Design And Implementation Of An Electronic Patient Management System

INTRODUCTION
1.1 Background of the Study
An Electronic Patient Management System is any tool used to assist in the delivery
of clinical care from point of care initiation to completion. Tools include computer
based attendance scheme for patient, payment processing software and information
technology systems, blood group and genotype to avoid test result mismatch of
data.Electronic based attendance scheme for Patients is used by hospital to create
process and record their attendance scheme for patient’s information. This system
is used to calculate the nurse punctuate to work. It’s an effective tool in the hands
of the hospital management.
Duty is a term that conveys a sense of moral commitment to someone or
something. The moral commitment is the sort that results in action, and it is not a
matter of passive feelings or mere recognition. When someone recognizes a duty,
that person commits himself/herself to the cause involved without considering the
self-interesting courses of actions that may have been relevant previously. This is
not to suggest that living a life of duty precludes one from the best sort of life, but
duty does involve some sacrifice of immediate self-interest.Cicero is an early
philosopher who acknowledged this possibility. He discusses duty in his work “On
Duty”. He suggests that duties can come from four different sources:
1. It is a result of being human
2. It is a result of one’s personality place in life (your family, country, and job)
3. One’s own moral expectations for you can generate duties
From the root idea of obligation to serve or give something in return, involved in
the conception of duty, have sprung various derivative uses of the word; thus it is
used of the services performed by a minister of a church, by a soldier, or by any
employee or servant.Nurses today have a broad scope of responsibility as health
care providers that require them, under some circumstance, to exercise independent
professional judgment. When nurses exercise their judgment negligently, they may
be held liable because courts hold them to a correspondingly higher level of
accountability.Nurses have been held liable for their failure to monitor and/or
promptly respond to patients by informing physicians of significant changes in
patient’s condition. Under these types of circumstance, nurses have an affirmative
duty to exercise their professional judgment to ensure that all adequate steps are
taken to treat patients appropriately.
Usage of Information Technology (IT) remained comparatively very less in Health
sectors that other sector despite having more potential. Health Institution, which is
an important sector, should encourage IT usage resulting better productivity,
effectiveness, efficiency and economics leading to better health care of all. This
paper tells a success of implementation of ICT (Information Communication
Technology) in monitoring of medicine in health institution. System work on low-
end resources and E-mail (Electronic mail) based data transfer from District Head
Quarter to State Head Quarter.Implementation of Med-Centre in all the district of
Enugu result in checking on pilferage (the act of stealing amounts or small articles)
for medicine, increase in availability of medicine at Government institution,
increase in attendance of patients/doctor in health institution, optimal utilization of
medicine and data capturing at source, resulting in availability of error-free data at
Head Quarter.
Electronic Patient Management System is a certified automated payment
processing software. It is used by hospitals to input, process and display their
patient information. This system is used to manage and maintain electronic
medical records, patient information, prescriptions, lab reports etc. It is an effective
tool in the hand of the hospital management. Shonahan Hospital,Nsukka, Enugu
which is the case study, has patients whose fees are to be collected after treatment.
Shonahan Hospital, Nsukka, Enugu is one of the biggest and well equipped
hospitals in Nigeria. It has nine (9) training schools/programmers in the
hospital.From the studies carried out by the researcher, the hospital’s initial means
of recording was manual from automated system to computerized system which
lacked some features such as patients and nurses records.
The Hospital is a very important part of our society and it is imperative for
healthcare providers to do their jobs in an efficient and effective manner. Each day
hundreds of thousands of patients enter healthcare facilities challenging the
administration to run the show smoothly. The employees have to manage and
integrate clinical, financial and operational information that grows with the
practice.Information technology has made a significant impact on the healthcare
sector. The past decade has witnessed the foray of numerous information systems
and their resultant products into the hospital scenario. The number of investments
in computers and types of hospital systems has increased. This is because paper
medical records are cumbersome, bulky to use and difficult to manage. On the
other hand digital records are much easier to handle and improve the workflow
efficiency by integrating various tasks. The ultimate objective therefore, is to build
a network of interdependent centers such as the clinical laboratory, radiology
department, pharmacy, and so on in order to effectively meet the needs arising
within the hospital. Despite the fact that these individual centers are autonomous,
they are interdependent in terms of delivering services and to ensure effectiveness
of providing care. All this can be achieved through hospital information systems
that have formed the cornerstone of today’s modern hospital.
A patient is any person who receives medical attention, care or treatment. The
person is most often ill or injured and in need of treatment by a physician or any
other medical professional whereas an outpatient is a patient who is not
hospitalized for 24 hours or more but who visits a hospital, clinic, or associated
facility for diagnosis or treatment. Treatment provided in this fashion is called
ambulatory care.
This Electronic Patient Management System is necessary to ensure the medical
practitioner to maintain its operations in an organized and well-coordinated
manner. These solutions save time and run the operations using the best
mechanisms against liabilities. This system is especially helpful in organizing and
keeping patient records up-to-date. Patient names, records of treatment and
medicine given records are well maintained. Maintaining patient records is really
helpful when you are allowed to refer to the patient’s old history. Say for example,
you want to refer your old patients for mouth cancer or jaw piece ulcers and
cancers, you may be able to locate such records on the basis of their symptoms or
conditions as you had entered in the database in the past. By law hospitals are
required to record in the outpatient information register once at the beginning of
the morning session and once during the afternoon whether the pupil is present,
absent, engaged in an approved, or unable to attend due to exceptional
circumstances as defined in regulation. If compulsory hospital patients are absent
the register must show whether the absence is authorized or unauthorized. It must
also record the nature of any approved activities.By using this Electronic Patient
Management System, the department will provide the patients with convenience
and security of having their payment records been stored automatically into the
database for further processing. This automated method is the most advanced and
least expensive way to maintain and process patient’s payment records. If a
patient’s payment record is not found in the database, definitely that patient’s fees
has not yet been paid.

1.2 Statement of the Problem
Prior to the problem encountered with patient’s attitude to their check up and
treatment, the nurse’s laxity (laziness) over their duties, the need arose to develop a
software that will be able to solve the problem. The problem caused by the use of
manual method of keeping outpatient information and the use of manual method of
keeping attendance scheme for patients can only be solved by computerizing the
hospital attendance scheme for patients and computerizing the hospital outpatient
information system. The problems that this project is set to solve in the manual
method of keeping outpatient information are:
1. Improper documentation of patient payment record.
2. Difficulty in retrieving patient payment record.

1.3 Objectives of the Study
The primary purpose of this project is to enhance the reliability, security, and
convenience in the administration of Shonahan Hospital, Nsukka, Enugu, and to
have a database that contains complete and comprehensive details of patient
departmental payment records as well as a computer based attendance scheme.
The subsidiary objectives of this project are:
1. To improve checkup and treatment load functionality: Staffing level and
appropriate skill-mix per shift can be more easily determined by the shift
modules. This leads to less time spent in designing and amending roasters.
2. Better care planning: Time spent on care planning is reducing, while the
quality of what is recorded improved. This makes for more complete care
plans and more complete assessments and evaluations.
3. To facilitate diagnosis of patients thereby reducing patients wasting time
4. To exploit the use of ICT as a platform for medical services
5. To better drugs administration
6. For better maintenance of duty rosters

1.4 Significance of the Study
A patient management system works best as an early intervention; more success
was reported when targeted at more entrenched cases.While some patient’s care is
usually required, the nursing supervisee’s new checkup and treatment include
setting up checkup and treatment schedules, assigning checkup and treatment to a
nursing staff, and ensuring that each member of the nursing team is adequately
trained.This means that they must ensure that nursing records are correctly
maintained, that report is correctly given at each shift change that patient data are
up to date and that equipment and other supplies are in stock. Among these, other
areas where this project work is significant include:
1. Reducingmortality rate arising from important administration in the medical
service.
2. Helping to determine how computerized of hospitals has contributed to easy
medical services.
Furthermore, this work will serve as a reference work to students who are carrying
research on this topic.

1.5 Scope of the Study
The scope of this study is centered on designing anElectronic Patient management
system for patients. In fact it involves all parts of medical field in terms of record
keepings for patient’s records and all other aspect of field. However, this project
has been limited to GOPD (General Out–Patient Department) which includes the
following areas:
1. Recording of patient health record
2. Acceptance of patient/personal symptom and compliant
3. Provisional prescription and treatment.
1.6 Definition of Terms
Computer: This is an electronic device that can accept data information of inputs,
process the data and it have the ability to store the data and also retrieves it for
future use.
Data: These are groups of non-random symbols such as words, figures, values
which represent event and things that have taken place.
Database: This is the collection of related files.
Doctors: These are those that give medical aid to patients.
Duty: This is a term that conveys a sense of moral commitment to someone or
something.
Hardware: This can be defined as the physical component of the computer
system. Such as monitor, keyboard, printer, mouse. Etc.
Hospital: This is a health facility where people who are ill or injured are given
medical treatments and care.
File: These are collection of related records.
Information: this is a data that has been processed into a form which is
meaningful to the recipient and which is of perceived value in either current or
prospective decisions or action by the recipient.
Management: This is the process of getting activities completed efficiently with
and through other people.
Nursing: This is a profession focused on assisting individuals, families and
communities in attaining, maintenance, and recovering optimal health and
functioning. Modern definition of nursing defines it as a science and an act that
focuses on promoting quality of life as defined by persons and families, throughout
their life experiences from birth to care at the end of life.
Records: These are collection of related fields.
Software: This is an application or program that can be run on computer.
Storage: This is a processing of storage data and information using storage media.

1.7 Project Work Organization
The report is explained in details from Chapter 1, which contains the preliminary
part of the project that discuss the procedures/methods used in carrying out the
research.
Chapter two discuss the literature review of various researchers in the field and
their analysis.
Chapter Three discuss the system design and methodology that explains the
methods used.
Chapter Four explains the system analysis, Implementation and Integration that
delivers the implied system of the work
Chapter Five discussed the summary, recommendation and conclusion of the
project