PATIENT TRACKING MANAGEMENT SYSTEM

CASE STUDY: MULAGO REFFERAL HOSPITAL

BY

NTEGE VICTOR MULUNGI

DIT/JAN22/W/1444

A RESEARCH PROPOSAL SUBMITTED TO THE DEPARTMENT OF

INFORMATION TECHNOLOGY IN PARTAIL FULFILLMENT OF THE
REQUIREMENT FOR

THE AWARD OF A DIPLOMA IN INFORMATION TECHNOLOGY AT

MAKERERE INSTITUTE OF TECHNOLOGY EAST

AFRICA AFFILIATED TO IBANDA

UNIVERSITY.
(MAY 2023)

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 DECLARATION

I NTEGE VICTOR MULUNGI declares that this work is original to the best of my knowledge
and has never been submitted to any university for the award of Diploma in Information
Technology.

Signature.........................................................

Date................................................................

i
 APPROVAL

This is to certify that NTEGE VICTOR MULUNGI with Reg No. DIT/JAN22/W/1444 has
been under the supervision of an institute supervisor and his work is ready to be submitted for
the award of a Diploma in Information Technology

Supervisors Name.....................................................

Signature..............................................................

Date.....................................................................

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TABLE OF CONTENTS
DECLARATION..............................................................................................................................i
APPROVAL....................................................................................................................................ii
LIST OF FIGURES.........................................................................................................................v
LIST OF TABLES..........................................................................................................................vi
LIST OF ACRONYMS / ABBREVIATION................................................................................vii

CHAPTER ONE............................................................................................................................1
1.0 INTRODUCTION.....................................................................................................................1
1.1 BACKGROUND OF THE STUDY..........................................................................................1
1.2 PROBLEM STATEMENT........................................................................................................3
1.3 OBJECTIVES OF THE STUDY...............................................................................................4
1.3.1 Main objectives.......................................................................................................................4
1.3.2 Specific Objectives.................................................................................................................4
1.4 Research questions.....................................................................................................................4
1.5 SCOPE OF THE STUDY..........................................................................................................4
1.5.1 Time scope..............................................................................................................................4
1.5.2 Geographical scope.................................................................................................................4
1.5.3 Content scope..........................................................................................................................5
1.6 Justification of the study............................................................................................................5
1.7 Significance of the study...........................................................................................................5

CHAPTER TWO...........................................................................................................................6
2.0 LITERATURE REVIEW..........................................................................................................6
2.1 REVIEW OF EXIXTING MANUAL CLINICAL INFORMATION SYSTEM......................6
1.5 Data flow diagram.....................................................................................................................8
2.1 Databases as Recordkeeping Systems.......................................................................................9

CHAPTER THREE.....................................................................................................................10
RESEARCH METHODOLOGY..................................................................................................10
3.1 Introduction..............................................................................................................................10
3.2 Research Approach..................................................................................................................10
3.4 Data collection tools...............................................................................................................10
3.4.1 Interview.............................................................................................................................10
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3.4.3 Data processing and analysis..............................................................................................11
3.5 Target Population.....................................................................................................................11
3.5 Sampling Techniques...............................................................................................................12
Sample Size...................................................................................................................................12
3.5.6 System Implementation........................................................................................................12
APPENDIX I.................................................................................................................................13
QUESTIONNAIRE.......................................................................................................................13
APPENDIX II................................................................................................................................15
APPENDIX III...............................................................................................................................16

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 LIST OF FIGURES
Figure 1.3 Data flow diagram

v
 LIST OF TABLES
RESEARCH BUDGET
RESEARCH WORK PLAN

vi
 LIST OF ACRONYMS / ABBREVIATION
SQL Structured Query Language

PHP Hypertext Pre protocol

HTML Hypertext markup language

IT Information Technology

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 CHAPTER ONE

1.0 Introduction
A referral hospital is made up of several units, departments, wards, blocks and levels. This is
because it handles patients with a variety of complications that require specialized care and
consultants for treatment as well as staying in the hospital. Patient tracking is mechanism of
knowing where and in which part of the hospital is a particular patient located at the time of
searching by the visitors.

1.1 Background of the study

The first health centers in Uganda were built by the missionaries and the very first one Mengo
Hospital was constructed by Dr. Albert Cook from the Church missionary society of England.
This was followed by many others including Lubaga and Nsambya hospitals among the
prominent ones. It is a fact that in all most all districts that make up Uganda, there exist at least
one mission-based hospital especially those that are managed by the Catholic Church. The first
public hospital to be built in Uganda was constructed by the colonial government and that is Old
Mulago. Towards the end of colonial rule in Uganda in the late 1950s, the British built new
Mulago as a national referral hospital with several departments, wards, units and levels to expand
specialized medical care to the growing population of Uganda. During the reign of Obote several
regional referral hospitals were built in different districts, these facilities included Kawolo
hospital in Mukono district and Masaka referral in Masaka district among others. Due to the
exponential growth of the Ugandan population and increasing pressure on the existing hospitals,
the current NRM government has constructed several health centers i.e. health center II at the
parish level, health center III at the sub parish level and health center IV at the municipality
level. Unlike the referral hospitals that were built before, these health centers handle simple
issues and basically offer out patients services. Health centers at the level of hospitals are the
only ones capable of admitting patients for specialized treatments.

In Mulago hospital for example, everything about a patient is recorded manually with papers and
ink and kept in files one which particulars of a patient are recorded. This information is confined
to doctors and other health personnel’s with the exception of the care takers. The receptionist at
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the main entrance of the hospital has insufficient information about the patients admitted in the
hospital most especially for a facility like Mulago that has thousands of patients admitted. In
case a visitor wants to visit a particular patient, there is no way he obtains information about the
patient apart from either contacting the patient directly or the caretaker using mobile phones
something that is not reliable. This is because some patients are unconscious and unable to speak
or knowing exactly where they are while some caretakers are ignorant of a specific location in
the hospitals. This coupled with problems associated with phones makes tracking a patient very
difficult to the visitors thus the visitors move around the hospital searching ward to word looking
their patients something that causes discomfort in hospitals. If a digitalized system existed in the
hospital such that the receptionist had data about the patients, then a click or entering a patient’s
name in a computer would retrieve the location of that patient in the hospital. This would ease
the tracking of patient so that visitors could not spend time moving from ward to ward looking
for their patients.

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1.2 PROBLEM STATEMENT
The problem of patient records tracking in Uganda poses significant challenges in the efficient
delivery of healthcare services and the overall quality of patient care. Despite efforts to digitize
healthcare systems, the lack of a centralized and standardized patient records tracking system
hampers the ability of healthcare providers to access accurate and up-to-date patient information,
leading to fragmented care, medical errors, and suboptimal treatment outcomes.

1.3 Main objectives

To design, develop, and evaluate a comprehensive and interoperable patient record tracking
system for Uganda that leverages digital technologies, standardizes data formats, and establishes
secure data-sharing mechanisms. The research aims to address the existing challenges in
accessing accurate and up-to-date patient information, improve the quality of healthcare delivery,
enhance patient outcomes, and contribute to effective public health initiatives in Uganda.

1.4 Specific objectives

(i) To design and implement the patient tracking management system
(ii) To know the effects of patient tracking management system
(iii) To examine the problems associated with patient tracking management system
(iv)To design problem measures to overcome problems associated with the patient tracking
Management system

1.5 Research questions

(i) How can patient Tracking Management system be designed?
(ii) What are the problems associated with patient tracking Management system.
(iii) Examine the effects of patient tracking Management system.
(iv)Analyze the probable measures that can be used to overcome the problems associated with
patient tracking Management system.

1.6 Scope of the study

Scope of the study is categorized into three i.e., geographical scope, content scope and time
scope

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1.6.1 Time scope
The study shall be conducted within 3 months running from February to April 2023

1.6.2 Geographical scope

The study shall be conducted in Kampala where Mulago Hospital is located. Kampala is made up
of 5 divisions, Central, Nakawa, Makindye, Lubaga and Kawempe

1.6.3 Content scope

The study shall focus on patient tracking management system where a researcher is going to
design a workable system based on programming languages such as PHP, HTML and SQL

PHP: Hypertext preprocessor will guide in the designing of an application which will be used by
users to access the database.

HTML: Hypertext markup language that will be essential for designing the website that will be
used access all learning materials.

SQL: Structured query language will be essential in programming the database.

1.7 Justification of the study

Although people can trace their patients in hospitals through contacting care takers who direct to
specific wards of their location, there remains a problem with this tracking system. Some care
takers are illiterate and others have no mobile phones, therefore, a fully developed and
implemented digital tracking system would solve this problem whereby information about the
patient’s location can be got from the receptionist by just a single click.

1.8 Significance of the study

To make it easier for visitors visiting admitted relatives in hospitals to know their location and
spend less time looking for them in the health facilities

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 CHAPTER TWO
LITERATURE REVIEW

2.1 INTRODUCTION
Patient Tracking System is a computerized medical information system that collects, stores and
retrieves patient information. It is a means to create legible and organized patient data and to
access clinical information. Electronic Clinical Information Systems are intended to complement
the existing manual medical record keeping system which is already familiar to practitioners.
Patient records have been stored in paper form for centuries, and over these periods, they have
consumed increasing space and notably delayed access to efficient medical care. In contrast,
electronic Clinical Information System store individual patient clinical information electronically
and enable instant availability of this information to all authorized users in the clinic and so assist
in providing coherent and consistent care. The advantages of clinical information system can be
summarized according to (Yamamato. 2006). as "optimizing the documentation of patient
encounters, improving communication of information to physicians, improving access to patient
medical information, reduction of errors, optimizing billing and improving reimbursement for
sendees, forming a data repository for research and quality improvement, and reduction of paper
usage."

The current goal of Clinical Information System is to use computers to collect, store, process,
retrieve and communicate relevant patient information.

Paper-based records have been in existence for centuries and their gradual replacement by
computer-based records has been slowly underway for over twenty years in western healthcare
systems. According to (iunter and ferry (2005), just like any other record keeping, moving
patients* records from paper and physical filing systems to computer and their super storage
capabilities create great efficiencies for patients for their providers, as well as health payment
systems.

According to Russell and Potts (2010), in the past, diagnosis was done on patients by asking the
patient questions such as: allergies, past treatment, and medications, Each tune a patient visited

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the clinic, he was asked for an appointment card that was issued during the last visitation and the
patient file is retrieved, then the doctor takes a review of the patient past medication before
administering treatments.

However, with the use of Clinical Information System, the doctor only need to ask of the
patient's name, and other pieces of identifying information which helps to easily pull up a
patient's record from the electronic storage space and all the information the doctor needs to see
will be there. Before treatment, it is important for the doctor to know the history of the patient
(past medications, drugs he reacts to, his allergies, etc.). Diagnosis and treatment decision might
then be altered based on the information supplied by this system (Clinical Information System).

Clinical information system is a computerized version of patient paper medical record. It delivers
a more complete picture of patient medical history, allowing doctors to provide the best
recommendations about a patient's medical care. The system also includes patient health
insurance and contact information. Doctors can view a complete medical history of any patient,
which is a function of the fast access to information provided by the system. Also, the new
system automatically crosschecks any new prescriptions the physician is giving, to ensure that
there are no negative reactions with your current medications.

Over the past decade, the need for change in almost all western countries has become stronger.
Incontrovertible evidence has increasingly shown that current systems are not delivering
sufficiently safe, high quality, efficient and cost-effective health services, and that
computerization of the health care system with the Clinical Information System, is an effective
way forward. As Tony Abbott (2005) said, "belter use of IT is no panacea, but there's scarcely a
problem in the health system it can't improve". For the first time, the responses have been
national and coordinate.

The main purpose was creating an ECG monitoring and alert system that detects cardiac
abnormalities like tachycardia and bradycardia. The downside to this project was its need for
medical professionals for operation. Proposed a heart rate monitor using a low-cost
microcontroller, AT89C52, He measured heart rate from the fingertip using infra-led transmitter
and receiver sensor box. The rate is then averaged and displayed on a text-based LCD, but does
not have voice output to aid visually impaired persons.

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The application and use of machines and computer-based technologies in health care have
undergone an evolutionary process. Advances in information, telecommunication, and network
technologies have led to the emergence of a revolutionary new paradigm for health care that
some refer to as e-health. New experience and knowledge that crosses traditional disciplinary
boundaries—particularly cross-disciplinary and multidisciplinary research in the fields of
information technology and health care, along with emerging knowledge to promote evidence-
based medicine (evidence-based medicine is discussed in the Case section of Chapter Thirteen),
e-medicine, and remote e-health services—are causing not just episodic but systemic
transformation of traditional health care systems and environments.

Health care administrators, clinicians, researchers, vendors, purchasers, and other

health practitioners are facing increasing pressure to adapt to growing expectations
for accountability from both the public and the private sector.
Hospitals used to store their data in traditional file system like: Microsoft Excel (compatible
with windows), Open office (compatible with windows/MAC/Linux), Google docs spreadsheets
(need internet access any time). The main drawback of traditional file system is data definition is
part of application program which works only with specific application.

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 CHAPTER THREE
RESEARCH METHODOLOGY

3.1 Introduction
This chapter consists of research designs, population, sample size, sampling, data collection
tools, and data analysis.

IT also consists of a detailed description of the selected methodology that is to say the systematic
methods that we intend to use to achieve the objectives of this research project.

A well-structured plan for the research project that will acknowledge the tasks needed to be
accomplished in the design of the proposed patient tracking system

3.2 Research Approach

The study shall use a cross-sectional descriptive survey design in order to gather a wide range of
information needed for the research objective to be achieved. Surveys are to be selected because
they provide useful information for drawing generalizations and comparisons. In-depth
Interviews are important tools in conducting qualitative research. Interviews shall be used to
gather first-hand information from different stakeholders like patients, health practitioners and
caretakers.

3.4 Data collection tools

These are tools or devices used to gather data or information, such as a paper questionnaires or a
system for computer-assisted interviews.

Tools used to gather data iclude case studies, interviews, observations, surveys, group focused
discussion and questionnaires

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3.4.1 Interview
This is the data collection method that relies on asking questions in a set order to collect data on
a topic

This method involves asking questions directly to different respondents in order to obtain the
information or data required by the research problem. Under this method, the researcher prepares
guiding questions both closed and open-ended questions which are used mostly to ensure
sufficient data collection.

The other three most common types of interviews are;

 Semi- structured interviews:

A few questions are predetermined, whereas the other questions aren’t planned.

 Unstructured interviews:
None of the questions are predetermined.

 Focus group interviews:

The questions are presented to a group instead of one individual.

Questionnaire method

This method involves the questions relating to the problem in which the respondent should
answer. This question aids the researcher to obtain data required for the problem under study.

The list of questions can be administered to the respondent directly/immediately or earlier so that
the respondent finds suitable time for him/her to respond to the questions accordingly.

3.4.3 Data processing and analysis

This is where data obtained from the interview and questionnaire responses are edited for
accuracy without changing the meaning given by the respondent. The responses could be coded
and arranged properly using tables.

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3.5 Target Population
The research will be conducted within the central Kampala, Uganda, and the population size will
involve a total of 100 participants selected from the organization and other population in
Kampala. These will include the in Uganda. A Census approach will be used because the
population is small. Additionally, one experienced consultant who had been involved with in the
Payroll and fieldwork respectively will be interviewed to supplement the survey data as the key
informants

3.5 Sampling Techniques

The research understudy will involve using the simple random sampling method which ensures
accuracy and permitted generation from the selected sample of the population it represent. 3.6

Sample Size
The study will be conducted in Kampala. A sample of 50 people is targeted and will be generated
using the formula to find the final sample size of this research.

n = 𝑋2∗𝑁∗𝑃∗(1−𝑃)/ (𝑀𝐸2∗(𝑁−1) + (𝑋2∗𝑃∗(1−𝑃)

Where n = Sample Size, X2 = chi-square for the specified confidence level at 1 degree of
freedom, N = Population size, P = Population proportion (50 in this table), ME = desired margin
of error (expressed as a proportion).

3.5.6 System Implementation

The system will be implemented using numerous tools that include the following.

a) HTML

This will be used to design user interface.

b) MySQL

It is preferred because it is efficient in developing database driven websites, an open source

database and is the most popular database systems in use today for relational databases. A
language called Structured Query Language.

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c) PHP

It is preferred because it is compatible with MySQL, fast search engine and PHP is a server-side
scripting language. PHP is important when establishing a connection to the database.

d) Sublime Text Editor

This will be used to perform the coding in developing the system. Any other code editor could
be used but Sublime is a very light text editor that have additional dependencies installed to
increase its functionality.

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 APPENDIX I
QUESTIONNAIRE
I am NTEGE VICTOR MULUNGI a student at Makerere Institute of Technology East Africa
pursuing a Diploma in Information Technology and I am here conducting research on PATIENT
TRACKING MANAGEMENT SYSTEM with a case study of MULAGO NATIONAL
REFFERAL HOSPITAL. I kindly request you to fill up this questionnaire by ticking in the
appropriate box and filling the answers in the spaces provided.

All the information given shall be kept confidential

SECTION A

1. Gender

1. Female

2. Male

2. Age group

A.18-25

B. 31- 40

C. Above 50

3 Marital status

1. Married

2. Single

3. Divorced

4 Education status

1. Secondary

2. Certificate

3. Diploma
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4. Degree

4. PHD

5 Religious status

1. Protestant

2. Muslim

3. Catholic

4. Born again

5. Adventist

SECTION B

What problems do you face when searching for your patient in a hospital?

………………………………………………………………………………………………………
………………………………………………………………………………………………………

Have you ever reported the problems to the concerned authorities?

…………………………………………………………………………………………………….
………………………………………………………………………………………………………

What do you think should be the solutions to the problem?

………………………………………………………………………………………………………
………………………………………………………………………………………………………

What is your opinion about a digitalized system for tracking admitted patients?

………………………………………………………………………………………………………
………………………………………………………………………………………………………

Any other comment?

………………………………………………………………………………………………………

THANK YOU FOR YOUR COOPERATION

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 APPENDIX II
RESEARCH BUDGET

No Item Quantity Unit prices Amount (shs)

1 Food 6 days 2,500 15,000
2 Pen 2 pens 500 1,000
3 Pencil 6 pencils 600 600
4 Research fee 1 60,000 60,000
5 Note book 2 3,500 7,000
6 Internet 1 5,000 10,000
7 Transport 6 days 20,000 30,000
8 Airtime 1 5,000 5,000
9 Typing and printing 1 20,000 20,000
10 Flash disc 1 20,000 20,000
Total 125,100

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 APPENDIX III
RESEARCH WORK PLAN

Months of the year

Planned Activities J F M A M J J A S O N D

Getting Research
Topic

Designing a concept
note

Writing a proposal
NUMBER OF ACTIVITIES TO BE DONE

Design the table of

approach
Meeting supervisor

Defending research
proposal

Designing a
Research
Questionnaire

Distributing
questionnaire in the
field
Analyzing
questionnaires

Interpreting data

Meeting supervisor

Designing a
workable system
Defending a system

Writing a system
report

Submission of the
system report for
approval.

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