Design and Implementation of an Online Healthcare System (Case Study of General Hospital, Minna)
Chapter One
AIM AND OBJECTIVES OF STUDY
To design an online healthcare in-out patient database system for a medical unit of General Hospital Minna which will provide easy access to patient records. The study has the following objectives:
- To explore the functions of the medical unit.
- To investigate the services being rendered to the outpatient.
- To explore the challenges of the service being rendered to the outpatient manually.
- To develop an online database system to solve the problems.
- To implement the outpatient record on the online data manually.
- To make a recommendation for the adoption of an online database management system.
CHAPTER TWO
LITERATURE REVIEW AND SYSTEM ANALYSIS
LITERATURE REVIEW
The application of information technology in health care is unceasingly evolving as the quality of patient care in contemporary times seems to depend on the timely acquisition and processing of clinical information related to the patient Brailer(2005). Cholewka (2006) asserted that a significant paradigm shift has occurred in health care service delivery from an era of physician centeredness to emphasis on quality of patient care, from isolationist practices by caregivers to networking in a global world, and from competition to collaboration among practitioners. In tandem with this trend, improvement in technology and advancement in information systems has been adopted in the health care industry as a business strategy to improve the quality of care Wilcke (2008).
A clear understanding of the usefulness of hospital information systems is lacking among health care policy makers in Nigeria. The Year 2000 World Health report ranked Nigeria 187 out of 191 countries in health care infrastructure and health services provision. A gap in knowledge exists regarding the exact number of hospital information systems functionally available in Nigeria, but subjective data project less than 5% implementation of any form of hospital information technology in a country of more than 150 million people Idowu, Adagunodo &Adedoyin, (2006). This review was designed to explore the reasons for lack of robust availability of hospital information systems in Nigeria.
Nigeria for a long time has suffered political instability, thus creating the opportunity for corruption to thrive and enhancing poor macroeconomic management Okafor-Dike (2008). Following years of military dictatorship and lack of government accountability, infrastructural decay did not attract the desired attention Okogbule (2007). The petroleum-supported economy faced years of blatant economic mismanagement and the squandering of resources through institutionalized corruption Pierce(2006). After a few attempts at democracy in the 20th century, Nigeria reestablished a democratically elected government in 1999, but one still recycling much of the political elements of the military era. A change in the body polity of the nation has been painfully slow and in some cases retrogressive Okafor-Dike(2008). A major task facing the current civilian regime is to rebuild the social institutions and health care sector by introduction of new national policies. As a result of decades of neglect, there is a serious shortage of modern health care facilities. The government has taken steps to promote the development of a basic national primary care program in the villages, but concerns abound about serious lack of specialized health care facilities Ouma&Herselman (2008).
The most recent population census held in Nigeria in 2006 estimated a population of 140 million inhabitants, whereas current projections puts the population at more than 150 million people making Nigeria the most populous country in Africa (World health report, 2008). According to the National Population Commission (2007), the population is young with 42% in the age group 0-14, 55% in the age group 15-64, and only 3% age 65 and above. The National Population Commission (NPC) published a wide range of information including the fact that the population is growing rapidly by 2.4% every year. The birth rate is 40 per 1000 and the death rate is 17 per 1000. The fertility rate is 5.5 children per woman. The population, which is ethnically very diverse, representing more than 250 different tribes and population groups, is also diverse in religious beliefs. About 50% are Muslims, 40% Christians, and 10% of different indigenous beliefs (National Population Commission, 2007).
Nigeria practices both orthodox medical care and traditional healing. Traditional medical practitioners are native doctors who practice in rural areas but occasionally find patronage in urban cities. The health care services by native doctors do not follow formal protocols or depend on scientific tests to arrive at diagnosis. Sometimes their treatments endanger the lives of their patients from overdose of herbal extracts. These traditional healers do not have orthodox training, but depend on generational beliefs handed down by ancestors (Okeke, 2008). Even though the practice of Western medicine is rapidly expanding in Nigeria, the non-availability of modern medical technologies in the health care arena remains a threat to the success of orthodox medicine Pierce(2008).
Health care service delivery in Nigeria falls short of international standards resulting from poor state of health care infrastructure, shortage of medical professionals, threat of re-emerging infectious diseases, and poor sanitation. Over the last five decades post-independence, growth, and development in health care has been dismal. HIV/AIDS has been a very serious health challenge. About 3.6 million of the population are HIV positive or have developed AIDS (equivalent to a prevalence of 5.4% of the adult population). More than 300.000 individuals die from AIDS every year (Arikpo, Etor &Usang, 2007). Another major problem is that of infant mortality. The World Health Organization Report (2008) indicated an infant mortality of 110 per 1000 live births. As a comparison, the infant mortality in Sweden is 2.7 per 1000 live births. Poverty has compounded these problems to give low life-expectancy of 52 years for women and 49 years for men.
Recognizable demographic diversity exists in Nigeria with consequent disparity in availability of health care facilities across the country Okeke, 2008; Ouma & Herselman(2008). Electronic medical record systems help to improve access to health care in remote suburban areas and ensure improved maintenance of long-term care Keenan, Nguyen, &Srinivasan, (2006). Onwujekwe (2005) and Ofovwe and Ofili (2005), in separate studies conducted to assess patient and community satisfaction, found discontent with community members who decried the poorly staffed and inadequately equipped Primary Health Centers (PHCs) in their rural settlements compared to hospitals in urban centers. Such demographic disparity in health care accessibility benefits from hospital information technologies and telemedicine to foster collaboration between clinicians in urban areas and those in rural settlements Ouma&Herselman (2008).
Healthcare information systems include strategic decision support systems and clinical documentation systems. Some of the clinical support systems include Laboratory Information Systems (LIS), Radiology Information Systems (RIS), and Computerized Order Entry (COE). Others are pharmacy information systems and personal data analysis systems with important added feature for messaging between providers and staff, and the ability to share data with other medical facilities Keenan et al., (2006). Telemedicine is a unique application of hospital information technologies. In its simplest form, telemedicine uses audiovisual information and communications apparatus to deliver health care services in a bid to modify socio-economic circumstances of the beneficiaries and improve accessibility to medical care Yun & Chun, (2008).
A paucity of government policy regarding the implementation of hospital information systems exists in Nigeria. The lack of strategic government programs has culminated in the poor adoption of hospital information technologies in health care facilities across the country. Okeke (2008) asserted that the lack of access to modern medical health care facilities has compelled many Nigerian patients to seek treatment with traditional healers and patent medicine dealers. The more affluent echelon of the society resorts to medical tourism overseas to obtain health care services, resulting in a loss of foreign exchange to Nigeria.
CHAPTER THREE
SYSTEM DESIGN
Based on the user requirements and the detailed analysis of a new system, the new system must be designed. The design phase of any system is very important, vital and crucial because the success of any system depends largely on its design specifications. In this phase, the final specifications are used for translating the model into a design of the desired system. In this phase, modules are being defined showing their relationships to one another in a way known as a structural chart using structured tools. The reason for the design phase is to specify a particular software system that will meet the stated requirements gathered at the analysis phase.
Structured design divides a program into smaller, independent modules. They are arranged orderly in a hierarchy that shows a model of the application area which is organized in a top-down manner. The concept of modification thus comes from structured design which is an attempt to reduce complexity and make a problem manageable by sub-dividing it into smaller segments.
ARCHITECTURAL DESIGN
The proposed system is designed to meet all the disadvantages of existing manual system. The proposed system is better and more efficient than existing system. It is designed to keep in mind all the draw backs of the present system to provide a permanent solution to the problem associated with it.
The primary aims of the new system is to design a user interactive web site, user friendliness is another peculiarity of the proposed system. The advantage of the proposed system is the reduction in labour as it will give access to the Administrator, doctor, nurse and patient to navigate on the web site and manipulate records on the demands of the management and as well as other officials can browse the site for available types of services, using the new system designed.
CHAPTER FOUR
SYSTEM IMPLEMENTATION AND DOCUMENTATION
SYSTEM IMPLEMENTATION
The system implementation and application is required to put the newly designed system. This talks about the requirements in terms of hardware configuration and system types, the mode of conversion and the documentation of the system. Implementation has to do with the effective series of step to be carried out that provide the practical means for operating the new system by the users (Doctors, Nurse and Patient).
The system design for healthcare is contained in a CD-plate; the following steps are followed for a proper accessing of the website.
The web-based package used in this research has been deployed to be tested locally. The implementation procedures are as followed
- A system with at least Window 7, for instance and XAMPP 1.7.4 installed or higher version of XAMPP.
- Installed the operating system feature called internet information service from “add and remove” window component”
- Copy the website portal into the c:\inetpub\wwwroot\healthcare
- Also copy the website portal into the c:\xampp\htdoc\ healthcare \
- Finally open an internet explorer, on the address bar type http://localhost\ healthcare\index.php.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
SUMMARY
This chapter summarizes all the work done. In-Out patients department in a Hospital is to computerize the working in the Office. The web-portal takes care of all the requirements of an average Hospital and is capable to provide easy and effective storage of information related to patients that come up to the Hospital. It generates test reports; provided prescription details including various tests, and medicines prescribed to patients. It also provides injection details, diagnosis and prescription.
CONCLUSION:
In conclusion, a properly computerized system can save time and money. It improves the business operation and give the power to access and manipulate vital information quickly and efficiently. This project has been worthwhile as our main aim which was inefficient and delay of manual system, and unavailability of backup of data and also security of patient’s information has been achieved. Moreover, the project enhances data security in the hospital because the new system ensures data authenticity, accuracy, and availability any time and in a fast and efficient way. The computerized system is therefore a great advantage to General Hospital Minna in general and specifically the Medical Record Department which till date operates a manual system of record keeping.
RECOMMENDATIONS:
Having successfully developed an online outpatient’s database system, I recommend the following for better performance of the application.
- Regular backup: is recommended for the purpose or recovering the database in the event of disasters such as hardware failure, fire outbreak, virus attack and unauthorized modification to data stored in the database all of which can lead to loss of information.
- User’s username and password should be change at regular interval to reduce cases of unauthorized access to certain information.
REFERENCES
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- Bailey, N. (1954). Queuing for medical care. Applied Statistics 3, 137-145.
- Blanco White, M. and M. Pike. (1964). Appointment systems in Out-patients’ Clinics and the Effect ofPatients’ Unpunctuality. Medical Care 2, 133-145.
- Medical condition dictionary (2010-2011). Retrieved from www.medicondition.net
- Brahimi, M and D. Worthington. (1991). Queueing Models for Out-patient Appointment Systems: ACase Study. Journal of the Operational Research Society 42, 9, 733-746.
- Cayirli, T and E. Veral (2003). Outpatient scheduling in health care: a review of literature. Production and Operations Management Society 12, 4, 519-549.http://en.wikipedia.org/hospital information system (2010), “hospital information system.” Retrieved 27, May 2011
