DESIGN AND IMPLEMENTATION OF A COMPUTERIZED PATIENT MANAGEMENT SYSTEM

1.1 Introduction

Computerized Patient Management is an information system that is used to record relevant information relating to the patients. Information tracking provides a relevant intelligence to decision making at the right time. One of the major activities in the medical data processing is the maintenance of patient's record. When a patient visits a particular hospital for the first time, a folder is prepared and an identification number known as the card member is issued to the patient. This number is peculiar to only that patient and any information on the patient is stored or accessed by searching out the hospital folder bearing that number. These tracking of information on patients are collects and stored away in their hospital folder. As these records increase with time, the hospital would have a collection known as the medical history of the patient. This medical history be very, voluminous, this makes it almost impossible to retrieve past records of the patients that have been stored away for long.

Much of these information management system is been done by the record officers who collects information from different sections of the hospital and stores them away as expected. The record officers may be able to maintain these information but the process of retrieving and even storing is generally slow, time consuming and possibly tedious.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Limitation of the study and Definition of technical terms.

1.2 Background of the Study

Historically, however, hospitals were often founded and funded by religious orders or charitable individuals and leaders. 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. 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.

The computer-based system has been designed to tackle some of the problems attached to information tracking while running a hospital. This is done basically by introducing certain data processing standards and information into the automated system to help govern and monitor the way the data and information is stored, accessed, used and retrieve. The processed information is stored in computer and they can be use of electric means. To prevent an epidemic outbreak within a region can only be provide a necessary statistics towards the number of death caused by a disease and the related solution, which can be used to tackle a disease. Information can be retrieved on a specific problem hence it is by electronic means.

Computerized Patient's Information Tracking System of Annunciation Hospital shows various drugs that one can purchase. It records the available drugs, the sold drugs and the money collected from the sold drug. It involves database programming to keep track of the event of the system. The program is also implemented using web based programming languages. Depending on the drug and its desired effect, there are a variety of administration methods. Most drugs are administered orally that is, through the mouth. Only drugs that will not be destroyed by the digestive processes of the stomach or intestines can be given orally. Drugs can also be administered by injection into a vein (intravenously), which assures quick distribution through the bloodstream and a rapid effect; under the skin (subcutaneously) into the tissues, which results in localized action at a particular site as with local anesthetics; or into a muscle (intramuscularly), which enables rapid absorption through the many blood vessels found in muscles. An intramuscular injection may also be given as a depot preparation, in which the drug is combined with other substances so that it is slowly released into the blood.

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.

1.3 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:

1. 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
2. Lack of immediate information storage: The information generated by various transactions takes time and efforts to be stored at right place

• 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.

1. 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.
2. Preparation of accurate and prompt reports: This becomes a difficult task as information is difficult to collect from various register.

1.4 Aim and Objectives of the Study

The aim of this project is to design a Computerized Patient Management System. In achieving this aim, the following specific objectives were laid out as follows to develop an application software that will:

1. Capture and store patients drug data for a teaching hospital
2. Generate and manage bills of each patient drug administered
3. Execute a proper recording of patients' drugs and diagnosis result.
4. Keep proper track of appointments made with the patient by the hospital
5. Keep track of list of patients' beds (Occupied and Vacant).

1.5 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.

With the growth in information technology, the study offers numerous values both to the film and to any hospital that deals on marketing of goods and items. Huge of files kept in the offices will no longer be there again because information will be stored on the computer with the help of the Computerized Patient Management System Because of the easy to use nature of the Computerized Patient Management System, any hospital can easily buy it to make use of them.

This study will be of immense benefit to academic students and other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.6 Scope of Study

The scope of the research is focused on the Design and Implementation of a Computerized Patient Management System using Echochin Hospital 9th Mile Enugu as a case study.

1.7 Limitation of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint:The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Establishment Policies:Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this institution to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
3. Research material: availability of research material is a major setback to the scope of the study.
4. Frequent power failure:This made the researcher append more money on fuel to ensure sustainable power.
5. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

1.8 Definition of Terms

Medication:

A medication is a substance that is taken in to or placed on the body that does one of the following things: most medications are used to cure disease or condition.

Prescription:

A prescription is a health-care program implemented by a physician or other qualified health care practitioner in the form of instructions that govern the plan of care for an individual patient.

Symptom:

A symptom is a departure from normal function or feeling which is apparent to a patient, reflecting the presence of an unusual state or of a disease.

Administration:

An administration is the act of giving a drug to somebody or a patient.