chapter 3: discussion of findings

8/2/2019 Chapter 3: Discussion of Findings

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Bachelor of Science in Information Technology

Discussion of Findings

Emergency. Emergency cases are automatically taken

direct to an ER bed which would be seen by a nurse and/or

resident physician. Orders are carried and patients data

are taken.

Auxiliary Services. Auxiliary services consist of

laboratory, pharmacy, x-ray and dental. This would be done

once the Resident-On-Duty requested for any test to the

laboratory, X-Ray scans, prescribed medicines or for dental

consultation

Billing Section. Once the doctor permitted the patient

to be discharged and all of the patients charts were

filled, all of the charts would be checked by the Billing

Section to countercheck and compute the bills of the

patient.

Cash Section. The Cash Section counter check the bills

of the patient, check computation of bills and collect

payment and issues official receipt and gives final

clearance for discharge to the patient if the patient was

admitted.

In-Patient Service. Nursing care services provided for

the admitted patients. Nurses checks the vital signs, give

medications, carry out orders of the doctor, records

progress and charts of the patient.


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Figure 3

Patient Management Flowchart


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Problems in the Bacnotan District Hospital Information

System

Based on interviews conducted among the staffs and

nurses, supplemented with personal observation done by the

researchers the following are the identified problems along

the areas on data management and security.

The identified problems along the area on data

management are redundancy of data and limited storage.

Redundancy of data. Nurses are required to fill out

forms every time a patient visits especially if the patient

visited the hospital for the first time. Some of the forms

require the same data specifically the personal information

of the patient specially if the patient visited and has

records in the hospital. Another instance is when a patient

visits the hospital and the nurses and staffs could not

locate the record of the patient due to misplaced form, a

new form would then be required to fill out by the nurses

in order to replace the missing record. This process

results to data redundancy.

Limited storage. With the numerous number of records

stored in shelves the problem on limited storage arises.

Once a new patient visits the hospital for consultation or

admission additional records are being kept on shelves.


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Security of the Records. Records are kept in shelves

and it is easy to access because it is not stored in a

room. The shelves are just behind the desk of the OPD and

once a staff or nurse gained access to the records they can

disarrange the records and can cause problems in retrieving

the information of the information of the patient.

Features of the Proposed System

Based on the existing processes and problems

identified, the following proposed features are drawn to

give solutions to the problems encountered by the Bacnotan

District Hospital.

Login Page. This feature allow user to login to the

system. Only users with registered account are only allowed

to log in into the system and this would prevent other

people looking to the records of the patient.

Figure 4

Login Page Module


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Admin User Privilege. On the Admin User Privilege, the

Admin can Add User Accounts, Edit or Reset the Password of

the Users, Update the privilege of a user and delete

accounts. This would limit the users using the system

because only few users can use the system because only the

user with an admin privilege can add users that can access

the system, change the account privilege, reset password

and delete the account.

Figure 5

Account Registration Module


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Figure 6

Account Management Module

Management of Patient Record. This feature allows the

nurses and staff to manage the patient records. This

feature is used during data buildup of the system

especially to a new patient.

The management of patient information and records

comprises of registration of new patients and updating

patient information and record. The patient record would

determine if the patient would be confined or not based on

the findings of the physician that was inputted into the

system.


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Figure 7

Patient Registration Module

Figure 7 above shows the new patient registration

module.

Figure 8

Patient List View Module

Figure 8 above shows the list of patients registered

in the system.


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Figure 9

Patient Search Module

Patient Search. This feature allows searching for

patients that were registered in the database. This would

fasten in searching patient records especially if the user

has already an existing record in the hospital.

Figure 9 above shows the patient search module.


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View Patient Information and Record. Patients

individual information is shown in this page. Previous

records are shown also in this page and there is Add Record

module included if the patient returned to the hospital.

Figure 10

Patient Information Module

Figure 10 above shows the patients personal

information.


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Figure 11

Patient Record List Module

Figure 11 above shows the records of the patient from

the previous records to the current records.

Figure 12

Patient Add Record Module

Figure 12 above shows the Add Record form. This is

used if the patient returned to the hospital.


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Figure 14

Patient Admitted List Module

Patient Admission Management. This feature allows the

nurses and staff to manage the patient records who were

admitted in the hospital. This feature is used to keep

track of the patients by looking into their charts.

The management of patients that were admitted in the

hospital comprises of viewing the charts of the patient,

updating the charts, transferring the patient to another

ward or room and discharging the patient.

Figure 14 above shows the list of patients admitted in

the hospital


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the patient, the bed number and the ward where the patient

would be admitted.

Figure 17

Patient Admission Information and Record Module

Figure 17 above shows the complete patients

information and record taken.


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Figure 18

Therapeutic Form Module

Figure 18 above shows the therapeutic form where all

the therapeutics given to the patient is listed. On this

form, the form automatically shows a new form once the day

changes to make inputting data much easier.


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Figure 20

History and Physical Form Module

Figure 20 above shows the History and Physical

Examination form. The nurse or doctor would input the

information they got from examining the patient. This is

one of the basis for checking the medical history of the

patient.


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Figure 21

Doctors Orders Form Module

Figure 21 above shows the list of orders from the

Attending Physician of the patient. There are options if

the order was carried, administered, request made, endorsed

or discontinued.


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Figure 22

Progress Notes Form Module

Figure 22 above shows the progress notes form. Nurses

input the progress of the patient.

Figure 23

Nurses Notes Form Module

Figure 23 above shows the nurses notes form. Nurses

input their notes about the patient.


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Figure 24

IVF Consumption Form

Figure 24 above shows the IVF consumed by the patient.

The nurse would input the shift and time the IVF

consumption started the name of the IVF and the date and

time the patient consumed the IVF.


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Figure 25

List of Patients for Discharge

Billing Management Module. This feature allows the

Billing Section to manage the patient billing statements

who were admitted and ready to be discharge from the

hospital. This feature is used to keep track of the

patients billing statement.

The management of patients that were admitted in the

hospital comprises of automatic calculation of the expenses

of the patient depending on the case of the patient,

discounts and benefits of the patient.

Figure 25 above shows the list of patient that was

already cleared and ready to be discharge.


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Figure 26

List of Previous Patients Discharged

Figure 26 above shows the list of patients that were

already discharged. This is used to keep track of the

previous billing statements of the patients.


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Figure 27

Billing Statement Form Module

Figure 27 below shows the form for creating the billing

statement of the patient. The form automatically computes

the bill of the patient


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Figure 28

List of Available Doctor Module

Doctor Management Module. This feature allows the

nurses and staffs to manage the doctors information. This

feature is used to keep track if theyre On-Duty, On-Call

or On-Leave.

The management of doctors in the hospital comprises of

doctor information with their contact numbers, duty,

specialization and position in the hospital

Figure 28 above shows the list of available doctors

that were On-Duty or On-Call.


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Figure 29

List of all Doctors Module

Figure 29 above shows the list of all of the doctors

working in the hospital.


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Figure 30

Add Doctor Module

Figure 30 above show the add doctor form where the

only user with Admin privilege can add a doctor to the

system.


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Figure 31

Doctors Information Module

Figure 31 above shows the doctors information

with its specialty, contact number, address and duty

status.

Figure 32

Doctors Current Patient List Module

Figure 32 above shows the list of current patients

handled by the doctor.


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Figure 33

Doctors Previous Patient List Module

Figure 33 above shows the previous patients handled by

the doctor.

Figure 34

User Information Module

Account Management Module. This feature allows the

user to manage his account. The user can view the users

information, login history, change the users password.


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Figure 34 (see page 65) shows the users information.

Figure 35

Account Settings Module

Figure 35 above shows the Account Settings module

where the user can view his login history and change his

password.


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Figure 36

Add Therapeutics Module

Figure 36 above shows the Add Therapeutics Form where

the user can add therapeutics by inputting the name of the

therapeutic, type and price the price.


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Figure 37

Add PhilHealth Pricing List Module

Figure 37 above shows the Add PhilHealth Pricing List

where the user can add a PhilHealth price list. The user

would input the membership type and the amount for each

benefit a patient can get.


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Figure 38

PhilHealth Price List Module

Figure 38 above shows the PhilHealth Price List. The

system shows the list of PhilHealth benefits a patient can

get according to the type of membership.


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Figure 39

Data Deletion and Update Security Module

Data Deletion and Update Security Feature. The records

of the hospital are sensitive because once a data was

deleted it can compromise the findings and diagnosis on the

cause of illness of a patient. It can also create conflicts

once a patient consults and the patients records are

nowhere to be found even though the patient previously

visited the hospital. Once the user tried to edit or delete

a patient record, the system would prompt the users

username and password to confirm if the user has the right

to delete or update patients records.

Figure 39 above shows the data deletion and update

security module.


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Figure 40

Use Case Diagram of the Proposed System


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Figure 41

Entity Relationship Diagram

Patient Doctor

Records

Admitted Charts

Bills

examines

has Fill-up

has

can be

has

1..* 1..*

1..*

1..*

1..*

1..*

1..* 1..*

1..1

1..*

1..1

1..* 1..*

1..*


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Database Scheme

tbladmissionaid, pid, rid, bednumber, roomno,

service, status, dateadmitted

PK: aidFK:-pid referencing to table tblpatients

-rid referencing to table tblpatientrecords

tblbed

bid, bednumber, roomno, roomtype,

pid, rid, aid, status,

priceperday, dateadmitted

PK: bidFK:-pid referencing to table tblpatients


-aid referencing to table tbladmission

tblclinicalface

cfid, pid, aid, rid, category,

nameofnextkin, relationshipkin,

addresskin, dateadmitted,

timeadmitted, datedischarged,

timedischarged, noofdays,

servicedept, ward, servicedept2,

did, admittingdiagnosis, wb, imp,

unmp, exp, ref, trans, hama, abs,

others, admittingphysician,

admittingclerk, disposition,

finaldiagnosis, complications,

surgicaldone, pathologicalreport,

residentincharge,

medicalspecialist,

seniorresidenthead,


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persondischarged, dateaddedform

PK: cfid

FK:-pid referencing to table tblpatients



-did referencing to table tbldoctors

tbldoctors

did, firstname, middlename,

lastname, title, specialization,

position, address, contact, duty,professionalfee, dateleave,

dateregistered

PK: did

tbldoctorsattendeddaid, pid, rid, did, task,

datetimeadded

PK: daid




tbldoctorsorderoid, pid, rid, aid, doctorsorder,

ordercarried, datetimeordered

PK: oid





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tblhistoryphysical

hid, rid, pid, aid, complaint,

presentillness, fcancer, ftb,

fhypertension, fmental, fblooddys,

heartdisease, fdiabetes,

fallergies, familyplanning,

genapp, skin, headbent, necklymph,

chestbreast, hrate, bp, rrate,

stomach, liver, gallbladder,

spleen, kidneyblad, genitalia,

spine, neurological, admitimpre,

doctor, dateadded

PK: hid





tblivfconsumption

cid, pid, rid, aid, datestarted,

shift, timestarted, ivfbt,

dateconsumed, timeconsumed

PK: cid




tbllogins lid, uid, browser, os, loginPK: lid

FK:-uid referencing to table tblusers


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tblnursenotesnid, pid, rid, aid, datetimeadded,

nursenotes

PK: nid




tblpastillness

iid, pid, rid, hid, aid, measles,

tb, malaria, arthritis, syphilis,

drugs, mumps, asthma, rheumatic,

typhoid, diarrhea, alcoholism,

mental, diabetes, cancer,

hypertension, blooddys, allergies,

others, previousop, children,

dateadded

PK: iid




-hid referencing to table tblhistoryphysical

tblpatientbills

pbid, pid, rid, aid, membership,

billingnumber, nurseonduty,

finaldiagnosis, drugsandmedicines,

supplies, laboratory, xray,

ultrasound, ecg, oxygen,accomsubs, professionalfee,

orfeedrfee, admissionfee,

wardservice, nebfee, ambulancefee,

phdrugsandmedicines, phsupplies,


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phlaboratory, phxray,

phultrasound, phecg, phoxygen,

phaccomsubs, phprofessionalfee,

phorfeedrfee, exdrugsandmedicines,

exsupplies, exlaboratory, exxray,

exultrasound, execg, exoxygen,

exaccomsubs, exprofessionalfees,

exorfeedrfee, exadmissionfee,

exwardservice, exnebfee,

exambulancefee, total, extotal,

status, datetimerecorded

PK: pbid




tblpatientrecords

rid, pid, dateofvisit, age,

timein, timeout, bp, cr, rr, temp,

weight, complaint, remarks,

foradmission, admit,

dateregistered

PK: rid



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tblpatients pid, firstname, middlename,

lastname, membership, sex, cs,

dateofbirth, opdnum, address,

placeofbirth, occupation,

contactno, religion, nationality,

dateregistered

PK: pid

tblphilhealthpricing

phid, membershiptype,

drugsandmedicines, supplies,

laboratory, xray, ultrasound,

ecg, oxygen, accomsubs,

professionalfee, orfeedrfee

PK: phid

tblprogressnotespgid, pid, rid, aid, datetime,

progressnotes

PK: pgid





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tbltheraconsumedtcid, pid, rid, aid, tid, shift,

given, givendate

PK: tcid




-tid referencing to table tbltherapeutic

tbltheranamestnid, therapeutic, type, price,

datetimeadded

PK: tnid

tbltherapeutictid, pid, rid, aid, theraname,

type

PK: tid

FK:-pid referencing tblpatients

-rid referencing tblpatientrecords

-aid referencing tbladmission

tblusers

uid, firstname, lastname,

username, password, priviledge,

department, dateregistered,

lastlogin

PK: uid


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Figure 42

Virtual Table of Contents of Bacnotan District Hospital

Information System


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63Discussion of Findings

As a summary, the existing processes in the hospital

patient management flow of BDH are focused on three areas

namely: storage, access, and security. Along on the area on

storage, the existing processes identified are filling out

of patient record and storing patient records on shelves.

Along the area on security, the processes are authorization

of user access, labeling of envelopes for records and

organizing of records.

The problems identified are redundancy of data,

limited storage for records, inefficiency in retrieval of

patient record, loss or misplaced charts and records, slow

pace of searching of records, unorganized filing shelves

and updating the patient records and charts.

The features drawn to give solutions to the problems

encountered include management of patient information,

management of patient records and charts, search engine

mechanism, automatic retrieval of patient records and

charts, automatic computation of bills and management of

user level.

The proposed system shall be a web-based user

interface which would run on an Intranet network

connection.

chapter 3: discussion of findings

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