CHAPTER ONE

INTRODUCTION

Nowadays many systems have been developed to make life easier. The system

will include database that will record all the data. For the private hospital, usually they are

using digital system to record the patient information and other information that related to

the hospital. There are many systems for clinic record management system, but it does

not meet the local user requirement that is still new in the electronic system. Here, it will

be more explanation of the system.

A system is an essential program that collects and stores data. An electronic

medical record system (EMR) is one of its examples. EMR is a system that contains all

of a patient’s medical history. It is designed to represent data that accurately captures the

state of the patient at all times. It allows for an entire patient history to be viewed and

assists in ensuring data is accurate, appropriate and legible.

Clinic record management system is a one(1) of the system that needed in the

nowadays management. The clinic record management is the system that has been

applied in the hospital management. In the hospital management have been divide into

few phase which are registration, ward, blood bank, pharmacy, EMR (Electronic Medical

Report), and staff management.

Many hospitals still used the paper usage to record all the medical report about

any patient. If the doctor needs the information the staff has to find the information and

give to the doctor. This process takes a few times only to search report of all the patient

treatment. This EMR module facilities the user or the doctor to record the patients' details
about the present illness and the past history. User or doctor has to enter the data using

clearly defined work flow. In the EMR system all the details about the patient has be

retrieving from the other department example from the blood bank,

This information very useful to the doctors or the user to refer all the history

information about the patient. In the EMR system there has the search part which help

the user to find the specific patient and after that they can viewed all the details about the

patient. The EMR system also has to come with the manageable database that can record

the database in the efficient way.

Background of the Study

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

to be done efficiently and effectively the existences of Clinic Record Management

System (CRMS) become necessary. The used of CRMS can enhance the services

and also the work flow of all activity that happens in a clinic where it helps in reducing

the workload of medical staff, the number of man power needed and it also make clinic

management become more manageable and easier to control. The main objective of

this research work is to design a computer base program that will cover all the aspects

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

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

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

clinic. The program will be used for proper handling of patients’ records and related

information in the clinic, the record file, date of appointments, Doctors in charge and
 other related medical information will be entered into the program. Which is stored in

a database that can be accessed easily within a short span, and yet securely stored

in an appropriate and stress free manner.

According to the quote, “Health is wealth”. It is essential that we have a healthy

body to enable us perform our everyday task and keeping track of it is very importance.

In every school, it is vital to have a system that tracks the medical transactions of its

students. That is why the researchers came up with the idea of making a school clinic

medical record system.

With a medical record system, you can gather and manage all that information in

one easily accessible location.

RECORD MANAGEMENT;

According to the (National Archives of Scotland) Records management is the systematic

control of an organization’s records, throughout their life cycle, in order to meet

operational business needs, statutory and fiscal requirements, and community

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

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

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

management is the foundation layer of all information systems. Management of patient

data, through the proper control of the content and the storage and retention of the

records, reduces vulnerability to legal challenge or financial loss and promotes best

practice through greater coordination of information.

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

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

be found when needed, and then used effectively. Accurate recording and knowledge of

the where about of all records is essential if the information they contain is to be located

quickly and efficiently. One of the main reasons why records get misplaced or lost is

because the destination is not recorded.

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

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

practice which they deliver and to which they contribute. Good practice in record

management is an integral part of quality of the clinical care.

1.2. Statement of the Problem

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

healthcare sector failure. The manual handling of the patient files has led to undue delays

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

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

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

retrieve long consult patients’ records, loss of records or files, alteration of information

etc., result in unnecessary delay of treatment which even sometime leads to the death of

the patient.

Before this, the management of the clinic is done manually. There are some

problem arise especially for the data retrieval. Clinic has a problem of loss of patient data.

There is also redundant patient data if the patient not sure whether they have come to
the clinic before. So the clerks consider the patient as a new patient and add new data.

Currently, the inventory for the medicine is done manually. The management of the clinic

also has to takes times to check for the medicine inventory.

The EMR system is the one of the most important application if it can be applied

to the hospital management system. The EMR include all the details of each patient begin

with the first time they get the treatment until now. Usually, before this all the information

about the patient will be safe by writing in a piece of paper.

The paper has been kept in the place that has been placed all the report paper of

the patient. If the report need to be used the staff need to find the report in the specific

place that contains all the patients information in the hospital.

1.2.1. Overview of the Current System

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

system. Where all information is being collect using form and all data is being kept in the

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

1.3. Research Questions

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

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

management system in the Ahmadu Bello University Sick-bay.

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

human error in the process of the records.

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

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

1.4. Aims and Objectives of the Study

When developing the system, some objective has been outlined. First, to fulfill the

requirement for the final year project (TMP 3012).From the technical view, the system will

help to make it easier to maintain the record of patient, doctor and medicine. It will help

to reduce the number of lost record for the patient. At the same time, it will improve the

data retrieval. It will be easier for the staff of the clinic to retrieve back the record of existing

patient and doctor may view the patient history. For the doctor, it will record all the profile

of doctor if the clinic has more than one doctor. Furthermore, the inventory modules for

the medicine will help in check the balance medicine and the information of the medicine

such as medicine manufacture and price. The system will display if the medicine is

running out of stock. The most important thing is the management can view the payment

record for the clinic. At the same time, the system may generate report for the operation

of the clinic. For example, report about the number of patient per day and total income for

the clinic per day.

This study aims to produce a medical record system of school clinic that contains

student’s personal information, medical history; medicine log and daily transaction that

will help the clinic personnel to provide a real-time data access and monitors the status

of every patient of the school.

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

efficient records keeping in the clinic. While the objectives of this study are as follows:-
a. To find out the challenges associated with the current patient’s record management

system in the Ahmadu Bello University Sick-bay.

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

the clinic.

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

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

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

clinic.

1.5. Significance of the Study

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

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

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

patients’ information. The program will be a web base program that will enable a quick

access to patient’s record globally in case of emergency. And will also provide adequate

security to patients records in which only authorize users can have access to the system

with username and password. The program will also provide an adequate scheduling for

both the doctors and the patients, in which appointment has to be made by the patient

before visiting the doctor.

The clinic record management system will improve clinic operation for both staff

and the Patient For the staff, it will make it easy during registration process. If the patient

is an existing patient, they can easily retrieve back the record of the patient. For the doctor
they can view history record of patient. In case, if the patient allergy with the certain

medicine, the doctor will give an alternative medicine for the patient. For the management,

it will help them view the report operation of the clinic. The other thing is it will maintain

the account for the clinic.

Scope and Limitations

The purpose of this study is to help the school clinic personnel to have a record system

which holds student’s personal information, medical history, medicine log and daily

transaction that can be easily access and updated. It makes the transaction faster, easier

and more accessible. The limitation of this study doesn’t involve medical billings and any

dealings outside the school, only within the school premises. The system is only

accessible by authorized persons

Scope of the Study

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

While the specific scopes of the study are as follows:-

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

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

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

will be design using hypertext pre-processor (PHP) and the relational database MYSQL

as the programming language tools.

d. The program will also have four (4) interfaces (Modules) which are as follows:-
Appointment Interface – this interface provide all the details of the doctors in the clinic

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

appointment to see the doctor.

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

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

also update the patient’s medical records after diagnosing.

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

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

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

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

Limitation of the Study

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

are categorized into two:-

1. Researchers limitation and

2. The program limitations.

Researcher limitations

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

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

the program to be implemented in a working environment.

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

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

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

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

like Python, Ajax.

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

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

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

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

hard

Program limitations

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

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

nonprofit making institution.

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

used at some point.

Definition of Some Key Terms

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

a. Hospital: refers to an institution where people receive medical or nursing care.

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

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

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

medicine; physician.

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

advise on their use.

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

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

prescribes.

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

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

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

treatment.

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

technology; usually involving electronic hardware "automation replaces human workers

by machines"

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

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

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

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

diagnostic statement and the prescribed treatment.