CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

An Electronic Patient Management System is any tool used to assist in the delivery

of clinical care from point of care initiation to completion. Tools include computer

based attendance scheme for patient payment processing software and information

technology systems blood group and genotype to avoid test result mismatch of

data.Electronic based attendance scheme for Patients is used by hospital to create

process and record their attendance scheme for patient’s information. This system

is used to calculate the nurse punctuate to work. It’s an effective tool in the hands

of the hospital management.

Duty is a term that conveys a sense of moral commitment to someone or

something. The moral commitment is the sort that results in action and it is not a

matter of passive feelings or mere recognition. When someone recognizes a duty

that person commits himself/herself to the cause involved without considering the

self-interesting courses of actions that may have been relevant previously. This is

not to suggest that living a life of duty precludes one from the best sort of life but

duty does involve some sacrifice of immediate self-interest.Cicero is an early

philosopher who acknowledged this possibility. He discusses duty in his work “On

Duty”. He suggests that duties can come from four different sources:

1. It is a result of being human

2. It is a result of one’s personality place in life (your family country and job)

3. One’s own moral expectations for you can generate duties

From the root idea of obligation to serve or give something in return involved in

the conception of duty have sprung various derivative uses of the word; thus it is

used of the services performed by a minister of a church by a soldier or by any

employee or servant.Nurses today have a broad scope of responsibility as health

care providers that require them under some circumstance to exercise independent

professional judgment. When nurses exercise their judgment negligently they may

be held liable because courts hold them to a correspondingly higher level of

accountability.Nurses have been held liable for their failure to monitor and/or

promptly respond to patients by informing physicians of significant changes in

patient’s condition. Under these types of circumstance nurses have an affirmative

duty to exercise their professional judgment to ensure that all adequate steps are

taken to treat patients appropriately.

Usage of Information Technology (IT) remained comparatively very less in Health

sectors that other sector despite having more potential. Health Institution which is

an important sector should encourage IT usage resulting better productivity

effectiveness efficiency and economics leading to better health care of all. This

paper tells a success of implementation of ICT (Information Communication

Technology) in monitoring of medicine in health institution. System work on low-

end resources and E-mail (Electronic mail) based data transfer from District Head

Quarter to State Head Quarter.Implementation of Med-Centre in all the district of

Enugu result in checking on pilferage (the act of stealing amounts or small articles)

for medicine increase in availability of medicine at Government institution

increase in attendance of patients/doctor in health institution optimal utilization of

medicine and data capturing at source resulting in availability of error-free data at

Head Quarter.

Electronic Patient Management System is a certified automated payment

processing software. It is used by hospitals to input process and display their

patient information. This system is used to manage and maintain electronic

medical records patient information prescriptions lab reports etc. It is an effective

tool in the hand of the hospital management. Shonahan HospitalNsukka Enugu

which is the case study has patients whose fees are to be collected after treatment.

Shonahan Hospital Nsukka Enugu is one of the biggest and well equipped

hospitals in Nigeria. It has nine (9) training schools/programmers in the

hospital.From the studies carried out by the researcher the hospital’s initial means

of recording was manual from automated system to computerized system which

lacked some features such as patients and nurses records.

The Hospital is a very important part of our society and it is imperative for

healthcare providers to do their jobs in an efficient and effective manner. Each day

hundreds of thousands of patients enter healthcare facilities challenging the

administration to run the show smoothly. The employees have to manage and

integrate clinical financial and operational information that grows with the

practice.Information technology has made a significant impact on the healthcare

sector. The past decade has witnessed the foray of numerous information systems

and their resultant products into the hospital scenario. The number of investments

in computers and types of hospital systems has increased. This is because paper

medical records are cumbersome bulky to use and difficult to manage. On the

other hand digital records are much easier to handle and improve the workflow

efficiency by integrating various tasks. The ultimate objective therefore is to build

a network of interdependent centers such as the clinical laboratory radiology

department pharmacy and so on in order to effectively meet the needs arising

within the hospital. Despite the fact that these individual centers are autonomous

they are interdependent in terms of delivering services and to ensure effectiveness

of providing care. All this can be achieved through hospital information systems

that have formed the cornerstone of today’s modern hospital.

A patient is any person who receives medical attention care or treatment. The

person is most often ill or injured and in need of treatment by a physician or any

other medical professional whereas an outpatient is a patient who is not

hospitalized for 24 hours or more but who visits a hospital clinic or associated

facility for diagnosis or treatment. Treatment provided in this fashion is called

ambulatory care.

This Electronic Patient Management System is necessary to ensure the medical

practitioner to maintain its operations in an organized and well-coordinated

manner. These solutions save time and run the operations using the best

mechanisms against liabilities. This system is especially helpful in organizing and

keeping patient records up-to-date. Patient names records of treatment and

medicine given records are well maintained. Maintaining patient records is really

helpful when you are allowed to refer to the patient's old history. Say for example

you want to refer your old patients for mouth cancer or jaw piece ulcers and

cancers you may be able to locate such records on the basis of their symptoms or

conditions as you had entered in the database in the past. By law hospitals are

required to record in the outpatient information register once at the beginning of

the morning session and once during the afternoon whether the pupil is present

absent engaged in an approved or unable to attend due to exceptional

circumstances as defined in regulation. If compulsory hospital patients are absent

the register must show whether the absence is authorized or unauthorized. It must

also record the nature of any approved activities.By using this Electronic Patient

Management System the department will provide the patients with convenience

and security of having their payment records been stored automatically into the

database for further processing. This automated method is the most advanced and

least expensive way to maintain and process patient’s payment records. If a

patient’s payment record is not found in the database definitely that patient’s fees

has not yet been paid.

1.2 Statement of the Problem

Prior to the problem encountered with patient’s attitude to their check up and

treatment the nurse’s laxity (laziness) over their duties the need arose to develop a

software that will be able to solve the problem. The problem caused by the use of

manual method of keeping outpatient information and the use of manual method of

keeping attendance scheme for patients can only be solved by computerizing the

hospital attendance scheme for patients and computerizing the hospital outpatient

information system. The problems that this project is set to solve in the manual

method of keeping outpatient information are:

1. Improper documentation of patient payment record.

2. Difficulty in retrieving patient payment record.

1.3 Objectives of the Study

The primary purpose of this project is to enhance the reliability security and

convenience in the administration of Shonahan Hospital Nsukka Enugu and to

have a database that contains complete and comprehensive details of patient

departmental payment records as well as a computer based attendance scheme.

The subsidiary objectives of this project are:

1. To improve checkup and treatment load functionality: Staffing level and

appropriate skill-mix per shift can be more easily determined by the shift

modules. This leads to less time spent in designing and amending roasters.

2. Better care planning: Time spent on care planning is reducing while the

quality of what is recorded improved. This makes for more complete care

plans and more complete assessments and evaluations.

3. To facilitate diagnosis of patients thereby reducing patients wasting time

4. To exploit the use of ICT as a platform for medical services

5. To better drugs administration

6. For better maintenance of duty rosters

1.4 Significance of the Study

A patient management system works best as an early intervention; more success

was reported when targeted at more entrenched cases.While some patient’s care is

usually required the nursing supervisee’s new checkup and treatment include

setting up checkup and treatment schedules assigning checkup and treatment to a

nursing staff and ensuring that each member of the nursing team is adequately

trained.This means that they must ensure that nursing records are correctly

maintained that report is correctly given at each shift change that patient data are

up to date and that equipment and other supplies are in stock. Among these other

areas where this project work is significant include:

1. Reducingmortality rate arising from important administration in the medical

service.

2. Helping to determine how computerized of hospitals has contributed to easy

medical services.

Furthermore this work will serve as a reference work to students who are carrying

research on this topic.

1.5 Scope of the Study

The scope of this study is centered on designing anElectronic Patient management

system for patients. In fact it involves all parts of medical field in terms of record

keepings for patient’s records and all other aspect of field. However this project

has been limited to GOPD (General Out–Patient Department) which includes the

following areas:

1. Recording of patient health record

2. Acceptance of patient/personal symptom and compliant

3. Provisional prescription and treatment.

1.6 Definition of Terms

Computer: This is an electronic device that can accept data information of inputs

process the data and it have the ability to store the data and also retrieves it for

future use.

Data: These are groups of non-random symbols such as words figures values

which represent event and things that have taken place.

Database: This is the collection of related files.

Doctors: These are those that give medical aid to patients.

Duty: This is a term that conveys a sense of moral commitment to someone or

something.

Hardware: This can be defined as the physical component of the computer

system. Such as monitor keyboard printer mouse. Etc.

Hospital: This is a health facility where people who are ill or injured are given

medical treatments and care.

File: These are collection of related records.

Information: this is a data that has been processed into a form which is

meaningful to the recipient and which is of perceived value in either current or

prospective decisions or action by the recipient.

Management: This is the process of getting activities completed efficiently with

and through other people.

Nursing: This is a profession focused on assisting individuals families and

communities in attaining maintenance and recovering optimal health and

functioning. Modern definition of nursing defines it as a science and an act that

focuses on promoting quality of life as defined by persons and families throughout

their life experiences from birth to care at the end of life.

Records: These are collection of related fields.

Software: This is an application or program that can be run on computer.

Storage: This is a processing of storage data and information using storage media.

1.7 Project Work Organization

The report is explained in details from Chapter 1 which contains the preliminary

part of the project that discuss the procedures/methods used in carrying out the

research.