Background of the Study

Technology has made human labor faster and easier in every office today. Reducing time and effort in accomplishing tasks along with security of records are essential for the office to survive in the modern world. Hospital Management System is a computer-based system that establishes an orderly and systematic method of managing hospital patient records more effectively and efficiently for both out-patients and in-patients. The functions of the system will help the user easily update the important given information of  In and Out patient including the guardian and the physicians schedule. It will also help the billing clerk to easily compute the bill of their patient. All the process are stored in the database so that they won’t be having any problem about storing and finding the reports.

The proposed system Hospital Management System of Dr. Manuel R. Rebueno Memorial Hospital enables the hospital to develop their organization and improve its effectiveness and quality of wor. It also enables hospitals and doctors to better serve their patients and keep their work easier to manage.

Their mission is to give best health care to all patients. Their vision is to become a better health care. Their goals are to continuous improvement in visibility, competitiveness, accessibility, total health management, communication and health education. Dr. Manuel R. Rebueno Memorial Hospital is PhilHealth Accredited (No Balance Billing (NBB) Policy).

           

Current Situation

Registration of patients is done by just writing the patients name, age and gender. Whenever the patient comes up his information is stored freshly. Bills are generated by recording price for each facility provided to patient on a separate sheet and at last they all are summed up. Diagnosis information to patients is generally recorded on the document, which contains patient information. It is destroyed after some time period to decrease the paper load in the office and all this work is done manually by the receptionist and other operational staff and lot of papers are needed to be handled and taken care of.

Problems of the study

Dr. Manuel R. Rebueno Memorial Hospital gives the best health care to all their patient’s encountered problems in their manual based system. Specific problems are listed below:

  1. Immediate retrievals of patients’ information.
  2. Un-updated patients’ information and schedule of staff
  3. Inaccurate computation of hospital bills.
  4. Accuracy and accessibility of reports.

 

Opportunities

Based from the problem that the company encountered, these are the benefits that system will give.

  1. Quick and easy patient registration.
  2. Proper recording of records of both out-patients and in-patients.
  3. Increasing effort in keeping the records of the patients and recording their activities (done manually).
  4. Maintain doctors and employees information.

Objectives of the study

            The main objective of this is study is to create a system that will automate the management of the hospital making it more efficient and error free.

  1. To easily access patients information.
  2. Updated Patients’ information and staff
  3. Accurate computation of bills
  4. Accurate and easy access of reports

System Scope and Boundaries

This system focused on the hospital management system of the Dr. Manuel R. Rebueno Memorial Hospital. The system manages patient information, staff information, medicines, and computation of the bill of every patient. The system cannot handle payment through credit card. The main function of the system is to manage daily activities of the hospital in all its departments. The administrator can create user accounts for the staffs. The system also can define the departments of the hospital and schedule for the doctor and other staff members which can be viewed all through the application.

Responsibilities

The proposed system will be used for a lifetime by the hospital. The system can minimize the paperwork’s and compared to manually patients recording system will store the data correctly and properly, privacy and security will also be implemented. The doctors and medical officers who will be using the system will undergo some training on how to use the system and the management as well.

Organizational Chart

Organizational Chart

Organizational Chart

Medical Director –   is a physician who provides guidance, leadership, oversight and quality assurance for the practice of local paramedics and EMTs within a predefined area.

Hospital Administrator- is the person responsible for the running, managing or supervising the hospital.

Administrative Officer- is responsible for the day-to-day operation of a hospital, manages care organization or public health agency.

Chief Nurse- generally responsible for supervising nurses and nurse managers, facilitating the design and implementing the delivery of patient care, recommending strategies to improve services, reaching established goals, Maintaining satisfactory outcomes and contributing to profitability.

Dermatologist- consults if you have any significant problem with your skin.

Resident Physician- is the one who lives in the hospital and cares for hospitalized patients under the supervision of the medical staff.

Billing Clerk-is accountable for creating invoices and credit memos, issuing them to customers by all necessary means, and updating customer files.

Medical Clerk- Responsible for maintaining, incorporating, and accurately accounting for all medical records information on each individual resident.

Business Constraints

The proposed program targets the Billing, Recording/Updating/Storing Patient, Staff Information, and Medicinal Drug Information. Patient-Staff Appointment Schedule/Record. Verification/Identification of external sources like Phil Health Account is outside of the Proposed Program’s capability which may not pose a problem since the Hospital already have a program for such. The management who will be handling the program may experience unfamiliarity towards the system.

 

Possible Alternatives

Due to the constraints that the hospital will encounter here are some possible alternatives to the problem:

  1. The person who will be using the program needs to train and familiarize himself/herself on how to use the system and its functions.
  2. The program may be subject to changes depends on the accessibility and reliability of the user.

Technical Feasibility

Hospital Management makes the hospital operation easier, faster and accessible. Here in this chapter, the system software and hardware will be discussed its importance and significance on the proposed system.

System Description

The Hospital management system is designed for Dr. Manuel R. Rebueno Memorial Hospital to replace their existing manual, paper based system. The new system is to control the following information Billing Records/Information, Patient information, staff schedules, and Doctors appointment schedules. These services are to be provided in an efficient, cost effective manner, with the goal of reducing the time and resource currently required for such tasks.

The user needs to log in using their username and password given by the administrator to the system to update the information needed. The password are matched with information stored in the database. Therefore the authenticated users can log on to the program with limited access. After the log in process the user will choose what to update. In the In-patient information form lets the user update the basic information of the patient including the department, room, medical history and the guardian information. The Out-Patient information form is similar to the In-Patient information form except for the department, room number, and guardians’ information. In the billing form it takes care of the patient billing. This is where all the receipt of payments made for the service that were offered to the patient during his/her stay in the hospital.

A significant part of the operation of Dr. Manuel R. Rebueno Memorial Hospital involves the schedules of the staff and timely storing of information. This information typically involves; patients personal information and medical history, staff information, room and ward scheduling staff. This system is going to be used in Dr. Manuel R. Rebueno Memorial Hospital for maintaining patient details and improve efficiency. The system working is quite easy to use and learn due to its simple and attractive interface.

System Users

These are the people who are authorized to use the system.

Hospital Administrator/ Medical Director-has the authority to access the database system, users account, information and schedules of the staff.  The administrator can create User accounts for the staff, define the departments of the hospital and schedule for the doctors and other staff members.

Medical Clerk- is the one who works on maintaining and updating the complete patients profile information and accurately accounting for all medical records information on each individual resident.

Front Desk Staff– is the one who can checks to see if the patient is already registered with the hospital and who can generate reports on bed availability about the following information: ward name, bed number, occupied/unoccupied.

Resident Physician- updates the treatment information and situation of the patient and is the one who can execute important reports to support daily medical tasks, retrieval and updating of hospital records.

Billing Clerk- computes the bill of the in and out patient and accountable for creating invoices.

System Diagram

            This part of the study shows the flow of the system and the sub process that is involved in the system process. It also indicates the contextual and the exploded diagram.

Contextual Diagram

Contextual Diagram

Contextual Diagram

Figure2 contains the process that generalizes the function of the entire system. The user/admin must log in to the system to access the information about the In/Out Patients details, Patient laboratory reports, schedule of all the physicians, and billing statements saved and stored in the hospital database which the administrator can view.

Data Flow Diagram

Data Flow Diagram

Data Flow Diagram

Figure 3 elaborately shows how the system will work starting from the Receptionist. The user will login first. The authority of the Account used depends on the Account being used or the authority set by Account with Administrative Authority which will be given to the Medical Director.

The system allows the Receptionist to store Patient Detail. The Doctor in-charge will then input the Treatment Detail and Lab Report manually and all the details will be stored in the Database. The Medical Director can manage all the data in the Database.

Exploded Diagram of 4.0 Process

Exploded Diagram

Exploded Diagram

This diagram shows the exploded diagram of treatment process of in and out of storing and retrieving input data of the Patient. Then the Laboratory Reports will be inputted/updated by the Doctor in-charge of the Patient. Then the Patient Report and Laboratory Report will be stored in the Calculation of Bills for Billing Purposes and for producing Receipt while also being stored in Database.

Exploded Diagram of 5.0 Process

Exploded Diagram

Exploded Diagram

This diagram shows the exploded diagram of the Calculation of Bills. And the Cashier can only access and generate bills and receipt. The Doctor in-charge of a specific Patient will input the Doctor Charges, Medical Charges, Room Charges and Service Charges. Then the Cashier will sum up all the Charges. The System can print a receipt with the information of all charges.

Technical Resources

This refers to person who’s capable of handling and managing the system like IT professionals, engineer or any person who has talent in detecting and identifying problems about the system. He will be the one to check, update and manage the process of the system and be able to fix problems.

Hardware

Hardware is the physical parts or components of a computer, such as the monitor, mouse, keyboard, hard disk drive (HDD), motherboard, memory, processor, Read –only Memory, Automatic Voltage Regulator, monitor, printer and Uninterrupted Power Supply.

The processor will be responsible for the speed of the system. The motherboard and the memory will be used for the processes of the unit. The hard disk drive will serve as the storage. The keyboard and mouse are the primary input devices.  The AVR and UPS are used to manage the electricity supply to avoid power shock during power interruption. The monitor will display the output and processes by the users.  The printer will print the result of the processes.

Software

The software takes care of all the requirements of the hospital and is capable to provide easy and effective storage of information related to patients that come up to the hospital. Software is a collection of computer and related data that provides the instructions for telling a computer what to do and how to do it. Software is a set of programs or procedures, concerned with the operation of a data processing system. The software requirements of the system are applied to operate the proposed system.  My SQL Server 2012 for data storage.

The other software requirements are: minimum of Microsoft windows 7 or Microsoft Windows 8 for the operating system. This will also be the intermediary software between application programs and computer hardware

 

System Requirements

The systems requirements for the propose system are categorized into the hardware and software requirements. The minimum and recommended specifications are also included.

Table 1. Hardware and Software System Requirements

Description Minimum Recommended
Hardware
Processor 1Ghz x32 processor 1Ghz x64 processor
RAM 2GB 4GB
Hard Disk Drive 500GB 750GB
Mouse Standard wheel mouse Standard wheel mouse
Monitor LCD Monitor LED Monitor
Keyboard Standard Keyboard Standard Keyboard
Motherboard Intel Motherboard Intel Motherboard
AVR/UPS 500VA 650VA
Printer SAMSUNG SRP 275C Printer EpsonTM-T88IV Thermal Printer
SOFTWARE
Operating System Windows 7 Windows 8/8.1
Database Software SQL SERVER 2012 SQL SERVER 2012

Table 1 shows the hardware and software system requirements of the proposed system.

System Interface

Shows all the design of our proposed system for Dr. Manuel R. Rebueno Memorial Hospital. It also shows the step by step process of the system and its functions starting from the log in interface up to the Search Module interface of the proposed system.

Log In

Log In

Every user who wants to use this software is authenticated my means of username and password which is already created by the administrator and is stored in the database. All entered parameter of the password are matched with information stored in the database, therefore only authenticated users can log on to the program with limited access. The administrator is the only one who has access to the entire module and interfaces of the software and can create a new user to access the software.

The administrator can create User accounts for the staff, define the departments of the hospital and schedule for the doctors and other staff members which can be viewed all through the application.

Table

Table

The In-Patient interface enables advance booking of Beds & Other facilities in the hospital. The System maintains status of Occupied & Vacant Beds in the hospital. At the time of admission of a patient, all relevant details are accepted along with booking advance, Deposit and Admission Form or Slip required in the Patient Case Sheet File in the ward will also be printed. Every patient is automatically assigned a unique In-Patient ID No., which is used for identifying the medicines and services utilized by the patients. Based on intimation from concerned Nursing Station, it updates Bed status for Discharge of a patient. Generate Discharge slips. This module will also cover extensively the complete billing functions involved from the date and time of admission of patent till discharge from hospital for the facilities provided to the Patient.

Table

Table

The Outpatient interface maintains Outpatients information and provides interfaces with Appointments & Medication. Every Patient will be given a unique patient id number for identifying various patient care services offered in the hospital including hospitalization particulars. This module will also cover extensively the complete billing functions involved from the date and time of admission of patent till discharge from hospital for the facilities provided to the Patient.

Table

Table

This module is takes care of physician’s schedules, outpatients and discharge patients appointment to the hospital either for check-ups or consultation with the doctors. The visiting patient either calls in or come in person to visit the available doctor as long as the situation is not critical or an emergency.

Table

Table

This is the module that takes care of the patient billing. This is where all the receipt of payments made for the service that were offered to the patient during his/her stay in the hospital and this module is linked to the invoice in the software system. The patient id number and name of the patient is of each patient who is issued a receipt is printed boldly on the receipt so s to identify the patient. Services that are charged in this module are predefined in the software as required by the hospital.

Table

Table

This module helps in generating patient’s discharge summary, which includes patient’s health at the time of discharge, medical history, various diagnosis and drug prescriptions, and history of patient’s illness and course of the hospital. It tracks all the patient records including medical records and inpatient records.

Table

Table

The search wizard module lets users search for specific content in information table and let user search both for users and for particular words in search table. Let user search all records in the system.

Schedule Feasibility

            This chapter discuss about the schedule of the proposed system. It also covers the system investigation, analysis and design, implementation, review and maintenance of the system. These are the steps involved in the system life cycle.

Project Schedule

Project schedule shows the time needed to conduct the whole study. It also started from planning to gathering of information for evaluating the system until the implementation task is accomplished.

Project Schedule

Project Schedule

Table 2 represents the project schedule of the proposed system. The proponents carefully analyzed what is the scope of the study. This includes choosing one of the four title proposals.

Systems Investigation

The Manuel R. Rebueno Memorial Hospital currently uses a manual system for the management and maintenance of information. If the proposed system will be implemented this will make the hospital transaction easier and faster.

The researchers conducted an interview on the company as our basis for the information needed for the proposed system to be able to know the company’s current system and the problems they are encountering. The investigation serves as the basis in the construction of the proposal.

Systems Analysis

At  this  point,  the manual system in  place  will be analyzed  to  determine  where  the  problem is,  in  an attempt  to  solve the  system.  This  step will involve  breaking  down the  system  in  different  pieces  to analyze  the  situation,  analyzing  project  goals,  breaking  down  what  needed to  be  created  and  attempting to engage users so that definite requirements could be defined.

The part of the software development process whose primary purpose is to formulate a model of the problem domain. Analysis focuses what to do, design focuses on how to do it.

System Design

In systems  design the  design  functions  and  operations will be described  in  detail,  including  screen layouts,  process  diagrams  and  other  documentation. Design  elements  will describe the  desired  system  features  in  detail,  and  generally will include functional   screen  layout  diagrams.

The design activities are of main importance in this phase, because in this activity, decisions ultimately affecting the success of the software implementation and its ease of maintenance are made. These decisions have the final bearing upon reliability and maintainability of the system. Design is the only way to accurately translate the customer’s requirements into finished software or a system.

 

Implementation

The system can be implemented only after thorough testing is done and if it is found to work according to the specification.

It involves careful planning, investigation of the current system and its constraints on implementation, design of methods to achieve the changeover and an evaluation of change over methods a part from planning. Two major tasks of preparing the implementation are education and training of the users and testing of the system.

Review and Maintenance

The review and maintenance phase focuses on change that is associated with error correction, adaptations required as the software’s environment evolves, and changes due to enhancements brought about by changing customer requirements.

To make sure that the system will be working effectively, review and maintenance is needed to maintain the reliability of the system. The system also needed to be evaluated for its safety. System inspection is needed to monitor the systems performance level if it will encounter problems in the future operations.

Maintaining the system secure the hospital’s productivity and will surely cause lesser errors.  Maintenance will done be twice a year after being implemented.

Economic Feasibility

This chapter deals with the contribution of the study to Dr. Manuel R. Rebueno Memorial Hospital where the system will be implemented. The system being developed is economic with the hospital’s point of view. It is cost effective in the sense that has eliminated the paper work completely. The result obtained contains minimum errors and are highly accurate as the data is required.

Benefits

Hospitals are an essential service and infrastructure and patient care is of utmost important. If the hospital management system and all other functions operate smoothly then it ensures better care and treatment facilities for the patients. Information technology has developed extensively to a stage where it is possible to garner its far-reaching capabilities to make the task of the hospital management much easier.

Hospital Management System not only provides an opportunity to the hospital to enhance their patient care but also can increase the profitability of the organization.

Total Project Cost

            This section discusses the sources of the capital needed in the implementation of the system. A specific capital is needed to finance the project. The training costs for the intended users of the system and other incidental costs that may be required and needed in the process are included.

Table 3. Estimated Project Cost

Hardware Cost
System and Programmer P 25,000.00
Printer P 13,000.00
Software Cost
Operating System P 5,980.00
Database Program P 3,000.00
Total Project Costs P 46,980

Given the specification of the system requirements, the hardware and software should be of a known brand for the best performance of the system and also to avoid inconvenience. It will also help in preventing the incompatibility of the system requirements and system failures.

Using the latest unit model will be very important so they will be assured that the system proposal will work properly and will not easily depreciated.

Project Related Cost

            To have smooth transactions and to implement the proposed project effectively, the requirements stated above are needed. The estimated cost of the project is P 46,980 including the hardware and software. Dr. Manuel R. Rebueno Memorial Hospital earns almost 300,000 every month.  So they will immediately recovered the money spent on project, thus, the hospital will be more profitable especially if the proposed system will be implemented.

Operational Cost

The cost needed to maintain the proposed system will be discussed on this part. Upon implementing the system, the person who will be using the system will undergo such training in order to maintain the system.

Table 4.  Operational Cost

Operational Cost Cost
Maintenance P 3,000.00
Supplies P 2,000.00
Total Expenses P 5,000.00

The table above includes maintenance and supplies cost monthly. The supplies include the ink and paper that will be used monthly. The maintenance fee will only be consumed whenever the system encountered failure on the hardware section only. Any failures on the system itself will be fixed by the proponents as this is included in the total project cost.

Accounting Methods

            The Hospital management system is designed for the hospital to replace their existing manual, paper based system. Dr. Manuel R. Rebueno Memorial Hospital uses manual method. The proponents are implementing the system to the company to automate their HMS to make it fast and reliable. The following sections provide computation of how economically feasible the system is once implemented and how long will it take to return the investment of the company after buying the system.

 

Payback Period Analysis

 

            The payback period refers to the period of time required for the return on an investment to “repay“” the sum of the original investment. This would inductively measure how long sometimes takes to “pay itself”. All else being equal, shorter payback periods are preferable to longer payback periods. The formula below shows the payback period of the proposed HMS system.

Payback Period = Estimated Project Cost

Annual Cash Flow

                        Computation for the company:

PP = 51,980.00

623,760.00

= 0.083333333 X 365 days = 30.4 months

Using the formula the payback period, the company will gain their investment in a span of 30 months. The case will be like this if the income is constant. However, after the system provided a better service.

Return of investment (ROI)

Return of investment is frequently used in business analysis and decision making. It is also a measure used to evaluate the efficiency of an investment. This will provide the company valuable information on how the available resources are being utilized and maximized to generated profit and can be used as tool in future investments.

ROI =    (Gain from investment – Cost of investments)

Cost of investments

Where,

Gain from Investment refers to gains of the company as they applied to the system, and

Cost of Investments refers to the project cost.

Computation for the company:

30.4 months x 51,980 = 1,580,192 (Gain from Investment)

ROI = (1,580,192 – 51,980)

51,980

 

ROI = 29.4or 29 %

Based from the computation above, in a span of 30.4 months or 29% of its investment will return to the company. This proves that the company is capable of buying the system and they can gain their investment back in a minimal time. Meaning the proposed project is profitable.

Conclusions and Recommendations

This chapter discusses the summary and findings in the study. The conclusion and recommendation is provided for the company, the user, and the future researchers. Hospital Management (HMS) system are application system that will capture various Patient Information, Doctor Information, and writing bill amount such that to shift from manual. Also this data can be maintained at central place for reference at specific intervals.

Conclusion

Hospital Management helps the hospital enables the hospital to develop their organization and improve its effectiveness and quality of work. Hospital Management System is a computer-based system that establishes an orderly and systematic method of managing hospital information and patient records more effectively and efficiently for both out-patients and in-patients. Hospital records as well will be directed to the database. The main function of the system is to manage daily activities of the hospital in all its departments. It will also minimize the paperwork’s compared to manually patients recording system, the system will store the data correctly and properly, privacy and security will also be implemented. The Management of the hospital is concerned with the increasing effort in keeping the records of the patients and recording their activities (done manually). It maintains full information of both indoor patients and outdoor patients for the purpose of future use.

Better visibility, control, and efficiency to improve their services and enhance healthcare experience to improve their hospital administration. HMS prevents the hospital to its difficulty to retrieve and to find particular information like to find out about the patient’s history. Manual management results in inconvenience and wastage of time.  The information generated by various transactions takes time and efforts to be stored at right place. Various changes to information like patient details or immunization details of child are difficult to make as paper work is involved. Manual calculations are error prone and take a lot of time; this may result to incorrect information.

The proposed system is operationally feasible. The needed resources are available anytime. The hardware and software required is of high quality and of reputable brand to minimize the time of the system to depreciate.

The Hospital Management process will become faster, accurate and updated. This will make the hospital operation easier, faster and accessible. Therefore the proposed system is technically feasible.

The proposed system is also economically feasible. The cost of the system is just right to invest with. The hospitals can loss thousands of pesos every year in their manual and paper based system. An investment of P 51,980 is nothing compared to what they loss in their manual system. The proposed system enables hospitals and doctors to better serve their patients.

Based on the interview conducted by the proponents, they are able to gather enough information to conduct the study.  In the manual Hospital Management System of the Dr. Manuel R. Rebueno Memorial Hospital they encounter human errors on their manual hospital management. The proposed Hospital Management System improves work efficiently; there will be lesser errors because it is computerized. Thus, the computerized system will lessen their workload and paperwork that causes more error on the system. The proposed system is made to be user-friendly.

Recommendations

            The researchers suggest a full computerization of all the sections and departments of the hospital. The computerized hospital management system may also be applied to other hospital for as long as they have similar workflows.

The system should be made available to the management to other section of the hospital by adding network connections to the other department so that the same hospital management system could be retrieved by them.

The researchers would also like to recommend to other researchers to improve the system and to go beyond the scope of the study.

Credits

Nuelen O. Ocampo

Judy Ann A. Palermo

Mark Joseph L. Villa

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