DECLARATION

I, UMUTONI Marie, declare that this study entitled “E-PATIENT MEDICAL

TRANSFER SYSTEM“ is my own work and to the best of my knowledge, it contains no
materials that were previously published or written by any other person nor material which
to a substantial extent has been accepted for the reward of any other degree or diploma at
CUR or any other educational institution except where due acknowledgement was made.
Any contribution made to the research by other is explicitly acknowledged in the report.
UMUTONI Marie: 1CUR18AK05412

Signature…………………………………….

Date……………………………………

i
APPROVAL

I, undersigned, certify that this dissertation has been conducted under my supervision
and has been submitted with my approval
Signature

Supervisor: Mr. Jean Marie Vianney

NSENGIYUMVA Date….…/……/………

ii
DEDICATION
 To the almighty God
 Our families
 Classmates
 Friends and colleagues
 We dedicate this final year project of ours

iii
ACKNOWLEDGEMENTS
First and foremost, i heartedly thank the Almighty God for the gift of life and spirit of hard
working that he always provides us especially in this period of concentrating to project work.

I am deeply indebted to give special thanks to my supervisor Mr. NSENGIYUMVA Jean

Marie Vianney whose help, stimulating suggestion and encouragement helped me in all
time of the research project and writing this report. I am very grateful to her for her careful
and close supervision of this project to make it a success.

I am grateful to all Lecturers of computer science Department for the knowledge extended to
me through the two years and half of extensive career shaping and skills development.

Love and sincere appreciations go to my family and relatives that have trimmed my discipline
to be the moral people that i am today and for their financial support to fulfill the requirement
to this project.

I humbly wish to thank the Ministry of Education; Republic of Rwanda; together with the
Administration of CATHOLIC UNIVERSITY OF RWANDA for both Financial and
Academic help they have abundantly offered for all the years in the College.

More thanks goes to my friends and classmates for their everyday advices during this
working period, contributed to our academic success.

May God bless you all!

iv
LIST OF ACRONYMYS, SYMBOLS AND ABBREVIATIONS
ICT : Information Communication and Technology

IPRC : Integrated Polytechnic Regional Center

SDLC : Software Development Life Cycle
CSS : Cascading Style Sheet

DBMS : Database Management System

EPMT : E-Patient Medical Transfer

HTTP : Hyper Text Transfer Protocol

HTML : Hyper Text Markup Language

IP : Internet Protocol

IT : Information Technology

MySQL : My Structured Query Language

PHP : Hypertext Preprocessor

TCP : Transfer Control Protocol

URL : Uniform Resource Locator

VUP : Vision Umurenge Program

WWW : World Wide Web

XAMPP : Extended Apache MySQL, PHP, Perl.

v
Table of Contents

DECLARATION........................................................................................................................i
APPROVAL..............................................................................................................................ii
DEDICATION..........................................................................................................................iii
ACKNOWLEDGEMENTS......................................................................................................iv
LIST OF ACRONYMYS, SYMBOLS AND ABBREVIATIONS...........................................v
LIST OF FIGURES..................................................................................................................ix
LIST OF TABLES.....................................................................................................................x
ABSTRACT..............................................................................................................................xi
CHAPTER 1: GENERAL INTRODUCTION...........................................................................1
1.1 INTRODUCTION.......................................................................................................1
1.2 BACKGROUND OF THE STUDY............................................................................1
1.3 PROBLEM STATEMENT..............................................................................................3
1.4.1 GENERAL OBJECTIVES........................................................................................3
1.4.2 SPECIFIC OBJECTIVES.........................................................................................3
1.5 SCOPE OF THE PROJECT.............................................................................................4
1.6 HYPOTHESIS OF THE STUDY....................................................................................4
1.7 METHODOLOGY...........................................................................................................4
1.8 ORGANIZATION OF THE PROJECT...........................................................................4
1.9 SIGNIFICANCE OF THE PROJECT.............................................................................5
CHAPTER 2: LITERATURE REVIEW...................................................................................6
2.1 INTRODUCTION............................................................................................................6
2.2 PATIENT.........................................................................................................................6
2.2 PATIENT MEDICAL TRANSFER................................................................................6
2.3 INFORMATION SYSTEM CONCEPTS........................................................................6
2.3.1 SYSTEM...................................................................................................................6
2.3.2 INFORMATION.......................................................................................................7
2.3.3 INFORMATION SYSTEM......................................................................................7
2.4 DATABASE CONCEPTS...............................................................................................7
2.4.1 DATA........................................................................................................................7
2.4.3 DATABASE.............................................................................................................7

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 2.4.4 DATABASE SYSTEM.............................................................................................7
2.4.5 DATABASE MANAGEMENT SYSTEM...............................................................7
2.5 NETWORK CONCEPTS................................................................................................8
2.5.1 CLIENT/SERVER ARCHITECTURE.....................................................................8
2.5.3 DATABASE SERVER.............................................................................................8
2.5.4 WEB SERVER..........................................................................................................8
2.5.5 WEB BROWSER......................................................................................................8
2.5.6 WEB PAGE..............................................................................................................9
2.5.7 WEBSITE.................................................................................................................9
2.6 TOOLS AND PROGRAMMING LANGUAGE TO USE..............................................9
2.6.1 STRUCTURED QUERY LANGUAGE...................................................................9
2.6.2 MYSQL.....................................................................................................................9
2.6.3 HTML.......................................................................................................................9
2.6.4 XAMPP.....................................................................................................................9
2.6.5 PHP.........................................................................................................................10
2.6.6 JAVASCRIPT.........................................................................................................10
2.6.7 CSS..........................................................................................................................10
2.6.8 Notepad++...............................................................................................................10
CHAPTER THREE: SYSTEM ANALYSIS AND DESIGN..................................................11
3.1 INTRODUCTION.....................................................................................................11
3.2 DATA AND INFORMATION COLLECTION TECHNIQUES.............................11
3.2.1 Documentation...................................................................................................11
3.2.2 The observation..................................................................................................11
3.2.3 The interview.....................................................................................................11
3.3 Software Development Process Models.........................................................................12
3.3.1 Waterfall Model......................................................................................................12
3.3 EXISTING SYSTEM.....................................................................................................14
3.4 NEW PROPOSED SYSTEM........................................................................................14
3.5 Use case diagram........................................................................................................15
3.6 ANALYSIS OF NEW SYSTEM...................................................................................15
3.6.1 ACTIVITY DIAGRAMS FOR SYSTEM USERS.................................................15
3.6.2 SENQUENCE DIAGRAM.....................................................................................18
3.7 CLASS DIAGRAM.......................................................................................................19

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 3.7.1 CLASS DIAGRAM FOR ELECTRONIC PATIENT TRANSFERRING SYSTEM
..........................................................................................................................................19
3.7.2 DATA DICTIONARY............................................................................................20
CHAPTER FOUR: SYSTEM IMPLEMENTATION.............................................................22
4.1 INTRODUCTION..........................................................................................................22
4.2 HARDWARE REQUIREMENTS.................................................................................22
4.3 SOFTWARE REQUIREMENTS..................................................................................22
4.4 THE SYSTEM INTERFACES......................................................................................22
4.4.1 HOME PAGE..........................................................................................................22
4.4.2 Hospital home page............................................................................................23
4.4.3 Add and manage services...................................................................................24
4.4.4 Add and manage Doctors...................................................................................24
4.4.5 Doctor interface..................................................................................................25
4.4.6 Received patients...............................................................................................26
4.4.7 Treated patients..................................................................................................26
4.4.8 Health center interface.......................................................................................26
4.4.9 Transferred patients............................................................................................27
4.4.10 Feedback from hospital......................................................................................28
CHAPTER FIVE: CONCLUSION AND RECOMMANDATIONS......................................29
5.1. GENERAL CONCLUSION.........................................................................................29
5.2 RECOMMENDATIONS...............................................................................................29
REFERENCES.........................................................................................................................30

viii
LIST OF FIGURES
Figure 1. Waterfall model........................................................................................................13
Figure 2: use case diagram.......................................................................................................15
Figure 3: Activity diagram symbols.........................................................................................16
Figure 4: Activity diagram of admin........................................................................................16
Figure 5: Activity diagram of health center.............................................................................17
Figure 6: Activity diagram of health center.............................................................................17
Figure 7: Sequence diagram.....................................................................................................18
Figure 9: System index page....................................................................................................23
Figure 10: Hospital home page................................................................................................23
Figure 11: Add and manage hospital services..........................................................................24
Figure 12 Add and manage doctors.........................................................................................25
Figure 13: Doctor interfaces.....................................................................................................25
Figure 14: Received patients....................................................................................................26
Figure 15: treated patients........................................................................................................26
Figure 16: New patient transfer................................................................................................27
Figure 17: transferred patients.................................................................................................27
Figure 18: feedback from hospital...........................................................................................28

ix
LIST OF TABLES
Table 1: Data dictionary...........................................................................................................21

x
ABSTRACT
The main purpose of my project is to design and implement a system which handles the
problems encountered during patient transferring from health centers to hospital, so that
health centers are able to view the availability of different services from hospital, and
enabling the hospital to get information of transferred patient from health centers without
asking patient a transfer document, and also allow health centers to get feedback from
hospital on transferred patient after being threatened.

It is a web based system called “E-Patient medical transfer” which will be used by health
centers of HUYE district to transfer their patient to the hospital according to the availability
of doctors via the use of this implemented system, so that we can facilitate both health centers
and patients to reduce time and resources wasted in that process.
This research has been conducted under the use of different tools as data collection including
documentations, observation and interview to gather the necessary data helpful to the
realization of my project;
Internet has been used to extend the concepts provided by books and observation to view
what is done in reality and analyzes it for more information. The software development
methodology that will be used is the waterfall model.

xi
CHAPTER 1: GENERAL INTRODUCTION

1.1 INTRODUCTION

Nowadays, Information communication and technology (ICT) is playing a big role in daily
human life. It changes the way a work can be done more powerfully by maximizing
production and minimizing time spending or wasting. However, in our country many
institutions and organizations offer their services manually so that they require more time to
achieve their goals and purposes on time; this affects the development of the organizations
and institutions.

To reduce those lateness and time spending, the social economy of our country must be based
on the use of information communication and technology (ICT) to carry out their daily
activity. That is why i have got an idea of developing a web based system called “E-Patient
medical transfer” which will be used by health centers of HUYE district to transfer their
patient to the hospital according to the availability of doctors via the use of this implemented
system, so that we can facilitate both health centers and patients to reduce time and resources
wasted in that process.

1.2 BACKGROUND OF THE STUDY

During many years ago until now many institutions and organizations are still serving as they
did many years ago, while others which understands the impact of ICT are migrating from
manual to computerized system.

Rwanda’s Health Sector services are provided through the public facilities, government
assisted health facilities (GAHFs), private health facilities and traditional healers. The public
sector is organized into levels, the intermediate level consists of 11 provincial health offices
managed under health, gender and social affairs guidelines. The Public Health Department of
Kigali City also is in the intermediate level.

The peripheral level consists of district health offices. Each district has an administrative
office, a district hospital and primary health care facilities (health centers). The district
administrative offices are responsible for planning, managing, coordinating and evaluating on
a daily basis the activities occurring in the health district.

1
The challenges in the health sector include Rapid population growth, Inadequate government
funding to the sector and  low income levels of families in the rural areas which causes stacks
in the implementation of health information technology in Rwanda.
A paper-based and electronic system exists since 1997 to report the activity of health care
facilities, but Microsoft is not fully to satisfy services delivered by health systems in Rwanda
to their patients and their needs including medical transfer of patients from one level to
another level of health system.
Patient transfer has been being done since many years ago even on the international health,
where they transfer a patient with the aim of getting much treatments with high qualified
facilities. Even these process requires much time and resources for both parties’ such as
health centres and patients but most of the time it depends on manual system that have been
working for long period of time.

Health information technology in Rwanda is a quickly growing industry with many

stakeholders the national government, several nongovernmental organizations and the private
sector. Six health technologies are being implemented in Rwanda. The package of systems
aims to respond to the health-care needs of the population and to improve management of the
health system so as to gain in productivity. The first two programs in the following list are
already operational.

 TRACNet: monthly monitoring of infectious diseases including HIV/AIDS,

tuberculosis and malaria.

 CAMERWA: a drugs and medical supply management system handled by the

national pharmaceutical company.

 Open MRS: an open medical records system that tracks patient-level data.

 Telemedicine: ICT used to deliver health services and health-care information and
education to geographically separated parties.

 HMIS: health management information systems.

 E-learning for nurses.

Even if the above listed technologies are being implement don’t satisfy the processes and
procedures of transferring patients from health centres to hospital and delivering feedback to
health centres about patients’ conditions and treatments got.

2
1.3 PROBLEM STATEMENT

Today when it is required to transfer a patient to the hospital, health center makes a phone
call to the hospital and asks the available day so that they can transfer a patient to a specific
service; health center’s nurse uses a phone to ask on hospital when the doctor will be
available in specified service, and then hospital replies on him/her by telling the availability
of doctors within specific hospital’s service before writing a transfer document to the patient.
When a nurse misses a phone call to the hospital, write a transfer document to the patient and
tell him to go there by himself/herself to ask for an appointment with doctor, it writes a
medical transfer to the patient according to its choice where a patient can meet with a
problem of getting another appointment when arrives on the hospital and costing him/her
much time and resources of returning back again and again.

 The patient also can lose transfer document, when a transfer document from health
center is missing on the hospital, he/she cannot be eligible to be received by hospital
because they don’t have any other proof which confirms that you are transferred from
a certain health center.

 When a patient is received by hospital and treated, there is no feedback to health

center which describe how the patient has been treated or which treatments, medicines
and advices given to the patient.

1.4 OBJECTIVES OF THE STUDY

1.4.1 GENERAL OBJECTIVES

The main purpose of our project is to design and implement a system which handles the
above listed problems, so that health centers are able to view the availability of different
services from hospital, and enabling the hospital to get information of transferred patient
from health centers without asking patient a transfer document, and also allow health centers
to get feedback from hospital on transferred patient after being threatened.

1.4.2 SPECIFIC OBJECTIVES

The specific objectives of this project are the following:

• To develop a system that facilitates the hospital to set available days for each service and
maximum number to be received on day.

3
• To develop a system which allows health centers to record all required information of
transferred patient and automatically generate transfer document.
• To develop a system which notifies a hospital for new transferred patient and help it to
view his/her detailed information note
• To develop a system that can be used to send feedback on health center when a
transferred patient has been treated.
• To design and develop a system which allows health centers to get periodic report of
transferred patients, and facilitates hospital also to get periodic report of received patients
from different health centers by each service.

1.5 SCOPE OF THE PROJECT

This proposed project only focuses on health centers of Huye district and Kabutare district
hospital. It only deals with the process of transferring patient from health center to hospital
and exchanging the information related to medical transfers between health centers and
hospital.

1.6 HYPOTHESIS OF THE STUDY

This research project aimed to achieve the following hypothesis “Practically, it is possible to
develop e_ patient medical transfer system which can help health center of huye district to
transfer the patients from any health center to KABUTARE hospital and facilitates hospital to
view the information of patient who is transferred.

1.7 METHODOLOGY

This research has been conducted under the use of different tools as data collection including
documentations, observation and interview to gather the necessary data helpful to the
realization of our project;
Internet has been used to extend the concepts provided by books and observation to view
what is done in reality and analyzes it for more information. The software development
methodology that will be used is the waterfall model.

1.8 ORGANIZATION OF THE PROJECT

This research project is organized into five chapters:

4
  The first chapter is general introduction which deals with the introduction, the
problem statement, the general and specific objectives and limitation of the project
The second chapter deals with theories of the general concept, languages and tools to
be used in this research project.
 The third chapter describes the methodology used to collect data; it also deals with the
techniques and methods used in system analysis.
 The fourth chapter describes the system design which refers to the interoperability,
scalability, awareness of the system and implementation refers to the interpretation of
the system that can be considered as working principal of the system.
 The fifth chapter describes the conclusion of the research project and
Recommendation for using the system for future work.

1.9 SIGNIFICANCE OF THE PROJECT

The main interest of this project resides in the promotion of the use of ICT in our daily
activities which can ameliorate information management, data exchange and keeping the data
for long period of use.

This system is going to facilitate health centers of Huye district to simplify services delivery
to their patients and communication between them and district hospital.

5
CHAPTER 2: LITERATURE REVIEW

2.1 INTRODUCTION

This chapter is reviewing theories, to provide a short explanation about basic concepts and
terminologies as well as other research done in the area of online application systems that are
used during development of this project.

It deals with theoretical concepts and fundamentals that support this project’s development
and implementation. It also provides the general overview of E-patient medical transfer
which provides definitions, explanations and characteristics of technologies and tools used in
the development of this project.

2.2 PATIENT

Patient is a person who is ill undergoing treatment for disease, the rights of patient are
concerned by fully informed about his/her illness, the diagnostic, and the written records of
care providers such as health center or hospital. (medical-dictionary, 2017)

The patient has the right toconsiderate and respectful care, delivered in response to a request f
or services and in a manner that provides continuity of care such as to be transferred to
another entity or care provider.

2.2 PATIENT MEDICAL TRANSFER

It is an important aspect of patient care which is often undertaken to improve upon the

existing management of the patient. That may involve transfer of patient within the same
facility for any diagnostic procedure or transfer to another facility with more advanced care.

2.3 INFORMATION SYSTEM CONCEPTS

2.3.1 SYSTEM

A System is an orderly grouping of interdependent components linked together according to a

plan to achieve a specific objective. It is a collection of elements or components that are
organized for a common purpose (merriam-webster, 2016)

6
2.3.2 INFORMATION

It is the processed data which is meaningful. It is obtained as a result of processing,

manipulating and organizing data in suitable form for human interpretation and in fashion
that add to the knowledge of person and make sense to him. (merriam-webster, 2016)

2.3.3 INFORMATION SYSTEM

An information system (IS) is an arrangement of people, data, processes, communications,
and information technology that interact to support and improve day-to-day operations in a
business as well as support the problem-solving and decision making needs of management
(D’Atri A., De Marco M., Casalino N, 2008)

2.4 DATABASE CONCEPTS

2.4.1 DATA

Data are the values that are stored in the database. They are static in the sense that they
remain in the same state until they are modified to give them value and make them
meaningful system. (P. Beynon-Davies, 2002)

2.4.3 DATABASE

A database is a collection of information organized to provide efficient retrieval. Typically, a

database contains all the data that is associated with one application or with a group of related
applications. (M.A. Kahn, D.L. Rumelhart, and B.L. Bronson, 1977)

2.4.4 DATABASE SYSTEM

Database system is basically a computerized record-keeping system. It is a computerized

system whose overall purpose is to store information and to allow users to retrieve and update
that information on demand. (David and John, 2010)

2.4.5 DATABASE MANAGEMENT SYSTEM

Database management system is a set of programs that enables storing, modifying, and

extracting information from a database. (David and John, 2010)

7
2.5 NETWORK CONCEPTS

2.5.1 CLIENT/SERVER ARCHITECTURE

Client server architecture is a technology that separates computers and application

software into two categories clients, and servers to better employ available
computing resources and share data processing loads. (Sun Microsystem, 2009)

2.5.3 DATABASE SERVER

A database server is a computer program that provides database services to other computer
programs or computers, as defined by the client–server model. It can also be defined as a
server dedicated to providing database services. (Urlocker, M. Zack, 2005)

2.5.4 WEB SERVER

A Web server is a program that, using the client/server architecture and the World Wide
Web's Hypertext Transfer Protocol (HTTP), serves the files that form Web pages to Web
users (whose computers contain HTTP clients that forward their requests). Every computer
on the Internet that contains a Web site must have a Web server program.
(webdevelopersnotes, 2017)

Two leading Web servers are

 Apache , the most widely-installed Web server, and

 Microsoft's Internet Information Server (IIS).

2.5.5 WEB BROWSER

A web browser is an interactive software application for retrieving, presenting, and traversing
information resources on the World Wide Web. The purpose of a web browser is to read
HTML documents and compose them into visible or audible web pages. An information
resource is identified by a Uniform Resource Identifier (URI) and may be a web page, image,
video, or other piece of content. Some of the popular web browsers are: Internet Explorer,
Mozilla Firefox, Netscape, and Opera. (Jacobs, Ian; Walsh, Norman, 2009)

8
2.5.6 WEB PAGE

A web page is a web document or other web resource that is suitable for the World Wide
Web and can be accessed through a web browser and displayed on a monitor or mobile
device identified by an URL. (Web design , 2016)

2.5.7 WEBSITE

A Website is a related collection of World Wide Web (WWW) files that includes a beginning
file called a home page. A company or an individual tells you how to get to their Web site by
giving you the address of their home page. From the home page, you can get to all the other
pages on their site. (Cailliau, Robert., 2007)

2.6 TOOLS AND PROGRAMMING LANGUAGE TO USE

2.6.1 STRUCTURED QUERY LANGUAGE

Structured Query Language (SQL) is a standard programming language used for accessing
and maintaining a database. SQL is the set of commands that are used to create, manipulate
the structures in a relational database. Also, SQL is the most powerful way of retrieving the
data from database. (Oppel, Andy, 2004)

2.6.2 MYSQL

MySQL is an open source relational database management system (RDBMS) based on

Structured Query Language. (Mackmillan, 2016)

2.6.3 HTML

Hypertext Markup Language (HTML) is the main markup language for creating web

pages and other information that can be displayed in a web browser. HTML defines the
structure and layout of a Web document by using a variety of tags and attributes. ( Philippe le
Hegaret, 2016)

2.6.4 XAMPP

XAMPP is developed by Apache Friends to promote the Apache web server. XAMPP
Acronym is X or extended (Apache, MySQL, PHP, PERL); Apache Friends developed this

9
software to help the people to install and configure Apache web server along with MySQL,
PHP and Perl.

So, when we were releasing our project we used this software in order to be connected
together with Mysql database, PHP and Apache as a web server within local host. (Burton,
Richard Antony. , 2014)

2.6.5 PHP

PHP is a recursive acronym that stands for Hypertext Preprocessor. It is a scripting language
that's usually embedded in HTML of a web page to make it dynamic. When the page is
requested, the web server executes the PHP script and substitutes in the result back into the
page. PHP is a server side scripting language and a widely used programming language for
web and software product development. This is because it supports different databases like
MySQL which is an open source database management system. (Lerdorf, Rasmus , 2007)

2.6.6 JAVASCRIPT

JavaScript is a programming language that can be included on web pages to make them more
interactive. It is used to check or modify the contents of forms, change images, open new
windows and write dynamic page content. This allows us to make parts of our web pages
appear or disappear or move around on the page. (Haverbeke, Marijn, 2011)

2.6.7 CSS

CSS stands for cascading Style Sheet and is a software application used to format layout of
web pages. It can be used to define text styles, table sizes and other aspects of web pages that
could be defined in the HTML pages. CSS helps the web and application developers create a
uniform look across several pages of the website or of applications. (Meyer, Eric A, 2006)

2.6.8 Notepad++

Notepad++ is a powerful, feature-packed text editor that more or less has everything Notepad
needs but lacks (it can replace Notepad in Windows). It supports 27 programming languages,
searches regular expressions, and supports syntax highlighting and folding, synchronized
edits and views, and much more. (Gael, Arianna, 2015)

10
CHAPTER THREE: SYSTEM ANALYSIS AND DESIGN
3.1 INTRODUCTION

This chapter focuses on how project is developed. It deals with methods and techniques that
have been used in this project to collect the data. In any domain on which the research is
carried out, some specific methods and other techniques that the research is referring are
recommended. It refers to the theoretical analysis of the system development and data
collection techniques

3.2 DATA AND INFORMATION COLLECTION TECHNIQUES

3.2.1 Documentation

It is a technique of searching in books or other publications available in libraries or on-line

(internet) that help in finding data to be useful for the topic under the study. Here we have
make some documentations on previous projects and other related systems on internet where
we have found out that main tool simplifying the procedures of transferring patients from
one level to another is electronic patient medical transfer.
3.2.2 The observation

Observation is an action of an attentive follow-up of a phenomenon in order to draw a

conclusion. “Observation is either an activity of a living being (such as a human), consisting
of receiving knowledge of the outside world through the senses”. By the observation, the
researcher notes by his/her own eyes what is done in reality. It can bring some modifications
on the results got by other techniques. We have observed the existing process of transferring
patients from health centers to hospitals where we have found out many stacks and
challenges.
3.2.3 The interview

“The interviews are the most common and most satisfactory way of obtaining information
about the objectives, constraints, allocation of duties and problems and failures in the existing
system. This technique proved to be efficient in the development of our software while
analyzing the real situation of finance and while thinking about its future. We have
interviewed patients, health centers nurses and hospitals doctors.

11
3.3 Software Development Process Models
Software process models represent a networked sequence of activities, objects,
transformations, and events that embody strategies for accomplishing software evolution.
Such models can be used to develop more precise and formalized descriptions of software life
cycle activities. Their power emerges from their utilization of a sufficiently rich notation,
syntax, or semantics, often suitable for computational processing (John w. and Sons, 2001).

3.3.1 Waterfall Model

The waterfall software development process model is probably the oldest publicized model. It
is sometimes referred to as the classic software life cycle model. Although many
organizations utilize this model. The name of waterfall model is derived from the process it
represents; tasks occur sequentially one after another, with the output from one task dropping
into next task (“Jones and Bartlett”, n.d, para 4). Stages of the Waterfall Model Details are
listed below:
 Requirement Analysis and Definition: All possible requirements of the system to be
developed are captured in this phase. Requirements are a set of functions and
constraints that the end user (who will be using the system) expects from the system.
The requirements are gathered from the end user at the start of the software
development phase. These requirements are analyzed for their validity, and the
possibility of incorporating the requirements in the system to be developed is also
studied. Finally, a requirement specification document is created which serves the
purpose of guideline for the next phase of the model.
 System and Software Design: Before starting the actual coding phase, it is highly
important to understand the requirements of the end user and also have an idea of how
should the end product looks like. The requirement specifications from the first phase
are studied in this phase and a system design is prepared. System design helps in
specifying hardware and system requirements and also helps in defining the overall
system architecture. The system design specifications serve as an input for the next
phase of the model.

 Implementation and Unit testing: On receiving system design documents, the work
is divided in modules/units and actual coding is started. The system is first developed
in small programs called units, which are integrated in the next phase. Each unit is

12
 developed and tested for its functionality; this is referred to as unit testing. Unit
testing mainly verifies if the modules/units meet their specifications.
 Integration and System Testing: As specified above, the system is first divided into
units which are developed and tested for their functions. These units are integrated
into a complete system during integration phase and tested to check if all
modules/units coordinate with each other and the system as a whole behaves as per
the specifications. After successfully testing the software, it is delivered to the
customer.

 Operations & Maintenance: his phase of the model is virtually a never-ending

phase. Generally, problems with the system developed (which are not found during
the development life cycle) come up after its practical use starts, so the issues related
to the system are solved after deployment of the system. Not all the problems come
into picture directly but they arise from time to time and need to be solved; hence this
process is referred to as maintenance.

Figure 1. Waterfall model

13
3.3 EXISTING SYSTEM

The health centers of HUYE district are still transferring patients as they did many years,
where they use paper based system to record new patient who is transferred to the hospital
and uses phone call to request an appointment for him with a risk of missing the phone call
which may cause to transfer a patient without given appointment with doctor.

Hospitals also are still asking the patient, transfer documents form health centers where they
cannot receive a patient who forgot to bring the transfer document got from health center
because of not having the system which helps health center and hospital to exchange the data
and information.

Health center also are not able to receive a feedback which describes if their transferred
patient has been cared or threatened in order to make follow up about his/her disease.

3.4 NEW PROPOSED SYSTEM

According to existing system, we have found that it would be better to design a web based
system resolving the problems that challenging the current system.

The new implemented system first of facilitates hospital to set availability of doctors within
different services, so that the nurse of health centers will access the time table set in order to
transfer a patient to the hospital and giving a patient an appointment without asking calling to
the hospital.

The system also will be used to recognize receive the patients without asking them where
they come from or transfer documents from health centers, because they will already have the
data of sent patients from different health centers.

Also it is used by hospital to send feedback to health centers of treatments and cares given to
their patients they have sent in order to follow them up.

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3.5 Use case diagram
A use case diagram is a graphic depiction of the interactions among the elements of a
system. 

A use case is a methodology used in system analysis to identify, clarify, and organize system
requirements. In this context, the term "system" refers to something being developed or
operated, such as a mail-order product sales and service Web site. Use case diagrams are
employed in UML (Unified Modeling Language), a standard notation for the modeling of
real-world objects and systems. (whatis.techtarget.com, 2014)

Figure 2: use case diagram

3.6 ANALYSIS OF NEW SYSTEM

3.6.1 ACTIVITY DIAGRAMS FOR SYSTEM USERS

Activity diagram is another important diagram in UML to describe the dynamic aspects of
the system. Activity diagram is basically a flowchart to represent the flow from one activity
to another activity. The activity can be described as an operation of the system.

The control flow is drawn from one operation to another. This flow can be sequential,
branched, or concurrent. Activity diagrams deal with all type of flow control by using
different elements such as fork, join, etc

As we have seen our system has three users, which are administration, institution and
applicant.

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Symbols of activity diagram:

Figure 3: Activity diagram symbols

3.6.1.1 ACTIVITY DIAGRAM OF SYSTEM ADMINISTRATION

Figure 4: Activity diagram of admin

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3.6.1.2 ACTIVITY DIAGRAM OF DOCTOR

Figure 5: Activity diagram of health center

3.6.1.3 ACTIVITY DIAGRAM OF HEALTH CENTER

Figure 6: Activity diagram of health center

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3.6.2 SENQUENCE DIAGRAM
Sequence diagrams describe interactions among classes in terms of an exchange of messages
over time. They're also called event diagrams. A sequence diagram is a good way to visualize
and validate various runtime scenarios. These can help to predict how a system will behave
and to discover responsibilities a class may need to have in the process of modeling a new
system.

Figure 7: Sequence diagram

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3.7 CLASS DIAGRAM

According to Laurie Williams (2004) Class diagrams are used in both the analysis and the
design phases. During the analysis phase, a very high-level conceptual design is created. At
this time, a class diagram might be created with only the class names shown or possibly some
pseudo code-like phrases may be added to describe the responsibilities of the class. The class
diagram created during the analysis phase is used to describe the classes and relationships in
the problem domain, but it does not suggest how the system is implemented. By the end of
the design phase, class diagrams that describe how the system to be implemented should be
developed. The class diagram created after the design phase has detailed implementation
information, including the class names, the methods and attributes of the classes, and the
relationships among classes.

3.7.1 CLASS DIAGRAM FOR ELECTRONIC PATIENT TRANSFERRING SYSTEM

The below class diagram shows a collection of classes, interfaces, associations, collaborations
and constraints of our system.

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3.7.2 DATA DICTIONARY
A data dictionary is an integral part of a database. It holds information about the database and
the data that it stores, i.e., the meta-data. Any well designed database will surely include a
data dictionary as it gives database administrators and other users’ easy access to the type of
data that they should expect to see in every table, row, and column of the database, without
actually accessing the database.

USER

Field Type Null

usID Int(11) no
Uname Varchar(255) no
Category Varchar(255) no
Reference Int(11) no

AVAILABILITIES

Field Type Null

AvID int(11) No
Maximum int(11) No
Patients int(11) No
Doctor int(11) No
Day date No

DOCTORS

Field Type Null

DocID int(11) No
DocFname Varchar(255) No
DocLname Varchar(255) No
DocServ Int(11) No
DocPhone Varchar(255) No
Photo varchar(12) No
FEEDBACKS

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FeedID Int(11) No
FeedPat Int(11) No
FeedDetails Varchar(255) No
HEALTH_CENTERS

HID Int(11) No
HName Varchar(255) No
Hcategory Varchar(255) No
Hphone Varchar(255) No
PATIENTS

PatID Int(11) No
Dte Date No
PatNames Varchar(255) No
PatIDNumber Bigint(20) No
P_phone Varchar(15) No
Age Int(11) No
Sex Varchar(255) No
Disease_description Text No
Additional_info Text No
HCenter Varchar(255) No
TDay Int(11) No
Receiver Int(11) No
SERVICES

ServID Int(11) No
ServName Varchar(255) No
Table 1: Data dictionary

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CHAPTER FOUR: SYSTEM IMPLEMENTATION

4.1 INTRODUCTION
This chapter describes in details implementation of “E-PATIENTS MEDICAL TRANSFER”
software and its functionality. It deals with how the system is used by end user after to be
implemented.

4.2 HARDWARE REQUIREMENTS

 One or two server for web (apache) and database (MySQL) server configurations.
 Clients computers with at least 512 MB of RAM, 1GHZ of processor and 100 GB for
HDD
 Internet connection
 1 GSM modem

4.3 SOFTWARE REQUIREMENTS

 Win 7, 8 or 10 for computer operating system.
 Browser (Mozilla, Chrome, Opera, etc...)
 XAMPP for local Apache and Mysql server configuration.

4.4 THE SYSTEM INTERFACES

The system has been designed with user friendly interfaces. User interface design is the
overall process of designing the interaction between a human (user) and machine (computer).
It includes graphic design, information design and a wide variety of usability methods.

4.4.1 HOME PAGE

This is a welcome page for all system visitors where the system prompts every user to make
login before accessing the system.

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Figure 8: System index page
4.4.2 Hospital home page
This is a welcome page for system administrator who is a hospital where he/she is able to add
and manage health centers, and add doctors and the available services.

Figure 9: Hospital home page

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4.4.3 Add and manage services
This is the interface used by hospital to add and manage the hospital available services

Figure 10: Add and manage hospital services

4.4.4 Add and manage Doctors

This is the interface used by hospital to add and manage the doctors and their services

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Figure 11 Add and manage doctors

4.4.5 Doctor interface

This is the interface used by doctors to set her/his availabilities

Figure 12: Doctor interfaces

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4.4.6 Received patients
Interface used by doctor to view received patients

Figure 13: Received patients

4.4.7 Treated patients

This is an interface of doctor where she/he is able to add comments about the patients he/she
treated.

Figure 14: treated patients

4.4.8 Health center interface

This is the interface used by health center to transfer new patients to hospital

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Figure 15: New patient transfer

4.4.9 Transferred patients

This interface shows the list of all transferred patients from health center to hospitall

Figure 16: transferred patients

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4.4.10 Feedback from hospital
This interface help health center to view feedback about transferred patients from hospital

Figure 17: feedback from hospital

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CHAPTER FIVE: CONCLUSION AND RECOMMANDATIONS

5.1. GENERAL CONCLUSION

The implementation of E-PATIENTS MEDICAL TRANSFER was the research that put in
practice the development of an automated information system to allow HUYE district
hospital and health centers to get advantages from the usage of information technology. This
work helped me to increase my knowledge gained from CATHOLIC UNIVERSITY OF
RWANDA in the period of 2 years spent there. According to the time that i had, i wished to
focus only to the system of e-patients medical transfer for HUYE hospital in order to help
health center to know the available doctors and their services in order to transfer new patient
to hospital.

The objectives of this research were to help district health centers to view the availability of
different services from hospital, and enabling the hospital to get information of transferred
patient from health centers without asking patient a transfer document, and also allow health
centers to get feedback from hospital on transferred patient after treatment. So the developed
software proved the achievement of the objectives. The current software offers to end users
many features to help its flexibility and user friendliness like:

It can also be used by each district hospital and health centers within the process of managing
and transferring the patients within specific doctors and services.

5.2 RECOMMENDATIONS
After implementing the software, i recommend the KABUTARE hospital and health centers
in HUYE district to use this software because it will help them to perform their day to day
activities timely and effectively in e-patients medical transfer.

I can’t pretend that this work was accomplished, that’s why i recommend to everyone who
will be interested in this domain to accomplish and improve it without hesitation mainly to
add the effort to the other activities and functionalities that can facilitate KABUTARE
Hospital and HUYE district health centers to deliver better services, simplifying the
program’s management and to keep their data that i haven’t done.

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