HOSPITAL MANAGEMENT SYSTEM REPORT IS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENT OF THE DIPLOMA IN ITESM UNDER THE SUPERVISION OF GUIDE & LECTURER MR.SHAHARYAR TAJ SUBMITTED BY AMAN KUMAR MISHRA (1736111005) AUG-NOV 2019 ADITYA INSTITUTE OF TECHNOLOGY (Unit of Dr. R.N. Gupta Technical Educational Society) AFFLIATED TO BOARD OF TECHNICAL EDUCATION PITAMPURA, DELHI - 110088 1 INDEX DECLERATON CERTIFICATE ACKNOLEDGEMENT INTRODUCTION DISCRIPTION SYSTEM ANALYSIS FEASIBILITY REPORT SYSTEM DESIGN SCREEN OUTPUT CODING CONCLUSION BIBLIOGRAPHY/REFERENC 2 DECLARATION This is to certify that this project report entitled “HOSPITAL MANAGEMENT SYSTEM” which is submitted by me in partial fulfillment of the requirement for the award of Diploma in ITESM to Aditya Institute of Technology, Delhi comprises only my original work and due acknowledgement has been made in text to all material used. Date: SUBMITTED TO: Mr. SHAHARYAR TAJ Lecturer (ITESM) 3 CERTIFICATE This is to certify that this project report entitled “PROJECT NAME” which is submitted by AMAN KUMAR MISHRA (1736111005.) in partial fulfillment of the requirement for the award of Diploma in ITESM to Aditya Institute of Technology; Delhi is a record of student’s own work carried out by him under my supervision. The matter embodied in this report is original and has not been submitted for the award of any other degree. Date: (Signature) SHAHARYAR TAJ Guide & Lecturer 4 ACKNOWLEDGEMENT I express my heartiest gratitude and respectful regards to Mr SHAHARYAR TAJ my project guide, for his valuable guidance, constructive criticism and consistent enthusiastic interest during the course of investigation and writing of manuscript that led this work to its successful completion. I regard my sincere thanks to the technical staff at the organization/ company that helped me during the project and made this project successful. I would also like to express my profound sense of gratitude to our internal guide Mr.SHAHARYAR TAJ, Lecturer of the Department of ITESM, Aditya Institute of Technology, for his support and encouragement while doing the project. Last but not the least our special thanks to our Parents and friends for their support and constant encouragement during the project work. I am highly indebted to the Department of ITESM, Aditya Institute of Technology for their support regarding our project report. 5 Introduction: The project Hospital Management system includes registration of patients, storing their details into the system, and also computerized billing in the pharmacy, and labs. The software has the facility to give a unique id for every patient and stores the details of every patient and the staff automatically. It includes a search facility to know the current status of each room. User can search availability of a doctor and the details of a patient using the id. The Hospital Management System can be entered using a username and password. It is accessible either by an administrator or receptionist. Only they can add data into the database. The data can be retrieved easily. The interface is very user-friendly. The data are well protected for personal use and makes the data processing very fast. Hospital Management System is powerful, flexible, and easy to use and is designed and developed to deliver real conceivable benefits to hospitals. Hospital Management System is designed for multispeciality hospitals, to cover a wide range of hospital administration and management processes. It is an integrated end-to-end Hospital Management System that provides relevant information across the hospital to support effective decision making for patient care, hospital administration and critical financial accounting, in a seamless flow. Hospital Management System is a software product suite designed to improve the quality and management of hospital management in the areas of clinical process analysis and activitybased costing. Hospital Management System enables you to develop your organization and improve its effectiveness and quality of work. Managing the key processes efficiently is critical to the success of the hospital helps you manage your processes 6 DESCRIPTION Problem Introduction: Lack of immediate retrievals: The information is very difficult to retrieve and to find particular information like- E.g. - To find out about the patient’s history, the user has to go through various registers. This results in in convenienceand 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 patient’s bill based on various treatments. Preparation of accurate and prompt reports: This becomes a difficult task as information is difficult to collect from various register. MODULES: The entire project mainly consists of 7 modules, which are Admin module User module (patient) Doctor module Nurse module Pharmacist module Laboratorist module Accountant module 7 1.3.1 Admin module: manage department of hospitals, user, doctor, nurse, pharmacist, laboratorist accounts. watch appointment of doctors watch transaction reports of patient payment Bed ,ward, cabin status watch blood bank report watch medicine status of hospital stock watch operation report watch birth report watch diagnosis report watch death report user module(patient): View appointment list and status with doctors View prescription details View medication from doctor View doctor list View blood bank status View operation history View admit history. like bed, ward icu etc Manage own profile Doctor module: Manage patient. account opening and updating Create, manage appointment with patient Create prescription for patient Provide medication for patients Issue for operation of patients and creates operation report Manage own profile Nurse module: Manage patient. account opening and updating Allot bed, ward, cabin for patients Provide medication according to patient prescription Manage blood bank and update status Keep record of patient operation, baby born and death of patient Manage own profile 8 Pharmacist module: Maintain medicine Keep records of hospitals stock medicines and status Manage medicine categories Watch prescription of patient Provide medication to prescriptions Laboratorist module: Watch prescription list Upload diagnostic report Preview of report files. like xray images, ct scan, mri reports Manage own profile Accountant module: Create invoice for payment Order invoice to patient Take cash payment Watch payment history of patients Manage own profile SPECIFICATION To be used efficiently, all computer software needs certain hardware components or the other software resources to be present on a computer. These pre-requisites are known as(computer) system requirements and are often used as a guideline as opposed to an absolute rule. Most software defines two sets of system requirements: minimum and recommended. With increasing demand for higher processing power and resources in newer versions of software, system requirements tend to increase over time. Industry analysts suggest that this trend plays a biggerpart in driving upgrades to existing computer systems than technological advancements. 9 HARDWARE REQUIREMENTS: The most common set of requirements defined by any operating system or software application is the physical computer resources, also known as hardware. A hardware requirements list is often accompanied by a hardware compatibility list (HCL), especially in case of operating systems. An HCL lists tested, compatibility and sometimes incompatible hardware devices for a particular operating system or application. The following sub-sections discuss the various aspects of hardware requirements. HARDWARE REQUIREMENTS FOR PRESENT PROJECT: PROCESSOR : Intel dual Core ,i3 RAM : 1 GB HARD DISK : 80 GB SOFTWARE REQUIREMENTS: Software Requirements deal with defining software resource requirements and pre-requisites that need to be installed on a computer to provide optimal functioning of an application. These requirements or pre-requisites are generally not included in the software installation package and need to be installed separately before the software is installed. SOFTWARE REQUIREMENTS FOR PRESENT PROJECT: OPERATING SYSTEM : Windows 7/ XP/8 FRONT END Html,css,java script. : SERVER SIDE SCRIPT : Php DATABASE Mysql : 10 Intangible handling: Bdtask HMS Software work as intangible handling for admins and owner. Because they can operate this medical software from anywhere and check anytime any data they wanted to see. Ensure the best Medicare: Medicare means proper medical care of a patient. In this HMS software user can provide the best service to the patient from admission to discharge without any kinds of difficulty. Dynamic management: Our Clinic Management software can accelerate all of your activities & reporting. It can manage all the important document in a certain place with a dynamic management system. Centralized controlling: Bdtask hospital management system operates all works under a chain of command. It starts from the admin and ends to the bottom. One operational place helps to maintain all very easily and smoothly. Accumulative services: Our HMS Software manages issues like medical, financial, administrative, and overall service and so on. Which covers the whole services a hospital offers generally. Maximization of profit: An organized management system software ascertain not only effective management but also minimize the operational cost and maximize profit. Grab the best HMS software to make the business profitable for the future. 11 Are you thinking! How Hospital Software add a extra value to your medical? Ok, Let's read the following information and our product features to take a wise decision about getting hospital automation system. What is hospital Management System? HMS software or Hospital management system is the digital outcome of traditional hospital or clinic management. Basically, the regular hospital activities like IPD, OPD, Billing, Test, Bed management, Account, HR management, etc what a hospital do manually now all of them are managed very efficiently by the medical software. It also brings reports as per your requirements. Like you can see daily, weekly, monthly, half-yearly and yearly reports of sales, revenue, patients, lab test, bed management, etc very easily. Just a few clicks, all you need to see the reports. Another thing is that an admin can observe everyone through the software. And internal messaging platform helps employees to communicate with each other as well. All in all clinic management software helps you to be with trends and it also gives you the chance to run your business administration digitally and very efficiently. How does a hospital management system take care of every operational aspect of a multi-sectoral hospital? Automation, Security and Storage: There have many reasons, why a hospital needs an entire hospital automation system.Because this kind of system mainly aims at taking care of functional aspects of entire hospital so that Medicare Center can concentrate on enhanced patient care. It conjointly aims at providing reliable automation of the prevailing systems. The system also provides glorious security at each level of user-system interaction and conjointly provides strong & reliable storage and backup facilities. 12 Helps To Do All Alternative Vital Tasks: To be the desirable and best hospital is not mean a large area you might have & a huge amount of profit you might gain. But the nice administration and management skills of all the staffers, nurses and doctors to realize results, Managing and maintaining up-to-date information on patient care, medications and alternative technological methodology of providing service etc. are the basic components of measurement for quality score to be the best. And if you have got an automatic system that may pay attention to relieve you to try and do alternative vital tasks. Remains Hospital Error Free: As a human being, Is it possible for medical officer & employee to be an erroneous staff? But every single mistake of misplacing of data creates a self-annihilation. Therefore, all medical professionals and hospital directors want to avoid errors. Having put in an automatic management software eliminates the possibility that is vulnerable to errors. It stores all the data regarding the hospital well guaranteeing that your hospital remains error free if you follow processes. Track Every Single Informations: Tracking every details is the foremost exciting but soothing step of a hospital management software. A Hospital Management system tracks the entire journey of each patient from appointment booking to medical emergencies. It virtually carries the burden of hospital employees to travel through multiple files to know patient’s records. It will reserve data including doctors, nurses and each hospital permanent and temporary workers those are working in your hospital according to locums you assigned on your hospital application and portal. Ensure The Best Patient Care: Rather than storing and showing knowledge, associate intelligent hospital management software can share insights to optimize utilization of hospital workers, occupancy rates, clinical activities and every aspects associated with hospitals. It'll solve errors by its own and inform users of their important tasks. The goal is to develop a sophisticated hospital working circle which will manage a patient’s journey to the hospital and worker records while not generating a long written account. When you have patient care as your 13 saying, you would like to own the most effective management system that may pay attention to your hospital and follow your hospital’s processes. Rescue From data Violation: Data violation is one of the most alarming and detrimental things for a business. Hospitals that record information manually usually misplace files and medical records of patients resulting unwanted confusions and heartburns. An HMS can manage all the access points via authentication for every user if he/she need to utilize the informations. It'll additionally verify that user is able to access information on their shift timings guaranteeing that out-of-turn information access is prohibited. So, Getting rescue from data violation this system will act as a gatekeeper. Implements Dotty Care And Bed Issues: Accurate information that's accessible at a time is essential to make sure that clinical selections are implementing dotty care and bed issues when elaborate data. It'll facilitate Pharmacists to produce medicines that are prescribed by the doctor, And Nurses to be conscious about the time that patient must have medications. Moreover, each Doctor at clinic and Patient receive notifications once a check-up is due. Ensure The Financial Growth: A hospital needs a endless stream of revenue and funding not to ensure solely sustainable growth however additionally improve their infrastructure and care processes. Developing an on-demand custom Hospital Management system not only save time and value but also generate reports to boost potency. The most important is that we get all necessary data are on the market with a mouse click. It'll facilitate scientific hospital management and respond to best financial growth. The software methodology Application System Development – A Life cycle Approach Although there are a growing number of applications (such as decision support systems) that should be developed using an experimental process strategy such as prototyping, a significant 14 amount of new development work continue to involve major operational applications of broad scope. The application systems are large highly structured. User task comprehension and developer task proficiency is usually high. These factors suggest a linear or iterative assurance strategy. The most common method for this stage class of problems is a system development life cycle modal in which each stage of development is well defined and has straightforward requirements for deliverables, feedback and sign off. The system development life cycle is described in detail since it continues to be an appropriate methodology for a significant part of new development work. The basic idea of the system development life cycle is that there is a well-defined process by which an application is conceived and developed and implemented. The life cycle gives structure to a creative process. In order to manage and control the development effort, it is necessary to know what should have been done, what has been done, and what has yet to be accomplished. The phrases in the system development life cycle provide a basis for management and control because they define segments of the flow of work, which can be identified for managerial purposes and specifies the documents or other deliverables to be produced in each phase. The phases in the life cycle for information system development are described differently by different writers, but the differences are primarily in the amount of necessity and manner of categorization. There is a general agreement on the flow of development steps and the necessity for control procedures at each stage. The information system development cycle for an application consists of three major stages. 1) Definition. 2) Development 3) Installation and operation The first stage of the process, which defines the information requirements for a feasible cost effective system. The requirements are then translated into a physical system of forms, procedures, programs etc., by the system design, computer programming and procedure development. The resulting system is test and put into operation. No system is perfect so there is always a need for maintenance changes. To complete the cycle, there should be a post audit of the system to evaluate how well it performs and how well it meets the cost and performance specifications. The stages of definition, development and installation and operation can therefore be divided into smaller steps or phrases as follows. 15 Definition Proposed definition : preparation of request for proposed applications. Feasibility assessment : evaluation of feasibility and cost benefit of proposed system. Information requirement analysis : determination of information needed. Design Conceptual design : User-oriented design of application development. Physical system design : Detailed design of flows and processes in applications processing system and preparation of program specification. Development Program development : coding and testing of computer programs. Procedure development : design of procedures and preparation of user instructions. 16 SYSTEM ANALYSIS EXISTING SYSTEM: Hospitals currently use a manual system for the management and maintainance of critical information. The current system requires numerous paper forms, with data stores spread through out the hospital management infrastructure. Often information is incomplete or does not follow management standards. Forms are often lost in transit between departments requiring a comprehensive auditing process to ensure that no vital information is lost. Multiple copies of the same information exist in the hospital and may lead to inconsistencies in data in various data stores. PROPOSED SYSTEM: The Hospital Management System is designed for any hospital to replace their existing manual paper based system. The new system is to control the information of patients. Room availability, staff and operating room schedules and patient invoices. These services are to be provided in an efficient, cost effective manner, with the goal of reducing the time and resources currently required for such tasks . FEASIBILITY STUDY The feasibility of the project is analysed in this phase and business proposal is put forth with a very general plan for the project and some cost estimates. During system analysis the feasibility study of the proposed system is to be carried out. This is to ensure that the proposed system is not a burden to the company. For feasibility analysis, some understanding of the major requirements for the system is essential. Three key considerations involved in the feasibility analysis are: Economic Feasibility This study is carried out to check the economic impact will have on the system will have on the organization. The amount of fund that the company can pour into the research and development of the system is limited. The expenditures must be justified. Thus the developed system as well within the budget and this was achieved because most of the technologies used are freely available. Only the customised products have to be purchased. 17 Technical Feasibility This study is carried out to check the technical feasibility, that is,the technical requirements of the system. Any system developed must not have a high demand on the available available technical resources. This will lead to high demands being placed on the client. The developed system must have a modest requirement, as only minimal or null changes for the implementing this system. Operational Feasibility The aspect of study is to check the level of acceptance of the system by the user. This includes the process of training the user to use the system efficiently. The user must not feel threatened by the system, instead must accept it as a necessity. The level of acceptance by the users solely depends on the methods that are employed to educate the user about the system and to make him familiar with it. His level of confidence must be raised so that he is also able to make some constructive criticism, which is welcomed, as he is the final user of the system. SOFTWARE SPECIFICATION HTML: HTML or Hypertext Markup Language is the standard markup language used to create web pages. HTML is written in the form of HTML elements consisting of tags enclosed in angle brackets (like <html>). HTML tags most commonly come in pairs like <h1> and </h1>, although some tags represent empty elements and so are unpaired, for example <img>. The first tag in a pair is the start tag, and the second tag is the end tag (they are also called opening tags and closing tags). Though not always necessary, it is best practice to append a slash to tags which are not paired with a closing tag. The purpose of a web browser is to read HTML documents and compose them into visible or audible web pages. The browser does not display the HTML tags, but uses the tags to interpret the content of the page. HTML describes the structure of a website semantically along with cues for presentation, making it a markup language rather than a programming language. HTML elements form the building blocks of all websites. HTML allows images and objects to be embedded and can be used to create interactive forms. It provides a means to create structured documents by denoting structural semantics for text such as headings, paragraphs, lists, links, quotes and other items. It can embed scripts written in languages such as JavaScript which affect the behavior of HTML web pages. 18 CASCADING STYLE SHEETS (CSS): It is a style sheet language used for describing the look and formatting of a document written in a markup language. While most often used to style web pages and interfaces written in HTML and XHTML, the language can be applied to any kind of XML document, including plain XML, SVG and XUL. CSS is a cornerstone specification of the web and almost all web pages use CSS style sheets to describe their presentation. CSS is designed primarily to enable the separation of document content from document presentation, including elements such as the layout, colors, and fonts.[1] This separation can improve content accessibility, provide more flexibility and control in the specification of presentation characteristics, enable multiple pages to share formatting, and reduce complexity and repetition in the structural content . CSS can also allow the same markup page to be presented in different styles for different rendering methods, such as on-screen, in print, by voice (when read out by a speech-based browser or screen reader) and on Braille-based, tactile devices. It can also be used to allow the web page to display differently depending on the screen size or device on which it is being viewed. While the author of a document typically links that document to a CSS file, readers can use a different style sheet, perhaps one on their own computer, to override the one the author has specified. However if the author or the reader did not link the document to a specific style sheet the default style of the browser will be applied. MySQL: MySQL is developed, distributed, and supported by Oracle Corporation. MySQL is a database system used on the web it runs on a server. MySQL is ideal for both small and large applications. It is very fast, reliable, and easy to use. It supports standard SQL. MySQL can be compiled on a number of platforms. The data in MySQL is stored in tables. A table is a collection of related data, and it consists of columns and rows. Databases are useful when storing information categorically. FEATURES OF MySQL: Internals and portability: Written in C and C++. Tested with a broad range of different compilers. Works on many different platforms. Tested with Purify (a commercial memory leakage detector) as well as with Val grind, a GPL tool. 19 Uses multi-layered server design with independent modules. Security: A privilege and password system that is very flexible and secure, and that enables hostbased verification. Password security by encryption of all password traffic when you connect to a server. Scalability and Limits: Support for large databases. We use MySQL Server with databases that contain 50 million records. We also know of users who use MySQL Server with 200,000 tables and about 5,000,000,000 rows. Support for up to 64 indexes per table (32 before MySQL 4.1.2). Each index may consist of 1 to 16 columns or parts of columns. The maximum index width is 767 bytes for InnoDB tables, or 1000 for MyISAM; before MySQL 4.1.2, the limit is 500 bytes. An index may use a prefix of a column for CHAR, VARCHAR, BLOB, or TEXT column types. CONNECTIVITY: Clients can connect to MySQL Server using several protocols: Clients can connect using TCP/IP sockets on any platform. On Windows systems in the NT family (NT, 2000, XP, 2003, or Vista), clients can connect using named pipes if the server is started with the --enable-namedpipe option. In MySQL 4.1 and higher, Windows servers also support shared- memory connections if started with the --shared-memory option. Clients can connect through shared memory by using the --protocol=memory option. On UNIX systems, clients can connect using Unix domain socket files. LOCALIZATION: The server can provide error messages to clients in many languages. All data is saved in the chosen character set. CLIENTS AND TOOLS: 20 MySQL includes several client and utility programs. These include both command-line programs such as mysqldump and mysqladmin, and graphical programs such as MySQL Workbench. MySQL Server has built-in support for SQL statements to check, optimize, and repair tables. These statements are available from the command line through the mysqlcheck client. MySQL also includes myisamchk, a very fast commandline utility for performing these operations on MyISAM tables. MySQL programs can be invoked with the --help or -? option to obtain online assistance. WHY TO USE MySQL: • • • • • • • • • Leading open source RDBMS Ease of use – No frills Fast Robust Security Multiple OS support Free Technical support Support large database– up to 50 million rows, file size limit up to 8 Million TB JAVASCRIPT: JavaScript is the scripting language of the Web. All modern HTML pages are using JavaScript. A scripting language is a lightweight programming language.JavaScript code can be inserted into any HTML page, and it can be executed by all types of web browsers. JavaScript is easy to learn. WHY TO USE JAVASCRIPT: JavaScript is one of the 3 languages all web developers must learn: 1. HTML to define the content of web pages 2. CSS to specify the layout of web pages 3. JavaScript to specify the behavior of web pages 21 Example x = document.getElementById("demo"); //Find the HTML element with id="demo" x.innerHTML = "Hello JavaScript"; //Change the content of the HTML element document.getElementById() is one of the most commonly used HTML DOM methods. OTHER USES OF JAVASCRIPT: Delete HTML elements Create new HTML elements Copy HTML elements In HTML, JavaScript is a sequence of statements that can be executed by the web browser. JAVASCRIPT STATEMENTS: JavaScript statements are "commands" to the browser. The purpose of the statements is to tell the browser what to do. This JavaScript statement tells the browser to write "Hello Dolly" inside an HTML element with id="demo": Semicolon; Semicolon separates JavaScript statements. Normally you add a semicolon at the end of each executable statement. Using semicolons also makes it possible to write many statements on one line. JAVASCRIPT CODE: JavaScript code (or just JavaScript) is a sequence of JavaScript statements. Each statement is executed by the browser in the sequence they are written. This example will manipulate two HTML elements: Example document.getElementById("demo").innerHTML="Hello Dolly"; document.getElementById("myDIV").innerHTML="How are you?"; JAVASCRIPT PROPERTIES: Properties are the values associated with a JavaScript object. A JavaScript object is a collection of unordered properties. Properties can usually be changed, added, and deleted, but some are read only. PHP: WHAT IS PHP? PHP is an acronym for "PHP Hypertext Preprocessor" 22 PHP is a widely-used, open source scripting language PHP scripts are executed on the server PHP costs nothing, it is free to download and use WHAT IS PHP FILE? PHP files can contain text, HTML, CSS, JavaScript, and PHP code PHP code are executed on the server, and the result is returned to the browser as plain HTML PHP files have extension ".php" WHAT CAN PHP DO? PHP can generate dynamic page content PHP can create, open, read, write, delete, and close files on the server PHP can collect form data PHP can send and receive cookies PHP can add, delete, modify data in your database PHP can restrict users to access some pages on your website PHP can encrypt data With PHP you are not limited to output HTML. You can output images, PDF files, and even Flash movies. You can also output any text, such as XHTML and XML. WHY PHP? PHP runs on various platforms (Windows, Linux, Unix, Mac OS X, etc.) PHP is compatible with almost all servers used today (Apache, IIS, etc.) PHP supports a wide range of databases PHP is free. Download it from the official PHP resource: www.php.net C-sharp (Hypertext pre-processor) Visual C#, pronounced C sharp, is a new object-oriented programming language that is an evolution of C and C++, providing a simple and type-safe language for developing applications. Objective:1) Define hospital 2) Recording information about the Patients that come. 3) Generating bills. 23 4) Recording information related to diagnosis given to Patients. 5) Keeping record of the Immunization provided to children/patients. 6) Keeping information about various diseases and medicines available to cure them. These are the various jobs that need to be done in a Hospital by the operational staff andDoctors. All these works are done on papers. Scope of the Project:1) Information about Patients is done by just writing the Patients name, age and gender. Whenever the Patient comes up his information is stored freshly. 2) Bills are generated by recording price for each facility provided to Patient on a separate sheet and at last they all are summed up. 3) 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. 4) Immunization records of children are maintained in pre-formatted sheets, which are kept in a file. 5) Information about various diseases is not kept as any document. Doctors themselves do this job by remembering various medicines. 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. Doctors have to remember various medicines available for diagnosis and sometimes miss better alternatives as they can’t remember them at that time PROJECT OVERVIEW : HOSPITAL MANAGEMENT SYSTEM PROJECT The Hospital Management System (HMS) is designed for Any Hospital to replace their existing manual, paper based system. The new system is to control the following information; patient information, room availability, staff and operating room schedules, and patient invoi ces. These services are to be provided in an efficient, cost effective manner, with the goal of reducing the time and resources currently required for such tasks. 24 A significant part of the operation of any hospital involves the acquisition, management and timely retrieval of great volumes of information. This information typically involves; patient personal information and medical history, staff information, room and ward scheduling, staff scheduling, operating theater scheduling and various facilities wait ing lists. All of this information must be managed in an efficient and cost wise fashion so that an institution's resources may be effectively utilized HMS will automate the management of the hospital making it more efficient and error free. It aims at sta ndardizing data, consolidating data ensuring data integrity and reducing inconsistencies. SYSTEM DESIGN: HOSPITAL MANAGEMENT SYSTEM PROJECT In this software we have developed some forms. The brief description about them is as follow:- Reception: The reception module handles various enquiries about the patient's admission and discharge details, bed census, and the patient's movements within the hospital. The system can also handle fixed -cost package deals for patients as well as Doctor Consultation and Scheduling, Doctor Consultancy Fees and Time Allocation. · Doctor visit schedule · Doctor Appointment Scheduling · Enquiry of Patient · Find History of Patient Enquired. Administration: This module handles all the master entry details for the hospital requirement such as consultation detail, doctor specialization, consultancy fee, and service charges. Employee 25 · Employee Detail Recording. · Doctor Type . · Doctor Master · Referral Doctor Pharmacy: This module deals with all medical items. This module helps in maintaining Item Master, Receipt of Drugs/consumables, issue, handling of material return, generating retail bills, stock maintenance. It also helps in fulfilling the requirements of both IPD and OPD Pharmacy. Laboratory: This module enables the maintenance of investigation requests by the patient and generation of test results for the various available services, such as clinical pathology, X-ray and ultrasound tests. Requests can be made from various points, including wards, billing, sample collection and the laboratory receiving point. The laboratory module is integrated with the in -patient/ outpatient registration, wards and billing modules. Registration: This module helps in registering information about patients and handling both IPD and OPD patient’s query. A unique ID is generated for each patient after registration. This helps in implementing customer relationship management and also maintains medical history of the patient. SOFTWARE REQUIREMENTS : HOSPITAL MANAGEMENT SYSTEM PROJECT 26 Web Technologies : ASP.NET 2.0 Language : C# Database : SQL SERVER 2005 Web Server : IIS Operating System : WINDOWS XP INTRODUCTION: HOSPITAL MANAGEMENT SYSTEM PROJECT Documenting the assembly, maintenance, use, and troubleshooting of a system as complex as a voting system is a difficult task. A single system might combine proprietary hardware, custom operating systems and software, commodity personal computers, and pen and paper. Describing these highly varied components is one function of voting system documentation .But it is not on ly voting system technology that is heterogeneous; so are voting systems users, and the environments in which the systems are used. Election officials, poll workers, and voters often need guidance from documents in order to administer or use a voting system. In addition, voting system certification —the process by which a system is approved for use in state— demands evidence that a voting system complies with one or more sets of standards or guidelines. Documentation provides the details that certification bodies need to evaluate the System. Taken as a whole, voting system documentation must explain the system in several ways to meet the needs of these multiple audiences. 27 As the modern organizations are automated and computers are working as per the instructions, it becomes essential for the coordination of human beings, commodity and computers in a modern organization. Many big cities where the life is busy ne eds the transaction of the goods within few minutes of time. So, this online information recorded by the distributor helps him to complete this task within the time. The administrators and all the others can communicate with the sys tem through this project, thus facilitating effective implementation and monitoring of various activities of the voting Software. 28 SYSTEM DESIGN: INTRODUCTION TO UML: UML Design The Unified Modeling Language (UML) is a standard language for specifying, visualizing, constructing, and documenting the software system and its components. It is a graphical language , which provides a vocabulary and set of semantics and rules. The UML focuses on the conceptual and physical representation of the system. It captures the decisions and understandings about systems that must be constructed. It is used to understand, design, configure, maintain, and control information about the systems. The UML is a language for: Visualizing Specifying Constructing Documenting Visualizing Through UML we see or visualize an existing system and ultimately we visualize how the system is going to be after implementation. Unless we think, we cannot implement. UML helps to visualize, how the components of the system communicate and interact with each other. Specifying Specifying means building, models that are precise, unambiguous and complete UML addresses the specification of all the important analysis design, implementation decisions that must be made in developing and deploying a software system. Constructing UML models can be directly connected to a variety of programming language through mapping a model from UML to a programming language like JAVA or C++ or VB. Forward Engineering and Reverse Engineering is possible through UML. Documenting The Deliverables of a project apart from coding are some Artifacts, which are critical in controlling, measuring and communicating about a system during its developing requirements, architecture, desire, source code, project plans, tests, prototypes releasers, etc... 29 UML Approach UML Diagram A diagram is the graphical presentation of a set of elements, most often rendered as a connected graph of vertices and arcs . you draw diagram to visualize a system from different perspective, so a diagram is a projection into a system. For all but most trivial systems, a diagram represents an elided view of the elements that make up a system. The same element may appear in all diagrams, only a few diagrams , or in no diagrams at all. In theory, a diagram may contain any combination of things and relationships. In practice, however, a small number of common combinations arise, which are consistent with the five most useful views that comprise the architecture of a software-intensive system. For this reason, the UML includes nine such diagrams: 1. Class diagram 2. Object diagram 3. Use case diagram 4. Sequence diagram 5. Collaboration diagram 6. State chart diagram 7. Activity diagram 8. Component diagram 9. Deployment diagram USE CASE DIAGRAM: A usecase diagram in the Unified Modeling Language(UML) is atype of behavioral diagram defined by and created from a use-case analysis.its purpose is to present a graphical overview of the functionality provided by a system in terms of actors, their goals(represented as use cases),and any dependencies between those use cases. Use case diagrams are formally included in two modeling languages defined by the OMG:theunfied modeling language(UML) and the systems modeling language(sysML) 30 Use case diagram of our project: Registration Reception Goto doctor Take recept doctor patient pharmacist laboratorist Discharge summary Class Diagram: A Class is a category or group of things that has similar attributes and common behavior. A Rectangle is the icon that represents the class it is divided into three areas. The upper most area contains the name, the middle; area contains the attributes and the lowest areas show the operations. Class diagrams provides the representation that developers work from. Class diagrams help on the analysis side, too. 31 Person +name_string +age_number +date of birth_number +* +address_string +phone num_number +gender_string Hospital +1 +name_string +address_string +phon_number +available time() +states() +date of join() +date of discharge() +1 +* Patient +gender_string +prescription_string -allergies_string Staff +joined: date +qulification_string +certification_string +languages_string +in_time() +out_time() +work dutes() +hoil days() Operations staff +names_string +deprt_string +join time() Doctor +name_string +addresss_string +phone_number +speciality_string +joined_date() +dute_time() Administrative staff Technical staff +name of emp_string #details_string -time period_number +name_string +location_string +open_list() +close_list() +join time() Laboratorist Nurse Receptionist Technician +name_string +address_string +phone_number +patient_details +problem_string +age_string +name_string +address_string +counter_number +name_string +test_details +time_number +join_date() +in_time() +ot_time() +opr_name() +total_opr() +room-num() +opr_time() surgen +opr_type +free_number +block_string +opr_time() +week period() 32 Sequence diagram: A Sequence Diagram is an interaction diagram that emphasis the time ordering of messages; a collaboration diagram is an interaction diagram that emphasizes the structural organization of the objects that send and receive messages. Sequence diagrams and collaboration diagrams are isomorphic, meaning that you can take one and transform it into the other. Doctor Registration Reception Patient Laboratory Pharmacy ischarge summary 1 : login() 2 : view appointment() 3 : registration() 4 : send request() 5 : done any surgeries() 6 : go to laboratory() 7 : take medicins() 8 : paitent ok() 9 : send discharge summmary() 10 : discharge paitent() Collaboration diagram: A Collaboration Diagram also called a communication diagram or interaction diagram, is an illustration of the relationships and interactions among software objects. The concept is more than a decade old although it has been refined as modeling paradigms have evolved. 33 1:Takes Appointment 10:Takes Appointment from doctor P1 : Patient R1 : Receptionist 4:confirms appointment 9:Ask for payment 7:Take medicins 3:Doctor available 5:Consult doctor 8:paitent ok 2:takes Appointment from doctor D1 : Doctor N1 : Nurse 6:Assist doctor Deployement diagram: A Deployment Diagram shows the configuration of run-time processing nodes and the components that live on them. Deployment diagrams address the static deployment view of architecture. They are related to component diagrams in that a node typically encloses one or more components. 34 desktop Client Printer Hospital Local Server Database Server Statechart Diagrams: The state diagram shows the states of an object and represents activities as arrows connecting the states. The Activity Diagram highlights the activities. Each activity is represented by a rounded rectangle-narrower and more oval-shaped than the state icon. An arrow represents the transition from the one activity to the next. The activity diagram has a starting point represented by filled-in circle, and an end point represented by bulls eye. 35 Enter Hospital Takes Appointment Undergo Diagnosis not cured Takes Treatment undergo labtests and buy medicines gets cured 36 SYSTEM TESTING: The purpose of testing is to discover errors. Testing is the process of trying to discover every conceivable fault or weakness in a work product. It provides a way to check the functionality of components, sub assemblies, assemblies and/or a finished product It is the process of exercising software with the intent of ensuring that the Software system meets its requirements and user expectations and does not fail in an unacceptable manner. There are various types of test. Each test type addresses a specific testing requirement. Testing: HOSPITAL MANAGEMENT SYSTEM PROJECT Testing is a process of executing a program with the indent of finding an error. Testing is a crucial element of software quality assurance and presents ultimate review of specification, design and coding. System Testing is an important phase. Testing represents an interesting anomaly for the software. Thus a series of testing are performed for the proposed system before the system is ready for user acceptance testing. A good test case is one that has a high probability of finding an as undiscovered error. A successful test is one that uncovers an as undiscovered error. Testing Objectives: 1. Testing is a process of executing a program with the intent of finding an error 2. A good test case is one that has a probability of finding an as yet undiscovered error 3. A successful test is one that uncovers an undiscovered error Testing Principles: Ø All tests should be traceable to end user requirements Ø Tests should be planned long before testing begins Ø Testing should begin on a small scale and progress towards testing in large Ø Exhaustive testing is not possible Ø To be most effective testing should be conducted by a independent third party The primary objective for test case design is to derive a set of tests that has the highest livelihood for uncovering defects in software. To accomplish this objective two different categories of test case design techniques are used. They are § White box testing. § Black box testing. White-box testing: White box testing focus on the program control structure. Test cases are derived to ensure that all statements in the program have been executed at least once during testing and that all logical conditions have been executed. Block-box testing: Black box testing is designed to validate functional requirements without regard to the internal workings of a program. Black box testing mainly focuses on the information domain 37 of the software, deriving test cases by partitioning input and output in a manner that provides through test coverage. Incorrect and missing functions, interface errors, errors in data structures, error in functional logic are the errors falling in this category. Testing strategies: A strategy for software testing must accommodate low-level tests that are necessary to verify that all small source code segment has been correctly implemented as well as high-level tests that validate major system functions against customer requirements. Testing fundamentals: Testing is a process of executing program with the intent of finding error. A good test case is one that has high probability of finding an undiscovered error. If testing is conducted successfully it uncovers the errors in the software. Testing cannot show the absence of defects, it can only show that software defects present. Testing Information flow: Information flow for testing flows the pattern. Two class of input provided to test the process. The software configuration includes a software requirements specification, a design specification and source code. Test configuration includes test plan and test cases and test tools. Tests are conducted and all the results are evaluated. That is test results are compared with expected results. When erroneous data are uncovered, an error is implied and debugging commences. Unit testing: Unit testing is essential for the verification of the code produced during the coding phase and hence the goal is to test the internal logic of the modules. Using the detailed design description as a guide, important paths are tested to uncover errors with in the boundary of the modules. These tests were carried out during the programming stage itself. All units of Vienna SQL were successfully tested. Integration testing: Integration testing focuses on unit tested modules and build the program structure that is dictated by the design phase. System testing: System testing tests the integration of each module in the system. It also tests to find discrepancies between the system and it’s original objective, current specification and system documentation. The primary concern is the compatibility of individual modules. Entire system is working properly or not will be tested here, and specified path ODBC connection will correct or not, and giving output or not are tested here these verifications and validations are done by giving input values to the system and by comparing with expected output. Topdown testing implementing here. ACCEPTANCE TESTING: This testing is done to verify the readiness of the system for the implementation. Acceptance testing begins when the system is complete. Its purpose is to provide the end user with the confidence that the system is ready for use. It involves planning and execution of functional tests, performance tests and stress tests in order to demonstrate that the implemented system satisfies its requirements. Tools to special importance during acceptance testing include: Test coverage Analyzer – records the control paths followed for each test case. Timing Analyzer – also called a profiler, reports the time spent in various regions of the code are areas to concentrate on to improve system performance. 38 Coding standards – static analyzers and standard checkers are used to inspect code for deviations from standards and guidelines. Test Cases: Test cases are derived to ensure that all statements in the program have been executed at least once during testing and that all logical conditions have been executed. Using White-Box testing methods, the software engineer can drive test cases that · Guarantee that logical decisions on their true and false sides. · Exercise all logical decisions on their true and false sides. · Execute all loops at their boundaries and with in their operational bounds. · Exercise internal data structure to assure their validity. The test case specification for system testing has to be submitted for review before system testing commences. The package was designed in such a way that future modifications can be done easily. The following conclusion can be deduced from the development of the project. Ø Automation of the entire system improves the efficiency Ø It provides a friendly graphical user interface which proves to be better when compared to the existing system. Ø It gives appropriate access to the authorized users depending on their permissions. Ø It effectively overcomes the delay in communications. Ø Updating of information becomes so easier. Ø System security, data security and reliability are the striking features. Ø The System has adequate scope for modification in future if it is necessary. TYPES OF TESTING: Unit testing: Unit testing involves the design of test cases that validate that the internal program logic is functioning properly, and that program inputs produce valid outputs. All decision branches and internal code flow should be validated. It is the testing of individual software units of the application .it is done after the completion of an individual unit before integration. This is a structural testing, that relies on knowledge of its construction and is invasive. Unit tests perform basic tests at component level and test a specific business process, application, and/or system configuration. Unit tests ensure that each unique path of a business process performs accurately to the documented specifications and contains clearly defined inputs and expected results. 39 Integration testing: Integration tests are designed to test integrated software components to determine if they actually run as one program. Testing is event driven and is more concerned with the basic outcome of screens or fields. Integration tests demonstrate that although the components were individually satisfaction, as shown by successfully unit testing, the combination of components is correct and consistent. Integration testing is specifically aimed at exposing the problems that arise from the combination of components. Functional test: Functional tests provide systematic demonstrations that functions tested are available as specified by the business and technical requirements, system documentation, and user manuals. Functional testing is centered on the following items: Valid Input : identified classes of valid input must be accepted. Invalid Input : identified classes of invalid input must be rejected. Functions : identified functions must be exercised. Output : identified classes of application outputs must be exercised. Systems/Procedures: interfacing systems or procedures must be invoked. Organization and preparation of functional tests is focused on requirements, key functions, or special test cases. In addition, systematic coverage pertaining to identify Business process flows; data fields, predefined processes, and successive processes must be considered for testing. Before functional testing is complete, additional tests are identified and the effective value of current tests is determined. 40 System Test: System testing ensures that the entire integrated software system meets requirements. It tests a configuration to ensure known and predictable results. An example of system testing is the configuration oriented system integration test. System testing is based on process descriptions and flows, emphasizing pre-driven process links and integration points. White Box Testing: White Box Testing is a testing in which in which the software tester has knowledge of the inner workings, structure and language of the software, or at least its purpose. It is purpose. It is used to test areas that cannot be reached from a black box level . Black Box Testing: Black Box Testing is testing the software without any knowledge of the inner workings, structure or language of the module being tested. Black box tests, as most other kinds of tests, must be written from a definitive source document, such as specification or requirements document, such as specification or requirements document. It is a testing in which the software under test is treated, as a black box .you cannot “see” into it. The test provides inputs and responds to outputs without considering how the software works. Unit Testing: Unit testing is usually conducted as part of a combined code and unit test phase of the software lifecycle, although it is not uncommon for coding and unit testing to be conducted as two distinct phases. Test strategy and approach Field testing will be performed manually and functional tests will be written in detail. 41 Test objectives All field entries must work properly. Pages must be activated from the identified link. The entry screen, messages and responses must not be delayed. Features to be tested Verify that the entries are of the correct format No duplicate entries should be allowed All links should take the user to the correct page. Integration Testing: Software integration testing is the incremental integration testing of two or more integrated software components on a single platform to produce failures caused by interface defects. The task of the integration test is to check that components or software applications, e.g. components in a software system or – one step up – software applications at the company level – interact without error. Test Results: All the test cases mentioned above passed successfully. No defects encountered. Acceptance Testing: User Acceptance Testing is a critical phase of any project and requires significant participation by the end user. It also ensures that the system meets the functional requirements. Test Results: All the test cases mentioned above passed successfully. No defects encountered. 42 E-R Diagram :Entity relationship diagram is used in modern database software engineering to illustrate logical structure of database. It is a relational schema database modeling method used to model a system and approach. This approach commonly used in database design. The diagram created using this method is called E-R diagram. 22 Hospital Management System The E-R diagram depicts the various relationships among entities considering each object as entity. Entity is represented as diamond shape and relationship is represented as rectangle. It depicts the relationship between data objects. The E-R diagram is the relation that is used to conduct the data modeling activity. Entity:- Entity is the thing which we want to store information. It is an elementary basic building block of storing information about business process. An entity represents an objects defined within the information system about which you want to store information. Relationship:- A relationship is named connection or association between entities used to relate two or more entities with some common attributes of meaningful interaction between the object. Attributes:- Attributes are the properties of the entities and relationship. Descriptor of the entity. Attributes are elementary pieces of information attached to an entity. 43 E-R Diagrams: HOSPITAL MANAGEMENT SYSTEM PROJECT The Entity-Relationship (ER) model was originally proposed by Peter in 1976 [Chen76] as a way to unify the network and relational database views. Simply stated the ER model is a conceptual data model that views the real world as entities and relationships. A basic component of the model is the EntityRelationship diagram which is used to visually represents data objects. Since Chen wrote his paper the model has been extended and today it is commonly used for database design For the database designer, th e utility of the ER model is: it maps well to the relational model. The constructs used in the ER model can easily be transformed into relational tables. it is simple and easy to understand with a minimum of training. Therefore, the model can be used by the database designer to communicate the design to the end user. In addition, the model can be used as a design plan by the database developer to implement a data model in a specific database management software. CONNECTIVITY AND CARDINALITY The basic types of connectivity for relations are: one -to-one, oneto-many, and many-to-many. A one-to-one (1:1) relationship is when at most one instance of a entity A is associated with one instance of entity B. For example, "employees in the company are each assigned their own office. For each employee there exists a unique office and for each office there exists a unique employee. A one-to-many (1:N) relationships is when for one instance of entity A, there are zero, one, or many instances of entity B, but for one instance of entity B, there is only one instance of entity A. An example of a 1:N relationships is a department has many employees each employee is assigned to one department A many-to-many (M:N) relationship, sometimes called non -specific, is when for one instance of entity A, there are zero, one, or many instances of entity B and for one instance of entity B there are zero, one, or many instances of entity A. The connectivity of a relationship describes the mapping of associated 44 ER NOTATION There is no standard for representing data objects in ER diagrams. Each modeling methodology uses its own notation. The original notation used by Chen is widely used in academics texts and journals but rarely seen in either CASE tools or publications by non-academics. Today, there are a number of notations used, among the more common are Bachman, crow's foot, and IDEFIX. All notational styles represent entities as rectangular boxes and relationships as lines connecting boxes. Each style u ses a special set of symbols to represent the cardinality of a connection. The notation used in this document is from Martin. The symbols used for the basic ER constructs are: entities are represented by labeled rectangles. The label is the name of the ent ity. Entity names should be singular nouns. relationships are represented by a solid line connecting two entities. The name of the relationship is written above the line. Relationship names should be verbs attributes, when included, are listed inside the e ntity rectangle. Attributes which are identifiers are underlined. Attribute names should be singular nouns. cardinality of many is represented by a line ending in a crow's foot. If the crow's foot is omitted, the cardinality is one. existence is represented by placing a circle or a perpendicular bar on the line. Mandatory existence is shown by the bar (looks like a 1) next to the entity for an instance is required. Optional existence is shown by placing a circle next to the entity that is optional Hospital information system Read in another language A hospital information system (HIS) is an element of health informatics that focuses mainly on the administrational needs of hospitals. In many implementations, an HIS is a comprehensive, integrated information system designed to manage all the aspects of a hospital's operation, such as medical, administrative, financial, and legal issues and the corresponding processing of services. Hospital 45 information system is also known as hospital management software (HMS) or hospital management system. Hospital information systems provide a common source of information about a patient's health history. The system has to keep data in a secure place and controls who can reach the data in certain circumstances. These systems enhance the ability of health care professionals to coordinate care by providing a patient's health information and visit history at the place and time that it is needed. Patient's laboratory test information also includes visual results such as X-ray, which may be reachable by professionals. HIS provide internal and external communication among health care providers. Portable devices such as smartphones and tablet computers may be used at the bedside. Hospital information systems are often composed of one or several software components with specialty-specific extensions, as well as of a large variety of sub-systems in medical specialties from a multi-vendor market. Specialized implementations name for example laboratory information system (LIS), Policy and Procedure Management System,[1] radiology information system (RIS) or picture archiving and communication system (PACS). Potential benefits of hospital information systems include: 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. Enhances information integrity, reduces transcription errors, and reduces duplication of information entries.[2] Hospital software is easy to use and eliminates error caused by handwriting. New technology computer systems give perfect performance to pull up information from server or cloud servers. OpenText Blogs The History of Heath Information Management – From Then to Now OpenText OpenText 2 years ago 46 Comprehensive, accurate medical records are important for a variety of reasons. Today, longitudinal patient records that capture a patient’s medical information from a variety of physicians, labs, clinics, hospitals and treatment sites not only provides a holistic view of the patient’s health history, but also provides a wealth of information that can be used to improve care and outcomes. Health information management is defined as the collection and analysis of healthcare data to provide information for health care decisions involving patient care, institutional management, health care policies, planning and research. The name of the function changed from medical records management to health information management as enhancements in technology expanded responsibilities from managing paper records to managing the full scope of the process of collecting and sharing electronically-captured information among disparate entities. The history of health information management begins with the simplest form of recording a patient’s symptoms, complaints and treatment for the use of one provider, to a comprehensive aggregation, integration and harmonization of data to support collaboration among providers, researchers and administrators. The First Medical Records The earliest forms of medical records were narratives written by ancient Greeks to document successful cures, share observations about symptoms and outcomes, and teach others who provided medical advice through these case studies. While written reports describing patients’ complaints and diagnoses predate the records of Simon Forman and Richard Napier – astrologers who documented clients’ medical questions and treatment – their records from 1596 to 1634 form the earliest complete collection of medical records in existence. The 1920s As healthcare advanced, physicians realized that the best way to continue improving diagnosing and treating illnesses was to carefully document observations and actions while treating patients – and share this information as a way to teach other health professionals. 47 As early as 1600, physicians offered advice on how to present information in a medical record, but it wasn’t until 1928 that the American College of Surgeons (ACOS) took steps to standardize the growing number of medical records by establishing the American Association of Record Librarians (AARL) – known today as the American Health Information Management Association (AHIMA). “Record librarians” was the term used because early medical records were documented on paper. Standardization of medical records and growth of complete record-keeping continued from the 1920s through the 1960s, but records were paper-based. The 1960s The development of computers presented the opportunity to maintain records electronically, but the expense of purchasing and maintaining a mainframe, and the expense associated with storage of data, meant that only the largest organizations could use technology to handle medical records. The field of health informatics, as it is known today, emerged when computer technology became sophisticated enough to manage large amounts of data. One of the earliest efforts took place under the jurisdiction of the American Society for Testing and Materials (ASTM). These first standards addressed laboratory message exchange, properties for electronic health record systems, data content, and health information system security. The 1960s also saw the introduction of Medicare and Medicaid, which required nurses to collect data to document care for reimbursement. While computers were increasingly used for accounting and billing functions, the use of computers to collect and manage medical records was not common. In 1964, El Camino Hospital in Mountain View, CA worked with Lockheed Corporation to develop a hospital information system that included medical records, but generally computer manufacturers did not understand the healthcare industry’s needs. Organizations that did opt for a computer system that handled medical records offered limited access to records –access only available at the site it was created. Records often only contained information about the hospital stay and tests or treatments provided within the walls of the hospital. Even though implementation of technology was slow, the need to standardize was recognized by several organizations, with SNOP by the American College of Pathology developing what would eventually become Systematized Nomenclature of Medicine (SNOMED) to systematize the language of pathology. Also, the concept of a Uniform Minimum Health Data Set (UMHDS) was formulated in an effort to develop national health data standards and guidelines. 48 The 1970s As computers became smaller, software designed to support clinical functions for pharmacy, clinical laboratory, patient registration and billing began to proliferate. The disadvantage of these health information systems was their department-specific functions – they were not accessible by other departments. The first attempt at a total, integrated health records system was implemented in a gynecology unit at the University Medical Center in Burlington, Vermont in 1971. Based on the problem-oriented medical record, the system was patient oriented – all disciplines included in care made notes in the record to provide an overview of care to see the relationship between conditions, treatments, costs and outcomes. Acceptance of the Problem Oriented Medical Information System was not widespread due to resistance to share information across disciplines. Although the idea for collaborative care was presented in the 1970s, the acceptance of collaboration and enhanced communication supported by a holistic health record system did not take place until the 1990s — with the advent of managed care. The 1980s The introduction of diagnosis related groups (DRGs) and data required for reimbursement increased the need for hospitals to pull detailed information from clinical systems as well as financial systems to ensure claims payment. Because personal computers and widespread health-related software applications had grown in popularity, hospital information technology (IT) staff were tasked with the responsibility to integrate multiple, disparate systems. As network solutions were developed, IT departments were able to connect financial and clinical systems – for limited functions. But as technology advanced, in most cases, hospital departments still could not access information outside their own silos – preventing data-sharing from disparate system. The 1990s The introduction of the master patient index (MPI), a database of patient information used across all the departments of a healthcare organization in the 1980s laid the groundwork for initiatives such as The Indiana Network for Patient Care (INPC), the foundation for today’s Indiana Health Information Exchange. In 2017, the health information exchange (HIE) leverages an internally developed MPI that includes 100 hospitals, representing 38 health systems; 12,000 practices with over 20,000 providers; 1,100 Veterans Administration sites and 12 million patients. 49 As competition in healthcare created consolidation of individual hospitals to form health systems, the need for integration grew. Technology advances gave hospitals access to computing systems that could share information across disparate systems to set the stage for data-sharing. In recognition of the expanded scope of its members’ role in health informatics and data management, the organization that began in 1928 as AARL underwent its fourth name change – to AHIMA. Health information professionals’ responsibility now expanded beyond the data included in a single hospital medical record to health information comprising the entire continuum of care. The 2000s As hospitals continued to merge into larger health systems and to acquire individual physician practices, the increased need for interoperability that supported data-sharing grew. The importance of integrated electronic health records (EHRs) to enable providers to make better decisions grew, and more hospitals and physicians implemented them to reduce the incidence of medical error by improving the accuracy and clarity of medical records. In his 2004 State of the Union Address, President George W. Bush called for computerized health records – the beginning of the electronic health record (EHR) revolution. Adoption of fully-functional EHRs grew more significantly with the passage of the American Recovery and Reinvestment Act (ARRA) in 2009. One of the measures included in ARRA was the Health Information Technology for Economic and Clinical Health (HITECH) Act. The HITECH Act promoted the concept of meaningful use of EHRs and supported financial incentives to encourage the adoption of EHRs and the interoperability necessary to share data among providers. As of 2015 96 percent of hospitals and 87 percent of office-based physician practices were using electronic health records (EHRs). Also, the introduction of cloud computing for a wide range of industry, including healthcare, supported expanded networks that went beyond specific sites and locations to tie all entities in a health system or HIE together without a significant investment in new technology. 50 The increased volume of data, ease of access to data and the need for health information professionals to guide the management of health data has led to an increasing reliance on health informatics, which is defined by the American Medical Informatics Association (AMIA) as a field of information science concerned with the management of all aspects of health data and information through the application of computers and computer technology. In the 2010s Increased focus on value-based care as opposed to fee-based care and a drive to improve patient outcomes propel the growing accumulation of data to support clinical as well as operational decisions in health care. Just as clinicians in the 1920s understood the importance of previous health records as learning tools that would improve outcomes, healthcare professionals leverage data to enhance care on a larger scale — using tools that analyze population health data. New delivery models, such as accountable care organizations (ACOs), are implemented to contain costs, promote collaboration and improve patient health care. While ACOs, HIEs and growing health system networks have EHR and other systems to collect data, there is still a gap in aggregating and harmonizing the information from various systems to produce data that can be easily analyzed. The Future While there is no crystal ball to predict the future, it is safe to say that as health systems grow and expand to include other hospitals, physician practices and outpatient clinics, and as the volume of data grows with expansion, the need to integrate and harmonize data to make it available to all users is critical. Finding the right platform to support and enable access to structured and unstructured data across disparate systems is the first step to better preparing for a value-based future. Interoperability, data-sharing and access to information will continue to be a critical requirement for process improvement, ACO enablement, information exchange and development of populationspecific care that improve outcomes. Health information management is a critical role in healthcare today. To see how effective management of patient data – clinical and financial – can help healthcare organizations improve patient care and safety as well as operational processes, see these articles: Clinical Data Management – Best Practices for the Pros and 4 Ways Health Informatics is Transforming Healthcare. 51 The concept of hospital administration seems obvious and necessary in modern medical practice. This wasn’t always the case. Although early institutions aiming to provide cures for health maladies have been around since the time of the ancient Greeks, hospitals as we know them have only been in existence for about a century and a half. Modest Beginnings In the fall of 1899, eight hospital superintendents met in Cleveland to formulate a plan to establish guidelines for medical practices. This meeting resulted in the formation of The Association of Hospital Superintendents, whose goal was to increase the dialogue among hospital administrators. For the first eight years, the association was relatively exclusive. The private club created by the original eight members did not allow assistant superintendents or anyone else involved with hospital management to join. In 1906, membership rules were loosened to allow executive officers and others who ranked below the superintendent to join, but without vote-casting privileges. Also at this time, the name was officially changed to The American Hospital Association. history Dynamic Vision Even over 100 years ago, healthcare administrators were trying to lower costs, as evidenced by the new language of the 1907 AHA’s goal, which was “The promotion of economy and efficiency in hospital management.” History shows us that although health care costs may not be inherently high, the struggle to keep them affordable has been steady going for over a century. Through the years, the language of the American Hospital Association’s mission statement has changed, often in accordance with new social and political attitudes of the populace. In 1917, the stated goal was changed as a precursor to the allowance of institutions into the AHA. Although “institutional care” and “hospital management” were included, the fact that the word “efficiency” was used twice adds to the evidence that hospitals have been battling costs since the beginning. 52 In 1937, perhaps owing to new vaccines for yellow fever and typhus, the language of the AHA mission was changed to emphasize education and scientific research. A number of initiatives throughout the 1940s aimed at providing better patient care raised the profile of the AHA. With a growing influence on national health policy, the AHA changed its mission once again in 1951. The new statement promised to “promote the public welfare through the development of better hospital care for all the people.” Meeting Challenges Throughout the latter half of the twentieth century until the present day, healthcare administrators have had to meet myriad challenges relating to patient care, rising costs, advances in technology and politics. With the advent of Medicare and Medicaid, hospital administrators were tasked with finding ways to integrate new payers into already complex and diverse cost management systems. In broader terms, they were attempting to increase the number of Americans who had health insurance. When Medicare came on the scene, fewer than half of elderly Americans had health insurance. In 1978, the AHA formed a political action committee after increasing involvement in national health policy caused a need for discussions with politicians in Washington D.C. Also around this time, Gail L. Warden, executive vice president of the AHA, outlined the shifting cultural change in medical care that allowed hospitals to become centers for community health and “major social institutions, adding value to their communities.” Healthcare management through the American Hospital Association became a necessary part of healthcare when hospitals began proliferating throughout the US and doctors realized a need for consistency and communication as part of giving Americans better medical care. In 2016, it remains a fast-growing field that shows no signs of deceleration. 53 IMPLEMENTATION: 5.1 Inroduction: Implementation is the stage of the project when the theoretical design is turned out into a working system. Thus it can be considered to be the most critical stage in achieving a successful new system and in giving the user, confidence that the new system will work and be effective. The implementation stage involves careful planning, investigation of the existing system and it’s constraints on implementation, designing of methods to achieve changeover and evaluation of changeover methods. 5.2 Sample code: Home.html: <!DOCTYPE html> <html> <body> <table width="1350" height="640" border="1" > <tr> <td colspan="2" style="background-color:#FFF5EE;"> <h1>HOSPITAL MANAGEMENT SYSTEM</h1> <h3 align="center">ADMIN PANEL</h3> </td> </tr> <tr> <td style="background-color:#00FFFF;width:50px;height:400px;"> <table align="center"> <tr><td><form action="doctor.php" align="center"> <input type="submit" align="center" value=" doctor </form></td> 54 "> </tr> <tr> <td><form action="nurse.php" align="center"> <input type="submit" align="center" value=" nurse "> </form></td> </tr> <tr> <td><form action="patient.php" align="center"> <input type="submit" align="center" value=" patient "> </form></td> </tr> <tr> <td><form action="pharmacist.php" align="center"> <input type="submit" align="center" value=" pharamacist "> </form></td> </tr> <tr> <td><form action="laboratorist.php" align="center"> <input type="submit" align="center" value=" laboratorist "> </form></td><tr> <td><form action="accountant.php" align="center"> <input type="submit" align="center" value=" accountant "> </form></td> 55 </tr> </table> </td> <td style="background-color:#eeeeee;height:200px;width:400px;height:400px;"><h3 align="center">Advanced, powerfull, flexible complete management software for hospital, clinic and medical institutes. Integrates and facilitates all user area of a hospital: </h3><h4>align="center">Administrator</h4> <h4 align="center">Doctor</h4> <h4 align="center">Patient</h4> <h4 align="center">Nurse</h4> <h4 align="center">Pharmacist</h4> <h4 align="center">Laboratorist</h4> <h4 align="center">Accountant</h4> </td> </tr> <tr> <td colspan="2" style="background-color:#9ACD32;text-align:center;"> <table align="right"> <th> <tr> <form action="appointment.php" align="center"> <input type="submit" align="center" value=" appointment </form> </tr> <tr> <form action="payment.php" align="center"> <input type="submit" align="center" value=" payment "> </form> </tr> 56 "> <tr> <form action="bloodbank.php" align="center"> <input type="submit" align="center" value=" bloodbank "> </form> </tr> <tr> <form action="medicine.php" align="center"> <input type="submit" align="center" value=" medicine "> </form> </tr> <tr> <form action="operations.php" align="center"> <input type="submit" align="center" value=" operations "> </form> </tr> <tr> <form action="birthreport.php" align="center"> <input type="submit" align="center" value=" birthreport "> </form> </tr> <tr> <form action="deathreport.php" align="center"> <input type="submit" align="center" value=" deathreport "> </form> </tr> <tr> <form action="bedallotment.php" align="center"> 57 <input type="submit" align="center" value=" bedallotment "> </form> </tr> </th> </table> </td> </tr></table></body></html> Doctor.PHP <!DOCTYPE html> <html> <body> <table width="1350" height="640" border="1" > <tr> <td colspan="2" style="background-color:#FFF5EE;"> <h1>HOSPITAL MANAGEMENT SYSTEM</h1> <h3 align="center">ADMIN PANEL</h3> </td> </tr> <tr> <td style="background-color:#00FFFF;width:50px;height:400px;"> <table align="center"> <tr> <td><form action="nurse.php" align="center"> <input type="submit" align="center" value=" nurse </form></td> </tr> 58 "> <tr> <td><form action="patient.php" align="center"> <input type="submit" align="center" value=" patient "> </form></td> </tr> <tr> <td><form action="pharmacist.php" align="center"> <input type="submit" align="center" value=" pharamacist "> </form></td> </tr> <tr> <td><form action="laboratorist.php" align="center"> <input type="submit" align="center" value=" laboratorist "> </form></td> <tr> <td><form action="accountant.php" align="center"> <input type="submit" align="center" value=" accountant "> </form></td> </tr> </table> </td> <td style="background-color:#eeeeee;height:200px;width:400px;height:400px;"> <?php $host='localhost'; $username='root'; $password=''; $dbname='hospital'; 59 $con=mysql_connect($host,$username,$password); mysql_select_db($dbname); $result = mysql_query("SELECT * FROM doctor"); echo "<h4 align='center'> doctors list </h4>"; echo "<table border=1 align=center><tr><th>s.no</th><th>name</th><th>d_id</th><th>qualification</th><th>speciality</ th><th>age</th></tr>"; while($row = mysql_fetch_array($result)) { echo "<tr>"; echo "<td>" . $row['s_no'] . "</td>"; echo "<td>" . $row['name'] . "</td>"; echo "<td>" . $row['d_id'] . "</td>"; echo "<td>" . $row['qualification'] . "</td>"; echo "<td>" . $row['speciality'] . "</td>"; echo "<td>" . $row['age'] . "</td>"; echo "</tr>"; } echo "</table>"; mysql_close($con); ?> <br><br> <table align="right"> <th> <tr> <form action="adddoctor.php" align="center"> 60 <input type="submit" align="center" value=" add new doctor "> </form> </tr> <tr> <form action="deletedoctor.php" align="center"> <input type="submit" align="center" value=" delete doctor "> </form></tr> <tr> <form action="viewcompletedoctor.php" align="center"> <input type="submit" align="center" value=" viewcomplete "> </form> </tr> <tr> <form action="admin.html" align="center"> <input type="submit" align="center" value=" home "> </form> </tr></table> </td> </tr><tr> <td colspan="2" style="background-color:#9ACD32;text-align:center;"> <table align="right"> <th> <tr><form action="appointment.php" align="center"> <input type="submit" align="center" value=" appointment </form> </tr><tr><form action="payment.php" align="center"> <input type="submit" align="center" value=" payment "> 61 "> </form> </tr><tr><form action="bloodbank.php" align="center"> <input type="submit" align="center" value=" bloodbank "> </form> </tr><tr> <form action="medicine.php" align="center"> <input type="submit" align="center" value=" medicine "> </form> </tr><tr><form action="operations.php" align="center"> <input type="submit" align="center" value=" operations "> </form> </tr><tr> <form action="birthreport.php" align="center"> <input type="submit" align="center" value=" birthreport "> </form> </tr><tr><form action="deathreport.php" align="center"> <input type="submit" align="center" value=" deathreport "> </form> </tr><tr><form action="bedallotment.php" align="center"> <input type="submit" align="center" value=" bedallotment "> </form> </tr></th> </table> </td></tr></table> </body> </html> Appointment.php 62 <!DOCTYPE html> <html> <body> <table width="1350" height="640" border="1" ><tr> <td colspan="2" style="background-color:#FFF5EE;"> <h1>HOSPITAL MANAGEMENT SYSTEM</h1> <h3 align="center">DOCTOR PANEL</h3> </td> </tr> <tr> <td style="background-color:#00FFFF;width:50px;height:400px;"> <table align="center"> <tr> <td><form action="docappointment.php" align="center"> <input type="submit" align="center" value=" Appointment "> </form> </td></tr> <tr> <td><form action="docperscription.php" align="center"> <input type="submit" align="center" value=" perscription "> </form> </td> </tr> <tr> <td> <form action="docoperation.php" align="center"> <input type="submit" align="center" value=" Operation "> </form> </td></tr> <tr> <td><form action="docmedicines.php.php" align="center"> <input type="submit" align="center" value=" Add Medicines "> </form></td></tr> <tr> <td> <form action="doctests.php" align="center"> <input type="submit" align="center" value=" 63 Add Tests "> </form></td> </table> </td> <td style="background-color:#eeeeee;height:200px;width:400px;height:400px;"> <h2 align="center"> Appointments </h2> <?php $host='localhost'; $username='root'; $password=''; $dbname='hospital'; $con=mysql_connect($host,$username,$password); mysql_select_db($dbname); $result = mysql_query("SELECT * FROM appointment WHERE d_id='$a'"); echo "<table border=1 align=center> <tr> <th>s.no</th> <th>pid</th> <th>name</th> <th>problem</th> <th>date</th> <th>time</th> <th>status</th> <th> update</th> </tr>"; while($row = mysql_fetch_array($result)) { echo "<tr>"; echo "<td>" . $row['s_no'] . "</td>"; echo "<td>" . $row['p_id'] . "</td>"; echo "<td>" . $row['name'] . "</td>"; echo "<td>" . $row['problem'] . "</td>"; echo "<td>" . $row['date_of_app'] . "</td>"; echo "<td>" . $row['time_of_app'] . "</td>"; echo "<td>" . $row['status'] . "</td>"; echo "<td>" ;?> <form action="updateappointment.php" align="center" method="POST"> <input type="hidden" name="sno" value=" <?php echo $row['s_no']; ?> "> 64 <input type="hidden" name="pid" value=' <?php echo $row['p_id']; ?> '> <input type="submit" align="center" value=" update "> </form> <?php echo "<td>"; echo "</tr>"; } echo "</table>"; mysql_close($con); ?> <br><br> <table align="center"> <tr> <td><form action="allappointment.php" align="center"> <input type="submit" align="center" value=" all Appointment "> </form> </td> <td><form action="pendingappointment.php" align="center"> <input type="submit" align="center" value=" pending Appointment "> </form> </td> <td> <form action="upcomingappointment.php" align="center"> <input type="submit" align="center" value=" upcoming appointment "> </form> </td> <td><form action="completedappointment.php" align="center"> <input type="submit" align="center" value=" completed Appointment "> </form></td></table> </td></tr> <tr> <td colspan="2" style="background-color:#9ACD32;text-align:center;"> <table align="center"> <tr> <td> Doctor name </td> <td> </td> <td> Doctor id </td> <td> </td> </tr> </table> 65 </td></tr> </table></body></html> 66 67 68