Requirements for an EMR-Based Virtual Reality Application for PROLANIS Education: A Literature and Process-Mapping Synthesis
DOI:
https://doi.org/10.47701/dx5mcf46Keywords:
Chronic Disease, Electronic Health Records, Health Education, Needs Assessment, Virtual RealityAbstract
Background: PROLANIS participants require repeatable chronic-disease education, while electronic medical records (EMRs) and virtual reality (VR) offer opportunities for personalized and interactive delivery. Before prototype development, requirements must reflect health literacy, workflow, privacy, and VR safety. Methods: This descriptive initial Research and Development stage used a literature- and document-informed requirements synthesis, a proposed PROLANIS process map, and minimum EMR data-element mapping for Sidorejo Lor and Sidorejo Kidul Community Health Centers, Salatiga City. No interviews, focus-group discussions, participant surveys, direct observations, or patient-level EMR extraction were conducted at this stage. Candidate requirements were organized into domains and provisionally prioritized using MoSCoW as design input requiring later stakeholder validation. Results: Five preliminary requirement groups were identified: concise chronic-disease education, EMR-based personalization, adult- and older-user accessibility, data security and confidentiality, and operational support for health workers. Proposed must-have functions include a patient education profile, simple visualization of examination results, and hypertension and diabetes modules. Non-functional requirements include simple navigation, large text, audio narration, seated mode, short sessions, stop/pause options, and role-based data access. Conclusion: The study provides an initial, literature- and process-mapping-based requirements model rather than empirically validated local user needs. Participatory co-design, stakeholder validation, usability testing, VR-safety assessment, data-governance review, and evaluation of patient understanding are required before implementation claims can be made
Downloads
References
1. Health Development Policy Agency, Ministry of Health of the Republic of Indonesia. Key results of the 2023 Indonesian Health Survey (SKI): non-communicable diseases (hypertension and diabetes). Jakarta: Ministry of Health of the Republic of Indonesia; 2024.
2. BPJS Health. PROLANIS Practical Guide. Jakarta: BPJS Health; 2014.
3. Ministry of Health of the Republic of Indonesia. Regulation of the Minister of Health of the Republic of Indonesia Number 43 of 2019 concerning Community Health Centers. Jakarta: Ministry of Health of the Republic of Indonesia; 2019.
4. Ministry of Health of the Republic of Indonesia. Regulation of the Minister of Health of the Republic of Indonesia Number 24 of 2022 concerning Medical Records. Jakarta: Ministry of Health of the Republic of Indonesia; 2022.
5. World Health Organization. Global strategy on digital health 2020-2025. Geneva: World Health Organization; 2021.
6. Curran VR, Hollett A. The use of extended reality (XR) in patient education: A critical perspective. Health Educ J. 2024;83(4):338-351. doi:10.1177/00178969231198955.
7. Li Y, Kim M, Sutedjo A. Effects of virtual reality as a patient education tool: A meta-analysis. J Educ Technol Dev Exch. 2024;17(2):216-228. doi:10.18785/jetde.1702.10.
8. Sung H, Kim M, Park J, Shin N, Han Y. Effectiveness of virtual reality in healthcare education: systematic review and meta-analysis. Sustainability. 2024;16(19):8520. doi:10.3390/su16198520.
9. Tene T, Vique Lopez DF, Valverde Aguirre PE, Orna Puente LM, Vacacela Gomez C. Virtual reality and augmented reality in medical education: an umbrella review. Front Digit Health. 2024;6:1365345. doi:10.3389/fdgth.2024.1365345.
10. Jiravska Godula B, Jiravsky O, Matheislova G, Kuriskova V, Valkova A, Puskasova K, et al. Virtual Reality for Patient Education about Hypertension: A Randomized Pilot Study. J Cardiovasc Dev Dis. 2023;10(12):481. doi:10.3390/jcdd10120481.
11. Gibson B, Simonsen S, Jensen JD, Yingling L, Schaefer J, Sundaresh V, Zhang Y, Altizer R. Mobile Virtual Reality Versus Mobile 360 Degree Video to Promote Enrollment in the Diabetes Prevention Program Among Hispanic Adults: Pilot Study. JMIR Diabetes. 2022;7(1):e26013. doi:10.2196/26013.
12. Siripongsaporn S, Yongsiriwit K, Tantitanawat K, Chirapongsathorn S. Use of virtual reality in patient education program to reduce anxiety in upper gastrointestinal endoscopy: a randomized controlled trial. JGH Open. 2024;8(3):e13046. doi:10.1002/jgh3.13046.
13. El Mathari S, Kuitert L, Boulidam N, Shehadeh S, Klautz RJM, de Lind van Wijngaarden R, Kluin J. Evaluating Virtual Reality Patient Education in Cardiac Surgery: Impact on Preoperative Anxiety and Postoperative Patient Satisfaction. J Clin Med. 2024;13(21):6567. doi:10.3390/jcm13216567.
14. Wang EY, et al. Acceptance of virtual reality in trainees using a technology acceptance model: survey study. JMIR Med Educ. 2024;10:e60767. doi:10.2196/60767.
15. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989;13(3):319-340.
16. Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: toward a unified view. MIS Q. 2003;27(3):425-478.
17. Holden RJ, Karsh BT. The Technology Acceptance Model: its past and future in health care. J Biomed Inform. 2010;43(1):159-172. doi:10.1016/j.jbi.2009.07.002.
18. Mergen M, Graf N, Meyerheim M. Reviewing the current state of virtual reality integration in medical education: a scoping review. BMC Med Educ. 2024;24(1):788. doi:10.1186/s12909-024-05777-5.
19. Malini H, Anwar M, Mailani F, Susianty S, Purna RS. Co-Designing a Digital Health Application for Assisting Self-Care Diabetes Patients: A Qualitative Study. Health Sci Rep. 2026;9(6):e72418. doi:10.1002/hsr2.72418.
20. Shanmugavel A, Shakya PR, Shrestha A, Nepal J, Shrestha A, Daneault JF, Rawal S. Designing and Developing a Mobile App for Management and Treatment of Gestational Diabetes in Nepal: User-Centered Design Study. JMIR Form Res. 2024;8:e50823. doi:10.2196/50823.
21. Naranjo-Rojas A, Perula-de-Torres LA, Molina-Recio G. Patients, caregivers, and healthcare professionals' needs when designing the content of a mobile application for the clinical monitoring of patients with chronic obstructive pulmonary disease and home oxygen therapy: a user-centered design. Internet Interv. 2022;29:100552. doi:10.1016/j.invent.2022.100552.
22. Banbury A, Nancarrow S, Dart J, Gray L, Dodson S, Osborne R, Parkinson L. Adding value to remote monitoring: co-design of a health literacy intervention for older people with chronic disease delivered by telehealth - The telehealth literacy project. Patient Educ Couns. 2020;103(3):597-606. doi:10.1016/j.pec.2019.10.005.
23. Niu J, Yin Y, Wang S. An Age-Adapted Co-Design Methodology for Community Health Research Involving Older Adults With Type 2 Diabetes. Health Expect. 2026;29(3):e70718. doi:10.1111/hex.70718.
24. Skidmore N, Ryan CG, Mankelow J, Martin D. Acceptability and feasibility of virtual reality to promote health literacy in primary care from the health professional's view: a qualitative study. Patient Educ Couns. 2024;123:108179. doi:10.1016/j.pec.2024.108179.
25. Ghodousi Moghadam S, Mazloum Khorasani Z, Sharifzadeh N, Tabesh H. A mobile serious game about diabetes self-management: design and evaluation. Heliyon. 2024;10(18):e37755. doi:10.1016/j.heliyon.2024.e37755.
26. Norman DA, Draper SW, editors. User centered system design: New perspectives on human-computer interaction. Hillsdale: Lawrence Erlbaum Associates; 1986.
27. International Organization for Standardization. ISO 9241-210:2019 Ergonomics of human-system interaction, Part 210: Human-centred design for interactive systems. Geneva: ISO; 2019.
28. Pressman RS, Maxim BR. Software engineering: a practitioner's approach. 9th ed. New York: McGraw-Hill Education; 2020.
29. Sommerville I. Software engineering. 10th ed. Boston: Pearson; 2016.
30. World Health Organization. Classification of digital health interventions v1.0: a shared language to describe the uses of digital technology for health. Geneva: World Health Organization; 2018.
31. World Health Organization. WHO guideline: recommendations on digital interventions for health system strengthening. Geneva: World Health Organization; 2019.
32. International Organization for Standardization. ISO 27799:2016 Health informatics: information security management in health using ISO/IEC 27002. Geneva: ISO; 2016.
33. Republic of Indonesia. Law Number 27 of 2022 concerning Personal Data Protection. Jakarta: Republic of Indonesia; 2022.
34. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi:10.1191/1478088706qp063oa.
35. Clegg D, Barker R. Case method fast-track: a RAD approach. Boston: Addison-Wesley; 1994.
36. International Organization for Standardization. ISO/IEC 25010:2011 Systems and software engineering: Systems and software Quality Requirements and Evaluation (SQuaRE): system and software quality models. Geneva: ISO; 2011.
37. International Organization for Standardization. ISO/IEC/IEEE 29148:2018 Systems and software engineering: life cycle processes: requirements engineering. Geneva: ISO; 2018.
38. Brooke J. SUS: a quick and dirty usability scale. In: Jordan PW, Thomas B, Weerdmeester BA, McClelland AL, editors. Usability evaluation in industry. London: Taylor & Francis; 1996. p. 189-194.
39. Lewis JR. IBM computer usability satisfaction questionnaires: psychometric evaluation and instructions for use. Int J Hum Comput Interact. 1995;7(1):57-78. doi:10.1080/10447319509526110.
40. Kennedy RS, Lane NE, Berbaum KS, Lilienthal MG. Simulator sickness questionnaire: an enhanced method for quantifying simulator sickness. Int J Aviat Psychol. 1993;3(3):203-220. doi:10.1207/s15327108ijap0303_3.
41. Stanney KM, Kennedy RS, Drexler JM. Cybersickness is not simulator sickness. Proc Hum Factors Ergon Soc Annu Meet. 1997;41(2):1138-1142. doi:10.1177/107118139704100292.
42. LaViola JJ Jr. A discussion of cybersickness in virtual environments. ACM SIGCHI Bull. 2000;32(1):47-56. doi:10.1145/333329.333344.
43. Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, Brand H. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. doi:10.1186/1471-2458-12-80.
44. Nutbeam D. Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int. 2000;15(3):259-267. doi:10.1093/heapro/15.3.259.
45. Saredakis D, Szpak A, Birckhead B, Keage HAD, Rizzo A, Loetscher T. Factors associated with virtual reality sickness in head-mounted displays: a systematic review and meta-analysis. Front Hum Neurosci. 2020;14:96. doi:10.3389/fnhum.2020.00096.
46. Birckhead B, Khalil C, Liu X, Conovitz S, Rizzo A, Danovitch I, et al. Recommendations for methodology of virtual reality clinical trials in health care by an international working group: iterative study. JMIR Ment Health. 2019;6(1):e11973. doi:10.2196/11973.
47. Nielsen J. Usability engineering. San Francisco: Morgan Kaufmann; 1993.
48. Nielsen J, Molich R. Heuristic evaluation of user interfaces. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems; 1990. p. 249-256. doi:10.1145/97243.97281.
49. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-357. doi:10.1093/intqhc/mzm042.
50. Xie Z, Chen F, Zou L, Wang F, Yang L. Using Virtual Reality in the Care of Older Adults With Dementia: A Randomized Controlled Trial. J Gerontol Nurs. 2023;49(11):25-32. doi:10.3928/00989134-20231011-01.
51. Xie Z, Zou L, Wang Q, Chen Y, Li L, Liao Y, Chen F. Application of immersive virtual reality (IVR) for the care of common diseases of older adults course: a mixed methods study. Geriatr Nurs. 2024;58:399-409. doi:10.1016/j.gerinurse.2024.06.003
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Mochammad Arief Darmawan, Setya Wijayanta, Adhani Windari, Sylvia Anjani, Faik Agiwahyuanto
This work is licensed under a Creative Commons Attribution 4.0 International License.
