An Automated System for Patient Record Record Management (A Case study of St Francis Hospital Nsambya, Uganda
!rac"# !rac"# Patient $nformation Management
Patient record management systems in %ospital today necessitate a competent administration &%en %andling patients, generating reports from cas%ier, patient details &%ic% ser'es ser'es as a "ey factor for t%e o& of business business transactions in St Francis Hospital Hospital Nsambya Nsambya,, Uganda Uganda)) Unfort Unfortunat unately ely t%e curre current nt Record ecord managem management ent system system leads leads to mispl misplac acem emen entt of drug drug detai details, ls, payme payment nt detai details, ls, and and late late relea elease se of repor eports ts and insecurity to records) !%is researc% pro*ect is aimed at computeri+ing all t%e records about about patient patients, s, sta and drug drug supplie suppliers) rs) $n order order to ac%ie' ac%ie'e e t%is goal, a t%oroug t%oroug% % System Study and in'estigation &as carried out and data &as collected and analy+ed about t%e current system using document and data o& diagrams) !%e concept of report production %as been computeri+ed %ence, no more delay in report generation to t%e t%e %osp %ospita itall manag manager er)) !%e !%e met%o met%od d used used to de'e de'elop lop t%e t%e syste system m inclu include de iter iterati ati'e 'e &aterfall model approac%, datao&, logical and entity relations%ip diagram &ere used to design t%e system and -nally t%e language used &ere MyS.l, p%p, H!M/, Css and 0a'aScript)
1enerally Automation plays an important role in t%e global economy and in daily e2perience) 3ngineers stri'e to combine automated de'ices &it% mat%ematical and organi+ationa organi+ationall tools to create create comple2 comple2 systems for a rapidly e2panding e2panding range of applications) !%e Patient $nformation Management System (P$MS is an automated automat ed system t%at is used to manage patient information information and its administration) administration) $t is meant to pro'ide t%e Administration and Sta, &it% information in real4time to ma"e t%eir &or" & or" more interesting and less stressing) !%e system de'elopment life cycle (S5/C &e c%ose to use t%e iterati'e &ate &aterf rfal alll mode model) l) $n t%is t%is mode model, l, t%e t%e syst system em foll follo& o&s s a seri series es of e'en e'ents ts from from t%e t%e re.uire re.uirement ment de-nition, de-nition, system and soft&are soft&are design, design, implementatio implementation n and unit testing, testing, integration integration and system testing and operational operational maintenance) maintenance) 6e also used dierent aspects asp ects from ot%er ot %er models li"e prototyping &%ic% %elped us come up &it% system de-nition and analysis, analysis, data o& diagrams (5F5 and entity relati relations% ons%ip ip diagram diagram (3R5) (3R5) !%e 3R5 &as used to s%o& t%e relatio relations%i ns%ip p bet&ee bet&een n entities &%ile t%e 5ata Flo& 5iagrams &ere used to s%o& t%e o& of data in t%e system) $terati'e &aterfall model di'ides t%e system de'elopment lifecycle into p%ases) 5uring 5uring eac% p%ase p%ase of t%e lifecycle, lifecycle, a set of &ell de-ned acti'ities acti'ities are carried carried out out for insta instanc nce e at t%e t%e An Analy alysis sis stage (struc (structur tured ed analy analysis sis of re.u re.uir irem emen ent t &as speci-cally speci-cally carried carried out in focus of t%e functionality of datao& at St Francis Hospital Nsambya) Nsamb ya) !%e system and structured analysis &as t%en transformed into soft&are soft&are design (soft&are (soft&are arc%itec arc%itecture ture to decompose decompose t%e t%e system system into modules modules and representa representation tion of relations%ip relations%ips s among t%e modules, modules, data structures structures and algorit%ms for t%e modules to be designed)
5A!A7AS3 53S$1N) A relational database design &as used to design t%e database) A relational database management system (R57MS is an e2cellent tool for organi+ing large amount of data and de-ning t%e relations%ip bet&een t%e datasets in a consistent and understandable &ay) A R57MS pro'ides a structure &%ic% is e2ible enoug% to accommodate almost any "ind of data) Relations%ips bet&een t%e tables &ere de-ned by creating special columns ("eys, &%ic% contain t%e same set of 'alues in eac% table) !%e tables can be *oined in dierent combinations to e2tract t%e needed data) A R57MS also oered e2ibility t%at enabled redesign and regeneration of reports from t%e database &it%out need to re4enter t%e data) 5ata dictionaries &ere used to pro'ide de-nitions of t%e data used8 t%ese included t%e -nal data structures for t%e 'arious tables and t%eir corresponding data -elds, description and si+es) !%e user application programs and interface &ere de'eloped using PHP, CSS, H!M/, and 0a'a Script &it% support of structured .uery language (S9/ and M:S9/) S9/ is a language used to create, manipulate, e2amine and manage relational databases) S9/ &as standardi+ed in ;<<= so t%at a program could communicate &it% most database systems &it%out %a'ing to c%ange t%e S9/ commands) Unfortunately one must connect to t%e database before sending S9/ commands and eac% database 'endor %as a dierent interface as &ell as dierent e2tensions of S9/) !%oug% S9/ is &ell suited for manipulating database, it is unsuitable as a general application language and programmers use it primarily as a means of communicating &it% databases, anot%er language is needed to feed S9/ statements to a database and process results for 'isual display or report generation) !%e ad'antage of PHP and H!M/ is t%at you can run t%eir programs on any enabled platform &it%out e'en recompiling t%e program)
S:S!3M $MP/3M3N!A!$>N !%is describes t%e tools used to implement t%e grap%ical user interface and t%e database) MyS9/ &as used to create and connect relational tables to t%e database) H!M/ &as used to de'elop t%e 1U$) PHP &as used to process .ueries and re.uest as% to integrate sounds and interfaces &as done to de'elop t%e model t%at meets all t%e re.uirements of t%is system)
S:S!3MS !3S!$N1 AN5 ?A/$5A!$>N !esting &as done after t%e system &as put in place) !%is &as done in t&o &ays# $mplementation and Unit testing &as carried out on indi'idual modules of t%e system to ensure t%at t%ey are fully functional units) 6e did t%is by e2amining eac% unit &%ic% &e c%ec"ed to ensure t%at it functions as re.uired and t%at it adds clients@ data and ot%er details and also ensured t%at t%is data is sent to t%e database) !%e success of eac% indi'idual unit ga'e us t%e go a%ead to carryout integration testing) All identi-ed errors &ere dealt &it%) 6e carried out integration and system testing after dierent modules %ad been put toget%er to ma"e a complete system) $ntegration &as aimed at ensuring t%at modules are compatible and t%ey can be integrated to form a complete &or"ing system) For e2ample &e tested to ensure t%at &%en a user is logged in, %es%e is lin"ed to t%e appropriate page, and could at t%e same time access t%e database) As one of t%e -nal speci-c ob*ecti'es of t%is study, 'alidation of t%e system &as 'ery important) ?alidation of t%e system &as done by comparing it to t%e .uestions as"ed by t%e users at St)Francis %ospital) Most of t%eir ans&ers matc%ed &%at t%e system can do)
53?3/>PM3N! >F !H3 S:S!3M !%is section describes &%at is e'ol'es to come up &it% t%e system and %o& t%e system &or"s) Front end# Html (%yper te2t ma"eup language enable t%e construction of easy and intuiti'e user interface for accessing t%e database and any bro&ser can display and %tml document) Middle end# p%p enables lin"s of t%e te2t entered in t%e created grap%ic user interface to be sent to t%e database 7ac" end# Mys.l its easy to use, ine2pensi'e database language it can run on a 'ariety of operating system suc% as &indo&,linu2,uni2)os= and ot%ers , its secured &it% tec%nical support &idely a'ailable on t%e internet but most of all it support large database)
S:S!3M ?A/$5A!$>N As one of t%e speci-c ob*ecti'es of t%is study, 'alidation of t%e system &as 'ery important) ?alidation of t%e system &as done by comparing it to t%e .uestions as"ed by t%e users at St Francis Hospital Nsambya) Most of t%eir ans&ers matc%ed &it% &%at t%e system can do) 0a'aScript &as used to 'alidate user
input and t%e respecti'e input) For e2ample t%e system does not accept blan" -eld8 t%e system also discriminate bet&een numerical and numerical c%aracters)
C>N?3R!$N1 $!3RA!$?3 6A!3RFA// M>53/ !> SP$RA/ M>53/
;)
$53N!$F$CA!$>N
S:S!3M R39U$R3M3N! !%is section describes t%e %ard&are components and soft&are re.uirements needed for eecti'e and eBcient running of t%e system8 Hard&are Re.uirement re.uirement Processor Memory 5is" space
Hard&are
Minimum
System
=) 1HD processor speed ;=E M7 RAM (=G M7 Recommended E 17 (including = 17 for database Management system
5isplay
E 2 G colors (;= 2 IGE Hig%
color4 ;G bit Recommended Abo'e s%o&s %ard&are components of t%e mac%ine t%at allo&s t%e system to function as re.uired for using P$MS8 Soft&are
Minimum System re.uirement
>perating System
6indo&s = or later
5atabase Management System
M:S9/
Run4time 3n'ironment
Apac%etomcat ser'er
Abo'e s%o&s soft&are re.uirements recommended to enable t%e system to run as re.uired for using P$MS
=)
53S$1N
After interpretation of t%e data, tables &ere dra&n and process of data determined to guide t%e researc%er of t%e implementation stage of t%e pro*ect) !%e tools, &%ic% &ere employed during t%is met%odology stage, &ere mainly tables, 5ata Flo& 5iagrams (5F5s and 3ntity Relations%ip 5iagrams (3R5s) !%e design ensures t%at only allo&s aut%ori+ed users to access t%e systems information)
ARCH$!3C!URA/ 53S$1N !%is gi'es a %ig% le'el 'ie& of t%e ne& system &it% t%e main components of t%e system and t%e ser'ices t%ey pro'ide and %o& t%ey communicate) !%e system is implemented using a t%ree4tier arc%itecture t%at comprises of user interface, process management and 57MS as illustrated belo&)
J)
C>NS!RUC! >R 7U$/5
As one of t%e speci-c ob*ecti'es of t%is study, 'alidation of t%e system &as 'ery important) ?alidation of t%e system &as done by comparing it to t%e .uestions as"ed by t%e users at St Francis Hospital Nsambya) Most of t%eir ans&ers matc%ed &it% &%at t%e system can do) 0a'aScript &as used to 'alidate user input and t%e respecti'e input) For e2ample t%e system does not accept blan" -eld8 t%e system also discriminate bet&een numerical and numerical c%aracters)
PR3S3N!A!$>N >F R3SU/!S
!%e presentation of t%e results of PRMS is analy+ed in terms of t%e interfaces of t%e system and output from t%e bac"end of t%e system) !%is includes acti'ities of t%e users)
)
3?A/UA!$>N AN5 R$SK ANA/:S$S
Strengt% of t%e Current System !%ese &ere introduced to sol'e problems &it% t%e e2isting manual systems) !%e automated Patient information Management system %as many ad'antages o'er t%e manual system) !%is can be e2plain as follo&# !%e ma*or bene-t &it% t%is is t%at it %elps t%e sta to accomplis% t%eir daily functions more eBciently) No more need for paper &or") 9uic" access to t%e re.uired information as it is only Lone clic" a&ay) $t sol'es t%e problem of time consuming, %ence customers are ser'ed on time) $t also en%ances security as access to t%e system re.uires aut%entication) !%is means t%at only aut%ori+ed users can access t%at system)
After a t%oroug% in'estigation of t%e present system, t%e follo&ing loop%oles &ere identi-ed) Regular complaints by patients, %ospital administrators, sta and drug supplier concerning misplaced or lost -nancial payment forms) !%e %ospital administration -nds it tiresome and time consuming &%en computing patient, drug supplier and sta payment receipts and 'ouc%er cards respecti'ely, t%is leads to late release of reports concerning t%e performance in t%e %ospital) !%e %ospital Administration currently uses %ealt% record -les for storing patients@, drug suppliers@, stas@ records on payment respecti'ely) !%is system of information
storage is susceptible to security problems suc% as illegal modi-cation and update of records)
