Online medical consultation: covid-19 system using software object-oriented approach

Bulletin of Electrical Engineering and Informatics
Vol. 10, No. 6, December 2021, pp. 3471~3480
ISSN: 2302-9285, DOI: 10.11591/eei.v10i6.3189 3471
Journal homepage: http://beei.org
Online medical consultation: covid-19 system using software
object-oriented approach
Ali Yahya Gheni1
, Hiba Adil Yousif2
, Yusmadi Yah Jusoh3
1,2
Department of Computer Science, University of Baghdad, Iraq
3
Department of Software Engineering and Information System, Universiti Putra Malaysia (UPM), Malaysia
Article Info ABSTRACT
Article history:
Received Jul 18, 2021
Revised Sep 29, 2021
Accepted Oct 24, 2021
The internet has been a source of medical information, it has been used for
online medical consultation (OMC). OMC is now offered by many providers
internationally with diverse models and features. In OMC, consultations and
treatments are available 24/7. The covid-19 pandemic across-the-board, many
people unable to go to hospital or clinic because the spread of the virus. This
paper tried to answer two research questions. The first one on how the OMC
can help the patients during covid-19 pandemic. A literature review was
conducted to answer the first research question. The second one on how to
develop system in OMC related to covid-19 pandemic. The system was
developed by Visual Studio 2019 using software object-oriented approach.
Online expert review was conducted within 6 experts from health and
academic industry to verify the model. Also, the system was validated by 11
users from heath and academic industry to confirm its usability. The statistical
package for social science (SPSS 22) was used to analyze the collected data.
The result of expert review confirmed that covid-19 system can help the
patients. Also, the validity of the system was confirmed by 11 users from
health and academic industry.
Keywords:
Covid-19 pandemic
Expert review
Object-oriented
Online medical consultation
Usability test
This is an open access article under the CC BY-SA license.
Corresponding Author:
Ali Yahya Gheni
Department of Computer Science
College of Education for Pure Science/Ibn Al-Haitham
University of Baghdad, Iraq
Email: ali.y.g@ihcoedu.uobaghdad.edu.iq
1. INTRODUCTION
Many people make their own medical decision by using the internet as a source of health-related
information [1], [2]. The term "online medical consultation" (OMC) is used in this research to refer to
medical consultations conducted via the internet. The phrase "remote consultation" refers to "consultation via
remote telecommunications, often for the purpose of diagnosis or treatment," therefore OMC can be
considered part of telemedicine. In three major ways, however, this paper distinguishes OMC from remote
consultations. For starters, non-internet-based consultations such as phone-only or radio-based consultations
are not included in the definition of OMC. Second, OMC represents a paradigm shift in the way patients seek
medical advice, allowing them to "shop around" for medical advice in the same way they shop for other
online services. Third, while OMC focuses on direct patient-doctor consultations, it excludes doctor-doctor
(provider-provider) consultations as well as consultations for health education and other objectives. The
notion of OMC goes beyond traditional telemedicine, which is usually limited to specific medical categories
for patients in specific geographical/geopolitical zones. Patients with a wide range of medical needs from
various locations or nations are usually welcome to use OMC. Patients have the option of selecting or being
allocated to any doctor or care provider who is available online. They are not constrained to a single provider

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Bulletin of Electr Eng & Inf, Vol. 10, No. 6, December 2021 : 3471 – 3480
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based on prior experience or proximity to them. Many countries throughout the world are becoming more
reliant on OMC in their health systems as a result of the covid-19 pandemic outbreak.
Individual medical decisions are increasingly being made using the internet as a source of health-
related information [3], [4]. The majority of publications evaluated remote consultation utilization for a
single medical practice rather than a big group. Medical consequences, communication methods, and
information exchange were the key topics of discussion. Consumer demographics, ailment categories,
reaction times, and certain effect and financial factors were all investigated in various OMC research [5]-[7].
OMC services are said to be popular among customers. Researchers from Pittsburgh University in
the United States found that the eVisit services provided patients with benefits in terms of access, speed, and
convenience while reducing the risk of improper or incomplete care [8].
There are no globally agreed definitions for the nomenclature used to designate various medical
services supplied via the internet [9]. Teleconsultation [10], [11], e-Visit [12], [13], e-Consultation [14], [15],
video consultation [16]-[18], or online medical consultation [19]-[23] are some of the terms used to describe
internet consultations. The term eVisit is more commonly used in the United States. In many sources,
however, the name is connected with the asynchronous variant of OMC [24].
OMC provides a wealth of research and practice options. Since the turn of the century, OMC has
piqued the interest of both suppliers and customers. Healthcare consumers have always wanted to be able to
communicate with doctors-electronically-the way they do with the rest of the world, according to the editor
of Health Management Technology magazine in 2006 [25]. This is especially true for non-urgent matters that
do not require a face-to-face office visit.
Recent study [26] supports a similar point. Patients from outlying areas, the elderly and disabled,
and those suffering from chronic ailments are likely to flock to OMC. Young and internet-savvy persons, as
well as those with rigid working conditions, may prefer it. According to academic assessments of
telemedicine/OMC/eVisits, patients benefit from enhanced convenience and accessibility to health services,
less travel and waiting time to visit a doctor, and a more cost-effective delivery option [27].
Patients don't have to leave their homes or places of work, sit in traffic, then sit in a room with other
patients, perhaps catch or cause an infection in the process, and then return home. A baby's mother may not
need to accompany her child to a clinic for diagnosis of a basic disease like diaper rash, which doctors may
diagnose accurately from certain photos. Patients with chronic conditions may benefit from OMC since it
allows them to undertake routine checkups and obtain test results without having to visit a clinic unless they
specifically request it.
Patients ranging in age from 4 days (for diaper rash) to 86 years (for sleeplessness and hypertension)
used the Mayo Clinic eVisit pilot program's online consultation service in 2010 [28]. OMC is a potential new
technology. eVisits have been demonstrated to be practical with excellent patient satisfaction scores in
several US papers [29].
Concerns have also been made about the safety and quality of OMC practices. According to a study
conducted in Australia, just 29% of the study group (young people) were willing to participate in a video
consultation about their sexual health difficulties, while 63 percent preferred telephone consultation [30].
Despite its international success, telepsychiatry has a limited penetration in Australia, according to another
study [31]. According to a recent media release from the royal Australian college of general practitioners
(RACGP), certain OMC providers' service delivery model makes it more difficult for doctors to diagnose
patients without fully understanding the medical and social context or being able to perform a physical
examination [32].
Furthermore, OMC's economic benefits may be questioned. The use of online GP consultations has
been demonstrated to increase the cost of healthcare in Denmark [33]. Another study in the United Kingdom
found a lack of evidence in teledental applications in terms of cost-effectiveness, quality, efficacy, and
patient satisfaction [34]. The following is how the paper is structured: The first section is an introduction,
which includes the OMC-related work as documented in the literature. The research technique and process
are presented in section 2, the system development is presented in section 3, and the results and discussions
are explored in section 4. Section 5 concludes with a summary of the findings and recommendations for
future research.
2. RESEARCH METHOD
This paper's initial study question is: How might the OMC assist patients? To answer the first
research question, a literature study was conducted:
RQ1: How can the OMC assist patients in the event of a covid-19 pandemic?
RQ2: How to establish system in OMC for covid-19 pandemic is the second research question.
Visual Studio 2019 was used to create the system, which used a software object-oriented strategy.

Bulletin of Electr Eng & Inf ISSN: 2302-9285 
Online medical consultation: covid-19 system using software object-oriented approach (Ali Yahya Gheni)
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To verify the model, six professionals from the health and academic industries participated in an online
expert review. The system's usability was also confirmed by 11 users from the health and academic
industries.
2.1. Confirmation study/expert review
To verify the model, it was subjected to an expert review by six specialists (3 from the health
business and 3 from academia). According to [35], the minimal number of expert reviews is three. Two
experts were handed a draft of the expert evaluation (the first one in the English language and the second in
questionnaire form). The expert evaluation was carried out, and the outcome was analyzed. The model was
fine-tuned in response to expert feedback. Figure 1 shows the process of confirmation study.
Figure 1. The process of confirmation study /expert review
2.2. Confirmation study/survey (usability test)
The technology was put to the test in two locations, each in a different industry. In Iraq, the top spot
goes to a hospital in the health business, while the second place goes to a university in the academic industry.
The snowball sampling technique was used to select a sample from these two industries at random. The
system usability scale (SUS) questionnaire was given to 11 respondents (5 from the health business and 6
from the academic industry) [36]. The questionnaires, which were adapted from [37] and initially from [38],
asked respondents about the system's ease of use when doing certain tasks. The questionnaires' subjective
usability assessment is based on a Likert scale. The tool uses a five-point Likert-type rating scale (ranging
from "strongly disagree" to "strongly agree") with 10 questions about satisfaction, efficiency, and
effectiveness to measure the usability of the system.
3. SYSTEM DEVELOPMENT
We developed this system by Visual Studio 2019 using object-oriented approach. In the object-
oriented approach, the focus is on capturing the structure and behavior of information systems into small
modules that combines both data and process. The main aim of object-oriented design (OOD) is to improve
the quality and productivity of system analysis and design by making it more usable. The main components
of the covid-19 system that will affect the interaction between covid-19 system and its users are:
− System log in: The user should log in with the right username and password which is mentioned by the
system otherwise, wrong message will appear.
− Start the test:
− The user should enter the current temperature.
− The user should choose Yes or No from the symptoms in the system.
− Treatment course for 7 days: The system offered course of treatment for 7 days, this course is offered by
World Health Organization.
− Some instructions on how to protect yourself: The system presents some important instructions to keep
the user safe.
− Questions and answers related to covid-19 pendamic: The system give the opportunity to the patient to
ask questions and the system will give the answer.
− Contact number: The user can call to get instructions a live from doctors and for emergency case.
3.1. Use case diagram
A use case diagram is a system analysis tool for identifying and organizing system requirements
[39]. All system actions that are important to users are represented in the use case diagram. A use case is a
collection of possible interactions between systems and users in a certain compound that are tied to a specific
purpose. The use case is used to identify system users and their actions in the system; it is also used to
explicitly explain the link between the functions of each user, such as which functions should be performed
and which are optional. The covid-19 system's requirements are supplemented by the use case diagram,
which depicts the system's user and functions. Figure 2 depicts a use case diagram. Identify covid-19 system
users and all of the covid-19 system functions they perform [40], [41].

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Figure 2. Covid-19 system use case diagram
3.2. System activity diagram
The workflow behavior of the covid-19 system was described using activity diagrams. Because
activities are the state of doing something in the system, activity diagrams are similar to state diagrams. It's
also used to represent the covid-19 system's workflow and is beneficial for analyzing use cases by stating
what activities must be taken. In the preceding sections, the requirements of the covid-19 system and its users
were identified. Activity diagrams were used to examine the covid-19 system's use case through each of the
system's functions. So, as shown in Figure 3, the general activity of the covid-19 system begins with requests
from the user to insert the username and password; after entering the correct username and password, the user
can smoothly log in to the covid-19 system, after which the user can enter the temperature, symptoms, and so
on. Figure 3 shows the system activity diagram.
3.3. System inplementation
The OMC is available in a number of shapes and designs, and the GUI design chosen and executed
was determined by the analysis and design processes. And, in order to provide better support, the system was
handed to numerous users for a test drive in order to obtain input on accessibility testing. The users must
input the correct username and password on the login screen, as shown in Figure 4. Covid-19 is a button-
based system that may be used by a wide range of users. Figure 5 depicts the screen. Figure 6 depicts the
notion of object-oreiented, which is dominant, and the rest of the author's code for the covid-19 system.

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Figure 3. Covid-19 system activity diagram
Figure 4. Covid-19 system log in

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Figure 5. Covid-19 system interface
Figure 6. Sample of covid-19 system code
4. RESULTS AND DISCUSSION
4.1. Results of confirmation study/expert review
After sending the draft of an expert questionnaire interview to one expert in English language and
one in questionnaire design, the questionnaire was refined, and the results were analyzed after an expert
review with six experts (3 from the health industry and another three from the academic industry). The
findings suggest that experts believe that the proposed paradigm is feasible. The experts also agree on the
suggested model's applicability, comprehensiveness, understandability, accuracy, and coherence.

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4.2. Results of confirmation study/survey (usability test)
After removing the damaged case and examining the outliers, the final sample consisted of 45.5
percent males and 54.5 percent females. 17.3 percent of those who responded were between the ages of 26
and 35. The Middle East was represented by all of the respondents. Because the study's focus was on
hospitals and universities, 45.5 percent of respondents worked in the medical field, while 54.5 percent
worked in academia. 63.6 percent of the samples have job experience ranging from 11 to 15 years. Finally,
all of them are from the public sector. Table 1 provides more detailed information on the demographic
characteristics of respondents.
Table 1. Demographic data of respondents
No Percent
1 Gender
Female 54.5%
Male 45.5%
2 Age
Less than 26
26-35 17.3%
36-45 9.1%
46-55 63.6%
More than 55
3 Nationality
Asian
Middle East 100%
European
North America
South America
4 Industry
Academic 54.5%
Health 45.5%
5 Qualification
Doctors 18.3%
Academic 76.7%
Software developer
6 Work experience
Less than one year
1-5 years 18.2%
6-10 years 18.2%
11-15 years 63.6%
16-20 18.2%
More than 20 years
7 Organization type
Government
Semi government 100%
Private
The technology was put through its paces in one hospital and one university. Several employees
from these two companies were chosen utilizing the snowball sampling technique. An online survey was sent
to 11 people (5 from the health business and 6 from the academic industry). Table 2 shows how the results
were analyzed using SPSS 22.
According to Table 2, the majority of respondents strongly agree that the system is simple to use and
understand. 81.8 percent of users stated they would like to use the system frequently in response to item 1 (“I
believe I would like to use this system frequently”). 81.8 percent of respondents strongly agree with item 2
(“I considered the system unnecessarily complex”). However, because this is a negative item (“I believe I
would require the assistance of a technical expert to be able to use this system”), users' responses to “strongly
disagree” (81.8 percent) and “disagree” (18.2 percent) are high. “Strongly disagree” (81.8 percent) and
“disagree” (81.8 percent) were similarly used by respondents for question 6 (“I thought there was too much
inconsistency in this system”) (18.2 percent).
In addition, replies to item 8 (“I found the system onerous to use”) reveal that users viewed the
system to be simple and straightforward. Item 10 demonstrates how simple the system is to learn. Finally, the
findings of the ten elements relating to system usability indicate that the system's usability is high, and users
are highly satisfied.

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Table 2. Frequency distribution for responses related to usability
no Item Strongly Disagree Disagree Agree Strongly Agree
1 I think that I would like to use this system frequently. 18.2% 81.8%
2 I found the system unnecessarily complex. 18.2% 81.8%
3 I thought the system would be easy to use. 18.2% 81.8%
4
I think that I would need the support of a technical person to
be able to use this system.
81.8% 18.2%
5 I found the various functions in this system well integrated. 9.1% 90.9%
6 I thought there was too much inconsistency in this system. 81.8% 18.2%
7
I would imagine that most people would learn to use this
system quickly.
9.1% 90.9%
8 I found the system cumbersome to use. 81.8% 18.2%
9 I felt confident using the system. 9.1% 90.9%
10
I needed to learn a lot of things before I could get going with
this system.
9.1% 90.9%
5. CONCLUSION
In conclusion, literature review was conducted to highlighted the importance of OMC for all
patients around the world. Furthermore, covid-19 system was developed to help the patients to do their own
test and get treatment for those who are affected. Different instructions mentioned in this system to keep
everyone safe and healthy. Finally, further research needs to do to develop OMC models of services and care.
ACKNOWLEDGEMENTS
First, I we would like to express our sincere gratitude to University of Baghdad for the continuous
support of the research in our academic environment. Secondly many thanks to Universit Putra Malaysia
(UPM) for all the knowledge we gain during our PhD and research journey.
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BIOGRAPHIES OF AUTHORS
Ali Yahya Gheni, he holds his PhD from Universiti Putra Malaysia (UPM) in Information
Systems, Faculty of Computer Science and Information Technology, Department of Software
Engineering and Information Systems, Malaysia. He holds his MSc. from University College
of Technology and Innovation (UCTI) in Information Technology Management, Department
of Information Technology Management, Malaysia. He holds his BSc. in Computer Science
from University of Baghdad, Department of Computer Science, Iraq. He is currently worked as
a senior lecturer in University of Baghdad, Department of Co. Science. His research interest
includes Information Systems, Information Technology Management and Software
Engineering.
Hiba Adel Yousif holds her MSc. from Universiti Putra Malaysia (UPM) in Software
Engineering, Faculty of Computer Science and Information Technology, Department of
Software Engineering and Information Systems, Malaysia. She holds his BSc. in Computer
Science from University of Baghdad, Department of Computer Science, Iraq. She is currently
work as a lecturer in University of Baghdad, Department of Co. Science. Her research interest
includes Software Engineering and Information Systems.
Yusmadi Yah Jusoh received the Ph.D. degree in System Science and Management from the
National University of Malaysia (UKM) in 2008. Currently, she is an Associate Professor at
Universiti Putra Malaysia (UPM), Faculty of Computer Science and Information Technology.
Her research interest is in Management Information System, Information System, Information
Technology Strategic Planning, and Software Project Management. Yusmadi is also a certified
software tester and an academician at Department of Software Engineering and Information
System, Faculty of Computer Science, and Information Technology, UPM since 1998. In 2008
she received her PhD in System Science and Management from UKM. She teaches software
project management, team software project management, information systems, and
management information systems. Her research interest includes software project management,
information systems, performance measurement, and management information system.

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