DESIGN AND IMPLEMENTATION OF PATIENT MANAGEMENT SYSTEM

CHAPTER ONE
INTRODUCTION
1.1     Background of the Study
The goal of any system development is to develop and implement the system cost effectively; user-friendly and most suited to the user’s analysis is the heart of the process. Analysis is the study of the various operations performed by the system and their relationship within and outside of the system. During analysis, data collected on the files, decision points and transactions handled by the present system. Krishna medical center, luck now (K. M. C.) is a prestigious hospital situated in the heart of Hazrat Genj with a very large patient capacity. This number is increasing at a rapid pace with each passing day. The management of the hospital is concerned with the increasing effort in keeping records of the patient and recording their activities. Health is generally said to be wealth.  It takes healthy people to generate the wealth the nation requires for the general well-being of its people. There is therefore the need for adequate Medicare especially in the area of diagnosis and treatment of diseases.  Since there is a good relationship between the job output and health of the workers, a good Medicare is vital. Unfortunately, in most developing nation (including Nigeria), this adequate Medicare is lacking due to how standard of technological know-how and manual handling of most medical problems.  As observed by Lyiama H.C. and D.C.
Chukwu, “very often, people in developing countries who are critically ill are rushed abroad for special treatment because it is felt that Medicare facilities at home are inadequate. This is partly because computer – aided Medicare has become a reality in many developed countries”.  It is also a known fact that the production of qualified medical doctors and other medical personnel and consultants in on the increase, but his is not enough to meet the health needs of the increasing population.  The ratio of patients to a doctor is still high.
This situation creates problems, because proper and adequate medical attention of patients is far-fetched.  Nowadays, the low-income class is mostly affected.  Doctors hurry over their duties in order to attend to all the patients.  At the end of the day, they are tired and over worked. Considering the rate of population growth the medical care and facilities available, and the health needs of the people, computer-aided Medicare is in evitable for more accurate.  Furthermore with the present shift to an information society, it is necessary to anticipate the future use of a sophisticated electronic machine the computer. This is necessary because the computer is rapidly finding its way into every field of human endeavor, including medicine. Its application includes patient care and protection, clinical administration, intensive monitoring during emergencies, surgical operations, diagnosis and automation of medical records.  For instance, during a complex surgical operation as exemplified by Lyiama and Chukwu, “the computer monitors person being operated on, revealing all vital signs (pulse, blood pressure, breathing rate, etc) of interest to the doctors in the theatre, thus helping them to be more accurate and effective in what they are doing. Such a patient monitoring system can be with a video Display Unit (VDU), a keyboard for interactive inputs and an alarm”. The wide range of the use of computer is due to its versatility as a data processing machine and its ability to do things including complicated tasks faster, better and more accurately than human beings would.
1.2     STATEMENT OF THE PROBLEM
It has been observed that to receive medical treatment in most of our hospitals, the patients queue up for several hours from one unit of the hospital to another starting from obtaining a new hospital folder, or retrieving an old one before consulting a doctor, to the laboratory unit for lab test then to the pharmacy to get the prescribed drugs and so on.  With the manual processes involved in handling the patient most of them waste the whole day in the hospital.  Very often, patients leave their homes very early in the morning in order to be among the first group to see the doctor.  Otherwise, they may end up wasting the whole day without due attention. This situation is discouraging to most patients and sometimes forces them to turn to non-professionals or even resort to self-medication for quick recovery. Moreover, the volume of work for the hospital personnel is much. Patients outnumber the doctors, nurses and other medical personnel that too much are required from them.  In this regard, to examine all his patients for the day the doctor hurries over his work without adequate attention and expertise to his clients.  Still, at the end of the day he is exhausted.
In addition to this, the diagnosis and prescription depend on the doctor‟s memory and drug of choice. Their brains are often loaded with different diseases, signs and symptoms, complications and various drugs for their treatment and so on.  Some of which are very similar. To remember and process these huge information in his clinical work is very tasking.  For this reason accurate diagnosis and prescription may not always be obtained.
 
The keeping and retrieval of accurate records on patients are poorly carried out in most of our hospitals.  Files may be misplaced; the record in them may be wrongly filled.  Hence, it is not easy to obtain accurate and timely information or data. This is also the case with obtaining other medical information and data especially when new folders and numbers are obtained each year. Finally, the keeping of folder for each patient manually takes a lot of time and money and some of the information are redundant.  All these have net effect of loss of lives and inefficiency on the part of management.
1.3     OBJECTIVES OF THE STUDY
This study is centered on the following objectives.
 
1.  To examine the current procedures employed in our hospitals with regards to patients admission, diagnosis and treatment.
2.  To examine the associated problem(s) or flaws in the current system
3.  To improve on the already existing system by designing an efficient practical patient billing software, this is aimed at an accurate, faster and reliable patient‟s information system.
1.4     SCOPE OF THE STUDY
This research work is limited to patient‟s admission information system including treatments, bills and payments. The software developed will be carried out using Microsoft C# to manage the database.
1.5     LIMITATIONS
This project covers all aspect of Medical system with regards to patient‟s information. Due to time and financial constraint, the software developed excluded laboratory units.
1.6     SIGNIFICANCE OF THE STUDY
Several possible advantages to practical patient billing software System over paper records have been proposed which includes:
 
Reduction of cost
A vast amount of funds are allocated towards the health care industry. The computerized system is implemented, it will reduce the personnel cost.
Improve quality of care
The implementation of electronic health records (EHR) can help lessen patient sufferance due to medical errors and the inability of analysts to assess quality.
Promote evidence-based medicine
Computerized medical record provides access to unprecedented amounts of clinical data for research that can accelerate the level of knowledge of effective medical practices.
Realistically, these benefits may only be realized if the systems are interoperable and wide spread (for example, national or regional level) so that various systems can easily share information.
Record keeping and mobility
EHR systems have the advantages of being able to connect to many electronic medical record systems. In the current global medical environment, patients are shopping for their procedures.
1.7     DEFINITION OF TERMS
Electronic Health Record– An electronic health record (EHR) (also electronic patient record (EPR) or computerized patient record) is an evolving concept defined as a systematic collection of electronic health information about individual patients or populations
 
INFORMATION – Information is data, or raw facts, shaped into useful form for human use.
SYSTEM – A system is a combination or arrangement of parts to form an integrated whole, working together to achieve specific tasks. A system includes an orderly arrangement according to some common principles or rules.
Subsystem – A complex system is difficult to comprehend when considered as a whole. Therefore, the system is decomposed or factored into subsystems. Subsystems constitute the entire system. They are complete systems on their own but exit in another system called the complex system. Subsystems can be further decomposed into smaller subsystems until the smallest subsystems are of manageable size. The subsystems resulting from this process generally form hierarchical structures. In the hierarchy, a subsystem is one of a supra-system (the system above it).
Expert system: is software that uses a knowledge base of human expertise for problem solving, or clarify uncertainties where normally one or more human experts would need to be consulted.
Hospital information system (HIS): variously also called clinical information system (CIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. This encompasses paper-based information processing as well as data processing machines.
MIS- Management Information System is the system that stores and retrieves information and data, process them, and present them to the management as information to be used in making decision. It can also be defined as an integrated machine system that provides information to support the planning and control functions of managers in all organizations. By these definitions, MIS must serve the basic functions of management, which include planning, organizing, staffing, directing and controlling. Information systems that only support operations and do not have managerial decision making significance is not part of MIS.
MCS- Management Control system is a form of Information System used by the management of an organization to analyze each application of information system in terms of input, storage, processing and output. The MCS has functional subsystems such as the hardware system, the operating system, the communication system and the database system. Management control systems are human artifacts. This means that MCS exits only because human beings design and build them.