New Technologies in Women's Health: Analysis of Mobile Application for Healthcare Records for Pregnant Women

1.0 Introduction

1.1 Overview

Pregnancy is one of the most important periods of a woman’s life where during this time, lots potentially worrying changes could occur in her body. Pregnant mothers need regular check-ups, regular supervision, and care once they find out they are pregnant. In Malaysia, the health ministry has created a health record book for pregnant women known as ‘Buku Pink’ or in medical terms, it is called antenatal red card, but because of its pink color, it is better known as a ‘Buku Pink’. This antenatal book is important as it contains a wealth of important information such as menstrual deadlines, delivery dates, and pregnancy history records, including prenatal screening appointments at the Maternal and Child Health Clinic (KKIA) and government or private hospitals. (Sayyed, n.d.)(“Buku pink dan keperluannya kepada ibu hamil - BabyCenter,” n.d.). These antenatal red cards are used to record the information about the medical history, physical examination and the test made (HIV, Hepatitis B, and others), and also the result. One important aspect of pregnancy that was found to be widely used was keeping daily records in a paper-based format. However, according to the authors' observations, there is no longer any mobile app for pregnant women's health records in Malaysia.

1.1.1 Pregnancy in Malaysia

According to Vital Statistic, Malaysia, in 2018, live births increased whilst the births rate declined in 2017. The number of live births was 508,685 in 2017, an increase of 0.1 percent as compared to 508,203 in 2016. The crude birth rate (CBR) declined from 16.1 (2016) to 15.9 (2017) per 1,000 population. More male babies were born than females. A total 262,575 (51.6%) male babies were born in 2017 as compared to 246,110 (48.4%) female babies. The CBR for both sexes declined from 16.1 per 1,000 population in 2016 to 15.9 in 2017. (“Department of Statistics Malaysia Official Portal,” n.d.) Generally, for pregnant women and especially for those who had their first experience of pregnancy will not be comfortable with the pregnancy symptoms such as morning sickness, tiredness, low backache, and /or pain and etc. Brown and Smith (2004) suggest that if women can have their own case notes, they will feeling safer under the doctor's observation of their medical records. Moreover, if they can maintain their own health records during pregnancy, they will feel more “maternal control and satisfaction”. They also found other benefits for providing pregnant women with their own health records, including “increased availability of antenatal records”.

1.1.2 Mobile technology

Mobile technology is a form of technology that is mostly used in cellular communication and other related aspects. Moreover, mobile technology is rapidly changing, and we are seeing new products, services, and innovations every day. As everyone knows, when mobile technology was introduced for the first time, basically it just have function of calls, messages, and games. Over the years, mobile technology has also taken steps to improve and adding more functions and has now transformed into a digital world and made life and business easier. Smartphone has rapidly become the preference device for most Malaysian to remain connected as it use the current mobile technology. Chief Statistitian Datuk Seri Dr. Uzir Mahidin said smartphone usage for internet access also increased to 97.7 percent compared to 97.5 percent in 2015. On mainstream internet activity, among the popular activities are social networking sites with 86.3 percent and downloading images, movies, videos or music and playing or downloading video games at 81.2 percent. (Alias, 2018) . From the statistic that have been mentioned, we can say that, people in our country like to use mobile technology in doing any work or anything including pregnant women because it is become more easier when the technology have been grows up.

1.1.3 Mobile technology trends in healthcare

Health telematics had becoming a great topic in terms of medical informatics and healthcare. Currently, most hospitals and clinics rely heavily on systems based on information technology and communications (IT) to improve the quality, safety, and productivity of healthcare services. Healthcare takes benefits from the revolution of smartphones, such as smart watches, or other sensors that control the health status of consumers. A survey showed that in Malaysia with 86.9% of users relying on the Internet to look for information, majority of them (77.2%) did look for health information online. The most common health-related information that users were seeking were on ‘symptoms and diseases’ (91.4%), followed by ‘health care tips’ (89.8%) and ‘treatment method’ (83.5%). Over half of them were looking for ‘medications/drugs information’ (73.7%), as well as a ‘place to get treatment’. (Unknown, 2012)

1.1.4 Mobile apps for pregnant women's healthcare records

The application developed and described in this paper is intended for use by the doctors and pregnant women and it assists maternal healthcare by automating the following: data collection, integration, and correlation, the regular checkup must be continue follow its schedule to check on the baby's condition and contextual advisory. This application will replace the antenatal book or ‘antenatal red card’ where all information in the book will be convert into a system and will be develop into the application. Other than that, this application also will synchronized with web-based system created by the hospitals to make sure the doctors also will get the data about pregnant women's health care records. This study will address system acceptance by measuring perceived usefulness and perceived ease of use by user testing, based on the following hypotheses: Pregnant women are more likely to adopt a pregnancy-specific PHR module when they find it useful. Pregnant women are more likely to adopt a pregnancy-specific PHR module when they find it easy to use. (Sayyed, n.d.)

1.2 Problem statement

Pregnancy is a period in life in which women must get used to a new state and begin to deal with new uncertainties and anxieties. During this period, pregnant women like to use the internet to find information on pregnancy care, prenatal education, and other than that. In addition to seeking information from the Internet, they also need to register at any nearest clinic, whether government or private in the early stages of pregnancy. This is because they need to sign up for a regular checkups on infants at a nearby clinic. After they have registered at a nearby clinic, they will be given a pink book or called an antenatal book or antenatal red card where the function of the book is to record their health as well as their infants during pregnancy.

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Health Ministry have develop the antenatal red card for pregnant women to keep all the record and status of pregnancy and their current health. The used of the antenatal red card is the manual way used by the current clinics to record the data about the pregnant women. The major problem of using this manual way is, the card could be lost or misplaced. Forgetting or neglecting is part of one's life. As human beings, we will never miss the attitude of always forgetting where things are or where things are wrong. This can be due to being overly busy, under stress, fatigue or possibly experiencing health problems such as depression, hypothyroidism or worse, dementia. However, this neglect or neglect is a normal occurrence in one's life regardless of age limit. A survey showed that the number of personal belongings that we lose each day has no official figure, but one company that produces gadgets to track personal items claims that we spend at least 10 minutes per day looking for lost or misplaced items — or about 2.5 days per year. Moreover, forgetfulness can also be genetic, in which case organic searching may not be enough. A German study also found that some people are more likely to be forgetful, thanks to carrying a D2 receptor gene (DRD2) in their DNA — 75% of 500 people surveyed. (“Virtual Lost and Found - Computer Science Zone,” n.d.)

The next problem is if the card or book is lost, the doctors will face the difficulties to analyze or to go through on the healthcare record and the pregnancy status of the cardholder. As we know, this antenatal book is very important for pregnant women and doctors who examine the baby in their womb. The pink book has two copies of which one will be kept by the patient himself and the other will be held by a clinic or doctor who examines the pregnant woman. Because of this, it's easy for both pregnant women and doctors to see and check their health as well as the unborn baby. But if the both of copies are missing, it will be difficult for a doctor to analyze healthcare records of the pregnant women. In addition to the loss of the book, issues such as stolen patient data can also occur again in a manual way where if the clinic does not store the data in the computer, it will make it easier for the third party to steal the antenatal book which has all the data on female patients pregnant. Meanwhile, there are some clinics are turning paper patient records into digital files. But hospitals and physicians typically don't take the extra step to protect those files -- making them easier than ever for a hacker to quietly steal the important file. A study that showed Recent numbers shows 90% of health care organizations have exposed their patients' data -- or had it stolen -- in 2012 and 2013, according to privacy researchers at the Ponemon Institute. (“90% of hospitals and clinics lose their patients’ data,” n.d.) Furthermore, the manual records maintenance requires more hours and effort to ensure patient privacy is protected and shared files are not accessed by unauthorized people. (O’Connor Stephen, 2015)

Next, we acknowledge the fact that the health Ministry are currently preparing the paper-based antenatal red cards. Paper-Based records are not as secure as digital files that are protected with encryption. Hospitals or clinics often have a single repository of patient data in paper form. Here we can conclude that using paper-based systems will take up a lot of space to keep patient records and data. This patient's data and health records are important for their reference and cannot be simply dismissed. Paper records also naturally deteriorate over time in storage, regardless of how well their environment is controlled, and they tend to decay upon excessive handling. Also, not all doctors have good written results when using paper to write patient health records will make it difficult for us to read and refer back to them. For paper records, if any other person is interested in obtaining a record of pregnant women's health for reference, the hospital or clinic must first convert the paper format to electronic format either by scanning or emailing before they can access the record. In terms of securities, paper records are not very secure because we do not know that someone may physically break into the repository of all the records and health data of pregnant women or any patient. Paper records also can be susceptible to natural disasters such as fires and floods. (“Paper vs. Electronic Medical Records | Chron.com,” n.d.)

1.3 Research question

The aim of this study was to design and implement a mobile application that replaces the pink book or antenatal books that are still used in any Malaysian clinic or hospital to keep a record of pregnant women's health care. More specifically, this study aims to answer these research questions: 1) what are the key features and content for this mobile application? 2) Do the functions of this mobile application help pregnant women and facilitate the work of the clinical administration in maintaining their health care records? And (3) explore their concerns about data privacy and security when using this mobile application.

1.4 Research objective

This paper is focused on determining how mobile applications can be used to improve the antenatal book that stores all data about pregnant women's healthcare records. This research conducted for the issue that faced by pregnant women and the healthcare workers who serve them. This review provides an overview of current literature on pregnancy apps and aims at describing 1) to determine the key features and content of the mobile application of pregnant women's healthcare records, 2) to find out whether this mobile applications are useful for the doctors and also for the pregnant women and 3) to investigate their concerns about the data privacy and security when using the mobile application.

1.5 Scope

The aim for this paper is to focus on the scope of antenatal book use by pregnant women or doctors in clinics and hospitals in Malaysia. In all cases, some countries have developed a mobile application for pregnant women, but in Malaysia still uses the antenatal book or pink book to keep their health care records. Health Ministry have developed the antenatal red card for pregnant women to keep all the record and status of pregnancy and their current health. The antenatal book is one of the systems that use paper-based and this research paper will describe about the mobile application that will replace the antenatal book.

This study will be conducted on clinics in Malaysia that are manage the pregnancy matter. Usually, pregnant women will register at the clinic nearby to get the antenatal book for their healthcare records and checkup schedule. Other than that, this study also will be conducted on pregnant women and the doctors or the healthcare workers who serve them because they are the user of the antenatal book and will be a user for this mobile application.

References

1. 90% of hospitals and clinics lose their patients’ data. (n.d.). Retrieved October 20, 2019, from https://money.cnn.com/2014/08/20/technology/security/hospitals-data/
2. Alias, A. (2018). Malaysia’s Internet penetration is now 85.7 per cent | New Straits Times | Malaysia General Business Sports and Lifestyle News. Retrieved October 19, 2019, from New Straits Times website: https://www.nst.com.my/business/2018/03/346978/malaysias-internet-penetration-now-857-cent
3. Buku pink dan keperluannya kepada ibu hamil - BabyCenter. (n.d.). Retrieved October 19, 2019, from https://www.babycenter.com.my/a25019647/buku-pink-dan-keperluannya-kepada-ibu-hamil
4. Department of Statistics Malaysia Official Portal. (n.d.). Retrieved October 19, 2019, from https://www.statistics.gov.my/index.php?r=column/cone&menu_id=dDM2enNvM09oTGtQemZPVzRTWENmZz09
5. O’Connor Stephen. (2015). Why Your Paper-Based System is Slowing Your Practice Down. Retrieved October 1, 2019, from Why Your Paper-based System is Slowing You Down website: https://www.adsc.com/blog/why-your-paper-based-system-is-slowing-your-practice-down
6. Paper vs. Electronic Medical Records | Chron.com. (n.d.). Retrieved October 20, 2019, from https://smallbusiness.chron.com/paper-vs-electronic-medical-records-40354.html
7. Sayyedi, K. (n.d.). A PERSONAL HEALTH RECORD MODULE FOR PREGNANT WOMEN: SYSTEM DEVELOPMENT AND USER ADOPTION STUDY.
8. Virtual Lost and Found - Computer Science Zone. (n.d.). Retrieved October 20, 2019, from https://www.computersciencezone.org/virtual-lost-found/