When visiting health facilities in the interior of Peru, considered as rural areas, we mostly found many shortcomings in the management of health facilities, which is not allowing efficient management, one of the processes is the registration of clinical and pathological analysis, the information they have are in Excel books or notebooks, which makes it difficult to search for patient and processing reports, stopping the good service in health facilities and delays the patient waiting for their results. In this paper we present the design of a web system for the process of care in the clinical laboratory service in health facilities in rural areas, we present the details of the implementation, the main interfaces and a statistic related to the application.
The use of technology in the area of health is playing an important role in the democratization of
health, which is why many of the innovations in health are supported by technology, we find work
related to the use of brain-computer interfaces, in order to characterize the behavior of the human brain
in different situations [
Technology in healthcare is being used from the design of simulation models for different
applications [
The works described are related to the use and implementation of technologies in health centers, located mainly in cities, for the case of towns or rural areas, this situation is contrary, showing a need for the use of technology and new equipment, the intention of this research is to propose a solution for the clinical laboratory service, helping in the process of patient registration and reporting of test results, we explain in detail the implementation and an evaluation of its implementation.
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The materials we present are related to the description of the problem and the description of the implementation of the web system: 2.1.
Currently there is a gap between health services in rural areas compared to services in cities, this gap makes it possible that many of the services are slow and complicated, one of the basic services is related to the management of laboratory tests, where it is based on the registration in notebook or Excel files. This way of working is very common in rural areas.
The development of a web system for the processes related to the management of a clinical laboratory section, will allow to establish more effective procedures for the registration and search of laboratory tests, where it will be possible to consider the time of registration of patient data, the system will reduce the time of issuance of results and we will achieve an improvement in patient satisfaction with respect to care. 2.2.
The following is the description of the method and procedures for the implementation of the system, where a three-layer architecture is considered: 1. Presentation layer: Know as client layer. It refers to the user delivery, that is, it has an interaction with the user through the application interface. 2. Business logic layer: for data validation, dynamic content management and generation of information for the user. In this layer, the customer’s request is taken and related to the data layer for data storage. 3. Data layer: this layer contains the data used by the application, that is, data that has to do with how and how the information is stored and how you have to get to it. To communicate with the data, it does so through and API.
This architecture is used by several interested entities around the world through a network. We can mention that the architecture consists of two parts: a client and a server, so you can install two types of applications:
We execute the code on the user's machine, the server provides the application and the browser is responsible for executing. For this application model, clients must have a compatible browser and application specifications, known as script. The client-side languages can be HTML, CSS and JavaScript, among the best known. There are also frameworks that facilitate the development work such as Angular or Booststrap (Berenguel Gómez, 2015).
Unlike the client side, the server runs the application, forming an HTML code that is returned so that it can be sent to the client through the HTTP protocol. The server executes the script, reducing compatibility issues with client browsers. Some server-side languages include PHP. Java. Python, C#, etc. Server-side scripts are secure, unlike client-side scripts, which are flat files making them vulnerable to attacks. 2.2.2. Backend
Part of the server, responsible for the correct functioning of the logical layer of the application. The application receives, processes and sends the data to be presented to the client.
In the backend we create the connection with the database, apply logical functions and manage the security of the application.
Backend Elements • • • •
API: Rest or Soap
It is on the client side, i.e. the part of the application that has a direct interaction with the user. Web technologies such as HTML, CSS or JavaScript are used to develop the components with which the user will interact and frameworks such as React, Angular, Bootstrap, among others, can be used.
Before the complexity was on the server side (backend), if any change was required in the web page needed to be reloaded to the same, however, came AJAX (Asynchronous JavaScript and XML). This technology is a set of techniques that allows you to create asynchronous applications, which means that you can receive or send information to the server without reloading the page, since these processes are performed in the background.
In Figure 2, we present the diagram of the implemented database, where we have the tables of type of examination, such as urine, urocoltivo, blood, complete hemoglobin, hemogram, parasitology.
In Figure 3, we present the detail of the files needed to run the database, it is necessary for the development, to know how the database is structured and the files needed for its correct operation.
Figure 4 shows the main files of the System, for the execution of the Web System, where the System starts with the execution of the file "Admision.exe". Next, we present the interfaces developed for the functionalities of the System: •
Figure 5 shows the validation of the user who will use the system. Each user, who is a health center worker, must be registered in the system and have a user name and password.
Figure 7 shows the main menu interface, where we have the processes of patient entry, laboratory test registration, analysis registration and results reporting.
Figure 8 shows the patient registration interface, where it is necessary to present the national identity document.
Figure 9 shows the registration of new patients, where the main personal data are recorded. After having registered the data, the next procedure is to register the samples for clinical analysis, as shown in the following figure:
Figure 10 shows the registration of a clinical laboratory examination, where the personal data and the laboratory procedures to be analyzed, which are the different types of examinations, are registered.
Figure 11 shows the results of the report of the tests performed, after having finished the clinical analysis process, the search is performed by searching by patients, organizing the results according to the dates of the tests performed. Number of tests
Test without result
This work was carried out based on the problem of the process that is performed in health facilities in rural areas, applied to the Peruvian reality, health centers located in rural areas, mostly do not have computer systems for the management of health processes, one of the important processes in medical diagnosis, is related to clinical laboratory tests, The implementation of the proposal is important because it allows the automation of clinical processes in health centers in rural areas, which allows the registration of patient data and the issuance of patient results, we can keep track of tests performed, to keep track of the tests performed, as well as the waiting time to perform the registration and the time to view the results.
As a mechanism for evaluating the level of impact generated by the proposal, we performed a descriptive analysis with different indicators, as described below:
Indicator: number of Laboratory examinations with no result due to technical error, evaluated before and after the implementation of the proposal.
In Table 1, we can see that, from a sample of 100 tests analyzed in the same period of time, before the implementation of the proposal, there was an average of 18 tests without results due to the effect of the work done on sheets and written by the same health personnel, with the use of the proposal there are 100% of tests with results, due to the use of the system, working on the premise that all tests recorded have results.
The conclusions we reached at the end of this research, is related to the development and implementation of computer systems, dedicated to improving the management processes of health processes, in our case applied to health centers in rural areas, it is evident that with the use of the proposal will improve the care of laboratory tests, resulting in improved management of human resources, equipment, supplies and laboratory materials, which can improve the degree of satisfaction by the users of health services that are patients in rural areas.
The implementation of new health services management processes allows for the streamlining of procedures in health facilities in rural areas, as well as the connection with reference centers in the regions, thus integrating them into the National Health System, all of this to achieve user satisfaction with health services. In relation to the development of the proposal, it allows to expand its scope by implementing the visualization of laboratory tests over time, as well as to have the results of all tests performed.
[10] Auccahuasi, W., Urbano, K., Ovalle, C., Felippe, M., Pacheco, O., Sandivar, J., ... & Ruiz, M. (2021). Methodology for the development of technological solutions, based on heterogeneous communication protocols: IOT+ RFID. [11] Auccahuasi, W., Ovalle, C., Ayvar, Z., Aybar, J., Quispe, R., Farfan, A., ... & Lovera, D. (2021).
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