Figure (3-7): add staff 30

CHAPTER ONE

Overview 1.1

Human Body is a very complex and sophisticated structure and comprises of millions of
functions. All these complicated functions have been understood by man him, part-by-part
their research and experiments. As science and technology progressed, medicine became an
integral part of the research. Gradually, medical science became an entirely new branch of
science. As of today, the Health Sector comprises of Medical institutions i.e. Hospitals,
HOSPITALs etc. research and development institutions and medical colleges. Thus the
.Health sector aims at providing the best medical facilities to the common man

Abstract 1.2

Hospital Management System provides the benefits of streamlined operations, enhanced

administration, control, superior patient care, strict cost control and improved profitability.
HMS is powerful, flexible, and easy to use and is designed and developed to deliver real
conceivable benefits to hospitals. More importantly it is backed by reliable and dependable
support. The project ‘Hospital Management System’ is based on the database, object oriented
and networking techniques. As there are many areas where we keep the records in database
for which we are using MY SQL software which is one of the best and the easiest software to
keep our information. This project uses JAVA as the front-end software which is an Object
Oriented Programming and has connectivity with MY SQL. Hospital Management System is
custom built to meet the specific requirement of the mid and large size hospitals across the
globe. All the required modules and features have been particularly built to just fit in to your
requirement. This package has been widely accepted by the clients in India and overseas. Not
stopping only to this but they are highly satisfied and appreciating. Entire application is web
based and built on 3 tier architecture using the latest technologies. The sound database of the
application makes it more users friendly and expandable. The package is highly customizable
and can be modified as per the needs and requirements of our clients. Prolonged study of the
functionalities of the hospital and its specific requirement has given it a wonderful shape both
technically and usability wise. It covers all the required modules right from Patient
Registration, Medicine details, Doctor, Wards, , Admin, Store, Patient appointment, bill
payment, record modification, discharge details etc. Human Body is a very complex and
sophisticated structure and comprises of millions of functions. All these complicated
functions have been understood by man him, part-by-part their research and experiments. As
science and technology progressed, medicine became an integral part of the research.
Gradually, medical science became an entirely new branch of science. As of today, the Health
Sector comprises of Medical institutions i.e. Hospitals, HOSPITALs etc. research and
development institutions and medical colleges. Thus the Health sector aims at providing the
.best medical facilities to the common man

Problem Statement Since Hospital is associated with the lives of common people and their
day-to-day routines so I decided to work on this project. The manual handling of the record is
time consuming and highly prone to error. The purpose of this project is to automate or make
online, the process of day to-day activities like Room activities; Admission of New Patient,
Discharge of Patient, Assign a Doctor, and finally compute the bill etc. I have tried my best to
make the complicated process Hospital Management System as simple as possible using
Structured Modular technique Menu oriented interface. I have tried to design the software in
such a way that user may not have any difficulty in using this package further expansion is
possible without much effort. Even though I cannot claim that this work to be entirely
exhaustive, the main purpose of my exercise is perform each Hospital’s activity in
computerized way rather than manually which is time consuming. I am confident that this
software package can be readily used by non-programming personal avoiding human handled
.chance of error

Significance of the Study 1.3

The study is important to the hospital patients since they could have medical information
without experiencing delays and incorrect information. If they wanted to access their medical
history, they would not be going through a difficult process. The hospital especially the
pharmacy and billing department would not go through a lot of paper reports when it comes
to payments and accounting records. The use of paper would still be there but it could be
.reduced so that excessive paper loads would not be a problem

The study was also significant to the staffs since they would be able to register, update,
delete, and search information within the system. It was beneficial to the hospital since it
could improve their management through connecting all their existing computers in one
system. In general, the study was important to the hospital and patients for it could serve as
.an applicable tool to maintain the productivity and quality of service in the hospital

Hospital is a leading among the public hospital. Health system functioning depends on
production and use of quality health data and information at all levels of the health system.
This study serves as a starting point for the assessment of HIS based on the situation in
public to identify the strengths and weakness of the system in improving health system
functioning. The study forms a basis for further research on evidence based management of
health services in general and specifically lead to generation of new ideas for better and more
efficient management of health facilities in Nairobi and the country at large. The study will
.look at the use of hospital information system in a private and a public hospital

Findings and recommendations of the study would contribute towards the ongoing efforts
of ministry of health to develop better health management operations system that would
benefit facilities and healthcare workers identify their weakness and thus propose better ways
that could help improve their efficiency through improved information use. The findings of
the study will be used by all health care workers and health care managers as and will not
rely on haphazard personal experiences or subjective personal judgments or of friends
/relative other than base their decisions and actions on concrete evidence and thus help re-
.invent themselves as problem solvers

Related Work 1.4

Hospital Management System (HMS) is designed for multispecialty hospitals, to cover a

wide range of hospital administration and management processes of patient-centric system. It
is an integrated end-to-end Hospital Management System that provides relevant information
across the hospital to support effective decision making for patient care (medical records
management and billings), and hospital administration, in a seamless flow. In existence, some
researchers have contributed positively in the improving of health care institutions
management systems. Therefore, we discuss in this section below, some of the related works
.done in hospital management system by researchers in the field

The work of [8] focused on understanding the performance indicators of Hospital

information systems (HIS), summarizing the latest commonly agreed standards and protocols
like Health Level Seven (HL7) standards for mutual message exchange, HIS components,
etc. The study is qualitative and descriptive in nature and most of the data is based on
secondary sources of survey data. However, the researchers identified several modules for the
implementation of E-Hospital Management and Hospital Management System in which
Emergency Management was one of them. The contents operation within this module
excludes the incorporation and use of Biometric Fingerprint Technology. Thus, this indicates
that emergency cases in the intensive units where the registration of patients is trivial cannot
be handled adequately with respect to time. It was noted that the success factors of E – HMS
/ HIS tend to vary depending upon leadership support, training, technology adoption, user
.friendliness, etc. within a country

identified the challenges existing in Mother-love Hospital, such as Data redundancy, [1]
data inconsistency, difficulty in accessing data, data isolation, integrity problems, atomicity
problem, concurrent access anomalies, and some security problems. They cited [4] among
others which pinpointed at techniques behind Database Management technologies, and thus
overcome the existing challenges. The system is visualized as a web based application with
three tier architecture. This architecture provides an increased degree of security because its
multiple zones isolate protected healthcare data making it difficult for a hacker to get system-
level access to the database. The solution proffered by this system did not incorporate
.enabling technology to handle patients’ in critical condition(s)

Project objectives 1.5

The objective of this project is to develop hospital management software based on

Microsoft window application with structured Query language (T-SQL and SQL Server as a
database) as the back-end database hospital from file based system to a computer database
system. This software will help the company to be more efficient in handling the daily
activities and registration of their patients. The purpose of this project is to give a complete
requirement documentation, design, and implementation of the software. It also explains the
user interface, hardware and software and different models that could be used to develop
.software such as this

Hospital are the essential part of our lives, providing best medical facilities to people
suffering from various ailments, which may be due to change in climatic conditions,
increased work-load, emotional trauma stress etc. It is necessary for the hospitals to keep
track of its day-to-day activities & records of its patients, doctors, nurses, ward boys and
.other staff personals that keep the hospital running smoothly & successfully

But keeping track of all the activities and their records on paper is very cumbersome and
error prone. It also is very inefficient and a time-consuming process Observing the
continuous increase in population and number of people visiting the hospital. Recording and
maintaining all these records is highly unreliable, inefficient and error-prone. It is also not
economically & technically feasible to maintain these records on paper. Thus keeping the
working of the manual system as the basis of our project. We have developed an automated
version of the manual system, named as “Administration support system for medical
” .institutions

The main aim of our project is to provide a paper-less hospital up to 90%. It also aims at
providing low-cost reliable automation of the existing systems. The system also provides
excellent security of data at every level of user-system interaction and also provides robust &
.reliable storage and backup facilities

Background to the Study 1.6

Healthcare especially in the developed world is characterized by rapidly increasing use of

information technology in patient care, increasing documentation, coding and billing, and
management. Rise of health information technology worldwide is increasing the efficiency of
health service delivery, reducing medical errors, improving quality of care and providing
.better information for patients and physicians (Pollak and Lorch, 2007:4)

The overall goal of the information management function is to obtain, manage, and use
information to improve health care and medical services, performance, governance and
.management and support processes

The importance of healthcare to individuals and governments and its growing costs to the
economy have contributed to the emergence of healthcare as an important area of research
for scholars in business and other disciplines. Information systems (IS) have much to offer in
managing healthcare costs and in improving the quality of care (Kolodner et al. 2008: 394).
In additional, Piontek et al., (2010: 618) asserts that healthcare influences the quality of
human lives and function in the society. Healthcare mistakes have serious consequences that
can affect ability to carry out social and productive endeavors. Recent reports highlight the
gravity of adverse events in hospitals and the dangers such events pose to individuals and the
public. Healthcare information systems have changed the healthcare industry drastically over
.the last decade as well as the last few years (Abraham & Jungles)

The forces of competition and advancements in healthcare technology are pushing

hospitals to follow the trend. Paperless healthcare systems have become inevitable and any
.healthcare institute that doesn’t follow this trend will fall behind the rest of the industry

Health information system is a must and the faster this is adopted the more successful the
healthcare facility will be.(Swanson et al. 2010: 9). Delone and Mclean being one of the most
cited models in the fields of information systems seeks to provide a comprehensive
understanding of information systems success by identifying, describing, and explaining the
relationships between six success variables categories: systems quality, information quality,
user, user satisfaction, individual impact, and organizational impact. Delone & Mclean
(2003) model provides a comprehensive frame work for measuring the performance of the
.information system and enhances the understanding of information systems success

World Health Organization (WHO, 2008) cautions that, the goal of a health information
system is often narrowly defined as the production of good-quality data. The ultimate goal is
to produce relevant information that health system stakeholders can use for making
transparent and evidence-based decisions for health system interventions. Health information
management system performance should therefore be measured not only on the quality of
data produced, but on evidence of the continued use of data to improve health system
performance, respond to emergent threats, and improve health (WHO, Improving health
information systems in terms of data availability, quality and use often requires interventions
.that address a wide range of possible ‘determinants of performance

Health information systems recognizes that although new developments in technology,

including the use of the internet and other modes of communication offer great potential in
the flow of information amongst the providers and recipients regarding the provision and
management of healthcare services, the Kenyan health sector remains far behind in taking
advantage of such developments to improve reporting (HIS, 2008). Despite vast amounts of
resources and time invested in the development and implementation of health information
systems, health data is barely used by health workers for service delivery planning and
decision-making. Performance is grossly under reported with developments to improve
information management lagging behind other sectors improvement activities; the whole
culture of information generation and use remain under-developed; and mechanisms for
.validating and assuring reliability are not optimally functional

System Requirement 1.7

Hardware Requirement

Disk space RAM Processor

 RPM hard drive and 5400 1GB of RAM (1.5 GB if running GHz or faster 1.6
5 GB of available hard disk on a virtual machine) processor
space

Table (1.1): Hardware Requirement

Software Requirements

User Interface Database Operating System

design

Visual studio 2013, Microsoft SQL Server Windows XP, Windows 7 Windows 8,
NET Framework Management studio ,SQL Windows10
4.5 Client

Table (1.2): Software Requirement

:Information about programming languages for the project 1.8

SQL

The origins of the SQL take us back to the 1970s, when in the IBM laboratories, new
database software was created - System R. And to manage the data stored in System R, the
SQL language was created. At first it was called SEQUEL, a name which is still used as an
alternative pronunciation for SQL, but was later renamed to just SQL. In 1979, a company
called Relational Software, which later became Oracle, saw the commercial potential of SQL
.and released its own modified version, named Oracle V2

Now into its third decade of existence, SQL offers great flexibility to users by supporting
distributed databases, i.e. databases that can be run on several computer networks at a time.
Certified by ANSI and ISO, SQL has become a database query language standard, lying in
the basis of a variety of well-established database applications on the Internet today. With the
progress in database technology SQL-based applications have become increasingly
affordable for the regular user. This is due to the introduction of various open-source SQL
.database solutions such as MySQL, PostgreSQL, and SQLite

SQL Standard

The SQL Standard has gone through a lot of changes during the years, which have added a
great deal of new functionality to the standard, such as support for XML, triggers, regular
expression matching, recursive queries, standardized sequences and much more. Due to SQL
Standard’s sheer volume, a lot of database solutions based on it, such as MySQL or
PostgreSQL; do not implement the whole standard. In a lot of cases, the database behavior
for file storage or indexes is not well defined and it's up to the vendors of the various SQL
implementations to decide how the database will behave. This is the reason why, even though
.all SQL implementations have the same base, they are rarely compatible

SQL Language elements

The SQL language is based on several elements. For the convenience of SQL developers
all necessary language commands in the corresponding database management systems are
.usually executed through a specific SQL command-line interface (CLI)

Clauses - the clauses are components of the statements and the queries •

Expressions - the expressions can produce scalar values or tables, which consist of •
columns and rows of data

Predicates - they specify conditions, which are used to limit the effects of the statements •
and the queries, or to change the program flow

Queries - a query will retrieve data, based on a given criteria •

Statements - with the statements one can control transactions, program flow, connections, •
sessions, or diagnostics. In database systems the SQL statements are used for sending
queries from a client program to a server where the databases are stored. In response,
the server processes the SQL statements and returns replies to the client program. This
allows users to execute a wide range of amazingly fast data manipulation operations
.from simple data inputs to complicated queries

#C

C# is a general-purpose, modern and object-oriented programming language pronounced

as “C sharp”. It was developed by Microsoft led by Anders Hejlsberg and his team within
the .Net initiative and was approved by the European Computer Manufacturers Association
(ECMA) and International Standards Organization (ISO). C# is among the languages
for Common Language Infrastructure and the current version of C# is version 7.2. C# is a lot
.similar to Java syntactically and is easy for the users who have knowledge of C, C++ or Java

A bit about. Net Framework. Net applications are multi-platform applications and
framework can be used from languages like C++, C#, Visual Basic, COBOL etc. It is
designed in a manner so that other languages can use it. know more about .Net Framework

?#Why C

C# has many other reasons for being popular and in demand. Few of the reasons are
:mentioned below

Easy to start: C# is a high-level language so it is closer to other popular programming .1

.languages like C, C++, and Java and thus becomes easy to learn for anyone

Widely used for developing Desktop and Web Application: C# is widely used for .2
developing web applications and Desktop applications. It is one of the most popular
languages that is used in professional desktop. If anyone wants to create Microsoft
.apps, C# is their first choice

Community: The larger the community the better it is as new tools and software will .3
be developing to make it better. C# has a large community so the developments are
.done to make it exist in the system and not become extinct

Game Development: C# is widely used in game development and will continue to .4

dominate. C# integrates with Microsoft and thus has a large target audience. The C#
features such as Automatic Garbage Collection, interfaces, object-oriented, etc. make
.C# a popular game developing language
 CHAPTER TWO

:Introduction 2.1

This chapter provides a comprehensive definition of the problem, people's perception of

the problem, and then provides a conceptual strategy for problem solving, ways to solve it,
the importance of problem solving, and then it passes to theoretical program design for
.problem solving and technology. The study used to solve this problem

Definitions of problems 2.2

A theoretical study of the problem and how to solve it

:Problems with conventional system

Lack of immediate retrievals: -The information is very difficult to retrieve and to find .1
particular information like- E.g. - To find out about the patient’s history, the user has to go
.through various registers. This results in inconvenience and wastage of time

Lack of immediate information storage: - The information generated by various .2

.transactions takes time and efforts to be stored at right place

Lack of prompt updating: - Various changes to information like patient details or .3

.immunization details of child are difficult to make as paper work is involved

Error prone manual calculation: - Manual calculations are error prone and take a lot of .4
time this may result in incorrect information. For example: calculation of patient’s bill based
.on various treatments

Preparation of accurate and prompt reports: - This becomes a difficult task as information .5
.is difficult to collect from various registers

Methodology. Project planning and scheduling 2.3

Project planning is part of project management, which relates to the use of schedules such
as Gantt charts to plan and subsequently report progress within the project environment.
Initially, the project scope is defined and the appropriate methods for completing the project
are determined. Following this step, the durations for the various tasks necessary to complete
the work are listed and grouped into a work breakdown structure. The logical dependencies
between tasks are defined using an activity network diagram that enables identification of the
.critical path

We have used Iterative and Incremental Development model (IID) for our project
development. This development approach is also referred to as Iterative Waterfall
Development approach. Iterative and Incremental Development is a software development
process developed in response to the more traditional waterfall model. This model is
designed to take care of such big project. The large and complicate project chiefly demand
better development and testing procedure. The waterfall model is well known for its repeated
.testing process. Hence I choose the waterfall model for developing my software

Design and Implementation of Hospital Management System 2.4

Hospitals are information-intensive organization and pay great attention to information

management and processing, which have to be to be carried out using appropriate
information system. Hospital information system and clinical information system are
computer- based systems used in hospitals to assist the overall management of the health
care facility through information about diseases and information about patient care (Haux,
2004) in terms of record keeping of patient information, accounting, human resource
.management, asset management, and stock management and knowledge management
Task of the hospital information system is to support patient care and associated
administration by providing: information, primarily about patients that information must be
correctly collected, stored, processed and documented; Knowledge, primarily about diseases-
such as drug actions and adverse effects-to support diagnosis and therapy; information about
the quality of patient care and hospital performance and costs (Haux, 2004). Hospital
management system is of great importance in modern hospital. Liu stated that the system
must be made of several parts such as: marking card, registration, medical treatment, drug
information management, pharmacy dispensing, emergency, data dictionary maintenance,
database backup, report printing and so on. There are seven function modules that are to be
considered, including: Emergency Register Management, Price Making, Charge, Nurse
Station Management, and Data Dictionary Maintenance. Based on the above design, the
.system can provide high quality treatments and good services for patients and their families

Relevance of Hospital information System 2.5

Due to extensive changes in medical technology and increased expectation of patients in

the twenty-first century hospitals that lack hospital information Systems will not be able to
compete with other hospitals. The most important necessity and reason for hospitals
information systems automation are inefficiency manual procedures (Meinert &
Peterson2009:9). Hospital information systems help to improve operational efficiency, care
quality and more informed decision making. According to Ghosh (2010), hospital
.information systems give comfortable and quick access to patient data

Technology and Efficiency 2.6

Technology as the sub-factors hardware, software and connectivity, the hardware needed
should be identified before the introduction of the system. This means that at the start of the
project an assessment should be made about the hardware already available and the hardware
which is still needed for full introduction of the system. One of the major concerns with IS, is
the fact that users often claim that they are not user friendly and lack intuitive data input. The
way in which data is put into a system reflects the individual’s practice style. The interface
design and structure of the data need therefore to conform to each other. The other issue is
that it depends on the technology being used. Flexibility and adaptability is also a challenge
when introducing such a system. Looking for the right terminology for input is also a concern
Software content issues include the lack of local content creation, the language used and the
relevance of content to the local situation. Appropriate language is frequently neglected in
ICT programmers and little content is available in local languages for health programmers.
Another concern of any health organization in the integration of health information systems
is the fact that healthcare institutions need timely patient information from various sources at
the point of- care. This means buying a fully functional system fulfilling all their needs from
one vendor. This suggests working with standards for better data integration (Kuhn et.
al2001). With connectivity one has to deal with things like the lack of an enabling telecom
policy and regulatory environment; access to electricity, solar power options, back-ups,
insufficient infrastructure, connectivity access and high costs. The better these things are
functioning the greater the chance for successful implementation. The actual integration of
isolated systems is an important issue for the success of an information system. The use of
simpler systems fitted better with the clinical work processes should also add to better
.solutions

Financial Resources 2.7

Generally, there is little investment in ICT for health in most developing countries. The
picture is one of fragmentation, with many different varieties of ICT being acquired from
different donors. Invariably, there is no national health information and information
technology infrastructure to underpin the delivery of health care. It is very important to make
a realistic financial plan for all the costs in the system before the introduction of the health
.management information system (Gladwin et. al 2003:12)

Sustainability is very important when considering the introduction of the health

management information system in the organization, especially in local hospitals in
developing countries. Being able to continue supporting the system financially on the long
run is the important issue to consider. Plans for sustainability should be clearly expressed
ensuring that capital investments and costs are identified up front as well as ICT, capacity
and infrastructure requirements. Monitoring and evaluation is also part of the sustainability
failure to adopt a particular IM strategy may signal inappropriateness. Encouraging
partnerships between stakeholders on local, national, regional and international level
.sustainability can grow

CHAPTER THREE

Introduction 3.1

In this chapter, we explain how to work on the application, enter the mechanism, and use it
.with pictures, along with an explanation of each image about its content

Explain the practical application

:Login interface 3.1

Figure 1

username: Enter the username-1

password: Enter the password -2

login: Button to enter the program-3

Main program interface 3.2

 Figure 2

About developer: About the programmer

Close app: Button to close the program

Patient registration: Login to record patient information

Patient information: Login to see patient information

Checkout: Log in to the account list

Room info: Access the room list and its information

Add staff: Register a new staff and information

recording all patient data 3.3

Figure 3
The special interface for recording all patient data such as; name, age, disease, address,
.type of disease, room number, building and price

:Show all patient data 3.4

Figure 4

The special interface for show all patient data such as name, age, disease, address, type
.of disease, room number, building, price etc

.To search for the patient in the hospital and find out details
 entering the patient's financial information 3.5

Figure 5

A page for entering the patient's financial information, the price of the medicine, the
price of the operation, in addition to the basic patient information to be saved in the
.database

room information 3.6

 Figure6

The page for adding rooms, types of rooms, usually, or VIP, room specialization, bed
.number, room cost, etc

add staff 3.7

 Figure7

A page to add or search for any employee or doctor in the hospital and know all the
.details

CHAPTER FOUR

Results and Discussion

The project results are summarized that despite several difficulties, whether software or
bad support, we have been able to program a simple and basic program for hospital
management and knowing almost all details, whether for patients or rooms or for the staff
and we can use and apply in Iraqi hospitals to support hospitals and help by introducing
technology to hospitals and also we can in the future of work On developing this project to
be better in all respects, we also explained in our research the problem that the project will
address and the people's view of the problem and how the work was previously and how we
are trying through our research to help, even with a small part of treating the problem and
pushing technology forward and help to introduce computers and their technologies to Iraqi
hospitals, and this is important This position, as all developed countries do not use the papers
in the hospital records or in their financial transactions, but have moved to apply the
.technology in their hospitals and transfer them to the electronic system

This project has been a rewarding experience in more than one way. The entire project
:work has enlightened us in the following areas

a) We have gained an insight into the working of the HOSPITAL. This represents a typical
.real world situation

b) Our understanding of database design has been strengthened this is because in order to
.generate the final reports of database designing has to be properly followed
c) Scheduling a project and adhering to that schedule creates a strong sense of time
.management

d) Sense of teamwork has developed and confidence of handling real life project has
.increased to a great extent

e) Initially, there were problem with the validation but with discussions, we were to
.implement validations

CHAPTER FIVE

Introduction 5.1

This chapter gives an overview of the findings, conclusion and recommendations made
.from the study. These are based on the objectives and research questions of the study

The aim of the study was to find out the use of hospital information management system in
provision of relevant and effective services in Kenyatta hospital and Mater hospitals. It is a
.comparative study between a private and public hospital

:Objectives of the study were to

.To assess the use of the hospital information systems in the two selected hospitals .1

Establish the extent to which the hospital information system provides accurate and .2
.relevant information of the patient

.Establish the perception of the healthcare workers towards the system .3

Find out the challenges faced in the use of hospital information management systems in .4
.the hospitals

.Find out possible solutions to the identified .5

Challenges in Use of Hospital Management System 5.2

The fourth objective of this study was to establish challenges healthcare workers in both
.hospitals encounter in the use of hospital information management system

:The main challenges encountered in

Mater hospital as system being slow, poor changeover between the new and old system, Few
ICT staff to assist when needed, system keeps going on and off, and incapability between the
old and new system., few ICT staff to assist when needed, few computers for use, inadequate
software coverage, systems is slow and lack of training of users, system not yet implemented
in some areas. Were found out as system providing inaccurate information, respondents not
knowledgeable with the system, System not user friendly, and employees having negative
.attitude towards the system. Respondents’ recommendations on improving system

In Mater Hospital more respondents would want development of electronic resource planning
.system for the hospital and development of specific tools to the current structure

Conclusion and Future work 5.3