LORMA Colleges Chapter 3 DISCUSSION OF FINDINGS This chapter presents and discusses the existing

process in the Bacnotan District Hospital, the problems in student record and the features of the proposed system.

Current processes of Bacnotan District Hospital Information System An interview was conducted by the researcher to gather the necessary information to draw the processes involved in the Bacnotan District Hospital. Maintaning the records of the patient are vital to the Bacnotan essential District for the Hospital. patients Since the records are proper very and

medical

history,

safe keeping of the patients are dimmed necessary. The data existing processes involved of along the area on and

management

are

filling-out

patient

records,

storing of patient records. Registration. Walk-in patients are needed to get a

number because of the First Come, First Serve policy of the hospital. Once the patient number is called and presented the patients hospital number or personal information, the staff would retrieve the patients records from the

shelves.

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LORMA Colleges Emergency. Emergency cases are automatically taken

direct to an ER bed which would be seen by a nurse and/or resident physician. Orders are carried and patients data are taken. Auxiliary Services. Auxiliary services consist of

laboratory, pharmacy, x-ray and dental. This would be done once the Resident-On-Duty requested for any test to the laboratory, X-Ray scans, prescribed medicines or for dental consultation Billing Section. Once the doctor permitted the patient to be discharged and all of the patients charts were

filled, all of the charts would be checked by the Billing Section patient. Cash Section. The Cash Section counter check the bills of the patient, and check computation of bills and and gives collect final to countercheck and compute the bills of the

payment

issues

official

receipt

clearance for discharge to the patient if the patient was admitted. In-Patient Service. Nursing care services provided for the admitted patients. Nurses checks the vital signs, give medications, carry out orders of the doctor, records

progress and charts of the patient.

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LORMA Colleges
Figure 3 Patient Management Flowchart

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LORMA Colleges Problems System Based on interviews conducted among the staffs and in the Bacnotan District Hospital Information

nurses, supplemented with personal observation done by the researchers the following are the identified problems along the areas on data management and security. The identified problems along the area on data

management are redundancy of data and limited storage. Redundancy of data. Nurses are required to fill out forms every time a patient visits especially if the patient visited the hospital for the first time. Some of the forms require the same data specifically the personal information of the patient specially if the patient visited and has records in the hospital. Another instance is when a patient visits the hospital and the nurses and staffs could not locate the record of the patient due to misplaced form, a new form would then be required to fill out by the nurses in order to replace the missing record. This process

results to data redundancy. Limited storage. With the numerous number of records stored in shelves the problem on limited storage arises. Once a new patient visits the hospital for consultation or admission additional records are being kept on shelves.

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LORMA Colleges Security of the Records. Records are kept in shelves and it is easy to access because it is not stored in a room. The shelves are just behind the desk of the OPD and once a staff or nurse gained access to the records they can disarrange the records and can cause problems in retrieving the information of the information of the patient.

Features of the Proposed System Based on the existing processes and problems

identified, the following proposed features are drawn to give solutions to the problems encountered by the Bacnotan District Hospital. Login Page. This feature allow user to login to the system. Only users with registered account are only allowed to log in into the system and this would prevent other people looking to the records of the patient. Figure 4 Login Page Module

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LORMA Colleges Admin User Privilege. On the Admin User Privilege, the Admin can Add User Accounts, Edit or Reset the Password of the Users, Update the privilege the of a user using and the delete system

accounts.

This

would

limit

users

because only few users can use the system because only the user with an admin privilege can add users that can access the system, change the account privilege, reset password and delete the account. Figure 5 Account Registration Module

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LORMA Colleges Figure 6 Account Management Module

Management of Patient Record. This feature allows the nurses feature and is staff used to manage the patient records. of the This

during

data

buildup

system

especially to a new patient. The comprises management of of patient of information patients and and records updating

registration

new

patient information and record. The patient record would determine if the patient would be confined or not based on the findings of the physician that was inputted into the system.

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LORMA Colleges Figure 7 Patient Registration Module

Figure module.

above

shows

the

new

patient

registration

Figure 8 Patient List View Module

Figure 8 above shows the list of patients registered in the system.

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LORMA Colleges Figure 9 Patient Search Module

Patient

Search.

This

feature

allows

searching

for

patients that were registered in the database. This would fasten in searching patient records especially if the user has already an existing record in the hospital. Figure 9 above shows the patient search module.

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LORMA Colleges View individual Patient Information is shown and in Record. this page. Patients Previous

information

records are shown also in this page and there is Add Record module included if the patient returned to the hospital. Figure 10 Patient Information Module

Figure information.

10

above

shows

the

patients

personal

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LORMA Colleges Figure 11 Patient Record List Module

Figure 11 above shows the records of the patient from the previous records to the current records.

Figure 12 Patient Add Record Module

Figure 12 above shows the Add Record form. This is used if the patient returned to the hospital.

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LORMA Colleges Figure 13 Add Remarks Module

Figure 13 above shows the Add Remarks form. This is where the doctor puts his impression on the patient. This will determine if the patient is for admission or not.

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LORMA Colleges Figure 14 Patient Admitted List Module

Patient Admission Management. This feature allows the nurses and staff to manage the patient records who were admitted in the hospital. This feature is used to keep track of the patients by looking into their charts. The management of patients that were admitted in the hospital comprises of viewing the charts of the patient, updating the charts, transferring the patient to another ward or room and discharging the patient. Figure 14 above shows the list of patients admitted in the hospital

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LORMA Colleges Figure 15 Patient for Admission List Module

Figure 15 above shows the list of patients that are for admission. It automatically updates the page if theres a patient for admission.

Figure 16 Admission Verification Module

Figure 16 above shows the form to admit the patient. The system would ask the user the doctor who would admit Bachelor of Science in Information Technology

Discussion of Findings

33

LORMA Colleges the patient, the bed number and the ward where the patient would be admitted.

Figure 17 Patient Admission Information and Record Module

Figure

17

above

shows

the

complete

patients

information and record taken.

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LORMA Colleges Figure 18 Therapeutic Form Module

Figure 18 above shows the therapeutic form where all the therapeutics given to the patient is listed. On this form, the form automatically shows a new form once the day changes to make inputting data much easier.

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LORMA Colleges Figure 19 Clinical Face Module

Figure 19 above shows the clinical face form where all of the information of the patient being admitted are

inputted and shown in this form this includes the number of hospital days the patient stayed, the final diagnosis of the patient and procedures done to the patient.

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LORMA Colleges Figure 20 History and Physical Form Module

Figure Examination

20

above The

shows nurse

the or

History doctor

and

Physical input the

form.

would

information they got from examining the patient. This is one of the basis for checking the medical history of the patient.

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LORMA Colleges Figure 21 Doctors Orders Form Module

Figure 21 above

shows the list of orders from the

Attending Physician of the patient. There are options if the order was carried, administered, request made, endorsed or discontinued.

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LORMA Colleges Figure 22 Progress Notes Form Module

Figure 22 above shows the progress notes form. Nurses input the progress of the patient.

Figure 23 Nurses Notes Form Module

Figure 23 above shows the nurses notes form. Nurses input their notes about the patient.

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LORMA Colleges Figure 24 IVF Consumption Form

Figure 24 above shows the IVF consumed by the patient. The nurse would input the shift and time the IVF

consumption started the name of the IVF and the date and time the patient consumed the IVF.

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LORMA Colleges Figure 25 List of Patients for Discharge

Billing

Management

Module.

This

feature

allows

the

Billing Section to manage the patient billing statements who were admitted This and ready is to be to discharge keep track from of the the

hospital.

feature

used

patients billing statement. The management of patients that were admitted in the hospital comprises of automatic calculation of the expenses of the patient depending on the case of the patient,

discounts and benefits of the patient. Figure 25 above shows the list of patient that was already cleared and ready to be discharge.

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LORMA Colleges Figure 26 List of Previous Patients Discharged

Figure 26 above shows the list of patients that were already discharged. This is used to keep track of the

previous billing statements of the patients.

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LORMA Colleges Figure 27 Billing Statement Form Module

Figure 27 below shows the form for creating the billing statement of the patient. The form automatically computes the bill of the patient

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LORMA Colleges Figure 28 List of Available Doctor Module

Doctor

Management

Module.

This

feature

allows

the

nurses and staffs to manage the doctors information. This feature is used to keep track if theyre On-Duty, On-Call or On-Leave. The management of doctors in the hospital comprises of doctor information with their contact numbers, duty,

specialization and position in the hospital Figure 28 above shows the list of available doctors that were On-Duty or On-Call.

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LORMA Colleges Figure 29 List of all Doctors Module

Figure 29 above shows the list of all of the doctors working in the hospital.

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LORMA Colleges Figure 30 Add Doctor Module

Figure 30 above show the add doctor form where the only user with Admin privilege can add a doctor to the system.

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LORMA Colleges Figure 31 Doctors Information Module

Figure 31 above with its specialty,

shows the doctors information number, address and duty

contact

status.

Figure 32 Doctors Current Patient List Module

Figure 32 above shows the list of current patients handled by the doctor. Bachelor of Science in Information Technology

Discussion of Findings

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LORMA Colleges Figure 33 Doctors Previous Patient List Module

Figure 33 above shows the previous patients handled by the doctor.

Figure 34 User Information Module

Account

Management

Module.

This

feature

allows

the

user to manage his account. The user can view the users information, login history, change the users password.

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LORMA Colleges Figure 34 (see page 65) shows the users information.

Figure 35 Account Settings Module

Figure

35

above

shows

the

Account

Settings

module

where the user can view his login history and change his password.

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LORMA Colleges Figure 36 Add Therapeutics Module

Figure 36 above shows the Add Therapeutics Form where the user can add therapeutics by inputting the name of the therapeutic, type and price the price.

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LORMA Colleges Figure 37 Add PhilHealth Pricing List Module

Figure 37 above shows the Add PhilHealth Pricing List where the user can add a PhilHealth price list. The user would input the membership type and the amount for each benefit a patient can get.

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LORMA Colleges Figure 38 PhilHealth Price List Module

Figure 38 above shows the PhilHealth Price List. The system shows the list of PhilHealth benefits a patient can get according to the type of membership.

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LORMA Colleges Figure 39 Data Deletion and Update Security Module

Data Deletion and Update Security Feature. The records of the hospital are sensitive because once a data was

deleted it can compromise the findings and diagnosis on the cause of illness of a patient. It can also create conflicts once a patient to be consults found even and the patients the records are

nowhere

though

patient

previously

visited the hospital. Once the user tried to edit or delete a patient record, the system would prompt the users

username and password to confirm if the user has the right to delete or update patients records. Figure 39 above shows the data deletion and update security module.

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LORMA Colleges Figure 40 Use Case Diagram of the Proposed System

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LORMA Colleges Figure 41 Entity Relationship Diagram

Patient 1..1 1..*

1..*

examines

1..*

Doctor 1..*

has

1..*

Records

1..*

Fill-up

can be

1..* 1..* Admitted 1..1 1..* has 1..*

1..*

Charts

has

1..*

Bills

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LORMA Colleges Database Scheme tbladmission PK: aid FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords aid, pid, rid, bednumber, roomno, service, status, dateadmitted

bid, bednumber, roomno, roomtype, tblbed PK: bid FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission pid, rid, aid, status, priceperday, dateadmitted

cfid,

pid,

aid,

rid,

category,

nameofnextkin, addresskin, timeadmitted, timedischarged, servicedept, tblclinicalface

relationshipkin, dateadmitted, datedischarged, noofdays, servicedept2, ward,

did, admittingdiagnosis, wb, imp, unmp, exp, ref, trans, hama, abs, others, admittingclerk, finaldiagnosis, surgicaldone, residentincharge, medicalspecialist, seniorresidenthead, admittingphysician, disposition, complications, pathologicalreport,

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LORMA Colleges persondischarged, dateaddedform PK: cfid FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission -did referencing to table tbldoctors

did, tbldoctors

firstname, title,

middlename, specialization, dateleave,

lastname,

position, address, contact, duty, professionalfee, dateregistered

PK: did

tbldoctorsattended PK: daid

daid,

pid,

rid,

did,

task,

datetimeadded

FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -did referencing to table tbldoctors

tbldoctorsorder PK: oid

oid, pid, rid, aid, doctorsorder, ordercarried, datetimeordered

FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission

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LORMA Colleges hid, rid, pid, aid, complaint, ftb,

presentillness, heartdisease, fallergies, tblhistoryphysical chestbreast, stomach, spleen, spine, PK: hid

fcancer,

fhypertension, fmental, fblooddys, fdiabetes, familyplanning, hrate, liver, kidneyblad, neurological, bp, rrate,

genapp, skin, headbent, necklymph, gallbladder, genitalia, admitimpre,

doctor, dateadded FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission -did referencing to table tbldoctors

cid, pid, rid, aid, datestarted, tblivfconsumption PK: cid FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission shift, timestarted, ivfbt, dateconsumed, timeconsumed

tbllogins PK: lid

lid, uid, browser, os, login

FK:-uid referencing to table tblusers

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LORMA Colleges tblnursenotes PK: nid FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission nid, pid, rid, aid, datetimeadded, nursenotes

iid, pid, rid, hid, aid, measles, tb, malaria, arthritis, syphilis, drugs, tblpastillness mental, others, dateadded PK: iid FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission -hid referencing to table tblhistoryphysical mumps, asthma, rheumatic, alcoholism, cancer, children, typhoid, diarrhea, diabetes, previousop,

hypertension, blooddys, allergies,

pbid, pid, rid, aid, membership, billingnumber, supplies, tblpatientbills ultrasound, accomsubs, orfeedrfee, phdrugsandmedicines, nurseonduty, xray, oxygen, admissionfee, phsupplies, finaldiagnosis, drugsandmedicines, laboratory, ecg,

professionalfee,

wardservice, nebfee, ambulancefee,

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LORMA Colleges phlaboratory, phultrasound, phaccomsubs, phecg, phxray, phoxygen, phprofessionalfee,

phorfeedrfee, exdrugsandmedicines, exsupplies, exlaboratory, exxray, exultrasound, exaccomsubs, exorfeedrfee, exwardservice, exambulancefee, PK: pbid FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission total, status, datetimerecorded execg, exoxygen, exprofessionalfees, exadmissionfee, exnebfee, extotal,

rid, tblpatientrecords weight,

pid,

dateofvisit, complaint,

age,

timein, timeout, bp, cr, rr, temp, remarks, admit, foradmission, dateregistered PK: rid FK:-pid referencing to table tblpatients

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LORMA Colleges tblpatients pid, firstname, membership, opdnum, middlename, sex, cs, address, occupation,

lastname,

dateofbirth, placeofbirth, dateregistered PK: pid

contactno, religion, nationality,

phid, drugsandmedicines, tblphilhealthpricing laboratory, ecg, PK: phid

membershiptype, supplies, ultrasound, accomsubs, xray,

oxygen,

professionalfee, orfeedrfee

tblprogressnotes PK: pgid

pgid,

pid,

rid,

aid,

datetime,

progressnotes

FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission

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LORMA Colleges tbltheraconsumed PK: tcid FK:-pid referencing to table tblpatients -rid referencing to table tblpatientrecords -aid referencing to table tbladmission -tid referencing to table tbltherapeutic tcid, pid, rid, aid, tid, shift, given, givendate

tbltheranames PK: tnid

tnid,

therapeutic,

type,

price,

datetimeadded

tbltherapeutic PK: tid

tid, type

pid,

rid,

aid,

theraname,

FK:-pid referencing tblpatients -rid referencing tblpatientrecords -aid referencing tbladmission

uid, tblusers username,

firstname, password,

lastname, priviledge,

department, lastlogin

dateregistered,

PK: uid

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LORMA Colleges Figure 42 Virtual Table of Contents of Bacnotan District Hospital

Information System

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LORMA Colleges As a summary, the existing processes in the hospital patient management flow of BDH are focused on three areas namely: storage, access, and security. Along on the area on storage, the existing processes identified are filling out of patient record and storing patient records on shelves. Along the area on security, the processes are authorization of user access, labeling of envelopes for records and

organizing of records. The problems identified are redundancy of data,

limited storage for records, inefficiency in retrieval of patient record, loss or misplaced charts and records, slow pace of searching of records, unorganized filing shelves and updating the patient records and charts. The features drawn to give solutions to the problems encountered management mechanism, include of management records retrieval of and of patient charts, patient information, search engine and

patient

automatic

records

charts, automatic computation of bills and management of user level. The interface connection. proposed which system would shall run on be an a web-based Intranet user

network

Bachelor of Science in Information Technology