User-centered Approach to Developing Solutions for Electronic Medical
Records: Extending EMR Data Entry
Viktor Mikhael M. Dela Cruz, Christian E. Pulmano and Ma. Regina Justina E. Estuar
Ateneo de Manila Univeristy, Katipunan Avenue, Quezon City, Metro Manila, Philippines
Keywords:
Electronic Health Records, Health Informatics, Usability, User-centered Design.
Abstract:
The rapid advancement of technology presents the opportunity to digitize practice management. With a doctor
to patient ratio of 1:33,000, digitizing health records in the Philippines is seen as one solution in providing
more efficient health care services. With the deployment of EMRs in the Philippines at its infancy, there is a
need to initiate studies on feasibility, usability and user perception. This paper reports findings on usability of
EMRs in a developing economy. Specifically, a system usability scale (SUS) was used to assess the usability
of an EMR and interviews were conducted to acquire user feedback. Results of the survey indicated an
overall mean SUS score of 70.76 with age and confidence in technology being key deciding factors. Further
observations and future research to streamline the heavy task of encoding on an EMR during patient-physician
consultation are explained.
1 INTRODUCTION
The World Health Organization (WHO) suggests that
the desirable doctor-patient ratio is 1:1000 (Kumar
and Pal, 2018) but last 2008, a doctor to patient ratio
of 1:28,000 was reported in the Philippines (Villar Jr.,
2008). As of 2016, the country had further increased
its doctor to patient ratio to an alarming 1 doctor for
every 33,000 patients (Sandoval, 2016), a far cry from
the WHO recommended standard.
To curb the staggering proportion of doctors and
patients, the recently promulgated Universal Health
Care Act (UHC) aims to provide policies and in-
frastructure that improves the situations of both
health service provider and health-seeking individual
(Congress of the Philippines, 2018). The UHC law
also cites a number of government programs that aim
to increase human resources for health. These pro-
grams include the National Health Human Resource
Master Plan, scholarships, training programs, and a
return service agreement where graduates of health-
related courses who are recipients of government-
funded scholarships are required to work in the public
health sector for at least three years.
This study builds its foundation from section 36 of
the act which states that health service providers are
required to maintain a complete health information
system, a component of which is the electronic med-
ical record (EMR). To increase adoption to the tech-
nology, public health clinics who submit patient pro-
files and patient encounters to the Philippine Health
Insurance Corporation (PhilHealth) via EMRs are en-
titled to receive cash incentives. The EMR is also an
avenue for receiving incentives for clinics that provide
health care services that are of high priority by the De-
partment of Health including maternal care and new
born care.
This study zooms in on the crossroads Philip-
pine doctors find themselves in through the Universal
Health Care Act. On one end, the continuously rising
number of Filipinos pushes the need for faster patient
turnaround times while the nation’s doctor-patient ra-
tio is being improved. On another end, physicians
are pressured to implement EMRs in their practice for
more efficient facilitation of electronic claims.
As of date, there has been no comprehensive study
on the utilization of EMRs since its initial implemen-
tation in 2015. Implementing and deploying EMRs
without focus on users and usability has been proven
to hinder adoption and further development of the
technology (Force, 2011). Solutions and features cur-
rently being developed whether for existing EMRs
or as new software may be rendered ineffectual once
shipped out without being grounded in user feedback
and without including the user within the center of the
design process.
The challenge to adopt and adapt to new and un-
familiar technology in the face of high work demand
130
Dela Cruz, V., Pulmano, C. and Estuar, M.
User-centered Approach to Developing Solutions for Electronic Medical Records: Extending EMR Data Entry.
DOI: 10.5220/0008944201300137
In Proceedings of the 15th International Joint Conference on Computer Vision, Imaging and Computer Graphics Theory and Applications (VISIGRAPP 2020) - Volume 2: HUCAPP, pages
130-137
ISBN: 978-989-758-402-2; ISSN: 2184-4321
Copyright
c
2022 by SCITEPRESS Science and Technology Publications, Lda. All rights reserved
may be a task too heavy for any user and may be coun-
terproductive to the goals the UHC set out. This pa-
per describes an application of user-centered methods
to ideate and create solutions for EMRs. The surge
in EMR usage and adoption in the country brought
about by the UHC has presented an opportunity to
survey and acquire the feedback of the users of exist-
ing EMRs. In response, research materials such as a
demographics questionnaire and the system usability
scale were produced and modified for distribution to
EMR users. A research team conducted a week-long
survey that covered a number of clinics hundreds of
kilometers apart.
2 USABILITY AND
USER-CENTERED DESIGN
FOR EMRs
User-centered or Human-centered design is defined
by the International Organization for Standardization
as an ”approach to systems design and development
that aims to make interactive systems more usable by
focusing on the use of the system and applying hu-
man factors/ergonomics and usability knowledge and
techniques (ISO Central Secretary, 2019). Improved
productivity, enhanced user well-being, avoidance of
stress, increased accessibility, and reduced risk of
harm are some of the benefits user-centered design
brings to systems (ISO Central Secretary, 2019). This
study takes inspiration from the goal of user-centered
design which is to optimize the user’s experience of a
system by including the user and the user’s perspec-
tive in all stages of the system’s development. De-
velopment of the research materials used in the study
were guided by user-centered design philosophy.
User-centered design highlights the importance of
and is heavily concerned with the subject of usabil-
ity. The Handbook of Usability Testing explains that
a product or a system is usable when users are able to
perform tasks they expect to be able to do without any
barriers or hindrances (Rubin and Chisnell, 2008). In
the scope of EMR usability, Belden et al. (2009) enu-
merated key methods in evaluating the usability of a
system by assessing its effectiveness, efficiency, and
satisfaction provided to users. Given how this study
deals with EMRs that have already been shipped for
production and distributed to the market, this study
focused on acquiring user feedback data to determine
if these systems were able to pass expected criterion.
Page and Schadler (2014) explored how to in-
crease the efficiency, effectiveness, and satisfaction
of the nursing interface of the University of Kentucky
Healthcare EMR. The study aimed to create systems
that made it easy to tell patient stories and reflect nurs-
ing practices through rapid iterative methods in de-
sign, prototyping, and user testing that spanned two
years segmented into 4 phases. A defining factor in
the whole process was using iterative development
phases that was guided by cognitive nurse workflow,
tangible requirements from work teams, and future
state user workflow. Including the users within the
design motivates them to continue using the technol-
ogy and become part of what drives the technology to
be better.
Rose et al. (2005) examined the results manage-
ment module of the Longitudinal Medical Record
(LMR) web-based EMR through two qualitative stud-
ies conducted among the EMR’s users. The study
used task analyses and focus groups as its main
methodologies to address usability factors in the sys-
tem. Prevalent issues in both studies included infor-
mation overload and poor organization, disruptive ef-
fects to physician workflows, and lack of visual cues
and feedback. Focusing on the user’s workflow in
their busiest time was a key recommendation moving
forward. This supports the motivation behind meet-
ing users face-to-face in order to be able to personally
observe what they really need from a system.
With regards to the system usability scale,
Kavuma (2019) surveyed and scored EMR systems in
19 reviewed publications based on efficiency, effec-
tiveness, ease of learning, cognitive load, and user sat-
isfaction using a 5-point rating system inspired by the
usability evaluation criterion of the Healthcare Infor-
mation and Management Systems Society (HIMSS).
The study aimed to evaluate the usability of EMRs in
sub-Saharan Africa and to find out how much usabil-
ity enabled or hindered EMR implementation in the
region. Findings showed that user satisfaction was
the key factor that pulled the general usability score
down. Moreover, it was observed that ease of learn-
ing was correlated to effectiveness as a number of sys-
tems simultaneously had high scores in both metrics.
The study recommended that EMR systems providers
pay special attention to user satisfaction when imple-
menting EMRs.
Furthermore, Shah et al. (2013) developed an
EMR system catered to palliative care providers in
low-resource areas of sub-Saharan Africa and eval-
uated its usability using the system usability scale.
The study aimed to provide palliative care to Africans
in response to rampant diseases such as HIV/AIDS,
tuberculosis, and cancer. The results from the sys-
tem usability scale showed a positive overall median
of 77.5, well above the accepted threshold of 70 to
be deemed usable. Participants, however, were con-
User-centered Approach to Developing Solutions for Electronic Medical Records: Extending EMR Data Entry
131
fused by the difference between ”agree” and ”strongly
agree” and likewise ”disagree” and ”strongly dis-
agree”. This may suggest the merging of the two pos-
itive and negative answers as the difference warranted
no significant effects to the overall result.
EMR usability is a rising field of study in many
nations and with the UHC, it is high time that EMRs
in the Philippines are also examined.
3 DATA COLLECTION
An open ended survey was constructed to measure
user experience including: what types of users are
there, how they perceive their EMR, how they use
their EMR, what features they like and dislike, what
their pain points are in using their EMR, what they
would like added or taken away, and what can be done
to improve their experience on their EMR. The SUS
was slightly modified to fit the context of the research
without sacrificing too much of the original essence.
Specifically, the word ”system” was replaced with
”EMR”, the verb tenses were changed from past tense
to present tense, and complex words such as ”cumber-
some” were replaced with simpler alternatives. Small
changes like these were also made by previous stud-
ies and had shown no significant effect to the result
(Finstad, 2006; Bangor et al., 2009). Additionally, an
interview script was created to allow further elabora-
tion of answers and for the participants to be able to
fully express their opinion.
These materials were primarily distributed to the
users and clients of the SHINEOS+ EMR service as
an initial survey population. SHINEOS+ is a web and
mobile-based EMR service that caters to a network
of health establishments and health professionals in
the Philippines (The Secured Health Information Net-
work Exchange, 2019).
Data collection was performed during a five-
day trip that covered three provinces in the Western
Visayas region of the Philippines. A mixture of al-
lied health professionals including midwives, nurses,
doctors-to-the-barrios, and municipal health officers
were asked to participate in a one-on-one session to
answer the research materials and be interviewed per-
sonally. Each session took an estimated 45 minutes
to an hour including the interview. Before each ses-
sion, compliant with modern ethical standards, partic-
ipants were oriented on details such as what the pur-
pose of the survey was, why they were asked to par-
ticipate, and if they could withdraw from interview
at any point. The survey proper started with the de-
mographics questionnaire, followed by a usability as-
sessment through the system usability scale, and con-
cluded with the interview.
The demographics questionnaire was created to
find out what kind of users implement the EMR at
work. Occupation, gender, and age were the standard
questions asked while literacy and confidence in tech-
nology were also assessed. Furthermore, participants
were also asked how long they have been using the
EMR, how often they use the EMR, and in what pe-
riod of a work day do they interact with the EMR the
most.
A version of the system usability scale was created
in order to attain a qualitative level of the usability of
the EMR based on its user’s perspective. The sys-
tem usability scale is a tool that yields a provisional
measure of a usability through a 10-item Likert-scale
questionnaire (Brooke et al., 1996). For the case of
this research, a total of 15 more items were added to
the SUS and the whole questionnaire was adapted to
fit the EMR context. The extra items were included
to encompass other areas such as technology stress
but for the purpose of this study, only the items con-
cerning the baseline SUS will be evaluated. In to-
tal however, the participants were asked to score 25
statements based on the degree of which the statement
pertains to them.
An interview was held in order to allow users free
speech on their opinion of the EMR as well as to be
able to further expound on their answers. The par-
ticipants answered a total of 12 questions that were
carefully formulated such that they were structured to
keep the topic within bounds of the EMR conversa-
tion but without being too leading as to provoke spe-
cific answers. The participants were asked questions
in English but were given free reign to use whatever
language they were most comfortable speaking.
Interview questions as well as SUS items were
meticulously formulated to map to a specific aspect
of usability, whether efficiency, effectiveness, or sat-
isfaction. Through this, participant answers are more
tangible, the survey is more more organized and con-
sistent, and data acquired is easier to classify. Table
1 illustrates the mapping of interview questions and
modified SUS items to specific usability factors.
Each one-on-one session was conducted in a sep-
arate room in order to minimize noise and establish a
more private setting. In both written and oral surveys,
no identifying information were collected in order to
preserve user anonymity. The demographics ques-
tionnaire and modified system usability scale were an-
swered by the participants with a pen on paper. The
interview was recorded using the interviewer’s mo-
bile phone and the audio recordings were stored on a
privately hosted repository on the cloud. Interviewers
were also advised to take notes as backup and imme-
HUCAPP 2020 - 4th International Conference on Human Computer Interaction Theory and Applications
132
diate sources of information.
After completion of all one-on-one sessions, data
from the demographics questionnaire and system us-
ability scales were tallied on a Google Sheets spread-
sheet while transcription from the interviews were
collated on a separate spreadsheet. A coding man-
ual providing a mapping of fields to descriptions, data
types, and sample values was created for a more struc-
tured encoding and more readable results.
4 RESULTS AND DISCUSSION
4.1 Demographics Results
A total of 15 regional health units and clinics were
visited at the end of the trip. From these 15 estab-
lishments, 36 health professionals agreed to partici-
pate to the study. Almost two-thirds of the partic-
ipants were in the age range of 18 to 35 while the
other one-third was aged 35 to 55 with one partici-
pant being 55 and above. Furthermore, among the
participants, 62% or 22 of them were confident with
technology while 28% or 10 of them were somewhat
confident. The remaining 10% consisted of one par-
ticipant not confident and technology and other par-
ticipants who preferred not to say. It was observed
that there was no correlation between age and tech-
nology literacy since there were participants within
the ages of 18 to 35 that were somewhat or not confi-
dent while there were participants within the ages of
35 and above who were confident. Lastly, 83% of the
participants use the EMR on a daily basis while the
remaining 17% use it either on a weekly or a monthly
basis. How frequent participants use the EMR was
observed to be not correlated to roles and most likely
be dependent on the strategy their respective clinics
implement with regards to EMR implementation.
4.2 SUS Score
Even though with an overall mode SUS score of 67.5,
participants rated the EMR with an overall mean SUS
score of 70.76 with a standard deviation of 10.54, just
slightly lying above the accepted passable score of 70
(Bangor et al., 2008). However, it must be noted that
the range of SUS scores ranged from as low as 40 to
as high as 90.
Findings showed that age was a factor in rating
the usability of the EMR as participants within the
age range of 18 to 35 provided an overall mean SUS
score of 71.75 while participants within the age range
of 35 to 55 had provided an overall mean SUS score
of 66.25 giving a huge 5-point difference. From here,
it can be said that the EMR appeared more usable to
younger participants compared to older participants.
It was also observed that confidence in technol-
ogy was also a factor affecting the SUS score. Partic-
ipants who indicated that they were confident in using
technology and computers provided an overall mean
SUS score of 73.75 while participants who indicated
that they were either somewhat confident or not con-
fident at all using technology and computers provided
Table 1: Mapping of SUS items and interview questions to key usability factors.
Usability Factor SUS item Interview question
Efficiency
”I find the EMR unnecessarily complex”,
”I find the various functions in this EMR
are well integrated”, ”I think there is too
much inconsistency in this EMR”
”Which tasks take the longest to accomplish
using the EMR? What are the steps you take
to accomplish these tasks?”, ”Does the EMR
become unresponsive at times? What are the
steps you take when it does?”
Effectiveness
”I think that I need the support of a
technical person in using this EMR”,
”I imagine that most people can learn how
to use this EMR very quickly”, ”I find the
EMR very unmanageable to use”, ”I need
to learn a lot of things before I can start
using this EMR well”
”How often do you encounter errors when
using the EMR? Which tasks are
error-prone?”, ”Have you had to change
any part of your workflow in order to fit
using the EMR? Which part of your
workflow did you change and how?”
Satisfaction
”I want to use this EMR regularly”,
”The EMR is easy to use”, ”I feel
very confident in how I use the EMR”
”Would you prefer to have alternative
(e.g. paper and pen, record book) methods
in storing your medical records? Why,
or why not?”
User-centered Approach to Developing Solutions for Electronic Medical Records: Extending EMR Data Entry
133
an overall mean SUS score of 62.5. Computer liter-
acy and confidence in technology proved to be a key
factor in assessing the EMR’s usability.
The roles played by participants within their work
did not however affect the SUS score. Encoders,
nurses, and municipal health officers as groups pro-
vided overall mean SUS scores within the range of 70
to 73, all rating the EMR system as passable.
4.3 Interview Results
A total of 300 minutes worth of interviews were
recorded during the one-on-one sessions. Table 2 il-
lustrates a summary of findings from the interviews.
With regards to efficiency, most of the participants
agreed that there were no tasks intrinsic to the EMR
that took glaringly long to accomplish. Words such as
”easy” and ”responsive”, after translation to English,
were used by the participants to describe the system.
The tasks that did take long to accomplish were reliant
on required third-party service providers and a stable
internet connection. It is important to note that these
issues causing delays to the users’ workflow is the
technology required in order for physicians to receive
incentives specified in the Universal Health Care Act.
On the topic of effectiveness, participants state
that errors happen only on the tasks that concern sub-
mission for eClaims. Aside from these, participants
find no other tasks error-prone. Furthermore, partic-
ipants also express that apart from the initial change
brought by learning how to use the system, the EMR
has caused no major change to their respective work-
flows. The participants explain that they have been
able to adjust well to the requirements of the tech-
nology and find that their original workflow is not as
different as their current process with the EMR. How-
ever, it was noted that the participants had to extend
work hours sometimes well beyond closing time as
their internet connection would only stabilize by af-
ternoon onwards. Albeit this change being the biggest
adjustment to the users’ workflows, it is an issue that
must be solved immediately as it deprives users of
regular work hours.
Finally, compared to traditional paper-based
records, participants were very satisfied with their
EMR but were more keen to the idea of implementing
an EMR while still keeping paper-based records for
the purpose of backup. As a response to intermittent
internet connection causing multiple downtimes dur-
ing the day, users adapt by using paper records first
then encoding the records once connection is stable.
Table 2: Summary of responses to interview questions pertaining to key usability factors.
Usability Factor Question Findings
Which tasks take the longest to
accomplish using the EMR? What
are the steps you take to accomplish
these tasks?
There are no tasks that take long
to accomplish within the system,
Weak internet connection is the main
culprit when tasks take a while
Efficiency
Does the EMR become unresponsive
at times? What are the steps you take
when it does?
Long loading times caused by weak
and unstable internet connection
How often do you encounter errors
when using the EMR? Which
tasks are error-prone?
Errors happen not often and are
immediately solved by service
provider when brought to attention,
Tasks that are error-prone are data
entry to eClaims and patient
admission
Effectiveness
Have you had to change any part of
your workflow in order to fit using
the EMR? Which part of your
workflow did you change and how?
Workflow did not change as same
processes are followed, Work hours
increased however due to availability
of internet
Satisfaction
Would you prefer to have alternative
(e.g. paper and pen, record book)
methods in storing your medical
records? Why, or why not?
A mix of electronic and paper records
is preferred
HUCAPP 2020 - 4th International Conference on Human Computer Interaction Theory and Applications
134
5 DISCUSSION AND
RECOMMENDATIONS
Initial scoring on usability of SHINEOS+ EMR falls
short compared to global counterparts. EMR systems
such as the DataPall system in Africa which scored
77.5 Shah et al. (2013) and the NexTech system in
Florida which scored 82 Schumacher et al. (2010) are
ahead in terms of usability.
Based on results of the survey, SHINEOS+ EMR
achieved good reviews with regards to its efficiency,
effectiveness, and user satisfaction, all pillars of us-
ability. However, there are still more improvements
that can be made to improve the service. It is appar-
ent that the main issue users encounter are with avail-
ability due to internet and interoperability with third-
party services. A solution to this can be the use of the
offline version of SHINEOS+ EMR where data en-
tered is first stored on local storage and is only saved
to the cloud once a connection to the internet is avail-
able. This innovation will allow users to be able to
work during the day without downtime which in turn
allows them to finish work within work hours.
Furthermore, it is also recommended that mem-
bers of the SHINEOS+ EMR team conduct more vis-
its to their users whether for the purpose of updating
them on what is new, or acquiring their feedback on
the current system, or checking on what makes the
work of their users harder and how the team can ad-
dress those issues. It is understandable how distance
can be an issue so a substantial visit every 6 months
can be a reasonable timeframe for this. A corner-
stone of user-centered design is the users themselves
and conducting a visit every once in a while not only
allows system makers to quickly and iteratively im-
prove their product but also gives users the opportu-
nity to participate in the development of the tools that
they use and more confidence in their chosen EMR.
6 FUTURE RESEARCH
It was a common trend among all rural health units
to have a staggering number of patients as early as
8 A.M. At these times, it was normal for the receiv-
ing area of each building to be filled by individuals
that need care or by mothers with children suffering
from an illness. Given the large number of people at
such an early time, as well as having a limited number
of staff, and only having one doctor assigned to each
rural health unit, these establishments had adopted
unique strategies for attending to their patients. Fig-
ure 1 illustrates three observed strategies.
Strategy A utilizes a completely paper-based ap-
proach of recording until the information is handed to
an encoder for encoding to the EMR as well for pro-
cessing of the patient record for the extra provisions
specified in the Universal Health Care Act. Strategy B
involves a paper-based approach of profiling until di-
agnosis where a doctor writes the diagnosis on paper
while a nurse by the doctor’s side encodes the diagno-
sis to the EMR as the doctor states it. Strategy C uses
an all-EMR approach.
It is interesting to note that during the diagnosis
stage of the strategies, some doctors encode directly
onto the EMR while some doctors still write their di-
agnoses on paper. When the doctors who preferred
writing on paper were asked why so, the general con-
sensus was that it would take them longer to encode
than to write particularly due to slow typing speed
and intermittent internet connection. However, it was
stated by some nurses and encoders that they have a
hard time reading doctors’ notes and result to consult-
ing with the doctor about what they wrote before en-
coding to the EMR. Considering the high demand for
fast patient turnover especially in the most rural areas,
every minute is precious and doctors can not afford to
waste time dealing with their EMR.
Studies by Poissant et al. (2005) and Hill Jr et al.
(2013) have shown that electronic charting can take
significantly longer compared to traditional handwrit-
ing. Furthermore, as of late, most EMRs only sup-
port typing input but Smelcer et al. (2009) explains
that many physicians still prefer to write on paper. A
challenge, then, is to figure out how to give doctors
another method of EMR data entry that is less cum-
bersome than manually typing through a computer.
Developing a solution for this will remove the extra
time taken to encode data from paper to an EMR and
will allow encoders to reallocate their time saved from
deciphering doctors’ notes to other tasks that may im-
prove overall rural health unit performance.
6.1 Handwriting Recognition
A possible solution and a continuation to this research
is to explore supporting handwriting as a method for
data entry to EMRs. This will be done by developing
a handwriting recognition interface and integrating it
to an EMR for testing, refining through user feedback,
and iterative development. The SHINEOS+ EMR ser-
vice will be used to pilot the technology as a testbed
and for possible public use in the future.
Recognizing handwriting involves acquiring data
such as plane coordinates, time between strokes, and
pressure levels from a compatible digital surface that
accepts handwriting input. Examples of digital sur-
User-centered Approach to Developing Solutions for Electronic Medical Records: Extending EMR Data Entry
135
Figure 1: Observed strategies implemented in rural health units.
Figure 2: Sample handwriting recognition implementation.
faces are tablet computers and pen tablets used by
graphic designers. The JavaScript library MyScrip-
tJS will be used to abstract these functions and bring
handwriting recognition to SHINEOS+. Figure 2 il-
lustrates a sample implementation developed to test
the capabilities of MyScriptJS.
Once initial capabilities have been measured, aug-
mentations to the recognition algorithm will be ex-
plored in order to improve handwriting recognition
accuracy if needed. Furthermore, user-centered de-
sign philosophies will be employed to ensure that
the final outcome is a solution that is usable and has
been developed with and for the users. After a de-
sirable state is achieved, the handwriting recognition
interface will be integrated to the SHINEOS+ EMR
as an additional option for data entry during patient-
physician consultation. Additional features such as
key clinical text extraction and automatic mapping to
EMR fields will also be developed to provide a seam-
less flow of data from doctor handwriting to free-text.
7 CONCLUSIONS
This paper explored the situation of healthcare in the
Philippines, specifically in the context of the Uni-
versal Health Care Act and how health professionals
are now to manage their practice with the aid of an
EMR. Users of the SHINEOS+ EMR were surveyed
to acquire their feedback and usability of their cho-
sen EMR through carefully selected research meth-
ods and materials inspired by user-centered design
philosophies. Results of the survey were reported and
additional insights and solutions were discussed.
In the case of the Philippines, there is an apparent
need for the provision of more policies and infrastruc-
ture that will support the technologies required by the
UHC. At the end of the day, software can only go in-
sofar as the resources it needs are available.
Even though the EMR discussed proved to be
passable in terms of usability, this does not necessar-
ily mean that it is also acceptable. Different contexts
necessitate different strategies to overcome unique
problems and technology should be made as flexible
as can be to accommodate the widest range of use
cases. In light of this, it is important that the users are
also included in the formulation and design process
of solutions. This assures that services and programs
truly do cater to the users needs and not just to the
assumptions of the provider.
HUCAPP 2020 - 4th International Conference on Human Computer Interaction Theory and Applications
136
ACKNOWLEDGEMENTS
The researchers express their gratitude to the Philip-
pine Department of Science and Technology and the
Ateneo School of Science and Engineering for fund-
ing this research through the DOST-ERDT grant and
SOSE Industry grant respectively. The researchers
would also like to acknowledge the support of the
Ateneo Center for Computing Competency Research
(ACCCRE).
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