PWANI HOSPITAL MANAGEMENT SYSTEM

HOSPITAL MANAGEMENT SYSTEM CASE: STUDY OF PWANI HOSPITAL

ByNAME: ODUOR JOHN PAUL ODHIAMBOREG NO.:BBIT/MSA/11/00108

Research proposal submitted in partial fulfillment for the requirement of the award of degree of Business Information Technology to the Department of Information Technology in the School for Pure and Applied Sciences, Mount Kenya University.

January, 2015

DECLARATIONThis proposal is my original work and has not been presented for a degree in any other University

ODUOR JOHNPAUL ODHIAMBO

.SignatureDate

This proposal/project has been submitted for examination with my approval as University Supervisor

MR. BENJAMIN KATHALE

.Signature Date

ACKNOWLEDGEMENTSI am most grateful to the most-high God for bringing me this far in my education. My sincere thanks go to my project supervisor Mr. Benjamin Kathale of the department of Information Technology for his patience, constructive criticism and effective supervision which were essential in shaping this project.My sincere thanks go to my head of department as well as lecturers in the department for their words of encouragements and support. My sincere gratitude goes to the director and entire management of the Pwani Hospital, Directorate for the support and encouragement they gave. Finally to my family especially my parents for their concern, prayers and support throughout all my life and education and also to my siblings for their love, prayers and support for all words of encouragement I say a big thank you and may God richly bless you all.

ABSTRACTThis is a brief statement of the problem, the system analyst recognize and define the problem in the current manual system at the hospital. Objectives of the study will be concentrated towards the development of such software product that will help in removing the problems encountered with the patients record keeping method and reservation facilities for the costumers in Hospital. This software will be focused for both Hospital managements and member who can manages all Hospital tasks in reliable way, saving the precious time. Target population, the targeted populations included the Hospital managements and the patients who need the reports or the receipts from the hospitals after making payments. The techniques for data gathering were: Interview, observations and document analysis was done. The system analysis approach was the Structured Analysis method. The system design technique used in the design of this system is the prototyping design. The new system will be developed using PHP Programming Language as the front end and MySQL as the backend of the programme. The system after construction is able to adequately and accurately record all patient folder information, manage stock of folders procured by the hospital, retrieve patient folders easily using a robust search interface as well tallying attendance of patients. The system also enables to generate varied reports with few clicks of buttons. The system was carefully designed to ensure maximum efficiency and effectiveness of the system at the hospital. To come up with patient registration system that would make it easy for patients to be registered and followed up when they come to the hospital. Results of the hospital management system would have New patient registration, Consultation, Visits to different sections (dental, eye, x-ray and general) and Invoicing and receipting. the system that enables small to medium sized hospitals which take new patients registrations, Consultation, Visits to different sections (dental, eye, x-ray and general) and Invoicing and receipting. It could either be uploaded to the internet so that hospital employees for example doctors can access the system whenever they are off duty or used on the hospital desk computers while they are at the hospital compound. It keep tracks of patients bills, posting of receipts and reports can also be produce to make work of the accounts department easier.

Table of ContentsCHAPTER 11INTRODUCTION11.1 Back ground Information11.2 Statement of Problem11.3 Objectives31.3.1 Main objective31.3.2 Specific Objectives31.4 Research Questions31.5 Justification of the study31.6 Scope of the study41.7 Limitation of the study4CHAPTER 25LITERATURE REVIEW52.1 Introduction52.2 Theoretical review/Conceptual Framework52.3 Critique of the existing literature relevant to the study.62.4 Conclusion10CHAPTER 311RESEARCH METHODOLOGY113.1 Research design113.2 Population/Sampling113.3 Data collection procedure.113.4 Data Processing and analysis.123.4.1 Limitations of the Existing System123.4.2 User Requirements analysis123.4.3 Design of the Proposed System133.5 Pilot test-depends on the instrument being used.143.6 Instruments.143.6.1 User Interface:143.6.2 Hardware interface:143.6.3 Software interface;143.6.4 Schedule153.6.5 Budgeting15References15

CHAPTER 1INTRODUCTION1.1 Back ground InformationHospital Management System is a type of interactive system which store health information which cannot be ignored since health policies and planning in any country are mostly dependent on the correct and timely information on various health issues. Health facilities throughout the world keep consistent records of patients. These Hospital records are normally kept confidential and in confined places such as records unit. Hospital record is a chronologically written account of a patient's examination and treatment that includes the patient's medical history and complaints, the physician's physical findings, the results of diagnostic tests and procedures, and medications and therapeutic procedures. In effect, Hospital record of a patient is the clinical representation of the patient that is built over a period by various clinicians with the consent, trust, privacy and confidence of the patient. It enables continuity of care and again, overtime, it becomes a comprehensive, clinical database from which various and salient clinical information is gathered through research.Hospital records serve many functions but their primary purpose is to support patient care and in almost all public health facilities in Kenya, they are kept in folders. Structuring the record can bring direct benefits to patients by improving patient outcomes and doctors' performance. On the side of patients, the records function as medical identification. This system facilitates the hospital management to keep the details of any items and services and edit them as required. It also enables one to calculate all the daily financial transaction which includes costs rates and other accounting module. One can also keep details regarding the check in and checkout time of every patient visiting the hospital. This system also keeps record of bookings the hospital services by the patients so that the management can easily handle such task in less time. Hospital management system will be designed aims at keeping good interaction between hospital management and patients, through graphical presentation so that both parties will benefit. The software is developed for easy management of the various types of tasks like recording New patient registration, Consultation, Visits to different sections (dental, eye, x-ray and general), Invoicing and receipting amongst others to be managed on a day-to-day basis. The Pwani hospital management system we will be description of its objectives of program functions, flowchart, algorithm, budget and project schedule.1.2 Statement of ProblemThe current manual system used in the Pwani Hospital generates huge amount of paper work that is difficult to deal with, in terms of storage, retrieval, maintenance and sharing among the medical personnel. The documents are transferred manually to the filling department for compilation of the patients file. The personnel spend more time looking for information than they would spend on health care delivery. Duplication of records resulting from multiple registration and misplacement of some of them makes the situation worse hence does not favour the generation of reports in terms of timeliness and accuracy. The personnel hands over the patients file to the accountant on the next table where the patients pays for the medical service fee and medicines which have been subscribed by the doctor. The patients file is updated on daily basis of his expenditure costs. The accounts department generates the bills on daily basis and delivered to the patients. The patients pays at the accounts desk, where the receipts are generated. Disadvantages of manual system at Pwani hospitals: Lack of immediate retrievals. The information is very difficult to retrieve and to find particular information like to find out about the patients history, the user has to go through various registers. This results in inconvenience and wastage of time. Lack of immediate information storage: The information generated by various transactions takes time and efforts to be stored at right place. Lack of prompt updating: Various changes to information like patient details or immunization details of child are difficult to make as paper work is involved. Error prone manual calculation: Manual calculations are error prone and take a lot of time this may result in incorrect information. For example calculation of patients bill based on various treatments. Preparation of accurate and prompt reports: This becomes a difficult task as information is prepared manually. The solution therefore will be to develop a computerizing patient management system which will solve most of the challenges if not all that arises from the manual management of patient records in the hospital. An electronic 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. It is going to be used in Pwani hospital for maintaining patient details and improve efficiency. To enable automated data entry methods, ensure efficient and reliable communication within the hospital. Avoid data entry errors by use of input masks, enable easy authorized modification of data, enforce security measures to avoid unauthorized access to patients records. Enable fast and easy retrieval of patients records and data for fast reference activities.

1.3 Objectives1.3.1 Main objectiveThe main objectives of the project will be to develop a computerized hospital management system that will alleviate cases of missing patients folders, double registration resulting from the manual management of patient folder records and registration of new patients in the Pwani Hospital.1.3.2 Specific Objectives1. To design a computer-based hospital management system for patients.2. To provide a faster way of retrieving patient folders for continuity of care.3. To propose state-of-the-art method for storing large volumes of patient folder records with the most minimal constraint.4. To design a system with enhanced security measure to prevent unauthorized access to patient information.5. To develop a system that can generate the patient report when needed.1.4 Research Questions1. How can we ensure that basic information of all clients visiting the hospital are captured and available at all times when needed?2. How can we ensure fast and easy retrieval of patient folders for continuity of care?3. What measures can be put in place to ensure storage of large volumes of patient folder records with the most minimal constraint?4. What security measures can be put in place to prevent unauthorized access to patient information?5. How can we ensure that the patient report needed by the hospital is generated electronically and accurately?1.5 Justification of the studyA good and reliable hospital management system should be able to work with little or no error associated with it to meet the need of its users. However, the findings from this study will enable the management to compare and determine which of the systems between the existing and proposed by providing the following benefits:1. Planned approach towards working: The work flow in the hospital will be well organized and planned as data will be stored properly in data stores which will help in quick retrieval of information as well as storage.2. Immediate retrieval of information: The function of the system will be to provide a quick and efficient way of retrieving patient background and folder information at any time the information is needed.3. Stock management: The system will also ensure an efficient management of procured patient folders in the hospital and ensure there are no shortages at any point in time.4. Flexible and easy to operate: this system will be easy to operate with minimal training in computer applications. The system due to its flexibility could be expanded to cover on services areas of the hospital to improvement the overall management process.5. Convenient: The system will offer a much convenient way of tracking outpatient attendance instead of tallying and counting all tallies at the end of the come out with the outpatient attendance report of the hospital.1.6 Scope of the studyThe Management System will be limited to the core services provided at the finding and recommendation stage. These will include New patient registration, Consultation, Visits to different sections (dental, eye, x-ray and general), Invoicing and receipting amongst others.1.7 Limitation of the studyLimitations of the System Usability With regard to its use, the system will only cater for English speakers. The GUI and associated documentation is in English. This may present a problem for non- English speaking users Accessibility The system has only two user levels which only cater for the administrator and data entrant. Security The system also does not cater for the automatic back up of the data in the database. This may present a security problem in the event of data loss. Advantage of the new system The main advantage of the new system is that it will enable faster and more efficient storage, execute important reports to support daily medical tasks, retrieval and updating of Pwani hospital records.

CHAPTER 2LITERATURE REVIEW2.1 IntroductionHospital records form an essential part of a patients present and future health care. As a written collection of information about a patients health and treatment, they are used essentially for the present and continuing care of the patient. In addition, Hospital records are used in the management and planning of health care facilities and services, for medical research and the production of health care statistics. Hospital record is a chronologically written account of a patient's examination and treatment that includes the patient's medical history and complaints, the physician's physical findings, the results of diagnostic tests and procedures, and medications and therapeutic procedures. Doctors, nurses and other health care professionals write up Hospital records so that previous medical information is available when the patient returns to the health care facility. The Hospital record must therefore be available. This is the job of the Hospital record worker. If a Hospital record cannot be located, the patient may suffer because information, which could be vital for their continuing care, is not available. If the Hospital record cannot be produced when needed for patient care, the Hospital record system is not working properly and confidence in the overall work of the Hospital record service is affected. (Medical Records Manual:, 2006) 2.2 Theoretical review/Conceptual FrameworkThe Management of the hospital is concerned with the increasing effort in keeping the records of the patients and recording their activities. The hospital treats the out-patients hence it maintains full information of both indoor patients and outdoor patients for the purpose of future use. Doctors who serve to the hospital are the regular employees of the hospital, sometimes-external doctors are used to handle complicated cases. So the hospital needs to maintain its Doctors records separately along with the records of its patients. All these operations are getting cumbersome day by day because of the stiff rise in data which results in the development of a computerized hospital management system that will alleviate cases of missing patients folders, double registration resulting from the manual management of patient folder records and registration of new patients in the Kilifi District Hospital hence the follows were to be done to achieve it: Design a computer-based hospital management system for patients folder which allow for the registration of new patients by writing the Patients name, age and gender and other personal or background information, correct missing patients information hence whenever the Patient comes up his information is stored freshly and remove the chances of double entry or registration. To provide a faster way of retrieving patient folders for continuity of care whenever diagnosis information of patients which is generally recorded on the document contains patient information it can retreived faster with easywhenever its needed hence they can be used for future reference. To propose state-of-the-art method for storing large volumes of patient folder records with the most minimal constraint since Hospital record of a patient is the clinical representation of the patient that is built over a period by various clinicians with the consent, trust, privacy and confidence of the patient. To prevent unauthorized access to patient information by ensuring that there is password protection and simple procedures to allows the user to enter the system only through proper user name and password. Manage the hospital patient folder stock since the doctors doesnt have to remember various medicines available for diagnosis or better alternatives as they can see them at that time in the system to give prescriptions. Designed to generate the Patient report by recording price for each facility provided to Patient on a separate sheet and at last they all are summed up.2.3 Critique of the existing literature relevant to the study.Records Management is the practice of identifying, classifying, archiving, preserving, and sometimes destroying records according (Record Management, ISO 2001) and also defines records as Information created, received, and maintained as evidence and information by an organization or person, in pursuance of legal obligations or in the transaction of business. The International Committee on Archives (CIA) and Electronic Records defines a record as, a specific piece of recorded information generated, collected or received in the initiation, conduct or completion of an activity and which comprises sufficient content, context and structure to provide proof or evidence of that activity. While the definition of a record is often identified strongly with a document, a record can be either a tangible object or digital information which has value to an organization. For example, birth certificates, medical x-rays, office documents, patient folder, databases and application data, and e-mail are all examples of records.Information System as any organized combination of people, hardware, software, communication networks and data resources, that control, transform and disseminate information in an organization. Further reveals that the data resources of information systems are typically organized, stored and accessed by a variety of data resource management technologies into: Databases that hold processed and organized data and Knowledge bases that hold knowledge in a variety of forms such as facts, rules, and Case examples about successful business practices. According to (World Health Organization, 2004) the following terms are defined as:1. Health information System: A system that integrates data collection, processing, reporting and use of information necessary for improving health service effectiveness and efficiency through better management at all levels of health service.2. Health management information system: This is an Information system specially designed to assist in the management and planning of the health programs as opposed to delivery of care.Steps in developing a Health Management Information SystemWorld Health Organization regional office for western pacific, (World Health Organization, 2004) recommends the following steps while developing health management information system: Review the existing system Define the data needs for relevant units within the health system Determine the most appropriate and effective data flow Design the data collection and reporting tools Develop the procedures, mechanisms for data processing and implement a training program for data providers and data users Pre-test, and if necessary re-design the system for data collection, data flow, data processing, data utilization, monitor and evaluate the system Develop effective data dissemination and feedback mechanisms and evaluate the systemThe process of development of an information System can be seen as a list of tasks, starting with identification and launching of an information systems project and ending with maintenance of its optional components for a period before the system is phased out or replaced. However, they say that this varies from one organization descript ion to another. On their part they suggest the following steps to be typical for most organizations: Identification of a problem, pressure, or opportunity Determination of general requirements for change Feasibility study to explore possible approaches Systems analysis to model detailed requirements for technical components or organizational reform Systems design to work out how requirements are to be met Development or acquisition of software and hardware and their configuration Systems implementation with the organizational settings Operation and maintenance Phase out when the system is no longer needed or used. Push for Hospital record ComputerizationReports that advocates say that electronic Hospital records could save140 billion dollars a year in health care expenses on things like file clerks and space for file cabinets, while also saving tens of thousands of lives each year by reducing medical errors. When Hospital records management is computerized, there are no rooms full of shelves lined with manila folders stuffed with charts. Instead, patients insurance, medication, examination, and treatment records are maintained on eight Dell servers stacked in a large closet. The technology dramatically reduces the time between a patients initial consultation with a physician and his receiving treatment, allowing physicians to see from 30 to 35 patients a day. (Meghan, 2002). Quotes Dr. Doroshik as saying that doctors think outside the box, increasing the likelihood that a patient will get an accurate diagnosis sooner. Analysts say that the use of Electronic Hospital Records (EHR) significantly reduces redundant and improper treatments, and cuts back on potentially fatal medical errors resulting from incomplete or erroneous information in a patients medical file.All organizations operations are ever changing. Management and information systems that support them have to deal with that change and adapt to their operations, systems and organizations themselves in order to survive and prosper. (Lucey, 1991) Reveals the following as factors that lead to these changes: More competition: All types of organizations face greater competitive pressures for example hospitals competing for business Faster pace: The knowledge and development that people have rapidly become obsolete because of changing requirements. Existing work patterns and practices need to be updated more or less continuously to keep pace. Current information rapidly becomes out of date as technology seems to change month by month Increased globalization(Ndagire, 2003) Reveals the following as some of the problems of manual information systems: Paper based systems are generally very bulky both to handle and to store, and office space is expensive Information manual techniques of processing information are more tedious, laborious, slow and inefficient Labor productivity is low and the process is slower where large volumes of data need to be dealt with.In the 20th Century had a challenge of a deficit of patient information, but the 21st Century is faced with a surplus. Compounding matters is the fact that the human brain, even a physicians, cannot keep up with the exponential growth in medical knowledge that will occur in forthcoming years. The ability of most humans to memorize things has remained flat, but the medical knowledge that needs to be assimilated is increasing at a very high rate. Sub-optimal medical care often is provided to patients because of the failure to access all the data necessary to make the right decision. (Bush, 2004) Argues that many Americans die each year from medical errors. Many more die or have permanent disability because of inappropriate treatments, mistreatment, or missed treatments in ambulatory settings. All these problems of high costs, uncertain value, medical errors, variable quality, administrative inefficiencies, and poor coordination are closely connected to the failure to use health information technology as an integral part of medical care and further reveals that in the outdated, paper-based system, patients vital medical information is scattered across Hospital records kept by many different care givers in many different locations - and all of the patients medical information is often unavailable at the time of care. He believes that innovations in electronic health records and the secure exchange of medical information help transform health care in America by improving health care quality, preventing medical errors, reducing health care costs, improving administrative efficiencies, reducing paperwork, and increasing access to affordable health care.The Hospital record of a patient is the clinical representation of the patient that is built over a period of time by various clinicians with the consent, trust, privacy and confidence of the patient. It enables continuity of care and again, overtime, it becomes a comprehensive, clinical database from which various and salient clinical information is gathered through research. Moreover Hospital records serve many functions but their primary purpose is to support patient care and in almost all public health facilities in Kilifi, they are kept in folders. Structuring the record can bring direct benefits to patients by improving patient outcomes and doctors' performance. On the side of patients, the records function as medical identification (Mann R, 2003). Proper filing of patient's Hospital records ensures easy retrieval and contributes to decreased patient waiting time at the hospital and ensures continuity of care. It is therefore, imperative, that Hospital records are always kept in the interest of both the clinician and the patient. The medical folder must always be in the custody of the health facility whiles the patient enjoys the right of information. Studies in other developing countries have observed their record keeping systems to be inadequate with about half of the records retrievable within one hour (Aziz S, 2002).In Kilifi, the existing recordkeeping systems of some hospitals were found not designed to collect. This affects monitoring, supervision and decision-making on these diseases. Other authors have also noted staff training, monitoring and regular supervision are important to successful improvement in records keeping. Some studies found that problems of poor record keeping practices in health care facilities such as duplication, incomplete data, and inaccuracies in data made it difficult for health administrators and researchers to accurately and reliably identify and define health problems. Therefore the strengthening of the Hospital records in general and the health electronic record in particular, could contribute to its position as a valuable source of information for health care delivery, public health and policy making (Kamadjeu RM, 2005).Furthermore change in public administration culture and good governance among others are all essential for the devolution of Health Management Information System (HMIS) to health decision making. As attendance in the health facilities increases with time, the volume of Hospital records becomes a big challenge to health facility management. This is no different in Kilifi. Of late most of our public health facilities are confronted with filing of Hospital records especially with the introduction of the national health insurance scheme which brought in its wake the introduction of new folders and NHIS identification cards. Anecdotal evidence from most public health facilities indicates that facilities are saddled with old and new folders for out-patient and in-patient department as well as a sizeable number of the patients having more than two folders due mainly to misfiling or patient forgetting their ID cards when visiting the facility. (Qazi MS, 2008)2.4 ConclusionAlthough many scholars have written about computerization of health records as an urgent requirement and a lot of research has been carried out, implementation is still insufficient. However, according to the literature available, there are numerous benefits that accrue from EHR and computerized patient folder management systems when compared with manual systems. For example there will be no duplication of records, sharing of information is made possible, the problem of missing and / or misplaced records is reduced and the information is available at the point of care. In order to continually improve the quality of healthcare, the Kilifi Health Service has put in place a routine reporting system backed up with electronic online databases replacing all pre-existing totally paper-based reporting instructions in districts all over the country. (Kilifi Health service Annnual Report, 2000).

CHAPTER 3RESEARCH METHODOLOGY3.1 Research designMethodology Methodology is a term used to describe a process, technique or manner in which an action is performed. Under the development of a system, a methodology refers to the process will be taken to ensure that a system is effectively and efficiently developed . In designing Pwani management system , the following system development methodology will be used. System Development Lifecycle In developing Pwani Management System, the following steps will be taken; Example: The research design chosen for this study is the qualitative approach and this choice is largely influenced by the exploratory nature of the research question. A single case study approach is used for finding empirical results to the problems under study. In view of this, qualitative methods of data collection such as interviews, observations and available information would be used. The methodology dealt with the methods and procedures that were followed in order to achieve the objectives of the study. It talks about the information needed and the methods that were employed to gather them. It also identifies the population, the sampling techniques used in data collection and analysis.3.2 Population/SamplingPopulation that will be involved in carry out this project are the patients which are individual who comes to the hospital to seek medical services or care in the hospital, Records Officer who will be the staff of the Hospital who is in charge of recoding the details of patients, issuing, filing and retrieving of patient folders, Clinicians/doctors who are staff of the hospital who attends to patients and records their medical history on their folders and Health Information Officer who is the staff of the Hospital who is in charge of data management and record keeping.3.3 Data collection procedure.Requirement gathering is the most crucial aspect as many times communication gaps arise in this phase and this leads to validation errors and bugs in the software program. Therefore, the following techniques will be used in analysis to gather information. Semi-structured interviews are conducted with a fairly open framework which allow for focused, conversational, two-way communication. They will be used both to give and receive information. In the process of developing the system, the development team will interview the data entrants at Pwani hospital inorder to identify the processes, obtain specific quantitative and qualitative information from the interviewees , obtain general information relevant to data entry, and to Gain a range of insights on the process of the system. Direct Observation is a method in which a researcher observes and records activities or duties while something is happening. This will be used in correspondence to interviewing in order to gain a more live view of the Hospitals current management system . Direct observation will be used as a research methodology of choice in designing the management system for Pwani Hospital because; Observations give additional, more accurate information on behavior of people than interviews or questionnaires. Using available information This is a data collection method that involves the process of examining and evaluating already existent literature material to obtain facts and data regarding a specific subject. Locating these sources and retrieving the information will help in data collection. In the development of the Pwani management system, this research methodology will be mainly used in the analysis and design phases of the system development process. 3.4 Data Processing and analysis.This is a model-driven process-centered technique used to analyze an existing system or define business requirements for a new system or both. It focuses on flow of data through business and software processes. The emphasis of structured analysis is on the process building blocks in the information system framework.3.4.1 Limitations of the Existing System The current manual system used generates huge amount of paper work that is difficult to deal with, in terms of storage, retrieval, maintenance and sharing among the medical personnel. The personnel spend more time looking for information than they would spend on health care delivery. Duplication of records resulting from multiple registration and misplacement hence does not favour the generation of reports in terms of timeliness and accuracy. Information retrieval from these sources is not easy hence patients have to wait for a long time as health workers are looking for their folders3.4.2 User Requirements analysisI approached the stake holders who will use the system during the study and asked them their expectation of the proposed system and this were the findings that the system should be easier to learn and use, improves on the efficiency of information storage and retrieval or timely reports, fast in producing results which will be ready at the point of care therefore reducing on waiting time and increasing on time to attend to the patients, has an element of error validation, provides attractive interfaces with easy navigation throughout the system and a restricts access to information to only authorized personnel.Functional requirements capture the intended behavior of the system which may be expressed as services, tasks or functions the system is required to perform. Therefore the proposed system is able to capture the patient information and attendance, store it and make it available at the time of need or generate statement of out-patient reports in a user friendly manner, present the users with a real-time display of the number of records in a database or generate reports accurately and timely, Search and display patient information details for folder retrieval purposesNon-Functional requirements which specify criterion that can be used to judge the operation of a system, rather than specific behaviors. This is contrasted with functional requirements that specify specific behavior or functions. Systems must exhibit software quality attributes, such as accuracy, performance, cost, security and modifiability plus usability, i.e. easy to use for the intended users. It help to achieve the functional requirements of a system. Thus the proposed system has high performance and reliability level. The mean time between failures, mean time to repair, and accuracy are very high, user-friendly interfaces. This ensures the ease with which the system can be learned or used. The system can allow users to install and operate it with little or no training and prevents unauthorized access to the system with user authentication via log-on system.3.4.3 Design of the Proposed SystemSystem design includes the preparation of a computer-based specification that will fulfill the requirements specified during system analysis. System design focuses on the technical or implementation concerns of the system. The system design aids expectation to simplify the complex system making it to be manageable a system so that it can be tackled with ease. The main philosophy behind the development of this software which is a computerized Patient System is to create a particular platform that will be fully robust, provide patient information and will help to ease jobs of record officers at the hospital and which patients can rely on it to have an accurate and timely access to their folders for continue of care. It will also save the hospital some resources as duplicate issuing of folders will be a thing of the past. The data retrieval will be able to track outpatient attendance and generate accurate statement of outpatient reports without errors and can take on large amount of data without constraints. The system will provide security measures that will prevent unauthorized access to patient information and grant access to authorized managers.3.5 Pilot test-depends on the instrument being used.Testing is critical for a newly developed system as a prerequisite for it being put into an environment where the end users can use it. Exhaustive testing is conducted to ensure accuracy and reliability and to ensure that bugs are detected as early as possible. Unit test is where the system is tested partially and independently, component by component, to ensure that particular portion or module is workable within it. In the development of the of Pwani management system, each component will be tested independently before finally integrating each of them into one system. System Test, A system normally consists of all components that makeup the total system to function. It will be required to ensure the smooth running of the system as a whole, and it should perform as expected and as required technical and functional testing will be performed. The technical testing will involve the process of testing the systems compatibility with the hardware, operating system, data integrity in the database and user authorization access rights. User Acceptance Test users will be involved so as to analyze acceptability and usability and also to identify areas that may require modification before the system can fully be commissioned for use.3.6 Instruments.3.6.1 User Interface:The software provides good graphical interface for the user any administrator can operate on the system, performing the required task such as create, update, viewing the details of the book and allows user to view quick reports like Book Issues/Returned etc. Stock verification and search facility based on different criteria. 3.6.2 Hardware interface:Hard disk: 500 GB RAM: 4 GB Processor: Pentium(R) Dual-core CPU 3.6.3 Software interface;PHP language which is a Web-based application.The system shall use the MySQL Database, which is open source and free. Operating System for development environment shall be Windows 7.3.6.4 ScheduleProject scheduling is a particularly demanding task for software preparation. Scheduling involves separating the total work involved in a project into separate activities and judging the time required to complete these activities. If project is technically advanced, initial estimate will almost certainly be optimistic even when we try to consider all eventualities. Its important is to avoid a situation where the whole project is delayed because a critical task is unfinished. It acts the calendar which is prepared by Gantt chart. Scheduling is the time table and driver for project. Scheduling for our project is noted in following manner.Activities

DurationIntroductionLiterature reviewmethodologySubmission

January1st Jan, 2015 -31st Jan, 2015

February1stFeb, 2015 -28th Feb,2015

March1st Mar, 2015-30th Mar, 2015

April1stApr, 2015-31stApr, 2015

3.6.5 BudgetingIs a part of a system budgeting and accounting practices which helps the system analyst to determine the approximate cost and savings for an organization. Budget Item Amount in Ksh. EQUIPMENT QTYItemsPrice

1Laptop Computer35,000

2Pen and pencil20

1Ream of printing paper 450

12 GB flash Disk 1,000

Total36,470

ReferencesAziz S, R. M. (2002). Existing Record Keeping System in Government Teaching. Bush, J. (2004). Where does it Hurt. New york.Kamadjeu RM, T. E. (2005). Designing and Implementing An Electronic Health Record System In Primary Care Practice. Med.(2000). Kilifi Health service Annnual Report. Lucey. (1991). Management Information System. UK.Mann R, W. J. (2003). Standards in medical record keeping.Medical Records Manual:. (2006). Geneve: World Health Organisation, W.Meghan. (2002). Innovation and Technology. Chicago.Ndagire, R. (2003). Information system. Durban.Qazi MS, A. M. (2008). The Health Management Information System. Record Management. (ISO 2001).World Health Organization. (2004).