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0 Research Description

Information system, an integrated set of components for collecting, storing, and

processing data and for delivering information, knowledge, and digital products. Business

firms and other organizations rely on information systems to carry out and manage their

operations, interact with their customers and suppliers, and compete in the marketplace.

For instance, corporations use information systems to reach their potential customers with

targeted messages over the Web, to process financial accounts, and to manage their

human resources. Governments deploy information systems to provide services cost-

effectively to citizens. Digital goods, such as electronic books and software, and online

services, such as auctions and social networking, are delivered with information systems.

Individuals rely on information systems, generally Internet-based, for conducting much

of their personal lives: for socializing, study, shopping, banking, and entertainment.

As major new technologies for recording and processing information have been

invented over the millennia, new capabilities have appeared. The invention of the printing

press by Johannes Gutenberg in the mid-15th century and the invention of a mechanical

calculator by Blaise Pascal in the 17th century are but two examples. These inventions

led to a profound revolution in the ability to record, process, and disseminate information

and knowledge. The first large-scale mechanical information system was Herman

Hollerith’s census tabulator. Invented in time to process the 1890 U.S. census, Hollerith’s

machine represented a major step in automation, as well as an inspiration to develop

computerized information systems.

Clinic Management software which helps in efficient clinic management by

managing Doctor's appointments, medical billing, patients treatment history, diagnostics

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information and the administrative activities of a clinic or a hospital. Apart from the

standard features of other clinic management software, Dynacrates was developed

considering the end user in mind. Dynacrates' ease of use, speed in retrieving

information, multi-user functionality and manageability are exemplary compared to other

applications.

Systems Plus College Foundation Extension serves more than 1,600 students and

have two main buildings where students resides to study. The locale uses manual

processing in managing student data and their medical records.

The proposed system will aid the locale to access the vital information of the

students who frequently visits the school clinic. The clinical information will facilitate an

easy venue to determine the kinds of cases of the students.

1.1 Overview of the Current State of Technology

Clinic Management Information System is a highly-customizable hospital

information system, developed using a multi-tier .NET framework, designed and

developed to provide complete automation of the operations of hospitals to enable them

to provide improved and speedy services to clients. Packed with all the modules available

in hospitals, our system is different from the rest in that it caters a workflow approval

process which makes patient, document, and billing tracking much faster than other

systems. The modules are in some way inclusive of accounting and human resource

management but are mainly customized for a hospital setting.

For clinics, index cards are eliminated therefore a complete and better patient

medication history is recorded. If the patient transfers to a different doctor, the complete

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chronological and historical prescription is printed out as requested by the patient to be

forwarded to his newly selected doctor. Also, doctors would have better monitoring of all

his clinics since appointment is done in an easier manner.

Optionally, the system would have a web-based interface for scheduling of

appointments. This software is configured to be used in a multi-user environment of 100-

150 concurrent users connected to a central server running on an RDBMS to provide

accurate, timely and relevant information to its users.

Several software are now being used to aid the schools in managing clinical issues

of their students by using an automated system. The researchers will be developing a

clinical system for the locale in order to aid the school nurse in maintaining student

records and diseases and the inventory of medicines and other school reports.

1.2 Research Objectives

The following are the different general and specific objectives of the study which

are vital in this study and will be the main basis of the proposed system.

1.2.1 General Objective

The main objective of the study is to develop a system that provides accurate

student medical records and information about student diseases.

1.2.2 Specific Objectives

The following are the specific objectives of the study that will determine the

deliverables:

 To provide a means of keeping student medical records and conditions.

 To determine the inventory of medicines.

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  To provide information about the students medical conditions.

 To eradicate the mal-consumption of medicines.

 To provide medicine costing based on the consumed medicines per

semester.

1.3 Scope and Delimitations of the Research

The study started on July 2012 until February 2012. It includes data gathering,

analysis, formulation of solutions and alternatives, development of the system, testing

and implementation.

The respondents are the students, administration, teachers and staffs of Systems

Plus College Foundation Extension.

The study covers the student medical record keeping, medicine inventory, yearly

casualty report for school and management of student information.

The budget for the medicine and the main cause of disease and symptoms are not

included in the system.

1.4 Significance of the Research

The locale will greatly benefit from this study since they will have a means of

monitoring student diseases, managing medicine distribution and finding the common

diseases that occur in the school. Also, the school nurse will have an automated

information system of all students and come up with reports such as common diseases,

annualcasualty reports.

Easy Access to student Data to generate varied records, including classification

based on demographic, gender, age, and so on. It is especially beneficial at ambulatory

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(out-patient) point, hence enhancing continuity of care. As well as, Internet-based access

improves the ability to remotely access such data.

It helps as a decision support system for the hospital authorities for developing

comprehensive health care policies. Efficient and accurate administration of finance, diet

of patient, engineering, and distribution of medical aid. It helps to view a broad picture of

hospital growth. Improved monitoring of drug usage, and study of effectiveness, this

leads to the reduction of adverse drug interactions while promoting more appropriate

pharmaceutical utilization and enhances information integrity, reduces transcription

errors, and reduces duplication of information entries.

Lastly, the researchers can also benefit from this study they can exercise their

skills in programming by untying the knots of programming.

1.5 Research Methodology

The SYSTEM DEVELOPMENT LIFE CYCLE is a process used by a systems

analyst to develop an information system, training, and user (stakeholder) ownership.

Any SDLC should result in a high quality system that meets or exceeds customer

expectations, reaches completion within time and cost estimates, works effectively and

efficiently in the current and planned Information Technology infrastructure, and is

inexpensive to maintain and cost-effective to enhance. Computer systems are complex

and often (especially with the recent rise of service-oriented architecture) link multiple

traditional systems potentially supplied by different software vendors. To manage this

level of complexity, a number of SDLC models or methodologies have been created,

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such as "waterfall"; "spiral"; "Agile software development"; "rapid prototyping";

"incremental"; and "synchronize and stabilize".

Figure 1.0 System Development Life Cycle

SDLC models can be described along spectrum of agile to iterative to sequential.

Agile methodologies, such as XP and Scrum, focus on lightweight processes which allow

for rapid changes along the development cycle. Iterative methodologies, such as Rational

Unified Process and dynamic systems development method, focus on limited project

scope and expanding or improving products by multiple iterations. Sequential or big-

design-up-front (BDUF) models, such as Waterfall, focus on complete and correct

planning to guide large projects and risks to successful and predictable results[citation

needed]. Other models, such as Anamorphic Development, tend to focus on a form of

development that is guided by project scope and adaptive iterations of feature

development.

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 In project management a project can be defined both with a project life cycle

(PLC) and an SDLC, during which slightly different activities occur. According to Taylor

(2004) "the project life cycle encompasses all the activities of the project, while the

systems development life cycle focuses on realizing the product requirements". SDLC

(systems development life cycle) is used during the development of an IT project, it

describes the different stages involved in the project from the drawing board, through the

completion of the project.

Figure 1.0 shows the software development process to be used in this study. This

model will aid the researchers in the developing reliable and accurate system by

following every process within the cycle.

Interview and observation will be used as data gathering technique for this study.

The researchers will then distribute system evaluation forms to the five (5) IT experts or

practitioners.

2.0 Review of Related Literature

An information system (IS) is any combination of information technology and

people's activities that support operations, management and decision making. In a very

broad sense, the term information system is frequently used to refer to the interaction

between people, processes, data and technology. In this sense, the term is used to refer

not only to the information and communication technology (ICT) that an organization

uses, but also to the way in which people interact with this technology in support of

business processes. (Sebis, 2011)

Some make a clear distinction between information systems, computer systems,

and business processes. Information systems typically include an ICT component but are
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not purely concerned with ICT, focusing in instead, on the end use of information

technology. Information systems are also different from business processes. Information

systems help to control the performance of business processes. (Kroenke, 2008)

Alter argues for an information system as a special type of work system. A work

system is a system in which humans and/or machines perform work using resources to

produce specific products and/or services for customers. An information system is a work

system whose activities are devoted to processing (capturing, transmitting, storing,

retrieving, manipulating and displaying) information. (O’Brien, 2003)

As such, information systems inter-relate with data systems on the one hand and

activity systems on the other. An information system is a form of communication system

in which data represent and are processed as a form of social memory. An information

system can also be considered a semi-formal language which supports human decision

making and action. (Alter, 2012)

Information systems are the primary focus of study for the information systems

discipline and for organizational informatics. (O’Brien, 2010)

Clinical information systems support medical andnursing staff in their daily work

by means of electronicdata processing. They cover local systems, anddepartmental

subsystems as well as hospital communicationsystems and hospital information systems

inboth inpatient and ambulatory care. The assessmentof clinical information systems

receives increasedattention as more and more are used in clinical routine (Bemmel,

1997).

Most industrialized countries have undertakenmajor reforms of their health care

systems duringthe last few years. These reforms have attempted tostrengthen the primary

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health care sector andfavors the emergence of integrated health carenetworks as a new

model of care organization (Payton, 2002).

In this new environment, the deployment ofclinical information systems (CIS)

such aselectronic patient record (EPR) systems, picturearchiving and communication

systems (PACS),telemedicine applications, and computerizedphysician order entry

(CPOE) systems has becomeone of the critical benchmarks for achievingseveral health

care reform priorities. The goals ofCIS include raising productivity levels

amongclinicians, integrating the care process, andimproving the quality of services

provided topatients by transferring routine, manual taskscurrently performed by health

professionals tosoftware solutions. Achieving these benefits has,however, been difficult

in practice, and it is notsurprising that many initiatives in this area still fail (Sicotte,

2006). For instance, a study by Kaplan (Kaplan, 2000) reporteda failure rate of about

50% among CISimplementations in health care organizations in theUnited States. This

appears to be a widespreadtrend affecting many industrialized countries (Sia, 2002).

Many experts attribute these problems to avariety of factors such as the quality of

projectmanagement, rather than the technology itself. Infact, currently available

technologies havefunctionalities that provide excellent solutions, butthe health care

industry appears to have difficultyfinding satisfactory solutions in today’senvironment of

health care production (Sicotte, 2006).

Medication errors are deleterious,prevalent, and costly.Over 7000 deaths in

theUnited States each year are attributedto medication errors. (Philips, 1998) One

study,conducted at two large tertiary carehospitals, estimated that almost 2 outof every

100 admissions experiencea preventable adverse drug event (ADE). (Bates, 1997) Rates

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from other studiesextrapolate to 380,000–450,000 preventableADEs annually, costing

thenation an estimated $3.5 billion in hospital costs alone. (Aspden, 2006)

Strategies to reduce medicationerrors have been suggested by

severalorganizations, including the Institute of Medicine (IOM), (Kohn, 2000) the

LeapfrogGroup, (Leapfrog Group, 2006) the National Quality Forum, (NQF, 2003) and

the Joint Commission. (JC, 2008) Aconsistent recommendation amongthese groups is the

implementationof information technology,particularly computerized physicianorder entry

(CPOE), in hospitalsand health systems. In addition toCPOE, other forms of

informationsystem technology that have demonstratedeffectiveness in

minimizingmedication errors include pharmacyinformation systems, clinicaldecision-

support systems (CDSSs),electronic drug dispensing systems(EDDSs), and bar-code

point-of-care(BPOC) medication administration systems. (Chaudhry, 2006)

While there are limited datademonstrating the effectiveness ofeach of these

systems in preventingmedication errors at various pointsin the medication-use process,

thereare even less data on the effectivenessof these systems when integrated together.

In addition, a majority of thepublished studies have been limitedto four

benchmark institutions usinginternally developed health information technology systems.

The mostrecent IOM report, Preventing MedicationErrors, recommends a shift insafe

medication-use research frommeasuring incidence rates to informing,developing, and

testing preventionstrategies. It also recommendsthe testing of vendor-based systems.

This article discusses the implementationof vendor-based integratedclinical

information systemtechnology and presents the resultsof an evaluation of its effect

onmedication errors throughout themedication-use process in the healthcare system.

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 Integration of clinical informationsystem technology decreased selectedtypes of

medication errors throughoutthe medication-use process ina health care system and

improvedtherapeutic drug monitoring in patientswith renal insufficiency and inpatients

receiving drugs with narrowtherapeutic ranges through use ofCDSS alerts.

Baselets are among the most powerful toolsin CIS and are conceptually similar to

themacro feature of word processing programs.Both tools are designed to allow users to

insertprewritten items into a document by usingonly a few keystrokes instead of

typingthe item completely, letter by letter. In CISbaselets, prewritten items may include

medicalhistory, results of physical examination,other types of assessment, physician

orders,and other plans. Items can be inserted asfull text or as coded terms. Any of these

itemsmay be selected (“turned on”) or deselected(“turned off”) by the person who is

charting.

Selecting an item causes the item tobecome part of the patient’s

permanentmedical record; deselected items do not become part of the permanent

record.(Groshek, 2002).

3.0 Theoretical Framework

VIHA is deploying advanced EHR functionality to support clinical decision-

making, improve quality and patient safety through proactive care planning and clinical

decision support. VIHA aims to achieve this in a multi-system environment with limited

resources.

In order to provide advanced functionality within VIHA, in a timely and

reasonable fashion, a set of interprofessional Core Patient Information (CPI) will need to

be defined and reside in VIHA’s primary EHR, Cerner.

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 Other regionally supported systems will need to be able to interoperate with the

Primary EHR to ensure that this data is up to date within Cerner.

What is considered Core Patient Information will evolve over time (see current

categories on the left). Additional information, such as Patient Alerts, Social History, and

Family History, will be considered. These will be added when there are suitable

structures to support them and regionally agreed to use and definitions. Diagnostic data,

such as lab and medical imaging are already captured in Cerner.

Without a clear understanding of the CPI, VIHA risks reduced interoperability,

hiding key patient information in electronic silos, and not being able to achieve the

benefits of electronic health records.

Focusing on the limited scope of the CPI necessary, due to resource demands,

complexity, and capability of systems. However, there is a risk that if the CPI is too

small, VIHA will be limited in its ability for advanced functionality. Additional

standardization of content across systems will also be required.

There are several clinical systems in VIHA and the content that will be stored in

each is not yet clear. This principle starts to hammer out a set of fundamental information

that will be stored in the primary patient record inside of Cerner. This means that

interfaces will need to be created to import data or share data from other systems inside

VIHA that contain similar medication. This is deemed the minimum set of content to

ensure future clinical decision support. (Figure 2)

The other aspect of this list is that we promoted components that we knew had

reasonable models inside the VIHA instance of Cerner. Family History, for example,

while useful, was excluded at this time as it would require VIHA to spend time

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developing that content internally, and there is an expectation that this feature will come

from Cerner in the future. This list alone will likely keep VIHA busy for a while. So this

list is targeted and will grow as is practical.

Figure 2.0Core Patient Information

3.1 Conceptual Framework

Figure 3.0 shows the paradigm of the study. The research will intend to solve the

problems using the data gathered. With the clinic system, the school nurse will be able to

centralized students data and the inventory of medicines. The figure also shows the main

flow of the paradigm of the study wherein main factor includes, students, medicines,

health problems (diseases), mortality rate and inventory.

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 This system will aid the locale prepare the needed reports submitted to school

every end of academic year which is very much vital in the decision making of school

officials.

Inventory

Admin/Nurse
Yearly casualty
report
Clinical
Information
System
Student Med
Report

Stock alert and

Figure 3.0 Conceptual Framework of the Study

4.0 Clinical Information System for Systems Plus College Foundation Extension

4.1 System Overview

The system is an automated clinic information system wherein the school nurse

will have a centralized databank of all the medical records of enrolled students of

Systems Plus College Foundation Extension. This will ensure the effectiveness of

providing quality medical services for students since data are easy to retrieve and not in

the usual manual process of using index cards.

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 4.2 System Objectives

The proposed system has different deliverables that are to be met by the system.

The following are the specific deliverables that the system will produce:

 Keep track of student medical records and conditions.

 Easily produce inventory of medicines.

 Prepare school annual mortality reports.

 Present a summary cases in experienced by the school nurse.

 Provide medicine costing based on the consumed medicines per semester.

4.3 System Scope and Limitation

The following are the scope and limitations of the system:

 Student information entry

 Student medical history

 Medicine inventory

 Medicine distribution report

 School annual mortality reports

4.4 Physical Environment and Specifications

In order to implement and execute the proposed system, the proponent needed to

have the different hardware and software requirements. These hardware and software

requirements are needed in order to achieve and utilize the full features of the proposed

system.

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 Development

Software

 Visual Studio 6.0

Hardware

 Computer

Implementation

Software

 Visual Studio 6.0

Hardware

 Computer
 Dot Matrix Printer

4.5 Architectural Design

The following are the different architectural designs used by the system and

helped the researchers in developing an accurate system. This section discusses the

architectural design of the proposed system. The Architectural design helps the researcher

the idea about the general structure of the system. It serves as the back-bone of the

proposed system. The proponent used the Entity-Relationship Diagram to design the

database structure of the system.

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Data Flow Diagram

The Data Flow Diagram is use to demonstrate the flow of the data from one

process to another. This tool allows the proponents to properly identify the processes

within the proposed system, the flow of data from input, to the processing stage up to the

generation of outputs. Also through this tool modules are properly identified and

eliminate unwanted processes.

Database Structure

This includes the structure of database design of the system; this allows the

proponents identify the needed inputs and the reports to be generated. The main database

structure includes Admin, blogs, comments, categories, and journal.

Data Dictionary

This includes the structure of database design of the system; this allows the

proponents identify and define every data to use within the system.

System Flowchart

System Flowchart is use to graphically illustrate the step-by-step procedure being

done by the system. This tool will show the main flow of the program combined with the

database structure. This will allow the proponents to identify major features needed and

the report generations.

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5.0 Design and Implementation Issues

The system was designed to help the school nurse keep track of the students

medical conditions to further monitor their help care and to determine the medicines to

purchase and stock.

Upon start of the development of proposed system the researchers designed a

working model for medicine entry, student information entry, medical conditions entry,

and medicine inventory.

After the researchers has completed the design using VB 6.0. The researchers

encountered some errors and problems regarding the retrieval of information in the

database.

After undergoing to tedious error tracing procedures, the system has successfully

generated on how to develop a standalone workstation system on the given information

from the user.

The problem that the researchers have encountered is that if the student will not

provide accurate medical history then the medication that the school nurse will be

providing is inaccurate and the medicines to be purchase and monitored. This should be

addressed by the administration of the school accordingly in order to fully implement the

system accurately and effectively.

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6.0 Results and Observation

The researchers interviewed and took pictures of the three (3) IT experts to test

and use the system. Then they evaluated it that corresponds to their findings, summary is

given.

The following are the evaluation results of the different resource persons or IT

practitioners who evaluated the system:

1. Does the system meet the set of objectives?

 Yes, objectives were able to show completion.

 Yes, because all the information needed in the system can be.

 Yes, for the inventory module system.

2. Evaluate the system in terms of speed, accuracy of data result and system

function?

 In terms of speed, no question about it.

 Yes, because the system response faster.

 For searching data the system is accurate.

3. Does the system provide user-friendly interface?

 Yes, the designs are related to the functionality of each form are good.

 Yes, because the system looks good in forms of design and easy to

use.

 Yes, the system supports GUI.

4. Does the system provide accurate security?

 Yes, Security is given for each type of users.

 Yes, because in terms of hiding the password.

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  Yes, because it has an user account.

5. Does the system provide accurate reports and outputs?

 Based on what we have seen, reports are ok and have given emphasis.

 Yes, because its display the other features of the system.

 Yes, data stored in the system can be seen the reports module.

7.0 Conclusions and Recommendations

The researchers asked three (3) IT experts to evaluate the developed system, the

respondents finds it accurate and secured.

The system was found accurate since the inventory and management of medicines

are kept well as noted by the IT experts. It is important for the school nurse to accurately

determine the inventory of medicine since the locale needs to make the budget for the

medicines every semester.

The system was designed using user-friendly interface wherein, even though the

users are not IT experts they can easily learn on how to use it. This is very much

important since the school nurse is not an IT expert only user of technology.

With regards to the report generation, the system proved that it can provide

accurate reports that are useful in preparing inventory and school mortality report that is

submitted every end of academic year. Moreover, the system is secured since the

researchers developed the system with different users and accounts.

Lastly, the system met the set objectives and requirements which were very vital

in the development and implementation of the system.

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Conclusions

The following are the different conclusions based on the conducted research and

system development:

 The system is secured.

 The system met all the required deliverables set by the locale.

 The system provides accurate reports.

 The system provided user-friendly interface.

 The system can accurately inventory of medicine.

 Mortality rate is determined.

Recommendations

The following are the different recommendations of the researchers:

 The locale should provide and setup a workstation at the school clinic.

 The locale should provide medicines every semester so that the school

nurse can accurately determine inventory of medicines.

 The nurse should update medicines on time.

 Future researchers may include costing of medicines.

 Graph may be used to generate mortality rate reports.

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