Chapter 2: Review of Related Literature

CHAPTER 2: REVIEW OF RELATED LITERATURE
The review of the literature for this study would cover the usage of an
automated patient record system, appointment system, and automated billing
system for dental clinics or other types of clinics, its capabilities and how
advantageous the outcome of the automated systems will be. The chapter would
start out on defining what these systems do and it’s understanding regarding
automated systems for clinics, and what these kinds of automated systems will
be throughout the years to come.
An appointment system is much recommended nowadays where an article

according to Diana P. Friedman (2013) says that Internet age has dramatically
altered communication patterns. Face-to-face interchanges continue to give way
to digital message exchanges. Channels for these digital communications have
rapidly morphed and expanded over the past years toward a faster, more
interactive means of exchange. This is the reality that faces dental practices:
Interaction with current and prospective patients will predominately take place
online. A national research study by Sesame Communications documented that
97 percent of dental patients would rather click than call their dental practice. The
same study found that 79.5 percent of dental patients prefer SMS text and email
reminders over phone calls from the practice. And so this is where an
appointment system would go along the ways, since the Internet age has
drastically rise and technology nowadays has almost at its maximum peak for
this generation.
Another article which are published by Jun Yan, Ping Yu and HongXiang
Hu (2010). Appointment system has brought in the benefits of eliminating
service provider's waiting lists, improving patients' timely access to services and
reducing no-show rate. However, to implement this model, practices need to
collect relevant information, develop contingency plans and set up practice
strategies to balance the provision of care and patient's demand. These tasks
are not always easy to achieve. Understanding the requirements and constraints
for effective management of patient booking is essential for developing an
automatic appointment system that effectively supports this model in practice.
Another article in regards to reducing appointment lead –time according to
Ronald E. Giachetti (2008) is the lengthy waiting time for patients to receive an
appointment. A long appointment delay cause patient dissatisfaction with the
health care clinic and also has clinical ramifications. Long appointment delays
are also found to increase patient no-shows, which further wastes medical
resources and leads to a decrease in clinical care. Thus making a policy of
eliminating multiple appointment types can be effective in reducing appointment
delay and as consequent no-shows. This policy is equally effective as general
overbooking without penalizing the entire patient population. So a need of an
appointment system could really help improve and allow patients a more
conventional way to communicate via online.
In the article, Automated Pharmacy System Cuts Waiting Time at Themba

Lethu Clinic, the title already gives us the idea that automation of something
may lead to cutting of waiting time. And so with the dental clinic, waiting time
also needs to be cut-off, and so with the implementation of the patient profile
and records automation, the waiting time of each patient should be lessen for
the clinic staff would only search his/her name if he/she has already filled-up
his/her information in the system.
After making-up with the automation of the patient, thinking of possible

way for the information to be more safe and secure, we come to think of
something that would make it better-off in the security field. In the article, IiWAS
'09 Proceedings of the 11th International Conference on Information Integration
and Web-based Applications & Services, they made an application, which is a
patient electronic medical records, to be a web-based application using the tools
needed. The idea of a web-based application are applied in our system, as this
secures the data more than storing it locally.
In the article, Dental Information System, they have supplied idea that is
similar to a tracker which would keep track of the information stored in the
system. An example of this is that if you have a bunch of patient information
stored in your system, you still can filter out information according to your needs,
like filter it out by date, name, etc. In our system, the idea is applied in the
patient record which would keep track of the treatment done to the patient, the
date, and also the payment of that transaction.
In the patient information part of the system, automation would be a

complete solution for the problems such as long waiting time, the possibility of
the loss of patient record, retrieving of manual records, redundancy of patient
information, and the information about the payments (incurred fees, paid,
balances).
According to a previous study made by Kevin A. Jones (2012) which

aimed to analyze one such application that codes endoscopy procedures based
on the documentation to compare the automated coding method with manual
physician billing to determine the efficacy of charge by documentation. He
concluded in the study that charge by documentation is effective and should be
considered where it is economically feasible. Implementing a system to tie
clinical documentation with billing data was said to have a positive revenue and
significant compliance impact. Our study is similar because we aim to develop a
billing system which will be documented by saving it to an automated patient
record.
An automated Billing system has been proven to be effectively reduce the

labor required for manual input based on an article by Mesel E, Wirtschafter
DD, and Ramsey-Klee DM (1976) wherein an on-line Medicaid billing system
for physicians' services was implemented and tested during a two and one-half
year period in 100 offices throughout the State of +0.50,Alabama. It was
concluded that the input time for the average claim billing for two separate
services was less than one and one-half minutes and resulted in a reduction of
clerical labor required for manual input by at least 50%. Another study made by
June Gibbs Brown (2000) has concluded that the same tools used to ensure
accurate billing can also be misused to maximize reimbursement and to submit
false claims. Even though the system will decrease human effort, it’s still prone
to human mistakes therefore the users would need to exercise caution at all
times.
A thesis made by Fadzhila Binti Sabri (2011) which was a Decision

Support System for Dental Clinic. Some features of the system are the same
with ours. The only feature which differs our system from his system is the
appointment notification through SMS messaging. Therefore it’s very feasible to
achieve our proposed system based on Sabri’s thesis.
References:
1. Friedman, D., & Williams, T. (2013, February 1). Clinical Practice Management.
2. Hu, H., Yu, P., & Yan, J. (2010). Design an automatic appointment system to
improve patient access to primary health care. HIKM '10 Proceedings of the Fourth
Australasian Workshop on Health Informatics and Knowledge Management, 108,
17-22.
3. Giachetti, R. (2008). A simulation study of interventions to reduce appointment lead-
time and patient no-show rate. WSC '08 Proceedings of the 40th Conference on
Winter Simulation, 1463-1468.
4. Automated Pharmacy System Cuts Waiting Time at Themba Lethu Clinic - eHealth
News ZA. (n.d.). from http://ehealthnews.co.za/news/automated-pharmacy-system-
cuts-waiting-time-at-themba-lethu-clinic/
5. Delimayanti, M., & Waluyanti, F. & Riandini (2009). IiWAS '09 Proceedings of the
11th International Conference on Information Integration and Web-based
Applications & Services. 567-571.
6. Dental Information System. (n.d.). from http://etd.uum.edu.my/990/
7. E, M., DD, W., & DM, R. (1976, December 14). Economic analysis of an automated
billing system for physicians' services. Retrieved November 18, 2014.
8. Jones, K. (2012, January 29). Automated Coding, Billing, and Documentation
Support for Endoscopy Procedures. Retrieved November 18, 2014
9. Brown, J. (2000, March 20). Medical Billing Software and Processes Used to
Prepare Claims. Retrieved November 18, 2014.
10. Sabri, F. (2011, May 9). Decision Support System for Dental Clinic. Retrieved
November 18, 2014.

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Chapter 2: Review of Related Literature

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CHAPTER 2: REVIEW OF RELATED LITERATURE

An appointment system is much recommended nowadays where an article

In the article, Automated Pharmacy System Cuts Waiting Time at Themba

After making-up with the automation of the patient, thinking of possible

In the patient information part of the system, automation would be a

According to a previous study made by Kevin A. Jones (2012) which

An automated Billing system has been proven to be effectively reduce the

A thesis made by Fadzhila Binti Sabri (2011) which was a Decision

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