Design and Implementation of A Hospital Database Management System (HDMS) For Medical Doctors

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International Journal of Computer Theory and Engineering, Vol. 10, No.

1, February 2018

Design and Implementation of a Hospital Database


Management System (HDMS) for Medical Doctors
Amaechi James C., Agbasonu Valerian C., and Nwawudu Sixtus E.

A. The Need for Database Management Systems


Abstract—This paper aimed at designing and implementing
in Hospital
an automated system that will alleviate the problem of
handling patients’ data in a hospital. The researchers were All large enterprises need the database systems for
motivated to embark on this project because of the inherent handling the information [2]. One kind of those enterprises
problems of the manual system of hospitals file management. is the hospital. Because of large number of patients, doctors
This manual system has so many problems associated with it
and other staff in hospitals, data processing becomes more
such as insecurity of files, poor file retrieval system and
inefficient file update system etc. This paper examines an crucial. Data Management in hospital can be used for
existing information system of a hospital and designed an achieving the patient’s information, arranging the doctors
automated system that can help Medical Doctors and those schedule and accounting business. Doctors should access
who handle hospitals’ data to perform their work more the patient’s record for giving the best diagnosis to cure the
effectively and efficiently. The System would be developed with
patient [4].
a Window, Apache, MySQL and PHP (WAMP) software. The
HDBMS would be a web application that runs in a computer On the other hand patient can access their lab results and
network. It would provide easy and fast access to stored data all kinds of information that doctors indicate. Data base
as needed by different users with security against unauthorized hospital helps to control the accounting business easily.
access. Any authorized user can add, delete and update data
into the database base on their user-assigned-role. It would B. Functions Provided in the Hospital
equally have the facility to give a unique identity for every Database Management System
persons and stores the details of every patient and the staff In the database management system all information
automatically. It includes a search facility to know the current
status of each room in the hospital. A user can search including prescription, survey, and diagnosis of patients can
availability of doctors and the details of a patient using the be carried out [2].
system. The interface is very user-friendly. 1) All information includes prescription survey, diagnosis
of patients.
Index Terms—Hospitals, database, management, medical 2) The patients and the doctor can handle all information
doctors, patients, system. 3) Patients can take appointment time for visiting and can
access their information via interest if the organization
is online.
I. INTRODUCTION 4) Administration can access the statistics about the
hospital such as patients capacity, number of employee
Hospitals are key institutions and there is need for
etc.
efficient service delivery in the hospital as good health is
paramount to a happy society. As a result of this there is
need for a system that will enable hospital management in II. SOURCES OF DATA
making effective and efficient decision [1]. Recently, efforts
are continuously being made in designing and constructing a A. Observation Method
user friendly and reliable database system to satisfy hospital The researcher made several visits to the hospitals to
or medical management system [2], [3]. observe and analyses the mode of operation for the
On the other hand, many hospitals and medical centers management.
are still adopting the manual system of hospital management. B. Interview
These methods of medical management system have
The doctors and some of the personnel were interviewed
continued to pose a lot of setbacks and problems to medical
in order to acquire some facts that will help in building the
practitioners, nurses, patients and other staff in both
new system.
government and private hospitals.
C. Information from Published Sources
Pieces of information were gathered from many existing
Manuscript received November 25, 2017; revised January 23, 2018. publication on this subject. Several books and journals on
Amaechi James C. is with the Widow and Orphans Empowerment, 110
Pent City Estate, Lokogoma Abuja, Nigeria (e-mail:
hospital database management were consulted to get
berogu12@gmail.com). information that would be necessary for the designs of the
Agbasonu Valerian C. is with IMO State University, Nigeria (e-mail: new system.
valpraise@gmil.com).
Nwawudu Sixtus E. is with NESN Humanitarian and Research Initiative, D. Documentation and Events in the Hospitals
31 rue Berthelot 4210 Saint-Etienne, France (e-mail:
ezenwawudu@yahoo.com). Many hospitals are still adopting the manual system of

DOI: 10.7763/IJCTE.2018.V10.1190 1
1
hospital management. This method of hospital management you buy equipment to record and store patient charts (much
have continued to pose a lot of setbacks, and problems to more expensive than paper and file cabinets), but efforts
medical practitioners, nurses, patients and other staffs both must be taken to convert all charts to electronic form.
private and government hospitals. Patients may be in the transitional state, where old records
Thus, a good example of these hospitals that are yet to haven’t yet been converted and doctors don’t always know
adopt the automated system of hospital management is Our this. Further, training on the hospital software adds
Lady of Mercy Hospital in Owerri. A case day shows that additional expense in paying people to take training, and in
Mercy hospital has over two thousand patient in a week paying trainers to teach practitioners.
most of whom are out patient and they treat between 30 – 50 Also, some are concerned about the security of their
patients per day. medical records, which should be completely confidential.
Hackers may ultimately be able to penetrate the system
E. Organizational Structure of the Hospital
despite security precautions, and they may then release
The diagram in Fig. 1 shown below illustrates the confidential information to others. This has some patients
hierarchy structure of Our Lady of Mercy hospital. worried about how safe and confidential their electronic
medical records really are.

IV. SYSTEM PROPOSAL/PROPOSAL OF NEW SYSTEM


The proposed system is going to focus on the personnel
and patients management system. The proposed system is
also aimed at achieving computer management base system.
See the flow chart of the proposed new system in Fig. 2.

Fig. 1. Organizational structure of the hospital. A. Expectation of the New System


1) To fully automate the operation of the hospital and
As seen from the chart in Fig. 1, the hospital is made up managerial system in the hospital.
of the following personnel: 2) To improve and standardize practice planning of
1) Director (medical doctor). efficient and communication skill in the hospital.
2) Assistant (medical doctor). 3) To achieve good computing skills for the management
3) Office manager. and staff of the hospital.
4) The consultant medical doctors. 4) To improve the accurate record keeping in the hospital
5) Eight qualified nurses, two auxiliary nurses. 5) To provide timely access to patients and personnel
6) The receptionist. records.
7) The laboratory technologists etc.

III. METHODS OF KEEPING RECORDS


The hospital accumulates the files and records of patients,
stock and payroll and processes them after the space of one
month.
A. Input and Output System
The system constitutes of patients inventory which would
contain patients records arrangement or organized in file
and the general stores record which includes the input of the
quantity in stock the drug code, drug number and the
expiring date of each drug in database.
The output to generate from this system will be to update,
add, delete, clear, and provide summary of the total monthly,
yearly even daily records of events in the various
departments of the hospital. It will also produce the estimate
of report generated by very given module.
B. Files and Records
The files and records will both contain the detail of the
event carried out in every department as performed by each
particular module or form.
C. Problems and Weakness of the Current System
The problem observed in the current system has to do
with cost. The startup costs are enormous. Not only must

2
2) It offers the hospital accurate information on
management issues and provides bases for large
database.
3) It also exposes the user to the knowledge of computing.
The system put a stop to unnecessary waste of time in
carrying out operations in the hospital.
D. System Design
The objective is to fully automate the operation and
management of Our Lady of Mercy Medical centre, Owerri.
The scope of the system is to develop a database system that
automates all the activities of patients in the hospital starting
from their registration to their discharge from the hospital.
The system to be developed would have the following
modules as seen from the case study [5].
1) The Administrative module
2) The Receptionist module
3) The Medical Doctor Module
4) The pharmacy Module
5) The Nurse Module
6) The Lab-Technologist module
7) The Account module

V. PROGRAM STRUCTURE
The Hospital database application runs in a web browser.
It was specially customized for Mozilla Firefox and Safari
browsers. It welcomes user to the introductory screen of the
package with the following information.
1) The logo and banner of Our Lady of Mercy Hospital,
2) Login section at the left hand side, which is requesting
for the username and password of the user in other to
use the application,
3) Slides of pictures displaying various section and
equipment of the hospital at the centre of the
application,
4) And a summary information of the applicability of the
Hospital application.
Username and password are necessary for one to use the
application. If you click on login without providing the
Fig. 2. New system.
password, it will alert you to provide the password. Then if
you provide wrong username or password, it will inform you
accordingly without opening the system for you. It is
B. Justification of the New System designed to make use of e-mail addresses for username field.
This system is justified based on the cost of running the If you have a successful login process, the application will
manual system compared with the one of the automated enable a hyperlink that assign duties base on user role. For
system. instance the user role of a Nurse is different from that of a
From observation and interview through case study, we Doctor. A Doctor can prescribe a Drug to the patients
found out that the management spent much money on whereas a Nurse cannot.
buying files and folders stores for alter access, hence from
A. System Requirement
analysis, the hospital spent up to forty thousand Naira
(N40,000.00) on buying files and stationary every month. The system requirement includes the software and the
While the installation and running of this new system will hardware that make the package being developed to run
cost at most N400, 000.00 hence it is considered more effectively. It also requires networking devices that will
advantageous for the management. enable connection within a Local Area Network (LAN).

C. Advantages of the New System B. Software Requirement


The following are the out timed advantages of proposed The software requirements are basically for both the
system: server and clients. The server side requires Window Apache
1) It offers the hospital on management issues and MySQL PHP (WAMP), whereas the clients require only the
provides a base for large database. web browsers. The following are the list:

1) WAMP server 2) Web Browser (Mozilla Firefox or Safari)


3) Operating system (Windows XP, Windows 7) Null

C. Hardware Requirement 17 Passport Varchar(20) Not Patient


Null Passport
This affects the usability and functionality of database on
the hospital management system. The software runs on a 18 time_of_reg Varchar(20) Not Time of

standard hardware whether in time sharing network, Null Registration


mainframe or minicomputers, thus the hardware 19 Admin Varchar(30) Not The staff that
requirements are: IBM Intel or Microsoft compatible Null registered
computers. A hard disk capacity of at least 2 GB, random patient
access Memory (RAM) size at least 64MB. Pentium II of
speed at least 26Hz, Laser Jet/Desk jet Printer, CD/DVD TABLE II: PATIENTS TRIAGE
writers, CD ROMs for backing up files or DVD ROMs, A S/N Fields Data Type Relations Description
switch that connects all the client computers to the server, (Field width) hips
and network cables that connect all the hospital units to the 1 triage_id Varchar(5) Primary Each Triage
server. Key identity
2 patients_id Varchar(5) foreign Patients
D. System Input/Output Design Key identity
The input design for the patients record in the data entry 3 nurse_id Varchar(5) foreign Nurse identity

design shown in Table I, II, III and IV. Key


4 blood_pressure Varchar(20) Not Null Blood Pressure
TABLE I: PATIENTS RECORD
S/N Fields Data Type Relatio Description 5 heart_beat Int Not Null Heart beat
(Field width) nships
6 sugar_level Varchar(20) Not Null Patients sugar
1 patients_id Varchar(20) Primar Patient
level
y Key Identifier/Car
7 Height Varchar(20) Not Null Patients height
2 patients_firstname Varchar(30) Not Patients
8 Weight Varchar(20) Not Null Patients
Null firstname
weight
3 patients_lastname Varchar(30) Not Patients
9 time_of_reg Varchar(20) Not Null Time of triage
Null lastname
check
4 Age Int Not Patients age
10 Comment Varchar(200) Not Null Nurse
Null
comment
5 marital_status Varchar(10) Not Patients
11 Fee Int Primary Fee charge
null marital status
Key
6 Gender Varchar(10) Not Patients
null gender
7 Lga Varchar(30) Not Patients LGA TABLE III: PATIENT TEST
S/ Fields Data Type Relatio Description
Null origin
N (Field width) nships
8 State Varchar(20) Not Patients state
1 test_id Varchar(5) Primary Each Test
Null of origin
Key identity
9 home_address Varchar(100) Not Patients home
2 test_name Varchar(20) Not Test name
Null address
Null
10 resident_address Varchar(100) Not Patient
3 test_description Varchar(50) Null Test description
Null resident
Address 4 patients_id Varchar(5) Foreign Patients identity

11 phone_no Varchar(15) Not Patients key

Null Phone number 5 lab_scientist_id Varchar(5) Foreign Lab technologist

12 Email Varchar(30) Not Patients E- key identity

Null mail 6 doctor_id Varchar(5) Foreign Doctors identity

13 next_of_kin_id Varchar(5) Foreign Next of kin key

key Identity 7 Date_time Date/Time Not Date and time of

14 Comment Varchar(200) Not Receptionist Null test prescription

Null comment 8 return_date Date/time Not Return date

15 Symptom_ Varchar(200) Not Patients Null

sickness Null sickness 9 test_result Varchar(50) Not Test result

16 Passport Varchar(20) Not Patient Null

Null Passport 10 Comment Varchar(200) Null Lab scientist

16 Patint_type Varchar(20) Not In/Out Patient comment


11 Fee Int Not Fee charge
Null

TABLE VI: PATIENTS’ BILL


S/N Fields Data Type Relationships Description
of the system [6].
(Field width)
The program involves user interface, thereby making the
1 bill_id Varchar(50) Primary Key bill identity
developed package user friendly. The options are accessible
2 patients_id Varchar(5) Foreign Key Patients through popup menus at the hyperlink such as Doctor’s
identity popup menu where you get view patients, Diagnose patients,
3 doctor_charge Int Not Null subscribe drugs etc. Popup menus will only display options
4 medicine_charge Int Not Null base on your job description or user-role. The logout button
is always there beside the welcome message to allow a user
5 room_charge Int Not Null
to logout after usage.
6 operation_charge Int Allow Null
A. Testing and Evaluation
7 no_of_days Int Allow Null
First and foremost, the skeleton of the entire system was
8 nursing_charge Int Allow Null set up with a module for the initialization phase. After
9 Advance Int Allow Null
testing to verify accuracy, subroutines were added. Thus,
the systematic top down testing before the rest lager of
10 health_card Varchar(50) Allow Null
complexity was added.
11 lab_charge Int Allow Null Hence, during implementation, programmers worked on
12 Bill Int Not Null Total Fee modules in parallel and periodic testing and check
charge performance of the whole system allowed management
growth in complexity without introducing untraceable bugs.
This involves the training of user in the operation of a new
E. Database File Specification information system.
The files and records in the database are accessed by the B. System Change Over
following methods [3]. This process can be achieved in two ways:
1) Direct access 1) Gradual system change over
The access of files in the database by the use of key field 2) Direct/immediate or direct systems change over
or index. 1) Gradual system change over
2) Serial access This happens when the new system, run alongside the
This is accomplishing in a project with use of data control manual or old system and after a period of time the old
to move to the next previous first or last records in the system is phased out and the new system continues.
database. 2) Direct/immediate or direct systems change over
F. The System Development This involves changing over directly to the en system
The development of this hospital database management without any significant delay.
system was carried out following the procedures for C. System Maintenance
developing a system using system development life circle Maintenance function begins once the system is fully
(SDLC). implemented. This is the process of making modification
The system is already existing system of management in after the software has been delivered. This requires an
the hospital was identified, defined and followed by understanding of the program. This is achieved by clearly
identifying the problems, setbacks and bottleneck of the studying the program code and associated documentation.
existing system, hence the alternative solution to the There are usually two types of maintenance. Enhancement
problems, device and implementation to put the automated maintenance has to do with the modification of the software
system in place, following the identification and definition due to changes in the ever dynamic environment and
of problems in our lady of mercy hospital. Feasibility study corrective maintenance is carried out as a result of error
carried out to find facts will help in the modeling of the new discovered after delivering the software.
computerized system. More so, the new system has been
analyzed in terms of the problem and the setbacks facing it.
Hence the development of the system emerged. Perhaps, the VII. RECOMMENDATIONS
new system is also available for some operations like
Since data in the Medical Centre are so essential that the
updating and modification of the programs in future, hence
management cannot do without it, then we do suggest that
it is open for maintenance and well documented.
the management of Our Lady of Mercy hospital should as
much as possible ensure that:
1) There are backups for all files for security reasons.
VI. PROGRAM DESIGN
Each office has its own computer with a large memory
The program is designed as a web application that runs to run the program.
on web browsers, more especially Mozilla Firefox. The 2) Each of the offices should be networked in order to
entire program development is a set of program module, reduce the need to be moving files from one office to
each performing a specific task as shown in the general another and also to save time.
structure 3) Uninterruptible power supply (UPS) with Inverter
should be provided for every computer to reduce the
rate for hard disk or system failures. [4] D. L. Kusis, The Medical Philosophy, Texas University of Medicine
4) Adequate power generating means should be provided Texas, USA, 2002.
to meet up with demands. [5] C. S. French, Computer Science, 5th ed. 1996.
[6] C. O. ANI, Assembly Language Programming, Immaculate
Publication L. T. D Enugu, 2002.

VIII. CONCLUSION James C. Amaechi is a graduate of computer science


from Anambra State University of Science and
The developed system and its evaluation so far have been Technology, Uli, Anambra State, Nigeria. He
carried out to improve the database system and management currently works at Widows and Orphans
Empowerment, Abuja, Nigeria.
processes in Our Lady of Mercy hospital. Thus, care was
taken to handle the way information about the hospital and
patients were treated from the first.
Usually, as the population of an area increases and the
database gets bigger. Hence, the Hospital database
Agbasonu Valerian C. (Ambp) is a lecturer of the
management needs to be improved or upgraded to meet any Department of Computer Science at Imo State
situation. It is capable of storing variety and large volume of University Owerri. He has the PhD in
computer/information system from American
database. More so, the software has been designed to
Heritage University of Southern California USA; the
include program modules to handle the Medical Centre PhD in computer science from the Imo State
information such as patients’ data, supply (drug) University Nigeria; the M.Sc. in computer science
from the Ambrose Ali University, Ekpoma, Nigeria;
management, patients bill etc. the PGD in computer science from Federal
Thus, this software contains the database files of hospital University of Technology/CCE Owerri; the PGD Education and B.Sc. hons
database file of Our Lady of Mercy Hospital and will in statistics from University of Nigeria, Nuskka.
Dr. Agbasonu has authored and co-authored many textbooks and
provide the necessary information of the hospital and also published many articles in reputable local and international journals. He is
will be compatible, accurate, flexible, secured and efficient a member of many professional bodies like Computer Professionals of
for the desired purpose it is to serve. Nigeria (CPN), International Society of Telemedicine and eHealth
(ISFTEH).

REFERENCES Nwawudu Sixtus Ezenwa was born in 1979. He has


[1] C. C. Oparah, Genesis of Computer, Nigeria Pradses Books & Press, the B. Tech degree in computer science, diploma in
2006. French language, culture and civilisation from
[2] J. I. Abdullahi, Introduction to Computer Management Tool, Nigeria Université Jean Monnet, France, the M.Sc. in
Victory Publishers, 2004. biometrics, optics, image, vision and multimedia
[3] E. H. James and J. J. Cimino, Biomedical Informatics: Computer from Université Paris -Est, Créteil (UPEC), France.
Applications in Health Care and Biomedicine, 3rd ed. New York: His current research interests are image and signal,
Springer, 2006. data mining, 3D visualization, bioinformatics, image
and signal, e-medicine etc.

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