CHAPTER ONE

INTRODUCTION

1.1    Background of the Study

The goal of any system development is to develop and
implement the system cost effectively; user-friendly and most suited to the user’s
analysis is the heart of the process. Analysis is the study of the various
operations performed by the system and their relationship within and outside of
the system. During analysis, data collected on the files, decision points and
transactions handled by the present system. Krishna medical center, luck now
(K. M. C.) is a prestigious hospital situated in the heart of Hazrat Genj with
a very large patient capacity. This number is increasing at a rapid pace with
each passing day. The management of the hospital is concerned with the
increasing effort in keeping records of the patient and recording their
activities. Health is generally said to be wealth.  It takes healthy people to generate the
wealth the nation requires for the general well-being of its people. There is
therefore the need for adequate Medicare especially in the area of diagnosis
and treatment of diseases.  Since there
is a good relationship between the job output and health of the workers, a good
Medicare is vital.

Unfortunately, in most
developing nation (including Nigeria), this adequate Medicare is lacking due to
how standard of technological know-how and manual handling of most medical
problems.  As observed by Lyiama H.C. and
D.C.

Chukwu, “very often, people in developing countries who are
critically ill are rushed abroad for special treatment because it is felt that
Medicare facilities at home are inadequate.  
This is partly because computer – aided Medicare has become a reality in
many developed countries”.  It is also a
known fact that the production of qualified medical doctors and other medical
personnel and consultants in on the increase, but his is not enough to meet the
health needs of the increasing population. 
The ratio of patients to a doctor is still high.

This situation creates problems, because proper and adequate
medical attention of patients is far-fetched. 
Nowadays, the low-income class is mostly affected.  Doctors hurry over their duties in order to
attend to all the patients.  At the end
of the day, they are tired and over worked.

Considering the rate of population growth the medical care
and facilities available, and the health needs of the people, computer-aided
Medicare is in evitable for more accurate. 
Furthermore with the present shift to an information society, it is
necessary to anticipate the future use of a sophisticated electronic machine
the computer. This is necessary because the computer is rapidly finding its way
into every field of human endeavor, including medicine. Its application
includes patient care and protection, clinical administration, intensive
monitoring during emergencies, surgical operations, diagnosis and automation of
medical records.  For instance, during a
complex surgical operation as exemplified by Lyiama and Chukwu, “the computer
monitors person being operated on, revealing all vital signs (pulse, blood
pressure, breathing rate, etc) of interest to the doctors in the theatre, thus
helping them to be more accurate and effective in what they are doing. Such a
patient monitoring system can be with a video Display Unit (VDU), a keyboard
for interactive inputs and an alarm”. The wide range of the use of computer is
due to its versatility as a data processing machine and its ability to do
things including complicated tasks faster, better and more accurately than
human beings would.

1.2     STATEMENT OF THE PROBLEM

It has been observed that to
receive medical treatment in most of our hospitals, the patients queue up for
several hours from one unit of the hospital to another starting from obtaining
a new hospital folder, or retrieving an old one before consulting a doctor, to
the laboratory unit for lab test then to the pharmacy to get the prescribed
drugs and so on.  With the manual
processes involved in handling the patient most of them waste the whole day in
the hospital.  Very often, patients leave
their homes very early in the morning in order to be among the first group to
see the doctor. 

Otherwise, they may end up wasting the whole day without due
attention.

This situation is discouraging to most patients and
sometimes forces them to turn to non-professionals or even resort to
self-medication for quick recovery.

Moreover, the volume of work for
the hospital personnel is much. Patients outnumber the doctors, nurses and
other medical personnel that too much are required from them.  In this regard, to examine all his patients
for the day the doctor hurries over his work without adequate attention and
expertise to his clients. 

Still, at the end of the day he is exhausted.

In addition
to this, the diagnosis and prescription depend on the doctor‟s memory and drug of
choice. Their brains are often loaded with different diseases, signs and
symptoms, complications and various drugs for their treatment and so on.  Some of which are very similar. To remember
and process these huge information in his clinical work is very tasking.  For this reason accurate diagnosis and
prescription may not always be obtained.

The keeping and retrieval of accurate records on patients
are poorly carried out in most of our hospitals.  Files may be misplaced; the record in them
may be wrongly filled.  Hence, it is not
easy to obtain accurate and timely information or data.

This is also the case with obtaining other medical
information and data especially when new folders and numbers are obtained each
year.

Finally, the keeping of folder for each patient manually
takes a lot of time and money and some of the information are redundant.  All these have net effect of loss of lives
and inefficiency on the part of management.

1.3     OBJECTIVES OF THE STUDY

This study is centered on the following objectives.

1.                
To examine the current procedures employed in our
hospitals with regards to patients admission, diagnosis and treatment.

2.                
To examine the associated problem(s) or flaws in the
current system

3.                
To improve on the already existing system by designing
an efficient practical patient billing software, this is aimed at an accurate,
faster and reliable patient‟s information system.

1.4     SCOPE OF THE STUDY

This research work is limited to patient‟s admission
information system including treatments, bills and payments. The software
developed will be carried out using Microsoft C# to manage the database.

1.5     LIMITATIONS

This project covers all aspect of Medical system with
regards to patient‟s information. Due to time and financial constraint, the
software developed excluded laboratory units.

1.6     SIGNIFICANCE OF THE STUDY

Several possible advantages to practical patient billing
software System over paper records have been proposed which includes:

Reduction of cost

A vast amount of funds are allocated towards the health care
industry. The computerized system is implemented, it will reduce the personnel
cost.

Improve quality of care

The
implementation of electronic health records (EHR) can help lessen patient
sufferance due to medical errors and the inability of analysts to assess
quality.

Promote evidence-based medicine

Computerized medical record provides access to unprecedented
amounts of clinical data for research that can accelerate the level of
knowledge of effective medical practices.

Realistically, these benefits may only be realized if the
systems are interoperable and wide spread (for example, national or regional
level) so that various systems can easily share information.

Record keeping and mobility

EHR systems have the advantages of being able to connect to
many electronic medical record systems. In the current global medical
environment, patients are shopping for their procedures.

1.7     DEFINITION OF TERMS

Electronic Health
Record– An electronic health record (EHR) (also electronic patient record
(EPR) or computerized patient record) is an evolving concept defined as a
systematic collection of electronic health information about individual
patients or populations

INFORMATION –
Information is data, or raw facts, shaped into useful form for human use.

SYSTEM – A system is a combination or arrangement of parts to form an
integrated whole, working together to achieve specific tasks. A system includes
an orderly arrangement according to some common principles or rules.

Subsystem – A
complex system is difficult to comprehend when considered as a whole.
Therefore, the system is decomposed or factored into subsystems. Subsystems
constitute the entire system. They are complete systems on their own but exit
in another system called the complex system. Subsystems can be further
decomposed into smaller subsystems until the smallest subsystems are of
manageable size. The subsystems resulting from this process generally form
hierarchical structures. In the hierarchy, a subsystem is one of a supra-system
(the system above it).

Expert system: is
software that uses a knowledge base of human expertise for problem solving, or
clarify uncertainties where normally one or more human experts would need to be
consulted.

Hospital information
system (HIS): variously also
called clinical information system (CIS)
is a comprehensive, integrated information system designed to manage the
administrative, financial and clinical aspects of a hospital. This encompasses
paper-based information processing as well as data processing machines.

MIS– Management Information System is
the system that stores and retrieves information and data, process them, and
present them to the management as information to be used in making decision. It
can also be defined as an integrated machine system that provides information
to support the planning and control functions of managers in all organizations.
By these definitions, MIS must serve the basic functions of management, which
include planning, organizing, staffing, directing and controlling. Information
systems that only support operations and do not have managerial decision making
significance is not part of MIS.

MCS– Management Control system is a form of Information System used
by the management of an organization to analyze each application of information
system in terms of input, storage, processing and output. The MCS has
functional subsystems such as the hardware system, the operating system, the
communication system and the database system. Management control systems are
human artifacts.

This means that MCS exits only because human beings design
and build them.