CHAPTER THREE

SYSTEM ANALYSIS

3.0 INTRODUCTION

In this chapter, the methodologies on how data are gathered are provided, the analysis of
existing system. It describes the methodology and aims to provide a clear vision on methods
and methodologies used for the existing system.

3.1 RE STATEMENT OF THE PROBLEM

The existing system employed at Usman danfodio University Teaching Hospital (UDUTH)
Nigeria, involves tedious paperwork and rigour of going through various registers to find out
patient’s medical record. During the system investigation, the following problems were
discovered:

 Information is very difficult to retrieve and to find particular information. For

example, to find out about the patient’s history, the user has to go through various
registers. This results in inconvenience and wastage of time.
 The information generated by various transactions takes time and efforts to be stored
at right place
 Various changes to information like patient details is difficult to make as paper work
is involved
 There is inaccurate and prompt report about patients’ details because it becomes a
difficult task as information is difficult to collect from various registers.

3.2 DESCRIPTION OF THE EXISTING SYSTEM

The diagnostic process in the existing system. First, a patient experiences a health problem.
The patient is likely the first person to consider his or her symptoms and may choose at this
point to engage with the health care system. Once a patient seeks health care, there is an
iterative process of information gathering, information integration and interpretation, and
determining a working diagnosis. Performing a clinical history and interview, conducting a
physical exam, performing diagnostic testing, and referring or consulting with other
clinicians are all ways of accumulating information that may be relevant to understanding a
patient's health problem. The information-gathering approaches can be employed at different

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times, and diagnostic information can be obtained in different orders. The continuous process
of information gathering, integration, and interpretation involves hypothesis generation and
updating prior probabilities as more information is learned. Communication among health
care professionals, the patient, and the patient's family members is critical in this cycle of
information gathering, integration, and interpretation. The working diagnosis may be either a
list of potential diagnoses (a differential diagnosis) or a single potential diagnosis. Typically,
clinicians will consider more than one diagnostic hypothesis or possibility as an explanation
of the patient's symptoms and will refine this list as further information is obtained in the
diagnostic process. The working diagnosis should be shared with the patient, including an
explanation of the degree of uncertainty associated with a working diagnosis. Each time there
is a revision to the working diagnosis; this information should be communicated to the
patient. As the diagnostic process proceeds, a fairly broad list of potential diagnoses may be
narrowed into fewer potential options, a process referred to as diagnostic modification and
refinement. As the list becomes narrowed to one or two possibilities, diagnostic refinement of
the working diagnosis becomes diagnostic verification, in which the lead diagnosis is
checked for its adequacy in explaining the signs and symptoms, its coherency with the
patient's context (physiology, risk factors), and whether a single diagnosis is appropriate.
When considering invasive or risky diagnostic testing or treatment options, the diagnostic
verification step is particularly important so that a patient is not exposed to these risks
without a reasonable chance that the testing or treatment options will be informative and will
likely improve patient outcomes. Throughout the diagnostic process, there is an ongoing
assessment of whether sufficient information has been collected. If the diagnostic team
members are not satisfied that the necessary information has been collected to explain the
patient's health problem or that the information available is not consistent with a diagnosis,
then the process of information gathering, information integration and interpretation, and
developing a working diagnosis continues. When the diagnostic team members judge that
they have arrived at an accurate and timely explanation of the patient's health problem, they
communicate that explanation to the patient as the diagnosis.

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3.4ANALYSIS OF EXISTING SYSTEM INPUT

The analysis involves the identification that represents the patient. For personal patient-
identifiable details, including name(s) address, phone, sex, marital status, blood group,
genotype, NHS number. Blood collection, or the collection of blood, usually involves the
removal of blood. But most commonly involves inserting a needle into a vein. Usually,
medical practitioners draw samples in their offices, at times convenient for them (if not
always for patients) is to look at the blood using a method called high-performance liquid
chromatography (HPLC). This test identifies which type of hemoglobin is present. To
confirm the results of HPLC, a genetic test may be done.

3.4 ANALYSIS OF THE EXISTING SYSTEM PROCEDURE

Generating a differential diagnosis that is, developing a list of the possible conditions that
might produce a patient's symptoms and signs is an important part of clinical reasoning. It
enables appropriate testing to rule out possibilities and confirm a final diagnosis the existing
system procedure Arriving at a diagnosis is often complex, involving multiple steps:
 taking an appropriate history of symptoms and collecting relevant data
 physical examination
 generating a provisional and differential diagnosis
 testing (ordering, reviewing, and acting on test results)
 reaching a final diagnosis
 consultation (referral to seek clarification if indicated)
 providing discharge instructions, monitoring, and follow-up
 documenting these steps and the rationale for decisions made

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3.4ANALYSIS OF EXISTING SYSTEM OUTPUT

When the diagnostic team members judge that they have arrived at an accurate and timely
explanation of the patient's health problem, they communicate that explanation to the patient
as the diagnosis. For the one-word condition, use the terms “undetermined,” “good,” “fair,”
“serious” or “critical.” Definitions of patient conditions are listed below:
Undetermined: Patient is awaiting physician and/or assessment.

Good: Vital signs are stable and within normal limits. Patient is conscious and comfortable.
Indicators are excellent.

Fair: Vital signs are stable and within normal limits. Patient is conscious, but may be
uncomfortable. Indicators are favorable.

Serious: Vital signs may be unstable and not within normal limits. Patient is acutely ill.
Indicators are questionable.

Critical: Vital signs are unstable and not within normal limits. Patient may be unconscious.
Indicators are unfavorable.

3.4.1 REPORTS

All reports i.e. lab investigation, X-ray reports, ultrasound reports, computed tomography
(CT-scan)/magnetic imaging resonance (MRI) reports, and histo-pathological reports should
be issued by a qualified person. Biopsy report should preferably be issued in duplicate so that
the referring doctor/hospital can keep the original copy. If the pathologist does not give a
duplicate copy the referring doctor should get it Xeroxed and should be handed over to the
patient.

3.4.2 PRESCRIPTION

Prescription must contain patient’s name, age, sex, address and institution/hospital name.
Prescribed drug should be preferably in capital letter or else clearly visible. One should
mention its strength (especially in pediatric age group), its dose frequency, duration in days,
and total quantity (number of tablets and capsules). Below the main drug, also mention other
instructions of precautions and what to avoid. If any investigation is advised, do not forget to
mention it on the prescription slip and call the patient after the investigation. If patient fails to

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keep follow up date and if then some complication occurs, then patient is also considered
negligent (contributory negligence)

3.4.3 DISCHARGE CARD

Consultant in-charge should himself fill or supervise the discharge card. Condition of the
patient on the admission, investigation done, the treatment given and detail advice on
discharge should be written on discharge card. Operation notes if mentioned have to be
correct otherwise just mention the name of the operation and give separate note in detail if
asked for. If any complication is expected after discharge asks the patient to report
immediately. Instructions while discharge must be very clear and elaborative. Keep in mind
that abbreviations may not be understood by others. Also do not use code messages, sarcasm
or poor opinion to the patient.
3.5 HUMAN ELEMENT
Much of that human element relates to a variety of experiences around all the different
dialogs (Nurse to patient, patient to doctor) Patients need face-to-face interaction or a
conversation about something other than their medical condition. Ensure that nurses spend
more time at bedside interacting with and caring for their patients. The amount of time spent
in direct contact with patients is also significantly different between doctors and nurses.
Nurses spend much more time interacting with patients directly than doctors do, as many of
their day-to-day tasks involve maintaining patient care. Doctors spend a larger proportion of
their day completing paperwork in relation to patient care than seeing their patients face to
face. Make a medical diagnosis of a patient's condition, prescribe a suitable course of
treatment, and prescribe medication.
3.6 FILE MAINTAINED
The existing system, managing medical records was relatively straight-forward. Patient
information was recorded on paper charts, which were stored in office filing cabinets. Collect
all the records and classify them according to the different section. Protect the records from
insect attack. Spray insecticide or place naphthalene balls over shelves to preserve the
records. Plan a periodical checking for the records.

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3.7 JUSTIFICATION FOR THE NEW SYSTEM
The new system captures scarce expert knowledge and renders it archival. This is an
advantage when losing the expert would be a significant loss. Distributing the expert
knowledge enhances employee productivity by offering necessary assistance to make the best
decision. The new system will distribute the expertise of a human. Which contain knowledge
from more than one human expert thus making the diagnosis process more efficient, it
decreases the cost of consulting an expert for medical diagnosis. To effectively manage and
control diagnosis and treatment processes. The systems have improved the experiences and
capabilities of physicians to make the diagnosis of sickle cell diseases. The system combines
an advanced medical information system containing various medical services supported by
information technologies with expert system capabilities Implementation of this system is
applied for sickle cell diseases. We have applied soft computing techniques for the diagnosis
of the diseases with improved effectiveness, suitable accuracy and speed when making
decisions.