Patient Records Management Systemin Magomeni Hospital
Patient Records Management Systemin Magomeni Hospital
Patient Records Management Systemin Magomeni Hospital
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ABSTRACT
The Patients Records Management System has been designed to help so many Health Centers in Tanzania
that need to computerize their operations to improve services delivered to their customers and increase the
productivity of the entire organization. This system seeks to provide hospital employees with a new state-
of-the-art, simple-to-use software since every basic concept, method and procedure has been explained fully
in a precise clear language that is understood by many, and that is systematic and procedural. The project
design work was done using a well-researched methodology according to the nature of the problem stated
and the requirements or needs which are intended to be met, which avails the user with important
illustrative information and content. In some cases, more efforts were done to describe more about the
situation. For college and university students this work should prepare students for the use of computer
and computer-based designed projects in problem-solving such as designing systems for institutions and
various organs and inspire them to take more advance courses in computer studies.
Keywords: Patients, Health Centres, Customers, Organization, Hospital employees.
INTRODUCTION
The health care industry all over the world faces the challenge of improving the quality of health care and
reducing costs [1-4]. To meet this challenge, health care providers are employing new technologies,
consolidating costly and specialist services, changing institutional structures and improving their
Information Systems. The quality of care at any hospital depends upon how well patients’ health care,
planning and administrative functions work together [5-10]. A hospital Information System supports the
quality of care by providing a fast, accurate and easy way to enter, store and retrieve data thus freeing the
hospital staff from many time-consuming tasks. Main aim for undertaking this project is to take up the
challenge to develop a computerized information system to help the hospital to effectively register its
patients, ease the process of registration for the registration clerks, minimize the errors and duplication of
patients’ records, propose a better way of storing and retrieving patient’s data among other issues [11-14].
The system shall be referred to as the Patients Records Management System – (PRMS) Magomeni hospital
is a public owned health center located three kilometers from town along Old Bagamoyo road Dar es salaam,
the coastal region in the shore of Indian ocean Tanzania. The institution was established in 1953 by
Karimjee and started operating in 1959, it was then taken by the government under the ministry of health
Tanzania. The institute offers the following services; post-natal and pre-natal health center, volunteer
counseling and testing center (VCT), maternity services, child immunization, health education and
counseling, it is a twenty-four hours, full patient hospital center that manages its operations in shifts. This
is done by the shifting sequence of nurses and doctors [15-17]. It operates by first registering the patients
before directed to the examination room, those who have files are first directed to the records room, the
process is manual and consumes a lot of time considering that many patients are served daily by the hospital
[18-19]. Dar es salaam contains a population of 5 to 7 million people. It’s the business centre for many
activities and businessmen, recently facing the problem of overpopulation which often causes frequent
eruption of epidemic diseases such as cholera, tuberculosis and malaria due to overcrowding and congestion
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of houses [1]. The hospital seeks to develop into a centre of excellence in service provision, education,
training, research, development, and transfer of cost-effective technology and management information
systems suitable for the health sector in Dar es Salaam and neighbouring regions in general.
Statement of Problem
The system which is in place of record keeping at Magomeni Hospital is mainly through the use of a manual
filing system which has the patients records stored in files and a partially automated system, file based
which deals with records of the patients being not sufficient and effective as many patients are attended Page | 25
daily. Due to the large volume of data that is required to be stored, processed, analyzed and also shared
among staff, members of this organization face a lot of weaknesses in their daily activities such as delaying
of in processing of information, some information is always lost due to poor security of the system and all
these contributed to a high level of operational cost in ability to make timely and accurate decision, hence
hinders the organization to meet its needs. All this is because of the fact that, the centre uses manual
systems in keeping the records so there is a need to develop a more efficient computerized system which
will be able to perform analysis, storage and produce a report in a given time.
Aim
The main objective of the project is to design a system that will capture patients’ information and store
records in the database.
Specific objectives
To investigate the present problems with the patient information system and develop a
database system which will provide a centralized management information system that
will reduce duplication errors and double registration.
To build a system that will be able to compete in the market with other organizations or
hospitals or other NGOs that provide similar services like what the hospital is offering.
To implement and maintain the system to meet requirements according to the increasing
needs of the organization operation and improve productivity.
Research questions
Will the system allow the application to share data with other programs?
i. Is it possible to build the system that can run over a network?
ii. Will the program allow the user to access data from the database?
iii. Is it possible to build a secure program in such a way that available data is viewed by only the
authorized user?
METHODOLOGY
Target population
The data collection technique targeted on senior managers, middle managers, low level managers
and patients. This is because the categorized managers plus patients were the ones who could give
out complete information which was useful for the establishment of the new system and knowing
more weaknesses of the current system.
Sample selection
The research used the following people according to their position at work, hospital director as a
senior manager who gave the information about strategic objectives, policies and organization
structure. The nurses and ward attendants about the operation of business procedures as a middle
manager. Secretaries and receptionists gave information about day to day activities of the
organization as low-level managers. Also research got information from patients about problems
facing them such as file missing or loss, inconsistencies etc.
Data collection technique
The research is used the most appropriate data collection techniques to collect data from the
organization.
i. Interview, the project used this technique to collect data from senior and middle managers
so as to get additional strategic information about the organization, patients could give
information about the problems they always face.
ii. Questionnaire, the research chose this technique to collect information from the
secretaries and receptionist about the difficulties facing them due to the current system.
iii. Observation, was done to gather information within an organization so as to get data
which were not found through questionnaire and interview techniques also to verify data
which were already found from interview and questionnaire techniques.
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Development methodology
To achieve the above objectives, the project used the system development life cycle (SDLC)
methodology which has five phases: preliminary investigation, problem analysis phase (extracting the
requirements), system design phase (first step in developing new software), implementation phase
(coding) and the maintenance phase (enhancing the software). Preliminary investigation helped the
researcher to study why the system to be built was and defining its requirements. It also helped the
researcher to carry out an investigation to establish what the current system did, what problems were Page | 26
and chose the requirements for the system. In carrying out an investigation, information about the
current system was collected by recording the problems and requirements described by the users of
the current system. Problem analysis, in this phase the researcher performed activities such as problems
identifications, analysis and even predicting potential problems that could arise in the future. The
deliverables of this phase gave the researcher a picture on how the system was supposed to be built and
guide the developers’ work. Analysis was carried out to establish the current system in detail in order
to find out, the difficulties and problems of the system, the user requirements, the inputs to the system
and the outputs generated. After the system analysis, led to the starting activities on designing, which
exactly determined how the system was to operate in terms of process data, hardware and user
interface. This specified how the system was to be implemented and presentations of the new system,
ease of capturing data and output formats. Implementation, it was probably the most resource, costly
and time consuming phase. Here is when the physical system was validated and finally installed. It also
included activities such as user training and system maintenance [2]. And then I came with the concept
of implementing the new system which improved the quality of service, utilization of resources, faster
access to management’s information and reduction of expenditure.
Development tools
Microsoft visual basic and Ms Access are the tools which were used in developing the new system.
Visual basic is a programming environment that is, a program specifically designed to facilitate the
creation of new program, would be used to create user interface. Ms Access used in creating the new
system particularly the database system and managing the application’s data. SPSS statistical software,
data analysis tool was used in analyzing the data obtained from the results of interview. This tool
assists in presenting the data by drawing a graphs such as histogram, bar charts or pie graph [3].
Other development tools included the hardware tools such as,
i. Pentium 4 of 3.20 GHz processor.
ii. Minimum of 256MB of RAM.
iii. 40GB or higher storage memory hard disk.
iv. Windows XP operating system.
Current system
The institution was using manual system in keeping its records; paper based and file based systems.
The following were the weaknesses of the current system.
The current system takes too much time to process the records.
There is no security and confidentiality of records which are stored.
High use of space due to bulk folders at the receptions and office inside while the health center is
expanding and hence it may become difficult to handle all of the documents produced.
Project size and structure
The project covered the automation of records and information storing. It focused on the receiving
of patients’ details and all necessary particulars required and store them for later or further use
when needed at any time. Also could produce a report about a particular patient admitted at the
hospital. The project included the computer that is a single computer or network of computers
Experience with development methodology
System development life cycle (SDLC) is the methodology which will be used in developing the
new system [4]. The researcher did not have much experience with the methodology but was
confident to use the methodology because he had studied and understood the methodology well.
With connection to SDLC visual basic programming language was used by the researcher to build
up a program and user interfaces, Ms Access to create database system and to run the application
developed.
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Economic feasibility
The new system has many benefits to the institution, for example after the study and implementation
the system is able to accommodate huge amount of patient records compared to the current system
[5]. Additionally, the new system proved the following benefits.
A high level of automation and accuracy.
The ability to keep records of patients and fast retrieval when needed, a real time access.
Hiding the database from the user in such a way that the database will be seen by only Page | 27
the database administrator and each user is restricted from seeing data or information not
correspond to his/her privileges given by the system.
Cost of building the system
In building the new system the researcher incurred much expenses in travelling to and from the
application area, buying the requirements for new system such as hardware and software, subsistence,
stationeries and research assistants [6].
Risk assessment
The researcher was not familiar with the application area, this could lead to get wrong information or
data during data collection therefore researcher made use of organization reports and current system’s
documents to study the current system so as to minimize the problem. As the time for creation of new
system was short forced the researcher to skip some of the steps in developing the system hence could
affect the system development [7]. It was therefore a worth thing that to come up with the
computerized information system which could be able to accommodate large number of patients
attended daily by registering them, keep their records, track their medical history and status, by
transforming the current system into a more automated, secured and controlled record keeping which
is reliable and effective.
RESULTS
Results from observation
The system which is in place of record keeping at application area was found to be mainly through the
use of a manual filing system which has the patients records stored in files, which are kept in drawers
and a partially automated system, file based which deals with records of the patients being not sufficient
and effective as many patients are attended daily.
Data analysis from interview
The Table below show the statistical values obtained from the interview
Number F
1-4 3
5-8 2
9-12 7
13-16 3
17-20 5
f=20
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Figure 1: Bar chart
2.5
2.0
Page | 28
1.5
RESPONDS
poor
.5 not ef f ective
new system
Count
0.0 insecurity
2.00 3.00 5.00 7.00
NUMBER
The responds are shown by the coloured bars, red represents those people who concluded that the existing
system was totally insecured in terms of security and confidentiality, blue colour is the respond to the
conlusion that the current procedures of record keeping is not effective and has a lot of drawbacks, army
green accepted the idea of introducing new system to cut out the poor record keeping, pink represents those
who agreed it to be poor and truth that it is time consuming in accessing the records is shown by the light
blue.
Requirements analysis
This phase described the functions of the Magomeni hospital patients’ records management system,
involved visiting the organization and interacting with the employees of the concerned offices to come up
with the system requirements and form a basis for the software development. The system constraints and
services were established in this stage and planning was underway basing on the fact gathered.
Hardware and software requirements
Since the system was transformed from manual and paper based to automated system, the following
hardware and software were recommended to be used for the introduced system.
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Non-functional requirements
A software requirement that described not what the software did, but how the software could do
it, as software performance requirements, software quality attributes. The non-functional
software requirements included the response time, language standard used by the system, data
integrity through validation rules, efficient and ease usability of the system, the choice of colour.
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Figure 2: Authentication process flow chart
Start
Start
Page | 30
Enter
password,
username
Display wrong
password or NO ELSE
username Is
message password
correct?
YES
Logon to the
system
YES
Perform tasks
Stop
System design
Information gathered from the requirements analysis phase were divided into three groups; the
software design had fundamental abstractions and their relationships were defined while the hardware
design required the architecture of the proposed system. The output of this stage was an architectural
model which described the hierarchical structure of the program components, the manner in which the
components interact and the structure of data used by the components.
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Architectural design
Splash
screen Page | 31
Login
Main menu
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Physical design
Patient registration table
number
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Ward table
Field Name Data Type Description
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test results
the patient
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given
at the hospital
Relational schema
Primary keys are bolded and underlined, foreign keys are in bold only.
Registration (pid, fnme, oname, gender, dob, address, district, datereg, age, regfee)
Staffs (sid, fname, oname, gender, address, contact, profession, salary, dateemply)
Ward (wardno, pid, sid, wardtype)
Inpatient (pid, wardno, dateadmit, datedischarge, bedno)
Diagnosis (pid, sid, results, comments, prescription)
Payments (pid, xray, ultrasound, labtest, bedcharge, prescription, total, datepay, nodays, cost)
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Logical design
The user data in the database was represented as relations as shown in the entity relationship diagram. The
columns of the table contain fields and arrows of the table containing records for particular entities in the
registration point. Microsoft Access was used to store the data.
Entity relationship diagram, E-R diagram Page | 36
Figure 4: E-R Model
attends
recorded m
Staffs Inpatient
1 m
performs 1 occupied 1
m goes 1 admitted
Registration Ward
m m 1 m
Diagnosis 1
pays
Payments
System presentations
The new system has the graphical user interface. Graphical user interface is a portion of program that
the user interacted with [8]. Graphical user interface includes the following.
A pointing device, typically a mouse.
On screen pull-down menus that can appear or disappear under the control of the pointing device.
Window that graphically display what the computer is doing.
Icons, which are graphical images that represent certain items such as files and directories.
Introduction to computer and information system.
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Page | 37
This is welcome screen which displays the title of the software product, version before loading the login
screen and the system.
This is the security login screen to the system, only authorized registered users with username and password
will be allowed to enter the system and access the records stored.
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This main form which contains all the forms included in the system, main operations starts here
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This is the registration form which captures the patients’ details during the registration
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Staff details form, captures and displays the employees recorded details from the database
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This is the form which is used to record results from the examinations done to the patient.
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This form displays ward details, shows the ward in which the patient is admitted.
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(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
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This is the payment form, captures, computes the transaction, stores and displays the bills.
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Page | 45
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Page | 46
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Page | 47
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DISCUSSION
Recommendations
The package is highly recommended to be used at Magomeni hospital for effective process of
registering, store and retrieval of patients’ information. The report generated can be used to make
statistics on how many patients are registered and treated at the health center, this will help senior
managers to make decisions and future strategies for the institution to develop and improve its
services offered daily to the people. Therefore, the researcher recommends that the organization to Page | 49
take full advantage of this new automated system for the operations to be more efficient.
Limitations to the study
Limited experience
Lack of experience in the particular field limited the speed and tact at which the project
could have been carried out by fully skilled and experienced person. Therefore, I have to
research and learn new techniques which also lessen the time available.
Time constraints
Other academic activities required attention; furthermore, time limits reduced the amount
of time I could take to research and perfect the project.
Financial constraints
Financing a study of this magnitude in terms of research, software, hardware and other
resources were costly, hence led to project stagnation.
Lack of resources
Resources to carry out such a project were not easily available, for example software.
CONCLUSION
Generally, the development of this software product was a great success because it was able to
meet the needs of the hospital as intended. The report described the manual and computer methods
of keeping information pointing out the drawbacks of current system in use giving the benefits of
the new system. It also gave the background of the whole study, objectives, methods used to tackle
the problem, risks encountered plus their solutions, requirements analysis, system design and
implementation.
Areas for future research
The researcher has made the product flexible to accommodate future requirements by the
organization resources such as medical store control, staff payments system was not covered and
left for future enhancement. Also as the institution is growing and expanding there is a need to
have the dynamic website catalog to expose the institution further, process of online doctors’
reservation appointment, payments for those use credit cards and health insurances.
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