CHAPTER ONE

GENERAL INTRODUCTION

1.1 Introduction

Integration of documentation and knowledge based computerized services in

information system is a tremendous means of helping health professionals in
their daily practices and to improve the quality of service delivery. Effort is
continuously being made in designing and developing economically and
reliable database system to satisfy a clinical database information system. This
project is about the design and implementation of a patients record system for
clinical management of the Maternal and child health care dogon zare Medical
Centre Potiskum and shows how record and data can be handled and stored
within the system.

The system will store inpatients and outpatient’s records, as well as other
relevant clinical information within the clinic. The system will be used by the
staff (Doctor Nurse, Clerks, Consultants and other relevant authorities as the
demand may be) within the clinic. It will process data speedily and accurately
provide information when and where required.

The clinical database system will be used to store data produce reports and
handle management inquiries. In clinics that are made up of Doctors, Nurse,
Patients and other personnel staff, an information system is required to keep
track of the day-to-day activities of the clinic and to improve the
communication skills. Also this system will help, in highlighting risk/complex

1
patients for consultant input alert of DNA; easily identify all patients taking
certain medications, monitor frequency of major complication e.g. peptic ulcer,
check for known drug interaction, and improve evidence based practice, record
questions.

Therefore, it is hoped that the design and implementation of a clinical database

system would provide a flexible and reliable management of the clinic. This
program is carefully designed to work in a standalone system or in a multi user
environment The Patient Record Management System (PRMS) is an automated
system that is used to manage patient information and its administration. It is
meant to provide the Administration and Staff, with information in real-time to
make their work more interesting and less stressing.

1.2 Background of the Study

Maternal and child health care dogon zare was established by late senator
Mamman B. Ali when he was governor of Yobe state on Tuesday 27 th may
2008. The scope of the service in the hospital is basically curative and
preventive and is offered in clinic unit x-ray/ ultra sound and laboratory in the
hospital. Other services include admission (ward) inpatient (where drugs are
issued), antenatal care, routing immunization, labor and delivery, HIV/AIDS
counseling, PMTC, CMAM, DOT, physiotherapy and family planning. The
hospital offers 24 hours services to its staff and the entire population. The
records of patients in the hospital have been using manual system. This led to
poor record keeping since it’s a paper based system. The reason why the
current system used is manual has led to a variety of problems and these
2
include; un necessary duplication of the data especially for inpatients and
outpatients, inconsistence may occur since data is held more than once and
hard to analyze the data hence difficult to trace the flow of patient past
medication data.

According Jantz (2001) the emergence of computer based information system

has changed the world a great deal, both large and small system have adopted
the new methodology by use of personal computer; to fulfill several roles in
the production of information therefore computerizing the documentation of
patient record to enable easier manipulation of the input process and output
will bring us to this existing new world of information system.

Patients records and disease pattern documentation is concerned with

documentation of information obtained from patients and their particular health
system in order to function properly. If this information is not documented
perfectly causing some data to get misplaced, the health system will not be
efficient.

According Tang (2001) In examining the document system that in existence at

the hospital that is mostly manual much importance has been placed on
creating a system that document the inpatient record using a computerized
database system with a secure procedure for accessing it.

One of the unit of the std/aids control program (STD/HCP) a server doctor at
consultant level who is assisted by 3 doctors, a secretary, medical assistance,
nurses trained consolers and laboratory technologists head of units. The

3
various diseases managed at the unit include the following syphilis, molluscus,
scabies‟, pubic lice, gonorrhea, trichomoiasis, gentle mart etc.

Patient information past and present is extremely vital in the provision of

patient’s care which guides the physician in the making of right decision about
the diagnosis. The rapid growth of information technology and system made to
choose the health care industry to borrow a page from the air industry for the
sake of patient’s safety. Pilots have instant access to the data they need in
whether condition and mechanical function to make information decision about
navigation and delay.

1.3 Statement of the Problem

The absence of a well established information system to serve patient and staff
has led to inconveniences. This has tantamount to the loss of patient and staff
records.

This is basically because of the weakness of the existing system which

includes over reliance on paper based work. Paper files consume a lot of the
office space, slow recording, processing and retrieval of patient details.
Accessing and sharing of information by different departments is difficult
because of the poor information management.

4
1.4 Objectives of the Study

1.4.1 Main Objectives

Our major objective is to develop an operational Patient Record Management

System for Maternal and child health care dogon zare hospital Potiskum.

1.4.1 Specific Objectives

i. To review literature on related systems and analyze the existing manual

system.
ii. To collect data and identify the system’s requirements.
iii. To design an automated Patient Record Management system.
iv. To implement the system.
v. To test and validate the system.

1.5 Scope

This project is basically designed for Maternal and child health care dogon
zare hospital Potiskum. This hospital provides a lot of services to patients
which includes; Daily treatment of patients, Admission of patients, Keeps
records about inpatients and outpatients respectively. Other services with
departments that include radiography and ultra sound, pathology, pharmacy,
inpatient and outpatient, causality and dental which in information will be used
for making reports for researchers in various departments, drug/stock taking
unit at the central pharmacy and medical practitioners. The following are the
language confined within the system to enable development and
implementation.

1.6 Significance of the Study

5
Currently the hospital operates a manual records system. With the introduction
of an automated system the following will be achieved;

i. The system is a land mark in the field of modern technology since its
automated it becomes a quick access to the required information as it is
only one click away.
ii. In the field of ICT, decision support and information availability which
is required by the administration. This is because it is able to generate
reports daily, monthly and yearly. This makes it simple for managers to
make decisions.
iii. Electronic security is maintained as the staff and management are able to
login and access the system depending on their privileges. They are also
able to work on the policies and claims more effectively and efficiently.

1.7 Methodology

The project is carried out following the appropriate stages involved in design
and development of clinical software. The stages are briefly discussed below.

i. Problem identification: The problems associated with the medical

centre are first identified. This is done by critically analysis of the
existing system
ii. Data collection: The data required for this clinical database is obtained
by interviewing staff, students and other medical personnel. Also vital
information was also obtained from the internet especially on the
technicality in designing and developing a clinical database.

6
iii. System modeling: Using relevant facts obtained from relevant sources,
the Clinical database system is designed.
iv. System Development and implementation: The conceptual design is
development and implemented as computer program. After the
development and implementation, the system is tested to ensure that it
fulfills the objectives of the project.
v. System installation: The developed clinical database system software is
installed on the computer system and made ready for use.

1.8 Definition of terms

Hospital: is defined as the entity that provides the medical services to the
patient in questioned at a given period of time which is basically curative and
preventive and is offered in clinic unit x-ray/ ultra sound, laboratory and dental
unit in the hospital.

Patient Record Management System: It is a system that can manage multiple

administrators and can have the track of the right assigned to them. It makes
sure that all the Administrators function with the system as per the rights
assigned to them and they can get their work done in efficient manner.

Medical Form: it refers to the medical document describing the patient

initials, diagnoses and treatment of a particular patient in question that can be
used for future reference incase of no improvement in the health condition of
the patient hence changes can be carried out accordingly.

7
CHAPTER TWO

8
 LITERATURE REVIEW

2.1 Introductions

In this chapter the researchers, location and analysis of the existing knowledge
related to the subject of inquiry are explored and cited. It also sells at the
relationship of the proposed research for purposes of good representation and
critical review of the existing literature.

Martin (1976) data within an organization is increasingly being regarded as a

basic resource needed to run the organization. As with other basic resources,
professional management and organization of data are needed. The importance
of efficient use of data for planning, predicting and other functions will
become so great in a computerized organization that it will have a major effect
on growth and survival of co-operations. In relation to the above argument, the
presence of an automated data management system in Mamman B. Ali
hospital’s efficiency, timely decisions and responses will be achieved.

2.2.1 Function of Patient Record Management System

According to Melongoza (2002) these are incorporated in the technical

(clinical) and business (administration) component of health service these are
divided into three (3); transactional control reporting, operating planning and
strategic planning.

i. Transactional functions: handle day to day operational and

administrative task of the organization example of this include the

9
 following; order entry, service scheduling, treatment and other personal
staffing and scheduling.
ii. Control reporting and operating function: provides summarized data
about the operation of the organization to the manager and health care
professional that permits the monitoring of various activities. These
tasks include medical record tracking, medical audit and peer review.
iii. Strategic planning function: provides a frame work from decision
making with long range implications which include patient care strategy
like level of care, occupancy and service demand, requirement and
project cost.

Thus the patient management information system in this study ideally consists
of integrated approach to maintain patient related administrative and clinical
data considering the continuum of care dependent on the services provided.

2.2.2 State of Electronics of Patient Record Management System

According to Murphy (1999), an electronic heath record (EHR) is a medical

record or any other information relating to the past, present or future physical
and mental health or condition of a patient which resides in the computer that
captures, transmits, receives, stores, retrieves, links and manipulates
multimedia data for the primary purpose of providing health care and health
related services. It also includes patient demographic, SOAP notes, problems,
medications, and vital sign posts medical history, immunizations, laboratory
data and radiology reports. An EHR automates and streamlines the clinical
workflow. The EHR has ability to generate a complete record clinical patient
encounter as well as supporting other care related activities directly or
10
indirectly via interface including evidence based on decision support, quality
management and outcome reporting.

Patient information system has benefits which accrue in the long run.
According to Wang (2003) the long term benefit of the health electronic record
(HER), the united states of used it to minimize a cost benefit per provider for
having used an (HER) system over a five (5) year period was estimated to be at
$87000 and $330900 over a ten (10) year period. The implementation of this
project was likely to reduce the cost in the long run.

2.2.3 State of Art of Patient Record Management System

Llan (2002) defined a medical record as confidential information kept for each
patient by heath care professional or organization. It contains the patients‟
personal details such as name, address, date of birth, a summary of the patient
medical history and documentation of each event including symptoms,
diagnosis, treatment and outcome. Relevant documents and correspondence are
also included. Traditionally, each healthcare provider involves in patient care
kept an independent record usually paper based, the main purpose of the
medical record of the summary of a person‟s conduct with the health care
provider and treatment provided to ensure appropriate health care, information
from medical record also provide essential data for monitoring patient care,
clinical audit and accessing patterns of care and services delivered. The
management information system enables the medical record to form a first link
in the information chain producing the depersonalized aggregated coded data
for statistical.
11
2.2.4 Related Case Study

Pioneering secure on line Patient Record management and collaboration

between doctors clinical and hospital using secured internet transmission
according to Mennel (2006).

In this project doctors are able to view patients’ medical records immediately at
their private offices using secure internet transmission. The project aimed at
increasing competitiveness of the medical profession by improving the
accuracy of medical records and efficient retrieval and usage of medical
records. Patient medical records are very critical for doctors to establish their
diagnosis, with detailed and on-hand patients’ medical records; doctors can
make appropriate medical decision efficiently. Security was a critical issue in
the storage and transferring of patient medical records between hospitals and
doctors‟ offices. All clients were authenticated with a patient identity number.

2.3 Electronic Medical Record Contrast with Paper base Record

An electronic medical record (EMR) is a computerized medical record created

in an organization that delivers care, such as a hospital and doctor's surgery,
Perlin JB (2006). Electronic medical records tend to be a part of a local stand-
alone health information system that allows storage, retrieval and modification
of records.

Paper based records are still by far the preferred method of recording patient
information for most hospitals and practices in the U.S. New England Journal
of Medicine, (March 25, 2009). The majority of doctors still find their ease of

12
data entry and low cost hard to part with. However, as easy as they are for the
doctor to record medical data at the point of care, they require a significant
amount of storage space compared to digital records. In the US, most states
require physical records be held for a minimum of seven years. The costs of
storage media, such as paper and film, per unit of information differ
dramatically from that of electronic storage media. When paper records are
stored in different locations, collating them to a single location for review by a
health care provider is time consuming and complicated, whereas the process
can be simplified with electronic records. This is particularly true in the case of
person-centered records, which are impractical to maintain if not electronic
(thus difficult to centralize or federate). When paperbased records are required
in multiple locations, copying, faxing, and transporting costs are significant
compared to duplication and transfer of digital records. Because of these many
"after entry" benefits, federal and state governments, insurance companies and
other large medical institutions are heavily promoting the adoption of
electronic medical records. Congress included a formula of both incentives (up
to $44K per physician under Medicare or up to $65K over 6 years, under
Medicaid) and penalties (i.e. decreased Medicare/Medicaid reimbursements for
covered patients to doctors who fail to use EMR's by 2015) for EMR/EHR
adoption versus continued use of paper records as part of the American
Recovery and Reinvestment Act of 2009.

One study estimates electronic medical records improve overall efficiency by

6% per year, and the monthly cost of an EMR may (depending on the cost of
the EMR) be offset by the cost of only a few "unnecessary" tests or
13
admissions, Perlin JB (2006). Jerome Groopman disputed these results,
publicly asking "how such dramatic claims of cost-saving and quality
improvement could be true". Hartzband (2009).However, the increased
portability and accessibility of electronic medical records may also increase the
ease with which they can be accessed and stolen by unauthorized persons or
unscrupulous users versus paper medical records as acknowledged by the
increased security requirements for electronic medical records included in the
Health Information and Accessibility Act and by recent large-scale breaches in
confidential records reported by EMR users, Institute of Medicine (1999).
Concerns about security contribute to the resistance shown to their widespread
adoption. Handwritten paper medical records can be associated with poor
legibility, which can contribute to medical errors. Pre-printed forms, the
standardization of abbreviations, and standards for penmanship were
encouraged to improve reliability of paper medical records. Electronic records
help with the standardization of forms, terminology and abbreviations, and
data input. Digitization of forms facilitates the collection of data for
epidemiology and clinical studies. In contrast, EMRs can be continuously
updated (within certain legal limitations). The ability to exchange records
between different EMR systems ("interoperability") would facilitate the co-
ordination of healthcare delivery in nonaffiliated healthcare facilities. In
addition, data from an electronic system can be used anonymously for
statistical reporting in matters such as quality improvement, resource
management and public health communicable disease surveillance, Judy
(2006).

14
2.4 Previous Studies from Maternal and child health care Dogon Zare
Hospital

Previously the hospital employees have been able to collect data from agents
by providing them with a piece of paper with required fields to fill. Its routine
for every health worker to collect data, this should be processed and stored
completely. They avail the right information and knowledge to the right person
and institution in the form at the right time and place. The information ranges
from individual patient reports to disease rebalance to mortality rate in the
right persons and institutions which include the counties that use the health
service, the service provider at local level, ministry of health and the donors.
The company's employees and patients are straining to process lots of policy
documents every day. Integrating and streamlining policy.

Application and document processes would ease administrative headaches for

patients and greatly strengthen relationships with their customers.

Streveler (2004) grouped the component making HIS into 2 which are
information processing and management. Information processing involves data
collection, transmission, processing, analysis and presentation of information
for use in patient care and health care management decisions. Health
management system cannot exist alone but as functional unit aimed at
improving the health of individuals and that of the community.

2.5.1 Advantage of computer-base information system

15
According to Gordon (2006), the following are what he identified as the
advantages of computers- base information system.

i. They are user friendly and the navigation is very easy.

ii. They help in organizing and managing documents effectively. Since the
data is stored in a highly organized manner, accessing necessary data is
very easy.
iii. It helps save time. People are able to access data needed in real time thus
enabling them access detailed information.
iv. Accurate, current and reliable data is provided. As data can be analyzed
correctly and plans made can be implemented at astounding speed due to
proper automated systems.
v. They are installed to improve internal efficiency of the organization.
vi. They increase security and protect the data from being misused.
vii. They are extremely useful, especially during disaster recovery, as paper
documents can be lost, causing a business millions of dollars in losses.

2.5.2 Problems of Administering Patient Management System

According to Gordon (2006) the following are possible problem to

encountered while administering PRMS

i. It is not suitable for computer illiterate people

ii. The user must be a member in order to make use of the system.
iii. The systems do not do away with paper work completely; the papers are
still used at some point.

16
 CHAPTER THREE

3.1 Introduction

In this chapter the description of method chosen to achieve the objectives of

the proposed system is described. It will go on to describe the techniques of
17
data collection that will be employed in the research study of the proposed
systems. The tools that will be used to implement the system are MySQL,
HTML and PHP.

3.2 Methods of Data Collection

We used the following methods during data collection: Observation,

Interviewing and Questionnaires as our research methods. Through this we
were able to collect raw data on PRMS at Mamman B Ali hospital where
existing reports on the current system were obtained. Verbal interview
techniques were used to interview employees from the hospital.

i. Observation:

We went to the hospital and observed their daily as regards their current system
and they were manually recording the patients’ records as specified by the
receptionists, doctors and pharmacist. A follow up was made to determine the
time it took to carry out the patient record management. We observed the
system’s weaknesses like it was vulnerable to errors.

ii. Interviewing:

In this method, there was interaction between us, the researchers and the Staff.
Interviews were conducted with the medical supridendant and some potential
employees to find out what difficulties they encountered with the existing
system. These interviews were held to verify the information collected using
the questionnaires since there was room to search for further information
during the interview.
18
iii. Questionnaires

The efficiencies and inefficiencies of the current system were reviewed by

issuing questionnaires to the users of the system. This helped us to establish the
requirements of the proposed system.

3.3 Database Design.

A relational database design was used to design the database. A relational

database management system (RDBMS) is an excellent tool for organizing
large amount of data and defining the relationship between the datasets in a
consistent and understandable way. A RDBMS provides a structure which is
flexible enough to accommodate almost any kind of data. Relationships
between the tables were defined by creating special columns (keys), which
contain the same set of values in each table. The tables can be joined in
different combinations to extract the needed data. A RDBMS also offered
flexibility that enabled redesign and regeneration of reports from the database
without need to re-enter the data.

3.3.1 System Implementation

This describes the tools used to implement the graphical user interface and the
database. MySQL was used to create and connect relational tables to the
database. HTML was used to develop the graphical user interface (GUI).
Javascript was used to send queries to PHP without reloading the page, PHP

19
was used to process queries and request flash to integrate sounds and interfaces
was done to develop the model that meets all the requirements of this system.

3.3.3 Development of the System

This section describes what is evolves to come up with the system and how the
system works.

Front end: Html (hyper text makeup language) enable the construction of easy
and intuitive user interface for accessing the database and any browser can
display the html document.

Middle end: PHP enables links of the text entered in the created graphic user
interface to be sent to the database

Back end: Mysql its easy to use, inexpensive database language it can run on a
variety of operating system such as window,linux,unix.os/2 and others , its
secured with technical support widely available on the internet but most of all
it support large database.

CHAPTER FOUR

SYSTEM ANALISYS AND SYSTEM DESIGN

4.1 Introduction

20
This chapter describes the system analysis and design of the developed
patients’ record management system of the Maternal and child health care
Dogon-Zare Potiskum.

4.2 System Analysis

After analyzing the data collected, we formulated a number of requirements,

these are user requirement, system, hardware and software requirement.

4.2.1 User Requirement

During data collection, we investigated and found out how the current system
operates, not only that but also tried out which problems are faced and how
best they can be settled. The users described some of the basic requirements of
the system this includes Add and Search of patients, register staff, update
patients’ records and View all types of reports.

4.2.2 System Requirement

This section describes the hardware components and software requirements

needed for effective and efficient running of the system.

Table 4.0 Hardware Requirement

Hardware Minimum System requirement

Processor 2.4 GHZ processor speed
Memory 128 MB RAM (256 MB Recommended)
Disk space 80 GB (including 20 GB for database
Management system)
Display 800 x 600 colors (1024 x 768 High color-
16 bit Recommended)
The table above shows hardware components of the machine that allows the
system to function as required.

Table 4.1 Software Requirements

Software Minimum system requirement

21
Operating system Windows 2000 or later
Database Management System MYSQL
Run-time Environment Apache web server (Xampp/Wampp)

The table above shows software requirements recommended to enable the

system to run as required.

4.3 System Design

After interpretation of the data, tables were drawn and process of data
determined to guide the researcher of the implementation stage of the project.
The tools, which were employed during this methodology stage, were mainly
tables, Data Flow Diagrams (DFDs). The design ensures that only allows
authorized users to access the systems’ information.

4.3.2 Login Form

Only authorized user with the right user name and password has right to access
the services to particular department he or she intent to view. When wrong user
name and password is used the system rejects access to the services.

22
Figure 4.1 Login page

4.3.4 Administrator/Staff Home page

This page can only be shown when a valid username and password is entered
in the above form. The security protection has been added to redirect a user
when try to bypass the login form. The navigation links are given to allow staff
to add, edit and delete a patient when necessary, search patient by entering his
unique number, update staff information and view record of the previous
visited patients.

Figure 4.2 Admin/Staff page containing list of added patient.

4.3.5 Patients Record Page

23
This is the most important page as it is the objective of this work, keeping
patients’ record. However we have to deal with some other facts. Hence they
are information to be used in filling a record of a specific patient. This record
can also be printed as a report.

Figure 4.3 Shows list of patients’ record.

4.3.6 Output Design

The project does not only focus on storing patients’ record in a database, but it
also has the feature of giving out that stored information as hard copy for
reference purposes. The figure below indicates a patient’s card generated from
the platform which can be printed and used by the patients and the hospital’s
staffs.

24
 Figure 4.4 Shows a patient’s card generated from patients
information stored in the database.

25
 CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION

5.1 Introduction

This chapter describes discuss the objectives of the system stipulated in earlier
chapter, Summary of the system conclusion and recommendation of the system

5.2 Summary

As discussed in the previous chapters the main problem that we addressed was
dealing with patient medical document. It is the above situation that drove us
to techniques of developing this Patient Record/Information Management
System to be used at Maternal and child health care dogon zare Potiskum to
enable them to handle details on policies efficiently and effectively. The project
has implemented Most of the objectives stipulated in earlier chapter. The
patient record management system offers a number of benefits to the user and
can capture data, store, view, add and delete the records entered the data can
also be posted information to the database. Problems Encountered during Data
collection: sensitive information released to us, few projects and books written
about patient records management system.

Problems Encountered during System Design: Limited time to finish up the

work, limited numbers of computers with the internet in the faculty hence it
becomes difficult to access the internet and In adequate financial support to
facilitate the project.

26
5.3 Conclusions

The core reason for the establishment of computerized patient records

management system is to enable the hospital administrators in a convenient,
fair, and timely manner. Therefore the IT used should support the core
objective of the system if it is to remain relevant to the hospital. A lot still
needs to be done in the IT department in order to make available technology
effective. This may involve training of the staffs on how to enter data in the
right and relevant data in the system and the management to keep updating the
hardware and software requirements of the system. IT and computer systems
need to be kept being upgraded as more and more IT facilities software are
introduced in today IT market. The researcher acknowledges the fact this
system does not handle all staffs the hospital like the security and asset section.
The researcher therefore suggests that for further research, the following can be
researched on. The most cost effective way of handling all staffs and
interlinking Maternal and child health care dogon zare Potiskum.

5.4 Recommendations

Training of all the members of the staff in the hospital to get accustomed to the
system will be a priority. This being a new system, some members of the staffs
management will get threatened that the computerized patient records
management system will replace their jobs .I would recommend that
management of the hospital educates the staff of how this system will operate
and how it will supplement their efforts .For the efficiency of the hospital,
users of the system need to be thoroughly educated about the use of the
27
passwords and staff name, not only that but also not to be careless of them.
They should be kept confidential. Access to the server room should be
physically guarded against unauthorized person; the server room should be
dust free and should be fully protected and should have an air conditioner to
prevent the server from overheating. Backup media like CDs, Diskettes and
Flush disks can be used for backups and storage of data.

5.5 Opportunity and Lesson Learned

During the course of this project, we were able to understand better what goes
in the patient records management system in the hospital. This was effectively
done through reading of literature and research. The whole process of
developing the system was an opportunistic challenge. Seeing the system into a
tangible system was a rewarding exercise.

28
 REFERENCE

Jantz, R. (2001) “Knowledge management in academic libraries:

Special tools and processes to support information professionals‟
reference service services review 29, 1:33-39.

Mennel, P.A (2006) “management information systems” information

management vs. decision making. Loudon..

Arizona, R., (2011): Electronic Health Records, about $500 Million at stake
in digital move. England: Smith and Sons.

Habib, J.L,. (2010). EHRs, meaningful use, and a model EMR. Drug Benefit
Trends. May 2010; 22(4):99-101.

Hoffman, S., & Podgurski, A. (2008). "Finding a Cure; The Case for
Regulation and Oversight of Electronic Health Record Systems"
(PDF). Harvard Journal of Law & Technology

Laura, D. (2007). "Electronic Health Records: Interoperability Challenges

and Patient's Right for Privacy". Shidler Journal of Computer and
Technology

Robson, B., Baek, K. (2009). The Engines of Hippocrates. From the Dawn of
Medicine to Medical and Pharmaceutical Informatics. USA: JohnWiley
& Sons

Starmer. K., Bratan, T., Byrne, E., Russell, J., & Potts, H.W.W. (2010).
Adoption and non-adoption of a shared electronic summary care
record. England: John Wiley & Sons.

Tüttelmann, F., Luetjens C.M., Nieschlag, E. (2006)."Optimising workflow in

andrology: a new electronic patient record and database". Asian Journal
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 APPENDIX

PROGRAM SOURCE CODE

<?php
require_once 'functions.php';
$usn_em = $usp = ""; ?>
<html lang="en"><head>
<title>HOSPITAL MANAGEMENT</title>
<?php include 'include'; ?></head>
<body>
<?php centered_logo(); ?>
<div class="formbox"><div id="ajax"></div>
<h2>Welcome...</h2><p class="error"></p>
<form method="post"><div class="field">
<i class="fa fa-user"></i> <label>Email... <span
class="req">*</span></label>
<input type="text" tabindex="1" autofocus required id="email"
name="email" value="<?= $usn_em; ?>"> </div><div class="field"><i
class="fa fa-lock"></i> <label>Password... <span
class="req">*</span></label>
<input type="password" tabindex="2" required id="pass" name="pass"
value="<?= $usp; ?>">
</div>
<div class="field"><input class="buttom" type="submit" value="Sign-in"
id="sign-in"></div>
<i class="fa fa-spinner"></i>
30
</form>
<span class="forgot"><a href="forgot.php">Forgot password</a></span>
</div></body>
</html><?php
require_once '../functions.php';
exit_non_logged();
is_installed();
if (isset($_GET['per_page']) && isset($_GET['page'])){
$per_page = $_GET['per_page'];
$page = $_GET['page'];
} else {
$per_page = 20;
$page = 1; } $START = $per_page * $page - $per_page;?>
elseif ($page < $pages){ $nxt = $page + 1; ?>
<div class="p"><a href="?page=<?= $nxt; ?>&per_page=<?=
$per_page; ?>">Next &raquo;&raquo;</a>
<?php } for ($p = 1; $p <= $pages; $p++){ ?>
<a href="?page=<?= $p; ?>&per_page=<?= $per_page; ?>"><?= $p; ?></a>
<?php } if ($page > 1){
$prv = $page - 1; ?>
<a href="?page=<?= $prv; ?>&per_page=<?= $per_page; ?
>">&laquo;&laquo; Previous</a>
<?php } ?> </div> </div></div></div> <?php include '../footer.php'; ?
></body></html>
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