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AUTOMATED CLINIC RECORD MANAGEMENT SYSTEM
A CASE STUDY OF AHMADU BELLO UNIVERSITY SICK-BAY
BY
ALFA MAHFOOZ AHMED
U11LS1018
A PROJECT SUBMITTED TO THE DEPARTMENT OF LIBRARY AND
INFORMATION SCIENCE IN PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE AWARD OF BACHELOR DEGREE IN LIBRARY AND INFORMATION
SCIENCE (BLIS)
September, 2015
ii
Declaration
I, Alfa Mahfooz Ahmed, declare that this project titled “Automated clinic record
management system, a case study of Ahmadu Bello University Sick-bay” was
written by me and all ideas borrowed from other people’s intellectual work has been duly
acknowledged.
________________________ ____________________
Alfa Mahfooz Ahmed Date
iii
Approval Page
The undersigned have read and approved this study titled “Automated clinic record
management system, a case study of Ahmadu Bello University Sick-bay” in partial fulfillment of
the requirement for the award of Bachelor degree in Library and Information Science (BLIS).
________________________ ____________________
Mal. Muhammad Musa Hayatu Date
Project Supervisor
________________________ ____________________
Dr. Abdullah I. Musa Date
Head of Department
iv
Dedication
This research work is dedicated to the following:
Parents: Alh. Ahmad Imam and Hajiya Rukyat AbdulRahman
Boss: Late Alh. Abdulkadir Suleiman Idris
Grand Mother: Late Hajiya Mairo
v
Acknowledgement
My profound gratitude goes to the almighty Allah for spanning my life to the end of this
phase of education. I also appreciate the help, guidance, encouragement and the creative
criticism of my supervisor, Mal. Muhammad Musa Hayatu (Ph.D. in anticipation Insah-Allah)
throughout the course of this project.
My appreciation goes to all my lectures in the Department of Library and Information
Science who helped in one way or the other throughout my programme in Ahmadu Bello
University, Zaria.
Special thanks goes to my parents, I will forever appreciate your gift of love, support,
sacrifice and prayers all in the bit to see that I obtained a degree. I am confidently proud of you.
I will also not forget to mention the contribution of my siblings, uncles, brothers, and
sisters especially Hajiya Latifat Ahmad Imam (Ummu Nusaiba), Hajiya Mansurat Ahmad
(Ummu Badrudeen), Ma. Muh. Najib Ahmad Imam, Alh. Mustapha Ahmad Imam, and the rest
of my family members for their moral support.
There are close friends who so dear to me, who have contributed in one way or the
other; Abdullahi Ibrahim Maska, Nura Aliyu Dabai, Bello Hamman Adama, Bello Bashir,
Zubaida Muhammad Nalado, Farida Jauro Umar and many that could not be mentioned, May
Allah (SWT) Blessed you all, and I am very grateful.
vi
ABSTRACT
This study was carried out to design and introduce the use of an automated clinic record
management system and has chosen Ahmadu Bello University Sick-bay as the case study for
the first implementation with the aim of improving their services especially in this digital era. A
qualitative research was adopted and the instrument used for the study are interview,
observation and questionnaire where some questions were raised by the researcher such as,
what are the challenges associated with the use of the current manual record management
system in the Ahmadu Bello University Sick-bay? How to improve on the current manual
record managements system to minimize human error in the process of the records? How to
improve on the current manual time management among the staff of the clinic? And how to
provide more privacy to patients’ records and information in the clinic? Fifteen (15)
respondents were randomly chosen from both the clients and staff of the clinic. And at the end
of the research, the findings were analyzed which led to the designing of the aforementioned
system. And in order to design the programme, the researcher uses some web development
tools such as; Adobe Dreamweaver and Notepad Plus Plus for the required coding; hypertext
preprocessor (PHP) and Java scripts (JS) to connect the interfaces to the database; and My-SQL
was used to design the databases that store the overall system data. Finally; summary,
conclusion and suggestion were given on the problems associated with the manual method of
record keeping such as difficulties in sorting, retrieving and updating records, lack of security
of records, loss of relevant information and so on, it was also suggested that the implementation
of this programme will help in improving the effectiveness and efficiency in our clinics.
vii
Table of Contents
Declaration..................................................................................................................................................................ii
Approval Page ..........................................................................................................................................................iii
Dedication...................................................................................................................................................................iv
Acknowledgement....................................................................................................................................................v
ABSTRACT...................................................................................................................................................................vi
LIST OF TABLES..........................................................................................................................................................x
LIST OF FIGURES..................................................................................................................................................... xi
LIST OF ABBREVIATIONS ...................................................................................................................................xii
CHAPTER ONE............................................................................................................................................................1
INTRODUCTION.......................................................................................................................................................1
1.1Background of the Study..................................................................................................................................1
1.2. Statement of the Problem...............................................................................................................................6
1.2.1. Overview of the Current System ........................................................................................................7
1.3. Research Questions..........................................................................................................................................7
1.4. Aims and Objectives of the Study...............................................................................................................8
1.5. Significance of the Study ...............................................................................................................................8
1.6. Scope of the Study ............................................................................................................................................9
1.7. Limitation of the Study ................................................................................................................................10
1.8. Definition of Some Key Terms..................................................................................................................11
Reference...................................................................................................................................................................13
CHAPTER TWO.......................................................................................................................................................14
LITERATURE REVIEW...........................................................................................................................................14
2.1. Introduction.....................................................................................................................................................14
2.2. Diffusion of Innovations.............................................................................................................................14
2.3. Previous Studies that Adopted this Theory..........................................................................................17
2.4. Automated Clinic Record Management System and the DOI theory .......................................21
viii
2.5. Summary of the Reviews.............................................................................................................................24
References.................................................................................................................................................................25
CHAPTER THREE ....................................................................................................................................................27
RESEARCH METHODOLOGY............................................................................................................................27
3.1. Introduction.....................................................................................................................................................27
3.2. Method Adopted for the Study .................................................................................................................27
3.3. Population of the Study ...............................................................................................................................28
3.4. Sampling and Sampling Procedure........................................................................................................29
3.5. Instrument used for Data Collection .....................................................................................................30
3.6. Procedures for Data Collection................................................................................................................31
3.7. Procedures for Data Analysis....................................................................................................................32
References.................................................................................................................................................................33
CHAPTER FOUR......................................................................................................................................................34
DATA ANALYSIS AND DESIGN........................................................................................................................34
4.1. Introduction.....................................................................................................................................................34
4.2. Data Analysis...................................................................................................................................................34
4.3. Descriptive Analysis......................................................................................................................................35
4.3.1. Respondents Details..............................................................................................................................35
4.3.2. Current records keeping system use in keeping records of patients in the clinic.......35
4.3.3. Challenges of the current system....................................................................................................36
4.3.4. Proposed record management system for the clinic................................................................36
4.3.5. Benefits of the proposed system.......................................................................................................37
4.3.6. System User Requirements.................................................................................................................37
4.4. Program Analysis and Design...................................................................................................................38
4.4.1. System Design .........................................................................................................................................38
ix
4.4.2. Tools used and System Specifications............................................................................................38
4.4.3. Database Design.....................................................................................................................................40
4.4.4 The Developed System Interfaces.....................................................................................................44
CHAPTER FIVE.........................................................................................................................................................49
SUMMARY, CONCLUSION AND SUGGESTION .......................................................................................49
5.1 Summary............................................................................................................................................................49
5.2 Conclusion.........................................................................................................................................................49
5.3. Suggestion.........................................................................................................................................................50
REFERENCES.............................................................................................................................................................51
Bibliography.............................................................................................................................................................53
APPENDIX.................................................................................................................................................................59
x
LIST OF TABLES
Table 3.1: Sampling size
Table 4.3.1: Respondents details
xi
LIST OF FIGURES
Figure 4.1 Entity Relationship Diagram
Figure 4.2 Admin table
Figure 4.3 Appointment table
Figure 4.4 Doctors' table
Figure 4.5 Patients table
Figure 4.6 Welcome interface
Figure 4.7 Appointment interface
Figure 4.8 Staff login interface
Figure 4.9 Patients login interface
Figure 4.10 Administrators interface
xii
LIST OF ABBREVIATIONS
ACRMS – Automated Clinic Record Management System
EHR – Electronic Health Record
ICT - Information and Communication Technology
PHECC - Pre-Hospital Emergency Care Council
DOI - Diffusion of Innovation
KARl - Kenya Agricultural Research Institute
MoARD - Ministry of Agriculture and Rural Development
ABU - Ahmadu Bello University
PHP - Hypertext Pre-processor
HTML - Hypertext Markup Language
CSS - Cascading Style Sheet
My-SQL - My - Structured Query Language
JS - Java Script
RAM - Random Access Memory
CPU - Central Processing Unit
UPS - Un-interruptible Power Supply
1
CHAPTER ONE
INTRODUCTION
1.1Background of the Study
With the advent of computers and its related technology, in which everything needs to be done
efficiently and effectively the existences of Automated Clinic Record Management System
(ACRMS) become necessary. The used of ACRMS can enhance the services and also the work
flow of all activity that happens in a clinic where it helps in reducing the workload of medical
staff, the number of man power needed and it also make clinic management become more
manageable and easier to control.
The main objective of this research work is to design a computer base program that will cover
all the aspects of management and operations of Ahmadu Bello University Sick-bay. It will
enable the clinic registration process becomes computerized and this feature will help a lot in
keeping records of all patients and whoever has once received a treatment in the clinic.
The program will be used for proper handling of patients’ records and related information in
the clinic, the record file, date of appointments, Doctors in charge and other related medical
information will be entered into the program. Which is stored in a database that can be
accessed easily within a short span, and yet securely stored in an appropriate and stress free
manner.
AUTOMATION; The word ‘Automation’ is derived from Greek words “Auto” which means (self)
and “Matos” (moving). Automation therefore is the mechanism for systems that “move by itself”.
However, apart from this original sense of the word, automated systems also achieve
2
significantly superior performance than what is possible with manual systems, in terms of
power, precision and speed of operation.
Automation can also be a set of technologies that results in operation of machines and systems
without significant human intervention and achieves performance superior to manual
operation. A Definition from Encyclopedia Britannica (2009) is the application of machines to
tasks once performed by human beings or, increasingly, to tasks that would otherwise be
impossible. Although the term mechanization is often used to refer to the simple replacement of
human labour by machines, automation generally implies the integration of machines into a
self-governing system.
CLINICAL AUTOMATION; Clinical automations centralized program or software tool
implemented within a clinical unit to support the recruitment of volunteers, directly capture
study data electronically (e-Source), streamline the clinical process, allows sharing online,
real-time, high quality data with clients.
One of the important trends in business managements is the focus on processes to create value
added services for their ultimate customers. This is to get rid of unwanted, time consuming,
unnecessarily repeated business activities of the processes and to monitor how value for
customer is as anciently as possible (Vissers J. M. H ,1998), (Johannes-son and
Jayaweera,2000). This is also very much valid for healthcare industry.
RECORD MANAGEMENT; according to the (National Archives of Scotland) Records
management is the systematic control of an organization’s records, throughout their life cycle,
in order to meet operational business needs, statutory and fiscal requirements, and community
expectations. Effective management of corporate information allows fast, accurate and reliable
access to records, ensuring the timely destruction of redundant information and the
3
identification and protection of vital and historically important records. Records management
is the foundation layer of all information systems. Management of patient data, through the
proper control of the content and the storage and retention of the records, reduces
vulnerability to legal challenge or financial loss and promotes best practice through greater
coordination of information.
We spend most of our lives creating, collecting, recording information – but each of these
records is only as valuable as the information it contains, and that is only of value if it can be
found when needed, and then used effectively. (Pre-Hospital Emergency Care Council, 2010).
Accurate recording and knowledge of the whereabouts of all records is essential if the
information they contain is to be located quickly and efficiently. One of the main reasons why
records get misplaced or lost is because the destination is not recorded.
The quality of records maintained by a clinic can be a reflection to the quality of care provided
by them to their patients. Clinics are legally accountable for the standard of practice which
they deliver and to which they contribute. Good practice in record management is an integral
part of quality of the clinical care. (PHECC, 2010)
History of the Ahmadu Bello University Sick-Bay, Zaria
The building of the University Health Services was initiated as a sickbay in 1952by the
Nigerian College of Arts and Science. It has grown through thick and thin to its bigness now
and continues to grow bigger. A population in excess of hundred thousand (100, 000) people
with 35,000 student population is now served.
At the beginning when the scheme was smaller and more intimate, it seemed easier to know the
students. Therefore, from the beginning the struggle has been of space and resources. On the
4
Main Campus, the present location of the 'Sickbay' adjacent to Suleiman Hall covers a total of
over 2,600 sq meters, and was occupied in 1968. Before this date, the 'Sickbay' had been
located in various areas at various times, from Nagwamatse road in residential Area A, to the
Cappa housing unit, then to the former Community Medicine Department and finally to the
present site.
Apparently, the movements and the expansions of Sickbay had been necessitated by the need to
create a more conducive space to cope with rising demand for these services as the institution's
population rapidly grew. An appreciation of this rising demand may be gained from the fact
that whereas in 1972 the main campus Sickbay had attended to an estimated average of 350
caseson daily basis, this figure had gone up to 500 by 1982 and 700 by 1987 and 700-1000 in
1997 to 2002.
On the Kongo campus, on the other hand, the Sickbay had occupied its present location
(opposite the Security office) since the inception of the campus, albeit with expansion
programme at various stages to cope with the rising demands for its services. Presently, the
Unit occupies about 2,000 sq meters and has attended to, on a daily basis, about 200 cases by
1972, 286 cases by 1982 and 309 cases by 1987, accordingly. The same trends have
characterized the Sickbay in all other campuses of the University and, like the libraries, the
Sickbays constitute points of daily convergence by University staff of all categories for the
purpose of meeting Personal and family needs. With the growth of the population, the scheme
has struggled to expand and is has now become a full-fledged University Health Services unit
with a curative wing at the status of secondary health care facility.
5
In 1996 the department was handed to Dr. A. Usman and to Dr. S.K. Musa in June 1997 to
2012, then M. A. Usman 2012 to 2014 and presently Dr (Mrs.) Madugu as acting director.
Hence, the key player in the progress and management of University Health Services is the
Director.
By 1995, the clinic was reduced to a mere transit camp for doctors due to inadequacy in the
University policy for attracting and retaining them. There is an exit of 13 doctors within five
years. The Unit which had 266 staff (80 senior and 186 junior staff) by 1998 now has 194 (61
senior and 133 junior), shrinking by 19 senior staff and 53 junior staff due to retrenchment
without replacement.
Despite the odds the dream of achieving the goal and objectives of an African University health
services was never lost. Success began with the period of military sole administrator rtd. Major
General Mamman Kwantagora, the unit was renovated in 1996 though the contract was
terminated at a stage and could not be completed, 80% of the work was achieved. This
administrator gave some level of autonomy to the UHS department began to strengthen
sanitation activity of the health services as well as the medical arm. Working closely with the
unit, the Mahadi administration (1999 -2004) made remarkable progress in sanitation that
has significant positive impacts on the environment, touching the physical, social and
psychological well-being of the community.
Management of casual laborers in Samaru and Kongo campuses with more than 2000 people
who have benefited and so far we have constantly 935 (excluding Students Affairs) currently
on the payroll. There is the expansion of preventive and sanitation to four sections:
environmental and sanitation, parks and gardens academic and parks and gardens residential
6
and the addition of forest guard with employment of more technical staff. In each residential
area workers are now permanently assigned to maintain sanitation.
The clinic has successfully gotten registered as a Primary Health Care Provider for NHIS Social
Health Insurance Programme. It also warns recently Secondary Health Care Provider in
Ophthalmology, Internal Medicine, Dental Pharmacy and Laboratory. This also requires the
improvement of UHS master plan.
The university through its health services unit and the teaching hospital provides medical and
health services to staff and their family limited by its resources. It also carries out pre-
employment medical examination to staff and insist on pre-registration medical examination
to new students. However there is now the new monetization and the National Health
Insurance Scheme policies
1.2. Statement of the Problem
The poor record keeping and filling system of our clinics is the bane of the healthcare sector
failure. The manual handling of the patient files has led to undue delays in attending to patients
at the clinic, and this has been a cause of concern to all citizens.
The manual system of record keeping and filling system in Nigerian clinics has over the years
proved inefficient. There had been incident of misplaced documents, not able to retrieve long
consult patients’ records, loss of records or files, alteration of information etc, result in
unnecessary delay of treatment which even sometime leads to the death of the patient.
7
1.2.1. Overview of the Current System
Current system that is being used at the Ahmadu Bello University sick-bay is a manual system.
Where all information is being collect using form and all data is being kept in the archive,
where this conventional ways lead to the need of space and time wasting.
Registration
The current method of registration in Ahmadu Bello University, Sick-bay where the case study
of this project is carried out, all tasks ware done manually. Before a patient can received a
treatment from doctors, they need to be registered by the file administrator in the clinic, and if
the patient have ever received a treatment from the clinic, then attendance are responsible to
retrieve their file where details of that particular person had been kept.
In registration process, every patient has to be open a file for in the administrative department
where the files are kept for subsequent retrieving whenever the patient visit or has an
appointment in the clinic.
1.3. Research Questions
This study was carried out to provide solution to the following research questions:
a. What are the challenges associated with the use of the current manual record
management system in the Ahmadu Bello University Sick-bay.
b. How to improve on the current manual record managements system to minimize
human error in the process of the records.
c. How to improve on the current manual time management among the staff of the clinic.
d. How to provide more privacy to patients’ records and information in the clinic.
8
1.4. Aims and Objectives of the Study
The aim of this study is to design a clinic record management system in order to achieve
efficient records keeping in the clinic. While the objectives of this study are as follows:-
a. To find out the challenges associated with the current patient’s record management
system in the Ahmadu Bello University Sick-bay.
b. To observe ways of improving on the current patient’s record management system in
the clinic.
c. To identify means of improving on time management among the staff of the clinic.
d. To investigate ways of providing a standard record storage and management system for
the clinic, in order to provide more secure patients record management system for the
clinic.
1.5. Significance of the Study
Currently, the Ahmadu Bello University Sick-bay operates a manual records management
system, with the introduction of an automated system, in which computers will be used will
achieve more accurate record management, time saving, and easy retrieval of patients’
information.
The program will be a web base program that will enable a quick access to patient’s record
globally in case of emergency. And will also provide adequate security to patients records in
which only authorize users can have access to the system with username and password.
The program will also provide an adequate scheduling for both the doctors and the patients, in
which appointment has to be made by the patient before visiting the doctor.
9
1.6. Scope of the Study
The general scope of this study will be focused on Ahmadu Bello University sick bay. While the
specific scopes of the study are as follows:-
a. The case study of the study is Ahmadu Bello University Sick bay.
b. A computer base program will be design to manage patents records in the clinic.
c. This program will be design using a Microsoft windows environment.
e. The program will be design using hypertext pre-processor (PHP) and the relational
database MYSQL as the programming language tools.
d. The program will also have four (4) interfaces (Modules) which are as follows:-
Appointment Interface – this interface provide all the details of the doctors in the clinic
together with their specialization and shifting time, from which a patient can make an
appointment to see the doctor.
Doctor’s Interface – through this interface, the doctor can create an account for himself,
from which he can make his schedule for the week, attend to his scheduled patients and
also update the patient’s medical records after diagnosing.
Patient’s Interface– from this interface patient can create an account for him/herself
and through which he can only view his medical reports or print them out when need
be.
The Admin Interface –the administrator has the full control over the system from which
he can create, read, update and delete any record or information from the system.
10
1.7. Limitation of the Study
Some of the anticipated shortcomings that may be face by the researcher in this project are
categorized into two:-
1. Researchers limitation and
2. The program limitations.
Researcher limitations
a. The biggest limitation is the time that is available for the research; this led to scaling
down of the program and leaving out some operations. There was no time available for
the program to be implemented in a working environment.
b. There is no time available for testing of the system in a working environment. The
system will only been test with sample data by the developer.
c. Programming languages: it was difficult in selecting the appropriate language to
develop the system. This was due to lack of knowledge of other programming languages
like python, ajax.
d. There was also shortage of funds to facilitate the whole research process therefore the
researcher had to work within the limited budget to produce what is possible.
e. The researcher encountered many problems in data collection because it was done
during the time when the clinic was busy therefore getting the required information
was hard.
Program limitations
a. The program will not be suitable for computer illiterate people.
11
b. The program will be suitable only for clinics in academic environment and other non-
profit making institution.
c. The program does not do away with paper work completely; as papers are still used at
some point.
1.8. Definition of Some Key Terms
For the purpose of this study the following terms are defined:-
a. Hospital/ Clinic/Sick-bay: refers to an institution where people receive medical,
surgical, or psychiatric treatment and nursing care.
b. Patient: somebody who needs or receives medical treatment.
c. Doctor: A person who is qualified and licensed to give people medical treatment and
according to advance learner dictionary a medical doctor is a qualified practitioner of
medicine; physician.
d. Pharmacist: A person who is trained and licensed to dispense medicinal drugs and to
advise on their use.
e. Nurse: A person who is trained to look after sick or injured people, especially somebody
who works in a hospital or clinic, administering the care and treatment that a doctor
prescribes.
f. Medicine: A drug or remedy used for treating illness.
g. Lab: A place where research and testing is carried out.
h. Ward: A room in a hospital, especially one for several patients being given similar
treatment.
12
i. Automation: The act of implementing the control of equipment with advanced
technology; usually involving electronic hardware "automation replaces human
workers by machines"
j. Management: Is a process of getting things done through people by making efficient use
of resources. It requires the manager to identify problems with the community.
k. Record: Record is documented information in print or non print format. The record can
be manual or digitized.
l. Medical Record: Is a record containing patient health information. It indicates doctor’s
diagnostic statement and the prescribed treatment.
13
Reference
Creswell, J. W. (1999). Mixed-method research: Introduction and application. In G. J. Cizek
(Ed.), Handbook of educational policy (pp. 455–472). San Diego: Academic Press.
Dictionary.com, retrieve from http://dictionary.reference.com/browse/automation
Donald Ary, Lucy Chese J.&AsgharRazavieh (1984), Introduction toResearch in Education:
Holt, Rinehart and Winston, Inc.
http://www.batesville.k12.in.us/physics/PhyNet/AboutScience/Hypotheses.html
Lim Chee S. E, Chennupati K. R, and Surya P. G. (2009, November). Electronic Medical Records
Management Systems: An Overview. Journal of Library & Information Technology, Vol.
29, No. 6, pp. 3-12
Microsoft Encarta 2009. (DVD): Microsoft Corporation. © 1993-2008
National Archives of Scotland (NAS), retrieve from
http://www.nas.gov.uk/recordKeeping/recordsManagement.asp
Online Encyclopaedia Britannica (2009)
Pre-Hospital Emergency Care Council (2010) www.phecc.ie
Prasad J., Jeewanie J., Lal Wellakkage V. M., Samantha L. (2006, September) Clinics
Management System (CMS) based onPatient Centered Process Ontology. RUHUNA
JOURNAL OF SCIENCE, Vol. 1, No. 1, pp. 40 – 39
ShaliniPrasad, AjithRao and EeshooRehani (2001, SEPTEMBER 18TH
) Developing Hypothesis
and Research Questions: 500 Research Methods
www.public.asu.edu/~kroel/www500/hypothesis.pdf
14
CHAPTER TWO
LITERATURE REVIEW
2.1. Introduction
This chapter review some related literature in the area of the study, from which the researcher
tried to identify, locate, read and evaluate some previous studies, observations, theories,
opinions and comments, which are arranged in the following headings:-
2.2. Diffusion of innovation theory.
2.3. Previous studies that adopted this theory
2.4. Automated Clinic Record Management System and the DOI theory
2.5. Summary of the reviews.
2.2. Diffusion of Innovations
Diffusion of Innovations is the process by which an innovation is communicated through
certain channels over time among the members of a social system. It is a special type of
communication, in that the messages are concerned with new ideas. Communication is a
process in which participants create and share information with one another in order to reach
a mutual understanding. This definition implies that communication is a process of
convergence (or divergence) as two or more individuals exchange information in order to
move toward each other (or apart) in the meanings that they ascribe to certain events. We
think of communication as a two-way process of convergence, rather than as a one-way, linear
act in which one individual seeks to transfer a message to another (Rogers and Kincaid, 1981).
15
The process of adopting new innovations has been studied for over 30 years, and one of the
most popular adoption models is described by Rogers in his book, Diffusion of Innovations
(Sherry & Gibson, 2002). Much research from a broad variety of disciplines has used the model
as a framework. Dooley (1999) and Stuart (2000) mentioned several of these disciplines as
political science, public health, communications, history, economics, technology, and
education, and defined Rogers’ theory as a widely used theoretical framework in the area of
technology diffusion and adoption.
In fact, much diffusion research involves technological innovations so Rogers (2003) usually
used the word “technology” and “innovation” as synonyms. For Rogers, “a technology is a design
for instrumental action that reduces the uncertainty in the cause-effect relationships involved
in achieving a desired outcome” (p. 13). It is composed of two parts: hardware and software.
While hardware is “the tool that embodies the technology in the form of a material or physical
object,” software is “the information base for the tool” (Rogers, 2003, p. 259). Since software (as
a technological innovation) has a low level of observability, its rate of adoption is quite slow.
According to Rogers1962; the Four Main Elements in the Diffusion of Innovations are stated in
the definition as the process by which (1) an innovation (2) is communicated through certain
channels (3) over time (4) among the members of a social system. The four main elements are
the innovation which is the idea, practice, or object that is perceived as new by an individual or
other unit of adoption, communication channels which has also been defined as the process by
which participants create and share information with one another in order to reach a mutual
understanding, time defines both the pace at which progress occurs and the positions
individuals occupy amid the evolution of such progress (Inman, 2000), and the social system is
defined as a set of interrelated units that are engaged in joint problem solving to accomplish a
16
common goal. They are identifiable in every diffusion research study, and in every diffusion
campaign or program.
Attributes of Innovations and Their Rate of Adoption
Attributes of innovations and their rate of adoption discourses why certain innovations spread
more quickly than others? And also why do other innovations fail? Diffusion scholars have
recognized five attributes that determine the success or failure of an innovation in any
organization, which are, relative advantage, compatibility, Simplicity, trialabilty, and
Observabilty:-
a. Relative advantage: This is the degree to which an innovation is perceived as better
than the idea it supersedes by a particular group of users, measured in terms that
matter to those users, like economic advantage, social prestige, convenience, or
satisfaction. The greater the perceived relative advantage of an innovation, the more
rapid its rate of adoption is likely to be.
There are no absolute rules for what constitutes “relative advantage”. It depends on
the particular perceptions and needs of the user group.
b. Compatibility with existing values and practices: This is the degree to which an
innovation is perceived as being consistent with the values, past experiences, and
needs of potential adopters. An idea that is incompatible with their values, norms or
practices will not be adopted as rapidly as an innovation that is compatible.
c. Simplicity and ease of use: This is the degree to which an innovation is perceived as
difficult to understand and use. New ideas that are simpler to understand are
adopted more rapidly than innovations that require the adopter to develop new
skills and understandings.
17
d. Trialability: This is the degree to which an innovation can be experimented with on
a limited basis. An innovation that is trialable represents less risk to the individual
who is considering it.
e. Observable results: The easier it is for individuals to see the results of an innovation,
the more likely they are to adopt it. Visible results lower uncertainty and also
stimulate peer discussion of a new idea, as friends and neighbours of an adopter
often request information about it.
According to Everett Rogers (2003), these five attributes determine between 49 and 87 percent
of the variation in the adoption of a new products.
These five attributes make a valuable checklist to frame focus group discussions or project
evaluations. They can help identify weaknesses to be addressed when improving products or
behaviours.
2.3. Previous Studies that Adopted this Theory
As mentioned earlier, several scholars from different disciplines have used this theory in
investigating, analyzing and exploring why new ideas (innovations) are adopted and why
others fail.
This section has discussed some of the previous studies that used the DOI Theory to explain
how innovations (new ideas) are developed, processed and implemented in organizations.
A study conducted by Olatokun W.M and gbinedion L.J (2009) on the Adoption of Automatic
Teller Machines in Nigeria: An Application of the Theory of Diffusion of Innovation, the main
objective of knowing what could be done to prevent the inhibition surrounding the use of
Automatic Teller Machines in Nigeria, the researchers have use the five attributes of innovation
18
according to Rogers (1995) - relative advantage, compatibility, complexity, trialability and
observability, in finding out the degree of influence attitude and the intention of the people to
use the technology, hypothesis are designed in testing each of the constructs. The data
collection instrument used was a structured questionnaire administered to ATM customers of
the selected 14 banks. While the findings of the study state that, Relative Advantage of using
ATMs; how hard it was to use ATMs, how compatible ATMs were with the lifestyle of the users;
how much has been registered (observed) about ATMs by the users and whether ATMs could
be tested before consistent use, were issues that influence users’ attitude towards intention to
use ATMs. It also states that, the Attitude of an ATM user would later affect his/her intent to use
an ATM. Since Observability had the greatest impact on attitude, it is important for banks to
give the right impression about ATMs. This could be in terms of locating ATMs in hidden places
so that non adopters could observe others use ATM before adopting it themselves.
Kamau L.M (2014), also conducted a study titled “Applying Rogers’ Diffusion of Innovations
Theory to Investigate Technology Training for Secondary Mathematics Teachers in Kenya” the
study was aimed at examine the extent technology training influence secondary mathematics
teachers’ decisions to adopt or not to adopt technology in the classroom practice from Nairobi
and Nyandarua counties in the Republic of Kenya. The study applied the case study research
design and the Rogers’ (2003) diffusions of innovations theory to investigate the research
problem. The study found that mathematics teachers have not received adequate technology
training relevant for mathematics teaching because of technologically unskilled trainers, lack
technology software related to mathematics teaching, and teachers are not motivated to attend
training for lack of incentives. The study suggests radical changes be undertaken on how
training of mathematics teachers by the Center for Mathematics Science and Technology
19
Education in Africa (CEMASTEA) and the National ICT innovation and Integration Centre
(NI3C) and the teacher training programs at the public universities and colleges. The study also
recommends that further research is needed to understand technology training for
mathematics teachers in Kenya.
Kiplang'at J. and Ocholla D.N (2005) also conducted a study titled “Diffusion of Information
and Communication Technologies in communication of agricultural information among
agricultural researchers and extension workers in Kenya” The paper reports on the findings of
a study that investigated the diffusion of Information and Communication Technologies (ICTs)
in communication of agricultural information among agricultural researchers and extension
workers in Kenya. The study focused on the public agricultural sector and covered the Kenya
Agricultural Research Institute (KARl) and the Ministry of Agriculture and Rural Development
(MoARD). A survey research method comprising a self-completed questionnaire and a
structured interview schedule was utilized to gather data from the respondents who comprised
of I59 agricultural researchers, 138 extension workers and 59 key informants. This was
supplemented by observation and document review.
It was found out that KARl and MoARD had adopted a wide variety of ICT tools and services in
an effort to facilitate information sharing and exchange among agricultural researchers,
extension workers, farmers and other actors involved in research and extension. These ranged
from modern ICTs based on digital information and traditional lCTs based largely on analogue
information waves. The ICT models adopted addressed the different kinds of information needs
and communication problems encountered by agricultural researchers and extension workers.
However, it was observed that despite the efforts to expand and modernize ICTs in the
agricultural sector, its growth had been hampered by a number of constraints and challenges
20
which require the intervention and interaction of all the stakeholders in the agricultural and
ICT sector and also involvement of the government.
Ibrahim M.A and Sadiq S.M (2012) also conducted a study on Mobile Banking Adoption:
Application of Diffusion of Innovation Theory; The objective of the study was to investigate a
set of technical attributes and how they influence mobile banking adoption in a developing
nation, like Saudi Arabia. The study uses diffusion of innovation as a base-line theory to
investigate factors that may influence mobile banking adoption and use. More specifically, the
objective of the research was to examine the potential facilitators and inhibitors of mobile
banking adoption. The researchers have uses hypothesis in testing each of the Rogers (2003)
attributes of innovation in related with the adoption of mobile banking. Survey instrument was
used for the research, in which 20 questionnaires are randomly shared among some selected
mobile banking users; findings also suggest that banks in Saudi Arabia, should offer mobile
banking services that are compatible with various current user requirements, past experiences,
lifestyle and beliefs in order to fulfill customer expectations. With better mobile banking
support and provision of variety of services, the more useful customers perceive mobile
banking to be and to increase their level of adoption. Hence, bank’s attention should focus on
understanding customer behavior and designing reliable mobile banking systems that will meet
their needs and provide useful and quality services. In addition, banks should focus on
communicating information that emphasizes the relative advantage and usefulness of mobile
banking compared to other banking channels like physical presence to the bank or using ATM
machines. Banks must seek to reduce risk perceived by their customers by offering specific
guarantees protecting them and taking their complaints seriously and urgently.
21
Another study conducted under this theory is by Eric W. F, Menachemi N. and Phillips T.
(2006), titled “Predicting the Adoption of Electronic Health Records by Physicians: When Will
Health Care be Paperless?” The purpose of this study was three fold. First, was to gather and
synthesize the historic literature regarding electronic health record (EHR) adoption rates
among physicians in small practices (ten or fewer members). Next, was to construct models to
project estimated future EHR adoption trends and timelines. The researchers then determined
the likelihood of achieving universal EHR adoption in the near future and articulate how
barriers can be overcome in the small and solo practice medical environment. This study used
EHR adoption data from six previous surveys of small practices to estimate historic market
Penetration rates. Applying technology diffusion theory, three future adoption scenarios,
optimistic, best estimate and conservative are empirically derived. EHR adoption parameters,
external and internal coefficients of influence are estimated using Bass diffusion models.
And all the three (3) EHR scenarios display the characteristic diffusion S curve that is indicative
that the technology is likely to achieve significant market penetration, given enough time.
Under current conditions, EHR adoption will reach its maximum market share in 2024 in the
small practice setting. And the study concluded with the promise of improved care quality and
cost control has prompted a call for universal EHR adoption by 2014. The EHR products now
available are unlikely to achieve full diffusion in a critical market segment within the time
frame being targeted by policy makers.
2.4. Automated Clinic Record Management System and the DOI theory
There are always reasons for introducing an innovation in an organization. As rightly pointed
out by Rogers (1995) the innovation process begins with agenda setting where one or more
22
individuals in an organization identify an important problem and then seek an innovation as a
means of coping with the problem. Rogers (1995) further observes that the problem usually
emanates from a performance gap which is the discrepancy between how the organization is
performing in comparison to its potential. He is of the view that the discrepancy is identified by
members of the organization and is a strong force that compels them to search for an
innovation to solve the identified problem.
For example, the introduction of an Automated Clinic Record Management System in the
Ahmadu Bello University Sick-bay in which patients’ records is previously collected manually,
and to achieve the objectives given in this study, the researcher has plan to apply the five
attributes of the Diffusion of Innovation theory to the planning and implementation of the
project (Automated Clinic Record Management System), which are, Relative advantage,
Compatibility, Simplicity, Trialabilty, and Observabilty:-
a. Relative advantage refers to the degree to which an innovation is perceived as providing
more benefits than its predecessor [Moore & Benbasat 1991]. Relative advantage results
in increased efficiency, economic benefits and enhanced status [Rogers 2003]. Past
research has found that relative advantage of an innovation is positively related to the
rate of adoption [Moore & Benbasat 1991]. Research suggests that when user perceives
relative advantage or usefulness of a new technology over an old one, they tend to adopt
it [McCloskey 2006; Rogers 2003]. In the context of ACRMS adoption, benefits such as
organize records management, easy retrieval of patients’ records, accurate scheduling
and secure patients records, which will speed up most activities in the clinic may likely
leads to the adoption of the program
23
b. Complexity; Cheung et al. [2000] defined complexity as the extent to which an
innovation can be considered relatively difficult to understand and use. Complexity is
the opposite of ease of use. Ease of use refers to the extent to which the program will be
perceived as easy to understand and operate. A vast body of research suggests that there
is a strong impact of perceived ease of use of new technology on its adoption [Gu et al.
2009; Luarn & Lin 2005; Venkatesh & Davis 2000; Wang et al. 2006]. As for the
ACRMS, the program will be in a GUI format that can be operate with few clicks and
will also save time compare to the manual system.
c. Compatibility refers to the degree to which a service is perceived as consistent with
users’ existing values, beliefs, habits and present and previous experiences [Chen et al.
2004]. Compatibility is a vital feature of innovation as conformance with user’s lifestyle
can propel a rapid rate of adoption [Rogers 2003]. As for the ACRMS, the program also
aim at providing an interface as it was on the manual record papers in the clinic.
d. Observability of an innovation describes the extent to which an innovation is visible to
the members of a social system, and the benefits can be easily observed and
communicated [Rogers 2003]. Moore & Benbasat [1991] simplified the original
construct by redefining observability into two constructs: visibility and result
demonstrability. In the context of ACRMS, observability will be define as the ability to
access the services of the clinic at any time and from any location without any delay or
queue, and conveying the accessibility benefits to others. Through such exposure, other
clinics also see its benefits and try to adopt it.
e. Trialability refers to the capacity to experiment with new technology before adoption.
Potential adopters who are allowed to experiment with an innovation will feel more
24
comfortable with it and are more likely to adopt it [Agarwal & Prasad 1998; Rogers
2003]. Here, the researcher plans to first deploy the program in-house, train the staff
on how the program works which will give the clinic chance to try the system and
know how it functions before implementing it.
2.5. Summary of the Reviews
This chapter has successfully discourses the Diffusion of Innovation theory, which is the
perceptions on how deferent people passive new innovation and what makes people adapt to
new methods of doing things in the society. It also discourses the five attributes of the theory
and some previous studies that adopted this theory, the first study that was reviewed was
conducted by Olatokun W.M and gbinedion L.J (2009) on the Adoption of an Automatic Teller
Machines in Nigeria, second study by Kamau L.M (2014), on Applying Rogers’ Diffusion of
Innovations Theory to Investigate Technology Training for Secondary Mathematics Teachers in
Kenya. Third study by Kiplang'at J. and Ocholla D.N (2005) on the Diffusion of Information
and Communication Technologies in communication of agricultural information among
agricultural researchers and extension workers in Kenya, forth study by Ibrahim M.A and
Sadiq S.M (2012) on Mobile Banking Adoption in a developing nation, like Saudi Arabia, and
the fifth study was conducted by Eric W. F, Menachemi N. and Phillips T. (2006), on the
Adoption of Electronic Health Records by Physicians. And the chapter ended with the
application of the theory to the adoption of Automated Clinic Record Management System
(ACRMS).
25
References
Chen, L., M. Gillenson, and D. Sherrell, “Consumer acceptance of virtual stores: A Theoretical
Model and Critical Success Factors for Virtual Stores,” ACM SIGMIS Database, Vol. 35, No.
2: 8-31, 2004.
Cheung, W., M. K. Chang, and V. S. Lai, “Prediction of internet and world wide web usage at
work: a test of an extended Triandis model,” Decision Support Systems, Vol. 30, No. 1: 83-
100, 2000.
Eric W. F, Menachemi N. and Phillips T. (2006). “Predicting the Adoption of Electronic Health
Records by Physicians: When Will Health Care be Paperless? J Am Med Inform Assoc.
2006;13:106–112. DOI 10.1197/jamia.M1913.
Gu, J-C., S-C. Lee, and Y-H. Suh, “Determinants of behavioral intention to mobile banking,”
Expert Systems with Applications, Vol. 36, No. 9: 11605-11616, 2009.
Ibrahim M.A and Sadiq S.M (2012). Mobile Banking Adoption: Application of Diffusion of
Innovation Theory. Journal of Electronic Commerce Research, VOL 13, NO 4, 2012
Inman, J. A. (2000). The Importance of Innovation: Diffusion Theory and Technological
Progress in Writing Centers.The Writing Centre Journal. 21(1), 48-66
Kamau L.M (2014). Applying Rogers’ Diffusion of Innovations Theory to Investigate
Technology Training for Secondary Mathematics Teachers in Kenya. Journal of Education
and Practice www.iiste.org ISSN 2222-1735 (Paper) ISSN 2222-288X (Online). Vol.5,
No.17, 2014
Kiplang'at J. and Ocholla D.N (2005). Diffusion of Information and Communication
Technologies in communication of agricultural information among agricultural
researchers and extension workers in Kenya. SA jnl Libs & Info Sci 2005, 71 (3)
Les Robinson (2009). A summary of Diffusion of Innovations. Enabling Change pdf.
26
Luarn, P. and H-H. Lin, “Toward an understanding of the behavioral intention to use mobile
banking,” Computers in Human Behavior, Vol. 21, No. 6: 873-891, 2005.
McCloskey, D. W., “The Importance of Ease of Use, Usefulness, and Trust to Online Consumers:
An Examination of the Technology Acceptance Model with Older Consumers,” Journal of
Organizational and End User Computing, Vol.18, No. 3: 47-65, 2006.
Moore, G. C. and I. Benbasat, “Development of an instrument to measure the perceptions of
adopting an information technology innovation,” Information Systems Research, Vol. 2,
No. 3: 192-222, 1991.
Olatokun W.M and gbinedion L.J (2009) The Adoption of Automatic Teller Machines in
Nigeria: An Application of the Theory of Diffusion of Innovation. Issues in Informing
Science and Information Technology Volume 6, 2009
Rogers, E. M. (1983). Diffusion of innovations (3rd
ed.). New York: Free Press.
Rogers, E. M. (2003). Diffusion of innovations (5th
ed.). New York: Free Press.
Venkatesh, V. and F. D. Davis, “A theoretical extension of the technology acceptance model:
four longitudinal field studies,” Management Science, Vol. 46, No. 2: 186-204, 2000.
Wang, Y-S., H-H. Lin, and P. Luarn, “Predicting consumer intention to use mobile service,”
Information Systems Journal, Vol. 16, No. 2: 157-79, 2006.
27
CHAPTER THREE
RESEARCH METHODOLOGY
3.1. Introduction
This chapter contains all the methodologies that were adopted in achieving the mentioned
objectives in chapter one, which consist of the following:-
3.2. Method Adopted for the Study
3.3. Population of the Study
3.4. Sampling and Sampling Procedure
3.5. Instruments used for Data Collection
3.6. Procedures for Data Collection and
3.7. Procedures for Data Analysis
3.2. Method Adopted for the Study
As mentioned earlier, the main objective of this research work is to design a computer base
program that will cover all the aspects of management and operations of Ahmadu Bello
University Sick-bay. It will enable the clinic registration process becomes computerized and
this feature will help a lot in keeping records of all patients and whoever has once received a
treatment in the clinic.
Research method refers to the process of scientific inquiry in research work. The success or
other wise of any research work depends largely upon how data is collected, organized and
analyzed (Idris, 2009). It is also the process of arriving at a dependable solution to a given
28
problems. This study has adopted a qualitative method of research. A qualitative research has
been defined as “any kind of research that produces findings not arrived at by means of
statistical procedures or other means of quantification” (Strauss & Corbin, 1990:17). According
to Creswell (2003:181), a qualitative research takes place in the natural setting. He states that
the qualitative researcher often goes to the site (office) of the participants to conduct the
research. This enables the researcher to be more detailed about the individual or place and be
highly involved in the actual experiences of the participants. According to Denzin and Lincoln
(1994) qualitative methodologies include “interviewing; observing; artifacts, documents, and
records; visual methods; personal experience methods; data management methods; computer-
assisted analysis; and textual analysis”. And with some of these methods the researcher intend
using to design the aforementioned Automated Clinic Record Management System for Ahmadu
Bello University Sick-bay.
3.3. Population of the Study
Population in research is simply the totality of the collection of individuals, objects, or
measurement (Yakeen, 2006) population in research refers to animate or inanimate things on
which the study is focused.
Abdulkareem (2006 et al.) defined population as the aggregate of all observations of all interest
to the researcher. The population of a research is the body of research subject being focused.
Usually this is expressed in terms of number of persons being addressed by the researcher.
However, in this study the population is not much and never small and therefore, it includes all
the clients and staff of the Ahmadu Bello University Sick-Bay, which include the professionals,
paraprofessionals and the non-professionals.
29
3.4. Sampling and Sampling Procedure
Sampling in a research work is a device employed in the selection of representative members,
objects or elements from a given population. Probability sampling techniques is used for the
selection of the sample; probability sampling is a form of sampling in which each member of
the population has equal chance of being selected in the sample (Abubakar, 2013). While
drawing the sample of this study, stratified sampling is used as a form of probability sampling
technique, in the selection of the sample. This is because according to Kabir Bello Dungurawa
(2007) in stratified sampling, the entire population is sub divided into smaller homogenous
groups to get an accurate representation. Each sub-group has unique characteristics. From
each sub-group random selection is carried out. Stratified sampling ensures that every
subgroup is represented in the same proportion.
The study sample according to Aina (2007) is the selection of some part from the study’s
population of interest. However, for this study, the researcher has plan to carefully select Seven
(7) from the clients meet in the clinic and two (2) from the professional staff, four (4) from the
paraprofessional staff and two (2) from the non-professional staff as representative so that the
outcome resulting from data obtained from them will be accurate, reliable and adequate for
this research.
Table 3.1: Sampling size
S/N Category Sample Size
1 Clients at the clinic 7
2 Professional Staff 2
3 Paraprofessional staff 4
4 Non- Professional Staff 2
Total 15
30
3.5. Instrument used for Data Collection
The instruments to be use in collecting data for this research are interview, observation,
existing document review and probably a questionnaire which are discussed below;
Interview: This fact finding method will be useful on getting information on how the clinic
organizes its data resources and the order in which the current system flows, the staff will be
interviewed by asking questions on how the current system is working, which will enabled the
researcher to recite areas of improvements and innovations in the current systems.
Observation: The researcher will observed a number of points to help him during the project.
This will be used in determine how best the records are managed. It will also reveal the kind of
information normally demanded from the health unit and how long it takes to retrieve this
information. Through observation the researcher will also be able to find out if the files are
normally returned to their rightful places that is cabinets immediately after recording or cross
checking any record. Some of the advantages of observation as a fact finding method are: -
 The researcher will not have to disrupt the workers’ time because he could easily access
the system and other requirements without any one’s help.
 The researcher will get more information as compared to the information he will get in
case of an interview because there will be access to everything without limitation.
 The researcher directly will see the shortcomings of the existing system other than
being fed by the staff that are available.
However this method also has shortcomings like:-
 The researcher will waste a lot of time looking for information that would have been
given in a short time in case the staff has been used.
 The researcher will not get detailed information since he has less knowledge of the
31
existing system.
Reviewing documented records: Here the researcher will review some documented patients
record from the records officers and probably from the main doctors and nurses in charge of
data management to get a picture of how data is stored, if necessary the researchers records
himself, as he is also a client in the clinic. With this method the researcher will get more
information relating to the system such as the arrangement of the fields in the records, and the
doctors diagnosing record update in the patients’ file.
Questionnaires: The questionnaire will comprise some set of simple questions precise and
concise and required straightforward answers, not to over burden the readers. The
questionnaires will be chosen to cater for the busy staff that will not able to spare time for the
interview.
3.6. Procedures for Data Collection
Before such a task could be accomplished and due to the nature of the research and also
sensitive data/information that are involve will first require the researcher to request for an
introductory letter from his department that will indicate that he is a student carrying out a
research on the topic, which will also serve as an evidence and prove that all information that
will be required by him (the researcher) in the course of this project will only be rightfully use
for the project.
The researcher will also be administrating the interview personally, this is to enable him to
avoid any type of misinformation, this is also important as the researcher is expected to
personally design the program in view.
32
3.7. Procedures for Data Analysis
Data analysis is the process of systematically applying statistical and/or logical techniques to
describe and illustrate, condense and recap, and evaluate data. According to Shamoo and
Resnik (2003) various analytic procedures “provide a way of drawing inductive inferences
from data and distinguishing the signal (The phenomenon of interest) from the noise
(Statistical fluctuation) present in the data”.
While data analysis in qualitative research can include statistical procedures, many times
analysis becomes an ongoing iterative process where data is continuously collected and
analyzed for patterns in observations through the entire data collection phase (Savenye,
Robinson, 2004).
Data generate from the above methodology will be analyze, after which will later led to the
designing of the aforementioned programme. And in order to design the programme that will
automates clinic record management for a health institution, the researcher has plane to use
some web development tools such as; Adobe Dreamweaver and Notepad Plus Plus for the
required coding of the programmes’ commands; hypertext preprocessor (PHP) and Java scripts
(JS) will be used to connect the interfaces, which will also be design with hypertext markup
Language (HTML) and cascading style sheets (CSS) to the databases to perform specific tasks
such as Editing, saving, deleting and searching data from the databases; and My-SQL will be
used to design the databases that will store the overall system data.
33
References
Bryman, A. (2003) Research methods and organization studies 3th ed.London: unwin Hyman.
Creswell W.J (2003). Research Design: Qualitative, Quantitative, and Mixed Methods
Approaches. 2nd Ed. Thousand Oaks, CA: Sage Publications.
Denzin, N. K., & Lincoln, Y. S. (1994). Introduction: Entering the field of qualitative research. In
N. K. Denzin& Y. S. Guba (Eds.), Handbook of qualitative research Thousand Oaks, CA:
Sage Publications.
Fontana, A. & Frey, J. (2003). The Interview: From structured questions to negotiated text
Chapter 2, in Denzin, N.K., & Lincoln Y.S (Eds) (2003).Collecting and Interpreting
Qualitative Materials. 2nd Edition, Thousand Oaks, CA: Sage.
Gay, L.R. (1987). Education research: competencies for analysis andapplication. 3rd .ed.
Columbus: Merril blushing.
http://ori.hhs.gov/education /products/n_illinois_u/datamanagement/datopic.html.
Internet (2006) Hypotheses in research http:/faculty.newc.edu/toconnor/308/308/lect03.htm
Retrieved 01/12/2014
Internet (2006) Sampling.http:/faculty.newc.edu/toconnor/308/308lect2.htm Retrieve on
02/12/2014
Nwana, O.C. (1981) Introduction to educational research for students teachers. Ibadan:
Heinemann Educational Book.
Sam A. Ifidon and Elizabeth I. Ifidon (2007) Basic Principles of ResearchMethods. Benin:
Goodnews Express Communicatios.
Yomere, G.O. and Agbonifoh, B.A. (1999) Research methodology in the social science and
education. Benin-city: cetrepiece consultants.
34
CHAPTER FOUR
DATA ANALYSIS AND DESIGN
4.1. Introduction
This chapter addresses the detailed data analysis and the program design issues and
functionality for the developed system. It addresses the conditions that were necessary for the
effective functioning of the system and also the reason for which it is analyzed, designed and
implemented.
4.2. Data Analysis
In order to come up with a good functioning system, a thorough and clear analysis about the
current system had to be made where the system requirements and expectations by the
potential end-users are specified. Data generated from the methodology used was checked for
efficiency and integrity and analyzed. The analyzing of these results led to the system
designing. The system analyst dealt greatly with summarizing facts, opinions and views
obtained from users after a detailed determination of their requirements.
The data collected for this study was discussed under two main sections; the descriptive
analysis and the program analysis and design.
35
4.3. Descriptive Analysis
Under the descriptive data analysis, the researcher tries to analyze and explain all the data
(responses) gathered from the conducted interview, observation, existing document review and
questionnaire on the course of this study.
4.3.1. Respondents Details
As explained earlier by the researcher at the sampling of the study, to carefully select Seven (7)
from the clients meet in the clinic and two (2) from the professional staff, four (4) from the
paraprofessional staff and two (2) from the non-professional staff as representative. The table
below gives the clear view of the respondents to the study.
Table 4.3.1: Respondents details
S/N Category of respondent Numbers of respondent
1 Clients at the clinic 7
2 Professional Staff 2
3 Paraprofessional staff 4
4 Non- Professional Staff 2
Total 15
The table 4.3.1, above gives the list of respondents consulted for the study, the researcher was
able to achieve this as he is also a student from the institute where the study was carried out
and also a member (client) in the clinic.
4.3.2. Current records keeping system use in keeping records of patients in the clinic.
It was understand from the responds also that, the current record management system that is
36
being used at the Ahmadu Bello University sick-bay is a manual system, where all patients’
records and information are being collected with papers and pens and kept in paper file folders
or box files. This system exhibits some strengths and weaknesses. The strength of this system is;
patients and staff records are properly kept in box files which are then stored in office file
cabinets, the system is also easy to use because it does not require any training of the user.
Weaknesses of the current system are; it takes a lot of time to retrieve the required records
especially when the files are big, updating of patients records is tire some, files are easily lost or
misplaced in cabinets, lack of data security, manual calculation are vulnerable to errors and big
storage space is wasted where file cabinets sit.
4.3.3. Challenges of the current system
Base on the responses and observations on the current manual system of record keeping and
filling in the Ahmadu Bello University Sick-bay, the following issues are experienced;
a. Inefficient record management.
b. Misplacement of patients documents,
c. Not able to retrieve long consult patients’ records,
d. Loss of records or files alteration of information which normally result in unnecessary
delay of treatment.
4.3.4. Proposed record management system for the clinic
Most of the respondents suggest an automated system for the clinic, in which a computer
program and other related technology can be used in the management and operational
functions of the clinic in other to benefit and experience the advantages of technology in the
37
digital era.
4.3.5. Benefits of the proposed system
It was also observed from the responses on this study that, the introduction of an automated
record management system, in which computers will be used in the management of patents
records and information in the clinic will leads to the following progress;
a. More accurate record management, time saving, and easy retrieval of patients
information will be observed.
b. The computer program can also be a web base that will enable a quick access to
patient’s record globally in case of emergency.
c. Computer program can also provide adequate security to patients records in which only
authorize users can have access to the system.
d. Computer program can also provide an adequate schedule for both the doctors and the
patients of the clinic, in which an appointment has to make over the internet by the
patient before visiting the doctor.
4.3.6. System User Requirements
The system is expected to meet the following requirements;
a. Should allow secure entry of patient records
b. Retrieval of these records should be done with ease
c. Should allow users to enter new records
d. Also the ability to edit, search, delete the existing records.
e. Should be able to create hard copies as well as system backup for all records in the
38
system.
f. Data entered by users, should be fast, give instant responses to inquiries.
g. Should provide security for data entered through authentic users to the system only.
h. Should display an error message to the user each time an error is encountered by the
system during data entry.
i. Should output patients’ records, diagnosis records and who carried out the particular
event.
4.4. Program Analysis and Design
This section deals with the clear analysis of the system design, tools used and system
specifications and its functions.
4.4.1. System Design
System design specifies how the system accomplished the set objectives. It consists of both
logical and physical design activities. The coding of the system design in a particular
programming language, in the case of this research work, the design/implementation where
done using the hypertext pre-processor (PHP) and MySQL as a database.
4.4.2. Tools used and System Specifications
This consists of data, software and the hardware specifications
a. Data; Data refers to the raw facts about a given sample specimen, which when
processed, results to information as the output. Data is the input to the system. Data
to the system in addition it comprises of the facts in a clear and orderly way, for the
39
purpose of being able to compute and relate other data so as to produce summary in
form of output.
b. Software Specifications; this provides all the facilities for manipulating data and its
interface between the end user of the system and the hardware. The proposed
system was designed using hypertext pre-processor (PHP) and MySQL as the back
end for storing data. In order for the system to function as expected the computer on
which it will be installed should have the following software installed as explained
in their respective manuals;
 A higher version of windows operating system like windows xp, windows7,
windows8 or windows10.
 A Xampp or Wamp server should be installed on which a created site will
run as well as the created data bases will be stored for the localhost.
 Notepad PlusPlus (np++) or any other text editor software for coding of the
system programme.
c. Hardware Specifications; these are the physical or tangible components of the
system; which include the monitor, CPU, mouse, keyboard, UPS, among others.
Data/information used in the designs will safely be stored on hard disks.
 The system requires a properly installed computer system to run effectively
 The system is suited for computers with a Pentium IV or higher processor
with a speed of at least 1.5GHz.
 Considerable amount of RAM and hard disk space are required for proper
functioning of the system. RAM 2GB and above is recommended
 Due to the need for installation and creation of backups, the system should
40
provide a means of connecting storage devices such as flash disks, compact
discs, and external hard disks among others.
 A good printer for printing the system output generated by the application
where printing is necessary
4.4.3. Database Design
This phase of the system designs focuses mainly on the procedures, tools and the
documentation that aids to support the process of database designs. The database will be
designed with interims of relationships and the tables are related by sharing common field.
The proposed system’s data will consist of the following entities;
a. Admin
b. Appointment
c. Doctor
d. Patients
e. Patient reports
f. Timings
41
Figure 4.1. Entity Relationship Diagram
Physical Database Design
This provides the detailed data description and data definition subsystem of the database
management system is set. It also referred to as data definition language. Database tables are
designed under physical database design.
42
Figure 4.2. Admin table
Figure 4.3. Appointment table
43
Figure 4.11. Doctors' table
Figure 4.12. Patients table
44
4.4.4 The Developed System Interfaces
Details of various interfaces of the system are given bellow:
Welcome interface
Below is the interface that is displayed when a user runs the system. It gives the user the
options of allowing him to make an appointment with a doctor, login or register as the staff of
the clinic, login or register as a patient in the clinic, and lastly, login as the record or system
administrator in the clinic.
Figure 4.13. Welcome interface
Appointment interface
From the appointment interface, the user has the option to see all the available doctors in the
clinic together with their specialization and their shifting time, from which the user can now
45
make or book an appointment with his/her preferred doctor after authenticating his/her login
details.
Figure 4.14. Appointment interface
Staff Login Interface
This interface provide for only the staff of the clinic, form which he/she can login or create an
account for him/her self.
When a staff is login to the system he can view all his appointment and from which he can also
attend to his patients with a provided interface to update the patients treatment records.
46
Figure 4.15. Staff login interface
Patients’ Login Interface
This interface provide access for patients to login or create an account from which he/she can
make an appointment with a doctor in the clinic, this interface also provide for the patient to
view or print his previous treatment reports and prescriptions by the doctors.
47
Figure 4.16. Patients login interface
Administrators interface
The Administrator has the full control of the system from which he can create, read, update or
delete any record or information from the system.
48
Figure 4.17 Administrators interface
49
CHAPTER FIVE
SUMMARY, CONCLUSION AND SUGGESTION
5.1 Summary
The present manual system of collection and keeping / storing records, documents, and all
other related patients’ information in the Ahmadu Bello University Sick-bay is inefficient and
below standard, hence, the need for the development of a computer application system in
Nigerian clinics as it has expanciated upon by this research work.
However, the study has revealed the problems associated with the manual method of record
keeping such as difficulties in sorting, retrieving and updating records, lack of security of
records, loss of relevant information and so on. The program developed for this project is used
to handle the proper storage of all records and related information in a clinic, the patients’
treatment reports, date of treatments, doctors in charge and other relevant information will be
entered into the system.
The application of computer in our health sector is meant to improve on or overcome the
lapses of manual method of record keeping in the Nigerian clinics.
5.2 Conclusion
In general, the developed system is an automated record management system that is for
efficient patient’s data management. With various interfaces which automate patients’ data
capture and review that is kept in the database, the command buttons on each interface are
well coded to allow only the required information to be entered into the system and error
50
messages displayed in case invalid input is entered, it allows the authorized users to perform
specific duties such as; inserting or adding patients’ records, deleting a record, editing and
searching through the database. With the developed system being used, problems such as
records misplacement, data redundancy and inconsistencies, difficulty in updating the existing
data, illegal access to data and time delay in processing data are easily handled by the system.
5.3. Suggestion
Due to the study limitations stated earlier in chapter one, the researcher suggest the following
about the system:
a. The researcher suggests that the users should be trained on how to use the system.
This will enable users to understand the functionalities of the system.
b. There is need for system upgrade as user requirements increase. User requirements
differ with time, therefore, it is of great help for the system to be flexible enough.
c. Other researchers can use this project as a basis during further studies on
automated clinic record management system.
d. There is need to do more research on other programming languages like JAVA,
PYTHON and alike.
51
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59
APPENDIX
AN INTERVIEW GUIDE FOR THE CLINIC ADMINISTRATORS
AHMADU BELLO UNIVERSITY, ZARIA
FACULTY OF EDUCATION
DEPARTMENT OF LIBRARY AND INFORMATION SCIENCE
Dear Respondent,
I am a student of Ahmadu Bello University, Zaria, Department of Library and Information
Science carrying out a research about the current record keeping System in use in Ahmadu
Bello University Sick-bay in an effort aimed at improving it or developing a new system if need
be. Please note that the information provided will be used for only this study and not shared
with any third party. I therefore request you to answer some of the following questions.
Yours faithfully
Alfa Mahfooz Ahmed
U11LS1018
1. What is your current work position and department in ABU Sick-bay?
2. How do you find the current records keeping system use keeping records of patients in
the clinic?
3. What problems do you find in the current system?
4. In case of a new system, what changes do you propose?
5. How will this system benefit you as an administrator (user)?
6. Comment about the way the services are rendered at ABU Sick-bay.
60
QUESTIONNAIRE I
AHMADU BELLO UNIVERSITY, ZARIA
FACULTY OF EDUCATION
DEPARTMENT OF LIBRARY AND INFORMATION SCIENCE
Dear Respondent,
I am a student of Ahmadu Bello University, Zaria, Department of Library and Information
Science carrying out research about the current record keeping System in use in Ahmadu Bello
University Sick-bay in an effort aimed at improving it or developing a new system if need be.
Please note that the information provided will be used for only this study and not shared with
any third party. I therefore request you to answer some of the following questions.
Yours faithfully
Alfa Mahfooz Ahmed
U11LS1018
61
Tick appropriately or write as the space provided.
Section A: Personal Information.
1. What is your gender?
f. Male [ ]
g. Female [ ]
2. What is your current status in the clinic?
a. Client [ ]
b. Doctor [ ]
c. Nurse [ ]
d. Administrator [ ]
Section B: other Information.
3. How do you assess the current patients’ records management system in the clinic?
a. Very good [ ]
b. Good [ ]
c. Fair [ ]
d. Poor [ ]
4. If administrator, what is your current work position and department in the clinic?
______________________________________________________________________
______________________________________________________________________
5. If worker, what is your current work position in the clinic?
______________________________________________________________________
6. What problems do you find in the current system?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7. In case of a new system, what changes do you propose?
______________________________________________________________________
______________________________________________________________________
8. How will this system benefit you as a user?
62
______________________________________________________________________
______________________________________________________________________
9. Do you even think there is a need for a new patients’ records management system in the
clinic?
a. Yes [ ]
b. No [ ]
10. Are you satisfied with the services provide at the clinic?
a. Yes [ ]
b. No [ ]
11. Do you think the new propose system will solve the problems that are in the existing
system in the clinic?
a. Yes [ ]
b. No [ ]

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AUTOMATED CLINIC RECORD MANAGEMENT SYSTEM A CASE STUDY OF AHMADU BELLO UNIVERSITY SICK-BAY

  • 1. AUTOMATED CLINIC RECORD MANAGEMENT SYSTEM A CASE STUDY OF AHMADU BELLO UNIVERSITY SICK-BAY BY ALFA MAHFOOZ AHMED U11LS1018 A PROJECT SUBMITTED TO THE DEPARTMENT OF LIBRARY AND INFORMATION SCIENCE IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF BACHELOR DEGREE IN LIBRARY AND INFORMATION SCIENCE (BLIS) September, 2015
  • 2. ii Declaration I, Alfa Mahfooz Ahmed, declare that this project titled “Automated clinic record management system, a case study of Ahmadu Bello University Sick-bay” was written by me and all ideas borrowed from other people’s intellectual work has been duly acknowledged. ________________________ ____________________ Alfa Mahfooz Ahmed Date
  • 3. iii Approval Page The undersigned have read and approved this study titled “Automated clinic record management system, a case study of Ahmadu Bello University Sick-bay” in partial fulfillment of the requirement for the award of Bachelor degree in Library and Information Science (BLIS). ________________________ ____________________ Mal. Muhammad Musa Hayatu Date Project Supervisor ________________________ ____________________ Dr. Abdullah I. Musa Date Head of Department
  • 4. iv Dedication This research work is dedicated to the following: Parents: Alh. Ahmad Imam and Hajiya Rukyat AbdulRahman Boss: Late Alh. Abdulkadir Suleiman Idris Grand Mother: Late Hajiya Mairo
  • 5. v Acknowledgement My profound gratitude goes to the almighty Allah for spanning my life to the end of this phase of education. I also appreciate the help, guidance, encouragement and the creative criticism of my supervisor, Mal. Muhammad Musa Hayatu (Ph.D. in anticipation Insah-Allah) throughout the course of this project. My appreciation goes to all my lectures in the Department of Library and Information Science who helped in one way or the other throughout my programme in Ahmadu Bello University, Zaria. Special thanks goes to my parents, I will forever appreciate your gift of love, support, sacrifice and prayers all in the bit to see that I obtained a degree. I am confidently proud of you. I will also not forget to mention the contribution of my siblings, uncles, brothers, and sisters especially Hajiya Latifat Ahmad Imam (Ummu Nusaiba), Hajiya Mansurat Ahmad (Ummu Badrudeen), Ma. Muh. Najib Ahmad Imam, Alh. Mustapha Ahmad Imam, and the rest of my family members for their moral support. There are close friends who so dear to me, who have contributed in one way or the other; Abdullahi Ibrahim Maska, Nura Aliyu Dabai, Bello Hamman Adama, Bello Bashir, Zubaida Muhammad Nalado, Farida Jauro Umar and many that could not be mentioned, May Allah (SWT) Blessed you all, and I am very grateful.
  • 6. vi ABSTRACT This study was carried out to design and introduce the use of an automated clinic record management system and has chosen Ahmadu Bello University Sick-bay as the case study for the first implementation with the aim of improving their services especially in this digital era. A qualitative research was adopted and the instrument used for the study are interview, observation and questionnaire where some questions were raised by the researcher such as, what are the challenges associated with the use of the current manual record management system in the Ahmadu Bello University Sick-bay? How to improve on the current manual record managements system to minimize human error in the process of the records? How to improve on the current manual time management among the staff of the clinic? And how to provide more privacy to patients’ records and information in the clinic? Fifteen (15) respondents were randomly chosen from both the clients and staff of the clinic. And at the end of the research, the findings were analyzed which led to the designing of the aforementioned system. And in order to design the programme, the researcher uses some web development tools such as; Adobe Dreamweaver and Notepad Plus Plus for the required coding; hypertext preprocessor (PHP) and Java scripts (JS) to connect the interfaces to the database; and My-SQL was used to design the databases that store the overall system data. Finally; summary, conclusion and suggestion were given on the problems associated with the manual method of record keeping such as difficulties in sorting, retrieving and updating records, lack of security of records, loss of relevant information and so on, it was also suggested that the implementation of this programme will help in improving the effectiveness and efficiency in our clinics.
  • 7. vii Table of Contents Declaration..................................................................................................................................................................ii Approval Page ..........................................................................................................................................................iii Dedication...................................................................................................................................................................iv Acknowledgement....................................................................................................................................................v ABSTRACT...................................................................................................................................................................vi LIST OF TABLES..........................................................................................................................................................x LIST OF FIGURES..................................................................................................................................................... xi LIST OF ABBREVIATIONS ...................................................................................................................................xii CHAPTER ONE............................................................................................................................................................1 INTRODUCTION.......................................................................................................................................................1 1.1Background of the Study..................................................................................................................................1 1.2. Statement of the Problem...............................................................................................................................6 1.2.1. Overview of the Current System ........................................................................................................7 1.3. Research Questions..........................................................................................................................................7 1.4. Aims and Objectives of the Study...............................................................................................................8 1.5. Significance of the Study ...............................................................................................................................8 1.6. Scope of the Study ............................................................................................................................................9 1.7. Limitation of the Study ................................................................................................................................10 1.8. Definition of Some Key Terms..................................................................................................................11 Reference...................................................................................................................................................................13 CHAPTER TWO.......................................................................................................................................................14 LITERATURE REVIEW...........................................................................................................................................14 2.1. Introduction.....................................................................................................................................................14 2.2. Diffusion of Innovations.............................................................................................................................14 2.3. Previous Studies that Adopted this Theory..........................................................................................17 2.4. Automated Clinic Record Management System and the DOI theory .......................................21
  • 8. viii 2.5. Summary of the Reviews.............................................................................................................................24 References.................................................................................................................................................................25 CHAPTER THREE ....................................................................................................................................................27 RESEARCH METHODOLOGY............................................................................................................................27 3.1. Introduction.....................................................................................................................................................27 3.2. Method Adopted for the Study .................................................................................................................27 3.3. Population of the Study ...............................................................................................................................28 3.4. Sampling and Sampling Procedure........................................................................................................29 3.5. Instrument used for Data Collection .....................................................................................................30 3.6. Procedures for Data Collection................................................................................................................31 3.7. Procedures for Data Analysis....................................................................................................................32 References.................................................................................................................................................................33 CHAPTER FOUR......................................................................................................................................................34 DATA ANALYSIS AND DESIGN........................................................................................................................34 4.1. Introduction.....................................................................................................................................................34 4.2. Data Analysis...................................................................................................................................................34 4.3. Descriptive Analysis......................................................................................................................................35 4.3.1. Respondents Details..............................................................................................................................35 4.3.2. Current records keeping system use in keeping records of patients in the clinic.......35 4.3.3. Challenges of the current system....................................................................................................36 4.3.4. Proposed record management system for the clinic................................................................36 4.3.5. Benefits of the proposed system.......................................................................................................37 4.3.6. System User Requirements.................................................................................................................37 4.4. Program Analysis and Design...................................................................................................................38 4.4.1. System Design .........................................................................................................................................38
  • 9. ix 4.4.2. Tools used and System Specifications............................................................................................38 4.4.3. Database Design.....................................................................................................................................40 4.4.4 The Developed System Interfaces.....................................................................................................44 CHAPTER FIVE.........................................................................................................................................................49 SUMMARY, CONCLUSION AND SUGGESTION .......................................................................................49 5.1 Summary............................................................................................................................................................49 5.2 Conclusion.........................................................................................................................................................49 5.3. Suggestion.........................................................................................................................................................50 REFERENCES.............................................................................................................................................................51 Bibliography.............................................................................................................................................................53 APPENDIX.................................................................................................................................................................59
  • 10. x LIST OF TABLES Table 3.1: Sampling size Table 4.3.1: Respondents details
  • 11. xi LIST OF FIGURES Figure 4.1 Entity Relationship Diagram Figure 4.2 Admin table Figure 4.3 Appointment table Figure 4.4 Doctors' table Figure 4.5 Patients table Figure 4.6 Welcome interface Figure 4.7 Appointment interface Figure 4.8 Staff login interface Figure 4.9 Patients login interface Figure 4.10 Administrators interface
  • 12. xii LIST OF ABBREVIATIONS ACRMS – Automated Clinic Record Management System EHR – Electronic Health Record ICT - Information and Communication Technology PHECC - Pre-Hospital Emergency Care Council DOI - Diffusion of Innovation KARl - Kenya Agricultural Research Institute MoARD - Ministry of Agriculture and Rural Development ABU - Ahmadu Bello University PHP - Hypertext Pre-processor HTML - Hypertext Markup Language CSS - Cascading Style Sheet My-SQL - My - Structured Query Language JS - Java Script RAM - Random Access Memory CPU - Central Processing Unit UPS - Un-interruptible Power Supply
  • 13. 1 CHAPTER ONE INTRODUCTION 1.1Background of the Study With the advent of computers and its related technology, in which everything needs to be done efficiently and effectively the existences of Automated Clinic Record Management System (ACRMS) become necessary. The used of ACRMS can enhance the services and also the work flow of all activity that happens in a clinic where it helps in reducing the workload of medical staff, the number of man power needed and it also make clinic management become more manageable and easier to control. The main objective of this research work is to design a computer base program that will cover all the aspects of management and operations of Ahmadu Bello University Sick-bay. It will enable the clinic registration process becomes computerized and this feature will help a lot in keeping records of all patients and whoever has once received a treatment in the clinic. The program will be used for proper handling of patients’ records and related information in the clinic, the record file, date of appointments, Doctors in charge and other related medical information will be entered into the program. Which is stored in a database that can be accessed easily within a short span, and yet securely stored in an appropriate and stress free manner. AUTOMATION; The word ‘Automation’ is derived from Greek words “Auto” which means (self) and “Matos” (moving). Automation therefore is the mechanism for systems that “move by itself”. However, apart from this original sense of the word, automated systems also achieve
  • 14. 2 significantly superior performance than what is possible with manual systems, in terms of power, precision and speed of operation. Automation can also be a set of technologies that results in operation of machines and systems without significant human intervention and achieves performance superior to manual operation. A Definition from Encyclopedia Britannica (2009) is the application of machines to tasks once performed by human beings or, increasingly, to tasks that would otherwise be impossible. Although the term mechanization is often used to refer to the simple replacement of human labour by machines, automation generally implies the integration of machines into a self-governing system. CLINICAL AUTOMATION; Clinical automations centralized program or software tool implemented within a clinical unit to support the recruitment of volunteers, directly capture study data electronically (e-Source), streamline the clinical process, allows sharing online, real-time, high quality data with clients. One of the important trends in business managements is the focus on processes to create value added services for their ultimate customers. This is to get rid of unwanted, time consuming, unnecessarily repeated business activities of the processes and to monitor how value for customer is as anciently as possible (Vissers J. M. H ,1998), (Johannes-son and Jayaweera,2000). This is also very much valid for healthcare industry. RECORD MANAGEMENT; according to the (National Archives of Scotland) Records management is the systematic control of an organization’s records, throughout their life cycle, in order to meet operational business needs, statutory and fiscal requirements, and community expectations. Effective management of corporate information allows fast, accurate and reliable access to records, ensuring the timely destruction of redundant information and the
  • 15. 3 identification and protection of vital and historically important records. Records management is the foundation layer of all information systems. Management of patient data, through the proper control of the content and the storage and retention of the records, reduces vulnerability to legal challenge or financial loss and promotes best practice through greater coordination of information. We spend most of our lives creating, collecting, recording information – but each of these records is only as valuable as the information it contains, and that is only of value if it can be found when needed, and then used effectively. (Pre-Hospital Emergency Care Council, 2010). Accurate recording and knowledge of the whereabouts of all records is essential if the information they contain is to be located quickly and efficiently. One of the main reasons why records get misplaced or lost is because the destination is not recorded. The quality of records maintained by a clinic can be a reflection to the quality of care provided by them to their patients. Clinics are legally accountable for the standard of practice which they deliver and to which they contribute. Good practice in record management is an integral part of quality of the clinical care. (PHECC, 2010) History of the Ahmadu Bello University Sick-Bay, Zaria The building of the University Health Services was initiated as a sickbay in 1952by the Nigerian College of Arts and Science. It has grown through thick and thin to its bigness now and continues to grow bigger. A population in excess of hundred thousand (100, 000) people with 35,000 student population is now served. At the beginning when the scheme was smaller and more intimate, it seemed easier to know the students. Therefore, from the beginning the struggle has been of space and resources. On the
  • 16. 4 Main Campus, the present location of the 'Sickbay' adjacent to Suleiman Hall covers a total of over 2,600 sq meters, and was occupied in 1968. Before this date, the 'Sickbay' had been located in various areas at various times, from Nagwamatse road in residential Area A, to the Cappa housing unit, then to the former Community Medicine Department and finally to the present site. Apparently, the movements and the expansions of Sickbay had been necessitated by the need to create a more conducive space to cope with rising demand for these services as the institution's population rapidly grew. An appreciation of this rising demand may be gained from the fact that whereas in 1972 the main campus Sickbay had attended to an estimated average of 350 caseson daily basis, this figure had gone up to 500 by 1982 and 700 by 1987 and 700-1000 in 1997 to 2002. On the Kongo campus, on the other hand, the Sickbay had occupied its present location (opposite the Security office) since the inception of the campus, albeit with expansion programme at various stages to cope with the rising demands for its services. Presently, the Unit occupies about 2,000 sq meters and has attended to, on a daily basis, about 200 cases by 1972, 286 cases by 1982 and 309 cases by 1987, accordingly. The same trends have characterized the Sickbay in all other campuses of the University and, like the libraries, the Sickbays constitute points of daily convergence by University staff of all categories for the purpose of meeting Personal and family needs. With the growth of the population, the scheme has struggled to expand and is has now become a full-fledged University Health Services unit with a curative wing at the status of secondary health care facility.
  • 17. 5 In 1996 the department was handed to Dr. A. Usman and to Dr. S.K. Musa in June 1997 to 2012, then M. A. Usman 2012 to 2014 and presently Dr (Mrs.) Madugu as acting director. Hence, the key player in the progress and management of University Health Services is the Director. By 1995, the clinic was reduced to a mere transit camp for doctors due to inadequacy in the University policy for attracting and retaining them. There is an exit of 13 doctors within five years. The Unit which had 266 staff (80 senior and 186 junior staff) by 1998 now has 194 (61 senior and 133 junior), shrinking by 19 senior staff and 53 junior staff due to retrenchment without replacement. Despite the odds the dream of achieving the goal and objectives of an African University health services was never lost. Success began with the period of military sole administrator rtd. Major General Mamman Kwantagora, the unit was renovated in 1996 though the contract was terminated at a stage and could not be completed, 80% of the work was achieved. This administrator gave some level of autonomy to the UHS department began to strengthen sanitation activity of the health services as well as the medical arm. Working closely with the unit, the Mahadi administration (1999 -2004) made remarkable progress in sanitation that has significant positive impacts on the environment, touching the physical, social and psychological well-being of the community. Management of casual laborers in Samaru and Kongo campuses with more than 2000 people who have benefited and so far we have constantly 935 (excluding Students Affairs) currently on the payroll. There is the expansion of preventive and sanitation to four sections: environmental and sanitation, parks and gardens academic and parks and gardens residential
  • 18. 6 and the addition of forest guard with employment of more technical staff. In each residential area workers are now permanently assigned to maintain sanitation. The clinic has successfully gotten registered as a Primary Health Care Provider for NHIS Social Health Insurance Programme. It also warns recently Secondary Health Care Provider in Ophthalmology, Internal Medicine, Dental Pharmacy and Laboratory. This also requires the improvement of UHS master plan. The university through its health services unit and the teaching hospital provides medical and health services to staff and their family limited by its resources. It also carries out pre- employment medical examination to staff and insist on pre-registration medical examination to new students. However there is now the new monetization and the National Health Insurance Scheme policies 1.2. Statement of the Problem The poor record keeping and filling system of our clinics is the bane of the healthcare sector failure. The manual handling of the patient files has led to undue delays in attending to patients at the clinic, and this has been a cause of concern to all citizens. The manual system of record keeping and filling system in Nigerian clinics has over the years proved inefficient. There had been incident of misplaced documents, not able to retrieve long consult patients’ records, loss of records or files, alteration of information etc, result in unnecessary delay of treatment which even sometime leads to the death of the patient.
  • 19. 7 1.2.1. Overview of the Current System Current system that is being used at the Ahmadu Bello University sick-bay is a manual system. Where all information is being collect using form and all data is being kept in the archive, where this conventional ways lead to the need of space and time wasting. Registration The current method of registration in Ahmadu Bello University, Sick-bay where the case study of this project is carried out, all tasks ware done manually. Before a patient can received a treatment from doctors, they need to be registered by the file administrator in the clinic, and if the patient have ever received a treatment from the clinic, then attendance are responsible to retrieve their file where details of that particular person had been kept. In registration process, every patient has to be open a file for in the administrative department where the files are kept for subsequent retrieving whenever the patient visit or has an appointment in the clinic. 1.3. Research Questions This study was carried out to provide solution to the following research questions: a. What are the challenges associated with the use of the current manual record management system in the Ahmadu Bello University Sick-bay. b. How to improve on the current manual record managements system to minimize human error in the process of the records. c. How to improve on the current manual time management among the staff of the clinic. d. How to provide more privacy to patients’ records and information in the clinic.
  • 20. 8 1.4. Aims and Objectives of the Study The aim of this study is to design a clinic record management system in order to achieve efficient records keeping in the clinic. While the objectives of this study are as follows:- a. To find out the challenges associated with the current patient’s record management system in the Ahmadu Bello University Sick-bay. b. To observe ways of improving on the current patient’s record management system in the clinic. c. To identify means of improving on time management among the staff of the clinic. d. To investigate ways of providing a standard record storage and management system for the clinic, in order to provide more secure patients record management system for the clinic. 1.5. Significance of the Study Currently, the Ahmadu Bello University Sick-bay operates a manual records management system, with the introduction of an automated system, in which computers will be used will achieve more accurate record management, time saving, and easy retrieval of patients’ information. The program will be a web base program that will enable a quick access to patient’s record globally in case of emergency. And will also provide adequate security to patients records in which only authorize users can have access to the system with username and password. The program will also provide an adequate scheduling for both the doctors and the patients, in which appointment has to be made by the patient before visiting the doctor.
  • 21. 9 1.6. Scope of the Study The general scope of this study will be focused on Ahmadu Bello University sick bay. While the specific scopes of the study are as follows:- a. The case study of the study is Ahmadu Bello University Sick bay. b. A computer base program will be design to manage patents records in the clinic. c. This program will be design using a Microsoft windows environment. e. The program will be design using hypertext pre-processor (PHP) and the relational database MYSQL as the programming language tools. d. The program will also have four (4) interfaces (Modules) which are as follows:- Appointment Interface – this interface provide all the details of the doctors in the clinic together with their specialization and shifting time, from which a patient can make an appointment to see the doctor. Doctor’s Interface – through this interface, the doctor can create an account for himself, from which he can make his schedule for the week, attend to his scheduled patients and also update the patient’s medical records after diagnosing. Patient’s Interface– from this interface patient can create an account for him/herself and through which he can only view his medical reports or print them out when need be. The Admin Interface –the administrator has the full control over the system from which he can create, read, update and delete any record or information from the system.
  • 22. 10 1.7. Limitation of the Study Some of the anticipated shortcomings that may be face by the researcher in this project are categorized into two:- 1. Researchers limitation and 2. The program limitations. Researcher limitations a. The biggest limitation is the time that is available for the research; this led to scaling down of the program and leaving out some operations. There was no time available for the program to be implemented in a working environment. b. There is no time available for testing of the system in a working environment. The system will only been test with sample data by the developer. c. Programming languages: it was difficult in selecting the appropriate language to develop the system. This was due to lack of knowledge of other programming languages like python, ajax. d. There was also shortage of funds to facilitate the whole research process therefore the researcher had to work within the limited budget to produce what is possible. e. The researcher encountered many problems in data collection because it was done during the time when the clinic was busy therefore getting the required information was hard. Program limitations a. The program will not be suitable for computer illiterate people.
  • 23. 11 b. The program will be suitable only for clinics in academic environment and other non- profit making institution. c. The program does not do away with paper work completely; as papers are still used at some point. 1.8. Definition of Some Key Terms For the purpose of this study the following terms are defined:- a. Hospital/ Clinic/Sick-bay: refers to an institution where people receive medical, surgical, or psychiatric treatment and nursing care. b. Patient: somebody who needs or receives medical treatment. c. Doctor: A person who is qualified and licensed to give people medical treatment and according to advance learner dictionary a medical doctor is a qualified practitioner of medicine; physician. d. Pharmacist: A person who is trained and licensed to dispense medicinal drugs and to advise on their use. e. Nurse: A person who is trained to look after sick or injured people, especially somebody who works in a hospital or clinic, administering the care and treatment that a doctor prescribes. f. Medicine: A drug or remedy used for treating illness. g. Lab: A place where research and testing is carried out. h. Ward: A room in a hospital, especially one for several patients being given similar treatment.
  • 24. 12 i. Automation: The act of implementing the control of equipment with advanced technology; usually involving electronic hardware "automation replaces human workers by machines" j. Management: Is a process of getting things done through people by making efficient use of resources. It requires the manager to identify problems with the community. k. Record: Record is documented information in print or non print format. The record can be manual or digitized. l. Medical Record: Is a record containing patient health information. It indicates doctor’s diagnostic statement and the prescribed treatment.
  • 25. 13 Reference Creswell, J. W. (1999). Mixed-method research: Introduction and application. In G. J. Cizek (Ed.), Handbook of educational policy (pp. 455–472). San Diego: Academic Press. Dictionary.com, retrieve from http://dictionary.reference.com/browse/automation Donald Ary, Lucy Chese J.&AsgharRazavieh (1984), Introduction toResearch in Education: Holt, Rinehart and Winston, Inc. http://www.batesville.k12.in.us/physics/PhyNet/AboutScience/Hypotheses.html Lim Chee S. E, Chennupati K. R, and Surya P. G. (2009, November). Electronic Medical Records Management Systems: An Overview. Journal of Library & Information Technology, Vol. 29, No. 6, pp. 3-12 Microsoft Encarta 2009. (DVD): Microsoft Corporation. © 1993-2008 National Archives of Scotland (NAS), retrieve from http://www.nas.gov.uk/recordKeeping/recordsManagement.asp Online Encyclopaedia Britannica (2009) Pre-Hospital Emergency Care Council (2010) www.phecc.ie Prasad J., Jeewanie J., Lal Wellakkage V. M., Samantha L. (2006, September) Clinics Management System (CMS) based onPatient Centered Process Ontology. RUHUNA JOURNAL OF SCIENCE, Vol. 1, No. 1, pp. 40 – 39 ShaliniPrasad, AjithRao and EeshooRehani (2001, SEPTEMBER 18TH ) Developing Hypothesis and Research Questions: 500 Research Methods www.public.asu.edu/~kroel/www500/hypothesis.pdf
  • 26. 14 CHAPTER TWO LITERATURE REVIEW 2.1. Introduction This chapter review some related literature in the area of the study, from which the researcher tried to identify, locate, read and evaluate some previous studies, observations, theories, opinions and comments, which are arranged in the following headings:- 2.2. Diffusion of innovation theory. 2.3. Previous studies that adopted this theory 2.4. Automated Clinic Record Management System and the DOI theory 2.5. Summary of the reviews. 2.2. Diffusion of Innovations Diffusion of Innovations is the process by which an innovation is communicated through certain channels over time among the members of a social system. It is a special type of communication, in that the messages are concerned with new ideas. Communication is a process in which participants create and share information with one another in order to reach a mutual understanding. This definition implies that communication is a process of convergence (or divergence) as two or more individuals exchange information in order to move toward each other (or apart) in the meanings that they ascribe to certain events. We think of communication as a two-way process of convergence, rather than as a one-way, linear act in which one individual seeks to transfer a message to another (Rogers and Kincaid, 1981).
  • 27. 15 The process of adopting new innovations has been studied for over 30 years, and one of the most popular adoption models is described by Rogers in his book, Diffusion of Innovations (Sherry & Gibson, 2002). Much research from a broad variety of disciplines has used the model as a framework. Dooley (1999) and Stuart (2000) mentioned several of these disciplines as political science, public health, communications, history, economics, technology, and education, and defined Rogers’ theory as a widely used theoretical framework in the area of technology diffusion and adoption. In fact, much diffusion research involves technological innovations so Rogers (2003) usually used the word “technology” and “innovation” as synonyms. For Rogers, “a technology is a design for instrumental action that reduces the uncertainty in the cause-effect relationships involved in achieving a desired outcome” (p. 13). It is composed of two parts: hardware and software. While hardware is “the tool that embodies the technology in the form of a material or physical object,” software is “the information base for the tool” (Rogers, 2003, p. 259). Since software (as a technological innovation) has a low level of observability, its rate of adoption is quite slow. According to Rogers1962; the Four Main Elements in the Diffusion of Innovations are stated in the definition as the process by which (1) an innovation (2) is communicated through certain channels (3) over time (4) among the members of a social system. The four main elements are the innovation which is the idea, practice, or object that is perceived as new by an individual or other unit of adoption, communication channels which has also been defined as the process by which participants create and share information with one another in order to reach a mutual understanding, time defines both the pace at which progress occurs and the positions individuals occupy amid the evolution of such progress (Inman, 2000), and the social system is defined as a set of interrelated units that are engaged in joint problem solving to accomplish a
  • 28. 16 common goal. They are identifiable in every diffusion research study, and in every diffusion campaign or program. Attributes of Innovations and Their Rate of Adoption Attributes of innovations and their rate of adoption discourses why certain innovations spread more quickly than others? And also why do other innovations fail? Diffusion scholars have recognized five attributes that determine the success or failure of an innovation in any organization, which are, relative advantage, compatibility, Simplicity, trialabilty, and Observabilty:- a. Relative advantage: This is the degree to which an innovation is perceived as better than the idea it supersedes by a particular group of users, measured in terms that matter to those users, like economic advantage, social prestige, convenience, or satisfaction. The greater the perceived relative advantage of an innovation, the more rapid its rate of adoption is likely to be. There are no absolute rules for what constitutes “relative advantage”. It depends on the particular perceptions and needs of the user group. b. Compatibility with existing values and practices: This is the degree to which an innovation is perceived as being consistent with the values, past experiences, and needs of potential adopters. An idea that is incompatible with their values, norms or practices will not be adopted as rapidly as an innovation that is compatible. c. Simplicity and ease of use: This is the degree to which an innovation is perceived as difficult to understand and use. New ideas that are simpler to understand are adopted more rapidly than innovations that require the adopter to develop new skills and understandings.
  • 29. 17 d. Trialability: This is the degree to which an innovation can be experimented with on a limited basis. An innovation that is trialable represents less risk to the individual who is considering it. e. Observable results: The easier it is for individuals to see the results of an innovation, the more likely they are to adopt it. Visible results lower uncertainty and also stimulate peer discussion of a new idea, as friends and neighbours of an adopter often request information about it. According to Everett Rogers (2003), these five attributes determine between 49 and 87 percent of the variation in the adoption of a new products. These five attributes make a valuable checklist to frame focus group discussions or project evaluations. They can help identify weaknesses to be addressed when improving products or behaviours. 2.3. Previous Studies that Adopted this Theory As mentioned earlier, several scholars from different disciplines have used this theory in investigating, analyzing and exploring why new ideas (innovations) are adopted and why others fail. This section has discussed some of the previous studies that used the DOI Theory to explain how innovations (new ideas) are developed, processed and implemented in organizations. A study conducted by Olatokun W.M and gbinedion L.J (2009) on the Adoption of Automatic Teller Machines in Nigeria: An Application of the Theory of Diffusion of Innovation, the main objective of knowing what could be done to prevent the inhibition surrounding the use of Automatic Teller Machines in Nigeria, the researchers have use the five attributes of innovation
  • 30. 18 according to Rogers (1995) - relative advantage, compatibility, complexity, trialability and observability, in finding out the degree of influence attitude and the intention of the people to use the technology, hypothesis are designed in testing each of the constructs. The data collection instrument used was a structured questionnaire administered to ATM customers of the selected 14 banks. While the findings of the study state that, Relative Advantage of using ATMs; how hard it was to use ATMs, how compatible ATMs were with the lifestyle of the users; how much has been registered (observed) about ATMs by the users and whether ATMs could be tested before consistent use, were issues that influence users’ attitude towards intention to use ATMs. It also states that, the Attitude of an ATM user would later affect his/her intent to use an ATM. Since Observability had the greatest impact on attitude, it is important for banks to give the right impression about ATMs. This could be in terms of locating ATMs in hidden places so that non adopters could observe others use ATM before adopting it themselves. Kamau L.M (2014), also conducted a study titled “Applying Rogers’ Diffusion of Innovations Theory to Investigate Technology Training for Secondary Mathematics Teachers in Kenya” the study was aimed at examine the extent technology training influence secondary mathematics teachers’ decisions to adopt or not to adopt technology in the classroom practice from Nairobi and Nyandarua counties in the Republic of Kenya. The study applied the case study research design and the Rogers’ (2003) diffusions of innovations theory to investigate the research problem. The study found that mathematics teachers have not received adequate technology training relevant for mathematics teaching because of technologically unskilled trainers, lack technology software related to mathematics teaching, and teachers are not motivated to attend training for lack of incentives. The study suggests radical changes be undertaken on how training of mathematics teachers by the Center for Mathematics Science and Technology
  • 31. 19 Education in Africa (CEMASTEA) and the National ICT innovation and Integration Centre (NI3C) and the teacher training programs at the public universities and colleges. The study also recommends that further research is needed to understand technology training for mathematics teachers in Kenya. Kiplang'at J. and Ocholla D.N (2005) also conducted a study titled “Diffusion of Information and Communication Technologies in communication of agricultural information among agricultural researchers and extension workers in Kenya” The paper reports on the findings of a study that investigated the diffusion of Information and Communication Technologies (ICTs) in communication of agricultural information among agricultural researchers and extension workers in Kenya. The study focused on the public agricultural sector and covered the Kenya Agricultural Research Institute (KARl) and the Ministry of Agriculture and Rural Development (MoARD). A survey research method comprising a self-completed questionnaire and a structured interview schedule was utilized to gather data from the respondents who comprised of I59 agricultural researchers, 138 extension workers and 59 key informants. This was supplemented by observation and document review. It was found out that KARl and MoARD had adopted a wide variety of ICT tools and services in an effort to facilitate information sharing and exchange among agricultural researchers, extension workers, farmers and other actors involved in research and extension. These ranged from modern ICTs based on digital information and traditional lCTs based largely on analogue information waves. The ICT models adopted addressed the different kinds of information needs and communication problems encountered by agricultural researchers and extension workers. However, it was observed that despite the efforts to expand and modernize ICTs in the agricultural sector, its growth had been hampered by a number of constraints and challenges
  • 32. 20 which require the intervention and interaction of all the stakeholders in the agricultural and ICT sector and also involvement of the government. Ibrahim M.A and Sadiq S.M (2012) also conducted a study on Mobile Banking Adoption: Application of Diffusion of Innovation Theory; The objective of the study was to investigate a set of technical attributes and how they influence mobile banking adoption in a developing nation, like Saudi Arabia. The study uses diffusion of innovation as a base-line theory to investigate factors that may influence mobile banking adoption and use. More specifically, the objective of the research was to examine the potential facilitators and inhibitors of mobile banking adoption. The researchers have uses hypothesis in testing each of the Rogers (2003) attributes of innovation in related with the adoption of mobile banking. Survey instrument was used for the research, in which 20 questionnaires are randomly shared among some selected mobile banking users; findings also suggest that banks in Saudi Arabia, should offer mobile banking services that are compatible with various current user requirements, past experiences, lifestyle and beliefs in order to fulfill customer expectations. With better mobile banking support and provision of variety of services, the more useful customers perceive mobile banking to be and to increase their level of adoption. Hence, bank’s attention should focus on understanding customer behavior and designing reliable mobile banking systems that will meet their needs and provide useful and quality services. In addition, banks should focus on communicating information that emphasizes the relative advantage and usefulness of mobile banking compared to other banking channels like physical presence to the bank or using ATM machines. Banks must seek to reduce risk perceived by their customers by offering specific guarantees protecting them and taking their complaints seriously and urgently.
  • 33. 21 Another study conducted under this theory is by Eric W. F, Menachemi N. and Phillips T. (2006), titled “Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care be Paperless?” The purpose of this study was three fold. First, was to gather and synthesize the historic literature regarding electronic health record (EHR) adoption rates among physicians in small practices (ten or fewer members). Next, was to construct models to project estimated future EHR adoption trends and timelines. The researchers then determined the likelihood of achieving universal EHR adoption in the near future and articulate how barriers can be overcome in the small and solo practice medical environment. This study used EHR adoption data from six previous surveys of small practices to estimate historic market Penetration rates. Applying technology diffusion theory, three future adoption scenarios, optimistic, best estimate and conservative are empirically derived. EHR adoption parameters, external and internal coefficients of influence are estimated using Bass diffusion models. And all the three (3) EHR scenarios display the characteristic diffusion S curve that is indicative that the technology is likely to achieve significant market penetration, given enough time. Under current conditions, EHR adoption will reach its maximum market share in 2024 in the small practice setting. And the study concluded with the promise of improved care quality and cost control has prompted a call for universal EHR adoption by 2014. The EHR products now available are unlikely to achieve full diffusion in a critical market segment within the time frame being targeted by policy makers. 2.4. Automated Clinic Record Management System and the DOI theory There are always reasons for introducing an innovation in an organization. As rightly pointed out by Rogers (1995) the innovation process begins with agenda setting where one or more
  • 34. 22 individuals in an organization identify an important problem and then seek an innovation as a means of coping with the problem. Rogers (1995) further observes that the problem usually emanates from a performance gap which is the discrepancy between how the organization is performing in comparison to its potential. He is of the view that the discrepancy is identified by members of the organization and is a strong force that compels them to search for an innovation to solve the identified problem. For example, the introduction of an Automated Clinic Record Management System in the Ahmadu Bello University Sick-bay in which patients’ records is previously collected manually, and to achieve the objectives given in this study, the researcher has plan to apply the five attributes of the Diffusion of Innovation theory to the planning and implementation of the project (Automated Clinic Record Management System), which are, Relative advantage, Compatibility, Simplicity, Trialabilty, and Observabilty:- a. Relative advantage refers to the degree to which an innovation is perceived as providing more benefits than its predecessor [Moore & Benbasat 1991]. Relative advantage results in increased efficiency, economic benefits and enhanced status [Rogers 2003]. Past research has found that relative advantage of an innovation is positively related to the rate of adoption [Moore & Benbasat 1991]. Research suggests that when user perceives relative advantage or usefulness of a new technology over an old one, they tend to adopt it [McCloskey 2006; Rogers 2003]. In the context of ACRMS adoption, benefits such as organize records management, easy retrieval of patients’ records, accurate scheduling and secure patients records, which will speed up most activities in the clinic may likely leads to the adoption of the program
  • 35. 23 b. Complexity; Cheung et al. [2000] defined complexity as the extent to which an innovation can be considered relatively difficult to understand and use. Complexity is the opposite of ease of use. Ease of use refers to the extent to which the program will be perceived as easy to understand and operate. A vast body of research suggests that there is a strong impact of perceived ease of use of new technology on its adoption [Gu et al. 2009; Luarn & Lin 2005; Venkatesh & Davis 2000; Wang et al. 2006]. As for the ACRMS, the program will be in a GUI format that can be operate with few clicks and will also save time compare to the manual system. c. Compatibility refers to the degree to which a service is perceived as consistent with users’ existing values, beliefs, habits and present and previous experiences [Chen et al. 2004]. Compatibility is a vital feature of innovation as conformance with user’s lifestyle can propel a rapid rate of adoption [Rogers 2003]. As for the ACRMS, the program also aim at providing an interface as it was on the manual record papers in the clinic. d. Observability of an innovation describes the extent to which an innovation is visible to the members of a social system, and the benefits can be easily observed and communicated [Rogers 2003]. Moore & Benbasat [1991] simplified the original construct by redefining observability into two constructs: visibility and result demonstrability. In the context of ACRMS, observability will be define as the ability to access the services of the clinic at any time and from any location without any delay or queue, and conveying the accessibility benefits to others. Through such exposure, other clinics also see its benefits and try to adopt it. e. Trialability refers to the capacity to experiment with new technology before adoption. Potential adopters who are allowed to experiment with an innovation will feel more
  • 36. 24 comfortable with it and are more likely to adopt it [Agarwal & Prasad 1998; Rogers 2003]. Here, the researcher plans to first deploy the program in-house, train the staff on how the program works which will give the clinic chance to try the system and know how it functions before implementing it. 2.5. Summary of the Reviews This chapter has successfully discourses the Diffusion of Innovation theory, which is the perceptions on how deferent people passive new innovation and what makes people adapt to new methods of doing things in the society. It also discourses the five attributes of the theory and some previous studies that adopted this theory, the first study that was reviewed was conducted by Olatokun W.M and gbinedion L.J (2009) on the Adoption of an Automatic Teller Machines in Nigeria, second study by Kamau L.M (2014), on Applying Rogers’ Diffusion of Innovations Theory to Investigate Technology Training for Secondary Mathematics Teachers in Kenya. Third study by Kiplang'at J. and Ocholla D.N (2005) on the Diffusion of Information and Communication Technologies in communication of agricultural information among agricultural researchers and extension workers in Kenya, forth study by Ibrahim M.A and Sadiq S.M (2012) on Mobile Banking Adoption in a developing nation, like Saudi Arabia, and the fifth study was conducted by Eric W. F, Menachemi N. and Phillips T. (2006), on the Adoption of Electronic Health Records by Physicians. And the chapter ended with the application of the theory to the adoption of Automated Clinic Record Management System (ACRMS).
  • 37. 25 References Chen, L., M. Gillenson, and D. Sherrell, “Consumer acceptance of virtual stores: A Theoretical Model and Critical Success Factors for Virtual Stores,” ACM SIGMIS Database, Vol. 35, No. 2: 8-31, 2004. Cheung, W., M. K. Chang, and V. S. Lai, “Prediction of internet and world wide web usage at work: a test of an extended Triandis model,” Decision Support Systems, Vol. 30, No. 1: 83- 100, 2000. Eric W. F, Menachemi N. and Phillips T. (2006). “Predicting the Adoption of Electronic Health Records by Physicians: When Will Health Care be Paperless? J Am Med Inform Assoc. 2006;13:106–112. DOI 10.1197/jamia.M1913. Gu, J-C., S-C. Lee, and Y-H. Suh, “Determinants of behavioral intention to mobile banking,” Expert Systems with Applications, Vol. 36, No. 9: 11605-11616, 2009. Ibrahim M.A and Sadiq S.M (2012). Mobile Banking Adoption: Application of Diffusion of Innovation Theory. Journal of Electronic Commerce Research, VOL 13, NO 4, 2012 Inman, J. A. (2000). The Importance of Innovation: Diffusion Theory and Technological Progress in Writing Centers.The Writing Centre Journal. 21(1), 48-66 Kamau L.M (2014). Applying Rogers’ Diffusion of Innovations Theory to Investigate Technology Training for Secondary Mathematics Teachers in Kenya. Journal of Education and Practice www.iiste.org ISSN 2222-1735 (Paper) ISSN 2222-288X (Online). Vol.5, No.17, 2014 Kiplang'at J. and Ocholla D.N (2005). Diffusion of Information and Communication Technologies in communication of agricultural information among agricultural researchers and extension workers in Kenya. SA jnl Libs & Info Sci 2005, 71 (3) Les Robinson (2009). A summary of Diffusion of Innovations. Enabling Change pdf.
  • 38. 26 Luarn, P. and H-H. Lin, “Toward an understanding of the behavioral intention to use mobile banking,” Computers in Human Behavior, Vol. 21, No. 6: 873-891, 2005. McCloskey, D. W., “The Importance of Ease of Use, Usefulness, and Trust to Online Consumers: An Examination of the Technology Acceptance Model with Older Consumers,” Journal of Organizational and End User Computing, Vol.18, No. 3: 47-65, 2006. Moore, G. C. and I. Benbasat, “Development of an instrument to measure the perceptions of adopting an information technology innovation,” Information Systems Research, Vol. 2, No. 3: 192-222, 1991. Olatokun W.M and gbinedion L.J (2009) The Adoption of Automatic Teller Machines in Nigeria: An Application of the Theory of Diffusion of Innovation. Issues in Informing Science and Information Technology Volume 6, 2009 Rogers, E. M. (1983). Diffusion of innovations (3rd ed.). New York: Free Press. Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: Free Press. Venkatesh, V. and F. D. Davis, “A theoretical extension of the technology acceptance model: four longitudinal field studies,” Management Science, Vol. 46, No. 2: 186-204, 2000. Wang, Y-S., H-H. Lin, and P. Luarn, “Predicting consumer intention to use mobile service,” Information Systems Journal, Vol. 16, No. 2: 157-79, 2006.
  • 39. 27 CHAPTER THREE RESEARCH METHODOLOGY 3.1. Introduction This chapter contains all the methodologies that were adopted in achieving the mentioned objectives in chapter one, which consist of the following:- 3.2. Method Adopted for the Study 3.3. Population of the Study 3.4. Sampling and Sampling Procedure 3.5. Instruments used for Data Collection 3.6. Procedures for Data Collection and 3.7. Procedures for Data Analysis 3.2. Method Adopted for the Study As mentioned earlier, the main objective of this research work is to design a computer base program that will cover all the aspects of management and operations of Ahmadu Bello University Sick-bay. It will enable the clinic registration process becomes computerized and this feature will help a lot in keeping records of all patients and whoever has once received a treatment in the clinic. Research method refers to the process of scientific inquiry in research work. The success or other wise of any research work depends largely upon how data is collected, organized and analyzed (Idris, 2009). It is also the process of arriving at a dependable solution to a given
  • 40. 28 problems. This study has adopted a qualitative method of research. A qualitative research has been defined as “any kind of research that produces findings not arrived at by means of statistical procedures or other means of quantification” (Strauss & Corbin, 1990:17). According to Creswell (2003:181), a qualitative research takes place in the natural setting. He states that the qualitative researcher often goes to the site (office) of the participants to conduct the research. This enables the researcher to be more detailed about the individual or place and be highly involved in the actual experiences of the participants. According to Denzin and Lincoln (1994) qualitative methodologies include “interviewing; observing; artifacts, documents, and records; visual methods; personal experience methods; data management methods; computer- assisted analysis; and textual analysis”. And with some of these methods the researcher intend using to design the aforementioned Automated Clinic Record Management System for Ahmadu Bello University Sick-bay. 3.3. Population of the Study Population in research is simply the totality of the collection of individuals, objects, or measurement (Yakeen, 2006) population in research refers to animate or inanimate things on which the study is focused. Abdulkareem (2006 et al.) defined population as the aggregate of all observations of all interest to the researcher. The population of a research is the body of research subject being focused. Usually this is expressed in terms of number of persons being addressed by the researcher. However, in this study the population is not much and never small and therefore, it includes all the clients and staff of the Ahmadu Bello University Sick-Bay, which include the professionals, paraprofessionals and the non-professionals.
  • 41. 29 3.4. Sampling and Sampling Procedure Sampling in a research work is a device employed in the selection of representative members, objects or elements from a given population. Probability sampling techniques is used for the selection of the sample; probability sampling is a form of sampling in which each member of the population has equal chance of being selected in the sample (Abubakar, 2013). While drawing the sample of this study, stratified sampling is used as a form of probability sampling technique, in the selection of the sample. This is because according to Kabir Bello Dungurawa (2007) in stratified sampling, the entire population is sub divided into smaller homogenous groups to get an accurate representation. Each sub-group has unique characteristics. From each sub-group random selection is carried out. Stratified sampling ensures that every subgroup is represented in the same proportion. The study sample according to Aina (2007) is the selection of some part from the study’s population of interest. However, for this study, the researcher has plan to carefully select Seven (7) from the clients meet in the clinic and two (2) from the professional staff, four (4) from the paraprofessional staff and two (2) from the non-professional staff as representative so that the outcome resulting from data obtained from them will be accurate, reliable and adequate for this research. Table 3.1: Sampling size S/N Category Sample Size 1 Clients at the clinic 7 2 Professional Staff 2 3 Paraprofessional staff 4 4 Non- Professional Staff 2 Total 15
  • 42. 30 3.5. Instrument used for Data Collection The instruments to be use in collecting data for this research are interview, observation, existing document review and probably a questionnaire which are discussed below; Interview: This fact finding method will be useful on getting information on how the clinic organizes its data resources and the order in which the current system flows, the staff will be interviewed by asking questions on how the current system is working, which will enabled the researcher to recite areas of improvements and innovations in the current systems. Observation: The researcher will observed a number of points to help him during the project. This will be used in determine how best the records are managed. It will also reveal the kind of information normally demanded from the health unit and how long it takes to retrieve this information. Through observation the researcher will also be able to find out if the files are normally returned to their rightful places that is cabinets immediately after recording or cross checking any record. Some of the advantages of observation as a fact finding method are: -  The researcher will not have to disrupt the workers’ time because he could easily access the system and other requirements without any one’s help.  The researcher will get more information as compared to the information he will get in case of an interview because there will be access to everything without limitation.  The researcher directly will see the shortcomings of the existing system other than being fed by the staff that are available. However this method also has shortcomings like:-  The researcher will waste a lot of time looking for information that would have been given in a short time in case the staff has been used.  The researcher will not get detailed information since he has less knowledge of the
  • 43. 31 existing system. Reviewing documented records: Here the researcher will review some documented patients record from the records officers and probably from the main doctors and nurses in charge of data management to get a picture of how data is stored, if necessary the researchers records himself, as he is also a client in the clinic. With this method the researcher will get more information relating to the system such as the arrangement of the fields in the records, and the doctors diagnosing record update in the patients’ file. Questionnaires: The questionnaire will comprise some set of simple questions precise and concise and required straightforward answers, not to over burden the readers. The questionnaires will be chosen to cater for the busy staff that will not able to spare time for the interview. 3.6. Procedures for Data Collection Before such a task could be accomplished and due to the nature of the research and also sensitive data/information that are involve will first require the researcher to request for an introductory letter from his department that will indicate that he is a student carrying out a research on the topic, which will also serve as an evidence and prove that all information that will be required by him (the researcher) in the course of this project will only be rightfully use for the project. The researcher will also be administrating the interview personally, this is to enable him to avoid any type of misinformation, this is also important as the researcher is expected to personally design the program in view.
  • 44. 32 3.7. Procedures for Data Analysis Data analysis is the process of systematically applying statistical and/or logical techniques to describe and illustrate, condense and recap, and evaluate data. According to Shamoo and Resnik (2003) various analytic procedures “provide a way of drawing inductive inferences from data and distinguishing the signal (The phenomenon of interest) from the noise (Statistical fluctuation) present in the data”. While data analysis in qualitative research can include statistical procedures, many times analysis becomes an ongoing iterative process where data is continuously collected and analyzed for patterns in observations through the entire data collection phase (Savenye, Robinson, 2004). Data generate from the above methodology will be analyze, after which will later led to the designing of the aforementioned programme. And in order to design the programme that will automates clinic record management for a health institution, the researcher has plane to use some web development tools such as; Adobe Dreamweaver and Notepad Plus Plus for the required coding of the programmes’ commands; hypertext preprocessor (PHP) and Java scripts (JS) will be used to connect the interfaces, which will also be design with hypertext markup Language (HTML) and cascading style sheets (CSS) to the databases to perform specific tasks such as Editing, saving, deleting and searching data from the databases; and My-SQL will be used to design the databases that will store the overall system data.
  • 45. 33 References Bryman, A. (2003) Research methods and organization studies 3th ed.London: unwin Hyman. Creswell W.J (2003). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. 2nd Ed. Thousand Oaks, CA: Sage Publications. Denzin, N. K., & Lincoln, Y. S. (1994). Introduction: Entering the field of qualitative research. In N. K. Denzin& Y. S. Guba (Eds.), Handbook of qualitative research Thousand Oaks, CA: Sage Publications. Fontana, A. & Frey, J. (2003). The Interview: From structured questions to negotiated text Chapter 2, in Denzin, N.K., & Lincoln Y.S (Eds) (2003).Collecting and Interpreting Qualitative Materials. 2nd Edition, Thousand Oaks, CA: Sage. Gay, L.R. (1987). Education research: competencies for analysis andapplication. 3rd .ed. Columbus: Merril blushing. http://ori.hhs.gov/education /products/n_illinois_u/datamanagement/datopic.html. Internet (2006) Hypotheses in research http:/faculty.newc.edu/toconnor/308/308/lect03.htm Retrieved 01/12/2014 Internet (2006) Sampling.http:/faculty.newc.edu/toconnor/308/308lect2.htm Retrieve on 02/12/2014 Nwana, O.C. (1981) Introduction to educational research for students teachers. Ibadan: Heinemann Educational Book. Sam A. Ifidon and Elizabeth I. Ifidon (2007) Basic Principles of ResearchMethods. Benin: Goodnews Express Communicatios. Yomere, G.O. and Agbonifoh, B.A. (1999) Research methodology in the social science and education. Benin-city: cetrepiece consultants.
  • 46. 34 CHAPTER FOUR DATA ANALYSIS AND DESIGN 4.1. Introduction This chapter addresses the detailed data analysis and the program design issues and functionality for the developed system. It addresses the conditions that were necessary for the effective functioning of the system and also the reason for which it is analyzed, designed and implemented. 4.2. Data Analysis In order to come up with a good functioning system, a thorough and clear analysis about the current system had to be made where the system requirements and expectations by the potential end-users are specified. Data generated from the methodology used was checked for efficiency and integrity and analyzed. The analyzing of these results led to the system designing. The system analyst dealt greatly with summarizing facts, opinions and views obtained from users after a detailed determination of their requirements. The data collected for this study was discussed under two main sections; the descriptive analysis and the program analysis and design.
  • 47. 35 4.3. Descriptive Analysis Under the descriptive data analysis, the researcher tries to analyze and explain all the data (responses) gathered from the conducted interview, observation, existing document review and questionnaire on the course of this study. 4.3.1. Respondents Details As explained earlier by the researcher at the sampling of the study, to carefully select Seven (7) from the clients meet in the clinic and two (2) from the professional staff, four (4) from the paraprofessional staff and two (2) from the non-professional staff as representative. The table below gives the clear view of the respondents to the study. Table 4.3.1: Respondents details S/N Category of respondent Numbers of respondent 1 Clients at the clinic 7 2 Professional Staff 2 3 Paraprofessional staff 4 4 Non- Professional Staff 2 Total 15 The table 4.3.1, above gives the list of respondents consulted for the study, the researcher was able to achieve this as he is also a student from the institute where the study was carried out and also a member (client) in the clinic. 4.3.2. Current records keeping system use in keeping records of patients in the clinic. It was understand from the responds also that, the current record management system that is
  • 48. 36 being used at the Ahmadu Bello University sick-bay is a manual system, where all patients’ records and information are being collected with papers and pens and kept in paper file folders or box files. This system exhibits some strengths and weaknesses. The strength of this system is; patients and staff records are properly kept in box files which are then stored in office file cabinets, the system is also easy to use because it does not require any training of the user. Weaknesses of the current system are; it takes a lot of time to retrieve the required records especially when the files are big, updating of patients records is tire some, files are easily lost or misplaced in cabinets, lack of data security, manual calculation are vulnerable to errors and big storage space is wasted where file cabinets sit. 4.3.3. Challenges of the current system Base on the responses and observations on the current manual system of record keeping and filling in the Ahmadu Bello University Sick-bay, the following issues are experienced; a. Inefficient record management. b. Misplacement of patients documents, c. Not able to retrieve long consult patients’ records, d. Loss of records or files alteration of information which normally result in unnecessary delay of treatment. 4.3.4. Proposed record management system for the clinic Most of the respondents suggest an automated system for the clinic, in which a computer program and other related technology can be used in the management and operational functions of the clinic in other to benefit and experience the advantages of technology in the
  • 49. 37 digital era. 4.3.5. Benefits of the proposed system It was also observed from the responses on this study that, the introduction of an automated record management system, in which computers will be used in the management of patents records and information in the clinic will leads to the following progress; a. More accurate record management, time saving, and easy retrieval of patients information will be observed. b. The computer program can also be a web base that will enable a quick access to patient’s record globally in case of emergency. c. Computer program can also provide adequate security to patients records in which only authorize users can have access to the system. d. Computer program can also provide an adequate schedule for both the doctors and the patients of the clinic, in which an appointment has to make over the internet by the patient before visiting the doctor. 4.3.6. System User Requirements The system is expected to meet the following requirements; a. Should allow secure entry of patient records b. Retrieval of these records should be done with ease c. Should allow users to enter new records d. Also the ability to edit, search, delete the existing records. e. Should be able to create hard copies as well as system backup for all records in the
  • 50. 38 system. f. Data entered by users, should be fast, give instant responses to inquiries. g. Should provide security for data entered through authentic users to the system only. h. Should display an error message to the user each time an error is encountered by the system during data entry. i. Should output patients’ records, diagnosis records and who carried out the particular event. 4.4. Program Analysis and Design This section deals with the clear analysis of the system design, tools used and system specifications and its functions. 4.4.1. System Design System design specifies how the system accomplished the set objectives. It consists of both logical and physical design activities. The coding of the system design in a particular programming language, in the case of this research work, the design/implementation where done using the hypertext pre-processor (PHP) and MySQL as a database. 4.4.2. Tools used and System Specifications This consists of data, software and the hardware specifications a. Data; Data refers to the raw facts about a given sample specimen, which when processed, results to information as the output. Data is the input to the system. Data to the system in addition it comprises of the facts in a clear and orderly way, for the
  • 51. 39 purpose of being able to compute and relate other data so as to produce summary in form of output. b. Software Specifications; this provides all the facilities for manipulating data and its interface between the end user of the system and the hardware. The proposed system was designed using hypertext pre-processor (PHP) and MySQL as the back end for storing data. In order for the system to function as expected the computer on which it will be installed should have the following software installed as explained in their respective manuals;  A higher version of windows operating system like windows xp, windows7, windows8 or windows10.  A Xampp or Wamp server should be installed on which a created site will run as well as the created data bases will be stored for the localhost.  Notepad PlusPlus (np++) or any other text editor software for coding of the system programme. c. Hardware Specifications; these are the physical or tangible components of the system; which include the monitor, CPU, mouse, keyboard, UPS, among others. Data/information used in the designs will safely be stored on hard disks.  The system requires a properly installed computer system to run effectively  The system is suited for computers with a Pentium IV or higher processor with a speed of at least 1.5GHz.  Considerable amount of RAM and hard disk space are required for proper functioning of the system. RAM 2GB and above is recommended  Due to the need for installation and creation of backups, the system should
  • 52. 40 provide a means of connecting storage devices such as flash disks, compact discs, and external hard disks among others.  A good printer for printing the system output generated by the application where printing is necessary 4.4.3. Database Design This phase of the system designs focuses mainly on the procedures, tools and the documentation that aids to support the process of database designs. The database will be designed with interims of relationships and the tables are related by sharing common field. The proposed system’s data will consist of the following entities; a. Admin b. Appointment c. Doctor d. Patients e. Patient reports f. Timings
  • 53. 41 Figure 4.1. Entity Relationship Diagram Physical Database Design This provides the detailed data description and data definition subsystem of the database management system is set. It also referred to as data definition language. Database tables are designed under physical database design.
  • 54. 42 Figure 4.2. Admin table Figure 4.3. Appointment table
  • 55. 43 Figure 4.11. Doctors' table Figure 4.12. Patients table
  • 56. 44 4.4.4 The Developed System Interfaces Details of various interfaces of the system are given bellow: Welcome interface Below is the interface that is displayed when a user runs the system. It gives the user the options of allowing him to make an appointment with a doctor, login or register as the staff of the clinic, login or register as a patient in the clinic, and lastly, login as the record or system administrator in the clinic. Figure 4.13. Welcome interface Appointment interface From the appointment interface, the user has the option to see all the available doctors in the clinic together with their specialization and their shifting time, from which the user can now
  • 57. 45 make or book an appointment with his/her preferred doctor after authenticating his/her login details. Figure 4.14. Appointment interface Staff Login Interface This interface provide for only the staff of the clinic, form which he/she can login or create an account for him/her self. When a staff is login to the system he can view all his appointment and from which he can also attend to his patients with a provided interface to update the patients treatment records.
  • 58. 46 Figure 4.15. Staff login interface Patients’ Login Interface This interface provide access for patients to login or create an account from which he/she can make an appointment with a doctor in the clinic, this interface also provide for the patient to view or print his previous treatment reports and prescriptions by the doctors.
  • 59. 47 Figure 4.16. Patients login interface Administrators interface The Administrator has the full control of the system from which he can create, read, update or delete any record or information from the system.
  • 61. 49 CHAPTER FIVE SUMMARY, CONCLUSION AND SUGGESTION 5.1 Summary The present manual system of collection and keeping / storing records, documents, and all other related patients’ information in the Ahmadu Bello University Sick-bay is inefficient and below standard, hence, the need for the development of a computer application system in Nigerian clinics as it has expanciated upon by this research work. However, the study has revealed the problems associated with the manual method of record keeping such as difficulties in sorting, retrieving and updating records, lack of security of records, loss of relevant information and so on. The program developed for this project is used to handle the proper storage of all records and related information in a clinic, the patients’ treatment reports, date of treatments, doctors in charge and other relevant information will be entered into the system. The application of computer in our health sector is meant to improve on or overcome the lapses of manual method of record keeping in the Nigerian clinics. 5.2 Conclusion In general, the developed system is an automated record management system that is for efficient patient’s data management. With various interfaces which automate patients’ data capture and review that is kept in the database, the command buttons on each interface are well coded to allow only the required information to be entered into the system and error
  • 62. 50 messages displayed in case invalid input is entered, it allows the authorized users to perform specific duties such as; inserting or adding patients’ records, deleting a record, editing and searching through the database. With the developed system being used, problems such as records misplacement, data redundancy and inconsistencies, difficulty in updating the existing data, illegal access to data and time delay in processing data are easily handled by the system. 5.3. Suggestion Due to the study limitations stated earlier in chapter one, the researcher suggest the following about the system: a. The researcher suggests that the users should be trained on how to use the system. This will enable users to understand the functionalities of the system. b. There is need for system upgrade as user requirements increase. User requirements differ with time, therefore, it is of great help for the system to be flexible enough. c. Other researchers can use this project as a basis during further studies on automated clinic record management system. d. There is need to do more research on other programming languages like JAVA, PYTHON and alike.
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  • 71. 59 APPENDIX AN INTERVIEW GUIDE FOR THE CLINIC ADMINISTRATORS AHMADU BELLO UNIVERSITY, ZARIA FACULTY OF EDUCATION DEPARTMENT OF LIBRARY AND INFORMATION SCIENCE Dear Respondent, I am a student of Ahmadu Bello University, Zaria, Department of Library and Information Science carrying out a research about the current record keeping System in use in Ahmadu Bello University Sick-bay in an effort aimed at improving it or developing a new system if need be. Please note that the information provided will be used for only this study and not shared with any third party. I therefore request you to answer some of the following questions. Yours faithfully Alfa Mahfooz Ahmed U11LS1018 1. What is your current work position and department in ABU Sick-bay? 2. How do you find the current records keeping system use keeping records of patients in the clinic? 3. What problems do you find in the current system? 4. In case of a new system, what changes do you propose? 5. How will this system benefit you as an administrator (user)? 6. Comment about the way the services are rendered at ABU Sick-bay.
  • 72. 60 QUESTIONNAIRE I AHMADU BELLO UNIVERSITY, ZARIA FACULTY OF EDUCATION DEPARTMENT OF LIBRARY AND INFORMATION SCIENCE Dear Respondent, I am a student of Ahmadu Bello University, Zaria, Department of Library and Information Science carrying out research about the current record keeping System in use in Ahmadu Bello University Sick-bay in an effort aimed at improving it or developing a new system if need be. Please note that the information provided will be used for only this study and not shared with any third party. I therefore request you to answer some of the following questions. Yours faithfully Alfa Mahfooz Ahmed U11LS1018
  • 73. 61 Tick appropriately or write as the space provided. Section A: Personal Information. 1. What is your gender? f. Male [ ] g. Female [ ] 2. What is your current status in the clinic? a. Client [ ] b. Doctor [ ] c. Nurse [ ] d. Administrator [ ] Section B: other Information. 3. How do you assess the current patients’ records management system in the clinic? a. Very good [ ] b. Good [ ] c. Fair [ ] d. Poor [ ] 4. If administrator, what is your current work position and department in the clinic? ______________________________________________________________________ ______________________________________________________________________ 5. If worker, what is your current work position in the clinic? ______________________________________________________________________ 6. What problems do you find in the current system? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ 7. In case of a new system, what changes do you propose? ______________________________________________________________________ ______________________________________________________________________ 8. How will this system benefit you as a user?
  • 74. 62 ______________________________________________________________________ ______________________________________________________________________ 9. Do you even think there is a need for a new patients’ records management system in the clinic? a. Yes [ ] b. No [ ] 10. Are you satisfied with the services provide at the clinic? a. Yes [ ] b. No [ ] 11. Do you think the new propose system will solve the problems that are in the existing system in the clinic? a. Yes [ ] b. No [ ]