Development Of Web Based Medical Record For Teaching Hospital

Patients receive medical treatment without being admitted to a hospital. They are not hospitalized for 24 hours or more but visit hospital, clinic or associated facility for diagnosis or treatment [1]. But the problems of keeping their records for quick access by the management and provision of confidential, secure medical report that facilitates planning and decision making and hence improves medical service delivery are vital issues. This paper explores the challenges of manual outpatient records system for Teaching Hospital, Minna and infers solutions to the current challenges by designing an online outpatient’s database system. The main method used for this re- search work is interview. Two (2) doctors, three (3) nurses on duty and two (2) staff at the record room were interviewed. Fifty (50) sampled outpatient records were collected. The combination of PHP, MYSQL and MACROMIDIA DREAMVEAVER was used to design the webpage and input data. The records were implemented on the designed outpatient management system and the outputs were produced. The finding shows these challenges facing the manual system of inventory management system. Distortion of patient’s folder and difficulty in searching a patient’s folder, difficulty in relating previous complaint with the new complains because of volume of the folder, slow access to patient diagnosis history during emergency, lack of back up when an information is lost, and preparation of accurate and prompt reports make it become a difficult task as information is difficult to collect from various register. Based on the findings, this paper highlights the possible solutions to the above problems. An online outpatient database system was designed to keep the outpatients records and improve medical service delivery.
 

TABLE OF CONTENTS

COVER PAGE

TITLE PAGE

APPROVAL PAGE

DEDICATION

ACKNOWELDGEMENT

ABSTRACT

CHAPTER ONE

INTRODUCTION

1.1      BACKGROUND OF THE STUDY

• AIM OF THE STUDY
• OBJECTIVE OF THE STUDY
• PURPOSE OF THE STUDY
• LIMITATION OF THE STUDY
• SIGNIFICANCE OF THE STUDY
• SCOPE OF THE STUDY
• DEFINITION OF TERMS
• STATEMENT OF PROBLEM
• PROJECT ORGANISATION

CHAPTER TWO

LITERATURE REVIEW

• REVIEW OF APPLICATION OF COMPUTER/ICT
• REVIEW OF PATIENT RECORD
• STRENGTHS AND WEAKNESSES OF PAPER PATIENT RECORDS
• PROBLEMS WITH PATIENT RECORD CONTENT
• OVERVIEW OF TEACHING HOSPITAL MINNA

CHAPTER THREE

• RESEARCH METHODOLOGY
• ANALYSIS OF THE EXISTING SYSTEM
• DATA COLLECTION
• SYSTEM DESIGN
• SOURCE OF DATA
• PROBLEM OF THE EXISTING SYSTEM
• POSSIBLE SOLUTIONS
• ONLINE SYSTEM
• PROPOSED SYSTEM
• ADVANTAGES OF THE PROPOSED SYSTEM
• CHOSEN WEB APPLICATION TECHNOLOGIES

CHAPTER FOUR

4.1      RESULTS

CHAPTER FIVE

• CONCLUSION
• RECOMMENDATION
• REFERENCES

CHAPTER ONE

1.0                                                        INTRODUCTION

Computer, since its evolution has made considerable impact to various area in our society and world in general, its scientific study discovery and development both in the field of science and technology owed to the strange swiftness, exact and accuracy with its works and carryout computer in many aspect of human endeavor leads to the speed and accurate execution of lengthy ad cumbersome fast (jobs).

Nevertheless, computer has been applied in most fields these days due to its benefit to the following area:

Education: Computers are used as aids students hearing, it acts as a patient teacher, which allows hearing at your own pace.

Business: Most business and large firms secretaries use a computer package called word processing to write letters, memories and report. A word processing program makes correction, edition of documents, quickly and easily resulting in a neat and readable output also, the emergence of intrnet has made a business possible that is, buying and selling of product though the internet.

Industry: Some companies employees master job with the aid of computer based training programs which most of the use in simulation technologies and other packages like CAM (Computer Aided manufacture) and CAD (Computer Aided Resign) are used in design and manufacturing of these products.

Other areas of which computer application has been helped are in computerization of some government owned parastatals billing system NITEL and NEAP, Computerization of airline reservation. Due to this and other mentioned benefits and reasons, computer is without break guiding ground (popularity while scientist, artist, engineering, doctors, business and education sectors etc. some computer package use in advising these goals are AUTO CAD Dbase and power point, Microsoft tutor IC. In fact the sky is the Limit for the use of computer.

In addition, in medical: Medical record of patients can be stored for Later retrieval though the use of computer thereby assisting in the training of medical history of patients, for appropriate treatment, also due to the emergence of internet, tale-medicine is now possible.    This is a situation whereby a patient can be treated over the internet.

Hospitals are highly information intensive organizations which spend substantial sums on information management and processing of inpatients and outpatients database system [2]. It naturally follows that technologies that improve the gathering, storage, transmission and processing of information will be useful tools in hospital management [3]. Since late 1950s, health care visionaries have predicted an information technology (IT) revolution within medical care delivery, a revolution that would transform the health care industry [4] [5]. The early pioneers of medical informatics (the study and use of computer and IT in health care.) formulated a vision for literally transforming modern medicine through use of hospital IT systems [6].

In 1991, the institute of medicines committee on improving the patient record stated a standard use of IT in health care in 2001 [7]. Most hospitals like Teaching Hospital Minna keep and update their paper based medical records after introducing an electronic medical record or database system for patient. There should be improvement in the hospital care outcome and care management, reduction of medical errors and increases in both administrative efficiency and patient satisfaction [8].

At the Teaching Hospital Minna, it is suggested that web based medical record patient database system should be adopted so that patient will not be waiting unnecessarily for cards to be found before they could be attended to. Getting access to all their past medical history can be a time consuming, frustrating, confusing process.

It is necessary for outpatient to have an ideal secured database record management system based on details of medical records [9]. The absence of computerized medical records in most hospitals in the country makes this ideal unattainable [10]. Although computerized medical records to be access online are forgone issues in developed countries, many hospitals are yet to embrace it in Nigeria [11]. This research seeks to practice the management of online access of patients’ records electronically so as to provide an easy access to critical patient records and also provide logical continuation to regional health network by allowing distant sites to collaborate and exchange their data for specific research via the computer system. This case study focuses on outpatient scheduling, by evaluating different appointment scheduling systems as a means to reduce patients’ waiting times, to improve the outpatient clinic’s utilization, to reduce doctor’s overtime and idle time, and to focus on the counter personnel’s peak workload as well.

1.1                                           BACKGROUND OF THE STUDY

The patient record is the principal repository for information concerning a patient’s health care. It affects, in some way, virtually everyone associated with providing, receiving, or reimbursing health care services. Despite the many technological advances in health care over the past few decades, the typical patient record of today is remarkably similar to the patient record of 50 years ago. This failure of patient records to evolve is now creating additional stress within the already burdened health care system as the information needs of practitioners,patients, administrators, third-party payers, researchers, and policymakers often go unmet. As described by Ellwood (1988:1550),

The intricate machinery of our health care system can no longer grasp the threads of experience. Too often, payers, physicians, and health care executives do not share common insights into the life of the patients. The health care system has become an organism guided by misguided choices; it is unstable, confused, and desperately in need of a central nervous system that can help it cope with the complexities of modern medicine.

Patient record improvement could make major contributions to improving the health care system of this nation. A 1991 General Accounting Office (GAO) report on automated medical records identified three major ways in which improved patient records could benefit health care (GAO, Bottom of Form

1991). First, automated patient records can improve health care delivery by providing medical personnel with better data access, faster data retrieval, higher quality data, and more versatility in data display. Automated patient records can also support decision making and quality assurance activities and provide clinical reminders to assist in patient care. Second, automated patient records can enhance outcomes research programs by electronically capturing clinical information for evaluation. Third, automated patient records can increase hospital efficiency by reducing costs and improving staff productivity.

Several sources support these conclusions. The GAO reported that an automated medical record system reduced hospital costs by $600 per patient in a Department of Veterans Affairs hospital because of shorter hospital stays (GAO, 1991). Reductions in the length of inpatient stays were also found in other studies of computerized medical records and medical record summaries (Rogers and Haring, 1979). Other investigators found enhanced care and improved outcome of care for clinic patients (Rogers et al., 1982) and a reduction in medication errors (Garrett et al., 1986).

The first step toward patient record improvement is a close examination of the users of the patient record, the technologies available to create and maintain it, and the barriers to enhancing it. To that end, the Institute of Medicine (IOM) of the National Academy of Sciences undertook a study to recommend improvements to patient records in response to expanding functional requirements and technological advances. This report is the product of the multidisciplinary panel’s 18-month study of how patient records can be improved to meet the many and varied demands for patient information and to enhance the quality of patient care and the effectiveness and efficiency of health care delivery.

1.2                                                     AIM OF THE STUDY

To design a web based medical record for patient database system for medical unit of Teaching Hospital Minna to provide easy access to outpatient record.

1.3                                              OBJECTIVES OF THE STUDY

Objectives are the following:

To explore the functions of medical unit and investigate the services being rendered to the outpatient.

1. To examine the challenges of the service being rendered to the patients’ records manually and the possible solution.
2. To design a web or online patient database system to solve the problems through the use of Dreamweaver and PHP programming
3. To implement outpatient records on the online database management system and make recommendations based on the research made from the study of medical

1.4                                                PURPOSE OF THE STUDY

The purpose of web based medical record is to provide an easy and reliable means of accessing patients record which also address the problem of security; privacy and confidentiality of patient health records. It also helps to check the delay, error, inconsistencies in medical records and timely access to historical records all of which had a significant impact on the quality of the hospital.

1.5                                           SIGNIFICANCE OF THE STUDY

This large scale sharing of medical records via network connections has the potential to bring us numerous benefits. Online outpatients’ record will be separated from the inpatient at the hospital. This study would be found useful for the teaching Hospital Minna because it will help to address the problem of security; privacy and confidentiality of patient health records. It also helps to check the delay, error, inconsistencies in medical records and timely access to historical records all of which had a significant impact on the quality of the hospital. The implementation of online hospital database system is vital to the provision of quality care, as well as adequate management of scares resources and productivity.

1.6                                          STATEMENT OF THE PROBLEM

The Teaching Hospital Minna outpatient record exhibited a lot of difficulties in the system which is manual and is based on paper cards to collect an outpatient record. So it needed Information Technology (IT) based solution, an evaluation of alternative appointment systems to reduce waiting times and underutilization of an outpatient database system in the hospital. Some of the problems are stated below:

1. Data is stored in a way which makes it difficult for the management to retrieve useful
2. Enquiries about the patients record are sometimes difficult to deal with as patient’s record are not stored in a form that is easily
3. Problems were encountered is the time-consuming nature of the manual of the patients lists and retrieval of patient file for various reason from the existing record
4. The hospital does not have back-up of medical records in the case of natural disaster for example flood, fire-outbreak.
5. Missing some or most of the patient’s
6. Patients’ information is usually mixed up while carrying files from one point to

1.7                                                  LIMITATION OF STUDY

i           Time: Time giving to us to write the project was short.

ii          Finance: The cost of writing the project was very expensive.

iii        Book: I was not able to find some of the books needed for research.

iv         Library: some of the libraries I visited was not equipped with enough books needed for the research.

1.8                                                       SCOPE OF STUDY

This study shows how to change the traditional way of presentation and accessing patient’s record to an online (web) mode is of great importance to the management of the teaching hospital and the record and statistics department. It goes a long way into help to encounter those problems that proves.

1.9                                                 DEFINITION OF TERMS:

COMPUTER:            Is an electronic device that can receive a set of instructions, of program and then carryout this problem by performing calculations on numerical data or by manipulating other forms of information.

COMPUTER PROGRAM: Are a set of instruction in a programming language, intended to be executed on a computer to perform a task.

1.10                                                RESEARCH QUESTIONS

Nurse Section

1) How do you create records for new patient?

2) How do you check for existing patient data?

3) How do you queue them up for Doctor’s awaiting list?

4) How do you delete from the awaiting list the patient the Doctors has attended to?

5) What are the major problem being encountered?

Doctors Section

1) How do you get the compliant of the patient in the awaiting list?

2) How do you diagnose the patient in the awaiting list?

3) What are the major problem being encountered?

1.11                                             PROJECT ORGANISATION

This work begins with an introduction that is the chapter one which is specifically areas.

Chapter two includes the overview of related literature stating the brief history of computerization of student’s academic record a case study of Imo State Polytechnic.

Chapter three includes definition of system investigation, system analysis and the description of data collection department and the system requirement for the computerized student’s academic record software development.

Chapter four is basically on programming program design, program structure, program implementation and program evaluation and the categories of programming language.

Chapter five, limitation of study, conclusion, recommendation and references were also included.