STUDENTS HEALTH RECORDS SYSTEM

A CASE OF NDEJJE UNIVERSITY HEALTH CENTER, LUWEEERO DISTRICT

By 2013
FACULTY OF BASIC SCIENCES AND INFORMATION TECHNOLOGY

A PROJECT REPORT SUBMITTED TO THE FACULTY OF BASIC SCIENCE AND

INFORMATION TECHNOLOGY IN PARTIAL FULFILLMENT OF THE
REQUIREMENT FOR THE AWARD OF BACHELOR DEGREES
IN COMPUTER SCIENCE AND INFORMATION TECHNOLOGY
OF NDEJJE UNIVERSITY

SUPERVISOR

MR. KAULI ROBERT

DEPARTMENT OF SCIENCE AND I.T
FACULTY OF BASIC SCIENCES AND INFORMATION TECHNOLOGY, NDEJJE
UNIVERSITY
kaulirobert@gmail.com, 0775380416
Email: info@ndejje university.ac.ug

MAY, 2013

DECLARATION
We hereby declare that this project report is wholly a work of our own and does not contain
any copy or duplicate of other work and has not been published or submitted for any other
degree award in any other university.

Group Names
S/NO

NAME

REG.N.O

COURSE

Namigadde Prossy

10/314/011/D/1

BIT

0782804568

Manyok Chol David

10/314/036/D/1

BIT

0718856532

Thon Kuir Biar Ayual

11/IF/306/D/173

BCS

0711903239

ii

SIGNATURE

TELEPHONE NO

APPROVAL
This project report has been submitted for examination with the approval of the supervisor.
Signature

Date ..

Mr. Kauli Robert

Faculty of Basic Science and Information Technology, Ndejje University

iii

DEDICATION
This project report is dedicated to the Almighty God, our parents, group members, friends,
University at large and mostly to our supervisor Mr. Kauli Robert who helped us in correction,
positive criticisms otherwise if it wasnt his help we wouldnt have managed to make it.

iv

ABSTRACT
This project report explain the design and development of Ndejje university students health
records management system .The project aim is to develop a system that would ease data entry,
processing and analysis in the university health center. Health Information Managers (HIMs) are
responsible for overseeing health information. The change management necessary during the
transition to electronic health records (EHR) is substantial, and ongoing. Archetype-based EHRs
are core health information system components which solve many of the problems that arise
during this period of change. Archetypes are models of clinical content, and they have many
beneficial properties. They are interoperable, both between settings and through time. They are
more amenable to change than conventional paradigms, and their design is congruent with
clinical practice. This paper is an overview of the current archetype literature relevant to Health
Information Managers. The literature was sourced in the English language sections of Science
Direct, IEEE Explore, Pub med, Google Scholar, ACM Digital library and other databases on the
usage of archetypes for electronic health record storage, looking at the current areas of archetype
research, appropriate usage, and future research. We also used reference lists from the cited
papers, papers referenced by the open EHR website, and the recommendations from experts in
the area. Criteria for inclusion were (a) if studies covered archetype research and (b) were either
studies of archetype use, archetype system design, or archetype effectiveness. The 47 papers
included show a wide and increasing worldwide archetype usage, in a variety of medical
domains. Most of the papers noted that archetypes are an appropriate solution for future-proof
and interoperable medical data storage. We conclude that archetypes are a suitable solution for
the complex problem of electronic health record storage and interoperability.

TABLE OF CONTENTS
Declaration ................................................................................................................................... i
Approval ..................................................................................................................................... iii
Dedication .................................................................................................................................. iv
Abstract ....................................................................................................................................... v
Table of contents ........................................................................................................................ vi
List of abbreviations ................................................................................................................... xi
CHAPTER ONE: INTRODUCTION ......................................................................................... 1
1.1 Background ........................................................................................................................... 1
1.2 Statement of the problem ...................................................................................................... 2
1.3 General objective................................................................................................................... 3
1.3.1Specific objectives............................................................................................................... 3
1.4 Scope of the project ............................................................................................................... 3
1.5 Justification of the project ..................................................................................................... 3
1.6 Significance of the project..................................................................................................... 4
1.7 Limitation of the project design and implementation ........................................................... 4
CHAPTER TWO: LITERATURE REVIEW ............................................................................. 5
2.0 Introduction ........................................................................................................................... 5
2.1 Records Management ............................................................................................................ 5
2.2 Information System ............................................................................................................... 5
2.3 Definition of health records management system. ................................................................ 6
2.3 Factors considered in designing health records management information system ............... 6
2.4 Benefits of Manual Health Records Management System.................................................... 7
2.5 Problems related to Manual Health Records Management System .................................... 7
vi

2.6 Solutions to the problems facing Manual Health Records Management System ................. 8
2.7 Integration of various health departments to ease patients health data sharing 8
2.8 Ease of data entry and retrieval ............................................................................................. 9
2.9.0 Problems facing computerized Health Records management systems .............................. 9
2.9.1 Solution to the problems facing computer based health management system ................. 10
CHAPTER THREE: METHODOLOGY ................................................................................. 11
3.0 Introduction ......................................................................................................................... 11
3.1 Data collection methods ...................................................................................................... 11
3.1.1 Interview........................................................................................................................... 11
3.1.2 Observation ...................................................................................................................... 11
3.1.3 Questionnaires .................................................................................................................. 11
3.1.4 Document Review ............................................................................................................ 12
CHAPTER FOUR: ANALYSIS, DEVELOPMENT, TESTING AND VALIDATION ......... 13
4.1 Introduction ......................................................................................................................... 13
4.2 Data analysis ....................................................................................................................... 13
4.3 System development languages .......................................................................................... 13
4.4 System requirements ......................................................................................................... 14
4.4.1 User Requirements ........................................................................................................... 14
4.4.2 Functional Requirements.................................................................................................. 14
4.4.3 Non-functional Requirements (NFR) ............................................................................... 15
4.5 System Design ..................................................................................................................... 15
4.5.4 .Logical database design .................................................................................................. 19
4.5.5. Physical database design ................................................................................................. 19
4.5.6 Architectural design ......................................................................................................... 20
vii

4.5.7. Data flow diagrams ......................................................................................................... 21

4.6. Implementation................................................................................................................... 21
4.7Testing .................................................................................................................................. 22
4.8 Validation ............................................................................................................................ 22
CHAPTER FIVE: DISCUSSION, RECOMMENDATION, LIMITATION AND
CONCLUSTION ....................................................................................................................... 23
5.1 Discussion ........................................................................................................................... 23
5.2 Limitation of the project ...................................................................................................... 23
5.3 Recommendation ................................................................................................................. 24
5.4 Conclusion........................................................................................................................... 24
REFERENCES .......................................................................................................................... 25
Appendix I : Interview guide .................................................................................................... 27
Appendix II : Questionnaire ...................................................................................................... 28
Appendix III:screen shots.......................................................................................................... 29

viii

List of Tables

Table 4.1 : Current system analysis ............................................................................................................ 13

Figure 4.1: Respondents Bar graph ............................................................................................................. 13

ix

LIST OF FIGURES
Figure 5.1: Login screen ............................................................................................................................. 29
Figure two: New Consultation Sheet .......................................................................................................... 30
Figure Three: Consultation Report ............................................................................................................. 30
Figure Four: Search Laboratory Results ..................................................................................................... 31
Figure Five: Nursing Department: Receive Admission .............................................................................. 31
Figure Six: Counseling Department: Client Post counseling form ............................................................. 32
Figure Seven: Dispensary New Inventory form ......................................................................................... 32
Figure 4.2.System Design Context Diagram ............................................................................................ 16
Figure 4.3.System Design user matrix ...................................................................................................... 17
Figure 4.4 .System Design Process diagram ............................................................................................. 17
Figure 4.5.Conceptual Database design ...................................................................................................... 18
Figure 4.6 Logical Database design: Sample Table: Patient Registration .................................................. 19
Figure 4.7 physical Database design: Sample Table: Patient Registration ................................................. 19
Figure 4.7 System architecture design: ....................................................................................................... 20
Figure 4.8 Data flow diagram ..................................................................................................................... 21

LIST OF ABBREVIATIONS
Mysql. ...My structured query language
HIV. ............................................Human immune virus
ER. ....Entity Relation
HRMS. Health Records Management System
T.B. ...Tuberculosis
ART. .........Antiretroviral Therapy
RAM . .......Random Access Memory
GB. ...Giga bytes
JDK. ..Java Development Kit
HDD. ........Hard Disk
COSTAR. .....Computer Stored Ambulatory Record
EHR. ...Electronic Health Records
EMR. ......Electronic Medical Record
CPR ........................Computerized Patient Record
CMR.....Computerized Medical Record

xi

CHAPTER ONE: INTRODUCTION

This project report explain Students Health Records Management System for Ndejje University
health center .This section covers the definition , background of the project, statement of the
problem, general and specific objectives, scope , significance and limitation of the project
1.1 Background
Health Records Management System is defined as any computer based information management
system that is used to capture patients health details for easy patient management.
Hannan (1999) describes Health Records Management System as an essential tool for collecting
and integrating medical information in order to improve clinical decision-making.
Hassey (2001) describes it as general practice records containing data on an individual with a list
of entries about individual medical health.
Health records management systems (HRMS) have been in use since the 1960's and were
developed in response to physicians concerns that, due to the increasing complexity of medical
care .HRMS systems and software programs could store vast amounts of patient data and provide
critical information quickly and accurately (Latter Day Saints Hospital in Utah USA)
In 1969 Harvard Medical School Debuted its Computer Stored Ambulatory Record (COSTAR)
and Duke University began developing its own electronic health records software The Medical
Record (TMR).
2000 and beyond: Electronic health records software continues to increase functionality to
become an interactive companion for physicians and healthcare providers.
In 2009 President Obama of the USA issues a mandate for a national HRM system by 2014.

Ndejje university health center is located in Luweero district, 50 kilometers away from Kampala
7 kilometers off Bombo road and 700 meters from Ndejje Trading center opposite Lady Irene
campus.
Ndejje university health center was initiated by Bishop Ssenyimba Michael who was the former
Vice Chancellor of Ndejje University. It started in 2006 as a single room within Lady Irene
campus as a non-profit making health center with its staff, drugs and laboratory equipments.

As a small clinic to offer health services to students, staff and other members of the community
living around the university, later it was transferred to the current premise which was previously
a small library before it was expanded to a health center three.
The mission of the health center is to provide quality integrated health care, in a holistic gender
sensitive manner, with primary focus on Ndejje University and neighboring communities.
The health center is funded by the university which pays its staff (health center staff) and drugs
purchase .The heath center place an order to the pharmaceutical supplier in Kampala (Now one
supplier) , then the supplier bring in new drugs stock according to the order. Health center staffs
are employed after advertisements are made and interviews are done of which successful
candidates are employed. The health center has various departments and among them are;
dispensary, laboratory, nursing/sickbay, guidance and counseling, doctors department, and
records department.
These departments offer the various services to the students, staff and the community; These
services include ; general

consultation, integrated HIV/Malaria /Tuberculosis management

,laboratory services with Tuberculosis screening facility ,Community outreaches and static clinic
, counseling and testing

in HIV/AIDS

, Antiretroviral Therapy (ART),Psychosocial and

spiritual counseling ,family planning , adolescent health service , medical IEC material and safe
motherhood offered 24 hours .These services are offered free of charge to student and staff , a
small fee is charged to other people of the community. These cash collection help to facilitate the
health center in the purchase of drugs and other essentials for sustainability.
Ndejje University Health Center is now an accredited health institution with an operating license
from the Ministry of Health, and therefore it is under the Ministry of Health supervision which
also provides free Antiretrovals (ARVs) to patients.
1.2 Statement of the problem
Ndejje university health center used manual health record system. Each department has a distinct
manual data records system which is not integrated. Health clerks too complain of difficulty and
waste of time in searching previous patient health history from record books, as well as
checking individual student health files , because of this, the health center need a software to
easy on data entry and retrieval. Manual health records system have no back up files and in case
of data lost, it is impossible to recover the health details of the patients.
2

In addition, monthly and weekly health reports are done manually, but if the system is deployed,
it would make it easy to auto-generate these reports .This would save time and effort exerted in
doing these tasks.
1.3 General objective
To develop a computerized health records management system, that will replace the current
Manual records management system in Ndejje university health center, and in Luweero district
1.3.1 Specific objectives
i. To integrate various health departments to ease students health data sharing
ii. To improve data security
iii. To ease students health data entry and retrieval processes.
1.4 Scope of the project
The project was be carried out in the Ndejje university health centre in main campus Luweero
district and it was carried out for in a period of four months between January and April 2013.
The project report and system design were steps toward the deployment of the system developed.
Departments that directly deal with clinical services will be dealt with. Only medical records will
be considered and these include:
1. Patient personal information
2. Laboratory examinations
3. Diagnosis
4. Prescriptions and Treatment
5. Follow up of the patient
1.5 Justification of the project
Having interviewed the staff members of Ndejje university health center they proposed to us that
there was an urgent need to computerize students health records management system because of
the following problems associated with the manual system.
i. Manual system is very slow.
ii. It is also tiresome especially when searching for previous patients data / reports
iii. Difficulties in accessing data in different departments
3

1.6 Significance of the project

The project brought various benefits to Ndejje university health center.
By deploying this project, the health center would have an integrated health records management
system where records from different departments can be kept and each department can view the
records from another department easily.
Who are recording on manual system would be relieved from manual work if the automated
system is introduced.
When searching patient records, drugs inventory, laboratory results for example, the use of
automated system would easy these activities.
The use of record management software would improve on data backup which is a problem with
the manual system. In case of registers aging, torn, wetted by chemical or water, burnt by fire,
records can be lost.
1. There has been automation and streamlining of clinicians work follow. This has
reduced medical errors, as there is readily available of necessary information on
which to base their decisions.
2. Patients records can now b e accessed anywhere in the departments of the hospital on
a computer screen. The problem of moving from department to department to get
some records is no more which has increased time to attend to the patient.
3. Paper-based record-keeping system was adding to the expense of health care. Doctors
and nurses used to spend time away from patients attending to a great deal of papers
4. Delayed or missing paperwork used to add time to patient hospital stays and could
lead to unnecessary or duplicate clinical tests.
1.7 Limitation of the project design and implementation
It took long time and large commitment to get good results with lectures going on alongside data
collection process.

CHAPTER TWO: LITERATURE REVIEW

2.0 Introduction
This chapter includes a vital look at the definition of health records management system, factors
to consider when designing health records management system , problems associated with paper
based health records management system ,benefits of computer based health record management
system,
Problem facing computer based health records management system, Solution to the problems
facing paper health records management system and solutions to the problems facing computer
based health records management system.
2.1 Records Management
Records Management is the practice of identifying, classifying, archiving, preserving, and
sometimes destroying records according ISO (2006) [7]. ISO (2001) [7] define records
information created, received, and maintained as evidence and information by an organization or
person, in pursuance of legal obligations or in the transaction of business
2.2 Information System
OBrien (2006) [13] Define Information System as any organized combination of human ware,
hardware, software, communication networks and data resources, that control, transform and
disseminate information in an organization. OBrien (2006) [13] further reveals that the data
resources of information systems are typically organized, stored and accessed by a variety of
data resource management technologies into:
1. Databases that hold processed and organized data.
2. Knowledge bases that hold knowledge in a variety of forms such as facts, rules, and case
examples about successful business practices.

2.3 Definition of health records management system.

Health records management system is a permanent documentation of the history and progress of
a patient's medical care. Records are used for continuity of a patient's care, verification of
insurance claims, as a legal business document outlining the course of a patient's medical care, to
provide statistical and factual information for hospital administration, licensing and other
regulatory bodies and medical research (Pickett 2011).
According to Karim (2008), different terms are used in the literature to explain health records
management system for patient healthcare data such as Electronic Health Records (EHR),
Electronic Patient Record (EPR), Electronic Medical Record (EMR), Computerized Patient
Record (CPR), and Computerized Medical Record (CMR). These names are given from time to
time in different nations and in different healthcare environments.
Abdul (2008) argues that Health Record Management System(HRMS) is different from an
EPR/EMR that is longitudinal and not site specific, in short HRMS is patient centric while
EPR/EMR are provider centric.
A health record management system defined by Murphy (1999) as any information relating to
the past, present or future physical health of a patient existing in an electronic system, which is
used to capture, transmit, receive, store, retrieve, and manipulate data for the main purpose of
providing healthcare and health-related services.
Hannan (1999) describes HRMS as an essential tool for collecting and integrating medical
information in order to improve clinical decision-making
2.3 Factors considered in designing health records management information system
According to Edwards et al (2006), one way to ease the transition from paper to electronic
records is to break the total transition into a series of small and manageable steps, where each
step paves its own way and lays the foundation for the next step. Thus, this scheme can proceed
in several steps from automation of billing and scheduling.

According to Chibambo (2003), a good records management framework consists of informationrelated laws, policies and programmes, records management standards and practices, and the
necessary qualified human resources to implement and manage the systems.
Scott and Rundall (2005) [15], in a fund-supported study find that the keys to successful
adoption and implementation of EHR include a participatory selection process, flexibility
regarding staff roles and responsibilities, and decisive leadership at critical stages.
EHR systems have great potential to improve health care quality. So far, however, real and
perceived barriers from high costs and decreased productivity to staff frustration-have prevented
most providers from implementing them.
2.4 Benefits Manual Health Records Management System
It is easy to use since it doesnt require advance computerized techniques
It is easy for workers will little or no computer skills
It can work as a backup file/copy incase of any data corrupt /injury
2.5 Problems related to Manual Health Records Management System
According to Nanda (2006), the present situation of healthcare in developing countries like India
are quite discouraging, as the physicians use a paper based system whereby they record patient
information, diagnosis and treatments on a Case Sheet.
Abdul (2008) mentions that each time a patient visits a hospital, a new case sheet is created, and
this creates an excess of paperwork, repetition of examination done previously leading to overconsumption of work force and other resources. He indicated that all the clinical information is
written in free style, and chances are high to miss or forget some important information leading
to serious effect on patients treatment and care. Retrieving a record would be a hard task given
number of medical records present and missing a record wont be a surprise in a huge pile of
paper based medical records. With time, information in paper records gets diminished of ageing
paper and ink, even fire accidents or natural disasters can ruin the archive of paper records.
In his view, Iguodala (1998) believes that personnel (secretaries and filling clerks) who maintain
the registry systems with filing cabinets containing the paper evidence of medical records are
inadequate and in fact ignorant of their responsibilities.
7

Other associated problems of recording, management identified include lack of record manual
and filing guidelines which lead to loss of vital information Iwhiwhu (2005).
Others are difficulty in record retrieval and lack of appreciation by management and staff of the
need for well-controlled records Egunleti (2001).
2.6 Solutions to the problems facing Manual Health Records Management System
Karim (2008) explains that the solution to problems facing paper based health records
management system can be over-come by implementing HRMS systems, it can not only solve
the problems but also improves the efficiency of healthcare by increasing accessibility, and needs
less resources to maintain records. HRMS can be used as a resource of researchers, it would be
a tool for disease surveillance, which can be used for public health initiatives and for practicing
Evidence based medicine.
2.7 Integration of various health departments to ease patients health data sharing
Sood et al (2008) discusses the advantages of HRMS systems as Assists speed and convenience
in obtaining consultations from distant specialists or from different departments in the same
health centre, makes clinical notes and documentation legible, and reduces clinical errors,
generate warnings for abnormal laboratory results, Support the handling of data for clinical
research, backs-up data and provide information on drugs for prescribing.

Nanda (2006) also highlights some of the benefits of HRMS systems: they are Improves
efficiency, quality assurance/improvement, measure physician/hospital performance, Increase
accountability and Managerial tool
2.8 Ease of data entry and retrieval
According to Salem (2009), the negative aspect of paper-based medical records can be overcome
by implementing HRMS systems. This means that patients have more choice and less waiting
time, the physicians save time and have pat history of patient instantly, thus ensuring safe,
efficient, consistent, and continuous healthcare for patients.

Hospitals are information intensive enterprises; hospital managers must understand that only
those with a strong information management system can have a smooth running of the enterprise
(Perspective health information management, 2006).
The General Accounting Office USA (GAO) reported that an automated medical record system
reduced hospital costs by $600 per patient in a Department of Veterans Affairs hospital because
of shorter hospital stays GAO (1991).
Reductions in the length of inpatient stays were also found in other studies of computerized
medical records and medical record summaries Rogers and Haring (1979).
Other investigators found enhanced care and improved outcome of care for clinic patients
(Rogers et al., 1982)
2.9.0 Problems facing computerized health records management systems
According to remote health Atlas, (n.d) one major problem to management of records in public
hospital is lack of medical records management standards and policies. Consequently, there are
standards set for management, storage, access and destruction of records which when not present
can lead to ineffective utilization of medical records.
Most records managers also face problems managing records because they don't undertake the
following records management procedures according to Roper and Millar (2009); Such as
Drawing up a Records Management Strategy. The hospital authority must have an agreed
strategy for managing all hospital records.
Generally, medical records management must be guided by some level of confidentiality, proper
maintenance, security, preservation of the content and context, etc Uwaifo (2004) Akporhonor
and Iwhiwhu, (2007)
Afolabi (1999) asserted that record management practice in Nigeria has a number of problems
which may include insufficient skilled and experienced record management personnel and
possibly, low priority of record management in the scheme of things.

2.9.1 Solution to the problems facing computer based health management system
However, whatever the record maybe, it is important that the staff get familiar with the legal and
ethical requirements for record management in their specific professional contexts and
jurisdiction Egwunyenga, (2009).

In the opinion of Awe (2000) the problems of record management can be viewed from the
perspective of governments, hospital management and the staff as their action and activities can
lead to effective or ineffective records management.

All these problems of high costs, uncertain value, medical errors, variable quality, administrative
inefficacies and p o or co ordination are closely connected to the failure to use health information
technology as an integral part of medical care.
Unlike other industries, medicine still operates primarily with paper-based records. The doctors
and nurses have to manage 21st century medical technology and complex medical information
with 19th century tools.
Bush (2004) [2] further reveals that in the outdated, paper-based system, patients vital medical
information is scattered across medical records kept by many different care givers in many
different locations - and all of the patients medical information is often unavailable at the time
of care. He believes that innovations in electronic health records and the secure exchange of
medical information help transform health care in America by improving health care quality,
preventing medical errors, reducing health care costs, improving administrative efficiencies
reducing paperwork, and increasing access to affordable health care.

10

CHAPTER THREE: METHODOLOGY

3.0 Introduction
This chapter describes the methods of data collection and analysis which were used by the
project designers to achieve the objectives of the project being implemented
3.1 Data collection methods
3.1.1 Interview
The project designers used oral interview to collect data from the health center. An interview
guide was the tool used and various departmental staffs were asked oral questions and the
answers from the interviewees were documented by the interviewers
It was chosen because it provided first hand information, saves time, makes the interviewee as
part of the system.
3.1.2 Observation
In this method of data collection where the project designers visit the data collection premises
and see various activities carried out in various departments and by different people then they
record all in the observations checklist they designed .The tool used was observation checklist.
1. This method was chosen because of the following advantages of it over other methods.
2. It provides first hand information to the designers
3. It helps to correct the vague data collected in other methods.
4. It measures the reliability and availability of the answers from the interview and the
questionnaire.
3.1.3 Questionnaires
This is a document containing standard set questions given to a large number of people to collect
information .the

attitudes, behaviors, characteristics, and beliefs from each department was

gathered then after the group collected then for analysis.

The technique was chosen because of the following advantages
1. Consistent answers are given without bias.
2. It saves time especially when the respondents are geographically scattered.
3. Questions are answered privately so the respondents are frank to answer every question.
11

4. Full opportunity is given to the respondents to provide inputs.

3.1.4 Document Review
A thorough review of the documents used in the health centre was done with the intent to study
How things are done and discover areas where improvement is necessary. A number of
Documents were reviewed including patient charts, registers, tally sheets, periodic reports and
laboratory reports among others. This method was used because of its advantages, which
Include:
1. It is inexpensive because the data is already there
2. It permits examination of trends over the past
3. Doesnt interrupt program or clients routine in program
4. There is no bias about information

12

CHAPTER FOUR: SYSTEM ANALYSIS, DESIGN AND IMPLEMENTATION,

TESTING AND VALIDATION
4.1 Introduction
This section describe data analysis, development, test and validation of the system
4.2 Data analysis
The project owners collected data on the ease of data entry, retrieval and the need of replacing
the current system used in the health center. The following outcomes were recorded;

Table 4.1: Current system analysis

To depict the data collected for better visual understanding, the project owners used the bar
graph to show suggestion about the current system.
Figure 4.1: Respondents Bar graph

4.3 System development languages

The development languages are Java as front end for application implementation and MYSQL as
the back end database implementation
13

We choose the above languages for our system development because of the following reasons;
i.

The health facility is small so it doesnt need large database tools like oracle making
MYSQL as the language of choice

ii.

MYSQL is easy to connect to java than other languages like SQL server.

iii.

We used Java because we wanted to try a new idea in programming not because of our
competency

4.4 System requirements

This process concerned with what functional necessities that the system would need to work .The
project designers gathered these requirements and analyzed them to investigated how they would
be achieved
4.4.1 User Requirements
It is very important to get users of the system fully involved such that the problem of change
management does not arise. The stake holders (Ndejje University Health Center), who will use
the system therefore, were approached during the study and were asked what they expected of
the proposed system and the following were the findings about what the users expected:
1. The system that is easy to learn and use
2. The system that improves on the efficiency of information storage and retrieval
3. The system that is fast in producing results which will be ready at the point of care
Therefore reducing on waiting time and increasing on time to attend to the patients
4. The system that has an element of error validation, i.e. one that prompts the user on entering
unusual command or data format inconsistent with the database.
5. The system that provides attractive interfaces with easy navigation throughout the sys-tem
6. The system that is faster, flexible and convenient.
7. The system that stores data and produces reports timely and accurately
8. The system that restricts access to information to only authorized personnel
9. The system that will generate automatic reports for each department
4.4.2 Functional Requirements
Functional requirements capture the intended behavior of the system. This behavior may be
expressed as services, tasks or functions the system is required to perform. Therefore the
14

Proposed system is able to:

1. Capture the patient information, store it and make it available at the time of need.
2. Present the users with a real-time display of the number of records in a database.
3. Allow the sharing of the data by the users from various departments.
4. Generate reports accurately and timely.
5. Search and display patient information details.
4.4.3 Non-functional Requirements (NFR)
Non-functional requirements are requirements which specify criteria that can be used to judge
the operation of the system, rather than specific behaviors. This is contrasted with functional
requirements that specify the precise behavior or functions. Systems must exhibit software
quality attributes, such as accuracy, performance, cost, security and modifiability plus usability,
i.e. easy to use for the intended users. NFRs help to achieve the functional requirement of a
system. Thus the proposed system does the following:
1. The system has high performance and reliability level. The mean time between failures, mean
time to repair, and accuracy are very high.
2. The system has user-friendly interfaces. This ensures the ease with which the system can be
learned or used. The system can allow users to install and operate it with little or no training.
3. Handles growing amounts of work in a graceful manner as can b e readily enlarged i.e. the
ease with which the system can be modified to handle a large increase in users, workload or
transactions.
4. The system prevents unauthorized access to the system with user authentication via log-on
system
4.5 System Design
During this stage, the system owners underwent through system design, database design both
conceptual, logical and physical database design.

15

Figure 4.2.System Design Context Diagram

4.5.1. User matrix

This is a table displaying various privileges that users are allowed to perform when using the
system. Project designers after having collected the user requirement came up with the user
matrix.

16

Figure 4.3.System Design user matrix

4.5.2 Process diagram

This diagram show how various processes in the system take place.
Figure 4.4 .System Design: Process diagram

17

4.5.3 Conceptual Database Design

This design is independent of physical or logical database design. The System designers use
ERD as the tool for conceptual database design.
This process described the construction of data model for each view of the real database this step
involved constructing the ER Model, Check the model for redundancy and validating the model
against user transactions. It also represented the Pictorial diagram of the database in terms of
entities which have attributes and relations between the entities.
Figure 4.5.Conceptual Database design

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4.5.4 .Logical database design

Under this process, the project designers constructed the model of information, which could then
be mapped into storage objects supported by MySQL database. It involved table generation From
ER Model
Figure 4.6 Logical Database design: Sample Table: Patient Registration

P_Id

Reg_No

Fname

Sname

Sex

Age

YAdmission

Faculty

Year

Symptoms

Diagnosis

4.5.5. Physical database design

During this stage, the project owners showed physical database structural image of the table
according to MYSQL .
The physical design of the database specified the physical configuration of the database on the
storage media. This step illustrated the database relations, integrity constraints and security
measures of the system.

Figure 4.7 physical Database design: Sample Table: Patient Registration

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4.5.6 Architectural design

This described the various parts and sections and the skeleton of the system .the project designers
used system architecture show the users how the system would work.
Figure 4.7 System architecture design:

20

4.5.7. Data flow diagrams

This is the graphical representation of how data move from one department to the other within
the system. The project designers used data flow diagrams to virtually show user how the system
receive, process and display the data
Figure 4.8 Data flow diagram

4.6. Implementation
This process depicted the tools, languages and environment which were used by the project
designers to put the project into practice. The project owners use Net bean 5.5 as the
implementation environment as well as the tool. The project was implemented using Java as a
21

front end language to development the application and MYSQL as a back end for developing
database for the application

4.7 Testing
The project designers after implementing the project tested and errors were debugged .Each each
added during project coding was tested to check for bugs. Later the whole project was tested
(integrated testing) .The system is now bugged free.
4.8 Validation
After analysis, design and development, the project team tested the system and found that it
fulfilled user requirements as follows;
The system allowed the right data entry to the right field and save data. It also output the search a
result according the user is searching and gives a feedback if the search result is not found. The
system enabled the user to update records .In addition, it generated reports about inputs. The user
who is not authorized cannot access the data .Therefore the system meet what the user expect the
system to perform.

22

CHAPTER FIVE: DISCUSSION, RECOMMENDATION, LIMITATION AND

CONCLUSTION
5.1 Discussion
Basing on the finding and analysis, computerization of health records management is venture
worth to invest in. Once taken seriously and embraced, there are a lot of benefits that can be
realized therein. Both the health centre and the community it is serving will benefit from it. For
example
i. Patients will no longer wait for long hours to be attended to because the time that would
be spent looking for information have been reduced
ii. Medical errors that were resulting from lack of information for proper decision making
on the part of doctors / nurses have been minimized. Records which were stored in the
records center, in form of charts and sometimes get lost are now being stored
electronically
iii. Periodic reports which are generated with the help of a computer are more accurate and
quick. Therefore with the introduction of computerization, the problem of late reporting
and errors in the reports have been solved
iv. It is important to note that this system is based on a file sharing server. This facilitates the
sharing of data in different departments. This helps personnel access the data at their
departments instead of moving from department to department looking for information
which is time consuming. Therefore departmental integration was achieved
5.2 Limitation of the project
1. Financial constraints: The study being a self sponsored venture, the researchers sometimes
faced problems to finance some of the activities involved in the study. How-ever, through hard
and thin, it has come to an end successfully.
2. Time constraints: The time allocated to the study looked not friendly given that the same
period involved the class work where there were a lot of course works, tests and lectures.
3. Busy schedules: The people working with current system were most of the time busy and this
made the work of the researchers difficult especially during data collection phase.

23

4. Fear for retrenchment: Some of the staff members at the hospital, especially the records staffs,
feared for their jobs with the introduction of the computerized system. They expressed fear that
they would be left with no work and risk being retrenched.
5. Throughout the whole study, electric power was never on the researchers side. It
Would go off at critical times and this hindered smooth progress and planning was made difficult
6. Lack of internet during the collection of resource materials for literature review
7. Low computer memory delay the project design and implementation
8. Connection to MYSQL server during database implementation was difficult to us but at last
solved
5.3 Recommendation
i.

We recommend that Ndejje health center adopt computer based students health records
management system to improve on data processing and analysis

ii.

It is realistic for Ndejje University to adopt the deployment of locally developed software
to motivate students in the IT department to put more effort in software development

iii.

Locally developed software are flexible to change than off the shelf (COTS) which do
accept less modifications and changes

5.4 Conclusion
Although this project is a demand for us to graduate, if implemented at Ndejje University health
center, would improve on time and effort exerted on by the staff in various department. It would
reduce paper work in the health center .It is true that this project is a prototype which can be redesign and implemented to meet the real health center requirements

24

REFERENCES
1.

Bell, J (1992). Doing your research project Milton Kinescope en University Pres UK

2.

Bush, G.W. (2004). President George W. Bush, Transforming Health Care through
Health Information Technology: State of the Union Address, January 20, 2004, retrieved
June 10, 2006 from itehousegov/in focus/technology/

3.

Chaiken, B. P., Edward, B., Bevan, K. B.and Seth, F. (2006). Clear and Lasting Dan-ger
Pandemic Flu, and How IT Can Help: Proceedings of the WTN Medias 2006 Dig-ital
Health care Conference , retrieved June 15, 2006 from http://wistechnology.com/

4.

Chrisanthi, A. and Tony, C. (1998). Developing Information systems: Concepts, Issues

And Practices, Palgrave, Newyork.

5.

Cisco (2005). Health care Industry Announcers of Change: Cisco Systems, Inc.: Over
viewed June 8, 2006 from http://www.cisco.com/web/strategy/docs/healthcare/ ehrconnected.pdf

6.

, W., Gary, W., Prekop, J., Traxler, J., and Melski, J. W. (2006) Data Over-st to Deliver
Knowledge. Proceedings of the WTN Medias 2006 Digital
Health care Conference, retrieved June 15, 2006 from http://wistechnology.com/

7.

International Standard Organization, 15489 (2001).Wikipedia: The free encyclopedia,

2, 2006 from [http://en.wikip edia.org/wiki/Records-management]

8.

Klein, M. (2006). Will Technology improve health care delivery? Wisconsin technology
Network

Journal

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12th

2006

from

http://wistechnology.com/
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Meghan, C. (2006).President to Push Medical Record Computerization the New York

Sun article January 6, 2006, retrieved June 8, 2006 from www.nysun.com/
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10.

Lucey, T. 2002. Management Information Systems, Continuum 11 York Road, London.

11.

MOH (2001). Uganda Health Bulletin Volume 7 - No 4

12.

Ndagire, Mary Lucy (2003). An inventory management system: Case study Rubaga
Hospital

13.

Obrien, J. A. (2002). Management Information Systems: Management information

Technology in the e-business enterprise, Tata McGraw-Hill, New Delhi

14.

Pushman, J. (2000) Tips on web page design, HTML and Graphics, Web Developers
Journal, Retrieved October 5 2006, 2002, from ABI/INFORM Global database.

15.

Scott J. T., Rundall T. G., Vogt T. M. (2005). Kaiser Permanentes Experience of

Implementing an Electronic Medical Records: A Qualitative Study, (BMJ, December
3, 2005), vol.29 Retrieved May 20, 2006 from http://www.cmwf.org/publications

16.

Steve, A., Joseph, W, Susan, J. H., Gary, M. K. (2006).Electronic Health Records: A

Global Perspective Overview Retrieved Sep 12 2006 from

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Weddi, D. (2005). Using information systems to manage health in Uganda: 2004-2005

Annual Health Sector Performance report Retrieved Sep 12 2006 from www.iconnect-

online.org
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WHO (2004). Developing Health Management Information System: A practical guide

For developing countries retrieved June 7, 2006, from www.wp.or.who.int/publications

26

Appendix I
Interview guide
An interview guide used in data collection at Ndejje University Health Centre.
1. Who was the founder of this health center?
2. When was this health center started?
3. Is the health center sponsored by any health organization or ministry?
4. Which departments does the health center have?
5. Does the health centre have enough skilled workers?
6. How does the health centre keep patients health records?
7. How good and bad is the existing record keeping system
8. What is your job title?
9. How many patients do you see daily?
10. What problems do you face with the existing system?
11. Do you recommend to continue with the existing system, if yes why?

27

Appendix II
Questionnaire

QUESTIONAIRE FOR NDEJJE UNIVERSITY HEALTH CENTER

Dear respondent, we are carrying out data collection for the project of Ndejje University Health
center as part for the award of the undergraduate degrees in the faculty of Science and
Information Technology of Ndejje university .The information that you would provide would be
used STRICTLY for academic purposes and would be treated as confidential
1. What health records system do you use in the health center?
...
2. What problems do you faced with the current system?
.
6. How strong is the current system?
.
7. How weak is the current system?
..
3. How many departments does the health center have?

4. How many patients do you register in a day?

..
5. What variables do you record about the patient?

28

Appendix III
5.5.3. System screen shots

Figure 5.1: Login screen

29

Figure two: New Consultation Sheet

Figure Three: Consultation Report

30

Figure Four: Search Laboratory Results

Figure Five: Nursing Department: Receive Admission

31

Figure Six: Counseling Department: Client Post counseling form

Figure Seven: Dispensary New Inventory form

32