HiLCoE

School of Computer Science and

Technology

System Analysis & Design (CS343)

Course Project
Group Members ID
1. Abraham Damtew
2. Barnabas Solomon
3. Eliyon Zewgemichael
4. Leul Dawit
5. Michyas Abeje
6. Robel Birhanu

Submitted To: Fantahun B.

Submission Date: August 2023

Hospital Prescription System: Transition from Paper-Based to E-
Prescription

1. Organization Background

1.1 Historical Background

The hospital has been serving the community since its establishment in 1970. Over the years,
it has grown to become a leading healthcare institution, providing a wide range of medical
services and specialized treatments.

1.2 Mission, Vision, Values, etc.

Mission: To deliver exceptional healthcare services with compassion, integrity, and

innovation.

Vision: To be the hospital of choice, recognized for excellence in patient care, research, and
education.

Values:

 Patient-Centered Care: Putting patients at the heart of everything we do.

 Excellence: Striving for the highest standards in healthcare delivery.

 Collaboration: Fostering partnerships and teamwork for optimal patient outcomes.

 Continuous Learning: Embracing innovation and staying up-to-date with medical

advancements.

 Integrity: Upholding ethical standards and maintaining patient confidentiality.

1.3 Activities

The activities of a hospital encompass a wide range of functions and services. The hospital
provides comprehensive medical services, including inpatient and outpatient care, emergency
services, surgeries, diagnostic procedures, and rehabilitation programs. It also actively
participates in medical research and collaborates with academic institutions for training and
education.

1.4 Input, Process, Output/Impact

Input: Inputs to the hospital prescription system include patient information, physician orders,
medication details, and pharmacy inventory.

Process: The current paper-based prescription system involves physicians manually writing
prescriptions, which are then physically delivered to the pharmacy. Pharmacists manually
process and dispense medications based on these prescriptions.

Output/Impact: The hospital prescription system aims to streamline the medication

management process, improve accuracy, reduce errors, and enhance patient safety. The
transition to an e-prescription system will lead to faster prescription processing, real-time
access to patient information, efficient medication tracking, and improved collaboration
between healthcare professionals.

2. Investigation

2.1 Problem in the Organization / Opportunities

The paper-based prescription system has several limitations, including illegible handwriting,
potential medication errors, time-consuming manual processes, and difficulties in accessing
patient history. These limitations pose risks to patient safety and can lead to inefficiencies in
medication management. The opportunity lies in implementing an e-prescription system to
address these challenges, improve accuracy, enhance efficiency, and increase patient
satisfaction.

2.2 Proposed Solutions (Ranked if Multiple Solutions are Suggested)

Proposed solutions for traditional hospital prescription systems aim to improve efficiency,
accuracy, and patient safety. Here are some commonly suggested solutions:
1. Transition to an E-Prescription System: Implement a comprehensive electronic
prescription system that allows physicians to create and transmit prescriptions
electronically, facilitating efficient processing and reducing errors.

2. Integration with Electronic Health Records (EHR): Implementing an EHR system

allows healthcare providers to digitally record and access patient information,
including prescriptions. This streamlines the prescription process, reduces errors, and
enables better coordination among healthcare professionals.

3. Integration with Pharmacy Systems: Integrating hospital prescription systems with

pharmacy systems allows for seamless communication and electronic transmission of
 prescriptions. This integration streamlines the prescription fulfillment process,
reduces errors, and improves medication management.

3. System Analysis and Design

3.1 User Requirements/Software Requirements

User Requirements:

 Physicians: User-friendly interface to create electronic prescriptions, access patient

history, and receive drug interaction alerts.

 Pharmacists: System for receiving, processing, and dispensing electronic prescriptions

efficiently.

 IT Department: Secure and scalable software solution that integrates with existing
systems and complies with relevant regulations.

Software Requirements:

 Electronic Prescription Module: Allows physicians to create, modify, and transmit

electronic prescriptions securely.

 Electronic Health Records (EHR) Integration: Seamless integration with the existing
EHR system to access patient data and ensure data consistency.

 Drug Interaction Alert System: Real-time alerts for potential medication interactions
during prescription creation.

3.2 Structured Requirements

Process Modeling

Physicians often write paper prescriptions and provide them directly to patients. Patients then
take the paper prescriptions to the pharmacy to have them filled.
Bottlenecks and Inefficiencies:

a) Dependency on paper prescriptions, which can be lost or damaged.

b) Potential for errors during manual data entry by pharmacists.
c) Limited visibility for physicians regarding prescription status and potential drug
interactions.
d) Inconvenience for patients to physically carry and present paper prescriptions.

Optimizations:

a) Physicians use an electronic prescribing software to create prescriptions digitally

during patient consultations.
b) The system generates a unique prescription code or barcode for each prescription
which can be printed out to the patient or integrated into the patient’s ID if they’re
registered to the system.
c) The patient takes the e-prescription barcode paper to a pharmacy or uses a digital
platform to transmit the barcode information to the pharmacy electronically.
d) The pharmacy verifies the e-prescription by scanning the barcode or entering the
barcode information into the pharmacy's system.
e) Pharmacists dispense medication based on the digital prescription, reducing manual
data entry and potential errors.

Provider’s Office

Prescriber Prescriber Patient receives Patient purchases

Patient Visits
Assesses generates e- unique barcode meds using the
Provider
Patient prescription barcode
.
By following this process modeling approach and implementing an e-prescription system,
healthcare organizations can streamline the prescription workflow, reduce errors, improve
patient safety, and enhance overall efficiency in medication management.

Data Modeling

Identifying Entities

 Prescriber/Healthcare Provider: This entity refers to the healthcare professional who

prescribes medications electronically. It can be a doctor, nurse practitioner, or other
authorized healthcare provider.
 Patient: The individual for whom the prescription is being written. The patient's
information, including demographics and medical history, is typically stored in the e-
prescription system.
 Medication: This entity represents the medications that can be prescribed. It includes
information such as the medication name, dosage, strength, and any other relevant
details.
 Prescription: This entity represents a specific prescription issued by a prescriber for a
patient. It includes information such as the prescribed medication, dosage instructions,
quantity, and any additional notes.

These entities work together to enable the electronic prescribing process, improving
efficiency, accuracy, and patient safety in medication management.

Finding Relationships and ERD

3.3 Hardware Requirements

1. Server
 A powerful server or a cluster of servers to host the e-prescription system.
 Sufficient processing power, such as multi-core processors, to handle concurrent
requests.
 Adequate RAM to ensure smooth performance and handle the system's workload.
 Sufficient storage capacity to store patient data, prescription records, and other
related information.
 Redundancy and backup systems to ensure data integrity and availability.
2. Network Infrastructure
 Reliable and high-speed internet connectivity to facilitate communication between
different components of the system.
 Network switches, routers, and firewalls to ensure secure and efficient data transfer.
 Load balancers, if necessary, to distribute the system's workload across multiple
servers.
3. Client Devices
  Desktop computers, laptops, or mobile devices for healthcare professionals to
access and use the e-prescription system.
 Adequate processing power and memory to run the necessary software smoothly.
 Secure and up-to-date operating systems and web browsers to ensure compatibility
and security.
4. Printers and Scanners
 Printers for generating physical copies of prescriptions, if required.
 Scanners to digitize any physical documents that need to be stored in the system.
5. Backup and Disaster Recovery
 Regularly scheduled backups of the system's data to ensure data protection and
recovery in case of any failures or disasters.
 Off-site storage or cloud-based backup solutions for added redundancy and data
security.
6. Security Measures
 Firewalls, intrusion detection systems, and antivirus software to protect the system
from unauthorized access and malware.
 Secure socket layer (SSL) certificates to enable secure communication between
clients and the server.
 Access controls and user authentication mechanisms to ensure only authorized
personnel can access the system.

3.4 System Specification

Sample User Interface

Design a user-friendly interface for physicians to create electronic prescriptions, view patient
information, and receive drug interaction alerts.

Process Design

1) Patient Visit
 The patient visits a healthcare provider for a consultation.
 The healthcare provider reviews the patient's medical history, symptoms, and
diagnoses.
2) Prescription Creation
 The healthcare provider accesses the e-prescription system and selects the patient.
  The system displays a user-friendly interface for medication selection, dosage,
frequency, and instructions.
 The healthcare provider enters the prescription details, leveraging decision support
tools for drug interactions and dosage recommendations.
 The system validates the prescription for accuracy and completeness.
 Once reviewed and approved, the reviewing healthcare provider electronically
signs the prescription using an electronic signature.
3) Prescription Generation
 After approval, the e-prescription system generates a scannable barcode or a
unique prescription code for the patient.
 The barcode or prescription code contains all the necessary prescription details,
including medication, dosage, frequency, and instructions.
4) Patient Access
 The patient receives the scannable barcode or the prescription code through the e-
prescription system's app or a secure communication channel.
 The patient can either scan the barcode using a barcode scanner app or enter the
prescription code manually into the app.
5) Prescription Retrieval
 The app or barcode scanner retrieves the prescription details associated with the
scanned barcode or entered prescription code from the e-prescription system.
 The patient can view the prescription details, including medication information,
dosage instructions, and any additional notes.
6) Prescription Fulfillment
 The patient visits a pharmacy of their choice and presents the scannable barcode or
the prescription code to the pharmacist.
 The pharmacist scans the barcode or enters the prescription code into the pharmacy
system.
 The pharmacy system retrieves the prescription details from the e-prescription
system and displays them for verification.
 The pharmacist verifies the prescription details, dispenses the medication, and
provides counseling to the patient.

This e-prescription workflow allows patients to receive their prescriptions through a

scannable barcode or an app, providing them with convenient access to their prescription
 details. It still involves the necessary steps of prescription creation, review, and approval,
while enabling patients to retrieve their prescriptions at the pharmacy using the provided
barcode or code.

Database Design

To design a database for storing prescription data, patient information, medication details,
and drug interaction data in a digital prescription system for a hospital, we can consider the
following schema:

1. Patient Table 2. Prescription Table 3. Doctor Table

- patient_id (Primary Key) prescription_id (Primary Key) - doctor_id (Primary Key)
- first_name patient_id (Foreign Key - first_name
- last_name referencing Patient Table) - last_name
- date_of_birth doctor_id (Foreign Key - specialization
- gender referencing Doctor Table) - contact_number
- contact_number prescription_date
- address
- prescription_status

4. Medication Table: 5. Prescription_Medication Table 6. Drug Interaction Table:

- medication_id (Primary Key) (Many-to-Many relationship - interaction_id (Primary
- medication_name between Prescription and Key)
- dosage Medication): - medication_id_1 (Foreign
- prescription_id (Foreign Key Key referencing Medication
referencing Prescription Table) Table)
- medication_id (Foreign Key - medication_id_2 (Foreign
referencing Medication Table) Key referencing Medication
- quantity Table)
- frequency - interaction_description

This schema allows you to store patient information, prescription details, medication
information, and drug interaction data. The Patient table stores patient-specific information,
the Prescription table stores details about each prescription, and the Doctor table stores
information about the prescribing doctor. The Medication table stores details about each
medication, and the Prescription_Medication table establishes a many-to-many relationship
between prescriptions and medications, allowing multiple medications to be associated with a
single prescription. Finally, the Drug Interaction table stores information about potential
interactions between medications.

4. System Implementation and Testing

4.1 Hardware Acquisition Plan

Identify the hardware infrastructure requirements, evaluate vendors, and acquire the
necessary servers, network equipment, and end-user devices.

Objective:

The objective of this hardware acquisition plan is to identify the necessary hardware infrastructure
requirements, evaluate vendors, and acquire the appropriate servers, network equipment, and end-
user devices for a paper-based infrastructure.

1. Identify Hardware Infrastructure Requirements:

- Assess the requirements of the paper-based infrastructure, considering factors such as the
number of users, volume of paper documents, and desired functionality.

- Determine the specific hardware components needed, including servers, network equipment,
scanners, printers, workstations, and storage devices.

2. Research and Evaluation:

- Research and evaluate different hardware vendors and models that cater to paper-based
infrastructures.

- Consider factors such as reliability, performance, scalability, compatibility with existing systems,
and cost.

- Seek recommendations from industry experts, consult user reviews, and evaluate vendor
reputation and track record.

3. Vendor Selection:

- Create a shortlist of potential hardware vendors based on the research and evaluation phase.

- Request detailed proposals from the shortlisted vendors, including information on hardware
specifications, pricing, warranties, and support services.
 - Evaluate the proposals based on predefined criteria, such as compliance with requirements, cost-
effectiveness, vendor reputation, and customer references.

- Conduct vendor interviews or demonstrations, if necessary, to gain further insights into the
hardware offerings.

4. Procurement:

- Develop a procurement plan that outlines the acquisition process, budget considerations, and
timelines.

- Initiate the procurement process, which may involve issuing a request for proposal (RFP) or
negotiating directly with vendors.

- Review and negotiate contractual terms, including pricing, warranties, support agreements, and
delivery timelines.

- Obtain necessary approvals and comply with any procurement policies or regulations.

5. Deployment:

- Coordinate with the hardware vendor to ensure timely delivery and installation of the acquired
hardware components.

- Develop an implementation plan that outlines the deployment process, including hardware setup,
network configuration, and system integration.

- Conduct thorough testing and quality assurance procedures to ensure hardware functionality and
compatibility with the paper-based infrastructure.

- Document the hardware configuration, including network diagrams, server specifications, and
storage configurations.

6. Maintenance and Upgrades:

- Establish a plan for ongoing hardware maintenance, including routine inspections, preventive
maintenance, and repairs.

- Develop a strategy for hardware upgrades and replacements to ensure the infrastructure's
scalability and longevity.

- Maintain relationships with hardware vendors to stay informed about new technologies, updates,
and support services.
By following this hardware acquisition plan, we will ensure the acquisition of reliable and appropriate
hardware components for a paper-based infrastructure, supporting efficient document management
and workflow processes.

4.2 System Construction/Development [you are not required to do this]

Develop the e-prescription system software, ensuring compliance with relevant regulations
and following industry best practices for security and data privacy.

4.3 People Specification

When transitioning from a paper-based prescription system to an e-prescription system, it is

important to consider the people involved in the process. Here is a sample people
specification outlining the desired qualities and skills for the transition:

1) Technical Proficiency
 Familiarity with computer systems and basic software applications.
 Ability to navigate and operate electronic systems efficiently.
 Comfortable with learning new technologies and adapting to digital workflows.
2) Attention to Detail:
 Strong attention to detail to ensure accurate data entry and prescription
information.
 Ability to review prescriptions for completeness, accuracy, and adherence to
regulations.
 Thoroughness in verifying patient information, medication details, and dosage
instructions.
3) Communication Skills:
 Effective communication skills to interact with healthcare providers and patients.
 Ability to clearly convey information and instructions related to the e-
prescription system.
 Active listening skills to understand and address any concerns or questions from
stakeholders.
4) Adaptability:
 Willingness to adapt to new processes and embrace the transition from paper-
based to electronic systems.
 Openness to change and ability to handle challenges that may arise during the
transition period.
  Flexibility to adjust workflows and procedures as necessary to optimize the use of
the e-prescription system.
5) Compliance and Security Awareness:
 Understanding of privacy regulations and the importance of patient data security.
 Knowledge of e-prescription regulations and compliance requirements.
 Adherence to best practices for data protection and confidentiality.
6) Teamwork and Collaboration:
 Ability to work collaboratively with other team members, such as healthcare
providers, pharmacists, and IT staff.
 Willingness to share knowledge, provide support, and contribute to a positive
team environment.
 Collaboration skills to coordinate with different stakeholders involved in the e-
prescription process.
7) Continuous Learning:
 Eagerness to engage in training and upskilling opportunities related to the e-
prescription system.
 Willingness to stay updated on industry trends, regulations, and best practices.
 Proactive attitude towards continuous learning and professional development.

4.4 System Conversion Strategies/Plan

Develop a comprehensive plan for transitioning from the paper-based prescription system to
the e-prescription system. This plan should include steps for data migration, training for
healthcare professionals, and a phased implementation approach to minimize disruptions to
patient care.

Transitioning from a paper-based prescription system to an e-prescription system requires careful

planning and execution to ensure a smooth transition while minimizing disruptions to patient care.
Here's a comprehensive plan that includes steps for data migration, training for healthcare
professionals, and a phased implementation approach:

1. Planning Phase:

- Establish a project team consisting of key stakeholders from various departments, including IT,
pharmacy, and medical staff.
 - Define clear project objectives, timeline, and budget.

- Conduct a comprehensive analysis of the existing paper-based prescription system to identify key
requirements and challenges.

- Develop a detailed transition plan outlining the specific steps and milestones for the
implementation process.

1. Data Migration:

- Evaluate the existing paper-based prescription data and determine the necessary data to be
migrated to the e-prescription system.

- Collaborate with the e-prescription software vendor to develop a data migration strategy and
ensure data integrity during the transition.

- Convert and transfer patient records, medication history, and other relevant data from the paper-
based system to the e-prescription system.

- Conduct thorough data validation and verification to ensure accuracy and completeness.

1. Infrastructure Readiness:

- Assess the hardware and software infrastructure requirements for the e-prescription system
based on vendor recommendations.

- Acquire and install the necessary servers, network equipment, and end-user devices as outlined in
the hardware infrastructure requirements section mentioned earlier.

- Configure the network infrastructure and ensure seamless integration with the e-prescription
software.

1. Training for Healthcare Professionals:

- Develop a comprehensive training program for healthcare professionals, including doctors, nurses,
and pharmacists, to familiarize them with the e-prescription system.

- Provide training sessions on how to navigate the software, input prescriptions, review medication
history, and utilize other system features.

- Conduct hands-on training sessions, workshops, and provide online resources to support
continuous learning and adoption of the e-prescription system.

- Train staff on data security and privacy protocols to ensure compliance with healthcare
regulations.
1. Phased Implementation:

- Implement the e-prescription system in a phased approach to minimize disruptions to patient

care.

- Identify specific departments or clinics to serve as pilot areas for the initial implementation.

- Monitor and evaluate the system's performance and gather feedback from users during the pilot
phase.

- Address any issues or concerns raised by the users and make necessary adjustments to enhance
system usability.

- Gradually expand the implementation to other departments or clinics, allowing time for staff to
adapt and providing ongoing support during the transition.

- Monitor the overall progress and conduct regular assessments to ensure a successful transition.

1. Continuous Support and Evaluation:

- Provide ongoing technical support and troubleshooting to address any issues that arise during the
transition phase.

- Gather feedback from healthcare professionals and staff to identify areas for improvement and
optimize system efficiency.

- Conduct periodic evaluations to measure the effectiveness of the e-prescription system, assess its
impact on patient care, and identify further enhancements.

By following this comprehensive plan, they can effectively transition from a paper-based prescription
system to an e-prescription system while ensuring a seamless and efficient process for healthcare
professionals and minimizing disruptions to patient care.

4.5 System Testing Plan

Create a testing plan to ensure the functionality, usability, and security of the e-prescription
system. Conduct rigorous testing, including unit testing, integration testing, and user
acceptance testing, to identify and resolve any issues before the system goes live

4.6 User Training Plan

Develop a training program to familiarize physicians, pharmacists, and other healthcare

professionals with the new e-prescription system. Provide comprehensive training materials,
conduct workshops, and offer ongoing support to ensure a smooth transition and user
adoption.

Objective:

The objective of this training program is to familiarize physicians, pharmacists, and other healthcare
professionals with the new e-prescription system, ensuring a smooth transition and successful user
adoption. The program will provide comprehensive training materials, conduct workshops, and offer
ongoing support.

Training Program Outline:

1. Introduction to the E-Prescription System:

- Overview of the benefits and features of the e-prescription system.

- Explanation of how the system improves patient safety, medication management, and workflow
efficiency.

2. System Navigation and User Interface:

- Detailed walkthrough of the user interface, including menus, screens, and navigation options.

- Overview of different user roles and their specific permissions.

- Demonstration of common tasks, such as logging in, accessing patient records, and prescribing
medications.

3. Prescription Entry and Management:

- Step-by-step instruction on how to enter new prescriptions into the system.

- Guidance on selecting medications, dosages, and frequencies.

- Training on how to review, modify, and cancel prescriptions as needed.

4. Drug Interactions and Allergies:

- Training on how to utilize the system's drug interaction checking feature.

- Explanation of how to identify potential drug-drug interactions and allergies.

- Instructions on how to handle alerts and make informed decisions based on the system's
recommendations.

5. Patient Record Access and Management:

- Training on how to search and retrieve patient records within the system.

- Guidance on updating patient information, medical history, and medication lists.

- Instruction on how to view and interpret lab results and diagnostic reports.

6. Reporting and Analytics:

 - Overview of the system's reporting capabilities and analytics features.

- Training on generating prescription history reports, medication usage trends, and other relevant
reports.

- Explanation of how to utilize the data for clinical decision-making and quality improvement
initiatives.

7. Workshop and Hands-on Practice:

- Conduct interactive workshops to provide hands-on practice with the e-prescription system.

- Provide sample scenarios and exercises to reinforce learning and simulate real-life situations.

- Encourage participants to ask questions and seek clarifications during the workshop sessions.

8. Ongoing Support and Resources:

- Provide comprehensive training materials, including user manuals, quick reference guides, and
video tutorials.

- Establish a dedicated support channel, such as a helpdesk or online forum, for users to seek
assistance and share knowledge.

- Offer periodic refresher training sessions to address any new system updates or advanced
features.

Evaluation and Feedback:

Conduct regular assessments and gather feedback from participants to evaluate the effectiveness of
the training program. Use the feedback to identify areas for improvement and make necessary
adjustments to enhance user adoption and satisfaction.

By implementing this training program, healthcare professionals will have the necessary knowledge
and skills to effectively use the e-prescription system, leading to a successful transition and improved
patient care.

4.7 Documentation

Prepare detailed documentation for the e-prescription system, including system requirements,
design specifications, user manuals, and technical documentation. This documentation will
serve as a reference for system maintenance and future enhancements.
5. System Maintenance

5.1 Maintenance Plan

Develop a maintenance plan to ensure the ongoing performance, security, and functionality of
the e-prescription system. This plan should include regular software updates, database
maintenance, and monitoring of system performance and user feedback.

Objective:

The objective of this maintenance plan is to ensure the ongoing performance, security, and
functionality of the e-prescription system. The plan includes regular software updates, database
maintenance, and monitoring of system performance and user feedback.

Maintenance Activities:

1. Software Updates:

- Regularly monitor and apply software updates, patches, and bug fixes provided by the e-
prescription system vendor or development team.

- Establish a process for testing and validating updates in a staging environment before deploying
them to the live production environment.

- Document the update process, including scheduling, backup procedures, and rollback plans in
case of any issues.

2. Database Maintenance:

- Perform regular database maintenance tasks, such as optimizing queries, indexing, and purging
old or obsolete data.

- Regularly back up the database to ensure data integrity and disaster recovery preparedness.

- Monitor database performance, including response times, query execution, and resource
utilization, and optimize as needed.

3. System Performance Monitoring:

 - Implement monitoring tools to track system performance metrics, such as response times, server
resource usage, and transaction volumes.

- Set up alerts and notifications for threshold breaches or abnormal system behavior to enable
proactive troubleshooting.

- Conduct periodic performance analysis to identify bottlenecks and areas for optimization, such as
hardware upgrades or software configuration changes.

4. User Feedback and Support:

- Establish a feedback mechanism, such as a helpdesk or online support portal, for users to report
issues or provide suggestions.

- Regularly review user feedback and prioritize issues based on their impact and severity.

- Provide timely support and resolution to user-reported issues, ensuring effective communication
and follow-up.

5. Security Maintenance:

- Regularly review and update security measures, including access controls, user permissions, and
authentication mechanisms.

- Conduct periodic vulnerability assessments and penetration testing to identify and address any
security vulnerabilities.

- Stay updated with industry best practices and regulatory requirements related to data security
and privacy, and implement necessary measures accordingly.

6. Documentation and Knowledge Management:

- Maintain up-to-date documentation of system configurations, installation procedures,

troubleshooting guides, and known issues.

- Establish a knowledge base or internal wiki to capture and share knowledge among the support
team and system administrators.

- Conduct regular knowledge transfer sessions to ensure the availability of expertise across the
team.

7. Continuous Improvement:

- Continuously seek opportunities for system enhancements and optimizations based on user
feedback, emerging technologies, and industry trends.

- Establish a process for evaluating and prioritizing feature requests, bug fixes, and system
enhancements.
 - Periodically review the maintenance plan and adapt it to changing requirements and evolving
technologies.

By implementing this maintenance plan, the e-prescription system will remain performant, secure,
and functional, ensuring that healthcare professionals can rely on it for safe and efficient medication
management.