AUTOMATED CLINIC RECORD MANAGEMENT SYSTEM

A CASE STUDY OF AHMADU BELLO UNIVERSITY SICK-BAY

BY

ALFA MAHFOOZ AHMED

U11LS1018

A PROJECT SUBMITTED TO THE DEPARTMENT OF LIBRARY AND

INFORMATION SCIENCE IN PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE AWARD OF BACHELOR DEGREE IN LIBRARY AND INFORMATION
SCIENCE (BLIS)

September, 2015
 Declaration

I, Alfa Mahfooz Ahmed, declare that this project titled “Automated clinic record

management system, a case study of Ahmadu Bello University Sick-bay” was

written by me and all ideas borrowed from other people’s intellectual work has been duly

acknowledged.

________________________ ____________________

Alfa Mahfooz Ahmed Date

ii
 Approval Page

The undersigned have read and approved this study titled “Automated clinic record

management system, a case study of Ahmadu Bello University Sick-bay” in partial fulfillment of

the requirement for the award of Bachelor degree in Library and Information Science (BLIS).

________________________ ____________________
Mal. Muhammad Musa Hayatu Date
Project Supervisor

________________________ ____________________
Dr. Abdullah I. Musa Date
Head of Department

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 Dedication

This research work is dedicated to the following:

Parents: Alh. Ahmad Imam and Hajiya Rukyat AbdulRahman

Boss: Late Alh. Abdulkadir Suleiman Idris

Grand Mother: Late Hajiya Mairo

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 Acknowledgement

My profound gratitude goes to the almighty Allah for spanning my life to the end of this

phase of education. I also appreciate the help, guidance, encouragement and the creative

criticism of my supervisor, Mal. Muhammad Musa Hayatu (Ph.D. in anticipation Insah-Allah)

throughout the course of this project.

My appreciation goes to all my lectures in the Department of Library and Information

Science who helped in one way or the other throughout my programme in Ahmadu Bello

University, Zaria.

Special thanks goes to my parents, I will forever appreciate your gift of love, support,

sacrifice and prayers all in the bit to see that I obtained a degree. I am confidently proud of you.

I will also not forget to mention the contribution of my siblings, uncles, brothers, and

sisters especially Hajiya Latifat Ahmad Imam (Ummu Nusaiba), Hajiya Mansurat Ahmad

(Ummu Badrudeen), Ma. Muh. Najib Ahmad Imam, Alh. Mustapha Ahmad Imam, and the rest

of my family members for their moral support.

There are close friends who so dear to me, who have contributed in one way or the

other; Abdullahi Ibrahim Maska, Nura Aliyu Dabai, Bello Hamman Adama, Bello Bashir,

Zubaida Muhammad Nalado, Farida Jauro Umar and many that could not be mentioned, May

Allah (SWT) Blessed you all, and I am very grateful.

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 ABSTRACT

This study was carried out to design and introduce the use of an automated clinic record
management system and has chosen Ahmadu Bello University Sick-bay as the case study for
the first implementation with the aim of improving their services especially in this digital era. A
qualitative research was adopted and the instrument used for the study are interview,
observation and questionnaire where some questions were raised by the researcher such as,
what are the challenges associated with the use of the current manual record management
system in the Ahmadu Bello University Sick-bay? How to improve on the current manual
record managements system to minimize human error in the process of the records? How to
improve on the current manual time management among the staff of the clinic? And how to
provide more privacy to patients’ records and information in the clinic? Fifteen (15)
respondents were randomly chosen from both the clients and staff of the clinic. And at the end
of the research, the findings were analyzed which led to the designing of the aforementioned
system. And in order to design the programme, the researcher uses some web development
tools such as; Adobe Dreamweaver and Notepad Plus Plus for the required coding; hypertext
preprocessor (PHP) and Java scripts (JS) to connect the interfaces to the database; and My-SQL
was used to design the databases that store the overall system data. Finally; summary,
conclusion and suggestion were given on the problems associated with the manual method of
record keeping such as difficulties in sorting, retrieving and updating records, lack of security
of records, loss of relevant information and so on, it was also suggested that the implementation
of this programme will help in improving the effectiveness and efficiency in our clinics.

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 Table of Contents
Declaration ..................................................................................................................................................................ii
Approval Page .......................................................................................................................................................... iii
Dedication...................................................................................................................................................................iv
Acknowledgement .................................................................................................................................................... v
ABSTRACT ...................................................................................................................................................................vi
LIST OF TABLES .......................................................................................................................................................... x
LIST OF FIGURES ..................................................................................................................................................... xi
LIST OF ABBREVIATIONS ................................................................................................................................... xii
CHAPTER ONE............................................................................................................................................................1
INTRODUCTION .......................................................................................................................................................1

1.1Background of the Study ..................................................................................................................................1

1.2. Statement of the Problem...............................................................................................................................6

1.2.1. Overview of the Current System ........................................................................................................7

1.3. Research Questions ..........................................................................................................................................7

1.4. Aims and Objectives of the Study ...............................................................................................................8

1.5. Significance of the Study ...............................................................................................................................8

1.6. Scope of the Study ............................................................................................................................................9

1.7. Limitation of the Study ................................................................................................................................ 10

1.8. Definition of Some Key Terms .................................................................................................................. 11

Reference ................................................................................................................................................................... 13
CHAPTER TWO ....................................................................................................................................................... 14
LITERATURE REVIEW ........................................................................................................................................... 14

2.1. Introduction ..................................................................................................................................................... 14

2.2. Diffusion of Innovations ............................................................................................................................. 14

2.3. Previous Studies that Adopted this Theory .......................................................................................... 17

2.4. Automated Clinic Record Management System and the DOI theory ....................................... 21

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2.5. Summary of the Reviews............................................................................................................................. 24

References ................................................................................................................................................................. 25
CHAPTER THREE .................................................................................................................................................... 27
RESEARCH METHODOLOGY ............................................................................................................................ 27

3.1. Introduction ..................................................................................................................................................... 27

3.2. Method Adopted for the Study ................................................................................................................. 27

3.3. Population of the Study ............................................................................................................................... 28

3.4. Sampling and Sampling Procedure ........................................................................................................ 29

3.5. Instrument used for Data Collection ..................................................................................................... 30

3.6. Procedures for Data Collection ................................................................................................................ 31

3.7. Procedures for Data Analysis .................................................................................................................... 32

References ................................................................................................................................................................. 33
CHAPTER FOUR ...................................................................................................................................................... 34
DATA ANALYSIS AND DESIGN ........................................................................................................................ 34

4.1. Introduction ..................................................................................................................................................... 34

4.2. Data Analysis ................................................................................................................................................... 34

4.3. Descriptive Analysis...................................................................................................................................... 35

4.3.1. Respondents Details .............................................................................................................................. 35

4.3.2. Current records keeping system use in keeping records of patients in the clinic. ...... 35

4.3.3. Challenges of the current system .................................................................................................... 36

4.3.4. Proposed record management system for the clinic................................................................ 36

4.3.5. Benefits of the proposed system ....................................................................................................... 37

4.3.6. System User Requirements ................................................................................................................. 37

4.4. Program Analysis and Design ................................................................................................................... 38

4.4.1. System Design ......................................................................................................................................... 38

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 4.4.2. Tools used and System Specifications ............................................................................................ 38

4.4.3. Database Design ..................................................................................................................................... 40

4.4.4 The Developed System Interfaces ..................................................................................................... 44

CHAPTER FIVE ......................................................................................................................................................... 49

SUMMARY, CONCLUSION AND SUGGESTION ....................................................................................... 49

5.1 Summary ............................................................................................................................................................ 49

5.2 Conclusion ......................................................................................................................................................... 49

5.3. Suggestion ......................................................................................................................................................... 50

REFERENCES ............................................................................................................................................................. 51
Bibliography............................................................................................................................................................. 53
APPENDIX ................................................................................................................................................................. 59

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 LIST OF TABLES

Table 3.1: Sampling size

Table 4.3.1: Respondents details

x
 LIST OF FIGURES

Figure 4.1 Entity Relationship Diagram

Figure 4.2 Admin table

Figure 4.3 Appointment table

Figure 4.4 Doctors' table

Figure 4.5 Patients table

Figure 4.6 Welcome interface

Figure 4.7 Appointment interface

Figure 4.8 Staff login interface

Figure 4.9 Patients login interface

Figure 4.10 Administrators interface

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 LIST OF ABBREVIATIONS

ACRMS – Automated Clinic Record Management System

EHR – Electronic Health Record

ICT - Information and Communication Technology

PHECC - Pre-Hospital Emergency Care Council

DOI - Diffusion of Innovation

KARl - Kenya Agricultural Research Institute

MoARD - Ministry of Agriculture and Rural Development

ABU - Ahmadu Bello University

PHP - Hypertext Pre-processor

HTML - Hypertext Markup Language

CSS - Cascading Style Sheet

My-SQL - My - Structured Query Language

JS - Java Script

RAM - Random Access Memory

CPU - Central Processing Unit

UPS - Un-interruptible Power Supply

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 CHAPTER ONE

INTRODUCTION

1.1Background of the Study

With the advent of computers and its related technology, in which everything needs to be done

efficiently and effectively the existences of Automated Clinic Record Management System

(ACRMS) become necessary. The used of ACRMS can enhance the services and also the work

flow of all activity that happens in a clinic where it helps in reducing the workload of medical

staff, the number of man power needed and it also make clinic management become more

manageable and easier to control.

The main objective of this research work is to design a computer base program that will cover

all the aspects of management and operations of Ahmadu Bello University Sick-bay. It will

enable the clinic registration process becomes computerized and this feature will help a lot in

keeping records of all patients and whoever has once received a treatment in the clinic.

The program will be used for proper handling of patients’ records and related information in

the clinic, the record file, date of appointments, Doctors in charge and other related medical

information will be entered into the program. Which is stored in a database that can be

accessed easily within a short span, and yet securely stored in an appropriate and stress free

manner.

AUTOMATION; The word ‘Automation’ is derived from Greek words “Auto” which means (self)

and “Matos” (moving). Automation therefore is the mechanism for systems that “move by itself”.

However, apart from this original sense of the word, automated systems also achieve

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significantly superior performance than what is possible with manual systems, in terms of

power, precision and speed of operation.

Automation can also be a set of technologies that results in operation of machines and systems

without significant human intervention and achieves performance superior to manual

operation. A Definition from Encyclopedia Britannica (2009) is the application of machines to

tasks once performed by human beings or, increasingly, to tasks that would otherwise be

impossible. Although the term mechanization is often used to refer to the simple replacement of

human labour by machines, automation generally implies the integration of machines into a

self-governing system.

CLINICAL AUTOMATION; Clinical automations centralized program or software tool

implemented within a clinical unit to support the recruitment of volunteers, directly capture

study data electronically (e-Source), streamline the clinical process, allows sharing online,

real-time, high quality data with clients.

One of the important trends in business managements is the focus on processes to create value

added services for their ultimate customers. This is to get rid of unwanted, time consuming,

unnecessarily repeated business activities of the processes and to monitor how value for

customer is as anciently as possible (Vissers J. M. H ,1998), (Johannes-son and

Jayaweera,2000). This is also very much valid for healthcare industry.

RECORD MANAGEMENT; according to the (National Archives of Scotland) Records

management is the systematic control of an organization’s records, throughout their life cycle,

in order to meet operational business needs, statutory and fiscal requirements, and community

expectations. Effective management of corporate information allows fast, accurate and reliable

access to records, ensuring the timely destruction of redundant information and the

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identification and protection of vital and historically important records. Records management

is the foundation layer of all information systems. Management of patient data, through the

proper control of the content and the storage and retention of the records, reduces

vulnerability to legal challenge or financial loss and promotes best practice through greater

coordination of information.

We spend most of our lives creating, collecting, recording information – but each of these

records is only as valuable as the information it contains, and that is only of value if it can be

found when needed, and then used effectively. (Pre-Hospital Emergency Care Council, 2010).

Accurate recording and knowledge of the whereabouts of all records is essential if the

information they contain is to be located quickly and efficiently. One of the main reasons why

records get misplaced or lost is because the destination is not recorded.

The quality of records maintained by a clinic can be a reflection to the quality of care provided

by them to their patients. Clinics are legally accountable for the standard of practice which

they deliver and to which they contribute. Good practice in record management is an integral

part of quality of the clinical care. (PHECC, 2010)

History of the Ahmadu Bello University Sick-Bay, Zaria

The building of the University Health Services was initiated as a sickbay in 1952by the

Nigerian College of Arts and Science. It has grown through thick and thin to its bigness now

and continues to grow bigger. A population in excess of hundred thousand (100, 000) people

with 35,000 student population is now served.

At the beginning when the scheme was smaller and more intimate, it seemed easier to know the

students. Therefore, from the beginning the struggle has been of space and resources. On the

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Main Campus, the present location of the 'Sickbay' adjacent to Suleiman Hall covers a total of

over 2,600 sq meters, and was occupied in 1968. Before this date, the 'Sickbay' had been

located in various areas at various times, from Nagwamatse road in residential Area A, to the

Cappa housing unit, then to the former Community Medicine Department and finally to the

present site.

Apparently, the movements and the expansions of Sickbay had been necessitated by the need to

create a more conducive space to cope with rising demand for these services as the institution's

population rapidly grew. An appreciation of this rising demand may be gained from the fact

that whereas in 1972 the main campus Sickbay had attended to an estimated average of 350

caseson daily basis, this figure had gone up to 500 by 1982 and 700 by 1987 and 700-1000 in

1997 to 2002.

On the Kongo campus, on the other hand, the Sickbay had occupied its present location

(opposite the Security office) since the inception of the campus, albeit with expansion

programme at various stages to cope with the rising demands for its services. Presently, the

Unit occupies about 2,000 sq meters and has attended to, on a daily basis, about 200 cases by

1972, 286 cases by 1982 and 309 cases by 1987, accordingly. The same trends have

characterized the Sickbay in all other campuses of the University and, like the libraries, the

Sickbays constitute points of daily convergence by University staff of all categories for the

purpose of meeting Personal and family needs. With the growth of the population, the scheme

has struggled to expand and is has now become a full-fledged University Health Services unit

with a curative wing at the status of secondary health care facility.

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In 1996 the department was handed to Dr. A. Usman and to Dr. S.K. Musa in June 1997 to

2012, then M. A. Usman 2012 to 2014 and presently Dr (Mrs.) Madugu as acting director.

Hence, the key player in the progress and management of University Health Services is the

Director.

By 1995, the clinic was reduced to a mere transit camp for doctors due to inadequacy in the

University policy for attracting and retaining them. There is an exit of 13 doctors within five

years. The Unit which had 266 staff (80 senior and 186 junior staff) by 1998 now has 194 (61

senior and 133 junior), shrinking by 19 senior staff and 53 junior staff due to retrenchment

without replacement.

Despite the odds the dream of achieving the goal and objectives of an African University health

services was never lost. Success began with the period of military sole administrator rtd. Major

General Mamman Kwantagora, the unit was renovated in 1996 though the contract was

terminated at a stage and could not be completed, 80% of the work was achieved. This

administrator gave some level of autonomy to the UHS department began to strengthen

sanitation activity of the health services as well as the medical arm. Working closely with the

unit, the Mahadi administration (1999 -2004) made remarkable progress in sanitation that

has significant positive impacts on the environment, touching the physical, social and

psychological well-being of the community.

Management of casual laborers in Samaru and Kongo campuses with more than 2000 people

who have benefited and so far we have constantly 935 (excluding Students Affairs) currently

on the payroll. There is the expansion of preventive and sanitation to four sections:

environmental and sanitation, parks and gardens academic and parks and gardens residential

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and the addition of forest guard with employment of more technical staff. In each residential

area workers are now permanently assigned to maintain sanitation.

The clinic has successfully gotten registered as a Primary Health Care Provider for NHIS Social

Health Insurance Programme. It also warns recently Secondary Health Care Provider in

Ophthalmology, Internal Medicine, Dental Pharmacy and Laboratory. This also requires the

improvement of UHS master plan.

The university through its health services unit and the teaching hospital provides medical and

health services to staff and their family limited by its resources. It also carries out pre-

employment medical examination to staff and insist on pre-registration medical examination

to new students. However there is now the new monetization and the National Health

Insurance Scheme policies

1.2. Statement of the Problem

The poor record keeping and filling system of our clinics is the bane of the healthcare sector

failure. The manual handling of the patient files has led to undue delays in attending to patients

at the clinic, and this has been a cause of concern to all citizens.

The manual system of record keeping and filling system in Nigerian clinics has over the years

proved inefficient. There had been incident of misplaced documents, not able to retrieve long

consult patients’ records, loss of records or files, alteration of information etc, result in

unnecessary delay of treatment which even sometime leads to the death of the patient.

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1.2.1. Overview of the Current System

Current system that is being used at the Ahmadu Bello University sick-bay is a manual system.

Where all information is being collect using form and all data is being kept in the archive,

where this conventional ways lead to the need of space and time wasting.

Registration

The current method of registration in Ahmadu Bello University, Sick-bay where the case study

of this project is carried out, all tasks ware done manually. Before a patient can received a

treatment from doctors, they need to be registered by the file administrator in the clinic, and if

the patient have ever received a treatment from the clinic, then attendance are responsible to

retrieve their file where details of that particular person had been kept.

In registration process, every patient has to be open a file for in the administrative department

where the files are kept for subsequent retrieving whenever the patient visit or has an

appointment in the clinic.

1.3. Research Questions

This study was carried out to provide solution to the following research questions:

a. What are the challenges associated with the use of the current manual record

management system in the Ahmadu Bello University Sick-bay.

b. How to improve on the current manual record managements system to minimize

human error in the process of the records.

c. How to improve on the current manual time management among the staff of the clinic.

d. How to provide more privacy to patients’ records and information in the clinic.

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1.4. Aims and Objectives of the Study

The aim of this study is to design a clinic record management system in order to achieve

efficient records keeping in the clinic. While the objectives of this study are as follows:-

a. To find out the challenges associated with the current patient’s record management

system in the Ahmadu Bello University Sick-bay.

b. To observe ways of improving on the current patient’s record management system in

the clinic.

c. To identify means of improving on time management among the staff of the clinic.

d. To investigate ways of providing a standard record storage and management system for

the clinic, in order to provide more secure patients record management system for the

clinic.

1.5. Significance of the Study

Currently, the Ahmadu Bello University Sick-bay operates a manual records management

system, with the introduction of an automated system, in which computers will be used will

achieve more accurate record management, time saving, and easy retrieval of patients’

information.

The program will be a web base program that will enable a quick access to patient’s record

globally in case of emergency. And will also provide adequate security to patients records in

which only authorize users can have access to the system with username and password.

The program will also provide an adequate scheduling for both the doctors and the patients, in

which appointment has to be made by the patient before visiting the doctor.

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1.6. Scope of the Study

The general scope of this study will be focused on Ahmadu Bello University sick bay. While the

specific scopes of the study are as follows:-

a. The case study of the study is Ahmadu Bello University Sick bay.

b. A computer base program will be design to manage patents records in the clinic.

c. This program will be design using a Microsoft windows environment.

e. The program will be design using hypertext pre-processor (PHP) and the relational

database MYSQL as the programming language tools.

d. The program will also have four (4) interfaces (Modules) which are as follows:-

Appointment Interface – this interface provide all the details of the doctors in the clinic

together with their specialization and shifting time, from which a patient can make an

appointment to see the doctor.

Doctor’s Interface – through this interface, the doctor can create an account for himself,

from which he can make his schedule for the week, attend to his scheduled patients and

also update the patient’s medical records after diagnosing.

Patient’s Interface– from this interface patient can create an account for him/herself

and through which he can only view his medical reports or print them out when need

be.

The Admin Interface –the administrator has the full control over the system from which

he can create, read, update and delete any record or information from the system.

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1.7. Limitation of the Study

Some of the anticipated shortcomings that may be face by the researcher in this project are

categorized into two:-

1. Researchers limitation and

2. The program limitations.

Researcher limitations

a. The biggest limitation is the time that is available for the research; this led to scaling

down of the program and leaving out some operations. There was no time available for

the program to be implemented in a working environment.

b. There is no time available for testing of the system in a working environment. The

system will only been test with sample data by the developer.

c. Programming languages: it was difficult in selecting the appropriate language to

develop the system. This was due to lack of knowledge of other programming languages

like python, ajax.

d. There was also shortage of funds to facilitate the whole research process therefore the

researcher had to work within the limited budget to produce what is possible.

e. The researcher encountered many problems in data collection because it was done

during the time when the clinic was busy therefore getting the required information

was hard.

Program limitations

a. The program will not be suitable for computer illiterate people.

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 b. The program will be suitable only for clinics in academic environment and other non-

profit making institution.

c. The program does not do away with paper work completely; as papers are still used at

some point.

1.8. Definition of Some Key Terms

For the purpose of this study the following terms are defined:-

a. Hospital/ Clinic/Sick-bay: refers to an institution where people receive medical,

surgical, or psychiatric treatment and nursing care.

b. Patient: somebody who needs or receives medical treatment.

c. Doctor: A person who is qualified and licensed to give people medical treatment and

according to advance learner dictionary a medical doctor is a qualified practitioner of

medicine; physician.

d. Pharmacist: A person who is trained and licensed to dispense medicinal drugs and to

advise on their use.

e. Nurse: A person who is trained to look after sick or injured people, especially somebody

who works in a hospital or clinic, administering the care and treatment that a doctor

prescribes.

f. Medicine: A drug or remedy used for treating illness.

g. Lab: A place where research and testing is carried out.

h. Ward: A room in a hospital, especially one for several patients being given similar

treatment.

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i. Automation: The act of implementing the control of equipment with advanced

technology; usually involving electronic hardware "automation replaces human

workers by machines"

j. Management: Is a process of getting things done through people by making efficient use

of resources. It requires the manager to identify problems with the community.

k. Record: Record is documented information in print or non print format. The record can

be manual or digitized.

l. Medical Record: Is a record containing patient health information. It indicates doctor’s

diagnostic statement and the prescribed treatment.

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 Reference

Creswell, J. W. (1999). Mixed-method research: Introduction and application. In G. J. Cizek

(Ed.), Handbook of educational policy (pp. 455–472). San Diego: Academic Press.

Dictionary.com, retrieve from http://dictionary.reference.com/browse/automation

Donald Ary, Lucy Chese J.&AsgharRazavieh (1984), Introduction toResearch in Education:

Holt, Rinehart and Winston, Inc.

http://www.batesville.k12.in.us/physics/PhyNet/AboutScience/Hypotheses.html

Lim Chee S. E, Chennupati K. R, and Surya P. G. (2009, November). Electronic Medical Records
Management Systems: An Overview. Journal of Library & Information Technology, Vol.
29, No. 6, pp. 3-12

Microsoft Encarta 2009. (DVD): Microsoft Corporation. © 1993-2008

National Archives of Scotland (NAS), retrieve from

http://www.nas.gov.uk/recordKeeping/recordsManagement.asp

Online Encyclopaedia Britannica (2009)

Pre-Hospital Emergency Care Council (2010) www.phecc.ie

Prasad J., Jeewanie J., Lal Wellakkage V. M., Samantha L. (2006, September) Clinics
Management System (CMS) based onPatient Centered Process Ontology. RUHUNA
JOURNAL OF SCIENCE, Vol. 1, No. 1, pp. 40 – 39

ShaliniPrasad, AjithRao and EeshooRehani (2001, SEPTEMBER 18TH) Developing Hypothesis

and Research Questions: 500 Research Methods

www.public.asu.edu/~kroel/www500/hypothesis.pdf

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 CHAPTER TWO

LITERATURE REVIEW

2.1. Introduction

This chapter review some related literature in the area of the study, from which the researcher

tried to identify, locate, read and evaluate some previous studies, observations, theories,

opinions and comments, which are arranged in the following headings:-

2.2. Diffusion of innovation theory.

2.3. Previous studies that adopted this theory

2.4. Automated Clinic Record Management System and the DOI theory

2.5. Summary of the reviews.

2.2. Diffusion of Innovations

Diffusion of Innovations is the process by which an innovation is communicated through

certain channels over time among the members of a social system. It is a special type of

communication, in that the messages are concerned with new ideas. Communication is a

process in which participants create and share information with one another in order to reach

a mutual understanding. This definition implies that communication is a process of

convergence (or divergence) as two or more individuals exchange information in order to

move toward each other (or apart) in the meanings that they ascribe to certain events. We

think of communication as a two-way process of convergence, rather than as a one-way, linear

act in which one individual seeks to transfer a message to another (Rogers and Kincaid, 1981).

14
The process of adopting new innovations has been studied for over 30 years, and one of the

most popular adoption models is described by Rogers in his book, Diffusion of Innovations

(Sherry & Gibson, 2002). Much research from a broad variety of disciplines has used the model

as a framework. Dooley (1999) and Stuart (2000) mentioned several of these disciplines as

political science, public health, communications, history, economics, technology, and

education, and defined Rogers’ theory as a widely used theoretical framework in the area of

technology diffusion and adoption.

In fact, much diffusion research involves technological innovations so Rogers (2003) usually

used the word “technology” and “innovation” as synonyms. For Rogers, “a technology is a design

for instrumental action that reduces the uncertainty in the cause-effect relationships involved

in achieving a desired outcome” (p. 13). It is composed of two parts: hardware and software.

While hardware is “the tool that embodies the technology in the form of a material or physical

object,” software is “the information base for the tool” (Rogers, 2003, p. 259). Since software (as

a technological innovation) has a low level of observability, its rate of adoption is quite slow.

According to Rogers1962; the Four Main Elements in the Diffusion of Innovations are stated in

the definition as the process by which (1) an innovation (2) is communicated through certain

channels (3) over time (4) among the members of a social system. The four main elements are

the innovation which is the idea, practice, or object that is perceived as new by an individual or

other unit of adoption, communication channels which has also been defined as the process by

which participants create and share information with one another in order to reach a mutual

understanding, time defines both the pace at which progress occurs and the positions

individuals occupy amid the evolution of such progress (Inman, 2000), and the social system is

defined as a set of interrelated units that are engaged in joint problem solving to accomplish a

15
common goal. They are identifiable in every diffusion research study, and in every diffusion

campaign or program.

Attributes of Innovations and Their Rate of Adoption

Attributes of innovations and their rate of adoption discourses why certain innovations spread

more quickly than others? And also why do other innovations fail? Diffusion scholars have

recognized five attributes that determine the success or failure of an innovation in any

organization, which are, relative advantage, compatibility, Simplicity, trialabilty, and

Observabilty:-

a. Relative advantage: This is the degree to which an innovation is perceived as better

than the idea it supersedes by a particular group of users, measured in terms that

matter to those users, like economic advantage, social prestige, convenience, or

satisfaction. The greater the perceived relative advantage of an innovation, the more

rapid its rate of adoption is likely to be.

There are no absolute rules for what constitutes “relative advantage”. It depends on

the particular perceptions and needs of the user group.

b. Compatibility with existing values and practices: This is the degree to which an

innovation is perceived as being consistent with the values, past experiences, and

needs of potential adopters. An idea that is incompatible with their values, norms or

practices will not be adopted as rapidly as an innovation that is compatible.

c. Simplicity and ease of use: This is the degree to which an innovation is perceived as

difficult to understand and use. New ideas that are simpler to understand are

adopted more rapidly than innovations that require the adopter to develop new

skills and understandings.

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 d. Trialability: This is the degree to which an innovation can be experimented with on

a limited basis. An innovation that is trialable represents less risk to the individual

who is considering it.

e. Observable results: The easier it is for individuals to see the results of an innovation,

the more likely they are to adopt it. Visible results lower uncertainty and also

stimulate peer discussion of a new idea, as friends and neighbours of an adopter

often request information about it.

According to Everett Rogers (2003), these five attributes determine between 49 and 87 percent

of the variation in the adoption of a new products.

These five attributes make a valuable checklist to frame focus group discussions or project

evaluations. They can help identify weaknesses to be addressed when improving products or

behaviours.

2.3. Previous Studies that Adopted this Theory

As mentioned earlier, several scholars from different disciplines have used this theory in

investigating, analyzing and exploring why new ideas (innovations) are adopted and why

others fail.

This section has discussed some of the previous studies that used the DOI Theory to explain

how innovations (new ideas) are developed, processed and implemented in organizations.

A study conducted by Olatokun W.M and gbinedion L.J (2009) on the Adoption of Automatic

Teller Machines in Nigeria: An Application of the Theory of Diffusion of Innovation, the main

objective of knowing what could be done to prevent the inhibition surrounding the use of

Automatic Teller Machines in Nigeria, the researchers have use the five attributes of innovation

17
according to Rogers (1995) - relative advantage, compatibility, complexity, trialability and

observability, in finding out the degree of influence attitude and the intention of the people to

use the technology, hypothesis are designed in testing each of the constructs. The data

collection instrument used was a structured questionnaire administered to ATM customers of

the selected 14 banks. While the findings of the study state that, Relative Advantage of using

ATMs; how hard it was to use ATMs, how compatible ATMs were with the lifestyle of the users;

how much has been registered (observed) about ATMs by the users and whether ATMs could

be tested before consistent use, were issues that influence users’ attitude towards intention to

use ATMs. It also states that, the Attitude of an ATM user would later affect his/her intent to use

an ATM. Since Observability had the greatest impact on attitude, it is important for banks to

give the right impression about ATMs. This could be in terms of locating ATMs in hidden places

so that non adopters could observe others use ATM before adopting it themselves.

Kamau L.M (2014), also conducted a study titled “Applying Rogers’ Diffusion of Innovations

Theory to Investigate Technology Training for Secondary Mathematics Teachers in Kenya” the

study was aimed at examine the extent technology training influence secondary mathematics

teachers’ decisions to adopt or not to adopt technology in the classroom practice from Nairobi

and Nyandarua counties in the Republic of Kenya. The study applied the case study research

design and the Rogers’ (2003) diffusions of innovations theory to investigate the research

problem. The study found that mathematics teachers have not received adequate technology

training relevant for mathematics teaching because of technologically unskilled trainers, lack

technology software related to mathematics teaching, and teachers are not motivated to attend

training for lack of incentives. The study suggests radical changes be undertaken on how

training of mathematics teachers by the Center for Mathematics Science and Technology

18
Education in Africa (CEMASTEA) and the National ICT innovation and Integration Centre

(NI3C) and the teacher training programs at the public universities and colleges. The study also

recommends that further research is needed to understand technology training for

mathematics teachers in Kenya.

Kiplang'at J. and Ocholla D.N (2005) also conducted a study titled “Diffusion of Information

and Communication Technologies in communication of agricultural information among

agricultural researchers and extension workers in Kenya” The paper reports on the findings of

a study that investigated the diffusion of Information and Communication Technologies (ICTs)

in communication of agricultural information among agricultural researchers and extension

workers in Kenya. The study focused on the public agricultural sector and covered the Kenya

Agricultural Research Institute (KARl) and the Ministry of Agriculture and Rural Development

(MoARD). A survey research method comprising a self-completed questionnaire and a

structured interview schedule was utilized to gather data from the respondents who comprised

of I59 agricultural researchers, 138 extension workers and 59 key informants. This was

supplemented by observation and document review.

It was found out that KARl and MoARD had adopted a wide variety of ICT tools and services in

an effort to facilitate information sharing and exchange among agricultural researchers,

extension workers, farmers and other actors involved in research and extension. These ranged

from modern ICTs based on digital information and traditional lCTs based largely on analogue

information waves. The ICT models adopted addressed the different kinds of information needs

and communication problems encountered by agricultural researchers and extension workers.

However, it was observed that despite the efforts to expand and modernize ICTs in the

agricultural sector, its growth had been hampered by a number of constraints and challenges

19
which require the intervention and interaction of all the stakeholders in the agricultural and

ICT sector and also involvement of the government.

Ibrahim M.A and Sadiq S.M (2012) also conducted a study on Mobile Banking Adoption:

Application of Diffusion of Innovation Theory; The objective of the study was to investigate a

set of technical attributes and how they influence mobile banking adoption in a developing

nation, like Saudi Arabia. The study uses diffusion of innovation as a base-line theory to

investigate factors that may influence mobile banking adoption and use. More specifically, the

objective of the research was to examine the potential facilitators and inhibitors of mobile

banking adoption. The researchers have uses hypothesis in testing each of the Rogers (2003)

attributes of innovation in related with the adoption of mobile banking. Survey instrument was

used for the research, in which 20 questionnaires are randomly shared among some selected

mobile banking users; findings also suggest that banks in Saudi Arabia, should offer mobile

banking services that are compatible with various current user requirements, past experiences,

lifestyle and beliefs in order to fulfill customer expectations. With better mobile banking

support and provision of variety of services, the more useful customers perceive mobile

banking to be and to increase their level of adoption. Hence, bank’s attention should focus on

understanding customer behavior and designing reliable mobile banking systems that will meet

their needs and provide useful and quality services. In addition, banks should focus on

communicating information that emphasizes the relative advantage and usefulness of mobile

banking compared to other banking channels like physical presence to the bank or using ATM

machines. Banks must seek to reduce risk perceived by their customers by offering specific

guarantees protecting them and taking their complaints seriously and urgently.

20
Another study conducted under this theory is by Eric W. F, Menachemi N. and Phillips T.

(2006), titled “Predicting the Adoption of Electronic Health Records by Physicians: When Will

Health Care be Paperless?” The purpose of this study was three fold. First, was to gather and

synthesize the historic literature regarding electronic health record (EHR) adoption rates

among physicians in small practices (ten or fewer members). Next, was to construct models to

project estimated future EHR adoption trends and timelines. The researchers then determined

the likelihood of achieving universal EHR adoption in the near future and articulate how

barriers can be overcome in the small and solo practice medical environment. This study used

EHR adoption data from six previous surveys of small practices to estimate historic market

Penetration rates. Applying technology diffusion theory, three future adoption scenarios,

optimistic, best estimate and conservative are empirically derived. EHR adoption parameters,

external and internal coefficients of influence are estimated using Bass diffusion models.

And all the three (3) EHR scenarios display the characteristic diffusion S curve that is indicative

that the technology is likely to achieve significant market penetration, given enough time.

Under current conditions, EHR adoption will reach its maximum market share in 2024 in the

small practice setting. And the study concluded with the promise of improved care quality and

cost control has prompted a call for universal EHR adoption by 2014. The EHR products now

available are unlikely to achieve full diffusion in a critical market segment within the time

frame being targeted by policy makers.

2.4. Automated Clinic Record Management System and the DOI theory

There are always reasons for introducing an innovation in an organization. As rightly pointed

out by Rogers (1995) the innovation process begins with agenda setting where one or more

21
individuals in an organization identify an important problem and then seek an innovation as a

means of coping with the problem. Rogers (1995) further observes that the problem usually

emanates from a performance gap which is the discrepancy between how the organization is

performing in comparison to its potential. He is of the view that the discrepancy is identified by

members of the organization and is a strong force that compels them to search for an

innovation to solve the identified problem.

For example, the introduction of an Automated Clinic Record Management System in the

Ahmadu Bello University Sick-bay in which patients’ records is previously collected manually,

and to achieve the objectives given in this study, the researcher has plan to apply the five

attributes of the Diffusion of Innovation theory to the planning and implementation of the

project (Automated Clinic Record Management System), which are, Relative advantage,

Compatibility, Simplicity, Trialabilty, and Observabilty:-

a. Relative advantage refers to the degree to which an innovation is perceived as providing

more benefits than its predecessor [Moore & Benbasat 1991]. Relative advantage results

in increased efficiency, economic benefits and enhanced status [Rogers 2003]. Past

research has found that relative advantage of an innovation is positively related to the

rate of adoption [Moore & Benbasat 1991]. Research suggests that when user perceives

relative advantage or usefulness of a new technology over an old one, they tend to adopt

it [McCloskey 2006; Rogers 2003]. In the context of ACRMS adoption, benefits such as

organize records management, easy retrieval of patients’ records, accurate scheduling

and secure patients records, which will speed up most activities in the clinic may likely

leads to the adoption of the program

22
b. Complexity; Cheung et al. [2000] defined complexity as the extent to which an

innovation can be considered relatively difficult to understand and use. Complexity is

the opposite of ease of use. Ease of use refers to the extent to which the program will be

perceived as easy to understand and operate. A vast body of research suggests that there

is a strong impact of perceived ease of use of new technology on its adoption [Gu et al.

2009; Luarn & Lin 2005; Venkatesh & Davis 2000; Wang et al. 2006]. As for the

ACRMS, the program will be in a GUI format that can be operate with few clicks and

will also save time compare to the manual system.

c. Compatibility refers to the degree to which a service is perceived as consistent with

users’ existing values, beliefs, habits and present and previous experiences [Chen et al.

2004]. Compatibility is a vital feature of innovation as conformance with user’s lifestyle

can propel a rapid rate of adoption [Rogers 2003]. As for the ACRMS, the program also

aim at providing an interface as it was on the manual record papers in the clinic.

d. Observability of an innovation describes the extent to which an innovation is visible to

the members of a social system, and the benefits can be easily observed and

communicated [Rogers 2003]. Moore & Benbasat [1991] simplified the original

construct by redefining observability into two constructs: visibility and result

demonstrability. In the context of ACRMS, observability will be define as the ability to

access the services of the clinic at any time and from any location without any delay or

queue, and conveying the accessibility benefits to others. Through such exposure, other

clinics also see its benefits and try to adopt it.

e. Trialability refers to the capacity to experiment with new technology before adoption.

Potential adopters who are allowed to experiment with an innovation will feel more

23
 comfortable with it and are more likely to adopt it [Agarwal & Prasad 1998; Rogers

2003]. Here, the researcher plans to first deploy the program in-house, train the staff

on how the program works which will give the clinic chance to try the system and

know how it functions before implementing it.

2.5. Summary of the Reviews

This chapter has successfully discourses the Diffusion of Innovation theory, which is the

perceptions on how deferent people passive new innovation and what makes people adapt to

new methods of doing things in the society. It also discourses the five attributes of the theory

and some previous studies that adopted this theory, the first study that was reviewed was

conducted by Olatokun W.M and gbinedion L.J (2009) on the Adoption of an Automatic Teller

Machines in Nigeria, second study by Kamau L.M (2014), on Applying Rogers’ Diffusion of

Innovations Theory to Investigate Technology Training for Secondary Mathematics Teachers in

Kenya. Third study by Kiplang'at J. and Ocholla D.N (2005) on the Diffusion of Information

and Communication Technologies in communication of agricultural information among

agricultural researchers and extension workers in Kenya, forth study by Ibrahim M.A and

Sadiq S.M (2012) on Mobile Banking Adoption in a developing nation, like Saudi Arabia, and

the fifth study was conducted by Eric W. F, Menachemi N. and Phillips T. (2006), on the

Adoption of Electronic Health Records by Physicians. And the chapter ended with the

application of the theory to the adoption of Automated Clinic Record Management System

(ACRMS).

24
 References

Chen, L., M. Gillenson, and D. Sherrell, “Consumer acceptance of virtual stores: A Theoretical
Model and Critical Success Factors for Virtual Stores,” ACM SIGMIS Database, Vol. 35, No.
2: 8-31, 2004.

Cheung, W., M. K. Chang, and V. S. Lai, “Prediction of internet and world wide web usage at
work: a test of an extended Triandis model,” Decision Support Systems, Vol. 30, No. 1: 83-
100, 2000.

Eric W. F, Menachemi N. and Phillips T. (2006). “Predicting the Adoption of Electronic Health
Records by Physicians: When Will Health Care be Paperless? J Am Med Inform Assoc.
2006;13:106–112. DOI 10.1197/jamia.M1913.

Gu, J-C., S-C. Lee, and Y-H. Suh, “Determinants of behavioral intention to mobile banking,”
Expert Systems with Applications, Vol. 36, No. 9: 11605-11616, 2009.

Ibrahim M.A and Sadiq S.M (2012). Mobile Banking Adoption: Application of Diffusion of
Innovation Theory. Journal of Electronic Commerce Research, VOL 13, NO 4, 2012

Inman, J. A. (2000). The Importance of Innovation: Diffusion Theory and Technological

Progress in Writing Centers.The Writing Centre Journal. 21(1), 48-66

Kamau L.M (2014). Applying Rogers’ Diffusion of Innovations Theory to Investigate

Technology Training for Secondary Mathematics Teachers in Kenya. Journal of Education
and Practice www.iiste.org ISSN 2222-1735 (Paper) ISSN 2222-288X (Online). Vol.5,
No.17, 2014

Kiplang'at J. and Ocholla D.N (2005). Diffusion of Information and Communication

Technologies in communication of agricultural information among agricultural
researchers and extension workers in Kenya. SA jnl Libs & Info Sci 2005, 71 (3)

Les Robinson (2009). A summary of Diffusion of Innovations. Enabling Change pdf.

25
Luarn, P. and H-H. Lin, “Toward an understanding of the behavioral intention to use mobile
banking,” Computers in Human Behavior, Vol. 21, No. 6: 873-891, 2005.

McCloskey, D. W., “The Importance of Ease of Use, Usefulness, and Trust to Online Consumers:
An Examination of the Technology Acceptance Model with Older Consumers,” Journal of
Organizational and End User Computing, Vol.18, No. 3: 47-65, 2006.

Moore, G. C. and I. Benbasat, “Development of an instrument to measure the perceptions of

adopting an information technology innovation,” Information Systems Research, Vol. 2,
No. 3: 192-222, 1991.

Olatokun W.M and gbinedion L.J (2009) The Adoption of Automatic Teller Machines in
Nigeria: An Application of the Theory of Diffusion of Innovation. Issues in Informing
Science and Information Technology Volume 6, 2009

Rogers, E. M. (1983). Diffusion of innovations (3rd ed.). New York: Free Press.

Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: Free Press.

Venkatesh, V. and F. D. Davis, “A theoretical extension of the technology acceptance model:

four longitudinal field studies,” Management Science, Vol. 46, No. 2: 186-204, 2000.

Wang, Y-S., H-H. Lin, and P. Luarn, “Predicting consumer intention to use mobile service,”
Information Systems Journal, Vol. 16, No. 2: 157-79, 2006.

26
 CHAPTER THREE

RESEARCH METHODOLOGY

3.1. Introduction

This chapter contains all the methodologies that were adopted in achieving the mentioned

objectives in chapter one, which consist of the following:-

3.2. Method Adopted for the Study

3.3. Population of the Study

3.4. Sampling and Sampling Procedure

3.5. Instruments used for Data Collection

3.6. Procedures for Data Collection and

3.7. Procedures for Data Analysis

3.2. Method Adopted for the Study

As mentioned earlier, the main objective of this research work is to design a computer base

program that will cover all the aspects of management and operations of Ahmadu Bello

University Sick-bay. It will enable the clinic registration process becomes computerized and

this feature will help a lot in keeping records of all patients and whoever has once received a

treatment in the clinic.

Research method refers to the process of scientific inquiry in research work. The success or

other wise of any research work depends largely upon how data is collected, organized and

analyzed (Idris, 2009). It is also the process of arriving at a dependable solution to a given

27
problems. This study has adopted a qualitative method of research. A qualitative research has

been defined as “any kind of research that produces findings not arrived at by means of

statistical procedures or other means of quantification” (Strauss & Corbin, 1990:17). According

to Creswell (2003:181), a qualitative research takes place in the natural setting. He states that

the qualitative researcher often goes to the site (office) of the participants to conduct the

research. This enables the researcher to be more detailed about the individual or place and be

highly involved in the actual experiences of the participants. According to Denzin and Lincoln

(1994) qualitative methodologies include “interviewing; observing; artifacts, documents, and

records; visual methods; personal experience methods; data management methods; computer-

assisted analysis; and textual analysis”. And with some of these methods the researcher intend

using to design the aforementioned Automated Clinic Record Management System for Ahmadu

Bello University Sick-bay.

3.3. Population of the Study

Population in research is simply the totality of the collection of individuals, objects, or

measurement (Yakeen, 2006) population in research refers to animate or inanimate things on

which the study is focused.

Abdulkareem (2006 et al.) defined population as the aggregate of all observations of all interest

to the researcher. The population of a research is the body of research subject being focused.

Usually this is expressed in terms of number of persons being addressed by the researcher.

However, in this study the population is not much and never small and therefore, it includes all

the clients and staff of the Ahmadu Bello University Sick-Bay, which include the professionals,

paraprofessionals and the non-professionals.

28
3.4. Sampling and Sampling Procedure

Sampling in a research work is a device employed in the selection of representative members,

objects or elements from a given population. Probability sampling techniques is used for the

selection of the sample; probability sampling is a form of sampling in which each member of

the population has equal chance of being selected in the sample (Abubakar, 2013). While

drawing the sample of this study, stratified sampling is used as a form of probability sampling

technique, in the selection of the sample. This is because according to Kabir Bello Dungurawa

(2007) in stratified sampling, the entire population is sub divided into smaller homogenous

groups to get an accurate representation. Each sub-group has unique characteristics. From

each sub-group random selection is carried out. Stratified sampling ensures that every

subgroup is represented in the same proportion.

The study sample according to Aina (2007) is the selection of some part from the study’s

population of interest. However, for this study, the researcher has plan to carefully select Seven

(7) from the clients meet in the clinic and two (2) from the professional staff, four (4) from the

paraprofessional staff and two (2) from the non-professional staff as representative so that the

outcome resulting from data obtained from them will be accurate, reliable and adequate for

this research.

Table 3.1: Sampling size

S/N Category Sample Size

1 Clients at the clinic 7
2 Professional Staff 2
3 Paraprofessional staff 4
4 Non- Professional Staff 2
Total 15

29
3.5. Instrument used for Data Collection

The instruments to be use in collecting data for this research are interview, observation,

existing document review and probably a questionnaire which are discussed below;

Interview: This fact finding method will be useful on getting information on how the clinic

organizes its data resources and the order in which the current system flows, the staff will be

interviewed by asking questions on how the current system is working, which will enabled the

researcher to recite areas of improvements and innovations in the current systems.

Observation: The researcher will observed a number of points to help him during the project.

This will be used in determine how best the records are managed. It will also reveal the kind of

information normally demanded from the health unit and how long it takes to retrieve this

information. Through observation the researcher will also be able to find out if the files are

normally returned to their rightful places that is cabinets immediately after recording or cross

checking any record. Some of the advantages of observation as a fact finding method are: -

 The researcher will not have to disrupt the workers’ time because he could easily access

the system and other requirements without any one’s help.

 The researcher will get more information as compared to the information he will get in

case of an interview because there will be access to everything without limitation.

 The researcher directly will see the shortcomings of the existing system other than

being fed by the staff that are available.

However this method also has shortcomings like:-

 The researcher will waste a lot of time looking for information that would have been

given in a short time in case the staff has been used.

 The researcher will not get detailed information since he has less knowledge of the

30
 existing system.

Reviewing documented records: Here the researcher will review some documented patients

record from the records officers and probably from the main doctors and nurses in charge of

data management to get a picture of how data is stored, if necessary the researchers records

himself, as he is also a client in the clinic. With this method the researcher will get more

information relating to the system such as the arrangement of the fields in the records, and the

doctors diagnosing record update in the patients’ file.

Questionnaires: The questionnaire will comprise some set of simple questions precise and

concise and required straightforward answers, not to over burden the readers. The

questionnaires will be chosen to cater for the busy staff that will not able to spare time for the

interview.

3.6. Procedures for Data Collection

Before such a task could be accomplished and due to the nature of the research and also

sensitive data/information that are involve will first require the researcher to request for an

introductory letter from his department that will indicate that he is a student carrying out a

research on the topic, which will also serve as an evidence and prove that all information that

will be required by him (the researcher) in the course of this project will only be rightfully use

for the project.

The researcher will also be administrating the interview personally, this is to enable him to

avoid any type of misinformation, this is also important as the researcher is expected to

personally design the program in view.

31
3.7. Procedures for Data Analysis

Data analysis is the process of systematically applying statistical and/or logical techniques to

describe and illustrate, condense and recap, and evaluate data. According to Shamoo and

Resnik (2003) various analytic procedures “provide a way of drawing inductive inferences

from data and distinguishing the signal (The phenomenon of interest) from the noise

(Statistical fluctuation) present in the data”.

While data analysis in qualitative research can include statistical procedures, many times

analysis becomes an ongoing iterative process where data is continuously collected and

analyzed for patterns in observations through the entire data collection phase (Savenye,

Robinson, 2004).

Data generate from the above methodology will be analyze, after which will later led to the

designing of the aforementioned programme. And in order to design the programme that will

automates clinic record management for a health institution, the researcher has plane to use

some web development tools such as; Adobe Dreamweaver and Notepad Plus Plus for the

required coding of the programmes’ commands; hypertext preprocessor (PHP) and Java scripts

(JS) will be used to connect the interfaces, which will also be design with hypertext markup

Language (HTML) and cascading style sheets (CSS) to the databases to perform specific tasks

such as Editing, saving, deleting and searching data from the databases; and My-SQL will be

used to design the databases that will store the overall system data.

32
 References

Bryman, A. (2003) Research methods and organization studies 3th ed.London: unwin Hyman.

Creswell W.J (2003). Research Design: Qualitative, Quantitative, and Mixed Methods
Approaches. 2nd Ed. Thousand Oaks, CA: Sage Publications.

Denzin, N. K., & Lincoln, Y. S. (1994). Introduction: Entering the field of qualitative research. In
N. K. Denzin& Y. S. Guba (Eds.), Handbook of qualitative research Thousand Oaks, CA:
Sage Publications.

Fontana, A. & Frey, J. (2003). The Interview: From structured questions to negotiated text
Chapter 2, in Denzin, N.K., & Lincoln Y.S (Eds) (2003).Collecting and Interpreting
Qualitative Materials. 2nd Edition, Thousand Oaks, CA: Sage.

Gay, L.R. (1987). Education research: competencies for analysis andapplication. 3rd .ed.
Columbus: Merril blushing.

http://ori.hhs.gov/education /products/n_illinois_u/datamanagement/datopic.html.

Internet (2006) Hypotheses in research http:/faculty.newc.edu/toconnor/308/308/lect03.htm

Retrieved 01/12/2014

Internet (2006) Sampling.http:/faculty.newc.edu/toconnor/308/308lect2.htm Retrieve on

02/12/2014

Nwana, O.C. (1981) Introduction to educational research for students teachers. Ibadan:
Heinemann Educational Book.

Sam A. Ifidon and Elizabeth I. Ifidon (2007) Basic Principles of ResearchMethods. Benin:
Goodnews Express Communicatios.

Yomere, G.O. and Agbonifoh, B.A. (1999) Research methodology in the social science and
education. Benin-city: cetrepiece consultants.

33
 CHAPTER FOUR

DATA ANALYSIS AND DESIGN

4.1. Introduction

This chapter addresses the detailed data analysis and the program design issues and

functionality for the developed system. It addresses the conditions that were necessary for the

effective functioning of the system and also the reason for which it is analyzed, designed and

implemented.

4.2. Data Analysis

In order to come up with a good functioning system, a thorough and clear analysis about the

current system had to be made where the system requirements and expectations by the

potential end-users are specified. Data generated from the methodology used was checked for

efficiency and integrity and analyzed. The analyzing of these results led to the system

designing. The system analyst dealt greatly with summarizing facts, opinions and views

obtained from users after a detailed determination of their requirements.

The data collected for this study was discussed under two main sections; the descriptive

analysis and the program analysis and design.

34
4.3. Descriptive Analysis

Under the descriptive data analysis, the researcher tries to analyze and explain all the data

(responses) gathered from the conducted interview, observation, existing document review and

questionnaire on the course of this study.

4.3.1. Respondents Details

As explained earlier by the researcher at the sampling of the study, to carefully select Seven (7)

from the clients meet in the clinic and two (2) from the professional staff, four (4) from the

paraprofessional staff and two (2) from the non-professional staff as representative. The table

below gives the clear view of the respondents to the study.

Table 4.3.1: Respondents details

S/N Category of respondent Numbers of respondent

1 Clients at the clinic 7
2 Professional Staff 2
3 Paraprofessional staff 4
4 Non- Professional Staff 2
Total 15

The table 4.3.1, above gives the list of respondents consulted for the study, the researcher was

able to achieve this as he is also a student from the institute where the study was carried out

and also a member (client) in the clinic.

4.3.2. Current records keeping system use in keeping records of patients in the clinic.

It was understand from the responds also that, the current record management system that is

35
being used at the Ahmadu Bello University sick-bay is a manual system, where all patients’

records and information are being collected with papers and pens and kept in paper file folders

or box files. This system exhibits some strengths and weaknesses. The strength of this system is;

patients and staff records are properly kept in box files which are then stored in office file

cabinets, the system is also easy to use because it does not require any training of the user.

Weaknesses of the current system are; it takes a lot of time to retrieve the required records

especially when the files are big, updating of patients records is tire some, files are easily lost or

misplaced in cabinets, lack of data security, manual calculation are vulnerable to errors and big

storage space is wasted where file cabinets sit.

4.3.3. Challenges of the current system

Base on the responses and observations on the current manual system of record keeping and

filling in the Ahmadu Bello University Sick-bay, the following issues are experienced;

a. Inefficient record management.

b. Misplacement of patients documents,

c. Not able to retrieve long consult patients’ records,

d. Loss of records or files alteration of information which normally result in unnecessary

delay of treatment.

4.3.4. Proposed record management system for the clinic

Most of the respondents suggest an automated system for the clinic, in which a computer

program and other related technology can be used in the management and operational

functions of the clinic in other to benefit and experience the advantages of technology in the

36
digital era.

4.3.5. Benefits of the proposed system

It was also observed from the responses on this study that, the introduction of an automated

record management system, in which computers will be used in the management of patents

records and information in the clinic will leads to the following progress;

a. More accurate record management, time saving, and easy retrieval of patients

information will be observed.

b. The computer program can also be a web base that will enable a quick access to

patient’s record globally in case of emergency.

c. Computer program can also provide adequate security to patients records in which only

authorize users can have access to the system.

d. Computer program can also provide an adequate schedule for both the doctors and the

patients of the clinic, in which an appointment has to make over the internet by the

patient before visiting the doctor.

4.3.6. System User Requirements

The system is expected to meet the following requirements;

a. Should allow secure entry of patient records

b. Retrieval of these records should be done with ease

c. Should allow users to enter new records

d. Also the ability to edit, search, delete the existing records.

e. Should be able to create hard copies as well as system backup for all records in the

37
 system.

f. Data entered by users, should be fast, give instant responses to inquiries.

g. Should provide security for data entered through authentic users to the system only.

h. Should display an error message to the user each time an error is encountered by the

system during data entry.

i. Should output patients’ records, diagnosis records and who carried out the particular

event.

4.4. Program Analysis and Design

This section deals with the clear analysis of the system design, tools used and system

specifications and its functions.

4.4.1. System Design

System design specifies how the system accomplished the set objectives. It consists of both

logical and physical design activities. The coding of the system design in a particular

programming language, in the case of this research work, the design/implementation where

done using the hypertext pre-processor (PHP) and MySQL as a database.

4.4.2. Tools used and System Specifications

This consists of data, software and the hardware specifications

a. Data; Data refers to the raw facts about a given sample specimen, which when

processed, results to information as the output. Data is the input to the system. Data

to the system in addition it comprises of the facts in a clear and orderly way, for the

38
 purpose of being able to compute and relate other data so as to produce summary in

form of output.

b. Software Specifications; this provides all the facilities for manipulating data and its

interface between the end user of the system and the hardware. The proposed

system was designed using hypertext pre-processor (PHP) and MySQL as the back

end for storing data. In order for the system to function as expected the computer on

which it will be installed should have the following software installed as explained

in their respective manuals;

 A higher version of windows operating system like windows xp, windows7,

windows8 or windows10.

 A Xampp or Wamp server should be installed on which a created site will

run as well as the created data bases will be stored for the localhost.

 Notepad PlusPlus (np++) or any other text editor software for coding of the

system programme.

c. Hardware Specifications; these are the physical or tangible components of the

system; which include the monitor, CPU, mouse, keyboard, UPS, among others.

Data/information used in the designs will safely be stored on hard disks.

 The system requires a properly installed computer system to run effectively

 The system is suited for computers with a Pentium IV or higher processor

with a speed of at least 1.5GHz.

 Considerable amount of RAM and hard disk space are required for proper

functioning of the system. RAM 2GB and above is recommended

 Due to the need for installation and creation of backups, the system should

39
 provide a means of connecting storage devices such as flash disks, compact

discs, and external hard disks among others.

 A good printer for printing the system output generated by the application

where printing is necessary

4.4.3. Database Design

This phase of the system designs focuses mainly on the procedures, tools and the

documentation that aids to support the process of database designs. The database will be

designed with interims of relationships and the tables are related by sharing common field.

The proposed system’s data will consist of the following entities;

a. Admin

b. Appointment

c. Doctor

d. Patients

e. Patient reports

f. Timings

40
Figure 4.1. Entity Relationship Diagram

Physical Database Design

This provides the detailed data description and data definition subsystem of the database

management system is set. It also referred to as data definition language. Database tables are

designed under physical database design.

41
Figure 4.2. Admin table

Figure 4.3. Appointment table

42
Figure 4.11. Doctors' table

Figure 4.12. Patients table

43
4.4.4 The Developed System Interfaces

Details of various interfaces of the system are given bellow:

Welcome interface

Below is the interface that is displayed when a user runs the system. It gives the user the

options of allowing him to make an appointment with a doctor, login or register as the staff of

the clinic, login or register as a patient in the clinic, and lastly, login as the record or system

administrator in the clinic.

Figure 4.13. Welcome interface

Appointment interface

From the appointment interface, the user has the option to see all the available doctors in the

clinic together with their specialization and their shifting time, from which the user can now

44
make or book an appointment with his/her preferred doctor after authenticating his/her login

details.

Figure 4.14. Appointment interface

Staff Login Interface

This interface provide for only the staff of the clinic, form which he/she can login or create an

account for him/her self.

When a staff is login to the system he can view all his appointment and from which he can also

attend to his patients with a provided interface to update the patients treatment records.

45
Figure 4.15. Staff login interface

Patients’ Login Interface

This interface provide access for patients to login or create an account from which he/she can

make an appointment with a doctor in the clinic, this interface also provide for the patient to

view or print his previous treatment reports and prescriptions by the doctors.

46
Figure 4.16. Patients login interface

Administrators interface

The Administrator has the full control of the system from which he can create, read, update or

delete any record or information from the system.

47
Figure 4.17 Administrators interface

48
 CHAPTER FIVE

SUMMARY, CONCLUSION AND SUGGESTION

5.1 Summary

The present manual system of collection and keeping / storing records, documents, and all

other related patients’ information in the Ahmadu Bello University Sick-bay is inefficient and

below standard, hence, the need for the development of a computer application system in

Nigerian clinics as it has expanciated upon by this research work.

However, the study has revealed the problems associated with the manual method of record

keeping such as difficulties in sorting, retrieving and updating records, lack of security of

records, loss of relevant information and so on. The program developed for this project is used

to handle the proper storage of all records and related information in a clinic, the patients’

treatment reports, date of treatments, doctors in charge and other relevant information will be

entered into the system.

The application of computer in our health sector is meant to improve on or overcome the

lapses of manual method of record keeping in the Nigerian clinics.

5.2 Conclusion

In general, the developed system is an automated record management system that is for

efficient patient’s data management. With various interfaces which automate patients’ data

capture and review that is kept in the database, the command buttons on each interface are

well coded to allow only the required information to be entered into the system and error

49
messages displayed in case invalid input is entered, it allows the authorized users to perform

specific duties such as; inserting or adding patients’ records, deleting a record, editing and

searching through the database. With the developed system being used, problems such as

records misplacement, data redundancy and inconsistencies, difficulty in updating the existing

data, illegal access to data and time delay in processing data are easily handled by the system.

5.3. Suggestion

Due to the study limitations stated earlier in chapter one, the researcher suggest the following

about the system:

a. The researcher suggests that the users should be trained on how to use the system.

This will enable users to understand the functionalities of the system.

b. There is need for system upgrade as user requirements increase. User requirements

differ with time, therefore, it is of great help for the system to be flexible enough.

c. Other researchers can use this project as a basis during further studies on

automated clinic record management system.

d. There is need to do more research on other programming languages like JAVA,

PYTHON and alike.

50
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 APPENDIX

AN INTERVIEW GUIDE FOR THE CLINIC ADMINISTRATORS

AHMADU BELLO UNIVERSITY, ZARIA

FACULTY OF EDUCATION
DEPARTMENT OF LIBRARY AND INFORMATION SCIENCE
Dear Respondent,

I am a student of Ahmadu Bello University, Zaria, Department of Library and Information

Science carrying out a research about the current record keeping System in use in Ahmadu

Bello University Sick-bay in an effort aimed at improving it or developing a new system if need

be. Please note that the information provided will be used for only this study and not shared

with any third party. I therefore request you to answer some of the following questions.

Yours faithfully
Alfa Mahfooz Ahmed
U11LS1018

1. What is your current work position and department in ABU Sick-bay?

2. How do you find the current records keeping system use keeping records of patients in

the clinic?

3. What problems do you find in the current system?

4. In case of a new system, what changes do you propose?

5. How will this system benefit you as an administrator (user)?

6. Comment about the way the services are rendered at ABU Sick-bay.

59
 QUESTIONNAIRE I
AHMADU BELLO UNIVERSITY, ZARIA
FACULTY OF EDUCATION

DEPARTMENT OF LIBRARY AND INFORMATION SCIENCE

Dear Respondent,

I am a student of Ahmadu Bello University, Zaria, Department of Library and Information

Science carrying out research about the current record keeping System in use in Ahmadu Bello

University Sick-bay in an effort aimed at improving it or developing a new system if need be.

Please note that the information provided will be used for only this study and not shared with

any third party. I therefore request you to answer some of the following questions.

Yours faithfully
Alfa Mahfooz Ahmed
U11LS1018

60
 Tick appropriately or write as the space provided.

Section A: Personal Information.

1. What is your gender?
f. Male [ ]
g. Female [ ]
2. What is your current status in the clinic?
a. Client [ ]
b. Doctor [ ]
c. Nurse [ ]
d. Administrator [ ]

Section B: other Information.

3. How do you assess the current patients’ records management system in the clinic?
a. Very good [ ]
b. Good [ ]
c. Fair [ ]
d. Poor [ ]
4. If administrator, what is your current work position and department in the clinic?
______________________________________________________________________
______________________________________________________________________
5. If worker, what is your current work position in the clinic?
______________________________________________________________________
6. What problems do you find in the current system?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7. In case of a new system, what changes do you propose?
______________________________________________________________________
______________________________________________________________________
8. How will this system benefit you as a user?

61
 ______________________________________________________________________
______________________________________________________________________
9. Do you even think there is a need for a new patients’ records management system in the
clinic?
a. Yes [ ]
b. No [ ]
10. Are you satisfied with the services provide at the clinic?
a. Yes [ ]
b. No [ ]
11. Do you think the new propose system will solve the problems that are in the existing
system in the clinic?
a. Yes [ ]
b. No [ ]

62