SEMINAR REPORT

ON

DESIGN AND IMPLEMENTATION OF A COMPUTERIZED HOSPITAL

RECORD SYSTEM
(CASESTUDY- UNIVERSITY CLINIC COOU)

BY

OKEKE CHINAZA CHARLES

2017 224 089

SUBMITTED TO THE
 DEPATMENT OF COMPUTER SCIENCE,
FACULTY OF PHYSICAL SCIENCE
CHUKWUEMEKA ODUMEGWU OJUKWU UNIVERSITY,
ULI CAMPUS

SUPERVISED BY

DR. OGOCHUKWU OKEKE

JULY 2021

SEMINAR REPORT

ON
DESIGN AND IMPLEMENTATION OF A COMPUTERIZED HOSPITAL
RECORD SYSTEM
(CASESTUDY- UNIVERSITY CLINIC COOU)

BY

OKEKE CHINAZA CHARLES

2017 224 089

SUBMITTED TO THE
DEPATMENT OF COMPUTER SCIENCE,
FACULTY OF PHYSICAL SCIENCE
CHUKWUEMEKA ODUMEGWU OJUKWU UNIVERSITY,
ULI CAMPUS
IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR
THE AWARD OF BACHELOR OF SCIENCE (B.SC)
DEGREE IN COMPUTER SCIENCE

SUPERVISED BY

Dr. OGOCHUKWU OKEKE

JULY 2021
 AKNOWLEDGEMENTS

This report is greatly indebted to a number of people, without whose ceaseless cooperation,
guidance, and encouragement and all manner of input this would not have been possible.

Sincere gratitude to my project supervisor, Dr. Ogochukwu Okeke, for his time, intellectual
input, constructive criticism and suggestions offered while undertaking the project. To my
colleagues; Jibuike kelvin, Chine chisom, for their priceless intellectual input.

I also wish to appreciate the efforts of all those without whose limitless and unconditional
support, this undertaking would not have come to be. Sincere Gratitude to Mary Moran, to, my
parents Joseph and Chinwe Okeke for their financial and moral support.

Most of all, my deepest and sincerest gratitude goes to the Almighty for bringing me this far.

iii
 DEDICATION

I wish dedicate this piece of work to my father Mr. Joseph Okeke, for being my inspiration, to
my mother Mrs. Chinwe Okeke , for being my pillar of strength.

iv
 ABSTRACT

“The purpose and essence of any Records Management system is the right information in the
right place in the right order, at the right time for the right person at the lowest cost.”- (Baje
1998). For this feat to be achieved, an integrated, highly efficient and effective records
management system is needed. With this in mind, a careful analysis of the records management
system being utilized by the University. The findings showed that the system was highly
inefficient- especially as far as retrieval of archival patient information was concerned. This
analysis established the need for a Records Management System (RMS) that would facilitate
effective and reliable records management through automated processes and served as the basis
for the research leading to the development of such an RMS.

The Major objective of the project was to design and develop an RMS that would automate
patient records Management and give direct benefit for the University clinic/Medical in terms of
fast information retrieval, enhanced decision-making (patient diagnosis) whilst avoiding any
confusion that would jeopardize the quality of patient care. The RMS was designed as a
client/server and web-based system and implemented using open source solutions that include
MySQL as the database, and PHP, HTML and JavaScript as the programming languages.

The system was developed using Extreme Programming methodology. An extensive evaluation
of the project determined that the project achieved many of its predefined objectives however,
the major limitation of the project was the scope covered. From a proper analysis and assessment
of the designed system, it can be concluded that the system developed is an efficient, usable and
reliable records management system.

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 TABLE OF CONTENTS

COVER PAGE …………………………………………………………………………………. I

TITLE PAGE …………………………………………………………...……………………... II
ACKNOWLEDGEMENTS ...................................................................................................... III
DEDICATION ........................................................................................................................... IV
ABSTRACT ................................................................................................................................. V
TABLE OF FIGURES .............................................................................................................. VI

CHAPTER ONE ……………………………………………………………………………….

1.1 Introduction ………………………………………………………………..………………… 1

1.2 Background of The Study……………….................................................…………………… 3
1.3 Statement of The Problem ……………………………………………….………………….. 4
1.4 Objectives……………………………………………………………….…………………… 4
1.4.1 General Objectives…………………………………………………..…………………… 4
1.4.2 Specific Objectives …………………………………………………..………………….. 4
1.5 Significance of the study ………………………………………………...……………........... 5
1.6 Scope of study …………………………………………………………………….................. 6
1.7 Limitation of study …………………………………………………………...……………… 7
1.8 Definition of terms ……………………………………………...…………………………… 8

CHAPTER TWO ……………………………………………………………………………

2.1 Literature overview ……………………………………………………………………..…… 9
2.1.1 Records …………………………………………………………………………..……… 9
2.1.2 Electronic records ……………………………………………………………....……… 10
2.1.3 Record functions …………………………………………………………….…………. 10
2.1.4 Record management …………………………………………………………….……… 11
2.1.5 Record keeping system …………………………………………………...……………. 12
2.1.6 Database as recordkeeping system ………………………………………...…………… 13
2.2 Theoretical Review ………………………………………………………………………… 14
2.3 Review of related works …………………………………………………...………………. 14

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2.4 Summary of related works and knowledge gaps……………………..……………………. 17

CHAPTER THREE ……………………………………………………………………………

3.1 Application Area …………………………………………………………………………… 18

3.2 Discussion ………………………………………………………………….………………. 19
3.2.1 State of Art of Hospital Record Management System…………………..……………… 19
3.2.2 State of Electronic of Hospital Record Management System ……………….…………. 21
3.2.3 Administration of Hospital Record Management System …………………..…………. 21
3.2.4 Problem Administration of Hospital Record Management System ……………………. 21
3.3 Summary …………………………………………………………………………...………. 21
3.4 Conclusion …………………………………………………………………………………. 21
3.5 Recommendation ……………………………………………………………...…………… 23
3.6 Future research ……………………………………………………………...……………… 23
3.7 Reference …………………………………………………………………...……………… 24

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 CHAPTER ONE

1.1 introduction

Hospitals deal with the life and health of their patients. Good medical care relies on well-
trained doctors and nurses and on high quality facilities and equipment. Good medical care
also relies on good record keeping. Without accurate, comprehensive and up to date and
accessible patient notes, medical personnel may not offer the best treatment or may in fact
misdiagnose the condition, which can have serious consequences . Associated records, such
as x-rays, specimens, drug records and patient registers, must also be well cared for if the
patient is to be protected. Good records care also ensures the hospitals administration runs
smoothly; unneeded records are transferred or destroyed regularly, keeping storage areas
clear and accessible; and key records can be found quickly, saving time and resources.
Records also provide evidence of the hospital’s accountability for its actions and they form
a key source of data for medical research, statistical reports and health information systems.

Managing Hospital Records addresses the specific issues involved in managing clinical and
nonclinical hospital records. A comprehensive records management system in a hospital
helps to ensure that staff have access both to clinical information and to administrative
records on a wide range of issues, including policy, precedents, legal rights and obligations,
personnel, finance, buildings, equipment and resources.

Records Management refers to an on-going process of managing the records in a media

neutral basis in accordance with approved policies, procedures and schedules. Records
Management as a discipline defines and applies business rules related to the creation,
protection, retrieval and disposition of an organization as records over time. Retention
schedules are the cornerstone of a successful Records Management process.

1
Records Management as a discipline involves records keeping. Record keeping is an
important aspect of every organizations/ institution’s day to day operations. There cannot
be a records management system without records and neither can there be efficient record
keeping without a good records management system. Therefore, record keeping is the
Systematic procedure by which the records of an organization are created, captured,
maintained, and disposed of. This system also ensures their preservation for evidential
purposes, accurate and efficient updating, timely availability, and control of access to them
only by authorized personnel. The record in question here refers to any item or collection
of data.

A management information system (MIS) is a system or process that provides the

information necessary to manage an organization effectively. An MIS should be able to
influence decision making. A records management system while incorporating aspects of a
MIS should be able to influence decision making in an institution/ organization

An information system (IS) is any combination of information technology and people's

activities using that technology to support operations, management, and decision-making.
In a very broad sense, the term information system is frequently used to refer to the
interaction between people, algorithmic processes, data and technology. In this sense, the
term is used to refer not only to the information and communication technology (ICT) an
organization uses, but also to the way in which people interact with this technology in
support of business processes and is therefore relevant to the development of a records
management system.

A management system is a proven framework for managing and continually improving an

organization’s policies, procedures and processes.

Therefore, a good and efficient records management system should be able to incorporate
specific aspects of the systems mentioned above in order to provide and efficient means of
records storage and management.

2
1.2 Background
COOU Clinic is a specialized medical center, funded by the Anambra state Ministry of
Health which was established in 2000. It is affiliated with the medical school of
CHUKWUEMEKA ODUMEWU OJUKWU university of Science and Technology, one of
medical schools in Anambra. It is the referral clinic for the students and staffs of the
university. The clinic also serves as the teaching hospital of the University. The clinic is
staffed by medical students and residents. Its bed capacity is 12.

One of the most vital departments in the hospital is the records keeping department. The
department was started at the inception of the clinic in 2000. The department however only
has archives dating back to 2004 owing to the fact that records that preceded that year were
destroyed.

The department is divided into a number of sections. One section is responsible for
collecting and storing patient’s medical information, another for sundries and drugs and
another section is responsible for Human Resources and financial records. The department
however liaises with the different clinics and departments in the hospital which reserve the
semi-autonomous responsibility of maintaining their own patient records.

The reception section in relation to student provides student details. This requires a
meticulous recording system that is able to keep systematic track of each individual’s
progress. In this Section, various operational functions are done such as; Recording
information about the Patients that come, keeping record of the patients. and Keeping
information about various diseases and vaccinations available. Like all other records in the
hospital, the records are paper based

In analyzing the current records management system at the clinic, a lot of the records are
stored in paper files. In the section, Information about Patients is done by just writing the
Patients name, age and gender. Whenever the Patient comes up his information is stored
freshly. blood test records of student are maintained in pre-formatted sheets, which are kept
in a file.

3
All this work is done manually by a few nurses and other operational staff on paper files.
This means that all this paper files need to be handled and taken care of with utmost care.
Unfortunately, this is rarely the case. Doctors and nurses have to remember various
medicines available for diagnosis and sometimes miss better alternatives as they can’t
remember them at that time. As regards records storage, the records are stored in cramped
record rooms. This situation is worsened by the massive number of student the section
receives each day. The current recording system in use is therefore inefficient and time
consuming.

1.3 Statement of the Problem

The system design and development was undertaken in order to eliminate the problem of
redundant, erroneous and incomplete data that was escalating the inefficiencies in data
retrieval. These limitations were mainly caused by the fact that data, under the previous
manual recording system was entered into books and paper files and was later stored in
overcrowded storage rooms that made retrieval of archival records close to impossible.

1.4 Objectives

1.4.1 General Objective

To design and develop a records management system for COOU clinic that would enable
faster and more efficient storage, retrieval and updating of clinic records.

1.4.2 Specific Objectives

The project’s specific objectives were;

• To carry out a feasibility study for the possibility of developing a records

management system for the student’s section of COOU clinic

• To design and develop a records management system for the clinic

• To test and validate the records management system for COOU clinic

• To implement the records management system for the COOU clinic

4
1.5 Significance of study

In designing and developing the records management system, it was hoped that the project
would have the following impact on all stakeholders.

The developed records management system was deemed as necessary for the automation
and streamlining of the clinic’s workflow thus minimizing medical errors. The system, it
was hoped, would enable clinic administrators to significantly improve the operational
control and thus streamline operations.

It would lead to faster service delivery with faster record insertion and retrieval thus
reducing the time spent by staff/student filling out forms and standing in line. This would
minimize on the time consumed in the input and retrieval of records, freeing resources for
more critical tasks and thus providing an opportunity to the clinic to enhance their patient
care.

It would also reclaim office space used for inefficient storage. A lot of space is taken up in
storing the paper-based records and this space was saved up by the implementation of the
computer-based records management system.

It would also secure the vital medical records and information in case of any disruption or
disaster. This is because the system was able to be backed easily and efficiently thus
ensuring a longer records life.

It would also save the hospital section on badly needed human resources. This is because
the records management system would require less number of Staff to cater more patients
in same time or even less. Therefore, this presents an opportunity for the hospital
administration to re-deploy the personnel that are currently working in the records desk to
other suitable locations- where they are needed more. The senior Doctors and nurses would
also be able to spend their precious time more in clinical activities than to put in clerical
activities otherwise.

5
The records management system would also prevent costly paper accumulation with
systematic record disposal.

Accounting sometimes becomes needlessly complex. This records management system

would eliminate any such complexity, since the retrieval of information through its MIS
would come virtually on the tip of the user’s fingers.

It would also improve the response time to the demands of patient care because it would
automate the process of collecting, collaborating and retrieving patient information.

The records management system would provide the stakeholders the ability to request and
receive any data in the system in the most efficient manner with confidence of a high level
of accuracy.

The development of a database with additional value added functionality would allow the
hospital to manage records in the most cost-effective manner. Serving all of the clinics,
wards and offices, this new functionality would not only result in cost-savings, time
savings and space savings, but also would greatly improve on records management at the
hospital.

The development of the records management system would also lead to better access of to
operational data. This would provide better control over the various processes and also
facilitate better decision making.

The services the system would offer would also; Save the clinic a lot of space by reducing
storage needs for records; Save hundreds of staff-time hours by providing quick and easy
access to important information; Save the Hospital resources used in the destruction of
unnecessary records

6
1.6 Scope of study

The scope provides for the boundary of the research in terms of depth of investigation,
content, and methodology, geographical and theoretical coverage.

The system was exclusively designed and developed for the COOU Clinic Records
Management Department in general and the student records section in particular. The
student records section is solely responsible for keeping medical -issues and related records
for both student and staff keeping track of this information.

The records management system was designed in such a way that makes it possible to
access it through any web browser. This serves as the user interface. The web browser
supported interface created is dynamic and as a result backed by a database system that
enables users to have the ability to input, access, manipulate and delete data from the
database

1.7 Limitations of the Study

Throughout the development of the COOU Clinic Records Management System, a few
areas were overlooked by the researcher. Some of these limitations can be presented as
follows;

Usability
With regard to its use, the system only caters for English speakers. The GUI and associated
documentation is in English. This may present a problem for non- English speaking users

Accessibility
The system has only two user levels which only cater for the administrator and data
entrant. However, there is no facility for a guest. Such a facility would be useful if the
patients themselves needed to access their electronic records via the system.

Security
The system also does not cater for the automatic back up of the data in the database. This
may present a security problem in the event of data loss.
7
Static FAQ File
The system currently has a static FAQ file. This is a limitation in the sense that the system
does not generate the dynamically file based on the frequently asked questions.

1.8 Definition of terms

HTML (Hyper Text Markup Language) and CSS (Cascading Style Sheets) were used as the
languages of preference for the design of user interfaces. In the interfaces, Java script was
used as the client side validation tool.

PHP was used as a scripting language for linking the interfaces to the SQL database(s).
PHP is a server-side scripting language that enables one the ability to insert into a web
interface instruction that web server software would execute before sending a response to
the web browser [11]

SQL was used as the programming language for developing the database. SQL is the de
facto standard language used to manipulate and retrieve data from these relational
databases.

Macromedia Dream weaver 8 was used as the editing tool for creating interfaces using
HTML, CSS, Javascript and PHP scripts. Macromedia Dreamweaver 8 is a professional
HTML editor for designing, coding, and developing websites, web pages, and web
applications. Dreamweaver supports the creation of dynamic, database-driven web
applications using server technologies such as CFML, ASP.NET, ASP, JSP, and PHP.

XAMPP an integrated database creation software tool was used as the software for creating
the MYSQL database(s)

8
 CHAPTER TWO
LITERATURE REVIEW

2.1 literature overview

In order to understand the concepts associated with records management and or computer
based records management systems, it is imperative to examine and analyze published
material from experts regarding the field. The purpose of this review is to analyze and
examine and obtain experience as regards the creation and archival processing of electronic
records. The review is based on an exhaustive assessment of the literature on computerized
electronic management and electronic records, and contains an overview of the main
concepts associated with the creation of an electronic records management system from the
perspective of published experts.

2.1.1 Records

A record is recorded information produced or received in the initiation, conduct or

completion of an institutional or individual activity and that comprises content, context and
structure sufficient to provide evidence of the activity regardless of the form or medium.

According to the National Archives and Records Administration (NARA) records include,
“… all books, papers, maps, photographs, machine-readable materials, or other
documentary materials, regardless of physical form or characteristics, made or received ...
or in connection with the transaction of public business and preserved or appropriate for
preservation by that agency or its legitimate successor as evidence of the organization,
functions, policies, decisions, procedures, operations, or other activities of the Government
or because of the informational value of the data in them.”

9
The International Council on Archives (ICA) Committee on Electronic Records defines a
record as "recorded information produced or received in the initiation, conduct or
completion of an institutional or individual activity and that comprises content, context and
structure sufficient to provide evidence of the activity." The key word in these definitions is
evidence. Put simply, a record can be defined as "evidence of an even.
The “record” is evidence of the occurrence of a particular transaction. With a paper
“record” the content (i.e. the writing on the page) the media (i.e. the paper) the structure
(i.e. how the writing is arranged on the page) and the context (i.e. the interrelationship
between the item, the file, and the business in which the transaction is taking place) are all
either physically linked or self-evident to the human eye.

Records consist of content, structure and context. The three qualities must be captured and
preserved together in order to meet the requirements for “recordness”. The content must be
put together with data about structure and context. We may call these data “metadata” (i.e.
data about data). If the metadata are lost the item loses its “recordness” (i.e. evidential
value) and becomes “business un-acceptable” (useless as evidence). In an article “Towards
A Reference Model for Business
Acceptable Communications”, David Bearman describes a record as “a metadata
encapsulated object”

2.1.2 Electronic Records

The distinctive feature of electronic records is that the content is recorded on a medium and
in symbols (binary digits) that need a computer or similar technology to read and
understand.

The concepts of "record" and "electronic record" are linked to the concept of the "archival
function" which was defined as that group of related activities contributing to, and
necessary for accomplishing the goals of identifying, safeguarding and preserving archival
records, and ensuring that such records are accessible and understandable.

10
2.1.3 Record Functions

As an organizational resource, records serve many functions in the operation of an

establishment such as a university library. Records represent all documentary materials
such as correspondence, forms, reports, drawings, maps, photographs, and appear in
various physical forms, e.g., paper, cards, microfilm, tape, CD-ROM, etc., which can be
preserved for short or long periods.
Records originating from functions or processes have always been kept together in some
kind of system, i.e., a “recordkeeping system”. Such systems are functioning, or have once
functioned, as a tool for those carrying out a process and its transactions.

2.1.4 Records Management

The ISO 15489: 2001 standard defines records management as "The field of management
responsible for the efficient and systematic control of the creation, receipt, maintenance,
use and disposition of records, including the processes for capturing and maintaining
evidence of and information about business activities and transactions in the form of
records".

As records management develops, it has also incorporated principles integral to information

science as "the means of processing information for optimum accessibility and usability,
concerned with the origination, collection, organization, storage, retrieval, interpretation,
transmissions, transformation and use of information" (Vakkari and Cronin, 1992). Such
principles are adopted by records managers in seeking to enhance the access and use of
records.

Stressing the use of technology in records management, McDonald (1995) opines that "in
developing record keeping solutions, it is necessary to understand the evolution that is
taking place in the use of technology." The application of Information and Communication
Technology (ICT) to the management of records therefore, would go a long way in making
such records accessible and usable.

11
Luciana Duranti (1996) in an attempt to explain the concept of records management and its
relationship to record keeping systems, defines records management as the “management
over time, from the creator's perspective and for its purposes, of the creator's records, of the
means used to control their creation (e.g. classification, registration, and retrieval
instruments), and of the human, technological, and space resources necessary to their
handling, maintenance, and preservation.” In his definition, Duranti relates records
management to Record systems. He alludes to the fact that Records Management and
Records Management Systems have to co-exist.

2.1.5 Recordkeeping Systems

Recordkeeping systems in the electronic, as well as in the paper, world are designed for the
use of operational staff in current office operations. In the paper world, it is the archivist's
role to preserve this tool undisturbed for future users’ organization – (principe de l'ordre
primitif)

Luciana Duranti(1996) defines a record keeping system as comprising a set of internally

consistent rules that govern the making, receiving, setting aside, and handling of active and
semi-active records in the usual and ordinary course of the creator's affairs, and the tools
and mechanisms used to implement them. According to Duranti “recordkeeping is
“keeping record of action”: as such, it is the presupposition for the existence and the first
object of records management.

Recordkeeping systems have concrete boundaries and definable properties, and they are
critical to the preservation of the records’ origin and evidential value. In the paper world,
recordkeeping systems range from a simple filing system to a central registry.

The purpose and essence of any record system is the right information in the right place in
the right order, at the right time for the right person at the lowest cost. For this feat to be
achieved, an integrated record management programme is needed (Baje, 1998).

12
2.1.6 Databases as Recordkeeping Systems
Databases are being used as the records management systems of preference because of their
informational value. Such databases are created for their informational value -- as an
information resource. Statistical databases are good examples of this kind of database.
Terry Cook and Eldon Frost have described the first generation of databases transferred to
the Canadian National Archives as mainly consisting of statistical and survey files.

2.2 Theoretical Review

In theory, the relevance of Hospital Management System (HMS) in Nigeria is designed for
multispecialty hospitals, to cover a wide range of hospital administration and management
processes of patient-centric system. It is an integrated end-to-end Hospital Management
System that provides relevant information across the hospital to support effective decision
making for patient care (medical records management and billings), and hospital
administration, in a seamless flow. In existence, some researchers have contributed
positively in the improving of health care institutions management systems.
Therefore, we discuss in this section below, some of the relevance works done in hospital
management system by researchers in the field. The work of focused on understanding
the performance indicators of Hospital information systems (HIS), summarizing the latest
commonly agreed standards and protocols like Health Level Seven (HL7) standards for
mutual message exchange, HIS components, etc. The study is qualitative and descriptive
in nature and most of the data is based on secondary sources of survey data. However, the
researchers identified several modules for the implementation of E-Hospital Management
and Hospital Management System in which Emergency Management was one of
them. The contents operation within this module excludes the incorporation and use
of Biometric Fingerprint Technology. Thus, this indicates that emergency cases in the
intensive units where the registration of patients is trivial cannot be handled adequately
with respect to time. It was noted that the success factors of E –HMS / HIS tend to vary
depending upon leadership support, training, technology adoption, user friendliness, etc.
within a country identified the challenges existing in Mother-love Hospital, such as Data
redundancy, data inconsistency, difficulty in accessing data, data isolation, integrity
problems, atomicity problem, concurrent access anomalies, and some security problems.

13
They cited among others which pinpointed at techniques behind Database Management
technologies, and thus overcome the existing challenges. The system is visualized as a web
based application with three tier architecture. This architecture provides an increased
degree of security because its multiple zones isolate protected healthcare data making it
difficult for a hacker to get system-level access to the database. The solution proffered by
this system did not incorporate enabling technology to handle patients’ in critical
condition(s)

Due to extensive changes in medical technology and increased expectation of patients in

the twenty-first century hospitals that lack hospital information Systems will not be able to
compete with other hospitals. The most important necessity and reason for
hospitals information systems automation are inefficiency manual procedures
(Meinert &Peterson2009:9). Hospital information systems help to improve operational
efficiency, care quality and more informed decision making. According to Ghosh
(2010), hospital information systems give comfortable and quick access to patient data.

2.3 Review of Related Works

The term hospital derives from the Latin word „hospitalist‟, which relates to guests and
their treatment. The word reflects the early use of these institutions not merely as places of
healing but as havens for the poor or for weary travelers. Hospitals first appeared in Greece
as Aesculapius, named after the Greek god of medicine, Aesculapius (Risse, 1990). For
many centuries they developed in association with religious institutions, such as the Hindu
hospitals opened in Sri Lanka in the 5th century B.C. and the monastery-based European
hospitals of the middle Ages (5th century to 15th century). The Hôtel Dieu in Paris, a
monastic hospital founded in ad 660, is still in operation today (Science Museum, 2014). A
record is stored information produced or received in the initiation, conduct or completion
of an institutional or individual activity and that comprises content, context and structure
sufficient to provide evidence of the activity regardless of the form or medium (Acheng,
2008). Records Management is the professional practice or discipline of controlling and
governing what are considered to be the most important records of an organization
throughout the records life-cycle, which includes from the time such records are conceived

14
through to their eventual disposal. This work includes identifying, classifying, prioritizing,
storing, securing, archiving, preserving, retrieving, tracking and destroying of records
(ARMA International, 2001). A medical error is a preventable adverse result that may
occur during a medical process irrespective of whether it is evident or harmful to the victim
of the error (usually the patient being attended to). Medical errors occur when a staff
member of a health care institution uses an unsuitable method of care or performs a wrong
method of care. These errors are often described as human errors in healthcare (Zhang,
Patel & Johnson, 2008). Errors may include misdiagnosis, administration of the wrong
drug to the wrong patient or in the wrong way which in some cases may be due to
misrepresentation of information, prescription of multiple drugs that may interact
negatively, surgery on an incorrect site, failure to remove all surgical instruments, failure to
take the correct blood type into account, or incorrect record-keeping (Wikipedia, 2013).
Poor communication (whether in one's own language or, as may be the case for medical
tourists, another language), improper documentation, illegible handwriting, inadequate
nurse-to-patient ratios, and similarly named medications are also known to contribute to the
problem. Patient actions may also contribute significantly to medical errors (Palmieri,
DeLucia, Ott, Peterson & Green, 2008). Most Hospitals today still maintain the traditional
writing materials (pen and paper) and methodologies for keeping records. This
methodology may include usage of printed forms that include all the necessary fields for
the respective medical process or medical department, the evolution of the digital world
and presence of modern-day devices which operate at high speeds suggest that these
traditional methodologies can be improved and be more efficient. Digital advancements of
this methodology can reduce costs, enhance patient safety and increase the pace of the
traditional methodology, thereby making it more efficient. Bayanno Hospital Management
System is one of the many products created by the developers at codecanyon.net. It is a
complete multi-language supported management software for hospital, clinic and medical
institutes. It supports desktop, laptop, Smartphone and tablet devices. It integrates and
facilitates seven types of user area of a hospital, namely Administrator, Patient, Doctor,
Nurse, Pharmacist, Laboratories, and Accountant. The software also includes a security
feature which is claimed to be insusceptible to threats such as SQL-injection, XSS attacks
and CSRF (Codecanyon.net, 2014). Improvements made by the proposed system regarding

15
Bayanno Hospital Management System include reduced possibility of data redundancy,
and cost effectiveness. Calorisplanitia Hospital Management System has the following
features: Registration, Patient Check in / Check Out, Out-Patient, Patient Record
Maintenance, and Billing. Registration: users are able to register, add, update and delete the
records from the system with username and password protected proper privileges,
according to organizational hierarchy; Patient Check in / Check Out: (IPD): new patient
gets admitted with unique records, including the room reservation, case papers, check out,
billing, and other details, generated for each patient. Out-Patient (OPD): the system
generates a unique record, including case papers, billing, and other details, for each out-
patient patient. Patient Record Maintenance: the system maintains a detailed record of each
patient. Billing: the entire detailed bill for each patient is automatically created
(Calorisplanitia.com, 2014). Sanjeevani Hospital Information Management System is an
integrated health management system, which addresses the critical requirements of
hospitals. It is a powerful, flexible and easy to use application designed and developed to
convey real conceivable benefits to hospitals and clinics which reduce the paper overload.
It streamlines the flow of information across the hospital that helps effective decision
making for patient care, hospital administration/management and streamline financial
accounting in an optimized and efficient manner. It could also be customized to the
requirements of a hospital. It is a platform independent, browserbased application
developed on .Net technology using 3.5 frameworks with MS-SQL as the database. It has a
user friendly Graphical User Interface (GUI). Its features include Hospital Administration,
Out- and In-patient Management, Emergency Patient Management, and Laboratory Tests,
among others (Centre for Development and Advancement of Computing, 2014). The
proposed system adopts this systems‟ ideology of emergency patient management. Most
existing healthcare management systems are too generalized. This may result in
omission/abstraction of necessary information which can result in horrendous
consequences. Fortunately, through specialization, said consequences can be avoided and
this is why a patient management information system is needed. It can be considered a sub-
system of a healthcare management system that specializes in managing patient
information effectively. OrangeHRM offers a flexible and easy to use Human Resource
Information System (HRIS) solution for small and medium sized companies free of charge.

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By providing modules for personnel information management, employee self-service,
leave, time and attendance, benefits and recruitment companies are able to manage the
crucial organization asset - people. The combination of these modules into one application
assures the perfect platform for re-engineering and aligning HR processes along with
organizational goals (OrangeHRM, 2013). Fedena is multi-purpose school management
software which is used by thousands of educational institutions worldwide for all
administration, management and learning related activities. Fedena school management
information system is used to manage students, teachers, employees, courses and all the
system and process related to running learning institutes efficiently (Fedena, 2013).

2.4 Summary of related works and knowledge gap

Computers are finding their way into every business, industry and research activity today.
The use of computers is diverse, such as in entertainment, education, problem solving,
research, personal management, among others. In hospitals, the process of maintaining the
record of patients and employees working in the hospital, calculating bills, and so on,
requires processing and record keeping in different departments. Keeping in view a strong
need for managing the various important information fast and efficiently, Patient
Information Management System (PIMS) has been designed and developed. Proper
analysis and assessment of the developed system indicates an efficient, usable and reliable
records-management system, which adequately meets the minimum expectations that were
set for it initially. The application scope, though, could be widened to accommodate entire
hospital records management. The system can also be further enhanced so that the patients
themselves can be able to access their information in a secure manner for the purpose of
greater doctor-patient transparency.

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 CHAPTER THREE

3.1 Application Area

This application is only specified and applied to COOU clinic

With regards to the operation of the system, it was assumed;

• That the system shall be used ONLY by the students/staff of COOU clinic.

• That every system user shall have a unique username and password which shall
be assigned by the administrator.

• That the system shall be used to add, update and delete student records

• That the normal user shall not have the right to delete information from the
system

• That the operating system environment shall have a client-server architecture

With regards to the intended users of the system, the following suppositions were made

• That the end user shall have a basic knowledge of working with computers

• That the end user shall have a basic knowledge of some rudimentary medical
terms such as names of vaccines

• That the end user shall have a basic knowledge of the English language which is
used in the GUI and associated documentation.

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3.2 Discussion
Pioneering secure on line Hospital Record management and collaboration between doctors
clinical and hospital using secured internet transmission according to Mennel (2006). In this
project doctors are able to view patient medical records immediately at their private offices
using secure internet transmission. The project aimed at increasing competitiveness of the
medical profession by improving the accuracy of medical records and efficient retrieval and
usage of medical records. hospital medical records are very critical for doctors to establish
their diagnosis, with detailed and on-hand patients‟ medical records; doctors can make
appropriate medical decision efficiently. Security was a critical issue in the storage and
transferring of patient medical records between hospitals and doctors‟ offices. All clients
were authenticated with a 2 patient identity number

3.2.1 State of Art of Hospital Record Management System

Llan (2002) defined a medical record as confidential information kept for each patient by
heath care professional or organization. It contains the patients‟ personal details such as
name, address, date of birth, a summary of the patient medical history and documentation
of each event including symptoms, diagnosis, treatment and outcome. Relevant documents
and correspondence are also included. Traditionally, each healthcare provider involves in-
patient care kept an independent record usually paper based, the main purpose of the
medical record of the summary of a person’s conduct with the health care provider and
treatment provided to ensure appropriate health care, information from medical record also
provide essential data for monitoring patient care, clinical audit and accessing patterns of
care and services delivered. The management information system enables the medical
record to form a first link in the information chain producing the depersonalized aggregated
coded data for statistical.

3.2.2 State of Electronics of Hospital Record Management System

According to Murphy (1999), an electronic heath record (EHR) is a medical record or any
other information relating to the past, present or future physical and mental health or
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condition of a patient which resides in the computer that captures, transmits, receives,
stores, retrieves, link sand manipulates multimedia data for the primary purpose of
providing health care and health related services. It also includes patient demographic,
SOAP notes, problems, medications, and vital sign posts medical history, immunizations,
laboratory data and radiology reports. An EHR automates and streamlines the clinical
workflow. The EHR has ability to generate a complete record clinical patient encounter as
well as supporting other care related activities directly or indirectly via interface including
evidence based on decision support, quality management and outcome reporting.

Patient information system has benefits which accrue in the long run. According to Wang
(2003) the long term benefit of the health electronic record (HER), the united states of used
it to minimize a cost benefit per provider for having used an (HER) system over a five (5)
year period was estimated to be at $87000 and $330900 over a ten (10) year period. The
implementation of this project was likely to reduce the cost in the long run.

Advantages
According to Gordon (2006), the following are what he identified as the advantages of
computers- base information system. They are user friendly and the navigation is very easy.
They help in organizing and managing documents effectively. Since the data is stored in a
highly organized manner, accessing necessary data is very easy.

 It helps save time. People are able to access data needed in real time thus enabling
them access detailed information.

 Accurate, current and reliable data is provided. As data can be analyzed correctly
and plans made can be implemented at astounding speed due to proper automated
systems.

 They are installed to improve internal efficiency of the organization.

 They increase security and protect the data from being misused.

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  They are extremely useful, especially during disaster recovery, as paper documents
can be lost, causing business millions of dollars in losses.

Weakness
 Hackers: information sent by use of the internet can easily be hijacked and
terminated by unauthorized persons before reaching its destination.

 Virus: this can destroy files by replicating themselves in the document hence losing
the meaning of the file

3.2.3 Administration of Hospital Record Management System

The Hospital Record Management System is a system that can manage multiple users of
the system and can have the track of the right assigned to them. It makes sure that all the
users function with the system as per the rights assigned to them and they can get their
work done in efficient manner. It is a Customizable and strong administration system i.e.
changes of password of users at the administration point. The information management
system will be able to capture information about an old patient the information captured
will be easily managed by the administrators more easily.

3.2.4 Problems of Administering Hospital Management System

According to Gordon the following are possible problem to encountered while
administering HRMS It is not suitable for computer illiterate people The user must be a
member in order to make use of the system. The systems do not do away with paper work
completely; the papers are still used at some point

3.3 Summary

In the attempt to evaluate the designed system, it is imperative that the researcher look back
at the predefined functionalities, goals and objectives and analyze those in relation to the
expectations met by the system. The Records Management System was evaluated based on
the set of predefined objectives and expected functionalities it was able to fulfill. The

21
Records Management System was designed to facilitate efficient records management in
Chukwuemeka Odumegwu Ojukwu University by providing an efficient, reliable
computerized records management system and after a careful evaluation process; it met a
considerable portion of those expectations.

The main objective was to design a system that enables faster and more efficient storage,
retrieval and updating of clinic records. As far as this is concerned, the system met this
expectation by giving direct benefit to the clinic such as fast records retrieval. It also
included functionalities that enable all data entrants to access the system online with the
assumption that a client-server architecture is in place, retrieve records on demand and
execute important reports to support daily medical tasks.

Fundamentally, the effectiveness of this project depended on meeting the project’s specific
objectives which were as follows;
 To carry out a feasibility study for the possibility of developing a records
management system for the Medicals/clinic;
 To design and develop a records management system for the Medicals/clinic;
 To implement the records management system for the Medicals/clinic. All the
objectives were met by the system, to a certain extent;

Analysis was successfully completed. This evaluation is based on the fact that data requirements
were collected that successfully enabled the design and development of the system.

The system design and development was carried out in a systematic manner and was based on
user requirements defined by the end users. The design objectives of creating an efficient records
management system was further accomplished with the creation of add, delete, search and edit
functionalities in the system that not only enable computerized but rather efficient, reliable and
fast data entry. All these functionalities possess a relatively high level of accuracy. In evaluating
this objective in relation to the system’s performance, it would therefore be accurate to state that
it was achieved to a large extent.

22
Still while evaluating the system design and performance, the system enables the
synchronization of records through its server-client architecture with a single database.
Therefore, data entered from one recording station will be seen on another recording station
using the same system.

3.4 Conclusion

The hospital workers will be trained on the use of the Computerized Management System before
installing the software application on their desktop computers. The HMS will serve as a backup
to all records of the Manual System which will reduce data inconsistencies that arise due to
storage of the same records in different locations.

3.5Recommendations/Future Research

As well as addressing the limitations presented, there is scope for work to further the
functionality and usefulness of this project. The researcher therefore made the following
recommendations for future enhancements to the system.

Widening the scope

Given the limited amount of time given to the developer, the project’s scope was rather
limited to only one clinic in the hospital. The scope can further be widened to include all
the other clinics to make a more integrated comprehensive system that covers the entire
hospital’s records management

Including additional components and functionalities

A few other components can be included in the system in future. This may include the
ability to compute calculations especially when determining a patient’s next appointment,
this will make the system more efficient and drastically minimize the amount of errors. The

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ability to include an upload functionality for patient images could greatly enhance the
usefulness of the system.

Increased accessibility
The system can also be further enhanced so that the patients themselves can be able to access
their information online in a secure manner; this will lead to greater doctor-patient transparency.

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[6]. Kemoni, H. Managing Hospital Reords in Kenya- A Case Study of the Moi National
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[7]. Patton, M. (1990). Qualitative Evaluation and Reserch Methods (2nd Edition ed.).
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