CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

The patient medical record is a detailed account of patient’s health and disease

after he/she has sought medical help from a health care center; usually, the notes in

the record are made by nurses, laboratory technicians or the physicians. The

patient’s record contains findings, considerations, test results and treatment

information related to the disease that the patient might be suffering from. Medical

records are usually kept confidential in an attempt to protect the patient’s privacy

(Agu, Nwadialor and Moses, 2016).

The Electronic Medical Record (EMR) management system may contain some

elements of paper record for example, in the event that a doctor wanted to refer a

patient to another clinic or a hospital, the diagnostic information and clinical notes

needs to be printed or handwriting on a paper and then sent to the new doctor to be

involved for further analysis and examination. In the present era of globalization

and advancement in information and communication technology, the need for

efficient record keeping increases because of its importance in decision making

which makes life better for man; health they say is wealth, therefore there is a need

for improving the quality of healthcare delivery. In a recent study on design and

1
implementation of hospital management system, pointed out that, the advancement

in technology and globalization remains an active ingredient that enhances the

quality of healthcare delivery provided by medical institutions as a result of

improvement in the quality of medical services rendered by the various medical

institutions all over the world (Asabe et al., 2013).

The emergence of computer technology has affected the medical institutions, like

most other industries all over the world. The application of computers on the

delivery of health care services has become a common place practice. In some

cases, it involves applying certain technologies to convert the existing paper

documents into an electronic format. In others, it is a transition towards the use of

the EMR. The EMR is designed to replace the paper record as the primary format

of record keeping in the various healthcare centers across the globe (James, 2019).

Considering the rate of population growth the medical care and facilities available,

and the health needs of the people, computer-aided Medicare is in evitable for

more accurate. Furthermore with the present shift to an information society, it is

necessary to anticipate the future use of a sophisticated electronic machine the

computer. This is necessary because the computer is rapidly finding its way into

every field of human endeavor, including medicine. Its application includes patient

care and protection, clinical administration, intensive monitoring during

emergencies, surgical operations, diagnosis and automation of medical records.

2
1.2 Statement of the Problems

It has been observed that to receive medical treatment in most of our hospitals, the

patients queue up for several hours from one unit of the hospital to another starting

from obtaining a new hospital folder, or retrieving an old one before consulting a

doctor, to the laboratory unit for lab test then to the pharmacy to get the prescribed

drugs and so on.

The keeping and retrieval of accurate records on patients are poorly carried out in

most of our hospitals. Files may be misplaced; the record in them may be wrongly

filled. Hence, it is not easy to obtain accurate and timely information or data.

This is also the case with obtaining other medical information and data especially

when new folders and numbers are obtained each year.

Finally, the keeping of folder for each patient manually takes a lot of time and

money and some of the information are redundant. All these have net effect of loss

of lives and inefficiency on the part of management.

1.3 Aim and Objectives

The broad aim of this project is to design and implement an online patient record

tracking information system. The specific objectives include to;

3
 i. To examine the current procedures employed in by most hospitals and

clinics in the management of patient records.

ii. Eliminate redundancy in term of data storage by the adoption of a

computerized patient record tracking based on web technologies

iii. Reduce the time wasted in retrieving data especially in finding a past health

records of patients.

iv. Increase Efficiency and Interactivity in any area of specialization in the

hospital

1.4 Significance of the Study

Several possible advantages to practical patient record tracking System over paper

records have been proposed which includes:

Reduction of cost

A vast amount of funds are allocated towards the health care industry. The

computerized system is implemented, it will reduce the personnel cost.

Improve quality of care

The implementation of electronic health records (EHR) can help lessen patient

sufferance due to medical errors and the inability of analysts to assess quality.

4
Promote evidence-based medicine

Computerized medical record provides access to unprecedented amounts of clinical

data for research that can accelerate the level of knowledge of effective medical

practices.

Realistically, these benefits may only be realized if the systems are interoperable

and wide spread (for example, national or regional level) so that various systems

can easily share information.

Record keeping and mobility

EHR systems have the advantages of being able to connect to many electronic

medical record systems.

1.5 Scope of the Study

This research work is limited to patient’s medical record tracking including

treatments, prescriptions and assigned doctors, etc. The software development will

be carried out using HTML for the interface layout and design, CSS for styling and

beautification, Javascript for object effect and behavior, PHP for the backend

scripting and data manipulation, while MySQL will be used for the database

management.

5
1.6 Limitations of the Study

This project covers all aspect of Medical system with regards to patient’s

information. Due to time and financial constraint, the software developed excluded

laboratory units.

1.7 Definition of Terms

Electronic Health Record– An electronic health record (EHR) (also electronic

patient record (EPR) or computerized patient record) is an evolving concept

defined as a systematic collection of electronic health information about individual

patients or populations.

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 functions with the system as per the right assigned to

them and they can get their work done in efficient manner

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

human use.

SYSTEM – A system is a combination or arrangement of parts to form an

integrated whole, working together to achieve specific tasks. A system includes an

orderly arrangement according to some common principles or rules.

6
Subsystem – A complex system is difficult to comprehend when considered as a

whole. Therefore, the system is decomposed or factored into subsystems.

Subsystems constitute the entire system. They are complete systems on their own

but exit in another system called the complex system. Subsystems can be further

decomposed into smaller subsystems until the smallest subsystems are of

manageable size. The subsystems resulting from this process generally form

hierarchical structures. In the hierarchy, a subsystem is one of a supra-system (the

system above it).

Expert system: is software that uses a knowledge base of human expertise for

problem solving, or clarify uncertainties where normally one or more human

experts would need to be consulted.

Hospital information system (HIS): variously also called clinical information

system (CIS) is a comprehensive, integrated information system designed to

manage the administrative, financial and clinical aspects of a hospital. This

encompasses paper-based information processing as well as data processing

machines.

MIS- Management Information System is the system that stores and retrieves

information and data, process them, and present them to the management as

information to be used in making decision. It can also be defined as an integrated

7
machine system that provides information to support the planning and control

functions of managers in all organizations. By these definitions, MIS must serve

the basic functions of management, which include planning, organizing, staffing,

directing and controlling. Information systems that only support operations and do

not have managerial decision making significance is not part of MIS.

MCS- Management Control system is a form of Information System used by the

management of an organization to analyze each application of information system

in terms of input, storage, processing and output. The MCS has functional

subsystems such as the hardware system, the operating system, the communication

system and the database system. Management control systems are human artifacts.

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

8
 CHAPTER TWO

LITERATURE REVIEW

2.1 Basic concepts, definitions, theories and important highlights related to

ELECTRONIC HEALTH RECORD

According to Adebisi et al. (2015), electronic health record (HER) is an evolving

concept defined as a systematic collection of electronic health information about

individual patients or populations. It is a record in digital format that is capable of

being shared across different health care settings, by being embedded in

networkconnected enterprise-wide information systems. Such records may include

a whole range of data in comprehensive or summary form, including

demographics, medical history, medication and allergies, immunization status,

laboratory test results, radiology images, vital signs, personal stats like age and

weight, and billing information. Its purpose can be understood as a complete

record of patient encounters that allows the automation and streamlining of the

workflow in health care settings and increases safety through evidence-based

decision support, quality management, and outcomes reporting, Swinglehurst D

(2019).The terms EHR, EPR and EMR (electronic medical record) are often used

interchangeably, although a difference between them can be defined. The EMR can

be defined as the legal patient record created in hospitals and ambulatory

9
environments that is the data source for the HER, Habib, (2010). It is important to

note that an EHR is generated and maintained within an institution, such as a

hospital, integrated delivery network, clinic, or physician office, to give patients,

physicians and other health care providers, employers, and payers or insurers

access to a patient's medical records across facilities.

A personal health record is, in modern parlance, generally defined as an EHR that

the individual patient controls. Within a meta-narrative systematic review of

research in the field, Prof. Trish Greenhalgh and colleagues defined a number of

different philosophical approaches to the HER (Habib, 2010). The health

information systems literature has seen the EHR as a container holding information

about the patient, and a tool for aggregating clinical data for secondary uses

(billing, audit etc.). However, other research traditions seen the EHR as a

contextualized artefact within a socio-technical system. For example, actornetwork

theory would see the EHR as an actant in a, while research in computer supported

cooperative work (CSCW) sees the EHR as a tool supporting particular work. Prof.

Barry Robson and OK Baek also reviewed these aspects and see the EHR as

pivotal in human history, Baek, OK. (2019). In the United States, Great Britain,

and Germany, the concept of a national centralized server model of healthcare data

has been poorly received. Issues of privacy and security in such a model have been

of concern. Privacy concerns in healthcare apply to both paper and electronic

10
records. According to the Los Angeles Times, roughly 150 people (from doctors

and nurses to technicians and billing clerks) have access to at least part of a

patient's records during a hospitalization, and 600,000 payers, providers and other

entities that handle providers' billing data have some access also Health &

Medicine (2006-06-26). Recent revelations of "secure" data breaches at centralized

data repositories, in banking and other financial institutions, in the retail industry,

and from government databases, have caused concern about storing electronic

medical records in a central location, CNN.com (May 23, 2006). Records that are

exchanged over the Internet are subject to the same security concerns as any other

type of data transaction over the Internet. The Health Insurance Portability and

Accountability Act (HIPAA) was passed in the US in 1996 to establish rules for

access, authentications, storage and auditing, and transmittal of electronic medical

records. This standard made restrictions for electronic records more stringent than

those for paper records. However, there are concerns as to the adequacy of these

standards (Wadzani, 2018).

In the European Union (EU), several Directives of the European Parliament and of

the Council protect the processing and free movement of personal data, including

for purposes of health care, European Parliament and Council (24 October 1995).

Personal Information Protection and Electronic Documents Act (PIPEDA) was

given Royal Assent in Canada on April 13, 2000 to establish rules on the use,
11
disclosure and collection of personal information. The personal information

includes both non-digital and electronic form. In 2002, PIPEDA extended to the

health sector in Stage 2 of the law's implementation. There are four provinces

where this law does not apply because its privacy law was considered similar to

PIPEDA: Alberta, British Columbia, Ontario and Quebec. One major issue that has

risen on the privacy of the U.S. network for electronic health records is the strategy

to secure the privacy of patients. Former US president Bush called for the creation

of networks, but federal investigators report that there is no clear strategy to protect

the privacy of patients as the promotions of the electronic medical records expands

throughout the United States. In 2007, the Government Accountability Office

reports that there is a “jumble of studies and vague policy statements but no overall

strategy to ensure that privacy protections would be built into computer networks

linking insurers, doctors, hospitals and other health care providers.”( Opeyemi,

Blessing and Blessing, 2016).

The privacy threat posed by the interoperability of a national network is a key

concern. One of the most vocal critics of EMRs, New York University Professor

Jacob M. Appel, has claimed that the number of people who will need to have

access to such a truly interoperable national system, which he estimates to be 12

million, will inevitably lead to breaches of privacy on a massive scale. Appel has

written that while "hospitals keep careful tabs on who accesses the charts of VIP

12
patients," they are powerless to act against "a meddlesome pharmacist in Alaska"

who "looks up the urine toxicology on his daughter's fiancé in Florida, to check if

the fellow has a cocaine habit."Appel (2008). This is a significant barrier for the

adoption of an EHR. Accountability among all the parties that are involved in the

processing of electronic transactions including the patient, physician office staff,

and insurance companies, is the key to successful advancement of the EHR in the

U.S. Supporters of EHRs have argued that there needs to be a fundamental shift in

“attitudes, awareness, habits, and capabilities in the areas of privacy and security”

of individual‟s health records if adoption of an EHR is to occur (Droma et al.,

2019).

According to the Wall Street Journal, the DHHS takes no action on complaints

under HIPAA, and medical records are disclosed under court orders in legal

actions such as claims arising from automobile accidents. HIPAA has special

restrictions on psychotherapy records, but psychotherapy records can also be

disclosed without the client's knowledge or permission, according to the Journal.

For example, Patricia Galvin, a lawyer in San Francisco, saw a psychologist at

Stanford Hospital & Clinics after her fiancé committed suicide. Her therapist had

assured her that her records would be confidential. But after she applied for

disability benefits, Stanford gave the insurer her therapy notes, and the insurer

denied her benefits based on what Galvin claims was a misinterpretation of the

13
notes. Stanford had merged her notes with her general medical record, and the

general medical record wasn't covered by HIPAA restrictions. Within the private

sector, many companies are moving forward in the development, establishment

and implementation of medical record banks and health information exchange. By

law, companies are required to follow all HIPAA standards and adopt the same

information-handling practices that have been in effect for the federal government

for years. This includes two ideas, standardized formatting of data electronically

exchanged and federalization of security and privacy practices among the private

sector (Droma et al., 2019). Private companies have promised to have “stringent

privacy policies and procedures.” If protection and security are not part of the

systems developed, people will not trust the technology nor will they participate in

it. So, the private sectors know the importance of privacy and the security of the

systems and continue to advance well ahead of the federal government with

electronic health records.

Legal liability in all aspects of healthcare was an increasing problem in the 1990s

and 2000s. The surge in the per capita number of attorney sand changes in the tort

system caused an increase in the cost of every aspect of healthcare, and healthcare

technology was no exception.

14
Failure or damages caused during installation or utilization of an EHR system has

been feared as a threat in lawsuits. Similarly, it's important to recognize that the

implementation of electronic health records carries with it significant legal risks.

This liability concern was of special concern for small EHR system makers. Some

smaller companies may be forced to abandon markets based on the regional

liability climate. Larger EHR providers (or government-sponsored providers of

EHRs) are better able to withstand legal assaults.

In some communities, hospitals attempt to standardize EHR systems by providing

discounted versions of the hospital's software to local healthcare providers. A

challenge to this practice has been raised as being a violation of Stark rules that

prohibit hospitals from preferentially assisting community healthcare providers

(Mohd-Zharif, 2010). In 2006, however, exceptions to the Stark rule were enacted

to allow hospitals to furnish software and training to community providers, mostly

removing this legal obstacle. An important consideration in the process of

developing electronic health records is to plan for the long-term preservation and

storage of these records. The field will need to come to consensus on the length of

time to store EHRs, methods to ensure the future accessibility and compatibility of

archived data with yet-to-be developed retrieval systems, and how to ensure the

physical and virtual security of the archives.

15
Additionally, considerations about long-term storage of electronic health records

are complicated by the possibility that the records might one day be used

longitudinally and integrated across sites of care. Records have the potential to be

created, used, edited, and viewed by multiple independent entities. These entities

include, but are not limited to, primary care physicians, hospitals, insurance

companies, and patients. Mandl et al. have noted that “choices about the structure

and ownership of these records will have profound impact on the accessibility and

privacy of patient information.” (Yeo, 2014).

The required length of storage of an individual electronic health record will depend

on national and state regulations, which are subject to change over time.

Ruotsalainen and Manning have found that the typical preservation time of patient

data varies between 20 and 100 years. In one example of how an EHR archive

might function, their research "describes a co-operative trusted notary archive

(TNA) which receives health data from different EHR-systems, stores data

together with associated meta-information for long periods and distributes

EHRdata objects. TNA can store objects in XML-format and prove the integrity of

stored data with the help of event records, timestamps and archive e-signatures."

(Vinayak et al., 2014).

In addition to the TNA archive described by Ruotsalainen and Manning, other

combinations of EHR systems and archive systems are possible. Again, overall
16
requirements for the design and security of the system and its archive will vary and

must function under ethical and legal principles specific to the time and place.

While it is currently unknown precisely how long EHRs will be preserved, it is

certain that length of time will exceed the average shelf-life of paper records. The

evolution of technology is such that the programs and systems used to input

information will likely not be available to a user who desires to examine archived

data. One proposed solution to the challenge of long-term accessibility and

usability of data by future systems is to standardize information fields in a

timeinvariant way, such as with XML language. Olhede and Peterson report that

“the basic XML-format has undergone preliminary testing in Europe by a Spri

project and been found suitable for EU purposes. Spri has advised the Swedish

National Board of Health and Welfare and the Swedish National Archive to issue

directives concerning the use of XML as the archive-format for EHCR (Electronic

Health Care Record) information.".

2.2 Overview of literatures/system related to topic

2.2.1 Electronic Medical Record Contrast With Paper-Based 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, (Daryl et

17
al., 2015). 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 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

18
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 admissions (Biswas et al.,

2014). Jerome Groopman disputed these results, publicly asking "how such

dramatic claims of cost-saving and quality improvement could be true". 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

19
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 (Ilo, Igbajar and Acholonu, 2015).

2.2.2 Review of Health Informatics in Many Countries

Health informatics (also called health care informatics, healthcare informatics,

medical informatics, nursing informatics, or biomedical informatics) is a discipline

at the intersection of information science, computer science, and health care. It

deals with the resources, devices, and methods required to optimize the acquisition,

storage, retrieval, and use of information in health and biomedicine. Health

informatics tools include not only computers but also clinical guidelines, formal

medical terminologies, and information and communication systems. It is applied

to the areas of nursing, clinical care, dentistry, pharmacy, public health,

20
occupational therapy, and (bio) medical research (Parameswari and Prabakaran,

2013).

Informatics was a central part of the Nazi health care system, which included Nazi

eugenics as one of its fundamental principles. New systems and technology, like

electronic punch card tabulating and sorting machines, and the science of medical

statistics, were used to gather, sort, and analyze personal information on a vast

scale unseen before in human history. The information was used to help find and

eliminate the 'genetically inferior' through sterilization or wholesale murder. Many

of the architects of these systems would go on to play a role in the post-war

medical informatics field (Ogwueleka, 2010). Worldwide use of technology in

medicine began in the early 1950s with the rise of the computers. In 1949, Gustav

Wager established the first professional organization for informatics in Germany.

The prehistory, history, and future of medical information and health information

technology are discussed in reference. Specialized university departments and

Informatics training programs began during the 1960s in France, Germany,

Belgium and The Netherlands. Medical informatics research units began to appear

during the 1970s in Poland and in the U.S. Since then the development of

highquality health informatics research, education and infrastructure has been the

goal of the U.S. and the European Union. Early names for health informatics

included medical computing, medical computer science, computer medicine,

21
medical electronic data processing, medical automatic data processing, medical

information processing, medical information science, medical software

engineering, and medical computer technology.

The health informatics community is still growing, it is by no means a mature

profession, but work in the UK by the voluntary registration body, the UK Council

of Health Informatics Professions has suggested eight key constituencies within the

domain information project management, ICT, education and research, clinical

informatics, health records(service and business-related), health informatics service

management. These constituencies accommodate professionals in and for the NHS,

in academia and commercial service and solution providers.

Since the 1970s the most prominent international coordinating body has been the

International Medical Informatics Association (IMIA).

Even though the idea of using computers in medicine sprouted as technology

advanced in the early twentieth century, it was not until the 1950s that informatics

made a realistic impact in the United States.

The earliest use of computation for medicine was for dental projects in the 1950s at

the United States National Bureau of Standards by Robert Ledley, Ledley RS

(2006).The next step in the mid-1950s were the development of expert systems

such as MYCIN and Internist-I. In 1965, the National Library of Medicine started

22
to use MEDLINE and MEDLARS. At this time, Neil Pappalardo, Curtis Marble,

and Robert Greenes developed MUMPS (Massachusetts General Hospital Utility

Multi-Programming System) in Octo Barnett's Laboratory of Computer Science,

Reilly (2013), at Massachusetts General Hospital in Boston, Reilly (2013). In the

1970s and 1980s it was the most commonly used programming language for

clinical applications. The MUMPS operating system was used to support MUMPS

language specifications. As of 2004, a descendent of this system is being used in

the United States Veterans Affairs hospital system. The VA has the largest

enterprise-wide health information system that includes an electronic medical

record, known as the Veterans Health Information Systems and Technology

Architecture (VistA). A graphical user interface known as the Computerized

Patient Record System (CPRS) allows health care providers to review and update a

patient’s electronic medical record at any of the VA's over 1,000 health care

facilities.

In the 1970s a growing number of commercial vendors began to market practice

management and electronic medical records systems. Although many products

exist, only a small number of health practitioners use fully featured electronic

health care records systems. Homer R. Warner, one of the fathers of medical

informatics, Cheng-Kun (2015), founded the Department of Medical Informatics at

the University of Utah in 1968. The American Medical Informatics Association

23
(AMIA) has an award named after him on application of informatics to medicine.

Since 1997, the Buenos Aires Biomedical Informatics Group, a nonprofit group,

represents the interests of a broad range of clinical and non-clinical professionals

working within the Health Informatics sphere. Its purposes are:

Promote the implementation of the computer tool in the healthcare activity,

scientific research, and health administration and in all areas related to health

sciences and biomedical research.

Support, promote and disseminate content related activities with the

management of health information and tools they used to do under the name of

biomedical informatics.

Promote cooperation and exchange of actions generated in the field of

biomedical informatics, both in the public and private, national and international

level.

Interact with all scientists, recognized academic stimulating the creation of new

instances that have the same goal and be inspired by the same purpose.

To promote, organize, sponsor and participate in events and activities for

training in computer and information and disseminating developments in this area

that might be useful for team members and health related activities.

24
The Argentinian health system is very heterogeneous, because of that the

informatics developments shows a heterogeneous stage. Lot of private Health Care

center have developed systems, as the German Hospital of Buenos Aires who was

one of the first in develop the electronic health records system. The first

applications of computers to medicine and healthcare in Brazil started around

1968, with the installation of the first mainframes in public university hospitals,

and the use of programmable calculators in scientific research applications.

Minicomputers, such as the IBM 1130 were installed in several universities, and

the first applications were developed for them, such as the hospital census in the

School of Medicine of Ribeirão Preto and patient master files, in the Hospital das

Clínicas da Universidade de São Paulo, respectively at the cities of Ribeirão Preto

and São Paulo campi of the University of São Paulo. In the 1970s, several Digital

Corporation and Hewlett Packard minicomputers were acquired for public and

Armed Forces hospitals, and more intensively used for intensive-care unit,

cardiology diagnostics, patient monitoring and other applications. In the early

1980s, with the arrival of cheaper microcomputers, a great upsurge of computer

applications in health ensued, and in 1986 the Brazilian Society of Health

Informatics was founded, the first Brazilian Congress of Health Informatics was

held, and the first Brazilian Journal of Health Informatics was published. Health

Informatics projects in Canada are implemented provincially, with different

25
provinces creating different systems. A national, federally-funded, not-for-profit

organization called Canada Health Info way was created in 2001 to foster the

development and adoption of electronic health records across Canada. As of

December 31, 2008 there were 276 EHR projects under way in Canadian hospitals,

other health-care facilities, pharmacies and laboratories, with an investment value

of $1.5-billion from Canada Health Info way.

Provincial and territorial programs include the following:

eHealth Ontario was created as an Ontario provincial government agency in

September 2008. It has been plagued by delays and its CEO was fired over a

multimillion-dollar contracts scandal in 2009.[12]

Alberta Netcare was created in 2003 by the Government of Alberta. Today the

netCARE portal is used daily by thousands of clinicians. It provides access

todemographicdata, prescribed/dispensed drugs, known allergies/intolerances,

immunizations, laboratory test results, diagnostic imaging reports, the diabetes

registry and other medical reports. netCARE interface capabilities are being

included in electronic medical record products which are being funded by the

provincial government.

26
In 2004 the U.S. Department of Health and Human Services (HHS) formed the

Office of the National Coordinator for Health Information Technology (ONCHIT).

The mission of this office is widespread adoption of interoperable electronic health

records (EHRs) in the US within 10 years. See quality improvement organizations

for more information on federal initiatives in this area.

The Certification Commission for Healthcare Information Technology (CCHIT), a

private nonprofit group, was founded in 2005 by the U.S. Department of Health

and Human Services to develop a set of standards for electronic health records

(EHR) and supporting networks, and certify vendors who meet them. In July, 2006

CCHIT released its first list of 22 certified ambulatory EHR products, in two

different announcements (Tüttelmann, Luetjens and Nieschlag, 2016).

For more details on this topic, see European Federation for Medical Informatics.

The European Union's Member States are committed to sharing their best practices

and experiences to create a European eHealth Area, thereby improving access to

and quality health care at the same time as stimulating growth in a promising new

industrial sector. The European eHealth Action Plan plays a fundamental role in

the European Union's strategy. Work on this initiative involves a collaborative

approach among several parts of the Commission services. The European Institute

27
for Health Records is involved in the promotion of high quality electronic health

record systems in the European Union (Starmer et al., 2010).

The NHS in England has contracted out to several vendors for a national health

informatics system 'NPFIT' that originally divided the country into five regions and

is to be united by a central electronic medical record system nicknamed "the

spine". The project, in 2010, is seriously behind schedule and its scope and design

are being revised in real time. In 2010 a wide consultation was launched as part of

a wider Liberating the NHS‟ plan. Many organizations and bodies (look on their

own websites, as most have made their responses public in detail for information)

responded to the consultation and a new strategy is expected in the second quarter

of 2011. The degree of computerization in NHS secondary care was quite high

before NPfIT and that programmed has had the unfortunate effect of largely

stalling further development of the installed base. Almost all general practices in

England and Wales are computerized and patients have relatively extensive

computerized primary care clinical records. Computerizations are the responsibility

of individual practices and there is no single, standardized GP system.

Interoperation between primary and secondary care systems is rather primitive. A

focus on interworking (for interfacing and integration) standards is hoped will

stimulate synergy between primary and secondary care in sharing necessary

information to support the care of individuals. Scotland has an approach to central

28
connection under way which is more advanced than the English one in some ways.

Scotland has the GPASS system whose source code is owned by the State, and

controlled and developed by NHS Scotland. GPASS was accepted in 1984. It has

been provided free to all GPs in Scotland but has developed poorly (Robson and

Baek, 2019). Discussion of open sourcing it as a remedy is occurring. The broad

history of health informatics has been captured in the book UK Health Computing:

Recollections and reflections, Hayes G, Barnett D (Eds.), BCS (May 2008) by

those active in the field, predominantly members of BCS Health and its constituent

groups. The book describes the path taken as „early development of health

informatics was unorganized and idiosyncratic‟. In the early -1950s it was

prompted by those involved in NHS finance and only in the early 1960s did

solutions including those in pathology (1960), radiotherapy (1962), immunization

(1963), and primary care (1968) emerge. Many of these solutions, even in the early

1970s were developed in-house by pioneers in the field to meet their own

requirements. In part this was due to some areas of health services (for example the

immunization and vaccination of children) still being provided by Local

Authorities. Interesting, this is a situation which the coalition government propose

broadly to return to in the 2010 strategy Equity and Excellence: Liberating the

NHS (July 2010); stating:

29
"We will put patients at the heart of the NHS, through an information revolution

and greater choice and control‟ with shared decision-making becoming the norm:

“no decision about me without me‟ and patients having access to the information

they want, to make choices about their care. They will have increased control over

their own care records.”

These types of statements present a significant opportunity for health

informaticians to come out of the back-office and take up a front-line role

supporting clinical practice, and the business of care delivery. The UK health

informatics community has long played a key role in international activity, joining

TC4 of the International Federation of Information Processing (1969) which

became IMIA (1979). Under the aegis of BCS Health, Cambridge was the host for

the first EFMI Medical Informatics Europe (1974) conference and London was the

location for IMIA‟s tenth global congress (MEDINFO2001). In 2002, the idea of a

profession of health informatics across the UK was first mooted and by 2004 a

voluntary open register was established. The UK Council for Health Informatics

Professions (UKCHIP) now has a formal Code of Professional Conduct, standards

for expressing competences which are used for entry, confirmation of fitness to

practice, re-grading and personal development. Consistent standards express

competences of health informatics professionals in both domain-specific and

generic informatics professional areas. The consistency is intended to apply in

30
operational care delivery organizations, academia and the commercial service and

solution providers. In 2011, self-assessment tools were introduced for use by any

interested party. In addition, the principles and UKCHIP model are being

considered internationally (as at 2011). UKCHIP certification is being considered

for regulatory purposes. In conjunction with workforce development tools such as

the NHS HI Career Framework it is possible for individuals to compare their skills

against typical job roles, determine their professional level, and for employers to

carry out detailed workforce analysis to meet the emerging requirements of the

informatics strategies of all the home countries.

The European Commission's preference, as exemplified in the 5th Framework as

well as currently pursued pilot projects, is for Free/Libre and Open Source

Software (FLOSS) for healthcare.

2.3 Technologies used in the systems reviewed

Web-based and Electronic Medical Record Management Systems

A recent study by Arizona (2011) demonstrated that nowadays, in our day to day

activities everything around us is going for digitization. The emergence of web

application domains have helped to minimize and reduce the real-world problem.

The electronic health records offer the medical institutions and organizations the

possibility to improve the management of their patient’s medical records. Most of

31
the healthcare software development organizations work in isolation from the

healthcare providers which leads to complications and confusions with regard to

correctness and interoperability among different healthcare systems. The term

interoperability refers to the way in which different subsystems access and use the

data reliably and quickly from various sources without the occurrence of errors.

The interoperability among the healthcare information systems enables these

systems to communicate with each other in order to share information, improving

its high availability. For example, a user whose computer system runs on a Unix

operating system and another user whose computer is running on the Windows

operating system can all access the web-based system regardless of the differences

in hardware design.

A recent study conducted by Habib (2010) defines an electronic medical record as

a digital version of a traditional paper-based medical record of a patient; an

electronic medical record system can be implemented as desktop based application,

mobile based or web-based depending on the end user’s requirement. The

Electronic Medical Record can be designed to work with computer systems (both

laptops and desktops); it can also be designed to work with the handheld mobile

devices such as the Android devices. The use of electronic medical record system

minimizes the amount of physical storage space required for storing patient and

staff records, and they also allow the patient records to be shared by the staff of the

32
various departments of the clinic and administrative officers without physically

transporting the records because they are readily accessible at any time from the

clinic’s database using computer devices. Time and distance being the major

barriers to the retrieval of information from the clinic’s medical record in the case

of paper-based medical record has been addressed by the introduction and

implementation of web-based version of the EMR.

A recent study by Hoffman and Podgurski (2018) on Hospital Information Systems

in Nigeria reveals that the methods used in collection, processing, and storage of

patient information that helps in administering clinical treatment to patient dates

back to the origin of medicine. The technique used in the collection of patients’

records and the ways in which this information is used and subsequently stored for

future references has continued to evolve from regular paper note takings to

electronic hospital information systems. The electronic hospital or clinical record

system makes use of the computer technology to record and store patient’s record

on dedicate web servers instead of the traditional paper record keeping system.

The increasing demand for well-structured and accessible patient data, in

accordance with development in computer science has triggered a great interest in

the development of electronic patient record. Computers have the potential to

improve legibility, accessibility and structure of the patient’s record. The

performance of healthcare system can be improved greatly with the use of

33
computers and modern information technology. The healthcare system and medical

institutions in the developing and third world countries like Bangladesh, India,

Myanmar, and Nigeria among others did not fully utilize the power of computers,

process automation, and information technology yet. In those countries, the

medical services did not completely integrate computers and information

technology into their day to day activities (Laura, 2017). The computer- based

medical record minimizes the amount of physical storage space required for storing

patient and staff records, and they also allow the records to be shared by the staff

of the various departments of the clinic and administrative officers without

physically transporting the records because they are readily accessible at any time

from the clinic’s website (proposed system). Time and distance being the major

barriers to the retrieval of information from the clinic’s medical record (paper-

based record) has been addressed by the introduction and implementation of a

computerized medical record system.

2.4 Summary of review from related literature/ existing systems in place

and their limitations

As far as this research project is concerned, patient records constitute the bulk of

the medical records of all the health care centers all over the world; to this effect,

medical records refers to the confidential information kept for each patient by

heath care professionals or organizations that contains the patient’s personal details
34
such as name, residential address, and date of birth, a summary of the patient’s

medical history and documentation of each event including symptoms, diagnosis,

treatment and outcome; it also contains a report of the results of a medical

examination of a patient.

2.5 Literature Gap

Having reviewed some scholarly articles and project works that are relevant to

medical records at both Paper-based and electronic based levels, the need for

electronic medical record management systems and security issues in electronic

medical record systems, this project has come up with the following issues that

have not been addressed properly by the reviewed articles:

i. In respect to concurrent access to medical records by the clinicians, some of

the papers reviewed in this project ended up in developing a single user desktop

application for their project, which can only be operated by a single user at a time

and does not support a concurrent access to medical data of any given medical

institution. In an effort to provide a system that offers a concurrent access to

medical records, this project work is determined to develop a distributed web-

based application that can be accessed concurrently by multiple users at the same

time.

35
None of the papers reviewed in this project have taken the testing of the software

developed into consideration, on the contrary this project have taken an in depth

coverage of software testing.

36
 CHAPTER THREE

SYSTEM ANALYSIS AND DESIGN

3.1 Methodology

Methodology is defined as a framework that is used to structure, plan, and control

the process of developing an information system. It is used to refer to a specific

series of steps, methods, techniques and procedures which governs the collection,

analysis and design of a particular project. In the dynamic world, the subject

methodology, system analysis and design mainly deal with the software

development activities (Uba, 2011).

3.1.1 Choice of Methodology

The System will adopt the object oriented approach to system design, which has

enormous benefits. It is an evolutionary and iterative process that encompasses

abstractions of the system attributes and behaviours using necessary tools such as

Unified Modeling language (UML).

Object oriented analysis and design methodology is used to analyze the present

system as well as to design the proposed system with the primary aim of;

1. Identifying the problems inherent in the present system.

2. Investigating the causes of these problems

37
 3. Proffering solutions to the manual systems

3.1.2 Justification of Methodology

1. It speeds up application development and requires less programming efforts.

2. Modules created in OOP can be re-used in other programs.

3. Programs can be modified by adding or removing modules.

The Object-Oriented Analysis and Design Methodology (OOADM) perform four

major activities namely:

1. Modeling the functional description of the system. To achieve this the

following steps has to be taken:

a) Identifying all actors and use cases

b) Construct a use case model

c) Document use case course of events

d) Define the analysis use case.

2. Finding and identifying business objects. To achieve this task, the steps

given below must be accomplished.

a) Review each use case to find potential objects (which are usually noun

corresponding to business entities or events)

38
 b) Select the proposed objects.

3. Organizing the objects and identifying their relationships. To achieve this

task, the steps given below must be accomplished.

a) Identify associations and multiplicity

b) Identify generalization/specification relationships

c) Identify aggregation relationships

d) Prepare class diagram.

Model the behavior of each object using state chart diagram. MrsEze, u.f (2008).

3.2 Method of Data Collection

Fact finding techniques aid in collecting information about system problems

requirements and preference. It is the process of collecting data and in formation

based on techniques which contains sampling of existing documents, research,

observation, questionnaires, interviews, prototyping and joint requirements

planning. (Essays, 2015). In this project, research, interview and observation are

the fact finding techniques that were deployed.

39
3.4.1 Research

Information such as background information, technical materials and news about

patient record management trends and development which were gathered to

publish this topic were obtained in sources like newspapers, journals and internet.

3.4.2 Interviews

Interview is the most commonly used techniques to collect information from the

face-to-face interviews and also one of the key research tools for finding out new

accurate data. I had the opportunity to move to hospitals/clinics and schedule

interview sessions with the patients and management. This information will helps

me in the development of the system to solve problems which are incurred in their

daily activities.

3.4.3 Observation

The observation is another fact finding techniques that was adopted, which I paid

close attention to the day to day activities which provided another perspective and

better understanding of procedures.

40
3.3 Analysis of the Existing System

System analysis is a structure process of collecting and analyzing facts in respect

of existing operations procedures and system in order to obtain a full appreciation

of the situation prevailing so that an effective computerized system may be

designed and implemented when proved feasible. According to E.C and chapman

R.J. “system analysis is defined as the method of determining how best to use

computer with other resources to perform tasks which meet the information needs

of an establishment. Before moving into the major system design building blocks

of this new system we need to analyze the existing system and identify their

weaknesses.

The existing system of patient record tracking system in most hospitals/clinics

involves manual activities. It has been observed that to receive medical treatment

in most of our hospitals the Patients queue according for several hours in the

sequence of first come first serve (FCFS) though, a new patient usually register

into the hospital by filling patients form which signifies that the person is an

official patient of that hospital. Also, this gives the person access to own a hospital

folder. Which is used to store the basic information about the diagnosis and drug

prescribed to the patient.

41
In other hand, if it is an old patient, the staff retrieved his hospital folder using the

patient’s form which the doctor have a look at first, before examining the patient

and carry out the appropriate therapy which is either he referred the patient to

laboratory unit for lab test (if the need be) or to the pharmacy unit to obtain the

prescribed drugs (if the matter is not too complex). But, any treatment offered to

the patient by the doctor must be recorded on the patient’s folder to avoid

inappropriate therapy. Though, it sounds so easy but it has some stumbling

blocks.

3.4 Analysis of Proposed System

Using the information obtained while analyzing the present system a new system

will be designed that will meet the requirement of all the users both the Domain

users and the public.

i. The system should captured patients initials at the registration panel that can

be used by all departments of the hospital.

ii. The system should generate patient’s identity number automatically.

iii. The system should identify treated and untreated patients at doctor and

pharmacist control panel concerning drug issuing.

3.5 Problem of the Existing System

42
The under-listed points constitute the major problems of the existing patient record

tracking system in most clinic as identified by this project:

i. Inefficiency of the existing System: The use of paper for keeping all the

medical records of the clinic have reduced the efficiency of the existing

system for example, various changes to medical records like staff details are

difficult to make as paper work is involved [4].

ii. Insecurity of data: The patient folders and medical cards used for record

keeping is easily exposed to unauthorized users; which can easily get vital

patient’s information from the clinic because the patient folder which

contains a patient’s medical records are just kept on the shelf in a file cabinet

without any security lock [5,2].

iii. Time consuming: By using medical cards, considerable amount of times are

wasted when the medical cards needs to pass from the nurse to the doctor

and then to pharmacy for drug collection; also, some of the clinic staff needs

to spend sometimes to organize the medical cards from time to time [4].

iv. Lack of effective back up facilities: lack of effective back up facilities for

data could lead to loss of the entire information that is kept in the clinic, in

the event of disaster [6].

3.6 Justification of the New System

43
The new system among other things will have the following characteristics which

will improvement the current system in use;

i. The new system designed will help the management to use computer system

to find patients information with regards to billing, treatments, etc.

ii. Accuracy is maintained, as the computer information will yield an accurate

result.

iii. There will not be much congestion in hospitals, as the medical system

developed will assist patients to be treated and the information stored.

iv. The speed of operation of the medical system is high when compared to

manual method.

44
3.7 System Flowchart

Start

Main Menu

1. Patients
2. Query
3. Report
4. Exit

Yes
Option 1 ? Call patients form

No

Yes
Option 2 ? Call query program

No

Yes
Option 3 ? Call Report Module

No

No
Option 4 ?

Yes

Stop

Fig. 3.1 System Flowchart

45
3.8 System Data Flow Diagram

Main Menu

Patients Query Report Help Exit

Admission
Patients
Record List of Admitted
Patients
Bill

Patients Bill
Payment Information

Treatment

46
 CHAPTER FOUR

SYSTEM IMPLEMENTATION, TESTING AND INTEGRATION

4.1 System Implementation

Here, the design stage is transformed into program codes. This phase is computer

and compiler specific. It is the stage whereby the developer actually writes out

program codes that will carry out all instructions to be performed by the system. In

other words, output documents of the design stage are converted into program

instructions in this stage.

However, to successfully build and implement this new system, a number of things

are very necessary and are much needed/required to be in place. These

requirements can be sub-grouped into hardware and software requirements.

47
4.2 Input Specification and Design

The input to the new system is the patient’s admission form, which is entered

through the keyboard. The input form design takes the format bellow.

48
4.3 Output Specification and Design

The output form is designed to generate printable reports from the database. The

output is placed on a database grid and contains information on patient’s records.

The output produced can be printed on a hard copy or viewed on the screen. The

output generated includes:

i. Patients File

ii. Bill Record

iii. Treatment Record.

49
4.4 File 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) and Entity Relationship Diagrams (ERDs). The design ensures

that only allows authorized users to access the system’s information.

50
4.5 Database Design

In any good database design, effort should be made to remove completely or at

worst reduce redundancy. The database design in the software is achieved using

Microsoft access database. Bellow is the structure of the file designed in the

database.

PATIENTS TABLE

FIELD FIELD TYPE FIELD SIZE

Card No Text 15

Patients Name Text 20

Address Text 30

Age Integer 2

Sex Text 8

Ward Text 20

Bill Single 4

Date admitted Date/time 8

Treatment Text 100

51
4.6 Justification of Programming Language Used

In developing a system that requires a high level sensitivity such as this one, a

language that simplifies thing was necessary for use. This was the reason for

choosing the PHP for scripting, HTML, with few elements of DHTML and CSS

for Interface design and styling. SQL was chosen for programming the database.

4.7 System Requirements

4.7.1 Hardware Requirements

For the effective and efficient implementation of this application, there are some

minimum hardware requirements that are necessary for the program to function

without problems. For a smooth computer execution, the program requires.

i. A Pentium processor (or any equivalent processor) of common speeds of

200 MHz or above. Intel’s Pro chip is also ideal for computers that use

powerful operating systems such as windows NT and UNIX Pentium pro

chips are available with speeds of 200 MHZ and above.

ii. The computer should be equipped with a minimum disk memory (RAM)

of 1GB or higher.

52
Other hardware requirements are a monitor of a high resolution for viewing data, a

standard keyboard and mouse for data input a CD-ROM and floppy disks drives

for external storage. The system may also have other peripheral attached to it

depending on the desire and financial power of the operators. Such peripherals

could be printers, scanners and a modern (for internet connectivity). It can also

posses a network card if the users intend to use the computer within a wide area

network (WAN), for easy accessing of the database from other remote computers.

4.7.2 Software Requirements

The software required for the implementation of this system include;

1. Windows 7 and later with Wamp server installed

2. Internet Explorer or Mozilla Firefox

4.8 Testing And Integration

4.8.1 Unit testing

This is the process of testing and verifying that the system developed functions as

planned. After compilation, the system is tested to see whether the resulting output

matches with the intended output for the program. Also, it is compared to check

whether of produces correct results. Finally, it is proved that the program built

solves the problem that was described in the requirement definition.

53
4.8.2 Test Data

The test tool adopted in this project is the white box testing approach. The code-

testing strategy examines the logic of the program. To follow this testing method,

the analyst develops test cases that result in executing every instruction in the

program or module so that every path through the program is tested. A path is a

specific combination of conditions that is handled by the program. Code testing

does not check the range of data that the program will accept.

• Exercises all logical decisions on their true or false sides.

• Executes all loops at their boundaries and within these operational bounds.

4.8.3 Test Result

Analysis is a key evaluation step that begins to make meaning of the evaluation

data collected from the system development process. Reporting the subsequent

evaluation results is an important step in documenting findings and staying

accountable. At the end of the development process, the evolution of the system

was done first by the developer and then the project supervisor and coordinator.

The evaluation revealed a 95% adherence to design principles and also a good

54
attempt in achieving all the requirements for a good intelligent traffic information

system.

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATIONS

5.1 Summary

As far as this research project is concerned, patient records constitute the bulk of

the medical records of all the health care centers all over the world; to this effect,

medical records refers to the confidential information kept for each patient by

heath care professionals or organizations that contains the patient’s personal details

such as name, residential address, and date of birth, a summary of the patient’s

medical history and documentation of each event including symptoms, diagnosis,

treatment and outcome; it also contains a report of the results of a medical

examination of a patient.

5.2 Conclusions

Computing devices like the laptop computers and desktop computers has become

one of the common means of accessing medical information within and outside the

55
clinical settings. Special caution should be taken while using the computing

devices for retrieval of the confidential medical records of a patient from the

clinic’s database by maintaining the security of Patients’ medical records; this is

achieved by restricting the access to a patient’s medical data such that only

authorized users can access the patient’s records. The problem of manually

searching the shelves of a file cabinet in order to locate a patient record has been

addressed in this project by designing a secured web-based medical record

management system.

5.3 Contribution to Knowledge

The findings from this project is an addition to the body of existing literatures in

the area of patient record management and general hospital management

information system and can be a useful resource material to lecturers, students, and

researchers in this field.

5.4 Recommendations

Having seen the usefulness of the proposed project; I recommend the following to

the clinic as stipulated below:

 The record keeping of the clinic should be completely automated.

 The staff of the various departments of the clinic should be adequately

trained on how to use the proposed system.

56
  Appropriate policy guidelines should be formulated that will protect the

privacy and security of patients’ information.

5.5 Suggested Area for Further Studies

In order to improve the proposed system in the future, it can be enhanced by

including more features like doctor’s appointment module, clinical inventory

module and billing system that will be used in computing the cost of drugs ordered.

The inclusion of such features into the proposed system will provide for more

patient satisfaction and yield higher productivity of the health care workers.

57
 REFERENCE

Agu, E.O., Nwadialor, G.O., and Moses, T. 2016. Design and Implementation of a
Dynamically Adapted Students’ Admission System: African Journal of
Education, Science and Technology Vol 3, 162-179

Asabe, S. A., Monday, G., and Oye, N. D. 2013. Hospital Patient Database
Management System: International Journal of Advanced Computer
Technology, 2 (3)

James, A. C. 2019. Computerization of Medical Records Retrieved on 18th

Jan, 2017 from http://www.ddclaw.com/news_events/articlesofinterest/p
dfs/Computerization%20of%20Medical%20Records.pdf.

Adebisi, O.A, Oladosu, D.A, Busari, O.A and Oyewola, Y.V. 2015. Design and
Implementation of Hospital Management System: International
Journal of Engineering and Innovative Technology Volume 5(1)

Wadzani, A. G. 2018. Computerized Medical Record System: A Case Study of

F.U.T.Y Clinic. Unpublished Bachelor of Technology Research Project,
Federal University of Technology Yola, Adamawa State

Opeyemi, A.A., Blessing, O. A., and Blessing, E. O. 2016. An Online Outpatient

Database System: A Case Study of General Hospital, Minna.
Intelligent IJCA : www.ijcaonline.org View publication stats formation
TM

Management, 103-114.

Droma, F., Bulyaba, H., Ssebwato, J., Nakawooya, K., Musah, K. C., Ongoro, A.,
Collins, S., and Ndege, R. 2019. An Automated System for Patient Record
Management: A Case study of St Francis Hospital Nsambya.
Unpublished Bachelor of Information Technology Project Report, Makerere
University

Mohd-Zharif, A. R. 2010. Patient Registration System: Unpublished Bachelor of

Computer Science Research Project, Universiti Tecknikal Malaysia Melaka.

Yeo, Y. P. 2014. Clinical Management Systems: Unpublished Bachelor of Science

(BSc) Project report, Universiti Malay

58
Vinayak, S., Anant, G., Surendra, W., Eknath, S., and Bhadkumbh, S. M. 2016
WEB Based e-Health System and Services: International Journal of
Innovative Research in Computer and Communication Engineering 4(3)

Daryl, A., Bulou, G., Nicholas, R., and Rohitash, C. 2015. Development of an
Android Application for an Electronic Medical Record System in an
Outpatient Environment for Healthcare in Fiji: Technical Report, AICRG,
Software Foundation, Fiji, March 2015

Ayodele, C. B. 2011. Hospital Information Systems in Nigeria: A Review of

Literature. Journal of Global Health Care Systems 1(3)

Biswas, S., Anisuzzaman, Tanjina, A., Kaiser, M. S., and Mamun, S. A.

2014. Cloud Based Healthcare Application Architecture and Electronic
Medical Record Mining: An Integrated Approach to Improve Healthcare
System: 2014 17th International Conference on Computer and Information
Technology (ICCIT)

Ilo, S.F., Igbajar, A., and Acholonu, J. C. 2015. Designing A Web Based Hospital
Management System For MOUAU Clinic: International Journal of Trend in
Research and Development, 2(6)

Rabi, P. P., Manas, R. P., and Suresh, C. S. 2012. Design and Implementation of a
Cloud based Rural Healthcare Information System Model: UNIASCIT, 2(1),
149-157

Parameswari, R., and Prabakaran, N. 2013. An Android Enabled Mobile Cloud

Framework for Development of Electronic Healthcare Monitoring System
using VPN Connection: International Journal of Advance Research in
Computer Science and Management Studies: 1(7)

Ogwueleka, F.N. 2010. Fundamentals of computer science: Printed by Okezzy

productions.com

Cheng-Kun, W. 2015. Security and privacy of personal health record, electronic

medical record and health information: Problems and Perspectives in
Management, 13(4)

Li, Z. R., Chang, E. C., Huang, K. H., and Lai, F. 2011. A secure electronic
medical record sharing mechanism in the cloud computing platform.
Proceedings of the 15th International Symposium on Consumer Electronics

59
 (ISCE’11) of the Institute of Electronics and Electrical Engineers (IEEE)
Singapore 2011, 98–103

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. (2018). "Finding a Cure; The Case for Regulation
and Oversight of Electronic Health Record Systems" (PDF). Harvard Journal
of Law & Technology

Laura, D. (2017). "Electronic Health Records: Interoperability Challenges and

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

Robson, B., Baek, K. (2019). The Engines of Hippocrates. From the Dawn of
Medicine to Medical and Pharmaceutical Informatics. USA: John Wiley &
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. (2016)."Optimising workflow in

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

Andrology March 2016

Wong, G., Bark, P., & Swinglehurst, D. (2019). “Tensions and paradoxes in
electronic patient record research”. A systematic literature review using the
meta-narrative method. Milbank Quarterly, 87(4), 729-88.

60
 APPENDIX I

PROGRAM INTERFACE

61
62
63
 APPENDIX II

PROGRAM SOURCE CODE

<?php

/*
*---------------------------------------------------------------
* APPLICATION ENVIRONMENT
*---------------------------------------------------------------
*
* You can load different configurations depending on your
* current environment. Setting the environment also influences
* things like logging and error reporting.
*
* This can be set to anything, but default usage is:
*
* development
* testing
* production
*
* NOTE: If you change these, also change the error_reporting() code below
*
*/
define('ENVIRONMENT', 'production');
/*
*---------------------------------------------------------------
* ERROR REPORTING
*---------------------------------------------------------------
*
* Different environments will require different levels of error reporting.
* By default development will show errors but testing and live will hide them.
*/

if (defined('ENVIRONMENT'))
{
switch (ENVIRONMENT)
{
64
 case 'development':
error_reporting(E_ALL);
break;

case 'testing':
case 'production':
error_reporting(0);
break;

default:
exit('The application environment is not set correctly.');
}
}

/*
*---------------------------------------------------------------
* SYSTEM FOLDER NAME
*---------------------------------------------------------------
*
* This variable must contain the name of your "system" folder.
* Include the path if the folder is not in the same directory
* as this file.
*
*/
$system_path = 'system';

/*
*---------------------------------------------------------------
* APPLICATION FOLDER NAME
*---------------------------------------------------------------
*
* If you want this front controller to use a different "application"
* folder then the default one you can set its name here. The folder
* can also be renamed or relocated anywhere on your server. If
* you do, use a full server path. For more info please see the user guide:
* http://codeigniter.com/user_guide/general/managing_apps.html
*
* NO TRAILING SLASH!
*
*/
65
 $application_folder = 'application';

/*
* --------------------------------------------------------------------
* DEFAULT CONTROLLER
* --------------------------------------------------------------------
*
* Normally you will set your default controller in the routes.php file.
* You can, however, force a custom routing by hard-coding a
* specific controller class/function here. For most applications, you
* WILL NOT set your routing here, but it's an option for those
* special instances where you might want to override the standard
* routing in a specific front controller that shares a common CI installation.
*
* IMPORTANT: If you set the routing here, NO OTHER controller will be
* callable. In essence, this preference limits your application to ONE
* specific controller. Leave the function name blank if you need
* to call functions dynamically via the URI.
*
* Un-comment the $routing array below to use this feature
*
*/
// The directory name, relative to the "controllers" folder. Leave blank
// if your controller is not in a sub-folder within the "controllers" folder
// $routing['directory'] = '';

// The controller class file name. Example: Mycontroller

// $routing['controller'] = '';

// The controller function you wish to be called.

// $routing['function'] = '';

/*
* -------------------------------------------------------------------
* CUSTOM CONFIG VALUES
* -------------------------------------------------------------------
*
* The $assign_to_config array below will be passed dynamically to the
* config class when initialized. This allows you to set custom config
66
* items or override any default config values found in the config.php file.
* This can be handy as it permits you to share one application between
* multiple front controller files, with each file containing different
* config values.
*
* Un-comment the $assign_to_config array below to use this feature
*
*/
// $assign_to_config['name_of_config_item'] = 'value of config item';

// --------------------------------------------------------------------
// END OF USER CONFIGURABLE SETTINGS. DO NOT EDIT BELOW
THIS LINE
// --------------------------------------------------------------------

/*
* ---------------------------------------------------------------
* Resolve the system path for increased reliability
* ---------------------------------------------------------------
*/

// Set the current directory correctly for CLI requests

if (defined('STDIN'))
{
chdir(dirname(__FILE__));
}

if (realpath($system_path) !== FALSE)

{
$system_path = realpath($system_path).'/';
}

// ensure there's a trailing slash

$system_path = rtrim($system_path, '/').'/';

// Is the system path correct?

if ( ! is_dir($system_path))
{
67
 exit("Your system folder path does not appear to be set correctly.
Please open the following file and correct this: ".pathinfo(__FILE__,
PATHINFO_BASENAME));
}

/*
* -------------------------------------------------------------------
* Now that we know the path, set the main path constants
* -------------------------------------------------------------------
*/
// The name of THIS file
define('SELF', pathinfo(__FILE__, PATHINFO_BASENAME));

// The PHP file extension

// this global constant is deprecated.
define('EXT', '.php');

// Path to the system folder

define('BASEPATH', str_replace("\\", "/", $system_path));

// Path to the front controller (this file)

define('FCPATH', str_replace(SELF, '', __FILE__));

// Name of the "system folder"

define('SYSDIR', trim(strrchr(trim(BASEPATH, '/'), '/'), '/'));

// The path to the "application" folder

if (is_dir($application_folder))
{
define('APPPATH', $application_folder.'/');
}
else
{
if ( ! is_dir(BASEPATH.$application_folder.'/'))
{
exit("Your application folder path does not appear to be set
correctly. Please open the following file and correct this: ".SELF);
}

68
 define('APPPATH', BASEPATH.$application_folder.'/');
}

/*
* --------------------------------------------------------------------
* LOAD THE BOOTSTRAP FILE
* --------------------------------------------------------------------
*
* And away we go...
*
*/
require_once BASEPATH.'core/CodeIgniter.php';

/* End of file index.php */

/* Location: ./index.php */

<!--sidebar end-->
<!--main content start-->
<section id="main-content">
<section class="wrapper site-min-height">
<!-- page start-->

<section class="col-md-9">

<section class="">
<header class="panel-heading tab-bg-dark-navy-blueee">
<ul class="nav nav-tabs">
<li class="">
<a data-toggle="tab" href="#todays"><?php echo
lang('todays'); ?> <?php echo lang('appointments'); ?></a>
</li>
<li class="">
<a data-toggle="tab" href="#patient"><?php echo
lang('patient'); ?></a>
</li>
<li class="">
<a data-toggle="tab" href="#prescription"><?php echo
lang('prescription'); ?></a>
</li>
69
 <li class="">
<a data-toggle="tab" href="#schedule"><?php echo
lang('schedule'); ?></a>
</li>
<li class="">
<a data-toggle="tab" href="#holiday"><?php echo
lang('holidays'); ?></a>
</li>
<li class="active">
<a data-toggle="tab" href="#calendar"><?php echo
lang('calendar'); ?></a>
</li>
</ul>
</header>
<div class="panel col-md-12">
<div class="tab-content">
<div id="todays" class="tab-pane">
<div class="">
<div class=" no-print">
<a class="btn btn-info btn_width btn-xs" data-
toggle="modal" href="#addAppointmentModal">
<i class="fa fa-plus-circle"> </i> <?php echo
lang('add_new'); ?>
</a>
</div>
<div class="adv-table editable-table ">
<table class="table table-striped table-hover table-bordered"
id="">
<thead>
<tr>
<th><?php echo lang('date'); ?></th>
<th><?php echo lang('patient_id'); ?></th>
<th><?php echo lang('patient'); ?></th>
<th><?php echo lang('status'); ?></th>
<th class="no-print"><?php echo lang('options'); ?
></th>
</tr>
</thead>
<tbody>
<?php
70
 foreach ($todays_appointments as
$todays_appointment) {
$patient_details = $this->patient_model-
>getPatientById($todays_appointment->patient);
if (!empty($patient_details)) {
?>
<tr class="">
<td><?php echo date('d-m-Y',
$todays_appointment->date); ?></td>
<td><?php echo $todays_appointment->patient;
?></td>
<td><?php echo $patient_details->name;
?></td>
<td><?php echo $todays_appointment-
>status; ?></td>
<td class="no-print">
<button type="button" class="btn btn-info
btn-xs btn_width editAppointmentButton" title="<?php echo lang('edit'); ?>" data-
toggle="modal" data-id="<?php echo $todays_appointment->id; ?>"><i class="fa
fa-edit"></i> </button>
<a class="btn btn-info btn-xs btn_width
delete_button" title="<?php echo lang('delete'); ?>" href="appointment/delete?
id=<?php echo $todays_appointment->id; ?>" onclick="return confirm('Are you
sure you want to delete this item?');"><i class="fa fa-trash-o"></i> </a>
<a class="btn btn-info btn-xs btn_width
green" title="<?php echo lang('history'); ?>" style="color: #fff;"
href="patient/medicalHistory?id=<?php echo $todays_appointment->patient; ?
>"><i class="fa fa-stethoscope"></i> <?php echo lang('patient'); ?> <?php echo
lang('history'); ?></a>
</td>
</tr>
<?php
}
}
?>
</tbody>
</table>
</div>
</div>
</div>
71
 <div id="patient" class="tab-pane">
<div class="">
<div class="adv-table editable-table ">
<?php if (!empty($appointment_patients)) { ?>
<table class="table table-striped table-hover table-
bordered" id="editable-sample">
<thead>
<tr>
<th><?php echo lang('patient_id'); ?></th>
<th><?php echo lang('patient'); ?> <?php echo
lang('name'); ?></th>
<th class="no-print"><?php echo lang('options'); ?
></th>
</tr>
</thead>
<tbody>
<?php
foreach ($appointment_patients as
$appointment_patient) {
$appointed_patient = $this->patient_model-
>getPatientById($appointment_patient);
?>
<tr class="">

<td><?php echo $appointed_patient->id;

?></td>
<td><?php echo $appointed_patient->name; ?
></td>
<td class="no-print">
<a class="btn green" title="<?php echo
lang('history'); ?>" style="color: #fff;" href="patient/medicalHistory?id=<?php
echo $appointed_patient->id; ?>"><i class="fa fa-stethoscope"></i> <?php echo
lang('history'); ?></a>
</td>
</tr>
<?php } ?>
</tbody>
72
 </table>
<?php } ?>
</div>
</div>
</div>
<div id="prescription" class="tab-pane"> <div class="">
<?php if ($this->ion_auth->in_group(array('Doctor'))) { ?>
<div class=" no-print">
<a class="btn btn-info btn_width btn-xs"
href="prescription/addPrescriptionView">
<i class="fa fa-plus-circle"> </i> <?php echo
lang('add_new'); ?>
</a>
</div>
<?php } ?>
<div class="adv-table editable-table ">
<table class="table table-striped table-hover table-bordered"
id="editable-sample">
<thead>
<tr>

<th><?php echo lang('date'); ?></th>

<th><?php echo lang('patient'); ?></th>
<th><?php echo lang('medicine'); ?></th>
<th class="no-print"><?php echo lang('options'); ?
></th>
</tr>
</thead>
<tbody>
<?php foreach ($prescriptions as $prescription) { ?>
<tr class="">
<td><?php echo date('m/d/Y', $prescription-
>date); ?></td>
<td><?php echo $this->patient_model-
>getPatientById($prescription->patient)->name; ?></td>
<td>

<?php
if (!empty($prescription->medicine)) {

73
 $medicine = explode('###', $prescription-
>medicine);
foreach ($medicine as $key => $value) {
$medicine_id = explode('***', $value);
$medicine_name_with_dosage = $this-
>medicine_model->getMedicineById($medicine_id[0])->name . ' -' .
$medicine_id[1];
$medicine_name_with_dosage =
$medicine_name_with_dosage . ' | ' . $medicine_id[3] . ' Days<br>';
rtrim($medicine_name_with_dosage, ',');
echo '<p>' . $medicine_name_with_dosage
. '</p>';
}
}
?>

</td>
<td class="no-print">
<a class="btn btn-info btn-xs btn_width"
href="prescription/viewPrescription?id=<?php echo $prescription->id; ?>"><i
class="fa fa-eye"> <?php echo lang('view'); ?> </i></a>
<?php if ($this->ion_auth->in_group('Doctor'))
{ ?>
<a class="btn btn-info btn-xs btn_width"
href="prescription/editPrescription?id=<?php echo $prescription->id; ?>" "><i
class="fa fa-edit"></i> <?php echo lang('edit'); ?></a>
<a class="btn btn-info btn-xs btn_width
delete_button" href="prescription/delete?id=<?php echo $prescription->id; ?>"
onclick="return confirm('Are you sure you want to delete this item?');"><i
class="fa fa-trash-o"></i> <?php echo lang('delete'); ?></a>
<?php } ?>
</td>
</tr>
<?php } ?>
</tbody>
</table>
</div>
</div>
</div>
74
 <div id="schedule" class="tab-pane"> <div class="">
<?php if ($this->ion_auth->in_group(array('Doctor'))) { ?>
<div class=" no-print">
<a class="btn btn-info btn_width btn-xs" data-
toggle="modal" href="#addScheduleModal">
<i class="fa fa-plus-circle"> </i> <?php echo
lang('add_new'); ?>
</a>
</div>
<?php } ?>
<div class="adv-table editable-table ">
<table class="table table-striped table-hover table-bordered"
id="editable-samplee">
<thead>
<tr>
<th> # </th>
<th> <?php echo lang('weekday'); ?></th>
<th> <?php echo lang('start_time'); ?></th>
<th> <?php echo lang('end_time'); ?></th>
<th> <?php echo lang('duration'); ?></th>
<th> <?php echo lang('options'); ?></th>

</tr>
</thead>
<tbody>
<?php
$i = 0;
foreach ($schedules as $schedule) {
$i = $i + 1;
?>
<tr class="">
<td style="background:#345678; color: #fff;"> <?
php echo $i; ?></td>
<td> <?php echo $schedule->weekday; ?></td>
<td><?php echo $schedule->s_time; ?></td>
<td><?php echo $schedule->e_time; ?></td>
<td><?php echo $schedule->duration * 5 . ' ' .
lang('minitues'); ?></td>
<td>
75
 <!--
<button type="button" class="btn btn-info btn-
xs btn_width editbutton" data-toggle="modal" data-id="<?php echo $schedule->id;
?>"><i class="fa fa-edit"></i> <?php echo lang('edit'); ?></button>
-->
<a class="btn btn-info btn-xs btn_width
delete_button" href="schedule/deleteSchedule?id=<?php echo $schedule->id; ?
>&doctor=<?php echo $schedule->doctor; ?>&weekday=<?php echo $schedule-
>weekday; ?>&all=all" onclick="return confirm('Are you sure you want to delete
this item?');"><i class="fa fa-trash-o"> </i> <?php echo lang('delete'); ?></a>
</td>
</tr>
<?php } ?>
</tbody>
</table>
</div>
</div>
</div>

<div id="holiday" class="tab-pane"> <div class="">

<div class=" no-print">
<a class="btn btn-info btn_width btn-xs" data-
toggle="modal" href="#holidayModal">
<i class="fa fa-plus-circle"> </i> <?php echo
lang('add_new'); ?>
</a>
</div>
<div class="adv-table editable-table ">
<table class="table table-striped table-hover table-bordered"
id="editable-sample">
<thead>
<tr>
<th> # </th>
<th> <?php echo lang('date'); ?></th>
<th> <?php echo lang('options'); ?></th>

</tr>
</thead>
76
 <tbody>
<style>

.img_url{
height:20px;
width:20px;
background-size: contain;
max-height:20px;
border-radius: 100px;
}

</style>
<?php
$i = 0;
foreach ($holidays as $holiday) {
$i = $i + 1;
?>
<tr class="">
<td> <?php echo $i; ?></td>
<td> <?php echo date('d-m-Y', $holiday->date); ?
></td>
<td>
<button type="button" class="btn btn-info btn-xs
btn_width editHoliday" data-toggle="modal" data-id="<?php echo $holiday->id; ?
>"><i class="fa fa-edit"></i> <?php echo lang('edit'); ?></button>
<a class="btn btn-info btn-xs btn_width
delete_button" href="schedule/deleteHoliday?id=<?php echo $holiday->id; ?
>&doctor=<?php echo $doctor->id; ?>&redirect=doctor/details" onclick="return
confirm('Are you sure you want to delete this item?');"><i class="fa fa-trash-o">
</i> <?php echo lang('delete'); ?></a>
</td>
</tr>
<?php } ?>
</tbody>
</table>
</div>
</div>
</div>

77
 <div id="calendar" class="tab-pane active"> <div class="">
<div class="panel-body">
<aside>
<section class="panel">
<div class="panel-body">
<div id="calendar" class="has-toolbar
calendar_view"></div>
</div>
</section>
</aside>
</div>
</div>
</div>

<div id="timeline" class="tab-pane">

<div class="">
<div class="">
<section class="panel ">
<header class="panel-heading">
Timeline
</header>
<!--
<div class=" profile-activity" >
<h5 class="pull-right">12 August 2013</h5>
<div class="activity terques">
<span>
<i class="fa fa-shopping-cart"></i>
</span>
<div class="activity-desk">
<div class="panel">
<div class="">
<div class="arrow"></div>
<i class=" fa fa-clock-o"></i>
<h4>10:45 AM</h4>
<p>Purchased new equipments for zonal
office setup and stationaries.</p>
</div>
</div>
</div>
78
 </div>
</div>
-->

<?php
if (!empty($timeline)) {
krsort($timeline);
foreach ($timeline as $key => $value) {
echo $value;
}
}
?>

</section>
</div>
</div>
</div>
</div>
</div>
</section>

</section>

<section class="col-md-3 col-sm-12">

<header class="panel-heading clearfix panel">
<div class="col-md-12 row">
<?php echo lang('profile'); ?>
</div>
</header>

<section class="panel">
<aside class="profile-nav">
79
 <section class="">
<div class="user-heading round">
<a href="#">
<img src="<?php echo $doctor->img_url; ?>" alt="">
</a>
<h1> <?php echo $doctor->name; ?> </h1>
<p> <?php echo $doctor->email; ?> </p>
</div>

<ul class="nav nav-pills nav-stacked">

<li class="active"> <?php echo lang('doctor'); ?> <?php echo
lang('name'); ?><span class="label pull-right r-activity"><?php echo $doctor-
>name; ?></span></li>
<li> <?php echo lang('doctor_id'); ?> <span class="label pull-
right r-activity"><?php echo $doctor->id; ?></span></li>
<li> <?php echo lang('profile'); ?><span class="label pull-right
r-activity"><?php echo $doctor->profile; ?></span></li>
<li> <?php echo lang('address'); ?><span class="label pull-right
r-activity"><?php echo $doctor->address; ?></span></li>
<li> <?php echo lang('phone'); ?><span class="label pull-right r-
activity"><?php echo $doctor->phone; ?></span></li>
<li> <?php echo lang('email'); ?><span class="label pull-right r-
activity"><?php echo $doctor->email; ?></span></li>
</ul>

</section>
</aside>
</section>

</section>

<!-- page end-->

</section>
</section>
<!--main content end-->
<!--footer start-->

80
<!-- Add Patient Material Modal-->
<div class="modal fade" id="myModal1" tabindex="-1" role="dialog" aria-
labelledby="myModalLabel" aria-hidden="true" style="display: none;">
<div class="modal-dialog">
<div class="modal-content">
<div class="modal-header">
<button type="button" class="close" data-dismiss="modal" aria-
hidden="true">×</button>
<h4 class="modal-title"><i class="fa fa-plus-circle"></i> <?php echo
lang('add'); ?> <?php echo lang('files'); ?></h4>
</div>
<div class="modal-body">
<form role="form" action="patient/addPatientMaterial" class="clearfix
row" method="post" enctype="multipart/form-data">

<div class="form-group col-md-6">

<label for="exampleInputEmail1"> <?php echo lang('title');
?></label>
<input type="text" class="form-control" name="title"
id="exampleInputEmail1" placeholder="">
</div>
<div class="form-group col-md-6">
<label for="exampleInputEmail1"> <?php echo lang('file');
?></label>
<input type="file" name="img_url">
</div>

<input type="hidden" name="patient" value='<?php echo $patient-

>id; ?>'>

<div class="form-group col-md-6">

<button type="submit" name="submit" class="btn btn-info"> <?php
echo lang('submit'); ?></button>
</div>

</form>

81
 </div>
</div><!-- /.modal-content -->
</div><!-- /.modal-dialog -->
</div>
<!-- Add Patient Modal-->

<!-- Add Medical History Modal-->

<div class="modal fade" id="myModal" tabindex="-1" role="dialog" aria-
labelledby="myModalLabel" aria-hidden="true" style="display: none;">
<div class="modal-dialog">
<div class="modal-content">
<div class="modal-header">
<button type="button" class="close" data-dismiss="modal" aria-
hidden="true">×</button>
<h4 class="modal-title"><i class="fa fa-plus-circle"></i> <?php echo
lang('add_medical_history'); ?></h4>
</div>
<div class="modal-body">
<form role="form" action="patient/addMedicalHistory" method="post"
enctype="multipart/form-data">
<div class="form-group">
<label for="exampleInputEmail1"><?php echo lang('date');
?></label>
<input type="text" class="form-control form-control-inline input-
medium default-date-picker" name="date" id="exampleInputEmail1" value=''
placeholder="">
</div>
<div class="form-group">
<label class="control-label col-md-3"><?php echo
lang('description'); ?></label>
<div class="col-md-9">
<textarea class="ckeditor form-control" name="description"
value="" rows="10"></textarea>
</div>
</div>

<input type="hidden" name="patient_id" value='<?php echo $patient-

>id; ?>'>
<input type="hidden" name="id" value=''>
82
 $('.genderClass').append(response.patient.sex).end()
$('.birthdateClass').append(response.patient.birthdate).end()
$('.ageClass').append(response.age).end()
$('.bloodgroupClass').append(response.patient.bloodgroup).end()
$('.patientidClass').append(response.patient.patient_id).end()
$('.doctorClass').append(response.doctor.name).end()

if (typeof response.patient.img_url !== 'undefined' &&

response.patient.img_url != '') {
$("#img1").attr("src", response.patient.img_url);
}

$('#infoModal').modal('show');

});
});

</script>

<script>

$(document).ready(function () {
var table = $('#editable-sample').DataTable({
responsive: true,
// dom: 'lfrBtip',

"processing": true,
"serverSide": true,
"searchable": true,
"ajax": {
url: "patient/getPatient",
type: 'POST',
},
83
 scroller: {
loadingIndicator: true
},
dom: "<'row'<'col-sm-3'l><'col-sm-5 text-center'B><'col-sm-4'f>>" +
"<'row'<'col-sm-12'tr>>" +
"<'row'<'col-sm-5'i><'col-sm-7'p>>",
buttons: [
'copyHtml5',
'excelHtml5',
'csvHtml5',
'pdfHtml5',
{
extend: 'print',
exportOptions: {
columns: [0, 1, 2],
}
},
],
aLengthMenu: [
[10, 25, 50, 100, -1],
[10, 25, 50, 100, "All"]
],
iDisplayLength: 100,
"order": [[0, "desc"]],

"language": {
"lengthMenu": "_MENU_",
search: "_INPUT_",
"url": "common/assets/DataTables/languages/<?php echo $this-
>language; ?>.json"
}
});
table.buttons().container().appendTo('.custom_buttons');
});

</script>

<script>
84
 $(document).ready(function () {
$(".flashmessage").delay(3000).fadeOut(100);
});
</script>

85