Design And Implementation Of An Automated Patient Record System

Introduction

1.1 Background of the Study

A hospital is an institution for health care that provides patient treatment by specialized staff and equipment. Usually, hospitals are funded by the public sector, by health organizations (for profit or nonprofit), health insurance companies or charities, including funds by direct charitable donations. Historically, however, hospitals were often founded and funded by religious orders or charitable individuals and leaders. Modern-day hospitals are largely staffed by professional physicians, surgeons, and nurses. Hospitals are distinguished by their ownership, scope of services, and whether they are teaching hospitals with academic affiliations. Hospitals may be operated as proprietary (for-profit) businesses, owned either by corporations or individuals such as the physicians or they may be voluntary-owned by non-profit corporations, religious organizations, or operated by federal, state, or city governments. Voluntary and non-profit hospitals are usually governed by a board of trustees, selected from among community business and civic leaders, who serve without pay to oversee hospital operations.

Most community hospitals offer emergency services as well as a range of inpatient and outpatient medical and surgical services. Community hospitals, where most people receive care, are typically small, with fifty to five hundred beds. These hospitals normally provide quality care for routine medical and surgical problems. Some community hospitals are nonprofit corporations, supported by local funding. These include hospitals supported by religious, cooperative, or osteopathic organizations. In the 1990s, increasing numbers of not-for-profit community hospitals have converted their ownership status, becoming proprietary hospitals that are owned and operated on a for-profit basis by corporations. These hospitals have joined investor-owned corporations because they need additional financial resources to maintain their existence in an increasingly competitive industry. Investor-owned corporations acquire not for profit hospitals to build market share, expand their provider networks, and penetrate new health care markets.

Teaching hospitals are those community and tertiary hospitals affiliated with medical schools, nursing schools, or allied-health professions training programs. Teaching hospitals are the primary sites for training new physicians where interns and residents work under the supervision of experienced physicians. Non teaching hospitals also may maintain affiliations with medical schools and some also serve as sites for nursing and allied-health professions students as well as physicians-in-training. Most teaching hospitals, which provide clinical training for medical students and other health care professionals, are affiliated with a medical school and may have several hundred beds. Many of the physicians on staff at the hospital also hold teaching positions at the university affiliated with the hospital, in addition to teaching physicians-in-training at the bedsides of the patients. Patients in teaching hospitals understand that they may be examined by medical students and residents in addition to their primary “attending” physicians. One advantage of obtaining care at a university-affiliated teaching hospital is the opportunity to receive treatment from highly qualified physicians with access to the most advanced technology and equipment. A disadvantage is the inconvenience and invasion of privacy that may result from multiple examinations performed by residents and students. When compared with smaller community hospitals, some teaching hospitals have reputations for being very impersonal; however, patients with complex, unusual, or difficult diagnoses usually benefit from the presence of acknowledged medical experts and more comprehensive resources available at these facilities. A teaching hospital combines assistance to patients with teaching to medical students and nurses and often is linked to a medical school, nursing school or university.

1.2 Statement of the Problem

In the current system of operation in Teaching Hospital Nnewi, when a patient enters the hospital, the following sequence of operation is carried out. First, the patient is registered in the card/registration room, and then the patient goes to the nurses’ workbench for examination (vital signs), the nurses then carries the patient folder to the doctors’ workbench for diagnosis. After the diagnosis, the patient is then sent to the laboratory for test or the patient is sent to the pharmacy for collection of drugs; the pharmacy section checks the patients prescribed drugs and cost them before the folder is sent to the bill office for billing. After diagnosis the patient can also be referred to another clinic or to see a consultant in the same hospital. For example he/she may be referred for radiology services (CT scan, MRI, and ultrasound) or to special services like dental care. There may also be possibilities for surgical services. The inpatient may recover fully and be discharged or die and will be given a death report.
These processes are tedious and full of man-made errors. The purpose of the hospital management system is to automate the system for easy storage and retrieval of data, smooth flow of information and management of hospital. Some errors identified in the current system include:

i. Lack of Immediate Retrievals:

The information is very difficult to retrieve and to find particular information like- E.g. – To find out about the patient’s history, the user has to go through various registers. This results in in convenience and wastage of time

ii. Lack of Immediate Information Storage:

The information generated by various transactions takes time and efforts to be stored at right place

iii. Lack of Prompt Updating:

Various changes to information like patient details or immunization details of child are difficult to make as paper work is involved.

iv. Error Prone Manual Calculation:

Manual calculations are error prone and take a lot of time this may result in incorrect information. For example calculation of patient’s bill based on various treatments.

v. Preparation of Accurate and Prompt Reports:

This becomes a difficult task as information is difficult to collect from various register.

1.3 Objectives of the Study

The main aim of this project is to design an automated patient record management system for Teaching Hospital Nnewi for controlling the flow of patient’s data in the hospital. To achieve the stated objective, the following specific objectives were laid out

Develop using web-based technologies a system capable of capturing and storing patients data for a teaching hospital

System should be able to generate and manage bills of each patient

Proper recording of patients’ diagnosis.

Keep proper track of appointments made with the patient by the hospital

1.4 Significance of the Study

The work will be beneficial to both the management and staffs within the hospital establishment as it makes patients management easier. It will enable the management to know the total number of patients and the payment made by patient as the software will keep tracks of all the patients’ transactions with the hospital. It will ensure that patients are attended on time and a how a patient can get registered first, before the proper bill process.

This project is significant to me as it enhanced my programming skills making me know more on how to practicalize my theoretical based knowledge. This project will also serve as a reference point to scholars who want to venture into programming.

1.5 Scope of the Project:

The patient record management system is capable of supporting any number of patents in the hospital. It has multiuser ability and each account runs independently without affecting other modules. This means that all departments of the hospital are connected but work independently. The integrity and security of the data in database system are given minimum consideration. It was designed using PHP programming language and MySQL for data storage. It has the patient section, the appointment sections and the diagnosis section.

1.6 Limitations of the Study

The data was collected from different hospitals, both private and government. In lack of time and resources, the data collection was merely informal recording and observation. Visiting all the hospitals within the valley was also constrained because of the lack of time and money as a student.

The greatest limitation of all, however, was during the actual writing of the software. There was lack of proper knowledge in the development of the project. It may not be of great surprise that in merely 3 months, hardly anybody could expect a young student to prepare a full fledge project on information system that wholly fulfills requirements of everyone from every perspective. However, utmost attempt has been done to improve the project at the greatest.

1.7 Organization of the Study

The project is made of five chapters: Chapter 1 introduces the project. It gives the background information of the project and discusses the problems, scope and objective of the project. It states the solution to the manual system of record keeping. Chapter 2 is the literature review of the project. It reviews the manual system of keeping record in the hospital. It states all the effort that has been made so far to computerize the existing system. The existing manual system has a lot of problems that are facing it like data redundancy, data manipulation, data collection, and data storage and data security. Chapter 3 discusses requirement elicitation, analysis and project design. It shows the flow chart and design of different modules of the project. The project is made of different modules which ensure easy access to the database and ease maintainability. CHAPTER 4 is the implementation and testing of the automated patient record management system. PHP is the programming language used while the MySQL database is the server. Each unit of the project will be tested to ensure correctness, robustness and maintainability. Chapter 5 is project summary, evaluation and conclusion

1.8 Definitions of Terms

Patient:

A person receiving or registered to receive medical treatment

Patient Record Management:

Computerized Patient Records (CPR) are computer-based documentations of all the meetings between a patient and a physician that contain the data of the various details about the patient, any clinical observations, investigations and diagnostic results.

Audit:

Independent review and examination of records and activities to test for compliance with established policies or standards, often with recommendations for changes in controls or procedures.