Online Appointment System

SAMIHA TABASSUM HAQUE (TP034305) 1
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.

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
1. Admin
2. System Change
Control (For Example:
Adding new user to the
system, updating the
system)
Admin User Functions
3. Log-in, Register Patient User Log in
2. Patient
4. Department List
Patient User functions
5. Physician List
6. Available Slots
7. Book
Appointment
8. Make Deposit
9. Update/ Cancel
10. Log-in Doctor User Log in
11. Update Doctor
Specification
Doctor User Functions 3. Doctor12. View Patient
Detail
13. View
Appointment
Record
14. Log in Nurse, Staff User Log in
15. View and Update
Patient Detail
Management Staff User
Functions
4. Staff16. View and Update
Appointment
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
Key
Varchar 8 Unique ID for account record
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
Key
Varchar 8 Unique ID for appointment
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
Key
Varchar 16 Unique number of the card
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
Key
char 8 Unique ID of Doctor
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
Key
Varchar 8 Unique ID of the branch of
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
Key
char 8 Unique ID for each specialty
according to departments.
Description Varchar 50 Detailed information about the
specialization.
Table: Database table for Specialty.
 Rating
Table Name Rating.

Online Appointment System

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Was ist angesagt?

Was ist angesagt? (20)

Ähnlich wie Online Appointment System

Ähnlich wie Online Appointment System (20)

Kürzlich hochgeladen

Kürzlich hochgeladen (20)

Online Appointment System