on the premise
that software development processes are to be repeatable thus predictable, Agile framework
emphasizes on unit-by-unit development.
The aim of Agile Method is to allow organizations to be agile in terms of delivering the product
quickly. Agile approach is a combination of group of methods. While Agile techniques vary in
emphasis and practices, they have common characteristics including iterative development and
focus on interaction, communication and the resource-intensive intermediate artifacts. (COHEN,
D., LINDVALL, M. and COSTA, P. (2004))

One of the key reasons why the developer chose Agile Methods for the proposed system is that
Agile approach is able to identify and respond to changes more quickly than using project using a
traditional approach.
Figure 16: Agile overall Process. (www.tutorialspoint.com, (2016))
While selecting a development methodology for the system, Agile method was the developer’s
first choice because Agile process requires less planning and it divides tasks into small increments.
Following this approach while developing the Online Patient Scheduling system would allow the
developer to make necessary changes according to user satisfaction.
3.3 Description of the System Development Methodology:

Agile development methods break a problem into smaller tasks. The processes do not require direct
ling-term planning for any requirements. Agile method provides modularity to the system. It
decomposes the complete system into manageable pieces called modules. Modularity is an
important role in software development. Following Agile process would allow the developer to
plan iterations that are of short period of time such as one to four weeks. Since the project is an
individual final year project, the developer herself would conduct each iteration that works in all
functions of software development such as planning, requirement analysis, design, coding, unit
testing and acceptance testing. As agile method is iterative in nature, it requires time limits on each
module with respective cycle, thus providing the developer with sufficient time window to work
on each module. The process produces increments and each increment in independent of others
that would allow the developer to integrate all the increments into complete system. Agile
approach is adaptive. The adaptive nature of the method would allow the developer to design the
system in an order that would adapt possible risks on its way to development.

3.3.1 Agile Manifesto

Agile methods stress productivity and values over heavy-weight process overhead and artifacts.
(Szalvay, V. (2004))
Agile Manifesto is a combination of agile software development methodologies. In 2001, founders
of many agile system development methods gathered with others who were also implementing
various agile methods in the same field and created ‘Agile Manifesto’.
Figure 17: Agile Manifesto Model. (AGILE MODELING AND PROTOTYPING. (n.d.))
The Agile Manifesto addresses features such as, individuals and interactions over processes and
tools, working software over comprehensive documentation, customer collaboration over contract
negotiation and responding to change over following a plan.
The Manifesto stands on twelve basic principles that states:
 Customer Satisfaction:
Maximum priority is given to satisfy the users’ requirements through early and continuous delivery
of valuable software.
 Welcoming Changes:
Changes are inevitable during any system development. Ever-changing requirements are to be
welcome, even late in the development stage. Agile processes work to increase users’ competitive
advantage.
 Delivering a working software:
Delivering a working software frequently, ranging from a few weeks to a few months, considering
shorter time-scale.
 Collaboration:

Agile methods signify collaboration between the user and the developer to work together during
the entire project life cycle.
 Motivation:
Projects are built around motivated individuals. The methodology provides an environment to
support the developer in decision making.
 Face-to-face Conversation:
Face-to-face conversation is the most efficient and effective method of conveying information to
and within the development phase.
 Measure the Progress as per the Working Software:
Working software are primary measures of progress during a system development.
 Maintaining Constant Pace:
Agile processes aim towards sustainable development. The developers, and the users are able to
maintain a constant pace with the project.
Figure 18: Agile Basic Principles. (AGILE MODELING AND PROTOTYPING. (n.d.))
 Monitoring:
Paying regular attention to technical excellence and significant design to enhance agility.
 Simplicity:
Agile methods make the system development simple and easily understandable for users.
 Self-organized Teams:
As an independent developer for the Online Patient Scheduling System, by following the Agile
approach, the developer is able to self-organize the tasks during the system development and
implementation.

 Review the Work Regularly:

Reviewing the work done at regular intervals in order to produce a more effective system and
adjust its behavior accordingly.
3.4 Agile Methodologies

There are several methodologies that could be implemented during the Online Patient Scheduling
System. Agile Methods are focused on different aspects of the software development life cycle.
Though few of the Agile methods are practice centric such as Extreme Programming, Pair
Programming, others focus on software projects such as the Scrum Approach.
3.4.1 Scrum Approach for Online Patient Scheduling
Among several methods available in Agile Methodology, the developer has chosen the Scrum
Approach to develop the proposed system. Scrum is one of the most widely used Agile Methods.
Ken Schwaber first described Scrum in 1996 as a process that “accepts that the development
process is unpredictable,” formalizing the “do what it takes” mentality, and has found success with
numerous independent software vendors. In the Scrum process, a project management is wrapped
around a software development methodology. This methodology is flexible and based on
incremental software development processes. In Scrum Approach, the entire development cycle is
divided into a series of iteration where each iteration is named as a sprint. There are three main
artifacts produced by Scrum method, Product Backlog, Sprint Backlog and Sprint Burn-down
chart.
Figure 19: Scrum Methodology Overview. (COHEN, D., LINDVALL, M. and COSTA, P. (2004))
Product Backlog:
It is an evolving, prioritized queue of business and technical functionalities that need to be
developed into the system and defects that need to be fixed during the release.

The Product Backlog contains a unique identifier for each requirement such as categories, feature,
enhancement, defect, status and the estimate for the features. It is kept in a spreadsheet-like format.
Sprint Backlog:
This is a list of all technical and business features, weaknesses and enhancements that have been
scheduled for an on-going iteration. These lists are known as Sprints. Maximum duration of a
sprint is 30 days. Once these requirements are listed, they are broken down into tasks. For each of
these tasks in the backlog, the formatted spreadsheet contains a short task description, the origin
of the task and who owns the task, the status and the number of hours remaining to complete the
task. The Sprint Backlog is updated each day by the developer to determine the latest estimates of
the work remaining to complete the task.
Figure 20: Scrum Methodology Simplified. (Sharma, S., Sarkar, D. and Gupta, D. (2012))
Sprint Burn-down Chart:

A graphical presentation of the hours remaining to complete Sprint tasks. This is a useful
demonstration that determines exact calculations of timeline of a sprint.
Figure 21: Sample of a Sprint Burn-down Chart. (Williams, L. (2007))
Overview of the Scrum Process:

The Scrum Process is composed of three phases:

Pre-Sprint Planning:
Works that are to be done on the system are kept in ‘release backlog’. During this phase
functionalities and features are selected from the release backlog and moved to sprint backlog. For
the proposed system, user requirements and functions of the system are gathered in the release
blog. Then one by one, the functionalities such as user log in, physicians’ list, available time slots,
appointment booking, and updating, sending notifications are moved to the sprint backlog.
The tasks in the backlog are generally at a higher level of abstraction, thus pre-sprint planning is
able to identify a sprint goal that determines the core and reason of the task.
Coding:
During the Sprint-backlog phase, code is integrated for each sprint such as home page log in for
users, management portal and physicians’ portal. Next the acceptability of each of these functions
is tested daily by the developer.
Figure 22: Brief picture of Scrum Process. (Williams, L. (2007))
Post Sprint Review:

After every sprint, a post-sprint analysis would be carried out by the developer to test project
progress and demonstrate the functions, design, strength, weaknesses and trouble spots of the
proposed system.
3.5 Scrum Implementation:

Product Backlog Sprint Backlog Sprint

1.Log-in Admin User log in

2. System Change Admin User Functions
Control (For Example: 1. Admin
Adding new user to the
system, updating the
system)
3. Log-in, Register Patient User Log in
4. Department List
5. Physician List
6. Available Slots Patient User functions 2. Patient
7. Book
Appointment
8. Make Deposit
9. Update/ Cancel
10. Log-in Doctor User Log in
11. Update Doctor
Specification
12. View Patient Doctor User Functions 3. Doctor
Detail
13. View
Appointment
Record
14. Log in Nurse, Staff User Log in
15. View and Update
Patient Detail
16. View and Update Management Staff User 4. Staff
Appointment Functions
Records
Table 1: Scrum Implementation Table

3.6 Conclusion:
The prime prevalence of Agile Project Management, especially the Scrum-based approach is its
simplicity. One of the major components in Scrum Approach is roles, the Scrum Master. In this
project, the developer herself is the Scrum Master who is responsible for self-organization and
maintain the product’s progress in a series of month-long “sprints”. The developer will be able to
develop, test and organize feature of the Online Patent Scheduling effectively. By focusing on
eliminating unnecessary bureaucracy, process and practice in managing the project, Agile
methodology will make it possible for the developer to eliminate re-occurring errors and actually
finish the project in time.

Chapter 4: System Architecture

4.1 Introduction
Information systems are complex artifacts lie airplanes and power plants. Because society heavily
depends on information system, they have to be developed very carefully. (Van Hee, K., Sidorova,
N., Voorhoeve, M. and van der Woude, J. (n.d.)) For a software architecture, software components
determines the functional architecture such as database management system, connectivity software
and workflow engine.
The proposed Online Patient Scheduling aims to follow the two main properties of software
architecture: Consistency and Completeness. The components of the Online Patient Scheduling
would be consistent internally in order to avoid any contradiction once they are implemented
together. System completeness is a modelling framework based on the information gathered from
Chapter 2, Chapter 3 and Chapter 4 for developing this system. System completeness would
provide a practical test from a set of models to examine the balance of internal and external
behavior.
The Online Patient Scheduling System is consisting three modules:
 Patient
 Physician/Nurse/Staff
 Administration.
System Features:
Patient Features:
To register new account and to login and logout from the system. Allows to view doctors list
according to departments as well as doctors’ specifications. Users are to book, update and cancel
an appointment with doctor. Once an appointment is booked, system automatically sends Email to
the doctor as well as to the Patient. To make payment for consultation deposit (payment process
is simulation only). Patients are able to rate a consultation visit experience with a doctor
Physician/ Nurse/Staff Features:
Physicians would be to view patient details and to update doctors’ specification details.
The system would allow physicians to view appointment records and to update appointment
record. For example: status of appointment from “New” to “Completed”. The system would be

designed that would allow clinical staffs to view patient details and to update doctors’ details.
Management staff would be allowed to view appointment records as well as to update appointment
record. Example: status of appointment from “New” to “Completed”.
Admin Features:
Administrative staff would be allowed to register new user in the system such as: Doctor, Nurse
& staff as well as Update system control records (For Example: Email address of the system to
send automatic Emails).
Figure 23: Simple Patient Scheduling Architecture.
4.2 Abstract Architecture

2-tier architecture would be implemented to the Online Patient Scheduling System. In the proposed
2-tier model, on the first-tier, patients are able to access appointment information with the web-
browser over the Internet. Now the second tier connects with the first tier in order to exchange
information using web-services. This architecture would be using the web-server to connect to the
Internet and handle the HTTP requests.

Figure 24: 2-tier Online Patient Scheduling System Architecture. (S, N. and Sarda, E. (2014))
Then it responses users’ request with HTTP protocol. In case the HTTP request is related to patient
appointment scheduling services, the IIS web-server would delegate the dynamic response to
another server side application located at application server to process the request. Then the results
response from application server is converted into HTML format through the web-server and
displayed in the standardized HTML web page. (Karen Davis, Stephen C. Schoenbaum, and Anne-
Marie J. Audet. (2005), (S, N. and Sarda, E. (2014)))
User login and user registration requests are processed by the portal server located in 2-tier.
Application server would be responsible to complete end-to-end appointment tracking and
scheduling. Multiple physician scheduling, available appointment searching, rescheduling,
confirmation and cancellation would be processed under the Application Server. (S, N. and Sarda,
E. (2014))
4.3 System Design

4.3.1 Use Case Diagram:
Previous Version:

Figure 25: Previous Version of Use Case Diagram.
New Version:

Figure 26: New Version of Use Case.

Figure 27: Use Case Diagram for Patient.

Figure 28: Use Case for Doctor/Staff and Admin Login.
4.3.2 Use Case Specification

 Use Case Specification for Login
Use Case Login
Brief Description To login to the system
Actor Admin, Doctor, Nurse, Patient
Precondition Actor needs to have a valid ID and password.
Main flow  Actor to identify itself as patient or staff.
 Actor to enter ID and password.
 System validates the entered ID and password.
 If ID and password are validated, system grants access
and displays the system main screen.
Alternative Flow If invalid ID or password is entered, system denied access to
the system.
Table: Use Case Specification for Login.
 Use Case Specification for Register New Staff

Use Case Register new staff

Brief Description To register new staff user in the system
Actor Admin
Precondition Actor needs to logon to the system
Main flow  Actor to enter all personal details of a new staff.

 Select a position for the staff.
 Assign the staff to work in a specific hospital.
 Confirm registration and a new staff ID will be
generated.
Alternative Flow If any invalid details are entered, warning message will be
displayed.
Table: Use Case Specification for Admin
 Use Case Specification for Patient Register

Use Case Register New Patient
Brief Description To register new Patient to use the system
Actor Patient
Main flow  Actor to enter all personal details of a new user.

 Confirm registration and a successful registration
message will be displayed.
displayed.
Table: Use Case Specification for Patient Register
 Use Case Specification for Manage Appointment

Use Case Manage Appointment
Brief Description To manage patient appointments
Actor Patient, Admin

Main flow  Actor needs to book an appointment.

 Actor can save the appointment and reschedule before
making payment.
 Making payment will send confirmation Email to the
user.
displayed.
Table: Use Case Specification for Manage Appointment.
 Use Case Specification for System Log/Patient Record

Use Case Patient Record
Brief Description To access system log/patient record
Actor Admin
Main flow  Actor needs to logon to the system.
 If actor is Patient they are only allowed view own
account details.
 If actor is the admin, he/she is allowed to view all the
system logs.
displayed.
Table: Use Case Specification for System Log.
 Use Case Specification for Post Reviews

Use Case Patient Record
Brief Description To post consultation ratings.
Actor Patient
Precondition Actor needs to logon to the system and complete an
appointment.
Main flow  Actor needs to logon to the system.

 Actor needs to confirm an appointment.

 Make payment and visit the physician.
 Review the physician’s service in the consultation rating
page.
Alternative Flow If any review is not posted, prompt message is displayed.
Figure: Use Case Specification for Post Review.
4.3.3 Class Diagram

First Version:
Figure 29: First Version of Class Diagram.
New Version:

Figure 30: New Version of Class Diagram.
Figure 31: Showing Base Cases.

4.3.4 Activity Diagram
Figure 32: Activity Diagram for Online Patient Scheduling System.
4.3.5 Sequence Diagram

First Version:

Figure 33: First Version of Sequence Diagram.
New Version:
 Sequence Diagram for Login

Figure 34: Sequence Diagram for Login.
 Sequence Diagram for New Account Register

Figure 35: Sequence Diagram for New Account Register.
 Sequence Diagram for Register New Doctor/Staff
Figure 36: Sequence Diagram for Register New Staff.

 Sequence Diagram for Patient Manage Appointment
Figure 37: Sequence Diagram for Patient Manage Appointment.
 Sequence Diagram for Admin/System Logs
Figure 38: Sequence Diagram for System logs.

4.3.6 Entity Relation Diagram

Previous Version
Figure 39: Previous Version of ERD Online Patient Scheduling.
New Version

Figure 40: New Version of Entity Diagram.
4.3.7 Database Table Structure

 Account
Table Name Account
Column Type Data Type Length Description
AccountId Primary Varchar 8 Unique ID for account record

Key
Email Varchar 50 Email address of user to login

to the system
Password Varchar 50 Password to login to the

system
FirstName Varchar 50 First name of user
LastName Varchar 50 Last name of user
ICNumber Varchar 12 IC number of user

Telephone Varchar 20 Telephone number of user
Address Varchar 100 Address of user

Table: Database table for Account
 Appointment
Table Name Appointment
AppointmentId Primary Varchar 8 Unique ID for appointment
Key
DoctorId Varchar 8 Unique ID for Doctor
HospitalId Varchar 8 Unique ID for Hospital
Date Datetime Date of the appointment
BookedbyAccountId Varchar 8 Account ID through which
appointment is being made
Status Varchar 20 Status of the appointment such
as; paid, unpaid, complete.
Table: Database table for Appointment
 Credit Card
Table Name Credit Card
CardNo Primary Varchar 16 Unique number of the card
Key
ExpiryDate Date Expiration date of the card
SecurityCode Varchar 100 Security code of the card
CardType nchar 10 Type of the card such as;
Visa/Master Card.
Table: Database table for Credit Card.
 Doctor
Table Name Doctor

DoctorIs Primary char 8 Unique ID of Doctor

Key
SpecialtyId char 8 Unique ID for each specialty
of the doctor.
YearOfExperience int Years of expertise of the
doctor.
ChargesRM decimal 18,2 Fee charged by the doctor.
Table: Database table for Doctor
 Hospital
Table Name Hospital
HospitalId Primary Varchar 8 Unique ID of the branch of
Key hospitals.
HospitalName Varchar 50 Name of the hospital
Address Varchar 50 Address of the hospital.
Telephone Varchar 50 Telephone of the hospital
Email Varchar 50 Official email of the hospital
for enquires.
Table: Database table for Hospital.
 Specialty
Table Name Specialty
SpecialtyId Primary char 8 Unique ID for each specialty
Key according to departments.
Description Varchar 50 Detailed information about the
specialization.
Table: Database table for Specialty.
 Rating
Table Name Rating.

AppointmentId Primary nchar 8 Unique appointment ID for

Key which user is posting review.
ConsultationRating int Categorizing the review.
Table: Database table for Rating.
 Payment
Table Name Payment
PaymentId Primary Int Unique ID for payment.
Key
CardNo Nchar 16 Card number through which
payment is being made.
PaymentDateTime Datetime Time and date of the payment
Amount Money The amount that is being paid
AppointmentId FK Nchar 8 The appointment for which
payment has been made.
Table: Database table for Payment.
 Staff
Table Name Staff
StaffId Primary Varchar 8 Unique ID for Staff.

Key
Email Varchar 50 Email address of user to login

to the system
Password Varchar 50 Password to login to the

system
FirstName Varchar 50 First name of user
LastName Varchar 50 Last name of user
ICNumber Varchar 50 IC number of user

Telephone Varchar 15 Telephone number of user
Address Varchar 100 Address of user
Position Varchar 10 Position of the user
HospitalId Varchar 8 Hospital ID where the staff is

registered in.
Table: Database table for Staff.
 System Email
Table Name System Email
Email Address Primary Varchar 50 Email address of the admin
Key
EmailPassword Varchar 50 Password to login.
Table: Database table for System Email
4.4 User Interface
Figure 41: Home Page Online Patient Scheduling

Figure 42: Patient Login
Figure 43: Department List

Figure 44: Specialize Doctor Selected
Figure 45: Booking an appointment

Figure 46: Physician Login Interface
Figure 47: Physician Activity Interface

Figure 48: Admin/ Staff Login
Figure 49: Staff Activity Interface.
4.5 System Development

During the system development phase, there are certain factors that are to be completed. These
steps are the key in order to develop and finish the proposed system.
4.5.1 Programming Language:
Programming language is defined as a set of grammatical syntaxes for instructing the computer to
perform specific tasks.
The programming language set for the Online Patient Scheduling System is C# (Sharp). C# is an
object-oriented programming language. The language is developed by Microsoft in coordination

with .Net platform. C# is a high-level programming language that is free of the backward
compatibility curse with updated features. One of the main benefits for the developer to choose C#
is that, the programing language provides garbage memory collection at runtime, memory access
checking and type. (Rasheed, F. (2006))
The language would maintain the useful operations of C++ like operator overloading, pre-
processor directives, function pointers in the form of delegates. C# is a distributed language with
an executable environment called Common Language Runtime. The developer would have the
advantage of the .Net platform that includes a bundle of standard libraries that provides basic
functionalities, debuggers and compilers. Coding with C# allows the developer to write portable
programs that means once the program is written, they are able to function with any changes on
different hardware platforms and operating systems.
4.5.2 IDE:
The developer has chosen Microsoft Visual Studio Enterprise 2017 as the Integrated Development
Environment for the Online Patient Scheduling. The IDE simplifies the development process of
the .Net Applications. The key benefit of selecting Microsoft Visual Studio Enterprise 2017 is the
auto complete features that automatically completes the syntax as the developer types a (.) dot with
namespaces, objects and enumerations. The Environment has project and solution explorer that
manages applications with multiple files. Microsoft Visual Studio Enterprise 2017 is built with
properties tab that allows the developer to set multiple properties for multiple windows and web
controls. The benefit of this standard debugger is that it allows the programmer to debug the
program using putting break points for observing run-time behavior. Together with Visual Studio
Team Services and Team Foundation Server, the IDE seamlessly deliver software to any targeted
platform. It supports extend DevOps processes to SQL Server through Redgate Data Tools and
safely automates database deployments within Visual Studio. Xamarin Test Recorder, together
with Xamarin test cloud will allow the developer to test on thousands of physical devices right
from within the IDE. (Visual Studio, 2017)
4.5.3 Database Management System:
Database Management System is a collection of interrelated data and a set of programs to access
the data. (Taneja, A. (n.d.)) Database Management System provides efficient data storage and
retrieval of information. In general terms, DBMS are developed to manage large amount of data

that includes defining structure for information storage and providing mechanism for information
manipulation.
Microsoft SQL Server: The developer has chosen Microsoft SQL as the Database Management
System environment. Microsoft SQL Server is a rational DBMS. One of the major reasons for
choosing Microsoft SQL Server is that, the system is scalable. SQL Server features built-in
automated back-up and recovery tools that protects information in case of a system failure. SQL
Server allows the developer to specify security policies at granular level such as, who can see
which column of data and under what circumstances.
While researching on the SQL Server DBMS, the developer focused on the major components of
SQL Server:
 Rational Engine, the query processor that manages execution of queries as it requests data
from storage engine and processes the results returned.
 SQL OS bridges the host machine and SQL Server. Highly configurable operating system
that handles all the activities performed on the database engine.
 Storage Engine handles storage and retrieval of the data on to the storage system. SQL
Server creates two types of files at the disk level- Data file that stores data in data pages
and Log file are used to store transactions performed on the database.
Figure 50: Data Flow of Online Patient Scheduling.
SQL Server Management Studio:

SQL Server Management Studio (SSMS) is the main administration console for SQL Server that would
enable the developer to create database objects (such as databases, tables, stored procedures, views etc),

view the data within the database, configure user accounts, perform backups, replication, transfer data
between databases, and more.
4.5.4 Operating System:

Windows 10:
The developer would choose Windows 10 as the operating system platform for the development
and implementation of the Online Patient Scheduling System. The key reason to run the program
on Windows 10 is that, the OS provides Universal Application platform. In general terms, the
developer is able to write the program on a different platform yet still be able to run the program
on the Windows 10. Thus, less codes to write for the developer and the program runs on multiple
platforms. Windows 10 provides a user-friendly interface and the OS is architected to handle all
devices regardless of type, screen size and functions.
4.5.5 Web Server:
Web servers accept network connection, parse HTML request, read files from disk and send
contents back. The general architecture of a web servers is simple.
Internet Information Server: The developer would implement IIS as the web server for the
Online Patient Scheduling. IIS is a protocol server that would be implemented as the system
services that use HTTP, FTP, NTTP and SMTP. This Microsoft built IIS delivers high speed and
provides the developer a platform to expand Internet standard communication capabilities. IIS
would be the first choice of the developer because of the security features the server offers such as
digestive authentication, secure communications and server-gate cryptography.
4.5.6 Web Browser:
Web browser is a media of displaying information on the computer by interpreting the Hypertext
Markup Language. The developer would be using Google Chrome browser to implement the
Online Patient Scheduling System.
Google Chrome:
An open-sources web browser designed for modern day internet users that offers a simple user
interface. One of the important characteristic of Chrome is its multi-process architecture.

Figure 51: Chrome Architecture. (Burstyn, J., Barleta, K., Berk, L., Cole, P. and Franzon, T. (2009))
The advantage of the multi-process feature is that it allows each tab process to run independently
from the browser so that each of the tab could dedicate to single web-application thus increasing
and stabilizing the browser performance.
4.5.7 AES Encryption for Security Code:
The developer will be implementing AES encryption to encrypt the security codes in the user credit
card credentials. Now-a-days people prefer to use credit cards as opposed to cash when paying for
any online service. Since the Online Patient Scheduling is aimed to offer to online payment, the
developer also has to consider abut protection solutions including fraud and data security. By
reducing any data’s vulnerability, encryption will also reduce the system’s risk of suffering from
data breach and financial and reputational damage.
AES Encryption algorithm is a block cipher that uses an encryption key and several rounds of
encryption. A block cipher is an encryption algorithm that works on a single block of data at a
time. The term rounds mean the way in which the encryption algorithm mixes the data re-
encrypting it ten to fourteen times depending on the length of the key. (AES Encryption: AES
Encryption and Related Concepts, 2016) In order to understand the importance and stability of
encryption process, the developer initially compared two different type of encryption algorithm:
AES and DES algorithm.
Characteristic DES Encryption AES Encryption

Basic Data block is divided The data block is

into two halves. processed as a single
matrix.
Principle Works on Feistel Works on
Cipher. Substitution and
Permutation
Principle.
Plain text 64 bits. 128, 192, or 256 bits.
Key size Smaller key size. Larger key size.
Rounds 16 rounds  10 rounds for
128-bit
algorithm
 12 rounds for
192-bit
algorithm.
 14 rounds for
256-bit
algorithm.
Round Names Expansion Sub bytes, Shift rows,

Permutation, X or, S- Mix columns, Add
box, P-box and Swap. round keys.
Security Smaller key which is Larger secret key
less secure. comparatively more
secure.
Speed Slower Faster.
Table: Comparison between DES and AES. (Tech Differences, 2016)
4.5.7.1 Justification to AES Encryption

One of the main properties of AES algorithm is that, its implementation is flexible and straight
forward. The encryption keys methods vary with the different use of the AES encryption method

itself. These modes of operations use AES in each different way. It is important for the developer
to understand that if she implements strong encryption in a weak way that could result in poor
security. Another important reason for the developer to choose AES over DES is to protect the
sensitive financial data that would increase the users’ trust. One of the prime advantage of
implementing AES would be that, the algorithm is executed in both of the hardware and software.
This is because AES algorithm takes 128-bit plain text and 128-bit secret key that makes a 128-bit
block depicting as 4x4 square matrix. This square matrix is an initial transformation that is
followed by 10 rounds. Among them, 9 rounds contain Sub-bytes that will use S-box performing
byte to byte substitution of the matrix, shift rows, shuffled columns of the matrix from right to left
and addition of round keys. (Tech Differences, 2016)

Chapter 5: Requirement Validation

5.1 Introduction
Designing a proper research methodology is an important component for software developing. A
well-designed research methodology helps developers to reach accurate conclusion for any on-
going system development. Research methodology starts with conducting primary research then
progress to secondary research. Primary research process includes a number of activities. These
activities are arranged in proper sequence of timing for carrying out the primary research.
As a tool for conducting primary research, the developer has chosen questionnaires and interview
to collect data from the users for the Online Patient Scheduling System.
5.1.1 Questionnaires
Questionnaire is an effective tool for collecting and recording information about a particular
system. It is made up of a list of questions that include clear instructions and space for answers
and details. A set of structured questionnaires would be distributed amongst thirty possible users
in order to conduct quantitative research for the Online Appointment Scheduling System.
Advantages:
 The developer is able to contact a large number of people at a relatively low cost.
 This is an easier way to reach to people who are spread across a wdie geographical area.
 Respondents are able to complete postal questionnaires in their own time and telephone
call-backs could be arranged for a more convenient time.
 Face-to-face questionnaires make it easier for the researcher to identify the appropriate
person to complete the questionnaire.
Justification of Choosing Questionnaire:
The proposed system has three modules: Patient, Physician and the administration. These four
modules would have the following deliverables:
Patient
 Register new account
 Login and logout from the system.
 To view doctors list according to departments as well as doctors’ specifications.
 To book, update and cancel an appointment with doctor.

 Once an appointment is booked, system automatically sends Email to the doctor as well as
to the Patient.
 To make payment for consultation deposit (payment process is simulation only).
 To rate a consultation, visit experience with a doctor.
Doctor
 To view patient details.
 To update doctor specification details.
 To view appointment records.
 To update appointment record. Example: status of appointment from “New” to
“Completed”.
Admin
 To view patient details.
 To update doctors’ personal details.
 To view appointment records.
 To update appointment record. Example: status of appointment from “New” to
“Completed”.
 To register new user in the system: Doctor, Nurse & staff.
 Update system control records (Example: Email address of the system to send automatic
Emails).
In order to identify the type and nature of information the researcher needs to collect from the end
users, a set of questionnaires are prepared regarding issues with the existing traditional
appointment scheduling process. Not only that, user location and user accessibility to online
services are also taken into consideration while designing the questionnaires. There are few more
factors mentioned in the questionnaire that would help the researcher to reach a calculation for this
project such as, how often and what percentage of users rely on Online services, how many of
users seek clinical help for non-severe health issues and what percentage of users are comfortable
with the functions proposed in the system. Questionnaires would be give out to thirty end users to
calculate the average opinion about the system functionality.

5.1.2 Interview
Interview is a systemic way of collecting data as well as gain knowledge from a professional about
any on-going project development. Kvale (1996, p.14) defined interview as an interchange of
views between two or more people on a topic of mutual interest. Interviews are an effective way
for participants to get involved and talk about their views regarding a certain topic.
The researcher has chosen Interview as another data collecting tool for the proposed Online Patient
Scheduling System. The interview would be conducted with three physicians and three hospital
management staff in order determine the organizational and productive function of the
appointment system. The reasons the researcher has chosen to interview the specialized physicians
and management staff are that, through this method, accurate information could be gathered
directly from the personnel who are involved with the system functions. There are no chances of
non-response as the interviewer personally collects the data. The collected data is taken to be very
reliable since the interviewer tactfully collects the information by cross examining the responders.
Structured Interview:
There are several types of interviews that could be conducted such as structured interview, semi-
structured interview, unstructured interviews, and non-directive interview.
As a data collecting tool, the researcher would design structured interview questions and would
interview the physicians and staff. A structured interview is defined as a standardized interview.
Through this process, the same questions would be asked to all respondents. Though this type of
interview introduces rigidity to the interview, it helps the interviewer to examine the difference in
answers and conclude a decision.
The questions to be asked during the interviews with physicians and management staff addresses
the respective organizational work-frame, employee productivity and management costs.
5.2 Analysis of Data collection through Questionnaire:

A set of questionnaires was posted online through Google Form. As per mentioned before, the
target audience for this research is regular day-to-day life population who have internet access and
are familiar with various online services. The questionnaire has been filled out by 30 anonymous
participants. Analysis of each collected data is explained below:
Question 1:

Figure 52: Question 1.
 Objective: To understand in what percent of the targeted audience have online access.
 Summary: From the response gathered, the majority of the participants have daily Internet
access which means 90% of the participants are familiar with online services. This result
establishes the initial objective of the Online Patient Scheduling System.
Question 2:
 Objective: In order to know to what extends of the participants understand the online
reservation concept.
 Summary: Around 60% of the participants are frequent online buyers. This data helps the
researcher to determine the range of users that would be beneficial with the Online Patient
Scheduling System.
Question 3:

Figure 54: Question 3
 Objective: To understand the user’s habits of using online services.

 Summary: Around 46.7% of the users purchase goods from various online services. This
establishes the ground that the users wouldn’t face difficulties while using the Online
Patient Scheduling.
Question 4:
 Objective: This question aims to understand the users’ pattern of illness to determine the
users’ usability of the Online Patient Scheduling.
 Summary: The majority opinion indicates that, 56.7% of users suffer from seasonal
illness. This result establishes the scope of the system.
Question 5:

 Objective: To understand the user’s scope of using the proposed system.

 Summary: The majority of users stated that they would go to a clinic while suffering from
viral flu. This indicates that, 36.7% of users would possibly be beneficial if they had the
chance to make a doctor’s appointment online.
Question 6:
 Objective: To collect legitimate data to determine the issue faced by users in a traditional
scheduling environment.
 Summary: The data collected shows that, 76.7% of participants have agreed to the fact
that they find it tiresome to wait for an appointment especially for non-severe illness. This
data is important to establish the ground that, not only large hospitals but also local clinics
could be beneficial from the Online Patient Scheduling.
Question 7:

 Objective: To understand the user range for implementing the system in local clinics.
 Summary: 86.7% of participants stated that they do not suffer from any chronical diseases.
This result establishes that small local clinics dealing with non-chronicle illness attends the
majority of users. Thus, local clinics could also be the targeted user base.
Question 8:
 Objective: To understand the users’ perspective of the traditional appointment scheduling

system.
 Summary: Majority of participants have stated that, the traditional way of appointment
making is time-consuming. 86.7% of the user data guides the researcher to develop a less
time-consuming online system.
Question 9:

 Objective: To understand the convenience of users between the traditional way and online
patient scheduling.
 Summary: Even though the data collected from the questionnaire, shows a tie result on
this question, majority of the participants agree on facing difficulties while making an
appointment over telephone.
Question 10:
 Objective: To determine the primary feature of the online patient scheduling while
comparing with the traditional way of appointment making.
 Summary: The data shows that, 50% of the users would choose not to make a phone call
and wait on the line to make appointment. This result helps the researcher to determine the
initial feature of the system where users are able to make appointment sitting at home.
Question 11:

 Objective: To establish the ground of how Online Patient Scheduling would cause the
users much less time.
 Summary: Majority of the participants agreed on the time-consuming factor on the
traditional appointment making.
Question 12:
 Objective: In order to understand the user requirements for the Online Patient Scheduling
System.
 Summary: The statistics show that, 50% of the participants agreed that an Online Patient
Scheduling would be suitable replacement as an effective healthcare facility.
Question 13:

 Objective: In order to understand the beneficial factors of the Online Patient Scheduling
System.
 Summary: 30% of the users would prefer not to wait on the telephone for appointment
confirmation. While 43.3% of users would prefer to be able to make changes in their
appointments. This result also helps the researcher to determine the initial requirements of
the system.
Question 14:
 Objective: To gather more user requirements for the Online Patient Scheduling.
 Summary: The collected data determines more requirements of the Online Patient
Scheduling. Since majority of the users would prefer a system that is quick-responsive and
is able to provide better quality service, the researcher’s main focus would to working on
these criteria.
Question 15:

 Objective: To gather more user requirements.

 Summary: According to the data collected, 60% of the participants would prefer to be
notified with a SMS prior to the appointment. In a real-life scenario, a SMS gateway would
be implemented. For the sake of this stimulation, the developer would choose an email
notification alert.
5.2.1 Analysis of the Data gathered through Questionnaire:
The response collected from the questionnaire would guide the research to categorize the prime
feature of the system. The collected data also provides an overall analysis between the main
questions. After a series of comparison, the prime scope and features of the system.
 Results analysis between Question 1 and 3:

According to the data collected, in question 1, majority of 90% users have daily internet access
where in question 3, 46.7% of the users purchase goods from online services. This data establishes
the ground for the Online Patient Scheduling. Based on the results, the online system would be
accessible to majority of users who are very much familiar with the services that the online patient
scheduling offers.
 Results analysis between Question 6 and 7:
According to question 6, 76.7% of the participants agree on the long waiting time in clinics for
any non-severe illness. In questoin7, 86.7% of the users do not have any chronicle diseases. This
result states the majority of users would be beneficial from the Online Patient Scheduling System
implemented in local clinics since patients with non-severe illness do seek clinical help. This
makes the local clinics in high demand for an online appointment system.

 Result analysis between Question 8 and 12:

Based on the responses gathered, 86.7% of participants agree on the fact that the traditional
appointment making is time-consuming whilst in question 12, 50% of majority thinks that an
effective appointment system shows awareness of healthcare organization about importance of
time of patient. This result emphasizes on the users’ perception towards the traditional appointment
making which brings up the requirements for the Online Patient Scheduling.
 Result analysis between Question 13 and 15:
These results are crucial to set the requirements for the Online Patient Scheduling. In question 13,
30% of the users has chosen not to wait on the telephone for appointment confirmation while
43.3% of users would prefer to be able to make changes in their appointments. The analysis of
these two data, highlights the prime user requirement for a less time consuming service and the
additional characteristic of the service for notification alert. Since majority of users would prefer
to receive a SMS notification, in real-life scenario the system would develop SMS gateway.
5.3 Conclusion:
Through the questionnaire, the researcher is able to determine the main features and functions of
the Online Patient Scheduling. Based on the data collected, the researcher has made decisions
according to majority of opinions. The Online Scheduling system would provide the users a
navigated service that is less time consuming and the users would be able to make changes in their
schedule. The system would also be implemented in small local clinics where patients visiting for
non-severe illness would be able to make quick appointments.
5.4 Analysis of Data through Interviews:

Three set of interviews have been conducted in order to gather information and to determine
requirements for the Online Patient Scheduling. The feedback collected from the interviews have
been taken as a guideline to set the prime features of the proposed system.
Description Position Location Medium Date
Interviewee 1 System Manager Robi Axiata Viber 12.03.2017
Limited. (Dhaka,
Bangladesh)
Table: Interviewee 1 Table.

Question 1: In what ways do you believe an Online Appointment Scheduler could be

implemented in perspective of Bangladesh?
 Answer: When you think about Bangladesh, especially in Dhaka, it is a headache for the
general public to get to the hospital, wait in queue to reserve an appointment and wait again
for their turn. In this highly-populated city, where majority of the public have Internet
access, an Online Patient Scheduling could actually be a relief. If the public is given the
opportunity to schedule their appointment online it could impact thoroughly in the medical
sector.
Question 2: If you were to develop the system, what would be the functionalities would you
like to include in the System?
 Answer: I would mainly focus on the flexibility of the system. For example, let’s say the
patient has already made an appointment for a certain day. For some reason, he cannot
make it that day. The system should be able to allow the patient to edit the time and date
of the appointment. Also, I would concentrate on the access control of the database. I would
prefer to implement role based access control where not all the users are capable of
accessing all the information.
Question 3: Would you prefer if patients were able to make an online deposit prior to the
scheduled appointment?
 Answer: I think for small local clinics, having an online deposit is a scheme of security
and surety that the patient will show up for the appointment. In large hospitals, online
deposit would also be beneficial. But from a smaller business point of view, online payment
would help manage time and productivity.
Question 4: In your opinion, do you think online payment would be a secure function
especially in perspective of Bangladesh?
 Answer: Well Yes. I think Online payment would be a new addition in a patient scheduling
system. Most similar services do not offer online payment yet. So, having an online
payment integration would be something new to have.
Question 5: Do you have any recommendation to enhance the proposed online service for the
future?

 Answer: The current system is already offering a bunch new stuff. In there were any
enhancement to be made, I would say the propose system could become the base for a
smart hospital management system.

Interviewee 2 Doctor Bangladesh Viber 12.03.2017
Institute of
Research and
Rehabilitation in
Diabetes,
Endocrine and
Metabolic
Disorders.
(Dhaka,
Bangladesh)
Table: Interviewee 2 Table

 Answer: First of all, considering the heavy traffic issue in Bangladesh, I think an Online
Patient Scheduling would be a great alternative. From my point of view, patients will have
the opportunity to schedule appointment days prior to the appointment. For small clinics
and hospitals, an online scheduling can help to manage the patient flow reducing much
pressure on nurses and staffs.
 Answer: I think I would concentrate on the availability of the system. The online patient
scheduling has to be available for users whenever the user is trying to access it.
 Answer: Actually Yes. I think online payment could be an encouraging step for the
physicians especially.

Question 4: In your opinion, do you think online payment would be a secure function
especially in perspective of Bangladesh?
 Answer: Yes, I think paying online for the appointment would be secure. In a real-life
scenario, online transaction can benefit the patients from the risk of hijacking or pick-
pockets in Dhaka city.
future?
 Answer: I think generating copy of the physician’s prescription could be an enhancement.

Interviewee 3 System Maskavia Viber 12.03.2017
Developer and Private Limited.
IT Manager. (Sentul East,
Kuala Lumpur
Malaysia)
Table: Interviewee 3 Table

 Answer: In a general scenario, online patient scheduling could be implemented in order to
reduce work load of hospital stuff. Especially large hospitals, managing a large number of
patient appointment manually could be tiresome and time-consuming. Having an online
patient scheduling could increase productivity.
 Answer: If I were to develop the propose system, I would definitely focus on the security
implementation of the system. For example, I would implement access control in the
database. I would implement AES encryption algorithm for encrypting the financial
credentials of the online payment integration. In addition, I think having a password
strength checker could be a useful tool for guiding the users while registering into the
system. I would also like to mention here that the system must be user friendly.

 Answer: Yeah. I think offering the users to make an online deposit could be a new addition
in such systems.
Question 4: In your opinion, do you online payment would be a secure function especially in
perspective of Bangladesh?
 Answer: Of course. As long as the patients’ card information is encrypted, it is definitely
a secured functionality that the system could offer.
future?
 Answer: As a developer myself, I think the proposed system could be the baseline for an
advanced online medical service with artificial intelligence implemented to prescribe
patients remedies online.
5.4.1 Conclusion from the Data collected through Interview:
All three specialists have similar observation about the Online Patient Scheduling System. All
the comments received from them will help the developer to develop the system in such a way
that will be easy to be use by the patients as well as the hospital staff. Interviewee 1 have
highlighted the importance of the flexibility of the system. That means, allowing the users to
make changes in their appointments. He has also suggested that online deposit would also be
beneficial. Interviewee 2 is a physician herself. She has put more importance on the system
availability. She has also recommended the system to generate prescriptions. Interviewee 3 has
talked about the technical implementation of the system. Encryption algorithm and access
control of the database has brought to the developer’s attention.

Chapter 6: Implementation
This chapter includes all details about the implementation of the system, which includes some
ground rules, technical details such as: programming technique, design consideration, and an
explanation for each key functionality in the system.
Business rules
There are some assumptions and business rules that the developer implemented into the system, to
better reflect the actual processes in a hospital. They are discussed as below.
1. There are multiple branches of hospital using the same system.
2. Each branch has its own staffs, such as: doctors and nurses.
3. One patient can only have one account in the system.
4. A patient can visit any branch under the same hospital group.
5. A hospital staff (doctor, nurse) can only work in a hospital.
6. Consultation fee is decided according to different doctor.
7. Office hour is from 9am to 6pm.
8. An appointment has to be made in at least 7 days in advance.
9. An appointment booked without payment is not a confirmed appointment. Only when
payment is done, the appointment is confirmed to both doctor and patient.
10. Only credit card payment is accepted.
11. A patient can only rate a completed appointment.
12. Rating for an appointment can always be updated, the rating records are for internal
reference only.
6.1 Screenshots
The system has an interactive design, which is very different from a typical hospital website.
Screenshots for the whole system will be documented below, with a description about each what
each page does.
6.1.1 Home page
This is the first page that a user lands to the hospital system, the home page is an interactive
and responsive page that differentiated from other hospital system.

Figure 67: Screenshot for “Home” page.
6.1.2 About page

The home page is a scrollable page, which user could scroll down to find details such as
“About”, “Events” and “Partners”. Similar to how Facebook works, it is very user friendly to even
the mobile users.
Figure 68: Screenshot for “About” page.

6.1.3 Events page

This section shows all the events organized by the hospital group. Different category of major
events happened in the group are illustrated here. For example, the talent acquisition program,
yoga session organized and sponsorship from the hospital.
Figure 69: Screenshot for “Events” page.
6.1.4 Partners page

The hospital group has a global presence and partnerships with different leading medical group in
the world. This section showcases different big names and what they said about the group. Also,
the specialists in the hospital are being introduced in this section.
Figure 70: Screenshot for “Partners” page.
6.1.5 Login page

Staffs and registered patients can login to the system from this page. First, they have to identify
themselves as a staff or patient, then enter the credential accordingly. For any patient that visits

the system for the first time, he or she can register a new account by clicking on the “Register”
button.
Figure 71: Screenshot for “Login” page.
6.1.6 Register new account page

Only email and passwords are required for the registration process. The developer tries to keep the
process simple and quick. A patient can update his or her personal details and so on in the later
stage.
Figure 72: Screenshot for “Register new account” page.

6.1.7 My account page

This is the first page after a user logins to the system. All personal details registered under the
account is displayed here. User could update and change the details in this page.
Figure 73: Screenshot for “My account” page.
6.1.8 New appointment page

A registered user can make an appointment with any doctor in the hospital. First, it will be started
with selecting the doctor to make appointment with. Once a doctor is selected, details such as:
specialty, station hospital of the doctor will be displayed.
As for the appointment date, the system has a rule to enforce an appointment to be made at least 7
days in advance. Also, the available appointment time is only from 9am to 5pm, which assumes
an appointment to take between 30 to 45 minutes.

Figure 74: Screenshot for “New appointment” page.
6.1.9 Appointment Update Page:

New Appointments could be rescheduled or updated only prior to making the payment.
Appointments could be made but not confirmed. Only Unpaid appointments could be updated and
then user will be directed to the “Make Appointment” page.
Figure 75: Select Appointment Record to Update.

Figure 76: Appointment Update Page.
Figure 77: Appointment Successfully Updated
6.1.10 Make payment page

In order to confirm an appointment, one has to make payment via credit card only. This page states
the consultation fee for the appointment, dominated in Ringgit (RM) and prompts user to make a
card payment.
All the credit card details entered will be validated, and payment can be confirmed only when valid
details are entered. Once the payment is completed, the appointment is considered as confirmed.
System sends a notification e-mail to both the appointed doctor and the patient.

Figure 78: Screenshot for “Make payment” page.
6.1.11 My appointment page

All appointments made by the patient will be displayed in this page. Status of each appointment is
shown as well, they could be: “UNPAID”, “PAID”, “CANCELLED” and “COMPLETED”.
For any unpaid appointment, patient could click on the record and proceed with payment. Also,
patient could cancel the appointment by clicking on the “Cancel” button.
Figure 79: Screenshot for “My appointment” page.

6.1.12 Consultation rating page

For any completed appointment, a patient can rate the consultation session with a rating. A scale
of 5 rating: “Very good”, “good”, “fair”, “poor” and “Very poor” are the available feedback for a
patient to evaluate the session.
Figure 80: Screenshot for “Consultation rating” page.
6.1.13 Doctor record page

All records of doctor are available for patients’ reference. A basic details and background of a
doctor can be checked in this page.
Figure 81: Screenshot for “Doctor record” page.

6.1.14 Patient record page

This page is accessible for staff users only. Patient records can be accessed in this page, which
allows user to view, update, and delete the record.
Figure 82: Screenshot for “Patient records” page.
6.1.15 System record page

The system record page can only be accessed by the admin user. This page specifies the email
address used by the system, to send appointment notification email. A valid email address and
password has to be provided in this page for such communication to happen.
Figure 83: Screenshot for “System record” page.

6.1.16 Register new staff page

To register a new hospital staff, admin user can use the below page. First, assign the staff to station
in a particular hospital and specify his or her position.
A staff ID will be automatically generated by the system, all admin user has to do is to fill in the
details of the new staff and click on the “Register” button.
Figure 84: Screenshot for “Register new staff” page.
6.1.17 Encryption
The credit card detail is encrypted in the database. As figure below shown, the “security
code” field is encrypted and unreadable.
Figure 85: Encryption for security code.

6.1.18 Password strength checker

When registering a new account, a password strength checker is implemented. It examines the
strength of the password entered, and display the message accordingly. For example, the below
screenshot shows that a password with 1 character is very weak.
Figure 86: Password strength checker.
6.2 Sample codes

The system is developed using object oriented concept, thus a class is created for every object that
interacts in the system. For example: staff, patient, appointment, payment and so on. By opening
the project in Visual Studio, all the objects in the system can be found in the “App_Code” folder.

Figure 87: Objects in the system.
6.2.1 Login page

Sample code will be shown and explained, from the easiest page: login page. This page is relatively
simple to understand, which the system validates the login details against the records in the
database.
To develop this function, an “Account” class is created which represents an account to login to the
system. As the sample code below shown, user entered credentials are set into the account object.
Then, this account object will be passed to the server to be verified. Once verified as valid login,
the system displays a welcome message.
Figure 88: Sample code for “Login” page.

6.2.2 Register new account page

Besides login page, the register new account is one of the other simplest pages. This page allows
new user to register a new account, which implements SQL INSERT statement to achieve the new
account registration. All user details retrieved from the front-end page are substituted into the SQL
statement, to be inserted into the database.
Figure 89: Register new account page.
6.2.3 My account page

The next page after login is the “My account” page, all user information is shown in this page.
Users are allowed to update their account details.
Prior to the update, any detail entered by the user will be validated. For example, user cannot leave
any detail to be blank. Once the details passed all validations, system will update the latest details
in to the database. In this case, SQL statement is used for the update.

Figure 90: Sample code for update account details.
6.2.4 Doctor record page

To view all doctor records in the system, an SQL SELECT statement is used for the
implementation. The system selects all doctor records, filtering by staff ID and to display the
details of a doctor. In fact, SQL statements are powerful and it is applicable for many functions in
the system.
Figure 91: Sample code for doctor record page.
6.2.5 New appointment

This page has slightly more rules and validations, which requires more explanations for the code.
First of all, a new appointment can only be made for a future date. Certainly, a past date validation
has to be in place. When user selects a past date for appointment date, system displays a warning
message. Otherwise, proceed to the next validation.

Figure 92: Sample code for new appointment past date validation.
Besides, an appointment has to be made in at least 7 days advance. To achieve this, system checks
the appointment date with the current date for the day difference. If the count is more than 7,
system displays a warning message.
Figure 93: Sample code for appointment 7 days’ advance rule.
Finally, system insert a new appointment record into the database. For a new appointment record,
the initial status will be “UNPAID”. At this stage, the new appointment is not considered as a
confirmed appointment yet. Not until the payment is settled.
Figure 94: Initial status of a new appointment.

6.2.6 Make payment

To confirm a new appointment, a payment has to be made. While only credit card payment can be
accepted, the system performs a basic validation for credit card details, such as: card number
length, security code and so on. As sample code below shown, a warning message will be displayed
if user failed any validation for credit card details.
Figure 95: Sample code to validate credit card details.
Next, the system will simulate the actual credit card verification process to the bank. All card
details such as: card number, issuer, expiry date and security code will be validated. A payment
can be completed only if the entered card details passed the verification process.
Figure 96: Sample code to validate credit card.

When the payment is completed, system updates the appointment status from “UNPAID” to
“PAID”. Finally, system also trigger an automatic notification e-mail to both the doctor and patient
who made this appointment.
Figure 97: Sample code for update appointment status.
6.2.7 Automatic notification email

The system sends a standard appointment confirmation email as figure below illustrated. This e-
mail is triggered by a successful credit card payment.
Figure 98: Sample notification email.
A function is coded for the system to send email, as below shown. This function will use the SMTP
server of Gmail, to send an email. In this case, the developer also created a function for admin user
to maintain a system email address for this purpose. The system will use a Gmail account to send
appointment confirmation email to the users.

Figure 99: Sample code to send appointment confirmation email.
6.2.8 Consultation rating

A patient is allowed to rate a consultation session, by a scale of 5 as below shown. In this case,
“Very good” is represented by point 1 and “Very poor” is 5.
Figure 100: Rating scale for consultation session.
The system checks the radio button selected by user, and to assign a point to the rating record. As
the sample code below shown, point is 1 when radio button 1 (“Very good”) is selected.
Figure 101: Sample code for rating point.

Then, system insert the rating record into the database. The key for each rating record is the
appointment ID, thus only patient who completed an appointment session can provide feedback
rating.
Figure 102: Sample code to insert rating record.
6.2.9 Security features

The encryption function is to hide sensitive information in the database, it is done by using AES
(Advanced Encryption Standard) algorithm. As figure below shown, an encryption key is
maintained in the code and the same has to be used for decryption.
Figure 103: Sample code for encryption.

The same key is being used for decryption, to reverse the encrypted data to be readable.
Figure 104: Sample code for decryption.
For the password strength checker, it is implemented by using the Ajax plugin. This is a tool in the
Visual Studio which allows a faster implementation of commonly used tool.
Figure 105: Sample code to implement password strength checker.

Chapter 7: System Validation

7.1 Unit Testing:
Unit testing would allow the developer to test individual software components of the Online
Patient Scheduling System. Since the developer would following Agile Method during the
development phase, unit testing is critical. It would help the developer to schedule the Agile
development. The developer would be able to verify even the minutest segment of the system as
well as determine the stability of modules developed in each Sprint. This way the developer is also
able to detect and fix errors based on it priority.
Accessing the
Sprint • Log in Possible
Sprint Registration system
Content • Sign up Product facilities.
Figure 106: Unit Testing Process of Registration Sprint of the Online Patient Scheduling.
This section is to undertake a small part of a testable unit and to test to see whether it runs with
deliverables as expected. Each unit of the system would be tested individually to assure desired
deliverables. For example, the log in/registration module would be programmed to consist of 5-10
characters. Through Unit Testing, the developer would be able to establish that to log into the
system, user has to input 5-10 characters. Only after each unit is tested successfully, the process
follows to the next phase.
 Unit Testing for “Login”:
Module: Login
No Test Case Expected Result Actual Result
1. Leave the email and password Warning message displayed As Expected
field empty and press “Login” to prompt email and
button. password.

2. Enter invalid email and Warning message displayed As Expected

password and press “Login” to show login failed.
button.
3. Enter valid email and password Greeting message As Expected
and press “Login” button. displayed. Once user click
“OK” on the message, home
page is redirected.
Table: Unit Testing for Login.
 Unit Testing for “Register”:

Module: Registration
1. Leave the email and password Warning message displayed As Expected
field empty and press to prompt email and
“Register” button. password.
2. Enter an email address that is Warning message displayed As Expected
already registered to the to show email address is
system. already registered.
3. Enter unregistered email and Warning message displayed As Expected
enter unmatched passwords. to prompt re-enter password
Finally, press “Register” correctly.
button.
4. Enter unregistered email and Information message As Expected
enter matching passwords. displayed to indicate
Finally, press “Register” successful registration.
button. Update personal detail page
is re-directed.
Table: Unit Testing for “Register”.
 Unit Testing for “Update Personal Information”:

Module: Update personal information

1. Enter no value and press Warning message displayed As Expected

“Save” button. to prompt for all required
details.
2. Leave one of the fields empty Warning message displayed As Expected
and press on “Save” button. to prompt value for missing
field.
3. Enter all valid details and press Information message is As Expected
“Save” button. displayed to indicate
successful update.
Table: Unit Testing for “Update Personal Information”.
 Unit Testing for “Make New Appointment”:

Module: Make New Appointment
1. Select a Doctor ID Doctor name, specialty and As Expected.
hospital name is
automatically displayed.
2. Select a past date and click on Warning message displayed As Expected
“Book”. to prompt for a future date.
3. Select a today date and click on Warning message displayed As Expected
“Book”. to prompt for at least 7 days
after today date.
4. Select a date which is 6 days Warning message displayed As Expected
after today and click on to prompt for at least 7 days
“Book”. after today date.
5. Select a date which is 7 days Information message As Expected
after today and click on displayed to show
“Book”. successful booking.
6. Book an appointment with user Warning message displayed As Expected
who has a future appointment. to decline booking, future

appointment details with

date and time are shown.
Table: Unit Testing for “Make New Appointment”.
 Unit Testing for “Update Appointment”:

Module: Update My Appointment.
1. Select an Appointment Record User is re0direted to the As Expected.
and press “Update”. update appointment page.
2. Select a past date and click on Warning message displayed As Expected
“Update”. to prompt for a future date.
3. Select a today date and click on Warning message displayed As Expected
“Update”. to prompt for at least 7 days
after today date.
4. Select a date that is even one or Success messages displayed As Expected
two days ahead from the showing that the
original date and click appointment has been
“Update”. updated.
Table: Unit Test for “Update My Appointment”.
 Unit Testing for “Make Payment”:

Module: Make Payment
1. Select the Wrong Card Type Warning message displayed As Expected
and Enter card number, expiry to prompt for all the correct
date and CVV2 and press required details.
“Confirm”.
2. Enter invalid value for one of Warning message displayed As Expected
the fields, and press on to prompt value for missing
“Confirm” button. field.


“Confirm” button. displayed to show
successful payment.
Table: Unit Testing for “Make Appointment”.
 Unit Testing for “Consultation Rating’:

Module: Consultation Rating
1. Leave the rating options empty Warning message displayed As Expected
and press “Rate” to prompt to choose the
rating experience.
2. Select any of the rating criteria Success message is As Expected
and press “Rate”. displayed.
Table: Unit Testing for “Consultation Rating”.
 Unit Testing for “Doctor Record for Patients’ Reference”:

Module: Doctor Record for Patients’ Reference.
1. Select no Doctor ID. No changes in the view As Expected
page.
2. Select any invalid Doctor ID. Warning message is As Expected
displayed showing invalid
Doctor ID.
3. Select a valid Doctor ID. Doctor’s detail information
is displayed.
Table: Unit Testing for “Doctor Record”.
 Unit Testing for “Patient Record for Staff Only”:

Module: Patient Record for Staff Only.
1. Login as a Staff with an invalid Error Message displayed As Expected
ID. showing Failed Login.

2. Login with a valid Staff ID. Patients’ Account ID, As Expected

Name, Email, Telephone
and Address is displayed.
Table: Unit Testing for Patient Record for Staff Only.
 Unit Testing for “Register New Staff”:

Module: Register New Staff.
1. Select a valid station hospital, The required fields to be As Expected
position and staff ID. filled up appear.
2. Leave any of the required Warning message is As Expected
fields empty and press displayed asking to fill up
“Register” all the required fields.
3. Fill up all the required fields Successful Registered
and hit “Register”. message is displayed.
Table: Unit Testing for “Register New Staff”.
7.2 Integration Testing:

Integration Testing involves two-tested unit being linked into a fundamental. For example, when
a patient selects a physician from the doctor list of a specific department, the system will collect
that specific physician’s specialization details from the database and show it on the front-end view
for the patient. For the test run, hypothetical data would be input into the database to check system
functionality.
 Integrating Testing for Registration and Account Login:
Module: Registration and Account Login
1. Enter no email and password Warning message displayed As Expected
and press “Register” button. to prompt email and
password.
2. Enter an email address which Warning message displayed As Expected
is already registered to the to indicate email address is
system. already registered.

3. Enter unregistered email and Warning message displayed As Expected

enter unmatched passwords. to prompt re-enter password
Finally, press “Register” correctly.
button.
4. Enter unregistered email and Information message As Expected
enter matching passwords. displayed to indicate
Finally, press “Register” successful registration.
button. Update personal detail page
is re-directed.
5. Enter newly registered email Greeting message As Expected
and password and press displayed. Once user click
“Login” button. “OK” on the message, home
page is redirected.
Table: Integration for Register Account and Account Login.
 Integration Testing for Make New Appointment and My Appointment Page:

Module: Make New Appointment and My Appointment Page
1. Select a date that is 7 days after Information message As Expected
today and click on “Book”. displayed to indicate
successful booking.
2. Book an appointment with user Warning message displayed As Expected
who has a future appointment. to deny booking, future
appointment details: date
and time are shown.
3. Patient to click on “My User will be re-directed to a As Expected
Appointment” option from new page and all
menu. appointment made by the
user will be displayed with
their status such as: Paid,

Completed, Unpaid,
Cancelled.
4. Make a New Appointment and An email will be sent to As Expected
fill up the required steps and person who booked his
press “Confirm”. appointment to inform
about the status change.
5. Select newly made Status of the selected record As Expected
appointment with status = will be updated to
“NEW” and click on “RESCHEDULED”. An
“Reschedule” button. email will be sent to person
who booked his
appointment to inform
about the status change.
Table: Integration for New Appointment and My Appointment Page.
 Integration for My Appointment and Make Payment:

Module: My Appointment Page and Make Payment
1. Patient to click on “My User will be re-directed to a As Expected
Appointment” option from new page and all
menu. appointment made by the
user will be displayed with
their status such as: Paid,
Completed, Unpaid,
Cancelled.
2. Click on the “Paid” status from Information displayed As Expected
the appointments. showing appointment has
been confirmed and a
notification email has been
sent.

3. Click on the “Unpaid” status User is re-directed to the As Expected

from the appointment. “Make payment” page.
4. Enter invalid value for one of Warning message displayed As Expected
the fields, and press on to prompt value for missing
“Confirm” button. field.
“Confirm” button. displayed to show
successful payment and
appointment is confirmed.
Table: Integration for My Appointments and Make Payment.
7.3 System Testing:

The developer would have to test the whole system thoroughly at this stage and assure each and
every function of the system is working as expected.
Module: Online Patient Scheduling System

No Test Feature Test Objective Test Status
1. Login Different types of user are Passed
able to login to the system.
2. Registration New accounts are registered Passed
3. Update personal information Personal information is Passed
updated accurately.
4. Make a New Appointment New Appointment is made. Passed
Seven days’ buffer time is
being enforced.
5. Updating Appointment. Only the unpaid Passed
appointments can be
rescheduled.
6. Making Payment. In order to confirm the Passed
appointment, a payment is
made.

7. View My Appointment All the appointments made Passed

by the user can be viewed
and their status.
8. View Doctor Record Patients can view the Doctor Passed
information about specialty
and experience.
9. Register New Staff. New Doctor/Staff/Nurse can Passed
be registered.
10. System Records. Only the Admin can view all Passed
the system records.
11. Rate consultation Patients are asked to rate Passed
their consultation regarding
the physician.
12. Sending notification Email. Users are notified via Email Passed
about the confirmation of the
appointment.
13. Password Strength Checker. While registering into the Passed
system users are guided on
the strength of the password.
Table: System testing for all the functions.
7.4 User Acceptance Test:

Agile User Acceptance Testing is initiated with user stories and user requirements. At this stage,
the developer would more concentrate on the business acceptance criteria rather than waiting till
the final implementation. The developer has framed out a user acceptance test for the Online
Patient Scheduling that involves user interactions at the end of each unit test. One of the benefits
of following Agile User Acceptance Testing is that, the developer is able to detect errors in the
system during earlier phase of the development since each sprint is test before reaching the final
product of the process.

Once the system is thoroughly tested, the developer would ask actual users such as doctors, nurse,
patients to test the system and their response would be collected. Their opinion would be evaluated
in the scale of: 1 = Poor, 2 = Fair, 3 = Good, 4 = Very Good, 5 = Excellent.
Participant Name: Ibrahima Sory Sanoh Nationality: Guinean
Position: Student Date: 19.03.2017
 Graphical User Interface Evaluation
Graphical user interface evaluation
No. Question Rating from Tester 1
1 2 3 4 5
1. Easy to access information? √
2. Appropriate font? √
3. Appropriate color? √
Table: User Acceptance Test for GUI.
 Human Computer Interaction Evaluation

Human computer interaction evaluation
1 2 3 4 5
1. System content easy to √
understand?
2. Is the validation appropriate? √
3. Does the error message helps? √
4. Is the system interruption clearly √
stated?
5. Is the system interruption √
helpful?
6. Appropriate use of textbox, √
check box and combo box?
Table: User Acceptance Test for Human Computer Interaction.
 Overall Functionality Evaluation

Overall functionality evaluation

No. Feature Rating from Tester 2

1 2 3 4 5
1. Login √
2. Registration √
3. Update personal information √
4. Make a New Appointment √
5. Updating Appointment. √
6. Making Payment. √
7. View My Appointment √
8. View Doctor Record √
9. Register New Staff. √
10. System Records. √
11. Rate consultation √
12. Sending notification Email. √
13. Password Strength Checker. √
Table: User Acceptance Testing for overall System.
Participant Name: Showmik Rahman Nationality: Bangladesh

Position: Student Date: 19.03.2017
1 2 3 4 5


1 2 3 4 5
understand?
stated?
helpful?

1 2 3 4 5
1. Login √
2. Registration √

Participant Name: Sharmin Kauser Nationality: Bangladesh

Position: Doctor Date: 20.03.2017
1 2 3 4 5

1 2 3 4 5
understand?
stated?
helpful?

1 2 3 4 5

1. Login √
2. Registration √
7.5 Conclusion:
The User Acceptance Testing was conducted through the Team Viewer software. The responses
collected from the real users determines the usability of the proposed system. majority of
participants found the system functionality and GUI organized and quick responsive.

Chapter 8: Reflection and Conclusion

8.1 Personal Reflection and Critical Evaluation:
The Online Patient Scheduling has been designed and developed aiming to introduce the online
platform for medical services in Bangladesh. The proposed system is the initial base for further
more technological enhancements in medical field in Bangladesh.
During the development phase of the system, the developer has strictly followed time management
and has focused on the usage and implementation of the system. The developer’s personal
reflection is evaluated down below:
 Time Management:
The developer believes in the old saying, “A stitch in time saves nine”. Since the beginning of
level 3, the developer has focused on planning and prioritizing tasks. During the two semesters of
level 3, initial planning and structure of the system were finalized. Proper time management was
implemented in order to manage time for documentation. The developer divided time equally
between designing documenting the system. Every improvement made in the program has been
documented immediately to assure sync and pattern in the documentation. During the development
phase, the developer has prioritized on improving programming skills and web development.
Constant evolution of the system has been maintained and documentation has been done with
critical specification.
 Limitations and Future Enhancement:
One way where the proposed system limits the users is that, the system is a simple online patient
scheduling system. Users are allowed to make appointments and make online deposit and the
admin is only capable of accessing patient records. The admin is capable registering new staff like
nurse and doctors. In terms of such functionalities, the system lacks behind from hospital
management system. The Online Patient Scheduling does not generate reports, it only generates
appointment status differing from Paid, Unpaid and completed.
 Importance of the System:
This project has been a challenging journey for the developer. A brief concept of research has been
conducted in order to construct a development framework and a development methodology. From
the developer’s perspective, this personal reflection is describing the choices and decisions made

during the development phase. While selecting an appropriate methodology, the developer has
looked into several software developer methods and gathered brief knowledge about the concepts.
However, majority number of similar system followed the traditional Waterfall Method, the
developer has chosen the Agile approach. The simplicity and organized framework of the Agile
method would be a great choice for Online Patient Scheduling. A lot of background readings have
been done to plan a primary research design. Questionnaires and Interviews have been conducted
in order to collect initial requirement data. This way the developer was able to determine the
system functionalities. Microsoft Visual Studio is used as the developing environment because the
developer is familiar with IDE. The developer has implemented C# ASP.Net framework for the
execution of the system.
8.2 Conclusion:
One of the prime reasons that Online Patient Scheduling is gaining popularity in recent days is
that, the system provides an easier for receiving healthcare facilities to the general users.
The paper has proposed an Online Patient Scheduling System built on the Web Service
architecture. The Web Service architecture would provide an appropriate paradigm for developing
this integrated healthcare system. The prototype of the system would provide the feasibility of the
proposed architecture. This case study also provides a preliminary research on the consumers’
acceptance and the functionality of each unit.
The system integrates technology of Visual Studio 2017 and c#.Net development environment.
This combination of the two technologies have been used as an experimental teaching technique
in the Hospital Information System field for years. The system is designed to achieve maximum
user satisfactory. Since the functionality of online credit card payment is too complex for the
developer to implement, only stimulation of the online transaction would be implemented. As the
project evaluated, each step of the development process met the system’s objectives and primary
user requirements. Certain enhancements could be suggested for the system in future are to
integrate actual online payment transaction, SMS integrated and implementing Artificial
Intelligence features that could make this Online Patient Scheduling system an automated
intelligence clinic management.

The system was developed following the aims and objectives stated in the initial proposal. Though
it had been a challenging process, the Online Patient Scheduling has been furnished with the notion
of meeting the requirements of the Bachelor Degree in Information System Security in Asia Pacific
University.

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APPENDIX
Project Proposal Form (PPF)
Introduction
Enhancing patient care management is one of the aims of healthcare industry to improve the
healthcare system worldwide. This goal is to be equally if not more important as the other keys of
improving the health of the population and managing per capita cost of care. (Berwick et al, 2008)
As the population continues to grow, so too does the need for healthcare services and options. (The
Benefits of Online Appointment Scheduling. 1st ed) Patient Scheduling System is an important
component of scheduling and managing appointments. Especially online scheduling software has
simplified and automated the process of hospital management for all-size organizations.
The proposed system advances with online facilities that eliminate the chaos of traditional
appointment services. This system offers online appointment booking, to view doctors list, to
cancel and update appointments with an administrative portal to manage all the sections. It
provides advanced functionality to streamline the process thus easy access to personal hospital
services that help organizations to stay connected with their customers, clients, students and most
importantly patients and can result in significant time and monetary savings.
Aims
The aim of patient scheduling service is to provide patients full access to manage their hospital
appointments which, facilitates with an online service for appointment reservation, updating and
canceling management minimizing customer inconvenience and assuring a better healthcare.
Objectives
 To develop a system that allows users to have control over their appointment making
service.
 To facilitate the patients with real time healthcare scheduling.
 To manage staff resources needed for managing appointments.
 To maximize operation hours.
 To make the use of online platform for less customer inconvenience and high productivity
among staff.
 To optimize time savings and monetary savings as both staff time and services translate
into expenses and revenue.

Problem Statement
Patient growth certainly is beneficial for healthcare business but it also creates challenges for
facility admins and staff. Procedures that were previously adequate may no longer be effective in
handling a rise in new patients. (The Benefits Of Online Appointment Scheduling. 1st ed.) The
appointment process especially in large organizations is challenging. It is often burdensome task
that requires significant time and staff resources to manage. The proposed patient scheduling
system replaces traditional booking chaos with online facility in addition with automated e-mail
and text message reminders. Patient scheduling system allows the users the power to book their
own appointments with respective doctors online that benefits organizations to manage a
tremendous amount of time that would otherwise have been spent answering phone, responding to
e-mails and voice messages. This online platform improves flexibility of healthcare service with
customized reporting and security features.
Literature Review
Studies by Ryan and Farrar (2000), Rubin et al. (2006), Cheraghi-Sohi et al. (2008), Gerard et al.
(2008) and Hole (2008) all point out that patients do have preferences regarding when to visit the
clinic and which physician to see. In general, patients prefer appointments that are sooner than
later, but they may prefer a later day over an earlier one if the appointment on the later day is at a
more convenient time. (Feldman, Jacob et al, 2014) Most of the studies in this area focuses on
inter-day scheduling and is determined in timing and sequencing patients with the objective of
finding the balance between in-clinic patient waiting times and doctor utilization. (Cayirli and
Veral, 2003, Gupta and Denton, 2008) This proposed model is viewed as a daily capacity
management for medical facilities. Online Patient Scheduling allows individuals to view list of
doctors in respective departments, book their schedule and if necessary to make changes and
update conveniently and securely through any Web-connected device such as laptop, smartphone
or tablet. This software is an efficient and affordable choice for all-sized organizations.
Flexibility of online patient scheduling enables it to be beneficial for a vast range of services and
activities at medical and healthcare institutions. While there is limited work on the customer side
behavior in appointment scheduling, there are numerous related papers in the operation side of
managing these paper works. Online scheduling lessens the time spent by staff on phone booking
and handling appointments. It reduces average waiting time for the ones who are to make the
appointments. A scheduling system eliminates the need for a staff to work overtime or for

management to hire new employees to handle reception work that could benefit the healthcare
organization with monetary savings. In addition, the automated appointment reminders reduce the
number of no-shows who fail to make their scheduled appointments. Many surveys have
concluded that these types of reminders can decrease the number of no-show by 50 percent. (The
Benefits Of Online Appointment Scheduling. 1st ed, 2012)
Deliverables
This system is designed to deliver specific facilities to the customers as in the patients as well as
the physicians and the administrative staff to manage their appointment work.
 To allow users to view doctor’s list and specifications.
 To allow users book appointments online.
 To allow admin staffs to monitor the number of patients attended by doctors especially in
large medical institutions.
 To allow physicians to manage the number of patients to be attended per day and to manage
their work load.
 To allow the administration to maximize customer satisfaction and assure service
efficiency.
If time and my skills are in favor, this system would be able to deliver:
 Online transaction for doctor’s fees.
 To apply security encryptions that will assure save transaction.
 To allow users to book vaccine dates for example flu shots.
 To schedule on-site seminars and events.

Project Specification Form (PSF)

Brief description on project background
Problem Context:
Online Patient Scheduling also commonly known as Online Appointment booking system an
optimized phase of medial healthcare service to improve patient healthcare journey in hospitals
and clinics. Motivated by the rising popularity of electronic appointment booking system, this
project aims to develop an appointment-scheduling model that takes into account the patient
preferences regarding when they would like to be seen. Currently, it is rational to establish the fact
that, very few hospitals provide online scheduling doctor-patient session. In fact, majority of the
medical centers in Kuala Lumpur provide traditional patient scheduling routines. In traditional
appointment scheduling process, patients are scheduled for a future appointment time and the
number of patient granted an appointment has an upper limit each time period. The appointment
lead-time could be very long for example, several weeks or a month in advance, which could result
in a high number of no-show. [Dai, X. (2013). Online Clinic Appointment Scheduling. 1st ed.]
In many ‘Open Access Appointment Scheduling’, the number of patients request is selected in
random. A patient is assigned to a time bucket within a relatively short time period such as one or
two day in advance from the time requested. Though the theory behind this process is to reduce
no-show probability, patient inconvenience and waiting time, communication error still holds back
the facility. In classical systems, patients are to go to the hospital and wait in the queue to make a
reservation and get an appointment. [Sherly, I. (2016). Online Appointment Reservation and
Scheduling for Healthcare- A Detailed Study. 2nd ed.] This process is time-consuming where
generally patients end up waiting for very long time intervals. Even though the patient might
choose to fix an appointment, this option is infeasible at all times and does not likely work well
for general public involved in the system. Online scheduling facilitates patients with quick
response service and convenient and accessible time.
Rationale
When on Online Patient Scheduling System is replaced with traditional appointment reservation
service, patients are the prime benefit holders. Hospitals and medical centers would definitely have
a better appointment management process as well as sophisticated control over doctors schedule
and employee productivity. The advantages will be time saving for both patients and doctors and
much convenient for the administrative staffs to manage all the appointments and paper work.

Online appointment scheduling would reduce the workload of the administrative staff and provide
much better customer satisfaction.
Online Patient Scheduling both has tangible and intangible benefits to both users who would book
appointments and the hospital management including doctors and staffs.
Tangible Benefits:
 Flexibility: Online scheduling features advanced functionalities that are automated and
improve the appointment reservation process and provide customers a simple healthcare
flow. For example, time-saving.
 Security: Maintains patient confidentiality and provide information protection. For
example, protected health information are not shared or discussed within even hearing
distance of other patients.
 Connectivity: Keeps organizations better connected with their customers and patients. By
staying connected with their customers, institutions get a better view of their management
process. For examples, reviewing and rating doctor-patient experience flow that helps the
hospital management to overview doctors’ average performance.
 Monetary Savings: Automated scheduling benefits large-scale medical centers monetary
savings. It lifts the burden of assigning staff members to manage scheduling appointments
and reduce employee pay in the form of over-time or hiring new staff.
 Accessibility: Online scheduling software is accessible for all type of users. All that’s
required is an Internet connection and users can access a vast range of facilities.
Intangible benefits:
 Patients are able to schedule for various medical procedures and treatments.
 Daily, weekly and monthly patient scheduled are easily viewed.
 Patient records and Appointments reports are created.
 Helps to track Patient Flow based on arrival, visit and departure time.
 No-show, missing, over-booking patients and other conflicts can be avoided.
 All appointments are assembled from the website.
Nature of Challenge:

To initiate the first phase of this project, I need to master web-developing concepts and user
browsing experience. Different screen-resolutions for different types of devices are to be
understood. As for selecting the programming language, I need to make a choice between using
java or ASP.net since I do not have brief knowledge about ASP.net. While developing the web-
application, security of the website would definitely be considered since I would like to add Online
payment transaction as an extra feature. Not only that other security measures such as prevention
from SQL Injection, Encryption of patient information are to be taken under consideration.
Brief description of project objectives
Deliverables
The intelligent Online Patient Scheduling System aids simple and easy appointment reservation
online as long as the specific device is connected to the Internet. This service will minimize patient
waiting time as well as the chaos of managing tons of appointments everyday by hospital
management. Once a patient has booked a schedule, he or she would also be allowed to make
changes, even cancel their appointment according to their convenience. The website should view
list of doctors with their respective specializations where users are able to select their certain
physician. The system also consists of an administrative panel where the system admin is able to
monitor the number of patient attended by the doctors daily, weekly and monthly. The core
functions of the system are listed below:
 Allows end-users to register, login and logout from the system.
 Allows users to view doctors list according to departments as well as doctors’
specifications.
 Allows users to book update and cancel their appointments.
 Allow the doctors to view the number of patients to be attended for the day.
 Allows respective management staff to be updated about the day’s activities.
Additional Features:
 Allow patients to review and rate their experience with the respective doctors.
 The system generates daily Patient records and Appointment reports for each specific
doctor-patient encounter.
 Once an appointment is booked, the system notifies the users by SMS one day prior to the
appointment.

Special Feature (Circumstance dependent)

 Patient will be able to make Online Payment for their appointment.
 The system will have necessary security encryption to protect patient’s transaction data.
Brief description of resource needed by the proposal
Hardware:
The minimum hardware requirements for development of this system would be:
 Processor Core i5
 Minimum 4 GB RAM
 Router for Internet Access.
Software:
 Operating System: X64bit Operating System
 Windows 7 and above
Code Editor and Database:
 Microsoft Visual Studio 2015
 Microsoft SQL Server
Server-side scripting, Web-server and File Transport Protocol Software:
 ASP.net
 Internet Information Services (IIS)
 FileZilla
Documentation and Planning:
 Microsoft word 2011
Access to Information
Initially, traditional approaches are applied to gather information about the proposed system such
as interviews, surveys, observation etc. Especially interviews with physicians as well as patient
and surveys on related processes. Apart from that, various journals, case studies and e-books have
been gone through for research purpose. For the development of the system, an ASP.net expert
would be consulted who has experience in web developing as well as an encryption specialist for
the security part.
Related Journals:
 Improving access, responding to patient By NHS Practice Management Network (2009)

 International Journal of Innovative Research in Computer and Communication

Engineering by ISSN (2016)
Related System:
 HSC Medical Center Appointment System
 Takaful Appointment System
 Xpert Fitness Center Appointment System.
User Involvement
User involvement is a significant aspect in the system development cycle. In recent studies of
software projects, user involvement, management support and clear statements of requirements are
thought as major reasons in leading system development. (Herlea, 1999)
During the initial feasibility study and design phase, it is crucial to find out the existing problems
and identify the requirements for the new system. To serve this purpose, system developers usually
get users involved. People who would be involved during this phase of the proposed system are
hospital staffs including management employees, physicians, customers those are patients and
expert users. I would have an interview session with administrative staffs those who are already
working on manual appointment scheduling service. Apart from that, to get feedback on the new
system proposal I would have to collect survey from general end-users as well as physicians. These
data will be contributing to the developing and testing phase.
Academic research being carried out and other information, techniques being learned
 Book: ASP.NET 3.5 Unleashed
 Author: Stephen Walther
 Publisher: SAMS Publishing.
 Book: Microsoft ASP.NET and AJAX: Architecting Web Applications.
 Author: Dino Esposito
 Publisher: Microsoft Press.
 Book: Beginning Microsoft SQL Server 2012 Programming
 Author: Paul Atkinson, Robert Vieira
 Publisher: Wrox Publishing.
 Book: Computer Security: Principles and Practice (Third Edition)
 Author: William Stallings, Lawrie Brown

 Publisher: PEARSON
 Book: Advances in Security Technology
 Author: Haeng-kon Kim, Tai-hoon Kim, Akingbehin Kiumi (Eds)
 Publisher: Springer.
Brief description of the development plan for the proposal project
System development methodology is an important framework that is used to structure, plan and
control the process of developing an information system. (SELECTING A DEVELOPMENT
APPROACH. (2008))
Among a wide variety of existing methodologies, I have considered to work under either the Rapid
Application Development or Agile framework. Both these methodologies are distinctive in their
own way and both have a discrete work frame to initiate, compile and implement any software
project.
Rapid Application Development: This iterative framework is commonly accepted for fast
development and high quality deliverables. RAD is less time-consuming than many other
methodologies since it involves the use of iterative Proto-typing especially at any stage of
development, active user involvement and computerized development tools such as Graphical
User Interface (GUI) builders, Database Management System, Code Generators, Object-Oriented
Techniques and Computer Aided Software Engineering (CASE) tools. One of the key strengths of
RAD is that this method concentrates on essential system elements from the user viewpoint that
makes this framework able to change system designs according to user demand rapidly. RAD
framework provides and stores necessary documentation to facilitate future development as well
as maintenance.
Agile Methodologies: Agile Method is programming centric. While other methodologies are
mainly based on the premise that software development processes are to be repeatable thus
predictable, Agile framework emphasizes on unit-by-unit development. Agile process requires less
planning since it adopts the unit coding as it proceeds. This framework divides tasks into small
increments minimizing the risk by developing the system in short time boxes also known as
iterations. The main objective of Agile method is customer satisfaction and that is the reason it
focuses on single requirement with multiple iterations. (Sharma, S., Sarkar, D. and Gupta, D.
(2012)) The process is believed to be suitable for short-term projects with an effort of progressive
workflow that follows software development life cycle strictly.

Chosen Methodology: I have chosen to follow the Agile method to develop the proposed Patient
Scheduling System. One of the prime factors to go with this framework is that, Agile method
decomposes the complete system into manageable pieces known as modules. Since the Agile
process is iterative in nature, it does demand a certain timeline for each module. In terms of time
consumption, RAD method is less time consuming. Though this process breaks a project into
smaller segment, it mainly focuses on fulfilling business requirements rather than programming
excellence that results in lower system quality overall. RAD follows a structure where often project
objectives are unclear that causes lack of scalability and re-usability. By following the Agile
structure, I could minimize the risk of errors especially in programming field due to its iterative
nature. Moreover, its adaptive behavior would allow adapting the processes to adopt the new risks
as well as the changes in real-time requirements. Agile structures would support collaboration
among the three modules in the Patient Scheduling System that would need to be integrated at the
end of the software development process.
Brief evaluation and test plan for the proposed project
Success Criteria
The main aim of Online Patient Scheduling is to provide users simple accessibility. Easy access is
about patients being able to schedule appointments instantly, within a reasonable timeframe and
pre-book one if they wish. (Practice Management Network. (2009).) In order to ensure system
functionality before delivering, I would team up with 10 regular users and 3 known physicians to
conduct a test run for the system. I would divide the test run process into three categories: Unit
Testing, Integration Testing and Usability Testing.
System Flows:
 Registration & Log In
 Select Department
 View Doctors’ List
 Select Doctor
 View available Appointment dates
 View Appointment
 Confirm/Edit/Cancel
 Generate reports

 Send SMS notification to the user

System Units:
 User (Patients)
 Physicians
 Admin.
Unit Testing: This section is to undertake a small part of a testable unit and to test to see whether
it runs with deliverables as expected. Each unit of the system would be tested individually to assure
desired deliverables. For example, the log in/registration module would be programmed to consist
of 5-10 characters. Through Unit Testing, it is established that to log into the system, user has to
input 5-10 characters. Only after each unit is tested successfully, the process follows to the next
phase.
Integration Testing: Integration Testing involves two-tested unit being linked into a fundamental.
For example, when a patient selects a physician from the doctor list of a specific department, the
system will collect that specific physician’s specialization details from the database and show it
on the front-end view for the patient. For the test run, hypothetical data would be input into the
database to check system functionality.
Usability Testing: This stage is to run the full system aiming to provide maximum user
satisfaction. 10 users teamed up for this test run would input actual data just like real patient would
use this service. This group of users would complete each step of the system that includes
providing their actual personal information such as phone number, email address and for Online
Payment account details. They would look up a physician from any specific department, view their
qualifications and book, update and cancel an appointment on the available date and time that are
shown on the screen. This group of users would also be able to rate their medical experience as a
feedback that would be saved in the database. The other group of physicians would log in from
their front-end and view the number patients to be attended for that day. If the special feature
Online Payment transaction were integrated into this system, doctors would also be able to view
their account balance that has been transferred.

Gantt Chart: Final Year Project Documentation
I Task Name Start Finish Duratio March

D n 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
1 Background 9th/3/ 17 9th/3/17 1day

of the project
2 Problem 9th/3/ 17 9th/3/17 1day
Statement
3 Rationale of 10th/3/17 11th/3/17 2days
the project
4 Scope and 11th/3/17 12th/3/17 2days
Objective
5 Deliverables 12th/3/17 15th/3/ 17 3day
6 Literature 16th/3/17 19th/3/ 17 3days

Review
7 Data analysis 9th/3/17 18th/3/ 17 9days
nd
8 Critical 22 /3/17 23rd/3/17 1day
Evaluation
and
Conclusion
Gantt Chart for Designing and Development of System:
I Task Name Duration January 2017 – February 2017

D Week1 Week2 Week3 Week 4 Week1 Week2 Week3
1 Designing 2 Weeks
2 Coding 6 Weeks
3 Testing 2 Weeks
4 Tuning 1 week

Simplified User Manual:
Register
log in
Patient Doctor/Staff Admin
Send confirmation
Make New View System Record
View Patient Records Update Patient Records email and reschedule of
Appointment Page
appointment
Reschedule view for Consulation
View My Appointments
Appointment Ratings
Make Payment
Detailed System Manual:

1) Register as a user to the system once the required details are filled.
2) Login with a valid Username and Password and press the “Login” button.
3) For Patient type, after successful login update personal information page will be opened.
4) Patient Type User-
 The user can book appointment.
 The user is allowed to reschedule appointment.
 The rescheduling function is conditional. It depends on the Paid and Unpaid status
of the appointment.

 Only when appointment status is unpaid, user can make changes in the
appointment. Then the system will re-direct the user to the Make Payment page.
 Patients are also able to rate their consultation experience with the physician.
5) Doctor/Staff User-
 Doctor/Staff is allowed to view appointment record.
 Also, allowed to update and delete records.
6) Admin User-
 Register new Doctor/Staff.
 Update Appointment Records.
 Sending confirmation email about the appointment status.
 View consultation rating.
 View system records.
Questionnaire Sample:
1. How often you use the Internet?
(a) Every other week
(b) Once in a week
(c) Everyday
(d) I do not have internet access
2. How often you use Online Services?

a. Everyday
b. Frequently in a month
c. Once in two months
d. I do not trust online services
3. How often you purchase goods online?

a. Every week
b. Everyday
c. Once in a month
d. Never

4. How often you suffer from non-severe health issues? (E.g. Headache, cough, flu)
a. Frequently
b. Depends on weather
c. Never
5. Do you seek pharmaceutical drugs while suffering from flu?
a. Yes
b. No
c. Maybe
6. Do you find it tiresome to wait for an appointment at the clinic for a non-severe illness?
a. Yes
b. No
c. Maybe
7. Do you have any chronicle disease?
a. Yes
b. No
8. Do you think the traditional appointment scheduling process in time consuming?
a. Yes
b. No
c. Maybe
9. Have you ever faced any difficulties while making an appointment over the telephone?
a. Often
b. Frequently
c. Never
10. Traditional appointment making process limits your option to update your schedule
because-
a. I have to make a call and wait on the line for my turn to be able to speak to an
administrative staff
b. I have to physically go to the clinic if I want to change my schedule
c. I will neither go nor update (No show)
d. None of the above

11. Having an Online Scheduling system would cause you much less time while making an
appointment
a. Strongly Agree
b. Agree
c. Indifference
d. Disagree
e. Strongly Disagree
12. Effective appointment system shows awareness of healthcare organization about
importance of time of patient-
a. Strongly Agree
b. Agree
c. Indifference
d. Disagree
e. Strongly Disagree
13. In what ways Online Appointment making beneficial for you?

a. I do not have to go to the clinic several hours before to make an appointment
b. I do not have to wait on the telephone for an admin staff to confirm my appointment
c. I want to be able to update my appointment time if I want to.
14. An effective appointment system should emphasize more on-
a. Time Consumption
b. Reduce congestion
c. Improve Quality
d. Increase number of patients
e. All of the above.
15. Please choose the way you would want to be notified once your appointment is confirmed-
a. Send me a SMS
b. E-mail me
c. Call me One day prior
d. I do not want to be notified.

Interview Question Sample

Online Patient Scheduling System
Profession: Physician / Management Staff
Interview Location / Media: ……………. Date: …………….
(1) In what ways do you believe an Online Appointment Scheduler could be implemented with
your facility?
(2) If you were to develop the system, what would be the functionalities would you like to
include in the System?
(3) Would you prefer if patients were able to make online deposit prior to the scheduled
appointment?
(4) In your opinion, do you think online payment would be a secure function especially in
perspective of Bangladesh?
(5) Do you have any recommendation to enhance the proposed online service for the future?
Interview Response from Mr. Yasir Sadullah (System Manager, Robi Axiata Limited,
Dhaka)

Interview Response from Dr. Sharmin Kauser (Physician, BIRDEM Hospital, Dhaka)

Interview Response from Mr. Louceny Camara (IT Manager, Maskavia)


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ONLINE PATIENT SCHEDULING SYSTEM

SAMIHA TABASSUM HAQUE (TP034305) 1

SAMIHA TABASSUM HAQUE (TP034305) 2

Chapter 4: System Architecture

SAMIHA TABASSUM HAQUE (TP034305) 3

SAMIHA TABASSUM HAQUE (TP034305) 4

7.4 User Acceptance Test: .......................................................................................................... 121

SAMIHA TABASSUM HAQUE (TP034305) 5

SAMIHA TABASSUM HAQUE (TP034305) 6

Table: Database table for Doctor .................................................................................................. 62

SAMIHA TABASSUM HAQUE (TP034305) 7

Figure 63: Question 12.................................................................................................................. 83

SAMIHA TABASSUM HAQUE (TP034305) 8

SAMIHA TABASSUM HAQUE (TP034305) 9

Table: User Acceptance Test for GUI. ....................................................................................... 122

SAMIHA TABASSUM HAQUE (TP034305) 10

Chapter 1: Introduction to the Study

SAMIHA TABASSUM HAQUE (TP034305) 11

1.2 Problem Context

SAMIHA TABASSUM HAQUE (TP034305) 12

SAMIHA TABASSUM HAQUE (TP034305) 13

1.4 Potential Benefits

SAMIHA TABASSUM HAQUE (TP034305) 14

1.4.2 Intangible benefits

1.5 Target Users

1.6 Scope and Objectives

SAMIHA TABASSUM HAQUE (TP034305) 15

1.7 Deliverables –Functionality of the proposed system

SAMIHA TABASSUM HAQUE (TP034305) 16

 Allows users to view doctors list according to departments as well as doctors’

1.8 Nature of Challenges

1.9 Overview of this report and Project Plan

SAMIHA TABASSUM HAQUE (TP034305) 17

Chapter 2: Literature Review

SAMIHA TABASSUM HAQUE (TP034305) 18

2.2. Domain Research:

SAMIHA TABASSUM HAQUE (TP034305) 19

SAMIHA TABASSUM HAQUE (TP034305) 20

influential factor on performance of Appointment Scheduling among three environmental factors

SAMIHA TABASSUM HAQUE (TP034305) 21

SAMIHA TABASSUM HAQUE (TP034305) 22

2.3 Technical Research:

SAMIHA TABASSUM HAQUE (TP034305) 23

Technical Requirement Analysis:

SAMIHA TABASSUM HAQUE (TP034305) 24

Figure 3: HSC Medical Center Appointment System interface. (http://www.hsc.com.my)

Takaful Appointment System

SAMIHA TABASSUM HAQUE (TP034305) 25

Figure 4: Takaful Appointment System. (https://www.takaful.com.my)

Xpert Fitness Center Appointment System

SAMIHA TABASSUM HAQUE (TP034305) 26

Figure 5: Xpert Appointment System. (http://www.getacoder.com)

Online Appointment for Medical Services by MD Zahidur Rahman

Figure 6:Signing up process for simplybook.me (https://simplybook.me)

SAMIHA TABASSUM HAQUE (TP034305) 27

DEPENDABLE ONLINE APPOINTMENT BOOKING SYSTEM FOR NHIS

SAMIHA TABASSUM HAQUE (TP034305) 28

SAMIHA TABASSUM HAQUE (TP034305) 29

Figure 7: System Configuration proposed by MD Zahidur Rahman. (Rahman, M. (2015))

Figure 8: Doctors’ Interface Output. (Rahman, M. (2015))

Figure 9: Management Interface Output. (Rahman, M. (2015))

SAMIHA TABASSUM HAQUE (TP034305) 30