CARIBBEAN EXAMINATION COUNCIL

UNIT 1- INTERNAL ASSESSMENT PAPER

INFORMATION TECHNOLOGY

A paper completed on partial fulfilment of the requirements sent out for the candidates sitting

the Unit 1 Caribbean Advanced Proficiency Examination (CAPE) for the Caribbean

Examination Council

February 2024

Title: Implementing a technology solution to solve the St. John’s Clinic medical records issue

Submitted to: Mrs. Denise Sadafal-Jerry

School: St. Stanislaus College

Name of Candidates: Candidate numbers:

Tessany Tiffany Stewart-Douglas 0900470623

Rhoshauna Christina Stephen 0900470615

1
 Table of Content

Problem Definition...................................................................................................................3

Gantt Chart...............................................................................................................................4

Analysis of Problem.................................................................................................................5

Questionnaire....................................................................................................................5

Interview...........................................................................................................................7

Research............................................................................................................................8

Identification of Possible Solutions.........................................................................................9

Evaluation of Possible Solutions...........................................................................................10

Possible Solution 1..............................................................................................................10

Advantages..................................................................................................................11

Disadvantages.............................................................................................................11

Budget Table...............................................................................................................11

Possible Solution 2..............................................................................................................12

Advantages..................................................................................................................13

Disadvantages.............................................................................................................13

Budget Table...............................................................................................................13

Possible Solution 3..............................................................................................................14

Advantages..................................................................................................................14

Disadvantages.............................................................................................................14

Budget Table...............................................................................................................15

2
Solution....................................................................................................................................16

Justification of Solution.........................................................................................................16

Bibliography...........................................................................................................................17

Appendix.................................................................................................................................19

Interview Sheet...................................................................................................................19

Questionnaire......................................................................................................................22

3
 Problem Definition

The St. John’s Medical Clinic located in Sussex-Ville; Georgetown is a private clinic that

deals with out-patients daily. It was first established in 1979 by the health ministry to help

people in the area with non-emergency cases, emergency cases, vaccinations, and regular

health check-ups. Medical records explain all details about a patient’s history, clinical

findings, progress, and prescriptions written by a doctor. The records are placed

alphabetically in drawers, usually maintained for 5-10 years.

Over the years, they have been unable to acquire and store patients’ medical records properly

due to the extensive number of patients. The manual retrieval of a person’s document is

timely because of the disorganized record keeping of medical records in the storage room.

The records pile up or get physically damaged due to insufficient storage. The patients also

complain about the long waiting hours. After years of developing medical technology, it is

now possible to use a computerized system to collect and store medical records. This is

known as an electronic medical record (EMR) system. With this problem resolved, retrieving

these documents will be quicker and more effective.

4
Gantt Chart

5
 Analysis of Problem

St. John’s Medical Clinic has been having a documentation crisis over the past few years as it

relates to the medical record keeping of patients. The doctors and nurses have been manually

retrieving patients' documents. Three appropriate investigative techniques were employed:

questionnaire, interview, and research. Each contributes a key role in gathering data for the

best type of medical recordkeeping in the clinic.

Questionnaire

A questionnaire is a research instrument consisting of a series of questions to gather

information from respondents. This questionnaire consisted of eight (8) multiple-choice

questions, distributed to thirty-five (35) clients of the St. John’s Medical Clinic, including

fifteen (15) males and twenty (20) females residing in various parts of Georgetown, East, and

West Coast of Demerara. The questionnaire was presented to the respondents in person to

complete on the spot. Thereafter, all thirty-five (35) sheets were returned.

6
Most respondents (71%) expressed dissatisfaction with the current method of record-keeping

being used in the clinic. The minority (29%) believe that the current method is efficient.

The customer service ratings due to said method are dissatisfactory given that the 44%

majority rating was three (3) of ten (10). The listed ratings proceeded after the most voted

rating (3 out of 10) respectively: five (5), six (6), and lastly two (2) out of ten (10).

The manual record-keeping used presents issues for most clients. Service time is the biggest

complaint, followed by record disorganisation, damage to medical records, and lack of

security respectively.

7
Interview

An interview is defined as a formal and detail-oriented conversation between an interviewer

and an interviewee where the former seeks answers from the latter, which checks their

capability of joining the desired post. Six interviews were conducted on 22 September at 9:00

am at the St. John’s Clinic. The interviewees consisted of the six registered doctors, each

questioned promptly. Upon retrieving the results, five doctors were aware of the paper

record-keeping crisis and found it to be the least best option for recordkeeping. The results

from question three revealed that they were unable to reach their full client's capacity per day

due to how time-consuming manual medical record keeping was. Some even said it was

disruptive to their daily work schedule. When asked about the storage unit in question, the

doctors pleaded that physical storage was not convenient for the number of patients they

received per day. They said the work environment was very disorganised and very often

records would get damaged, misplaced, or lost. The interview therefore concluded that the

staff found the current paper record-keeping method to be difficult, with complaints ranging

from the disorganised state of the workplace, the distressed patients, the unsatisfactory work

schedule, and damaged records. Additionally, it was a very time-consuming process which

led to incompleteness in various areas as well as frustration. Instead, they recommended an

electronic system for recordkeeping, one that would utilise the clinic’s database in a fast and

secure way. Others suggested employing more staff to aid in the overload of work.

8
Research

Research is the creation of new knowledge or the use of existing knowledge in a new and

creative way to generate new concepts, methodologies, and understandings. According to

Microsoft Bing Copilot: Before computer evaluation, all data recording was on paper which

took several days to finish. Following the introduction of computers, record keepers and other

authorities uncovered the upsides of using the device in processing, such as the reduction in

time required. Many institutions are now installing systems that let computers handle record-

keeping duties and online services, making physical transactions unnecessary.

A study was conducted “to explore and describe the challenges experienced by nurses with

regard to record-keeping at selected public hospitals in the Vhembe district, Limpopo

Province, South Africa.” T. Mutshatshi (2018). The study involved interviews conducted for

two months. Results obtained by the researcher confirmed the disadvantages that manual

record-keeping presented to hospital staff.

In the study previously mentioned, doctors and nurses pointed out that recording all activities

was strenuous while the following challenges presented themselves: inadequate time to

complete records, increased admission of patients or work overload, and insufficient supply

of recording material leading to incomplete recording. These are repetitive struggles

expressed by the people involved.

9
 Identification of Possible Solutions

1. Electronic Medical Record Software.

2. Healthcare Database Administrator.

3. Staff Cross-training.

10
 Evaluation of Possible Solutions

Possible Solution 1

In the research obtained, there are numerous situations where manual record keeping is time-

consuming and difficult. Not only when acquiring these records for frequent patients but also

when the records are developing in real time. This solution involves creating a digital

database system known as an electronic medical record [EMR] system for doctors. These

EMRs include completed standard forms, a large database storage unit, and the option to send

specific documentation directly to the respective personnel. Additionally, a downloading and

uploading feature finalizes its record-keeping purpose. These devices would be inter-

connected to a primary mainframe in which the records automatically save.

11
Advantages

○ Improvement in time for data recording

○ Almost instantaneous access to records

○ Increased security/protection

○ Easier transfer of information

Disadvantages

○ Costly

○ Complex Setup.

Budget Table

Single Provider Office - Cost Benefit Analysis

Initial cost Total Cost (1
Per Provider Cost (GYD) year)
Software License $200,000.00 $200,000.00

12
 Internet Provider $10,000.00 $10,000.00
Software Development $17,500.00 $17,500.00
Hardware and Software Setup $17,500.00 $17,500.00
Support and Maintenance (Hardware) $35,000.00 $420,000.00
Support and Maintenance (Software) $17,500.00 $210,000.00
Server $43,750.00 $43,750.00
Fire Wall $5,000.00 $5,000.00
Mobile/Tablet Setup $480,000.00 $480,000.00
Employee Training Program $43,750.00 $43,750.00
Annual Cost $870,000.00 $1,447,500.00

Per Provider Benefits

Transcript Cutback $70,000.00 $840,000.00
Managing Chart $43,750.00 $525,000.00
Patient Chart Search $17,500.00 $210,000.00
Prescription Refills $52,500.00 $630,000.00
Improved Software $175,000.00 $2,100,000.00
Annual Benefits $358,750.00 $4,305,000.00

Possible Solution 2

According to NIH Library (n.d.) a Hospital Database Administrator’s role involves

overseeing the organization, maintenance, and security of critical healthcare data within the

hospital’s database systems. These professionals play a pivotal role in ensuring efficient

patient care, accurate record-keeping, and smooth hospital operations. This solution ensures

that all patient information is safely stored in a database and can be easily updated to save

both time and space.

13
Advantages

○ Allows nurses time to focus on more urgent tasks.

○ Gives administrative staff the ability to learn and develop new skills.

○ Creates more job openings.

Disadvantages

○ Lack of Authority.

○ Perfectionism.

Budget Table

Budget Heads Cost (GYD)

Allowance for Trainees $60,000.00
Salary to Trainers $50,000.00
Convocation Event Cost $100,000.00
Raw materials $10,000.00
Total Cost $220,000.00

14
Possible Solution 3

This solution ensures that staff mindfully navigate document management systems before

transferring data into those systems. This makes staff more familiar with operating database

systems. Functionality slows down significantly if staff aren’t familiar with the work

environment. In addition, staff should be skilled with flexibility for crowded days.

Advantages

○ Continuity in case of abrupt departures

○ Improves staff functioning and teamwork.

○ Decreases the chances for mistakes.

Disadvantages

○ Time-consuming

○ It may distract other staff.

15
 ○ The quality of work produced relies on the training skills of higher staff.

Budget Table

Budget Heads Cost (GYD)

Salary for Training Director $50,000.00
Training Coordinator $30,000.00
Allowance to Trainees $60,000.00
Repair and Maintenance of Equipment $160,000.00
Total Cost $300,000.00

16
 Solution

The most suitable solution is solution one (1). This solution incorporates the complete

conversion of the manual record-keeping system to a digital database.

Justification of Solution

Though this solution involves the greatest cost among the possible solutions, it’s the most

rational for the issue of obtaining and regulating medical records efficiently. This solution

also provides the most accurate system, along with the strongest security for patient

confidentiality. There are four steps in creating an EMR. The first is Documentation. When

the documentation process is adhered to, the system automatically creates a medical record

form that the doctor can conveniently fill out, making this process faster.

The second processes are the distribution and archival. After the documentation, the results

are saved automatically to a database designed specifically by the user in an organized way.

This system produces more time for attending to more patients, allowing the hospital to

accommodate more walk-in patients, resulting in a financial boost. This profit will help the

hospital with the costs of various expenses. The last process is disposal, which simply means

removing the older files from the system. Investing in electronic medical record systems

[EMRS] can benefit the clinic in a variety of ways.

17
 Bibliography

Saul Mcleod, PhD, (October 11, 2023), Questionnaire: Definition, Examples, Design and

Types, SimplyPsychology, https://www.simolypsychology.org/questionnaires.html

Pallavi Pradeep Purbey, (September 4, 2023), What is an Interview? Definition, Types and

Objectives, GETMYUNI, https://in.indeed.com/career-advice/interviewing/what-is-interview

Definition of Research | Western Sydney University. (n.d.-c).

https://www.westernsydney.edu.au/research/researchers/preparing_a_grant_application/

dest_definition_of_research

Mutshatshi, T. E., Mothiba, T. M., Mamogobo, P. M., & Mbombi, M. O. (2018). Record-

keeping: Challenges experienced by nurses in selected public hospitals. Curationis, 41(1).

https://doi.org/10.4102/curationis.v41i1.1931

How Manual Medical Records Should Be Stored And Secured, (March 2020), Calysta,

https://calystaemr.com/how-to-store-secure-manual-medical-records/#:~:text=This%20can

%20be%20problematic%20for%20several%20reasons%2C%20including,handing%20it

%20off%20to%20the%20wrong%20staff%20member

18
Thanh Tran, (March 10, 2021), 6 Ways To Improve Your Healthcare Record-keeping

Efficiency, Effective Delegating, EMR Industry, https://www.emrindustry.com/6-ways-to-

improve-your-healthcare-record-keeping-efficiency/#:~:text=6%20Ways%20To%20Improve

%20Your%20Healthcare%20Record-keeping%20Efficiency,%28EHR

%29%20...%206%206.%20Artificial%20Intelligence%20%28AI%29%20

J Oncol Pract., (March 2010), Essentials of staff development and Why you should care,

PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835475/

5 Benefits of Implementing Electronic Health Records, (April 21, 2021), What are Electronic
Healthcare Records?, Tycoonstory, https://www.tycoonstory.com/resource/5-benefits-of-
implementing-electronic-health-records/

Doctors Hospital Corridor nurse pushing gurney stretcher bed, (July 23, 2015), 1MediX,

Doctors Hospital Corridor Nurse Pushing Gurney Stretcher Bed – 1MEDiX

RVH: Online Patient Portal, (June 19, 2022), Ward 6 Connects (Barrie), RVH: Online

Patient Portal (kevinlepage.ca)

19
 Appendix

Interview Sheet

Name of interviewee: ______________________________________

Time of interview: _________________

Job title of the interviewee: ___________

The mood of the interviewee: ___________

Questions and responses:

1. Are you familiar with the type of medical recordkeeping used at the clinic?

_________________________________________________

2. Has this method of record-keeping proven to be the best choice? If not, why?

___________________________________________________________________________

___________________________________________________________________________

3. How has this type of recordkeeping affected your daily work schedule with patients?

___________________________________________________________________________

___________________________________________________________________________

4. How has this type of recordkeeping affected the clinical storage unit?

20
___________________________________________________________________________

______________________________________

5. If you had the choice to utilise an electronic recordkeeping system instead. Would you

implement it?

___________________________________________________________________________

6. In your opinion, would the implementation of this system improve the services provided by

the clinic? If not, why?

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Interviewee signature: _______________________ Date: ______________

21
 Letter of introduction

Lots 1-3 Brickdam St,

Georgetown, Guyana

20th October 2023

Dear Respondent,

This questionnaire is for the completion of an Information Technology Internal Assessment at

St. Stanislaus College. The information you are requested to enter will be completely

confidential between you and the researchers and a great contribution to this survey. Thank

you for your highly appreciated cooperation.

Yours respectfully,

Tessany Douglas and Rhoshauna Stephen

RESEARCHERS

22
Questionnaire

Please answer all questions by either checking a box or writing in the space provided.

1. What is your age?

☐18 - 30

☐31- 43

☐44- 56

☐57 - 69

☐70 – 82

☐82+

2. How long have you attended the St. John’s Medical Clinic for medical aid?

☐less than a year

☐1 - 3 years

☐4 - 6 years

☐7 - 10 years

☐10 + years

3. Who is your usual doctor in the clinic?

☐Dr. D.Steven

☐Dr. M.English

☐Dr. D.James

23
 ☐Dr. R.Swammy

☐Dr. B.Duglous

☐Dr. G.Singh

4. On an average day, how long does it take to get service when visiting the clinic?

☐1 – 5 mins

☐10 – 20 mins

☐20- 30 mins

☐30mins +

5. Are you familiar with the medical recordkeeping system in the clinic?

☐Yes

☐No

6. If yes, do you think this system is compatible with the efficiency required for the

clinic’s services?

☐Yes

☐No

7. On a scale of 1 – 10, with 1 being the worst. How would you rate the customer service

due to the current recordkeeping system?

☐1

24
 ☐2

☐3

☐4

☐5

☐6

☐7

☐8

☐9

☐10

8. What are the issues you’ve experienced involving this type of recordkeeping?

25