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\begin{document}

             \author[1]{Ali Ibrahim  Latif}

             \affil[1]{  Universiti Tenaga Nasional, Kajang, Malaysia.}

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\date{\small \em Received: 10 December 2015 Accepted: 3 January 2016 Published: 15 January 2016}

\maketitle


\begin{abstract}
        


Health care services is one of the most important domains in the world. One of most important goals of healthcare services is the need of make accurate healthcare decisions in the right time. Retrieving useful historical health records of patients in real-time is necessary to provide accurate healthcare decisions. Traditional health record systems like paper-based system require time and efforts to collect, manage, and retrieve patients? records. Electronic health record systems were adopted to allow health staff to retrieve useful health records in real-time and consequently improve and speed up healthcare services. EHR is effective to serve patients in their local countries. Although EHR is effective for local healthcare services (i.e. hospitals within patient country), the implementations of EHR for global purposes is still an issue. EHR is not applicable for the persons who travel to other countries. One of the most important travelling purposes for Muslims is the pilgrimage journey. Each year millions of Muslims travel to KSA to complete pilgrimage rites. Pilgrims may need healthcare services and these services should be accomplished accurately in real-time which requires historical health records based electronic approaches. This study aims to investigate the importance and viability of IoT implementations to support EHR retrieving of pilgrims using electronic tags. A questionnaire with 60 academic staff and interview with five experts from KSA were conducted to address the main aim of this study. The significance of the results show that EHR supporting tags reading is a promising solution to enhance healthcare services and avoid the challenges of EHR implementations in pilgrimage.

\end{abstract}


\keywords{EHR, electronic tags, IoT, pilgrimage travellers.}

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\let\tabcellsep& 	 	 		 
\section[{I. Introduction}]{I. Introduction}\par
ealth professionals need to have good vision of health cases in order to make timely and accurate decisions \hyperref[b10]{(Hibbard \& Peters, 2003}). Patient's health records represent important source that support healthcare decisions \hyperref[b7]{(Bose, 2003)}. None-the less, the traditional retrieving systems of health records such as paper based system are still face many problems such as probability of damage or harm the health records, and time requirement of health records collecting, managing, and retrieving \hyperref[b17]{(Tang et al., 2006)}.\par
These challenges and more could delay or effect on the efficiency of health services.\par
Many people have travelled abroad to different destinations for different purposes and have been exposed to different health risk \hyperref[b9]{(Cossar and Reid, 1989)}. Pilgrimage is considered as the most holy and important travel for Muslims. Each year millions of Muslims travel to complete pilgrimage rites.\par
Health risks have been documented most notably during the Hajj \hyperref[b2]{(Ahmed, Arabi, \& Memish, 2006)}. Moreover, travel-related somatic and psychic health problems occur more frequently but are less severe remain unreported and should be explored only in specific studies  {\ref (Cossar et al., 1990;}\hyperref[b12]{Page, Clift, \& Clark, 1994)}.\par
Pilgrims need healthcare services and these services should be accomplished accurately in real-time which required historical health records based electronic approaches (Ahmed, Q. \& Balaban, V., 2013). EHR encompasses all health information in all media forms regarding an individual and is primary source for recording and documenting client health data \hyperref[b6]{(Bickford and Hunter, 2006)}. EHRs combine data from all ancillary services with other medical care components. These clinical data have different methods for sharing or importing various components, such as presentation or data integration \hyperref[b8]{(Carter, 2008)}. Internet of Things (IoT) technology could be effective solution to retrieve health records of pilgrims from their original countries and pass it to health staff in pilgrimage health centres. This research focuses on importance and viability of deploy IoT to retrieving EHR of pilgrims using electronic tags reading.\par
The main purpose of this study is to analyse the viability and importance of EHR using electronic tags in pilgrimage to enhance the health services of pilgrims. It also aimed to investigate the challenges of current health records approaches and the importance of EHR. 
\section[{II. Proposed Framework}]{II. Proposed Framework}\par
Outdoor services like pilgrims' healthcare services require two main IoT Layers which are  {\ref (} ? Service Layer: This layer is about providing real IoT services, the data that delivered from abstraction layer are processed and the results display on output devices such as monitors (Da et al., 2014). These monitors are usually connecting with the tags in connectivity layer. Thus, the results of data processing send from service layer to connectivity layer through access and abstraction layers respectively.\par
According to the IoT framework, pilgrims need to have an electronic tag which identifies their personality (ID). In case of need for healthcare services, healthcare centre contains wireless sensors to read pilgrim tag. Data is transferred from wireless sensor to base station via super nodes. Base station sends request via internet network to the pilgrim's country of origin in order to acquire pilgrim EHR from health database in central web server. Web server sends pilgrim EHR via internet network to base station. Base station display outputs on monitor that is connected with the sensor that sends tag data. 
\section[{III. Materials and Methods}]{III. Materials and Methods}\par
Data was collected from health staff in Kingdom Saudi Arabia (KSA) using a questionnaire in order to explore the current processes and challenges of healthcare services in pilgrimage and the importance of EHR to support these activities. The sample of the study is composed of 60 out of 350 healthcare staff in four healthcare centres. According to \hyperref[b21]{Yount (2006)}, the sampling percentage should be 10\% at minimum for the size of population between 101-1000 workers. Thus, the sampling percentage of this research is valid (i.e. 17.1\% of study population).\par
The questionnaire included four sections which are: (1) personal information to ensure the expertise validity of experts, (2) importance of EHR to support healthcare services in pilgrimage, (3) challenges of EHR implementation in pilgrimage healthcare services, and (4) EHR supporting tags reading to support pilgrimage healthcare services. 
\section[{IV. Results}]{IV. Results} 
\section[{a) Demographic Data}]{a) Demographic Data}\par
With regards to the respondents' gender, there was 22\% female of all respondents while the number of male respondents 78\%. The percentage of gender variable considered as reflect the reality of health activities in pilgrimage. The male staff members are usually more involved in the pilgrimage health activities more than female staff members.\par
Regarding to respondents' percentages based on their age. Most of respondents' ages are between 30-40 years which represent 65\% of respondents (39 respondents). Thus, the presented data from the respondents will be efficient for future development i.e. the respondents will work in the health domain in KSA for a long period (i.e. 15 years).\par
According to the respondents' job roles, there are 29 respondents working as nurses (48\% of total respondents) followed by 24 respondents working as doctors (40\% of total respondents). There are also 7 respondents working as support staff (12\% of total respondents). Most respondents are mainly involved in the healthcare activities (i.e. doctors and nurses).\par
The majority of the respondents had 4-7 years of experience (33 respondents), followed by 34\% with more than 7 years of experience (22 respondents). Therefore, this segment of respondents is mature enough to provide the needed information for the study, the employees with long experience years can provide rich data to support the questionnaire analysis usefulness. With regards to the number of pilgrimage seasons attended by respondents, 43\% of total respondents attended more than 8 pilgrimage seasons (26 respondents). There were 22\% of respondents that attended 4-7 pilgrimage seasons (13 respondents), followed by 20\% that attended 2-4 pilgrimage seasons (12 respondents). The respondents that attended less than two Pilgrimage seasons are 15\% of total respondents (9 respondents). Therefore, the respondents are able to provide valid responses based on real situation of pilgrimage healthcare activities. 
\section[{Global Journal of Computer Science and Technology}]{Global Journal of Computer Science and Technology}\par
Volume XVI Issue III Version I  \hyperref[tab_2]{2} reflects on challenges: lack of staff and infrastructures are apparently major challenges. It was also shown that the respondents are not familiar with the technical issues of electronic healthcare methods. Therefore, they are not sure about the privacy effectiveness of electronic healthcare approach. Table \hyperref[tab_3]{3} shows consistent answers that support the importance of having EHR for timely decision making and better services. Notably, respondents were aware that EHR would improve communication and reduce costs. 
\section[{V. Findings Summary}]{V. Findings Summary}\par
The current healthcare services in pilgrimage are not supportive by EHR. Usually the paper forms are used for specific purposes such as producing general reports about pilgrimage activities. The use of EHR in pilgrimage could speed up and improve the quality of healthcare services. EHR implementations in pilgrimage face many challenges such as time, effort, and financial costs. The EHR supporting tags reading is a promising solution to enhance healthcare services and avoid the challenges of EHR implementations in pilgrimage. 
\section[{VI. Conclusion and Future Works}]{VI. Conclusion and Future Works}\par
Retrieving health records using electronic systems is important to improve the accuracy and speed up health services of patients. EHR retrieving using IoT considered as effective approach to retrieve health records of travellers. IoT facilities can be applied in pilgrimage through retrieve pilgrims' health records from central database in their countries by using electronic tags reading. Pilgrims tags could be accessed by sensors and these sensors send health record request through IoT layer (connectivity, access, abstraction, and service layers). Thus, health records can be retrieved in real time to support healthcare services for pilgrims. Data collection using questionnaire and interview show that the implementation of proposed idea of health records retrieving using electronic tags reading is important and viable.\par
In future, the importance and viability of proposed ideas implementation need to be investigated according to perspective of pilgrims' courtiers. On other hand technical framework of proposed ideas would be developed to clarify overall aspects of EHR retrieving 5 Year 2016 ( ) using IoT. This requires empirical case study of specific country of pilgrims such as Malaysia. experience of illness and the implications of these findings. J Infect. 1990 Jul; 21(1): 27-42.\begin{figure}[htbp]
\noindent\textbf{1} \par 
\begin{longtable}{P{0.85\textwidth}}
Year 2016\\
2\\
( )\end{longtable} \par
  {\small\itshape [Note: c) Challenge of Health Records RetrievalTable]} 
\caption{\label{tab_1}Table 1 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{2} \par 
\begin{longtable}{P{0.85\textwidth}}
Year 2016\\
3\\
Volume XVI Issue III Version I\\
( )\\
Global Journal of Computer Science and Technology\end{longtable} \par
 
\caption{\label{tab_2}Table 2 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{3} \par 
\begin{longtable}{P{0.07705152671755724\textwidth}P{0.04541984732824427\textwidth}P{0.616412213740458\textwidth}P{0.013788167938931296\textwidth}P{0.004866412213740458\textwidth}P{0.00892175572519084\textwidth}P{0.00892175572519084\textwidth}P{0.012166030534351144\textwidth}P{0.02838740458015267\textwidth}P{0.0340648854961832\textwidth}}
\tabcellsep \tabcellsep The traditional healthcare\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep 14\tabcellsep approaches (i.e. paper-based) decrease the\tabcellsep 0\tabcellsep 0\tabcellsep 0\tabcellsep 1\tabcellsep 59\tabcellsep 4.98\tabcellsep Very High\\
\tabcellsep \tabcellsep understanding of health\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep cases\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep The traditional healthcare\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep 15\tabcellsep approaches (i.e. paper based) increase the\tabcellsep 0\tabcellsep 0\tabcellsep 0\tabcellsep 1\tabcellsep 59\tabcellsep 4.98\tabcellsep Very High\\
\tabcellsep \tabcellsep expenses of healthcare\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep services\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
\tabcellsep \tabcellsep There are challenges in\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
Year 2016\tabcellsep 16\tabcellsep healthcare services understand the non-Arabic pilgrims in the context of\tabcellsep 0\tabcellsep 0\tabcellsep 0\tabcellsep 1\tabcellsep 59\tabcellsep 4.98\tabcellsep Very High\\
4\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \\
Volume XVI Issue III Version I H ( )\tabcellsep Item No. 17 18\tabcellsep Item The EHR speeds up the health care services The EHR supports the accuracy of healthcare services The EHR based on Arabic language increa-ses the usefulness of healthcare services\tabcellsep \multicolumn{2}{l}{SD D 56 4}\tabcellsep N 1 0\tabcellsep A 0 0\tabcellsep SA 0 0\tabcellsep Mean 4.80 4.86\tabcellsep Agreement Level\\
Global Journal of Computer Science and Technology\tabcellsep 22\tabcellsep The EHR based on Arabic language makes the healthcare services easier EHR can increase the performance of communi cation with the pilgrims' country (i.e. Health Minis-try) to describe health EHR decreases the expense of traditional healthcare approaches (i.e. paper-based) cases accurately\tabcellsep 56 57\tabcellsep 3 1\tabcellsep 1 2\tabcellsep 0 0\tabcellsep 0 0\tabcellsep 4.93 4.91\tabcellsep \\
\tabcellsep \multicolumn{2}{l}{© 2016 Global Journals Inc. (US) 1}\tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \tabcellsep \end{longtable} \par
 
\caption{\label{tab_3}Table 3 :}\end{figure}
 			\footnote{© 2016 Global Journals Inc. (US)} 			\footnote{( ) © 2016 Global Journals Inc. (US) 1} 		 		\backmatter  			 
\subsection[{Global Journal of Computer Science and Technology}]{Global Journal of Computer Science and Technology}\par
Volume XVI Issue III Version I 			 			  				\begin{bibitemlist}{1}
\bibitem[Zhu et al. ()]{b22}\label{b22} 	 		\textit{},  		 			B Zhu 		,  		 			C Chen 		,  		 			E F Loftus 		,  		 			C Lin 		,  		 			Q He 		,  		 			C Chen 		.  		2010.  	 	 (Individual differences in false) 
\bibitem[Al-Turjman et al. ()]{b4}\label{b4} 	 		‘A delay-tolerant framework for integrated RSNs in IoT’.  		 			F M Al-Turjman 		,  		 			A E Al-Fagih 		,  		 			W M Alsalih 		,  		 			H S Hassanein 		.  	 	 		\textit{Computer Communications}  		2013. 36  (9)  p. .  	 
\bibitem[An Investigation of Iot Importance and Viability of Health Records Retrieval using Electronic Tags in Pilgrimage H memory from misinformation: Personality characterristics and their interactions with cognitive abilities Personality and Individual Differences]{b23}\label{b23} 	 		‘An Investigation of Iot Importance and Viability of Health Records Retrieval using Electronic Tags in Pilgrimage H memory from misinformation: Personality characterristics and their interactions with cognitive abilities’.  	 	 		\textit{Personality and Individual Differences}  		48 p. .  	 
\bibitem[Shibl et al. ()]{b15}\label{b15} 	 		‘Consensus recommendation for meningococcal disease prevention for Hajj and Umra pilgrimage/travel medicine’.  		 			A Shibl 		,  		 			H Tufenkeji 		,  		 			M Khalil 		,  		 			Z Memish 		.  	 	 		\textit{EMHJ}  		2013. 19  (4) .  	 
\bibitem[Carter ()]{b8}\label{b8} 	 		‘Electronic Health Records: a guide for clinicians and administrators’.  		 			J Carter 		.  	 	 		\textit{Global Journals Inc}  		J. H. Carter (ed.)  		2008. 2016. US. p. .  	 	 (What is the Electronic Health Record) 
\bibitem[Wager et al. ()]{b19}\label{b19} 	 		\textit{Health Care Information Systems: A Practical Approach for Health Care Management},  		 			K A Wager 		,  		 			F W Lee 		,  		 			J P Glaser 		.  		2009.  	 	 (2nd ed.) 
\bibitem[Cossar and Reid ()]{b9}\label{b9} 	 		‘Health hazards of international travel’.  		 			J Cossar 		,  		 			D Reid 		.  	 	 		\textit{World Health Statistics Quarterly -Rapport Trimestriel de Statistiques Sanitaires Mondiales}  		1989. 1989. 42 p. .  	 
\bibitem[Ahmed et al. ()]{b2}\label{b2} 	 		\textit{Health risks at the Hajj. The Lancet},  		 			Q A Ahmed 		,  		 			Y M Arabi 		,  		 			Z A Memish 		.  		2006. 367 p. .  	 
\bibitem[Da Xu et al. ()]{b16}\label{b16} 	 		‘Internet of things in industries: a survey. Industrial Informatics’.  		 			L Da Xu 		,  		 			W He 		,  		 			S Li 		.  	 	 		\textit{IEEE Transactions on}  		2014. 10  (4)  p. .  	 
\bibitem[Agrawal and Das (2011)]{b0}\label{b0} 	 		‘Internet of Things-A paradigm shift of future Internet applications’.  		 			S Agrawal 		,  		 			M L Das 		.  	 	 		\textit{Engineering (NUiCONE)},  				2011. December. 2011.  	 
\bibitem[Zhu et al. (2010)]{b24}\label{b24} 	 		‘Iot gateway: Bridging wireless sensor networks into internet of things’.  		 			Q Zhu 		,  		 			R Wang 		,  		 			Q Chen 		,  		 			Liu 		,  		 			W Qin 		.  	 	 		\textit{Embedded and Ubiquitous Computing (EUC), 2010 IEEE/IFIP 8th International Conference on},  				2010. December. IEEE. p. .  	 
\bibitem[Tao et al. ()]{b18}\label{b18} 	 		‘IoTbased intelligent perception and access of manufacturing resource toward cloud manufacturing. Industrial Informatics’.  		 			F Tao 		,  		 			Y Zuo 		,  		 			L Da Xu 		,  		 			L Zhang 		.  	 	 		\textit{IEEE Transactions on}  		2014. 10  (2)  p. .  	 
\bibitem[Jia et al. (2012)]{b11}\label{b11} 	 		 			X Jia 		,  		 			Q Feng 		,  		 			T Fan 		,  		 			Q Lei 		.  		\textit{RFID technology and its applications in Internet of Things (IoT). In Consumer Electronics, Communications and Networks (CECNet), 2012 2nd International Conference on},  				2012. April. IEEE. p. .  	 
\bibitem[Bose ()]{b7}\label{b7} 	 		‘Knowledge management-enabled health care management systems: capabilities, infrastructure, and decision-support’.  		 			R Bose 		.  	 	 		\textit{Expert systems with Applications}  		2003. 24  (1)  p. .  	 
\bibitem[Nirma University International Conference on]{b1}\label{b1} 	 		\textit{Nirma University International Conference on},  				IEEE. p. .  	 
\bibitem[Tang et al. ()]{b17}\label{b17} 	 		‘Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption’.  		 			P C Tang 		,  		 			J S Ash 		,  		 			D W Bates 		,  		 			J M Overhage 		,  		 			D Z Sands 		.  	 	 		\textit{Journal of the American Medical Informatics Association}  		2006. 13  (2)  p. .  	 
\bibitem[Yount ()]{b21}\label{b21} 	 		\textit{Populations and Sampling. DR Yount, Research Design and Statistical Analysis for Christian Ministry},  		 			R Yount 		.  		2006.  	 
\bibitem[Ahmed and Balaban ()]{b3}\label{b3} 	 		\textit{Saudi Arabia: Hajj Pilgrimage. Centres for Disease Control and Prevention},  		 			Q Ahmed 		,  		 			V Balaban 		.  		 \url{http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-4-select-destinations/saudi-arabia-hajj-pilgrimage}  		2013. 2015.  	 
\bibitem[Schloeffel et al. ()]{b14}\label{b14} 	 		 			P Schloeffel 		,  		 			T Beale 		,  		 			G Hayworth 		,  		 			S Heard 		,  		 			H Leslie 		.  		\textit{The relationship between CEN 13606, HL7 and open EHR. HIC},  				 (Sydney, Australia)  		2006. 2006. 2006.  	 
\bibitem[Atzori et al. ()]{b5}\label{b5} 	 		‘SIoT: Giving a social structure to the internet of things’.  		 			L Atzori 		,  		 			A Iera 		,  		 			G Morabito 		.  	 	 		\textit{Communications Letters}  		2011. 15  (11)  p. .  	 	 (IEEE) 
\bibitem[Hibbard and Peters ()]{b10}\label{b10} 	 		‘Supporting informed consumer health care decisions: data presentation approaches that facilitate the use of information in choice’.  		 			J H Hibbard 		,  		 			E Peters 		.  	 	 		\textit{Annual Review of Public Health}  		2003. 24  (1)  p. .  	 
\bibitem[Waters (2002)]{b20}\label{b20} 	 		\textit{The Goodness of Attachment Assessment: There Is A Gold Standard But It Isn't As Simple As That},  		 			E Waters 		.  		 \url{http://www.psychology.sunysb.edu/attachment/online/goodness\textunderscore of\textunderscore attachment\textunderscore measures.pdf}  		2002. October 22, 2013.  	 
\bibitem[Qawasmeh and Qawasmeh ()]{b13}\label{b13} 	 		‘The Role of Organization Culture in Achieving Organizational Excellence: Jadara University as a Case Study’.  		 			. F N Qawasmeh 		,  		 			I Qawasmeh 		.  	 	 		\textit{International Journal of Economics and Management Sciences}  		2013. 2013. 2  (7)  p. .  	 
\bibitem[Bickford and Hunter ()]{b6}\label{b6} 	 		‘Theories, models, and frameworks’.  		 			C J Bickford 		,  		 			K M Hunter 		.  	 	 		\textit{Essentials of Nursing Informatics},  				 (New York)  		2006. McGraw-Hill. p. .  	 
\bibitem[Page et al. ()]{b12}\label{b12} 	 		‘Tourist health: The precautions, behaviour and health problems of British tourists in Malta’.  		 			S J Page 		,  		 			S Clift 		,  		 			N Clark 		.  	 	 		\textit{Tourism. The state of the art},  				 			A V Seaton 		 (ed.)  		 (Chichester)  		1994. Wiley.  	 
\end{bibitemlist}
 			 		 	 
\end{document}
