On designing and implementing the emergency Ambulance services to reduce the uncertain death rates of people in the context of Nepal

ABSTRACT

One of the main leading factors is technology in the evolution globalization. Human lives are being highly controlled by 0’s and 1’s. In information and communication technology we know that innovation comes in different size. It also becomes more efficient and more affordable. Smartphones plays important role by enabling the mobility of business. Banking, e-banking, entrepreneurship and health delivery system are its extension. Now a days from student to elderly people uses the smartphone in certain part of a day. As a gateway for communication, messaging, entertainment and information, mobile phones have become the declaration of the “digital age”. Situations might come in life-time which require medical care immediately and very small amount of time can dramatically change people’s life. The service of an ambulance, first aid and paramedics has importance in all society as they save tens of thousands lives on daily basis by answering and responding to emergency calls all over the world. Services of Ambulance includes expertise with experiences and equipment the emergency situation. Mediation, assessment, transport and management to the patients in varying situation of controlled, uncontrolled, and disastrous situations. However, no proper database of the ambulances is available despite its urgent need for contact in situational crisis. So, integrating the need of ICT with health delivery system, Ambulance app aims to provide on-demand ambulance service on request. It also seeks to send assistance tips as per the need of the user. Analysing the current scenario, Ambulance app aims to be a great benefit to every single person and overcome the problem of ambulance availability and access in the city. It also carries the potential to bring a breakthrough in the ambulance service which ultimately is connected with human lives. Making impact on the community and digitizing a developing country like Nepal with the help of a department and technologies that no one stays away from helps the country to take a big leap in the use of ICT in this technological era.

Keywords: Mobile application for health service, On-demand ambulance request

LIST OF ABBREVIATIONS

1. ICT – Information and Communication Technology

2. GPS – Global Positioning System

3. HCP – Health Care Professional

4. VDC – Village Development Committee

5. BLS – Basic Life Support

6. ALS – Advanced Life Support

7. LBS – Location Based Services

8. PNT – Positioning Navigation and Timing

9. IDE – Integrated Development Environment

10. APK – Android Package Kit

11. SQL – Structured Query Language

12. XML – Extensible Markup Language

13. DFD – Data Flow Diagram

14. ERD – Entity Relationship Diagram

CHAPTER 1: INTRODUCTION

1.1  Background

Ambulance, the vehicle which is used for transportation and medical emergencies. ƎƆИA⅃UꓭMA is simply a lateral inversion of AMBULANCE. The vehicles in the front can see and understand the name quicker and can give the way for the ambulance. This project is named ƎƆИA⅃UꓭMA as it aims at enhancing the present ambulance scenario of Nepal using the internet and the mobile technology.

Information and Communication Technology (ICT) in ambulance services includes all the related operations carried through electronic and internet technology. Complex electronic devices and the accompanying technologies are being used extensively in developed countries for the ambulance operation. However, the concept is still new to developing countries like Nepal. Nepal’s ambulance service totally relies on the traditional approach of the phone calls and human interaction. While technology is taking over every aspect of human life, technology in Nepal’s ambulance service remains still in a very primitive stage [Nepalyp.com. 2017].

Information and Communication Technology (ICT) in transportation services of Nepal is in its very primitive state. While the developed countries have totally adapted to technology for the transportation, very few attempts are being made to implement technology in the transportation service of Nepal. Implementation of GPS in some of the local transportation services and few rides sharing and online booking applications are some of the few countable implementations of technology in Nepal’s transportation service, but as a matter of fact these are all just limited to the capital city [Tootle Today,2017]. With this present scenario of both the ambulance and transportation service being very new areas of technological implementation in the Nepal, ƎƆИA⅃UꓭMA aims to bring more technological exposure to the general people and also assist in the operation of ambulance from both the related aspects of it, the patient and the ambulance service operators.

1.2  Problem Statement

Ambulances have crucial importance in Trauma Care, Emergency Medical Services and Emergency Medicine. Studies have found that patient-friendly and proper ambulance services can contribute to reduce deaths among seriously injured or trauma patients. Prompt ambulance service and efficient delivery can avert considerable number of premature deaths. However, the Ambulance Service in Nepal identifies the neglected aspect of the health service delivery system. Having different contact numbers in different places have created confusion and delay in emergency services. As not all roads in residential areas are adequately signposted, it’s very difficult to locate patient’s residence in towns and cities [S. Poudel, 2009]. The time wasted during identifying location leads to deterioration of the patient’s condition. The crisis in the Operational Management of Ambulance Service System necessitates innovative technical solution [R. Gongal and P. Vaidya, 2012].

To address the need for prompt, patient-friendly and efficient Ambulance Service, ƎƆИA⅃UꓭMA aims to list all ambulances operating in Nepal, take in request for ambulance service, track ambulance on its way to pick up the patients, and provide immediate treatment tips. These services at the tips of their fingers, helps the people in need to break the operational constraint and have efficient ambulance delivery as per their need. It also assists them to adhere to emergency treatment by providing tips. At the present era, when people of every age are found using smartphones to a large extent, there could not be a better option than mobile technology for bringing the implementation of technology in the medical field along with transportation and moreover, implementing for the emergency cases, where people’s lives are at the line. This project also helps to impact the transportation service of Nepal which has not been much influenced by the technological innovation in comparison to
the other services and aspects of our day-to-day life.

1.3 Aim

Design and implement the emergency Ambulance services to reduce the uncertain death rates of people in the context of Nepal

1.4 Objectives

The main objectives of the ƎƆИA⅃UꓭMA are as follows:

•             List all ambulances operating in the Nepal and develop and application to request ambulance for service

•             Track the requested ambulance on its way to pick up patient using GPS Track ambulance on its way to pick up patients

•             Extend the service for organizations with ambulance to fix the problem with latest technologies

•             Request all hospital information regarding emergency services

•             Health tips through app

•             Phone directory by states with hospital names

1.5 Scope of the Project

Nowadays modern technology that is taking a both positive and negative leap each day, one can easily get access to experts, leaders and other professionals in any fields of their interest, all over the world at any wanted time. This project can be implemented by various types of organizations that are related with the health service for purposes such as listed below:

• Hospitals for providing information about their services
• Different private and public health-sector related organization to assist people in emergencies
• Organizations with ambulance service to extend their service
• Ministry of Health to enhance their nation-wide health service

Technology has been emerging one of the biggest boons for the human civilization and most of the people are fascinated most of the time with the capabilities of the technology and technology has left no one untouched, from a small kid to elderly people, everyone is being adaptive to technology. Thus, ƎƆИA⅃UꓭMA, in regard of its user scope, has a very wide range.

Below are some of the scenarios where ƎƆИA⅃UꓭMA can be of immense help to people:

• To request ambulance for service with tracking facility to keep up with the ambulance on its way
• In case of emergencies, where people seek for some home-based treatments while the ambulance is on the way
• To contact and locate different organizations providing ambulance service.

1.6 Features of the Project

Some of the notable features that will help in the implementation of this project are as following:

1. Request ambulance sharing the current location with just a single touch
2. Track the ambulance while it is on its way
3. Get home based treatment tips while ambulance is on the way so as to prevent the patient’s condition from worsening
4. Get to contact all the ambulance service providers from a single point of use

1.7 Requirement Analysis

The initial task performed in software projects can be known as requirement. It is mainly including of studying already existed system, data collection, hardware necessity and software requirement.

1.7.1 Existing System

Till date, there are not any mobile based applications incorporating the technological achievements that have been developed for use in Nepal, not even for the capital city. But in contrast, there are applications that have been specifically developed for the ambulance service through mobile phone in other parts of the world. Some of the existing mobile based system for ambulance service have been discussed below:

1.7.1.1 Call Ambulance Application – Emergency App

Call Ambulance is a platform which is based on network, user should come to network they can find emergency providers. Currently, Call Ambulance is highly focused on Hyderabad, India only. Over time, they are aware that this should be built out to other major places too but even if user is not in Hyderabad, the application can be used to get user’s family or guardians informed. They also have networks of own blood donor friends’ network and many extras’ features.

Ambulance can come easily from app, Call Ambulance the process is simplified and prepares users to acknowledge to an emergency situation. On normal basis many hospitals prepare them with user’s health record and insurance records before arriving at user’s location. [5].

1.7.1.2 108 Ambulance Mobile Application

108 Ambulance app is designed to help user or victim to get medical help before all the official formalities is completed by police. This app can make easy to call an ambulance and also help with first sight procedure. If there is any kind of accident, instead of waiting for official formalities of police, ambulance reaches to the spot as soon as getting response. Ambulance Doctor or driver can take photos if accident scene and can immediately respond to patient and can send those photos to police later. 108 Ambulance motives is to prioritize emergencies help to peoples [NDOT,2017].

1.7.2 Data Collection

Data collection plays a vital role for the practicality of any project. It generally includes one-to-one interviews, focus group discussion, surveys, life experiences and observations [Business Dictionary,2017]. In case of this project, actual observation of the scenario has played the vital role in the emerging in its idea. The importance of technology in ambulance field was and is still being realized and dreamt of by every individual who has experienced delay in ambulance service during emergencies and problems faced by the traffic scenario of Nepal for any service.

1.7.3 System Requirement Specification

The requirements of the proposed system are categorized as follows:

1.7.3.1 Functional Requirements

· Authentication Mechanism: An authentication mechanism is required to allow only authorized users to access the services of the application.

 · Real-time Tracking: It should be able to track the location of the ambulance while it is no its way to pick up the patient.

· Data Storage: A database system is required to maintain the record of the available ambulance and the registered users.

1.7.3.2 Software Requirements

The software requirements for both the development of the project and its operation on the user’s device have been listed below:

· Development:

· Platform: Android Studio 2.3.3

· Operating System: Windows 7 or newer

· Processor: minimum Intel i3

· RAM: 3 GB minimum

· Disk Space: 900 MB

· JDK Version: Java Development Kit (JDK) 7 minimum

· User Requirements:

This project is based on internet connection and availability of GPS enabled mobile devices. Mobile science has been considered as a possible service provider since it can offer services everywhere. The possible delivery of technology of smart phone is that it can offer services wherever it is. This application allows user to geo-locate themselves and also the ambulance on its way which will be providing service to the user.

The basic requirements in the user’s mobile phones for smooth functioning of this project are as listed below:

· Operating System: Android 4.1 Jelly Bean minimum

· Memory on Device: 5 MB for installation

· RAM: 768 MB minimum

1.8 Feasibility Study

Feasibility analysis, an evaluation is proposed and analysis is put forward to this project, which ensures if it is technically, economically and operationally feasible [BrightHub,2017]. As the name suggests, a feasibility analysis is a study of the feasibility of an idea. It majorly counters answering the essential question to “should this proposed project idea be proceeded?” [Business Dictionary,2017].

1.8.1 Technical Feasibility

The issue mainly escalates during the practicality stage of the technical analysis includes the following:

· Would the technology to achieve whatever is proposed exist to this day?

·Will the proposed application provide satisfactory response to inquiries and provide information to the users?

· Are there any technical guarantees of reliability, accuracy, ease of access?

The project here developed is technically feasible with this analysis. The application is built in Android Studio platform using Java programming language and can be installed and used on Android phones running operating system with and above 4.1 Jelly Bean.

1.8.2 Economic Feasibility

Developing and deploying this application has a very little economical cost. All the platforms used to develop the application are open source. All the application software is freely available on the internet. The software was installed by downloading from website. The cost of the mobile device depends on the mobile phone. Developing this application is economically feasible as there are no extra or overhead costs that could arise during the development of the project and even after its development. The only cost involved would be the cost of the mobile phones and since the project doesn’t need any specific mobile phones, the smartphone being used by the development team can be used to build this application.

1.8.3 Operational Feasibility

The system design, development can apply significant and timely application of both management and also engineering efforts to meet the previously mentioned boundaries. The operating and technical attributes are engineered into the design. The application is designed so that it is beneficial in real world implemented system. The user requirements were taken into thought beforehand, thus there is no question of individuals resisting the prospective benefits of the program.

1.8.4 Legal Feasibility

The user’s and the ambulance service provider’s data are safe in the database. No unauthorized user can get access to the user’s account as the password has been encrypted using an encryption algorithm. The application uses general data of the user, which is provided is by the user and uses general data of the locations provided on the internet hence will not violate any rules and regulations. The reference utilized are listed with published documents and names of the authors. The design does not infringe copyright since the writers have delicately recorded every small element with a detailed description of the sources. And in regards of codes, they are coded by the project team members and the copyright solely goes to the team members only.

CHAPTER 2: LITERATURE REVIEW

A software development process is the Waterfall approach – also known as the Waterfall Model – wherever progress is continuously flowing towards the conclusion (like a waterfall) in the project phases (that is, analysis, design, development, testing). This includes a complete advance documentation of a project, including UI, user stories and all the changes and results of the features. Waterfall model is implemented to the project.

2.1 Digitization of Human Lives

The digitization of our world has never looked back once it got kicked off few years back, the journey of digitization has always marched forward with abrupt changes in the human lifestyle and the digital trend itself. Looking back at just few years, we ourselves are surprised at all small instances of life how things were done back then and what we are doing at the present for the same. Almost everything we do are now being controlled by chips and boards, what used to be touched and felt is now just visualized [TreeHugger, 2017]. A pocket in the pant has replaced a whole bag pack that used to be carried around, more interesting is that the small device in our pocket has the ability to work more effectively and produce optimal results. And this transformation has never ceased, it is ever growing and developing every time into something better. Looking at how we have changed ourselves in a sub-conscious manner, we hardly find any areas of us lives where we have not let technology intervene.

This is the digital industries era, which is shaping fast. Organization back then needed years to look their pace where as one can measure the pace of digital interference in months. Digital transformation management change is the most tailback till now [Deloitte, 2016]. New way of thinking is very important in organization. Either in public or private sector, the digital era is moving rapidly which also leads in transforming ways the organization operates.

2.2 Impact of Mobile Applications

With the world being digital, smartphone is on the top of the list for this cause. Over 1 billion tablets, smartphones and laptop are used in which almost 180 billion apps are installed or downloaded yearly. Mobile app development is surely one of the greatest innovative and busily growing sectors [Techlabs, 2017]. There is a rapid increment in smartphone users in global market which leads to scale and grow in number of application that consumers can use in their phones. The popularity of mobile apps is expanding quicker than a beanstalk. This sector is enormous and rising every day and the end is in view. The app dev population is expected to expand and there have been new highs on the market for mobile apps [Smashingmagazine.com, 2017]. The Apple App store says user downloads 2.5 million apps and Google play store says users downloads apps are 2.2 million, here we can understand app can play critical role and makes our communication convenient. Access to the information that is vital. These data show that 52 percent of the time people use digital media is spent on mobile applications [business2community, 2017].

The study results show that over 90% of consumers’ multimedia time in mobile applications showed a progressive growth in smartphone media compared to internet computer and that it is much higher in the last quarter. There is very heavy usage of accessing applications on smartphones or small devices than big devices, due to the easy access of application and help of social platform – as information are consumed more on smartphones as we can see decline in print for media [Smart Insights, 2017]. The major conclusion that anyone can draw is that the digitization has been highly promoted by mobile applications, thus any changes to be brought into actions lead towards the change through mobile applications.

2.3 Mobile Applications in Health Services

Information and Communication Technology plays as a vital role in the field of health services. ICT has already established itself as an inseparable part of the health services. With the high-level implementation of ICT in health facility in the developed countries, the developing countries are putting on remarkable efforts.

Taking the annual report of Department of Health Services, Nepal Government, the concerned authorities are making attempts to incorporate ICT in our country’s health services [DOHS, 2016]. Health services are required by every person, sooner or later. Following the day-to-day life, the human body gets through a lot of health determining factors, some good and some bad. At the present time, considering the environment and the uprising level of pollution over the years, the human body is at risk and being vulnerable to various health issues which have now become a global concern and several national and international agencies have approached the concerned national authorities. They 11 have been trying identify repeated patterns of the urban vulnerabilities and the identification the possible steps to lighten the vulnerabilities [Scientific Research, 2017].

In the clinical practice and treatment practice cell phones and digital gadgets have been used by healthcare and hospitals. Smart phones have been used in health care preference, leading to fast growth in software or applications for the creation of the whole platform [NCBI, 2014]. Various applications are available to help HPCs with many essential and difficult jobs. The work may involve information and timing management, access and maintenance to health records, communication and advice, information and reference collection, surveillance and management of patients, clinical decisions, and medical educational and training. Mobile equipment and applications may be used by HPCs and points-of-care tools are increased, which have been demonstrated to promote better clinical decisions and better patient results [PCMAG 2017]. Modern-age medical centres, like the emergency protocols, must be connected to patient records 24 hours a day. More demanding patients; rising rules and problems in compliance. In this circumstance, mobility solutions enable to prioritize emergency patients and support in several ways, like:

• Enhance feedback and patient satisfaction response.
• Simplify smartphone staff collaboration to achieve better outcomes.
• It removes wasteful time spent seeking for or trying to reach some management team on different digital devices.
• Patient care and documentation support and attention. •
• Ensures communication on a single digital device by merging voice, pictures and text messages.
• Improve the treatment of patients by transmitting messages to a timely place of care rather than to a central nursing facility.
• Helps prevent misunderstanding and muddling [Softweb Solutions, 2016].

2.4 AMBULANCE Services: Roles and Responsibilities

Although ambulance immediate services usually perform both patient transfer and emergency response on behalf of the health sector, their primary function is to provide emergency pre-hospital medical treatment. They make health services more accessible, especially after hours, and through advanced communications infrastructure, they contribute considerably to telephone triage and telephone health services. Recently, it has become clear that rising health care system constraints can’t be managed just by additional resources; they also require innovative service delivery techniques. The ambulance service is well-positioned to serve as the first line of care in the health-care continuum, and it can make a substantial contribution to ‘treat and transfer’ or ‘treat and depart’ initiatives. By merging ambulance immediate services into the health system as a whole, their different strategic agendas are linked, boosting efficiency and allowing an ambulance immediate service to influence the success of ‘health’ projects with its relevant knowledge [CPD, 2007]. A technician and a paramedic make up the emergency ambulance service crew. When paramedics arrive at the location, they evaluate the patient’s condition and circumstances before choosing whether or not to take them to the hospital. One of most important tasks for the ambulance crew is to promptly secure and treat patients to avoid any malfunctions before they arrive to the hospital. They provide fast and efficient care that saves lives while ensuring maximum mobility in a safe and clinical working environment. They have extensive knowledge of first aid skills to cure a range of circumstances such as heavy bleeding, crushing and falling injuries, cardiac arrests, road accidents and more. [ezinearticles, 2010].

2.5 Ambulance Service in Nepal

The country’s ambulance operating organizations are not fully inventoried. A complete study of the ambulance operation in the country is not feasible without such information. All ambulance-enabled organizations cannot be deemed in existence and many prior ambulance-related organizations may have been abandoned. The study indicates that an operational ambulance service involves a wide 13 different companies with a variety of features. There were also other criteria for the services offered, such as size, operational range, range of activities and availability of resources. [ezinearticles, 2010]. The findings of types of ambulances can be listed as:

– Government Institutions

– Private Hospitals

– Local authorities (Municipalities/VDCs/Wards)

– Family Security Operations processes and services of the ambulances need particular types of connections between the provider organisation, drivers and users that are based on trust, partnership and cooperation. This relationship is a co-operation and complementary agreement between three parts in the running of ambulance services. This is a sort of tripartite partnership including all three sides’ active involvement in protecting the lives of the people [CPD, 2007]. This partnership includes an effective communication system and a good-condition vehicle between the users and suppliers. The management provides the structure for making the system work effectively and efficiently.

Communication is crucial to the ambulance service’s success. In addition to saving lives, systematic communication between consumers and ambulance providers contributes to the sustainability of the service. Ambulance operators must tell people about the facility and the way it is used and what to expect [MOHP, 2010]. The major information channels utilized by ambulance workers are local publications advertising in the city. Personal communication is also an essential route in the communication to communities, especially in the rural regions, regarding the telephone number of ambulances [ReliefWeb, 2012].

2.6 Mobile Application for Ambulance Service

Mobile applications act as a single point of information by providing all medical records of the patient and encrypting the doctor-patient dialogue and guaranteeing compliance. Mobile applications aimed at this area have gained enormous relevance with technological advances, the growth of smartphones and the growing awareness of health. These applications also contribute to enhancing the effectiveness of healthcare service providers. Mobile healthcare applications are becoming more and more popular everyday as more healthcare providers and searchers benefit from it. The creation of mobile applications for doctors and medical professionals is gaining ground via technical advances and great interest in a medical environment. Mobile applications for the ambulance service are also tremendously growing at the present age. These applications have been built with a lot of features in it. The main purpose of these apps is to book ambulance faster and hassle-free. It is better to book an ambulance than to waste important time by calling out individuals [Risgabhsoft, 2014].

Often, a road collision might occasionally be an emergency; it cannot be only a fatal crash. We witness folks on the streets suffering heart arrest on many times. Situations such as a heat stroke, an asthma attack or even a diabetic emergency may also occur. Some preventive steps that we may do before an ambulance arrives can play an important part in saving a life. [bloodforsure, 2016]. All the required information and first help measures for these crises are provided by these applications. This function is introduced to the application as emergency medical services demand quick transport to the closest medical institution, as well as a rapid evaluation of the emergency. These applications have also been designed for patient transport, basic life support (BLS), support mortuary services and advance life, also provides flexibility to choose the preferred hospital [Times of India, 2016].

The information that is accessible via mobile network to mobile appliances and the ability to utilize the geographic position of their mobile device are entertainment services and location services (LBS). Mobile systems broadcast and receive radio signals with every number of microwave antenna-equipped cell site base stations. These sites are generally installed on a tower, pole or building in crowded regions and linked to a cable channel and switching system. [Reto Meier, 2020].

The GPS is an American company. It offers consumers location, navigation and time services (PNT). The GPS constellation consists of 27 terrestrial orbital satellites. The orbits are planned to make at least four satellites visible in the sky at all time, wherever on Earth [Pahang, 2012]. Four or more of these satellites must be searched and their distances calculated and used by the GPS receiver to traverse 16 of them to infer their placement. Detailed trip information has been gathered via GPS for mobile communications. Presently, individuals may utilize their friends, mobile phones to look for the nearest amenities or to watch the children. [Signal Acquisition, 2017].

2.7 Existing Mobile Applications for Ambulance Service

Few of the existing mobile applications being used in the global context for providing ambulance service have been discussed below:

2.7.1 Call Ambulance – Emergency App

Call Ambulance is a platform which is based on network, user should come to network they can find emergency providers. Currently, Call Ambulance is highly focused on Hyderabad, India only. Over time, they are aware that this should be built out to other major places too but even if user is not in Hyderabad, the application can be used to get user’s family or guardians informed. They also have networks of own blood donor friends’ network and many extras’ features.

Ambulance can come easily from app, Call Ambulance the process is simplified and prepares users to acknowledge to an emergency situation. On normal basis many hospitals prepare them with user’s health record and insurance records before arriving at user’s location. [Play Google, 2017].

2.7.2 VMEDO – Emergency App

VMEDO is India’s best emergency medical application, providing assistance in their situations through connections with the nearest emergency provider (blood donor, blood bank, First aid, hospital, ambulance, etc.).

Most functions to aid individuals in medical crises and few capabilities to support voluntary activities are included in the application. In addition to providing several functions and features, it will be made easy to use, fast, 17 light and safe. The app provides services for first aid, finding ambulance, finding nearby hospitals, health tools, emergency button, profile and social sharing to name a few [Play Google, 2017].

2.8 Comparison and Analysis of Tools

Android Studio was used to build the application. Android studio is the leading Integrated Development Environment for android application development. There surely are other IDEs such as Eclipse which helps in building Android development but Android Studio stands above all. Android studio is also the official Integrated Development Environment for Android application founded on IntelliJ IDEA development after the declaration on Nov, 2014 [Android Studio, 2017]. Android Studio provides a versatile Gradle-based built-in system, build variations and several file generation APK (Android installation package) templates to assist develop common app functions.

An advanced Interface design viewpoint is available to Android Studio in which developers may see a developer’s interface and the components associated with it.

Build Tools

The Gradle build mechanism is used by Android Studio. Android Gradle comprises a Groovy DSL, allowing automated compilations [W3C, 2002].

Advanced Code Completion/Refactoring

Android Studio has support for specific Android refactoring and code than other IDEs. Android Studio is based on IntelliJ which has a lot of features and more “intelligent” auto completion algorithm and predicts far good what you want to do. Android Studio is definitely superior in this area.

 User Interface Design

Android Studio features a completely redesigned user interface design tool. The UI tool in Android Studio allows for more flexibility and is more responsive.

Project Organization

The UI tool in Android Studio allows for more flexibility and is more responsive.

IDE Performance/Stability

Android Studio can make the project in thirty seconds which would have taken a minute or two in Eclipse under the same configuration of the system [Android Studio, 2017]. Android Studio is constantly improving itself and with the release of new updates frequently, the current version of Android Studio provides a very good experience to developers in comparison to other IDEs. Seen as all-in-one package, Android Studio provides more stable performance guarantee than other IDEs.

 

CHAPTER 3: SYSTEM DEVELOPMENT

3.1 Project Management Tools and Strategy

Project management is described as a process of using expertise, knowledge, instruments and procedures in project activities in order to fulfil project needs. Project management processes may be classified into five sections initiating, planning, executing, monitoring and control and closing, according to Project management consultants “A guide for Project Management Knowledge Body” [PMI, 2016].

3.1.1 Work Breakdown Structure

A framework for job breakdown splits a project manager into manageable pieces. It describes the project into digestible pieces that can be comprehended by a project team. There are multiple definitions and details for different levels of the working breakdown structure. In simple words, it is an outline map of the particular project. It is also used to identify the potential risks and their feasible solution [Work Breakdown Structure,2014].

The graph below displays the structure of the project’s work breakdown. This project “Ambulance” has been broken down into six stages such as initial study, requirement analysis, planning, designing, development and testing. In the initial study, the existing system and research papers have been studied. Similarly, in the requirement analysis phase, the feasibility of the project has been studied and analysed. During the planning phase, time schedule and cost analysis have been done. In the designing phase, system designs that define the components of the project have been made. The system design includes system architecture, system flowchart, context diagrams, data flow diagrams, schema diagrams as well as ER diagrams. Similarly, in the development phase, coding as well as documentation and report writing have been done simultaneously. The tests are carried out throughout the testing process such unit test, integration testing and system testing.

3.1.2 Development Model

Development model, in general, is a conceptual framework used in making a diagnosis, understanding of developing process and forming a prognosis for continued digital development [Medical Dictionary, 2017]. The incremental model works for this project best, as each new feature is only added after the preceding features have been completed and the project has been broken down into several components and each component is independently constructed.

The progressive development model is a system approach in which the project model is gradually defined, implemented and tested. Each time till the thing is done, tiny additional characteristics are added. Development and maintenance are involved.

The product is declared to be completed only when it satisfies all of its requirements [TestingExcellence,2017]. The technology is broken down into several parts and each component is independently developed and produced. This permits partial use of the product and prevents a protracted period of development. However, before breaking it and constructing it incrementally, it needs solid strategy, design and a clear and full explanation of the overall system [istqbexcertification,2017].

The diagram in Figure above shows the incremental model of software development. A product is broken down into numerous components under this concept. Each component is then individually developed and produced. It is quick and adaptable, and the major advantage of the incremental model. In the smaller iteration, it is also easy to test and troubleshoot.

3.1.3 System Development Tools

System development tools are the tools used for the completion of this project. Some of the tools are described as follow:

3.1.3.1 Android Studio

Android Studio is the official Android IDE for development and contains all necessary information for developing Android apps in a unified download. Android Studio offers the quickest tools to create apps on every Android phone model [play.google,2017]. Android Studio is based on Intellij IDEA and enables coding and workflow to be executed as well as possible. The project structure and builds of Android Studio and Gradle give the freedom to produce APKs for various sorts of devices [w3.org,2017].

Development environment for User Interface with templates to help novice developers start developing android [Developer.android,2018]. Developers will discover that Studio offers them the tools for building a new smartphone and tablet technology application is incremental Model solutions for watch or android wear, Android box or TV and additional contextual models. [techtarget,2020] Android Studio has been used to develop this project as all the layouts have been defined in XML inside Android Studio. The programming done in Java for building the project has also been used as classes in the Android Studio.

3.1.3.2 VS Code

VS Code also known as Visual Studio is one of the most sophisticated text editors for coding and markup. PC World has rated it 5/5 for its simplicity and sophistication at the same time. It’s quick, leaning to the surfaces without toolbars, settings, and offers an equal view over Linux, Windows and MacOS X. It fills up the gap between fundamental text programs such as Notepad, TextEdit, gedit, etc. and provides complete IDE-like integrated development environments such as Sublime, Eclipse, NetBeans and so on. It is particularly suitable for software development and highly customized with plug-ins and themes throughout the platform. For building this project, VS Code Text has been used to write the API and Mongo queries to connect and query the database.

3.1.3.3 Kotlin

In 2011, Kotlin was initially launched by JetBrains as programming language and computing platform. Kotlin is quick, safe and confident. Kotlin may be used everywhere from laptops to data centres, game consoles to science supercomputers, mobile phones, etc. The Kotlin programming language was developed by a small team of JetBrains. All the business logic of this project has been written in Kotlin which defines the functionality of the project. Features of Kotlin such as interface, inheritance, event handler have been widely used in this project.

3.1.3.4 Node.js

Node.js is the commonly used interactive programming server – side scripting language development which may be integrated in the API. There is an API with embedded code instead of several commands to produce Kotlin Node.js Pages. For building this project, API has been used to carry out all the server-side scripting ranging from database connection to performing all the database queries and retrievals.

3.1.3.5 XML

For data description, Extensible Markup Language (XML) is utilized. The XML standard is a versatile and simplest approach to produce information and to distribute structured data electronically over public internet and business networks. XML code is comparable to Hypertext Markup Language, formally recommended by the World Wide Web Consortium (w3c) (HTML). XML data is referred to as self-definition and auto description [SearchMicroservices,2017]. XML has been used in this project to design and build all the layouts in the mobile application. All the user interfaces have been developed in the XML format.

3.1.3.6 MongoDB

The Mongo DB is a relational database driver used in the Node.js scripting language to provide an interface with MongoDB databases. Mongo DB compass is implemented using the API insertion. An extension typically exposes an API to the Android developer, to allow its facilities to be used programmatically. Mongo Db has been used in building this project to write the queries for database operations which have used with Node.js.

3.1.3.7 Canva

The environment for graphic design that supports the production of various designs. It is used in graphics, posters, presentations, papers and other visual content for social posts. Templates for free or premium users are included in the app.

3.2 System Analysis (Methodology)

Systems analysis is a thorough assessment of an action to discover and establish methods for achieving the intended goals efficiently. It includes the investigation of a problem and the identification and also ranking of different solutions to the problem found, typically by mathematical means in order to discover the most effective operations and techniques to achieve them. The four important phases of system analysis are design phase, study phase, implementation phase and development phase [University of Oulu]. The structural process of system analysis provides a good analysis that is essential for the development of a new improved system.

This project is based on mobile technology with the primary requirement of internet and GPS. Hence, it has used the tools required to develop an interactive system for use during emergencies. Basically, as the user requests for the ambulance, his/her contact details, name and contact number provided during registration is sent to the ambulance service provider with his/her current location. As soon as the service provider starts the service, the service requester will then be able to track the ambulance while it is on its way. During emergencies, some basic home-based techniques can also help the patient and control the situation from worsening, thus while the ambulance is on its way to pick up the patient, the immediate health tips can be utilized to take the home-based steps to assist the patient and control the situation up to the best possible level.

Survey:

What do you think of AMBULANCE app Impact?

8 responses

Response 1: The impact of delayed off-loading and therefore delayed ED care for patients stuck in ramped ambulance queues, as well as the interaction between the urgency of the clinical condition, position in the queue, and patient outcomes, warrants further study.

Response 2: Patients in an ambulance queue, awaiting off-loading on arrival at the hospital, are not currently subjected to a formalized, well-conducted triage process.

Response 3: The impact of delayed off-loading and therefore delayed ED care for patients stuck in ramped ambulance queues, as well as the interaction between the urgency of the clinical condition, position in the queue, and patient outcomes, warrants further study.

Response 4: It will be useful

Response 5: It would save time. And stop users from panicking

Response 6: Very Much helpful

Response 7: Can help more people fast

Can there be misuse of this app?

8 responses

Response 1: I Don’t Think so.

Response 2: In the future, paramedic-informed, contextual and non-clinical criteria might supplement clinically based criteria for emergency service-use evaluation and may inform more patient-centred policy interventions to reduce ambulance misuse and inappropriate use.

Response 3: the ambulance call and transport – and provides insights into how paramedics’ perceptions of appropriate versus inappropriate cases might differ from existing conceptualizations. Paramedic perspectives provide especially rich insights into underappreciated non-clinical and contextual factors that both heighten emergencies for patients and legitimize them in the eyes of paramedics.

Response 4: Not really

Response 5: I don’t think so

Response 6: No

Response 7: Nope, maybe of prank calls

3.3 System Design

 System design is essentially a method for specifying a system’s features, modules, interfaces and data so that prior needs may be satisfied. It may also be characterized as a system process that creates or alters the procedures, techniques, models and methods to which it can be utilized. [Mitre, 2010]. System design includes the identification and access to data sources, the kind and type of data. It also guarantees that the system is developed to meet user requirements. The second important thing about system development is that it is primarily designed to develop an interactive system that can respond to changes if needed. [Fareed Siddiqui, 2017].

The main purpose of the detailed design of the service is to provide a plan for the platform that fulfils the objectives of designing the conceptual system [Ecomputernotes, 2017]. In general, the detailed system design includes: Project design and control, user involvement, major subsystem definition, input / output implementation, user feedback, database design, process design and documentation for design layout [NIOS, 2016].

The system design used for building this project include system architecture, system flowchart, context diagram, DFD (Data Flow Diagram), sequence diagram, use case diagram, activity diagram, schema diagram, ER diagram (Entity Relationship diagram). The diagrams are shown and represented in further below.

3.3.1 System Architecture

The diagram in Figure below shows the overall system architecture of Ambulance app. The user using his/her smartphone requests for the ambulance service which is first stored in the database, after that the driver or the ambulance service provider is notified about the request. Following the request notification, the service provider is to confirm if they are providing the service. Once the service provider starts the ride, the user is sent notification about it. The location of the ambulance is tracked and following the server and the central database, the user gets information about the ambulance location. The service stops once the ambulance picks up the patient and stops the location sharing.

3.3.2 System Flowchart

The diagram in figure 5 shows the system flowchart of Ambulance app. The first requirement for using the application is the user login. The logged in user are redirected to the home screen whereas the users not logged in must login themselves first. Then, the user can perform any of the available three operations. For requesting the ambulance, the user calls any of the available ambulance and then after the request confirmation, the driver shares his location with the patient which the user can track through the application only. For the other two options, i.e., ambulance directory and the immediate help, the application fetches data from the database of the application.

3.3.3 Context Diagram

In principle, a context diagram reflects the system’s high-level view. It describes the domain of the system in the field of environmental study. It describes the top process and its main input and outgoing data flows related to outside participating organizations. [Kizz, 2011]. It is familiar with external entities and main data interfaces which interact with targeted systems. It may thus be a valuable tool for identifying the scope of the project [PQWS, 2013].

The diagram above, figure above shows the context diagram of the project Ambulance. Ambulance app consists of two primary entities who are involved in its working.

User has the privileges of three major services, the most important one being requesting an ambulance for service during emergencies. The user can request for ambulance by 29 sharing the personal details, name and contact number provided during registration and then his/her current location. The other available operations for user are to search or get information about the ambulance service inside Nepal and the other available operation is to get immediate treatment helps which will be completely home-based.

The other entity, the ambulance driver or ambulance service provider has one operation to be done which is to accept or reject the ambulance service. Once the user requests for the service, the ambulance service provider are notified about it. If they accept the request, their location will be shared with the user thus the user will be able to track the ambulance throughout its journey. Once the ambulance has reached the address of the patient, the service providers can then stop sharing location or if anyone related to the patient who cannot go with him/her asks to keep his location sharing throughout the way back to the hospital, the ambulance service provider can do so as well. Once they reach the hospital and the ambulance service provider will get the information through tracking and thus the ambulance service provider can then stop sharing the location.

3.3.4 Data Flow Diagram Level 1

The Data Flow Diagram (DFD) is a diagram showing how inputs and outputs are handled by a system. As its name says, it focuses on the flow of data, where data comes from, how it is stored or preserved. [Smart Draw, 2016]. In a DFD, just four symbols are used: circles, squares, open rectangles and arrows. The squares are external entities that are data sources or destinations. Each circle is a process, which processes, processes and outputs data. The arrows indicate the flow of data, which might be electronic or physical data. The open rectangles are also the data storage devices, including electronic stores like database or eXtensible Markup Language (XML) and physical stores like cabinets or paper stacks [AmbySoft, 2014].

This project has five major processes which have been represented as individual processes in the Data Flow Diagram. The five major processes are as follows:

 · Requesting ambulance for service

· Ambulance Directory

· Immediate help in case of emergency

· Maps Operation for the location sharing and locating the ambulance service providers

· Accepting requesting of ambulance service by the ambulance service provider, in most of the cases, the ambulance driver

All of these processes have been further decomposed individually to provide a clear view about all of these processes take place and what sub-processes are involved in this process.

The diagram below in the figure above represents how the operation starts in this project and the data flow sequence from one process to another to get the work done in the application.

3.3.5 Data Flow Diagram Level 2

3.3.5.1 Decomposing Process 1

The diagram in Figure above is the decomposition of process 1 of DFD level 1. In this diagram, the user first selects the pickup location which will be the current location of the user, then the patient’s detail will be sent to the ambulance service provider. After the request has been placed, the service provider will be notified about it and once the service provider accepts the request, the user will be notified about it and then will be able to track the ambulance on its way to pick up the patient. Once the ambulance reaches the patient’s location, the operation is said to be complete. The ambulance can be further tracked on its way back to hospital as well for patient’s family conformity. The tracking service will be stopped only when the ambulance service provider stops the service.

3.3.5.2 Decomposition Process 2

The diagram in figure above is the decomposition of process 2 of DFD level. Here the operation of ambulance directory has been shown. First of all, the user can access a list of ambulance from the directory. Then the user can search as per his needs and then get the details about it. Furthermore, to know the location the user can use the location service to find the ambulance service provider’s location.

3.3.5.3 Decomposition Process 3

The diagram in figure above is the decomposition of process 3 of DFD level 1. The decomposition shows how the operation of locating on map is performed. At first, the latitude and longitude of the requested ambulance service provider is found out and then it is located on the map with a pin point.

3.3.5.4 Decomposition Process 4

The diagram in the figure above is the decomposition of process 4 of DFD level 1. The operation of immediate home-based treatment helps has been decomposed here. The user first gets a list of possibly helps for various types of sickness and emergency condition. The user can search help for the needed one and carry out the proceedings accordingly.

3.3.5.5 Decomposition Process 5

The diagram in the figure above is the decomposition of process 5 of DFD level 1. This decomposition shows how the ambulance service provider perform their operation. As soon as any user requests an ambulance for service, the service provider is notified about the request with the user’s name, contact number and location. Then, the driver accepts the request if available. As fast as the driver accepts the request of emergency, the user is notified about it and then the ambulance service provider starts sharing the location thus the user will be able track the ambulance on its way to pick up the patient. The location will be shared by the ambulance service provider until it reaches the patient’s address. Furthermore, the service provider can keep on sharing the location on its way back if the patient’s family or closed one requests for the service.

3.3.6 Use Case Diagram

In a system, the users execute an activity, which is known as case diagram in the description. It illustrates the user system and the behaviour of the system while responding to a request [usability.gov, 2016]. It is basically a type of textual requirements specification that captures how a user will interact with a system to achieve a specific goal. The use case diagram usually contains an actor, basic flow, post conditions and processes [Bridgingthe-gap, 2017].

The diagram in figure above shows the use case diagram of Ambulance app. There are three actors; patient, ambulance service provider and the admin. The patient or the user includes three operations; request ambulance, search ambulance and get immediate health tips. The option of requesting an ambulance extends to sharing the name, contact number and the location. The ambulance directory option extends to locate on map but this is on request.

The ambulance service provider has one option which is to accept request. Once the ambulance service provider accepts the request, the option extends to sharing the location of the ambulance so as the patient or the user can track the ambulance on its way.

 The admin is responsible for all the user and ambulance registration and carrying out all the related operations such as maintain the ambulance registry, immediate health tips so that all the operation can be performed effectively and efficiently in the application.

3.3.7 Sequence Diagram

Sequence diagrams visually describe the logic flow inside the system, enabling both the documentation and the logic validation. It is used both for analytical purposes and for design. The time passes from top to bottom, i.e., the interaction starts close to the top of the picture and finishes at the end of the diagram. [trademodeler, 2014].

The sequence diagram for two major operations of the project, requesting an ambulance and accepting ambulance request have been explained below:

3.3.7.1 Sequence Diagram for Requesting Ambulance

The operations that are followed in an order to place a request for ambulance consist of enabling the location sharing on the user’s phone then selecting the menu of request ambulance form where the user places a request for ambulance. This record is then sent in the database for record. The request is then passed on the server from where the ambulance service provider is made aware of the request.

The diagram in figure above shows sequential operations for requesting an ambulance using the Ambulance application.

3.3.7.2 Sequence Diagram for Accepting Ambulance Request

The sequence diagram for accepting an ambulance request by the ambulance service provider has been shown in figure above. In the operation of accepting the request, the ambulance service provider is first notified about the new request. Then the service providers are to respond to the request and give confirmation. After the confirmation, the service provider starts sharing the location through the GPS and all the location history of the ambulance service provider are then regularly updated in the database. The storing of location is brought to an end once the ambulance reaches the user’s location.

3.3.8 Schema Diagram

A skeletal structure that reflects the logical perspective of the whole database may be specified as a database schema. It describes simply how the data are structured and the interactions between them. All the limitations must be placed after formulation upon that data. A schema for a database describes all its elements and their relationships. It includes a detailed database information that helps programmers understand and utilize the database [Tutorialspoint, 2016].

The above diagram in Figure above represents the database table schema of the project that shows the database table and their relationships. The database is comprised of following tables:

Ambulance Record: This table consists of all the related details of ambulances in the application. Every ambulance is assigned a unique ID, which will be called as ambulance ID. These details will be available for the user from the ambulance directory of the application.

Location Feed: This table is used to keep track of the ambulance while it is on its way to pick up the patient. Every update will be kept unique by assigning a unique ID to 38 every update following the request. The user will track the ambulance following the records of this table.

Request Ambulance: This table is used to keep track of the records placed by the users for the ambulance service. Every request will be identified by its unique request ID. The table will contain details about the service requester and the provider following the unique ID for the ride.

User Details: This table as per its name will have record of the user. The table will be updated every time a new user register him/herself. The registration will require details such as the username, e-mail address, contact number and password. The login will also be carried out following the rows of every registered user using this table.

3.3.9 Entity Relationship Diagram

The relationships of the entities contained in a database are generally illustrated in an enterprise relation (ER) diagram. An entity can be interpreted as a data component. ER diagrams usually depict the logical database structure. It is a way of displaying the connection of information generated by a system. The ER diagram consists of five basic components. The objects are shown as rectangles. Diamond shapes are depicted, which demonstrate how two items in the database communicate information. The characteristics of the entity are ovals. The linking joins the associated diagram properties. The following graphic shows how many entities link to another targeted entity instance [Project Insight, 2017].

The diagram above in Figure above is an abstract representation of the entities and their relationship of the database used in the project. The rectangular box represents the entity, ellipse represents the attributes and the diamond represents the relationships. The entities in the above figure are explained below:

i. Ambulance

Attributes: Ambulance_ID, Assocaited_Hospital, Contact, Location, Number

Plate

Primary Key: Ambulance_ID

Relationship with: Location, Request Form

ii. Location

Attributes: Update_ID, Ambulance_ID, Request_ID, Latitude, Longitude

Primary Key: Update_ID

Foreign Key: Ambulance_ID, Request_ID

Relationship with: Ambulance, Request Form

iii. Request Form

Attributes: Request_ID, Name, Location, Contact, Responding Ambulance

Primary Key: Request_ID

Relationship with: Ambulance, Location

3.4 Project Schedule

 The project schedule is an instrument that provides information on the work to be done and on the resources to be collected for work in that timeframe. It essentially reflects the effort related to the project delivery in due course [gantt,2017]. 

3.4.1 GANTT Chart

This kind of diagram is usually used for project management. Gantt Chart is the most common and efficient technique of displaying events and activities. Activities are time frame based, a list of activities for a left portion of the chart and a time period for the top section. The length and position of the bar represents the date, durations and finish date of the activity. Each component of the activity is shown in bar.

• A Gantt chart enables you to see at a glance any parameters relating to projects:
• What are the different activities?
• When every activity starts and finishes
• The length allocated for each segment of activity
• Where tasks intersect with another activity, when they are complicated, as well as how much
• The beginning and finish of the entire project [Tutorial Point, 2017]

The Gantt chart of this project is represented in the figure below which shows all the activities that we carried out for this project and the time scale and the overall time schedule. The Gantt chart helps to visualize the overall processes involved in Ambulance at once.

3.4.2 Time Schedule

The detailed time schedule of this project is explained below:

3.5 Testing

Testing is the software assessment according to users’ or customers’ project needs and system requirements. In program code, software system testing discovers key faults, flaws, mistakes and warnings which have to be resolved or corrected in order for applications to work properly. The testing is carried either at the phase level in the program development cycle or in software code at the module level. The verification and validation of software testing includes [tutsplus, 2012].

The testing performed in this project are mentioned below:

3.5.1 Unit Testing

Testing units involves testing particular code functions and fields. It helps in checking that each code functions as scheduled. It helps to discover algorithm errors and logic, so that the reliability of the code that comprises a specific function is improved [Miscrosoft, 2016].

Unit testing has been performed for every function in this project during its development phase.

3.5.2 Integration Testing

Integration tests are essentially a logical extension of the test unit. In small terms, you may merge two units into a component and fully evaluate the interaction between them. It highlights issues when several units are mixed [istqbexamcertification, 2016].

The many components of this project were tested when they were integrated.

3.5.3 System Testing

System tests examine the behaviour of the entire system in accordance with the development project field. Risk and requirement-based tests may include, business process, use cases and high-level descriptions of operating systems interactions, system behaviour and system resources. During the final test, the system should match the specifications and goals so that system testing is carried out [UKY, 2017].

System tests are carried out when every application or feature is completed and enhancements to the current system are continuously being made. The below system test scenarios and the test output image have been listed:

3.5.3.1 Test Case 1

 Test Objective: Test for Splash Screen

Test Performed: 5.00-inch multitouch screen with a resolution of 720 pixels * 1280 pixels

Output: Test is successful with the splash screen being displayed.

Conclusion: Splash screen appears when the app is loaded.

3.5.3.2 Test Case 2

Test Objective: Test for Valid Registration

Test Data:

Valid Credentials: Username: Linus | Contact No.: 9843123456 | E- mail address: linusd@hotmail.com | Password: linus123

Invalid Credentials Case 1: Username: | Contact No.: 98034444444 | E-mail address:pds@gmail.com | Password: pranesh1

Invalid Credentials Case 2: Username: Jeyy karki | Contact No.: 9841567895 | E-mail: jeyy@gmail | Password: password

Output: Valid Credentials: Android toast of Registration Successful Invalid Credentials Case 1: Android toast of Please Enter Valid Username

Invalid Credentials Case 2: Android toast of Please Enter Valid Email

Conclusion: A new account can only be registered after providing all the required credentials in its correct form.

3.5.3.3 Test Case 3

Test Objective: Test for Valid Login

Test Data: Valid username: Linus Dhakal | password: linus123

Invalid username: Linus | password: password

Output: Valid: Home screen Loaded

Invalid: Generated toast of Invalid Username or Password and stayed in the login screen only

Conclusion: Application can be accessed only with valid username and password

3.5.3.4 Test Case 4

Test Objective: Test for Ambulance Request

Test Performed: Ambulance was requested from Buddhanagar.

Output: Request was placed.

Conclusion: Ambulance can be requested from the current location.

3.5.3.5 Test Case 5

Test Objective: Test for tracking of ambulance

Test Performed: The request was made from Buddhanagar to ambulance in Thapathali.

Output: The ambulance was tracked throughout its ride.

Conclusion: Ambulance on its way as response to the request can be tracked throughout its journey.

3.5.3.6 Test Case 6

Test Case: Test for functioning of ambulance directory

Test Performed: An operation was carried out to locate an ambulance service provider in map from the directory.

Output: The ambulance service provider was located in the map.

Conclusion: The user can contact or get information about the service providers using the application.

3.5.3.7 Test Case 7

Test Case: Test for functioning of immediate help

Test Performed: Immediate home-based treatment for snake bite was searched.

Output: List of home-based activities to control the spread of snake bite effects were displayed.

 Conclusion: The user can get home based treatment help form the app.

3.6 Implementation Method

This system describes system implementation. It is installed, managed and maintained. The system also fulfils the quality criteria. It also assures System Implementation is the testing program for the entire system to establish its functionality and limits in its current environment, which also proves its full operation and its compatibility with the rest of the subsystems and supporting components needed for planning and operation [UKY.edu, 2017].

The displays were designed in XML and the company logic in Kotlin. The database is mongo dB, where all user registration and current location information is present. Nodejs are the web service for connecting Mongo dB to Android. On the server you may find the kotlin files. The web services have been hosted in the free webhost service provided by 000webhost.com. Google Maps API has been used to make it easy for the user to track the ambulance while performing its operation.

From the user aspect, the project can be implemented just by installing the app in their android phones and allowing permission of GPS. You may easily launch the program through the internet. The project is convenient and cost-effective, which allows any common person to utilize it. The minimum Android version required for this application is 4.1, so people using the older versions of Android can also easily use the app and be benefitted by its services.

This project is an initiation to bring the changes in how we have used the ambulance service. While everything else in the world gets digitalised and taken over by technology, the initiative will also allow individuals to increase their technical ability in their everyday lives and exploit the free donation of technology. The project can be implemented by the governmental level health-related departments as well to provide the technological gift to people wherever possible.

3.7 Support and Maintenance

Support and maintenance are an ongoing process throughout the project operation. The support and maintenance for this project shall be continued with improving features of the project. New progress and features that will make the project more functional, practical and user-friendly should be added. Similar progress and features should be added to the server as well, with the establishment of dedicated servers and increasing the project operational area to a larger geographical area and make the project accessible to all users wherever the project is feasible.

CHAPTER 4: RESULT ANALYSIS

 

4.1 Screenshots

The final result of this project was the development of an Ambulance app. Although it is a single project development of two applications was necessary, one application for the user and the other for the ambulance service provider or the ambulance driver. For the operation to take place, the user or the requester uses the Ambulance application whereas the driver uses the Driver application. The request is made using Ambulance and the response is given using Driver. Both the application should be working stage and should provide required privileges in the mobile for the operation.

The screenshots of the main pages of the system are placed and explained below.

4.1.1 Splash Screen

The image in the figure below shows the splash screen of the Ambulance app. It is the first screen that is loaded when the application is opened. This screen remains for 1.5 seconds and redirects to home screen if the user is logged in else it redirects to the registration page where the unregistered user registers him/herself and following the screen the logged-out user logs in into the application.

4.1.2 Registration Screen

The image in the above shows the registration screen for users of Ambulance app. Various validation techniques have been implemented for the registration process such as none of the fields can be empty or giving wrong format e-mail address or even not giving the correct length of the mobile number. The checking of mobile number has been set as per the convention of the ten-digit. After providing all the correct 53 information can only a user register his/her account. The already registered but logged out users can login from the button in this screen which will redirect to the login screen.

4.1.3 Login Screen

The image in the figure above shows the login screen of the Ambulance app. The user login procedure is carried out in two steps. In the first step, check for empty fields are carried out. If any one of the fields is empty, then the user is asked to fill up the empty field. When both the fields have been filled and user taps the login button, a check is carried out with the database to see if the correct username and password have been provided by the user. If correct login credentials have been provided, then, the user is redirected to the home screen else the user is notified about invalid username and password and login is not granted.

4.1.4 Home Screen

The image in figure above shows the home screen of the Ambulance app. When the already logged in user opens the app, the splash screen will be directly redirected to this screen and for the users who have not logged in, they will have to login first and then will be redirected to this screen. The home screen provides menu for all three operations that can be performed in Ambulance app. The user’s name and email address are also displayed in the home screen so as to keep the user aware about the account in use.

4.1.5 Ambulance Requesting Screen

The image in the figure above shows the ambulance request screen from which the user can select the ambulance service provider and the request for ambulance. A list of the available service providers will be given to the user and then the user can select the ambulance as per the location convenience.

4.1.6 Tracking the Ambulance

The image in the figure above shows the tracking of the ambulance that is in on its way as per the response to an ambulance request. Once the ambulance service provider starts the service, the user will then be able to track the ambulance in the same way as shown in the figure above. This will give users real time idea of where the ambulance has reached at that instance of time. The tracking will update frequently so the tracking can be considered as the real time tracking without any lag.

4.1.7 Ambulance Directory Screen

The image in the figure above shows another available operation of this project which is to provide an updated ambulance directory to the user. The user will get all the details of the service provider such as the name of the service provider, location, contact number and the number plate of the associated ambulance of the service provider. Additionally, the user will be available to call the ambulance service provider directly from this application

4.1.8 Immediate Help Tips Screen

The image in the figure 37 shows the immediate health tips screen of the Ambulance app. In case of emergencies or while the ambulance is still on the way, the user can get related home-based treatment tips that will prevent the situation from worsening and can help to bring the situation under control.

4.2 Critical Analysis

Information and Communication Technology has made impacts in every aspect of human life, the only difference is the level of impact it has made. Humans in the developed countries have started being dependent on ICT for almost everything, even for buying groceries. But the scenario is quite different in developing countries like ours where technology is gradually growing and people are slowly adapting to it. The major problem is evident as: technology for the daily life operations being concentrated in only certain age group. The main hindrance seen among people adapting to technology has been the doubts and uncertainty regarding its security and trustable service. People are sceptical as to whether they will get reliable service from the technology related resources.

In context of the Nepalese society, the acknowledgement of technology has been growing. However, the growth has not been even in all aspects of human lives. Fields such as transportation and health care are yet to incorporate technology in the scale as of commerce and social networking. Only few initiatives have been taken in these fields and the general people are still not sure to utilize the services provided by them. A large number of people acknowledging technology, in contrast, use the basic web-service as Google Maps very rarely. In this scenario, Ambulance app is seen as an initiative to incorporate technology in the field of transportation for health care. Ambulance app primarily targets the ambulance service which is one of the most important aspect of health for human life. At the present context, not a single governmental or non-governmental body having a complete inventory of ambulances are seen in operation. The technology-incorporated ambulance service to such scenario becomes a remote assumption and unviable in imagination.

The ambulance service is also not as efficient as it should have been, considering the high level of associativity between the ambulance service and human lives. Generally, people in case of emergencies have to scan for phone numbers in newspapers or hospital documents. These procedures can take a lot of time considering the emergency. Thus, Ambulance app acts as a single hub to get contact details of ambulances operating inside Nepal. Getting information about the ambulances at one platform will save a lot of time and also make the process a lot easier. Ambulance app is not limited to the listing of ambulances. It also serves as a new initiative wherein ambulances could be requested just from a single touch at the current location. This feature of Ambulance app believes to link people with technology, widen their idea of technological services and build their trust on technology. While, the major target would always be on serving people during emergencies such that they do not have to encounter the problems they face, generally with the traditional approach.

The service of ambulance is equally important to everyone as human life is unpredictable and anyone may need the ambulance service at any instant. Ambulances are associated with the life and death of a person; thus, a prompt service is a must. At the present scenario there is no other better option than incorporating technology for this service. Among all the technological devices, smartphones are on the top of the list. As today’s user-friendly interfaces have made people addicted to their phones, developing a system for mobile would serve as the best choice. Additionally, the mobile system would also be inclusive of a wide range of users.

Ambulance with very simple operations to perform can with ease allow anyone to request the ambulance. Considering the emergency need, the users do not need to provide information through any additional form. They will just have to press one button and the required details such as username and contact will be sent from the registration detail. The operation has been designed to be as simple as possible and easy to use. The User Interface (UI) with needed concerns has been made very minimalist with more focus been given to the service. The objective has been given a life associated service through a simple operation following easy to use interfaces. The operations have been made very simple such that anyone can use the application easily, without any expertise. People of any age can use the application and benefit from the service.

The present scenario of road transportation has been a major concern for this project. It is not that every ambulance service is slow in their service. There are service providers 65 who give prompt responses; however, the main issue lies in the journey from the hospital to the patient’s location. Once the ambulance leaves the hospital to pick up the patient, the patient will have no idea of where the ambulance has reached. The only possible way is to make a phone call. A phone call may not be always feasible as the driving rules prohibit the use of mobile phones. Also, the location told will just be an approximation in most of the cases. Thus, one of the considerable aspects of Ambulance app is the tracking facility of the ambulance. Once the ambulance has left the hospital, the user will be able to track the ambulance throughout its journey, having a clear idea of where the ambulance is at present.

This project has been built using Android Studio as it is the best IDE for android software development with a lot features assisting the developers and development of the project. It provides faster automatic code completion which makes it a lot easier for the developers. Android Studio provides an interactive development for designing the layout using the XML and business development logic can also be developed easily using Java programming language. Android Studio provides better project organization than other IDEs which sets it at the top. The layout built using XML has been designed to be as simple as possible; but with the provision of required verification tools such as checks for empty fields and email verification. PHP has been used as the server side scripting language and to connect the database operations with the application. Regarding the database operations, MongoDB has been used. The project has been run on a free web hosting server thus not confined to any localhost. It can be accessed regardless of the changes that would occur in the device used for the development, a prime concern for hosting any project in the localhost.

Ambulance app has been seen as an initiative to bring out the real potential of technology and the impact it can have on human life. The project being the first developed version of this initiative can be advanced to a larger extent regarding its functionality and operations. The project at current lacks password retrieval and if a user loses his/her password there is no feature to retrieve it. This, however, can be implemented in the project in the coming days. As only one account per phone number is possible, it is suggested that the user would not log out of the system. A small fraction 66 of time can lead to some unwanted consequences and as the application is for the purpose of covering emergency needs, being logged always is a better option. Being an emergency situation prompt service provider, requesting ambulance for the purpose of fun or other irresponsible purpose could lead to undesired situations of the service. Even one such irresponsible act can prevent the person needing the service from getting the service.

In many cases, a simple home-based step taken can also prevent the situation from worsening. Following this idea, Ambulance app also has some home-based treatment tips that could be very useful while the ambulance is still on its way or in cases of emergencies such as chemical burns, shock, electric shock that could have adverse effect on the health.

The project has been developed in the limited time due to which there are a lot of rooms for improvement and advancement which shall take place with the course of time in the future.

4.3 Applications of the System

• Request Ambulance: This application can be used to place requests for ambulance whenever required from any place inside Nepal. The service providers will be listed in the interface and the user can then select the ambulance and request them. Application has been made for emergency cases so the user need not have to fill up any additional forms as the details of the user provided during the registration will be used.
• Ambulance Tracking: One of the main applications of Ambulance app is to be able to track the ambulance while it is on its way to pick up the patient. This way the user will have a clear idea of where the ambulance is and can take necessary steps rather than just approximation.
• Immediate Help: Keeping in mind the fact that emergency conditions can at time be brought under control or the consequences can be reduced by a large scale by following procedures of some home-based simple treatment, the application provides list of immediate treatment help to make an attempt to help the patient’s family.
• Single Point of Information: A complete updated inventory of service providing ambulances of Nepal is not available conveniently and following this limitation, Ambulance app provides a list of Nepal based operating ambulances with an option to call them directly from the application.

4.4 Limitation and Future Enhancement

Though a lot of effort and study has been invested on this project, this project still lags in few places, which can be improved in the future. Some of the limitations of the project are:

1. No time calculation during tracking

At the present level, the user can only locate the ambulance on the map but cannot know how much time will it take for the ambulance to reach the user.

1. No implementation of shortest path suggesting algorithm

The developed project at present doesn’t suggest the driver the shortest path to reach the destination following the shortest path detection algorithms. The driver will have to decide the way him/herself.

1. No history of rides kept distinctively per user

A separate record dedicated just for the requests placed by the user is not maintained. The user cannot afterwards know when had he/she requested for ambulance and get the journey details.

1. No information about availability of ambulance

The user at the present scenario cannot know if any ambulance is available for service at the current time or not.

• Driver’s information not shared with the user

The only information that users get is the details of the organization providing the ambulance service. Until the ambulance arrives, the user will have no idea about the driver coming up to pick the patient.

• E-mail confirmation for user registration

The user can register for a new account by just filling up the simple form in the registration menu. No any further steps are taken to verify the user. Thus, the account creation process will be very easy.

On the basis of given limitations, following would be the future enhancements:

• The time needed for reaching the destination will be calculated following algorithms dealing with distance, speed and time.
•  An API for suggesting the shortest route will be implemented.
• A separate section under profile can be maintained for keeping record of all the service requests by the user.
• A feature of availability can be added to the driver app so that they can give information about their availability under headings of available or not available.
• Once the ambulance service provider starts the service, an implementation can be made to share the driver’s detail such as name and phone number along with the location.
• Reliable password retrieval feature will be developed and added in the application.

4.5 Conclusion

Information and Communication Technology is gradually growing in Nepal. Even though the rate of growth may be very slow, but the positive aspect is that in a developing country like Nepal it is growing and people are slowly adapting to technology. This project has been developed with two major objectives, the primary being to provide ambulance service and related helps with ease and the secondary to help people assist in acknowledging technology in their daily life. The project is related to one of the most complex life issues thus providing a reliable service will definitely make people use the service and in return be benefited by the service.

One of the main concerns of this project is to be able to track the ambulance on the way to provide service. In context to the present traffic scenario where the traffic flow gets affected time and again, being able to know where the ambulance is exactly at that 69 instance of time will be a great help. The user requesting the service will have a clear idea and being able to track the location will not lead to phone calls to the driver which will prevent any consequences that could occur with the disturbance while driving.

At the present scenario, different applications for ride sharing have also been developed but people are still in doubt regarding the service of the application and the associated rules and regulations for some of the application while some of the applications have been developed but they do not function or have not maintained. Looking at this scenario, this project aims to give provide the required services and also build trust among people for using and recommending the service. The project has been built such that no any additional resources are required for its operation. The user can simply install the application and use it right away for the service. The project aims to enhance the ambulance service both aspects, the service provider and the user and build a technological ground for the technological implementation in transportation and medical related services.

This project being an initiative surely has lots of room for improvement for its full-fledge operation. The authors are well aware about the limitations that are existing in the application at this stage of development. The further improvements and update would include the time calculation for the driver to reach to the patient’s location. Similarly, the future development would include suggesting the best route along with other possible routes for the driver so that if any of route is not available the driver can take the other route. This feature will help both the service provider and the user.

The password has been encrypted with using MD5 encryption algorithm to ensure data security. However, password retrieval functions are yet to be added in the system so that the user can get back to his/her account in case he/she forgets the password. The project has been built for the most used mobile operating system thus its usage covers a wide range of people. Additionally, the project has been built as simple as possible regarding both the requirements and the user interface. The project for larger implementation can have their dedicated cameras installed in the streets that would provide information about the traffic density at different places which would help to determine the routes and make the driver aware of the traffic condition. Adding more 70 required functionality and operating this project in full fledge in real time can bring a breakthrough in the technological background of Nepal along with the public services of transportation and ambulance.

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APPENDIX

Survey Link  

https://docs.google.com/forms/d/e/1FAIpQLSdiyYBkIAJAzLCT3b9maK94FZd9WvUoIjjGytf3ci4lcz1iAw/viewform

Ambulance video link

Mind Map