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1 INTRODUCTION

Health is very important for everyone. Unfortunately, almost everyone now a days are
suffering from at least one type of illness, like bronchitis, pneumonia, hepatitis, back
pain to name a few of them. Since there are so many patients everywhere, more medical
experts are needed. For example, from the latest statistics, the ratio for a doctor and a
patient is 1:10000. However, according to the World Health Organization there should be at
least one doctor for every thousand people.

The government is finding it difficult to have enough medical experts to get a good ratio
among medical experts and patients. Furthermore, the doctors have to consider lots of
issues before they could subscribe an accurate treatment for a patient.

In addition, computer technology also has gone through very drastic changes and the
changes have also influenced many fields and revolutionized the way they function. One of
the major fields which have been revolutionized by computer technology is medicine and
healthcare field. It has brought many changes to this field ranging from the organization
of patient’s data to the management of operating theatres.

Medical expert system has also created with many application systems to complement the
duties of a doctor. Medical expert systems have been applied in a wide range of industrial and
commercial problems including diagnosis, planning, scheduling, decision support and
process monitoring and control. These systems capture and deliver knowledge that is
not easily represented using traditional computing approaches. Therefore, the main
advantage of expert system is that it can be used to gain access to expertise knowledge
immediately, around the clock, anywhere in the world and by lots of people at the same
time. However, traditional expert systems in medicine and healthcare often utilize a
static set of questionnaire that does not intelligently ask pertinent questions. Moreover,
many traditional expert systems often utilize only one inference strategy. We argue that
these limitations do not make expert system effective and efficient in addressing the issues of
health monitoring and diagnosis in health care.

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1.2 REVIEW OF LITERATURE

According to Fonseca, Mora and Barroso internet plays an important role by allowing
physicians, patients and other healthcare providers to access information’s easily and
faster especially about cancer disease. Even in earlier times, recording the information’s
through paper is well accepted by the doctors and patients. It is because most
people have single family doctor to consult with and the doctors will remember the patients’
medical history. The traditional way of keeping the information on papers leads to the
current version of electronic record. Fonseca et al. also added that proper patients’
information is required because current medical practice is more difficult and complicated
involving many healthcare providers, greater mobility of citizens, complex medical
examinations and others.

Anderson, Moazamipour, Hudson and Cohen also specify that physicians can obtain
needed information about patients and make wise decisions through Internet. Medical
decision support systems was designed and evaluated in several medical applications. In
addition, Knowledge-based systems (KBS) and Intelligent Computing Systems have
been widely used in the medical planning, diagnosis and treatment. The KBS consists of
rule-based reasoning (RBR), case- based reasoning (CBR) and model-based reasoning
whereas intelligent computing method (ICM) includes genetic algorithm (GA),
artificial neural network (ANN), fuzzy logic (FL) and others (Pandey and Mishra).Rule-
based reasoning have been developed and employed by many researchers in the
treatment and diagnosis of various diseases. Most of the rule-based model and
knowledge-based system have utilized reason based system for knowledge
representation. Whereas, case- based reasoning used in learning and problem-solving
system to solve new problems by recalling and reusing specific knowledge obtained from
past experience. Case- based reasoning is self-updatability and can handle unexpected
cases not recorded in the system or missing input values.

There are also many websites present on the internet which help us in the same way any web-
based application for medical diagnostic system would work. One such example that we have
found during our research was symptomate.com. It is an easy five minute diagnosis and
people having internet access can easily find out if their symptoms indicate something
serious.

Hence, information and communication technology have a major role to play in the
overall development of innovative formal and informal regulatory mechanisms that will
impact on the management of health knowledge. In most of the countries, health
system are complex, highly marketed and lightly regulated by government or
professional bodies, the quality and cost of services may be highly dependent on the rules and
associated sanctions that can be applied to providers by those whom they claim to serve.
In such situation, individual cannot use a particular provider or accept a recommended
course of treatment (Mackintosh and Tibandebage).

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 In the meantime, some confusion also detected in the literature over whether tier
three or tier two post is most preferred. On the other hand the literature also unable
to conclusively decide over whether utilization of Physician Order Entry System
(POES) would give better results as compared to traditional system. As such there is a
need to explore these issues, so that more valuable arguments could be added into the
literature.

Computer-based Physician Order Entry System (POES) has been developed and used in
many clinical institutes in Taiwan (Lee, Hsu, Hsieh and Li ). Wang- Fang Hospital in
Taipei has developed three-tier web-based POSE and successfully implemented it. The
system provides the Subjective, Objective, Assessment, and Plan (SOAP) structure for
the physician to enter subject, object, diagnoses, medicine dosage, treatment and
laboratory test request, and prints out the prescription and necessary document. The doctor
can also repossess the patient’s medical record on the system. One of the special
characteristics of the system is its custom-made design.

Now, let’s look into the portal hypertension disease that has been one of the hot button
issues nowadays. Portal hypertension disease is considered as silent killer. In general, it
affects a lot of people globally. Usually, portal hypertension occurs without presenting sign
and symptoms.

In Malaysia, most of the pharmacies recommended the cheap drugs that patient able to
get with or without prescription. But some patients probably do not want to take risk
with this type of pharmacies. But OMDS(Online Medical Diagnostic System) will
display the results and also the prescriptions. The patients can get the medicines in
authorized pharmacies or dispensaries. The patient’s information’s in the OMDS system
will be protected by privacy procedures with the strongest protection. The personal
health information in the OMDS systems will be observed with the Personal Information
Privacy Act that governs the usage of information on OMDS database.

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 1.3 REPORT ON THE PRESENT INVESTIGATION

Chapter 1

Methods

In this paper, the new system has been developed which is known as Online Medical
Diagnostic System(OMDS). This system has the features for users to do diagnostics for
the health problem and also the system will provide some health monitoring and tips for
the user to follow. Meanwhile the doctors also can use this system to do further
diagnostics and patient’s database references. Moreover this system provides patient’s
health information for hospital administration]. The main objective of Online Medical
Diagnosis System (OMDS) is to provide convenience to doctors, hospital administration
and patients, increase accuracy of the patient’s illness by hospital doctors for their
patient. This system will concentrate on the management of three main parts such as
Patients Registration and Administration, Diagnosing and Treatment, Health Monitor
and Tips. In the first part there will be two users that is the person registering in as patient
and another one is the hospital staff. In the second part there will be two users also where
here the doctors and the patient play the role. While in the part three there will be the
patients only. Each patient will have a username and a password. So whenever the patient
enters their username, the system will get their information from the patient’s database
and give appropriate diagnosing and health tips according to their medical records. Each
patient will have their own different database including the doctor. The doctor can access to
the patient’s database to go through the patient’s updated health record. At the same time,
the database can be used by doctors to diagnose the patient’s illness when the patient
meets face to face.

The main weaknesses of the current system are in terms of time wasted by the
patient. According to the current system, the patients spend almost a day at the
hospital. There will be more hassle when it comes to referring a patient to a different
doctor. Other than that, variable also being an important aspect. When a doctor is
diagnosing an illness of a patient, they might tend to forget certain criteria like
symptoms that should be considered before deciding the right treatment for a patient.
This may cause a major problem to the patient. And this might lead to a situation where
the patient would sue the doctor for being careless in prescribing the right treatment. It could
cause the doctor to pay a large sum of money. And lastly, manual file keeping is also a
major barrier of the current system. There are still hospitals and clinics that use manual
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system including the file keeping. Since the files are kept using the clip files or the paper
files and are placed on the shelves, it is a problem for someone who wants to do the
inserting, deleting and retrieving data. The files which are kept for a long time might be
very tedious to read because the content might become blur or being destroyed by insects.
The files might get lost too. This cause problem for keeping old data. The researcher
has developed the new idea of Online Medical Diagnosis System(OMDS) after considering
current and similar system. The similar system includes calculating the cancer risk. It is
a Cancer Research Society’s risk factor questionnaire. The web site asking questions like
living habits, like smoking and consuming liquor. Anyone is welcome to complete a checklist
of the most important lifestyle factors for which can do something about in terms of
reducing risk of cancer. Hence, Breast Cancer Risk Assessment Tool also one of the
important tool under similar system. It is an estimation based web site to calculate the risks of
the breast cancer. Just like the other web site, it using combinations of survey, questionnaire
and information collecting methods to bring out the results and quotations.

Chapter 2
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 Use Cases

1. Patient Use Case :-

The patient accesses the Online Medical Diagnostic System , registers its full details and
creates a username and password.
Initial Step-By-Step Description
Before this use case can be initiated, the patient has already accessed the Online Medical
Diagnostic System.
i) The patient enters the area in his body where it has most problems.
ii) The patient selects those symptoms which he has been having and then on the basis of the
symptoms provided the system makes a probable diagnosis or more than one diagnosis. It also
provides prescription if the diagnosis is not serious and if the symptoms point to something
serious the system will advise the patient to visit a hospital.
iii) The patient can look at its past medical history, doctors prescription and total expenses.
iv) The patient can find the nearest doctor available and fix an appointment.

2. Doctor Use Case:-

The doctor can really benefit as from here he can know the patient medical history and also
find the illness.

Initial Step-By-Step Description

Before this use case can be initiated, the Doctor has already connected to the Online Medical
Diagnostic System

i)The doctor can enter the symptoms of the patient and get to know his/her health condition.

ii) The doctor can now know about the medical history of the patient.

Chapter 3

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 Material and methodology

As this is an Android based application, we used different set of tools. In front-end, for
coding and framework we used, Eclipse J2EE, SDK-11, ADK and compatible emulator to
check the time running of the application just as on android device. For back-end we used
Oracle database to store the symptoms. The symptoms are being taken as binary digits ‘0’ or
‘1’, ’1’ being the true value. Array is being made with binary bits corresponding to its
respective symptoms.

Extensibility

This software is extendable in ways that its original developers may not expect. The
following principles enhance extensibility like hide data structure, avoid traversing multiple
links or methods, avoid case statements on object type and distinguish public and private
operations.

Reusability

Reusability is possible as and when require in this website.Reducing the amount of code also
simplifies understanding, which increases the likelihood that the code is correct. We follow
up both types of reusability: Sharing of newly written code within a project and reuse of
previously written code on new projects.

Understandability

A method is understandable if someone other than the creator of the method can understand
the code (as well as the creator after a time lapse). We use the method, which small and
coherent helps to accomplish this.

Cost effectiveness

Its cost is under the budget and make within given time period. It is desirable to aim for a
system with a minimum cost subject to the condition that it must satisfy the entire
requirements.

Chapter 4

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 Diseases Covered

The application covers many known diseases. The list of different types of diseases is shown
in the tables below.

Table 1: List of Diseases Related to Pain in the Body

PAIN TYPE

Osteoarthritis

Spondilytis

Spinal Stenosis

Aplastic Anaemia

B12 deficiency anaemia

Osteomylitis

Leg Perthes disease

Sideroblastic Anaemia

Slipped Capital Femoral Epiphylis

Peripheral Vascular Disease

The table above gives a list of diseases which can be diagnosed on the basis of pain in
different parts of the body.

Table 2: List of 'Skin type' problems

Skin Type

Hypothyroidism

Schmidt's Syndrome

Hypercortisolism

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The above table provides all the common skin type problems that are commonly experienced
by the people.

Table 3: List of 'Respiratory type' problems

Respiratory type

Pneumonia

Sarcoidosis

Hemothorax

Chronic Bronchitis

The above table provides all the common respiratory type problems that commonly occur in
people.

Table 4: List of all the probable 'Gastrointestinal type' of diseases

Gastrointestinal type

Peripheral Vascular Disease

Osteoarthritis

Ankylosing Spondilytis

Spinal Stenosis

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Hepatitis A

UTI

Conspitation

IBS

Schmidt's Syndrome

The table above lists all the probable ‘Gastrointestinal type’ of diseases used in the database
and this would actually be reviewed by an expert Medical Practitioner .

Chapter 5

Procedure Used
According to the diagrams, it is two tier architecture. We provide a form that shows a list of
symptoms. FRom the listed symptoms, user has to select those that he/she have. On the basis
of selected symptoms, an array of symptoms is generated giving ‘1’ for the symptoms being
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input by the user and then the system will generate related diseases. If the information for the
disease is not enough the system will redirect to give symptoms again.

Symptoms:-

1 0 1 1 1 0 1 0

taken not taken taken taken taken not taken taken not
taken

Figure 1: Array where symptoms input by user gets '1' and symptoms by default gets its
values as '0'.

On the basis of the given series of information a query is generated and the database
responses to that query based on the particular set of symptoms given by the user to the
database.

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 Figure 2: Request response flow of control.

This shows the request-response flow of control in this application. User inputs the symptoms
through UI and DOM(Document Object Model) helps to enter into DB which returns the
allopathic/ayurvedic cures of the probable diseases.

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1.4 RESULTS AND DISCUSSIONS

This is a final year semester project. Being a web-based project, it provides a platform for
online appointment between doctor and patient.

Health care technologies include medical devices that are used in the home as well as
information technologies related to home-based health care. The adoption of the
recommendations would improve the usability and effectiveness of technology systems and
devices, support users in understanding and learning to use them, and improve feedback to
government and industry that could be used to further improve technology for home care.

Environmental aspects: Healthcare Environment is always a major concern in the field of

medical services. It is required to be taken into major consideration when it comes to

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society’s health. To maintain healthy environment, health care systems are providing extra
services in order to make patient’s feel healthier and fresh.

Cultural aspects : Providing quality health care to ethnically diverse patients requires cultural
flexibility to elicit and respond to cultural factors in medical encounters. Interventions to
reduce disparities in health and health care in the USA need to address cultural factors that
affect the quality of medical encounters.

Societal aspects : Studying diagnosis from a sociological perspective offers clinicians and
students a rich and sometimes provocative view of medicine and the cultures in which it is
practiced.

Safety measures taken : Just as in clinical medicine, any measurement of safety and quality
is useful only if it actually measures what it is supposed to, and is used and interpreted
correctly.

Cost estimation : Electronic medical record systems improve the quality of patient care and
decrease medical errors, but their financial effects have not been as well documented. The
purpose of this study was to estimate the net financial benefit or cost of implementing
electronic medical record systems in primary card.

Project type : It is a web based project.

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1.5 SUMMARY AND CONCLUSIONS

Average waiting time in the specialists reduce from 19 minute to 30 seconds.

•The clinic increase its efficiency more than 40 %.
•Patient will satisfy his need and exceed his expectation.
•Reduce cost because initial and maintenance cost of the medical diagnosis will be much
lower than specialists annual salary.
•Reduce the cycle time for patients.
•Avoid the fairness and stress for patients.
•We suggest next step find out what are the possible way to increase the efficiency of x-ray
process.

START UP IDEA

The aim of this project is to design and develop a diagnosis system that can be used in the
clinics to achieve the following objectives:
• Meeting patient's satisfaction by:
Reducing waiting times
Reducing service times
Increasing the quality of the services.
• Increasing work efficiency, by saving
Time.
Cost.
Effort.

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1.6 APPENDIX :

APPENDIX I:

The 12 graduate attributes and how they are fulfilled by our project:-

1.) A knowledge base for engineering:- Our branch being information technology, this
project demonstrates our competence in mathematics,natural sciences, engineering
fundamentals and specialized engineering knowledge.

2.) Problem analysis:- The complex problem of giving medical help to rural India with the
help of our application is tackled in this project.

3.) Investigation:- The inputted data will be thoroughly investigated before reaching to valid
conclusions.

4.) Design:- The design of this project is aimed at societal development keeping in mind the
health risks we are facing today

5.) Use of engineering tools:- Modern techniques that we have learned will be adeptly applied
to the project.

6.) Individual and team work:- The project will be fruitful in finding our individuality and
team spirit while demonstrating our leadership skills.

7.) Communication skills:- This project will help in communicating the latest technologies to
the society.

8.) Professionalism:- Our social responsibilities as a professional engineer will be

demonstrated with this project.

9.) Impact of engineering on society and the environment:- This project analyzes the social,
health and economic aspects of our society.

10.) Ethics and equity:- This project depicts our ability to apply professional ethics,
accountability and equity by displaying extraordinary teamwork.

11.) Economics and project management:- Practices such as project,risk and change
management will be given priroity.

12.) Life-long learning:- The project fulfills our educational needs which will be necessary
int he long run in the IT industry.

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1.7 LITERATURE CITED

Internet plays an important role by allowing physicians, patients and other healthcare
providers to access information’s easily and faster especially about cancer disease.

Physicians can obtain needed information about patients and make wise decisions
through Internet. Medical decision support systems was designed and evaluated in several
medical applications.In addition, Knowledge-based systems (KBS) and Intelligent
Computing Systems have been widely used in the medical planning, diagnosis and
treatment. The KBS consists of rule-based reasoning (RBR), case- based reasoning (CBR)
and model-based reasoning whereas intelligent computing method (ICM) includes
genetic algorithm (GA), artificial neural network (ANN), fuzzy logic (FL) and others
(Pandey and Mishra, [11]). Rule- based reasoning have been developed and employed by
many researchers in the treatment and diagnosis of various diseases. Most of the rule-
based model and knowledge-based system have utilized reason based system for
knowledge representation

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1.8 ACKNOWLEDGEMENT

We would like to express our deepest appreciation to all those who provided us the possibility
to complete this report.
Furthermore I would also like to acknowledge with much appreciation the crucial role of our
mentor Mrs Paramita Manna who guided us throughout the project.
We have to appreciate the guidance given by other supervisor as well as the panels especially
in our project presentation that has improved our presentation skills thanks to their comment
and advices.

_______________________ __________

Signature Date

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