CHAPTER ONE

INTRODUCTION
Electronic Medical Records (EMRs) are computerized medical
information systems that collect, store and display patient information.
They are a means to create legible and organized recordings and access
to clinical information about patients. EMRs are intended to replace
existing (paper based) medical records which are already familiar with
practitioners (physicians). As the national growth rate increases, the
tendency of medical exercises and attention also compound. This
population growth tends to overwhelm the limited physicians, health
workers and available facilities. Physicians are in constant need of
innovations that would boost their day to day encounters with patients.
Several documented research have taken place in this regard. Some
include the development of record systems/information systems to
store and manage patient health history. Paper based systems were
introduced in the early age of mankind to support physicians by
keeping track of their patients.
1.1 Background to Study
Information management is an important and integral aspect of every
organization as it provides a means for data query and retrieval. The
health sector with its vital position as the chief information office, is

not left out of this need. This is so because physicians on daily bases
are faced with the challenges of how to effectively store and retrieve
patient health history. Over the years, the paper based system of
recording patient information dominated the health sector, but one
question is needful here. How efficient, secured and reliable has it
been? With its open-endedness there is a need to critically look at it. A
recent survey placed the daily health demand at an alarming rate hence
the need for an optimized and efficient information system. This is so
because research has shown that ensuring a speedy medical access; an
improved medical recording system must be adopted.
According to the United Nations, the population of Nigeria is expected
to reach 258.5million by 2050 (World Population, UN). Health care
systems are managed by the three tiers of government, with the federal
government taking responsibility for policy, drug regulations, diseases
control, vaccinations, and trainings. The federal government runs the
management of teaching and orthopedic hospitals.
Health care professionals in Nigeria have reportedly complained of the
declining quality of health care in the country. Adeyi (2011) attributes
the deterioration state to the funding, mismanagement, politics and the
impact of civil war. He argued that educational resources to improve
the existing infrastructure must be provided by the government. Other

authors like Awokola et al. (2012) cited the use of health IT like EMR
as a tool to improve the quality of health care.
Paper records are increasingly obsolete and inadequate in this 21st
Century. They limit the flow of information, insufficiently document
patient care, impede the integration of health care delivery, create
barriers to research, and limit the information available for
administration and decision making (Roy Romanow, 2002). The
quality of care provided to patients matters. If one cannot measure it,
one can improve it (Lord Kelvin); the ability to repeatedly measure and
monitor the care that is provided is a prerequisite for quality
improvement efforts. Such an undertaking can be laborious and time
consuming if the data are recorded on paper.
Owing to the above documented disadvantages in the continued usage
of the paper based systems in this 21 st century, a new system which is
capable of meeting current demands has been proposed which is the
development of an electronic/ computerized medical record system.
Although, this idea has been around since the late 1960s, when Larry
Weed introduced the concept of the Problem Oriented Medical Record
(Tim Benson, 2012) into medical practice, as a means to help doctors
through the aid of a third party who verifies a diagnosis, accurately
treat patients based on the available health history. The early
computing powers limited the technology even when the first medical

record system was developed in 1972 at the Regeenstereif Institute

(MD Murray, 2003). With attention to improving the quality of
healthcare in the United States, the Bush administration proposed a
plan that would enable all U.S citizens have easy access to their
medical records by 2014 (Hoffman,2009; Morton & Wiedenbeck,
2009). To uphold the commitment of the Federal Government to this
initiative, president Obama In 2009 established the American Recovery
and Reinvestment Act, to provide funding for the health care sector
amounting in $22 billion to modernize health information technology
systems(Hoffman, 2009). According to Hoffman (2009), from this
money, a physician is eligible for up to $64,000.00 and a hospital could
receive up to $11million if an EMR is implemented.
EMR systems are seen as a way to improve quality of healthcare and to
minimize treatment time (Biruk, Yilma, Andualem, & Tilahun, 2014).
In a survey of parents of patients at pediatric rheumatology practice in
Pittsburgh, Pennsylvania, a month before implementation of an EMR
system, & 3 months after the implementation, Rosen, Spalden,
Hannon, Boudreau, and Kwoh (2011) reported that parents of patients
agreed that EMR has improved the quality of health care service of
their children. Rosen et al. also stated that the parents of those children
were reportedly happy that doctors were able to spend more time with
their children. Healthcare professionals have stated that EMR can

improve the quality of healthcare (Biruk et al. 2014). They also stated
that EMR saved physician time and has allowed them to spend more
time with their patients (Rosen, et al. 2011). In this study, I have
detailed the weaknesses of the current recording system, which is still
widely used in Federal Medical Center Asaba. I have also explored the
significant impact EMR have had in developed nations and budgetary
plans in those nations. I have also detailed how an EMR can be
implemented in a Nigerian hospital with Federal Medical Center Asaba
as a case study.
1.2 Statement of the Problem
Patients records have been stored in paper form for centuries and, over
this period of time; they have consumed increasing space and notably
delayed access to efficient medical care. The cost involved in
maintaining a paper based system is very high due to duplication of
efforts and records. One typical example of this duplication is the
copying of records and the distribution of such files around which is a
redundant practice, amounting huge maintenance cost. Storage of the
paper record necessitates the use of valuable spaces that could be better
utilized in other areas like drug packing or equipment keeping. The
records also need to be protected from water, fire, or mishandling to
preserve their physical integrity.

Another issue is that, the existing systems encourage the duplication of

records or test results due to loss of previous or missing test results.
Repeating such procedures would jeopardize the potential health of a
patient, creating a potential opportunity for an adverse medical event.
Duplicate testing wastes scarce medical resources (such as; time,
supplies and equipments) that could be used for other patients. It is a
contributing source to the rising costs of health care generating
additional charges to be billed to the patient, insurance company, or
other third party payor. Claims submitted for medical errors that could
have been prevented using Electronic Medical Systems (EMRs) are
issues associated with the use of paper record.
Accessibility of medical records is one major issue associated with
paper based records. In this case, there exists only one access to the
record, meaning staffs needing access to the record must wait until it is
available for their use. This also contributes to the difficulty of
updating the paper record especially for an active patients chart since
that chart travels with the patient to each location of care. Delivering
documentation lends itself to the potential for losing or misplacing the
records. Delayed access to the chart negatively affects billing and
reimbursement processes.
Quality of manual medical records is an issue that encompasses the
physical records, the documentation and patient care. There are

limitations to the physical quality of the paper records; Paper is fragile

and does not last permanently. Normal use of the record may result in
torn or stained document; inks used for the documentation can fade.
A well planned and implemented electronic medical record system
should address and alleviate many of the general disadvantages of the
paper records. This is an immense undertaking that requires an indepth review of current processes, a detailed strategy for determining
the organizations future needs and goals, an organizations willingness
and ability to make significant changes, and the financial investment to
achieve the desired results. It is also a very time-intensive project that
demands the utmost dedication and commitment by the entire health
system. Patients, providers, and other interested parties could all expect
to derive benefits from a properly planned and installed automated
system (EMR)
1.3 Motivation
The death cases reported from use of paper based systems has led to
research works on how to better the hospital, physician and patient
recording system. This is to ensure that patient files are not misplaced
or submerged in rural cases. This alone gave room for proposed
systems that could militate and remedy the paper based system. The
motivation behind using an electronic means to record patient details is

because of its non-volatility, efficiency, durability, reliability,

understandability, and usability. Electronic means used in other works
of lives have recorded huge successes. These challenges experienced in
using the paper based system cast my conscience into designing and
developing

computerized

medical

recording

system

using

information technology as a tool.

1.4 Aims and Objectives
The objective of this research is to:

Develop a patient record system that would be technology

inclined.

Increase the number of patients attended to by physicians on

daily bases.

To promote confidentiality between patients and the health

workers.

To provide easy record access by physicians during

consultations.

Develop a system that would not wear nor tear like the paper
based type.

1.5 Purpose of the Study

Information and communications technology has gained grounds and
eased life in almost works of life from aviation, to finance, military,
educational sector, legal sector and now the health sector. These days,
we have electronic scanners for ultra sounds, electronic body mass
instruments and even sugar level detection devices. But there is still the
existence of paper based recording systems in most hospitals which is
keeping the health sector behind in terms of trending technologies.
This research is designed towards implementing a record system that
would run electronically using some programming tools. The purpose
of the research is therefore:

To introduce a new form of patient based recording that would

follow up on the trending technologies.

To ensure that there is an improved recording system in the

health sector.

To ensure that confidentiality is restored in the health sector.

To ensure that the health sector benefit from the versatility of

information technology.

To boost the morale of health workers by reducing their

redundant activities of always using the paper based system.

To enable students in information technology know they could

do more in the health sector by assisting the sector
technologically.

To reduce the death rate and delay rate associated with the
obsolete paper based systems.

To create a system that would promote prompt retrieval of data.

To

create

medical-information

and

communication

technology relationship.

To improve the quality of care in the health sector and to reduce

cost of maintaining the paper based system.

1.6 Significance of the Study

The health care sector is one area required to improve the standard of
living of every nation; hence, its growth, stability and development
should be the priority of the government and its citizenry most

10

especially during war, flood and trying times. Going by the recent
happenings in the world and in Nigerias north east for instance, where
there have been cases of bombings and floods; one would agree that
hospitals around such areas receive more patients than those in other
parts of the world or country. This is indeed a problem if the records of
such patients are not properly stored. That is if their records are stored
on papers. Research has shown that before a patient is attended to, his
health records must and will be checked first. This is to avoid
complications during treatment. That is why the need for accurate, safe
and proper documentation of such records cannot be overemphasized.
Economically, the health sector will be able to generate more revenue
for the country as more patients will be attended to on daily bases. The
allocation shared to the health care sector shows how important the
sector is to the nation hence the improvement in the sector affairs. The
high cost associated with the paper based system will be reduced if not
removed with the implementation of the electronic based record
system which not only is very convenient but also very efficient.
Academically, this research will benefit students as it will serve as a
base for future research in this area particularly in improving it. It will
also open the eyes of most young programmers to try their hand in
developing software for different sectors and not just on one side.

11

It is on these factors that I can categorically say that the study EMR
will not only provide accuracy, efficiency, integrity to physicians,
health workers and patients but also to the academic institutions and
the nations economy.
1.7 Limitations of the Study
The limitations faced during the project include; getting information
from health workers, most were willing to share their day-to-day
experience with paying with me. Majority of nurses in the hospitals I
visited did not see the project as feasible due their strong desire to
continue using the paper based system, while the physicians received
the idea with open arms. Information derived from my studies where
through questionnaires, most persons gave their views, while in certain
cases some refused to be a part of the session. Frequent power outages
during my online research stage marred my speed and activities online,
also getting materials on the proposed topics witnessed drawbacks as
much publication are not available. The cost of executing the project is
huge and that left me with an option of quitting or continuing.
1.8 Scope of Study
Although the health sector has several departments, this project is
aimed at developing a computerized patient record for both out-patient
and in-patients in a given department. Two computer languages were

12

used to develop the software; an object oriented languages and a

database language, with both having distinctive functions. It is worth
saying here, that although the project is about developing a
computerized medical record system; emphasis has been laid on good
programming practice.

1.9 Definition of Terms

EMR- Electronic Medical Records (EMRs) are computerized medical
information systems that collect, store and display patient information.
PBMR- Patient based medical record system (PBMR) is a record
system manually (paper) used to capture patient information.
STRUCTURED QUERY LANGUAGE (SQL)- This is a language
used to store records in a database.

13

CHAPTER TWO
REVIEW OF RELATED LITERATURE
Healthcare in Nigeria as in some other African countries is confronted
with increased pressure and demand for medical treatment and services
due to factors such as growing population and higher standard of
living. Miller argues that healthcare has been an issue of growing
importance for national government. Many national and regional
healthcare plans have been developed in the past decades, in order to
control the cost, quality and the availability of healthcare for all
citizens. Brown opined that the application of Electronic Medical
Information System (EMIS) has generated useful insight into the
quality of data accuracy and health care provision in primary care
settings. This is partly one of the adapted style and approach to data
entry influenced by the design presented in recent structure. They

14

further emphasize that there is a great need for improved education and
protocols for constituting data entry in the (EMIS) and also subsequent
follow up of patient clarification on the policy for duration and
frequency treatment.
Laubbel, define medical health record, or medical documentation of a
patients medical history and care as medical record used bath as the
physical folder of patients and for the body of information which
comprises the total of each patients health history. Medical records are
intensely personal document and there are many legal issues
surrounding them such as the degree of third-party access and
appropriate storage and disposal. The key advantage of shifting to
electronic/computer based patient record is the opportunity to
strengthen the link between the hospital records and management
information system. So that resource usage and quality of care can be
analyzed using Hospital database (electronic means) which increases
physician efficiency and reduce costs, as well as promote
standardization of care.
2.1 Overview of Paper Based Patient Medical Record System
Most of the patient and administrative information that flow
throughout the health care system is still recorded on paper. This is not
without reasons, Dick and Steen (1991) note that the traditional paper

15

record is still used due to its familiarity to users, portability, and ease
of recording findings. A survey by cnnmoney.com in the United States
estimates that only 8% of the nations 5,000 and 17% of its 800,000
physicians currently use the computerized record-keeping systems
(cnnmoney.com, 2009). Paper records usually require large space for
storage and hence cannot be used in hospitals with limited space.
Mutilations can occur in the paper systems thus reducing the integrity
of reports. Paper records are usually stored in different locations thus,
collecting and transporting them to a single location for usage/review
by a health care provider is time consuming. In 2004, an estimate was
made that 1 in 7 hospitalizations occurred when medical records were
not available. Additionally, 1 in 5 laboratory tests were repeated
because of mutilation and non-availability at the point of treatment.
Electronic medical records are estimated to improve efficiency by 6%
yearly, and the monthly cost of an EMR is offset by the cost of only a
few unnecessary tests or admissions. Handwritten paper medical
records can be associated with poor legibility, which can contribute to
medical errors. In an analysis of U.S Army outpatient clinics, Tufo and
Speidel (1971) found as many as 20% of charts had missing
information, such as laboratory data and radiology report. Furthermore,
abstractions of paper record are stored in large databases, such as those
of the Medical Information Bureau, which are maintained by health
insurance companies to prevent fraud but contain medical information

16

of

more

than

12million

Americans

(Rothfeder,

1992).

An

undocumented survey carried out at the Federal Medical Center Asaba,

shows that all the departments of the hospital have separate records for
patients. This is an inefficient approach to solving time wastage during
consultation. Patients should have a centralized database of their
records which can be shared across the various departments of the
hospital, thus promoting efficiency.
2.2 Review of Electronic-Medical Patient Record
Laing suggested that if all information in paper-based records were
digitized and embedded within information system, it will provide
context sensitive access to the data and link to their information in the
institution. The health care delivery could fully document information
using a variety of conventional and handheld computer equipment such
as keyboard, pen-based input devices. Structured data entry or hand
writing recognition illegibility or inconsistent entries could be caught
and corrected as they are entered in medical order entry system, their
results and all other internal transactions could be tracked
automatically.
There are many potential benefits of the Electronic Medical Record.
Unlike the paper record, it can potentially be accessed from a
centralized database from remote location at any given time and within

17

clinics across town or even across the country which would result in
data not lost or misplaced. With an appropriate back-up mechanism, it
should serve as a permanent record of an individuals interaction with
the health care system. Furthermore, with the EMR, queries can be
carried out efficiently with respect to time. Finally, with the potential
for the incorporation of reminders and decision support, the likelihood
of mistakes and omissions should decrease.
In addition to benefiting the individual patient, the Electronic Medical
Record is also likely to benefit the larger population. Clinical research
will likely be enhanced, as researchers have easier access to
information about patients that will increase understanding of disease
and its treatment.
Screening and other preventive measures will become easier to
implement as patients of various attributes (i.e., gender, age, presence
of other risk factors) can be identified and contacted.
Fielde, stated that transformation of medical practices is emerging not
only as a result of the availability of these technology but as a
deliberate attempt to address the image challenges facing the health
care delivery. According to National Alliance for Health Information
Technology (NAHIT), The EHR refers to an electronic record of
health-related information on an individual that conforms to nationally

18

recognized interoperability standards and that can be created, managed,

and consulted by authorized clinicians and staff across more than one
health care organization.
2.3 Expected Electronic Medical Records Tasks
Key tasks of an Electronic Medical Record Role
Key tasks

Electronic medical record role

Memory

Comput
ation
Provide

Review

Display

Patient

available patient contextual

History

history

and view

demographics

Decision Collabora
Support
Recommend

tion
Incorpora

care based on te
of patient

informati

patients

characteristic

on

health

outside

Action

sources
Coordina

oriented

tes across

for Compute

from

Conduct

Prompt

Patient

required

Assessment

information

clinical

multiple

Determine

Relate

reminders
Support

providers
Staff

clinical

assessment

based

views or

decisions

patient history

statistics

Display
to trends,
reference

research and instructio

ranges

recommendat ns
ions

19

Develop

Standard

of Apply

treatment plan

care, care plans, standards of based

evidence based care
guidelines

on

Evidence

Patient
care summary

based adjusted

by education

patient patient

al tools

characteristi

characteristic
s
Alignment

Create

Order

Review

c
Determine

additional

previous

appropriate

with

referral

service

services

provider

insurance

facility

requirements

provider
communi

Instructions,

cation
Patients

history allergies calculation

contraindicat

instructio

formulary

ion,

ns

effectiveness

effects

Prescribe

Medication

medications

Dose

side

and
Document

Diagnosis

and Prompt/auto

visit

treatment codes

matic
population

Insurance

warnings
Patient

guidelines

education
,
coordinat
ion with
multiple

20

providers
Table 2.1
2.3.1 Financial Benefit of EMR
One of the reforms of the Patient Protection and Affordable Care Act
by the Obama Administration is to contain the cost of health care by
the use of EMR system (Encinosa & Bae, 2011). Boonstra and
Broekhuis (2010) showed that the cost of setting up EMR was mostly
reported among the barriers to adopting the technology in their
practices. However, the business case for the adoption of the
technology is that it has the potential to cut costs by reducing the
length of stay in the hospital, reducing the demand for clinicians, and
reducing inappropriate laboratory procedures (Furukuwa, Raghu, &
Shao, 2010). Since the cost of setting up EMR is prohibitive, clinicians
are worried about the ROI that they have made (Boonstra & Broekhuis,
2010). Boonstra and Broekhuis argued that it could take years before
any return can be manifested. In spite of the high cost of purchasing
EMR, the technology is widely believed by some circles that it would
yield both financial and clinical benefit (Thompson & Fleming, 2008).
Moreover, Thompson and Fleming (2008) argued that the benefits of
the tool do outweigh the cost of implementation and maintenance. In
an attempt to encourage the adoption of EMR in the United States, the
Bush administration proposed a plan that all medical records of the

21

citizens of the country be fully computerized (Hoffman, 2009; Morton

& Wiedenbeck, 2009). In support of the initiative of the Bush
Administration, the HITECH Act of 2009, which is a portion of the
American Recovery and Reinvestment Act of 2009, the Obama
administration, allocated some funds to health care providers as an
incentive to encourage the adoption of EMR (Brooks & Grotz, 2010;
Spruell et al., 2010).
In spite of the HITECH stimulus money, Spruell et al. (2010) argued
that some steps must be considered before investing in the
implementation of EMR. Some of these activities as listed by Spruell
et al. are as follows:
Problem definitionWhat is to be accomplished with the purchase,
including

the

assessment

of

project

scope

(partial

of

full

implementation of EMR), feasibility study, and physician cost during

this period, such as physician and office managers time re vendors,
loss of revenue during the meetings with vendors, and consultant fees.
Site preparationThis includes hardware purchases, installation, and
upgrades.

Licensing fees, training costs, and maintenance fees.

Training of staff and final preparation to go live.

22

Furukuwa et al. (2010) stated that the business case for investment in
EMR is that it would eventually cut down the cost of health care, but
they could not justify it in their experience. In their studies of EMR
implementation at a California hospital from 1998 to 2007, they found
out that the use of EMR increased the cost of treatment at the hospital.
According to Furukuwa et al., there was an increase of 6% to 10% in
the cost per discharge in medical acute units. These researchers argued
that EMR may even lead to an increase in demand for skilled nurses,
which would not necessarily lead to cost savings. Furukuwa et al.
stated that they focused on EMR implementation in the first 3 years
rather than the long-term effect. For this reason, they concluded that
they could not generalize their findings as being applicable to other
hospitals. Thompson and Fleming (2008) also argued that published
information on the financial benefit on EMR does not have a common
basis for comparison and that there are inconsistencies between studies
regarding financial benefit of the technology.
2.3.2 Technical
A full adoption of EMR would make IT a critical component of
helping hospitals to deliver health care (Boonstra & Broekhuis, 2010).
However, Boonstra and Broekhuis (2010) argued that a lack of
technical skills is one of the barriers to full adoption of EMR in health
care settings. According to Boonstra and Broekhuis, a certain level of

23

computer skills is required in order to master the complexity of

hardware and software of EMR system. Boonstra and Broekhuis stated
that EMR vendors may have underestimated the level of technical
skills required by clinicians to master the use of the technology.
Boonstra and Broekhuis (2010) argued that clinicianslack of technical
knowledge to deal with EMRs may have contributed to their resistance
to adopting the system. Some physician practices that have adopted
EMR stated that going from [PBMR] to EMR was hard and
challenging initially, but none of those practices was ready to go back
to using [PBMR] (Atwal, 2011). According to Atwal (2011), these
practices considered the readily available information of records in
EMR system as beneficial to their settings.
Some physicians argued that EMR is unnecessarily too complicated or
too limited in its capability when it was compared with a paper-based
manual entry system (Boonstra & Broekhus, 2010). Other factors
limiting the adoption of EMR as argued by Boonstra and Broekhuis
(2010) are unfriendly complex screens, lack of standardization with
respect to data exchange, and reliability of the system with respect to
unexpected crash during the examination of patients. Higgins et al.
(2012) echoed the difficulty of using EMR, stating that, after initial
installation, it could take up to 1 year to reach a stable utilization of the
system. Boonstra and Broekhuis (2010) opined that the complexity of

24

hardware, software, and network deployment could be problematic

when deploying EMR. New evolution in the deployment of EMR that
would make it ubiquitous is cloud computing (Wenjun, 2012). Haag
and Cumming (2010) as cited in Aljabre (2012), defined cloud
computing as a computer model in which all services such as
applications, backups, resources, and development tools are delivered
over the Internet as hosted services.
2.3.3 Time
Some physicians have argued that the use of EMR has limited their
focus on their patients since they spend more time on the technology
rather than their patients (Smith, 2010). In a study of EMR adoption in
Massachusetts by American Medical Informatics Association, 81% of
respondents are reported to resist the technology because of fear of
productivity loss (Etzioni, 2010). On the other hand, Haig (2010)
argued that clinicians are spending too much time on EMR by looking
out for the best-paying code rather than focusing more on patients care.
Haig argued that the effort that one spends on entering and changing
passwords every two months is a waste of time. According to Haig, IT
takes too much time and energy from physicians and has prevented
them from focusing on their patients. According to Boonstra and
Broekhuis (2010), some physicians stated that they spent too much

25

time on EMR per patient than they would normally spend on using
[PBMR].
On the contrary, Calder (as cited in Smith, 2010), argued that the use of
EMR has provided him with an opportunity to spend more time with
his patients. The 2001 Institute of Medicine (IOM) on Crossing the
Quality Chasm reported that timeliness is an area that needs
improvement in health care management (Rosen, Spalding, Hannon,
Boudreau, & Kwoh, 2011). Calder argued that the time that he saved
by using EMR has allowed him to spend more time with his patients
and as a result, was able to improve the quality of health care for them.
In a survey of parents of patients at pediatric rheumatology practice in
Pittsburgh, Pennsylvania, in a month before implementation of EMR
system, and 3 months after the implementation, Rosen, et al. (2011)
reported that parents were satisfied with EMR usage. According to
Rosen et al., parents of the patients agreed that EMR has improved the
quality of health care of their children. Rosen et al. also stated that the
parents of those children were reportedly happy that doctors were able
to spend more time with their children.
2.3.4 Safety
Electronic medical record has been reported to have improved the
quality of care for patients with minimal increase in the cost of health

26

care system (Gilmer et al., 2012). The safety use of EMR as a

technology that can reduce medical errors is also echoed by Crane and
Crane (2008). Melendez (2012) noticed the failure of an EMR when
the system processed some wrong data of patients when his team
(Medical Device Integration Informatics) was trying to integrate
patientsdata from medical devices to the
EMR at

Brigham and Womens hospital

and Ma Melendez

and his team developed a scenario that was based on a day in the life of
a patients from admission to discharge visit. According to Melendez,
his team was not sure whether buffered data from medical device
(which were generated by network interruption) were loaded correctly
into every patient record all of the time.
Loading incorrect data into patient records raises significant safety
implications (Melendez, 2011). According to the Melendez, most
EMRs today receive data from Health Level 7 (HL7) interface or
terminal servers by location rather than by patient identifier (PID).
Melendez and his team were able to resolve this issue by using a
computer system that used PID to load the data, rather than using a
medical device that identifies patients by location. Melendez advised
that hospitals should use medical devices that identify patient with PID
rather than the room location identifier.

27

According to Melendez, data flow can synchronize with the correct

patients inference on EMR if PID for patients identification.
Harrington, Kennerly, Johnson, and Snyder (2011) also echoed their
concern on EMR usage safety in their review of some literature from
2000 to 2009. These authors advised that health care leaders should try
to understand the complexity of this technology, and to ensure that
vendors comply with sound design, development, and on usage. They
argued that stake holders should be aware of threats that can be
introduced during implementation of EMR from design to delivery.
Harrington et al. (2011) argued that loss of data during system crashes,
loss of connectivity, and keypad entry error can result in unintended
consequences. While some of the issues on EMR are technologically
related, safety issues on environment, process, and organizational set
up are also of major concern (Harrington et al., 2011). These authors
advised that leaders on the provider side should be involved in the
maturation of EMR in order to realize the potential of the technology.
2.3.5 Legal
In spite of the strong backing of EMR by the Obama administration
(Jones & Kessler, 2010), there are concerns about keeping medical
records information safe. Boonstra and Broekhuis (2010) argued that
physicians must be wary of the safety of medical information in order

28

to avoid legal issues that could arise from it. Boonstra and Broekhuis
stated that physicians are not sure if EMR is secure enough to prevent
unauthorized users from accessing the data of their patients. The
breach of confidentiality of patients information was not taken lightly
at University of California (UCLAS) Medical Center (Mir, 2011).
According to Mir, the hospital disengaged 13 of its employee (none
were physicians) for unauthorized access to Britney Spears
confidential medical records (Mir, 2011). Moreover, Mir stated that,
six physicians of the same medical center were also disciplined for
improperly looking at Spears medical record.
2.3.6 Social
In medical practices, physicians usually work with other parties such
as vendors, insurance companies, patients, administrative staff, and
other clinicians (Boonstra & Broekhuis, 2010). According to Boonstra
and Broekhuis, the decision to implement EMR by physicians is
influenced by these parties, and this could also affect the relationship
between physicians and their patients. The lack of support and
technical training by vendor can be a barrier to the adoption of EMR
systems (Boonstra & Broekhuis, 2010). According to these authors, the
lack of competition in this industry testifies to the fact that the industry
has not matured, and as such, many of these vendors could disappear
before EMR systems get better. Some physicians also stated that their

29

decision to adopt EMR was affected by local or regional organizations

that were not active in EMR debate (Boonstra & Broekhuis, 2010).
Other social issues such as insufficient computer skills and lack of
training are reported to make EMR time consuming to use (Granlien &
Hertzum, 2012).
2.4 Structured Query Language
Before the advent of commercially available databases, every system
in need of persistent storage had no choice but to implement its own,
usually in some proprietary file format (binary or text) that only this
application could read from and write to. This required every
application that used these files to be intimately familiar with the
structure of the file, which made switching to a different storage all but
impossible. Additionally, you had to learn a vendor-specific access
mechanism to be able to use it. Relational model dealt with
complexities of data structures, organizing data on logical level, but it
had nothing to say about the specific of storage and retrieval except
that it had to be set based and follow relational algebra rules. Left to
their

own

devices,

the

early

RELATIONAL

DATABASE

MANAGEMENT SYSTEMs implemented a number of languages,

including SEQUEL, developed by Donald D. Chamberlin and
Raymond F. Boyce in the early 1970s while working at IBM; and

30

QUEL, the original language of Ingres. Eventually these efforts

converged into a workable SQL, the Structured Query Language.
SQL is a Relational Database Management System programming
language designed to define relational constructs (such as schemas and
tables) and provides data manipulation capabilities. Unlike many
programming languages in general use, it does not exist outside the
relational model.
2.4.1 The SQL Standard
To bring greater conformity among vendors, the American National
Standards Institute (ANSI) published its first SQL Standard in 1986
and a second widely adopted standard in 1989. ANSI released updates
in 1992, known as SQL92 and SQL2, and again in 1999: SQL99 and
SQL3. Each time, ANSI added new features and incorporated new
commands and capabilities into the language.
The ANSI standards formalized many SQL behaviors and syntax
structures across a variety of products. These standards become even
more important as open source database products (such as MySQL and
Postgre SQL) grow in popularity and are developed by virtual teams
rather than large corporations.

31

The SQL Standard is now maintained by both ANSI and the

International Standards Organization (ISO) as ISO/IEC 9075 standard.
The latest released standard is SQL: 2008, and work is underway to
release the next version of the standard to accommodate new
developments in the way RDBMSs collect and disseminate data.
2.4.2 MYSQL
MySQL was first developed by Michael Widenius and David Axmark
back in 1994, with its first release in 1995. It was initially positioned as
a lightweight, fast database to serve as the back end for data-driven
websites. Even though it was lacking many features of the more mature
RDBMS products, it was fast in serving information and good
enough for many scenarios. (To be really fast, MySQL can bypass
referential integrity constraints and ditch transactional support)
MySQL was acquired by Sun Microsystems in which was
subsequently swallowed by Oracle.
Currently, Oracle offers a commercially supported version of MySQL
as well as a Community Edition. Following this acquisition, a number
of fork versions sprang up, such as MariaDB and Percona Server,
committed to maintain free status under the General Public License
(GPL), one of the least restrictive open source licenses.

32

The latest released version of MySQL is 5.5, with version 6 on the

horizon. It is multiplatform (Linux/UNIX/Windows), and supports
most of the features of SQL: 1999; some of the features depend on the
selected options (for example, a storage engine).
2.5 The History of Java
To fully understand Java, one must understand the reasons behind its
creation, the forces that shaped it and the legacy that it inherits. Like
the successful computer languages that came before, Java is a blend of
the best elements of its rich heritage Combined with the innovative
concepts required by its unique mission. Although Java has become
inseparably linked with the online environment of the Internet, it is
important to remember that Java is first and foremost a programming
language. Computer language innovation and development occurs for
two fundamental reasons:

To adapt to changing environments and uses

To implement refinements and improvements in the art of

programming
2.5.1 The Development of Java Language

33

Java was conceived by James Gosling, Patrick Naughton, Chris Warth,

Ed Frank, and Mike Sheridan at Sun Microsystems, Inc. in 1991. It
took 18 months to develop the first working version. This language
was initially called Oak, but was renamed Java in 1995. Between
the initial implementation of Oak in the fall of 1992 and the public
announcement of Java in the spring of 1995, many more people
contributed to the design and evolution of the language.
Bill Joy, Arthur van Hoff, Jonathan Payne, Frank Yelling, and Tim
Lindholm were key Contributors to the maturing of the original
prototype.
Somewhat surprisingly, the original impetus for Java was not the
Internet! Instead, the primary motivation was the need for a platformindependent (that is, architecture-neutral) language that could be used
to create software to be embedded in various consumer electronic
devices, such as microwave ovens and remote controls. As you can
probably guess, many different types of CPUs are used as controllers.
The trouble with C and C++ (and most other languages) is that they are
designed to be compiled for a specific target. Although it is possible to
compile a C++ program for just about any type of CPU, to do so
requires a full C++ compiler targeted for that CPU. The problem is that
compilers are expensive and time-consuming to create. An easierand
more cost-efficientsolution was needed. In an attempt to find such a

34

solution, Gosling and others began work on a portable, platformindependent language that could be used to produce code that would
run on a variety of CPUs under differing environments. This effort
ultimately led to the creation of Java.
About the time that the details of Java were being worked out, a
second, and ultimately more important, factor was emerging that
would play a crucial role in the future of Java.
This second force was, of course, the World Wide Web. Had the Web
not taken shape at about the same time that Java was being
implemented, Java might have remained a useful but obscure language
for programming consumer electronics. However, with the emergence
of the World Wide Web, Java was propelled to the forefront of
computer language design, because the Web, too, demanded portable
programs.
Because of the similarities between Java and C++, it is tempting to
think of Java as simply the Internet version of C++. However, to do
so would be a large mistake. Java has significant practical and
philosophical differences. While it is true that Java was influenced by
C++, it is not an enhanced version of C++. For example, Java is neither
upwardly nor downwardly compatible with C++. Of course, the
similarities with C++ are significant, and if you are a C++

35

programmer, then you will feel right at home with Java. One other
point: Java was not designed to replace C++. Java was designed to
solve a certain set of problems.

CHAPTER THREE
RESEARCH METHODOLOGY
The purpose of this research was to explore by qualitative means, how
EMR can reduce time wastage seen in the use of paper based record
system and to see to the implementation of EMR as a means to help
revamp the health sector. I have selected Federal Medical Center Asaba
as my case study. Currently, the hospital has EMR running in one of
the departments, while in other departments, paper based record is still
used. I was able to assess the time spent on medical records and time
spent by physicians on patients to ascertain the gap in treatment. In this
chapter, I will describe the research design, methodology, data
collection procedures, data analysis, and a summary.
3.1 Research Design

36

I conducted multiple studies (case studies) in order to gain firsthand

experience with respect to EMR implementation, time spent by doctors
in checking records of patients before treatment and how people feel
about technology in the health sector with respect to Nigerian
hospitals.
A comparative case study was considered the most appropriate method
for this study. As it allowed me compare views across the case study
hospitals visited. Qualitative research allows more freedom than other
approaches and allows the researcher to adjust the process as the
project develops. In this research, I have explored how the
implementation of an EMR would impact more on the number of
patient attended to by physicians and the time spent on paper based
records. This type of comparison is consistent with qualitative research
method. The units of analysis in qualitative research are numbers,
whereas qualitative research uses words or visual images for unit of
analysis (Denscomber, 2003). Therefore I adhered to use the unit of
analysis that was consistent with qualitative measurement in this study.
3.2 Methodology
Research participants for this research study were patients, doctors and
record management staffs from my case study hospital. In my

37

selection, I recruited 28 doctors, 20 patients, and 16 record

management staffs from Federal Medical Center Asaba.
3.2.1 Inclusion Criteria
Participants were selected to be part of this study because they
belonged to a group that either was identified to be a patient in the
patients waiting room of the out-patient department or an attending
doctor in the out-patient. Selected participants were adults who:

Came to the hospital on their own

Came to the hospital without police escort.

Were not on sick bed

Were able to express themselves fluently in English language or

Were doctors who were general practioners in the outpatients

department

3.2.2 Exclusion Criteria

I excluded non-English speakers, friends, relations, and business
associates plus those who did not want any inclusion.
3.3 Instrumentation

38

Singleton and Straits (2010) argued that sampling and interview

instruments are vital to a successful research survey. They stated that
generalizations about population depend on the quality of the samples
used. To collect research data, four basic methods of interview are
used: Face-to-Face, telephone, computer-assisted self-interviews, and
paper-and-pen questionnaires. Other methods stated by singleton and
Straits, include observation and examining public or private
documents. The data collection methods used are briefly described
below. The interview guides for this study can be found in Appendix A
and Appendix B.
The method of data collection I used for this study is the face-to-face
interviews. According to Singleton and Straits (2010), one of the
advantages of the FTF interviews is that the interviewer can restate
questions unclear to the respondents. I ensured clarity by restating my
questions to my participants. Singleton and Straits argued that the
interviewer can unobtrusively observe an area of interest to the
researcher. A disadvantage in the face-to-face approach according to
(Denscomber, 2003) is geographical location of the respondent. An
audio recorder in face-to-face interviews can inhibit an informant who
may not feel comfortable being recorded (Descomber, 2003).
3.4 Procedure for Recruitment, Participation and Data Collection

39

The study was to explore using qualitative means on how EMR can
reduce time wastage seen in the use paper based systems and to ensure
the implementation of it as a means to revamp the health sector.
I used non-probability purposive sampling for participant selection in
this study. Frankfort-Nachmias and Nachmias (2008) stated that nonprobability sampling does not guarantee that every unit of the
population will have some chance of being included in the sample.
However, the authors wrote that probability sampling is characterized
by a sampling size in which every individual has an equal chance of
being selected. Having equal access to a target population would
engender the use of probability sampling. However, I conducted the
non-probability purposive sampling method because it was impractical
to select a sample that was large enough to be a probability sample.
The three major non-probability sampling techniques employed by
social scientists are quota samples, purposive samples, and
convenience samples (Frankfort and Nachmias, 2008). In this study, a
purposive sampling technique was used. This technique allows
researcher to select sampling units that appear to be representative of
the population (Frankfort and Nachmias, 2008, p.168). For this study I
interviewed 20 patients, 28 doctors, and 16 record management staffs
from Federal Medical Center Asaba. I conducted my interviews from
September 1 through September 22, 2015.

40

In conducting my research, I was provided with a private room in the

hospital to perform my study. My participants were drawn from the
outpatient department; this is so because in Nigeria, Outpatient
department is where patients see their doctors first before meeting any
other specialist. To avoid treatment/consultation disruption, interviews
were carried out during free hours for all participants. My questions
where direct to save time and to capture my research objective.
On daily bases, I spend 8hrs starting from 7am-3pm in the hospital
reviewing the paper based system and asking case study questions.
3.5 Data Analysis
The data collected for this study were analyzed with Nvivo 11,
automatic coding as was suggested by Robertson (2014). According to
Robertson (2014), using automatic coding allows for broad-brush
coding for large volumes of textual data, which a researcher can later
review and refine for further analysis. Automatic coding is also used to
predetermine elements of source materials (Edhlung and McDougall,
2012). There were three interview schedules used for the research: one
for doctors, one for patients, and on for record management staffs.
After the interviews, results were collated to analyze divergent views
and responses to interview questions. The tables that identify the
frequency of response to questions can be found immediately in their

41

respective categories in chapter four. Mariam (2009) stated that

researchers can make sense of their data by including the process used
to provide answers to their research questions.

CHAPTER FOUR
IMPLEMENTATION AND EVALUATION
4.1 Medical Record Hardware Requirement

X86 or X64 based processor

Intel/AMD processor
Graphical user interface enabled computer
RAM of 2GB and above
Hard-disk of at least 100GB

4.2 Medical Record Software Installation Requirement

There are minimum system requirements for all software, and this
software is no different. For adequate deployment and running of
MEDICAL RECORD software for optimum performance, the
following requirements must be met:

42

CPU: Intel Pentium 1 compatible systems and above

RAM: at least 2GB
Operating System: Windows XP/7/8.This software can also be
installed in UNIX and Linux Operating System, this is because

Java is compatible with all operating systems.

Graphical User Interface
Netbeans 6.0 and above
Java development kit (JDK)
MYSQL server

4.3 Data Source

4.3.1 Demographics
Participants demographics for this study included the gender and
locations of participants. The demographic factors are shown in table
1, 2, and 3. Table 1 contains the list of participating doctors practicing
in the outpatient department of federal medical center Asaba. Table 2
contains the list of patients in the out-patient department of Federal
Medical Center Asaba, while table 3 contains the names of record
management staffs in the same hospital.
Demographic factors of research participants (Doctors).
Participants
28
Table 4.1

Location
FMC-ASABA

Males
15

Demographic factors of research participants (Patients).

43

Females
13

Participants
20
Table 4.2

Location
FMC-ASABA

Males
11

Females
9

Demographic factors of research participants (Record Management

Staffs).
Participants
16
Table 4.3

Location
FMC-ASABA

Males
8

4.4 Data Collection

Participants in this study were 64. I collected data from 28 doctors, 20
patients, and 16 record management staffs at Federal Medical Center
Asaba. The interview sections were held from September 1 st through
September 22nd, 2015. A consent form was distributed the first day of
my visit to the hospital, where some of the participants gave me
answer to my questions after their engagements. The interview sections
lasted for approximately 20 minutes on average. Although doctors
schedule consultation time with patients from 8am to 4pm, most
patients arrive earlier at about 7am.
My interview questions were direct to the point. My instruments for
patients, doctors and record management staffs are in Appendix A, B,
C.

44

Females
8

Study Results.
The result of the study was analyzed using structural auto coding
(Nvivo 11). The transcribed data were later categorized. Thematic
coding was used to reveal recurring themes and patterns. Three
different interviews schedules were adopted: one for doctors, one for
patients, and one for record management staffs.
The following questions were adapted from the questionnaire questions
in the appendix.
The first of them is for doctors and their response to fielded questions
include:
4.4.1 What are the current challenges faced with the paper based
medical record (PBMR)?
Responses include:
Using (PBMR) is our normal daily experience and it affects the
number of patients we see daily. It leads to spending a lot of time on a
patient, where we have to do several verifications.
The use of (PBMR) has negatively affected the time I spend with my
patients. I spend most of my time looking for missing case notes rather
than attending to patients.

45

The use of (PBMR) has not really affected the number of patients I see
on a daily basis, said one of the doctors.
Using (PBMR) will make you start searching forever, for example if
you have a patient who has regularly been visiting, say for five years.
I have no problem with the (PBMR) as it has been in use for ages, I am
very conversant with it and accustomed to its operation and
deficiencies.
What are the current challenges faced with the paper based medical
record (PBMR)?
Responses of Participants

Frequency
as stated by
FMC

Practitioners
PBMR leads to time wastage
7
PBMR has no effect on my 1
patients
PBMR should be replaced by a 8
more efficient type e.g. EMR
I have treated the wrong patient 5
due to wrong record
Table 4.4
4.4.2 What do you think should be done to remedy the PBMR.

46

Responses from the doctors

I think using an electronic means would help reduce negative cases in
PBMR. Technology is helping disciplines grow, and I think adopting a
technological means would go a long way in improving patient
attendance and care.
I do not think replacing PBMR is good for now due to electricity. We
should wait till we can guarantee 24hrs of power supply.
Adopting automated or computerized method of storing patient
information that could be shared across various units in the hospital is
a solution.
What do you think should be done to remedy the PBMR.
Responses From Participants
Using technology would help a lot
Using EMR is the way out
Electricity is not a problem
Table 4.5

Frequency as stated by FMC Practitio

6
8
7

4.4.3 Ease of Use of EMR

Although when this question was asked, respondents said they have
heard of it, but have not used it before. I have a facebook account
managed and controlled by me, so I can use EMR very well.

47

It would not be a problem provided it has a user interface. It would be

a difficult experience during first periods but we would get to learn it
as time goes on. I clearly believe in learning so I do not see a problem
with accessing it.
Ease of Use of EMR

Responses from participants

Frequency stated by FMC participan
EMR would be easier
7
I have not used it before, so I cannot make a 4
statement.
I will cope when its time
It would be user friendly
Table 4.6

7
6

4.4.4 Attitude of doctors at Federal Medical Center toward EMR

implementation.
Most of the doctors who participated in this study at FMC agreed to
the prospect of using EMR in their practice. They even advice the
federal government to approve it for all hospitals in the country.
Attitude of doctors at Federal Medical Center toward EMR
implementation
Responses from participants
EMR would be time consuming
EMR should be deployed across hospitals
We would need training first
Table 4.7

48

Frequency as stated by FMC particip

2
7
9

4.5 Questions Asked To The Patients And Responses.

4.5.1 How do you see the paper based medical record in Nigeria?
Quite a number of the patients had negative things to say about the
PBMR.
It wastes time a lot, with so many steps involved before you get to
meet the doctor finally.
The PBMR is a stress for us, if the hospital can introduce an
electronic means to store our records, it would be helpful.
I have had issues in the hospital when I was told my record was
missing. Clearly, we need an alternative to the PBMR.
I would love to see a computerized version of the PBMR.
Responses from participants
It waste time
I have had issues with PBMR
I would love a computerized version of PBMR
PBMR is stressful
Table 4.8
4.5.2 Have you heard or used EMR before?

49

Frequency as stated by FMC particip

5
7
9
6

I have not heard about EMR but since it is a computerized version of

PBMR, it is okay.
I have heard of it, but have not seen it.
This is the first time I heard such name.
Have you heard or used EMR before?
Responses from participants
I have not heard about EMR before
Have you used EMR before
Table 4.9

Frequency as stated by FMC particip

8
5

4.5.3 Do you think the PBMR is inefficient now and should be

replaced?
I do not think the PBMR is inefficient as it has been there for ages and
should not be replaced.
Obviously, PBMR is inefficient as it waste a lot of time and should be
replaced.
I agree totally that PBMR is a waste of time, hence very inefficient and
should be replaced
Responses from participants
I do not think PBMR is inefficient
PBMR should be replaced by EMR
PBMR wastes lots of time

50

Frequency as stated by FMC particip

4
9
6

. Table 4.10
4.6 Implementation Procedure
The three major aspects of implementation are:

Training personnel

Conversion procedures

Post-implementation review

4.6.1 Training Personnel

Even well-designed system can succeed or fail because of the way they
are operated and used. Therefore, the quality received by the personnel
involved with the system in various capacities helps or hinders and
may even prevent the successful implementation of management
information system. Those who are directly or indirectly related with
the system development work must know in detail what their roles will
be, how they can make efficient use of the system and what the system
will or will not do for them. Both systems operators and users need
training to effectively use the software and understand the software
environment.

51

4.6.2 Conversion Procedures

The procedure employed in the deployment of the software would
follow the following forms:
4.6.2.1 Phase-In
This method is used when it is not possible to install a new system
throughout an organization all at once. The conversion of files, training
of personnel or arrival of equipment may force the staging of the
implementation over a period of time, ranging from weeks to months.
It allows some users to take advantage of the new system early. Also it
allows training and installation without unnecessary use of resources.
4.6.3 Post-Implementation Review
After the system is implemented and conversion is complete, a review
should be conducted to determine whether the system is meeting
expectations

and

where

improvements

are

needed.

A post

implementation review measures the systems, performance against predefined requirements. It determines how well the system continues to
meet performance specifications. It also provides information to
determine whether major re-design or modification is required. A postimplementation review is an evaluation of a system in terms of the
extent to which the system accomplishes stated objectives and actual

52

project costs exceed initial estimates. It is usually a review of major

problems that need converting and those that surfaced during the
implementation phase. The post-implementation study begins with the
review team, which gathers and reviews requests for evaluation.
Unexpected change in the system that affects the user or system
performance is a primary factor that prompts system review. Once
request is filed, the user is asked how well the system is functioning to
specifications or how well the measured benefits have been realized.
Suggestion regarding changes and improvements are also asked for.
4.7 Design Flowchart

Input Data -Employment File

Input From the user

Keyboard
Result in Dbase dddsaedddbaScreen
Processor
Output (Report)
Disk
Storage

Fig 4.1
4.7.1 Sample Implementation Input Snapshot

53

Fig 4.2
4.7.2 Sample Implementation Output Snapshot

Fig 4.3
4.8 Evaluation of Results

54

A research study that included 64 participants drawn from my case

study hospitals was done to explore the current record system and to
introduce/implement a new system. This interview took place from
September first to twenty second, 2015 at the Federal Medical Center
Asaba. In chapter 3, I introduced my research methodology and
collected results were analyzed using Nvivo11 software. There were
three different interview schedules used. The first one (Appendix A)
was targeted at the patients, the second (Appendix B) to doctors, and
the third was for the record management staffs.
Responses from participants showed that the current system (PBMR)
has issues and is not meeting the daily demands of the patients.
Therefore they looked forward to a better solution, one that would be
efficient and speedy.
It was a general agreement, that the PBMR is long overdue, although
that the introduction of a computerized system would be daunting and
required training, but would go a long way to help the disadvantages
present in (PBMR). The next chapter (chapter 5) contains a discussion
of the summary of results, conclusions, recommendations, suggestions,
references, and appendix and source codes.

CHAPTER FIVE

55

DISCUSSION AND CONCLUSION

5.1 Summary of results
In this project, two programming languages where use: Java and SQL
programming language and the database engine used are MySQL
Server. Java is used to program the software project and SQL is used to
query the database. There are different types of database e.g. Postgres
database; oracle etc. The reason why we used MySQL for this project
is because of its flexibility. The research study and result analysis
shows that PBMR has issues while the respondents agreed
unanimously to adopt an electronic medical record as a way to reduce
the issues in paper based medical record. The reason why Java was
used in this project is because it is a cross-platform programming
language, this means that it can run in all Operating Systems.

5.2 Conclusion
Medical record system as proposed was designed and developed to
help reduce the issues in PBMR, the software developed and integrated
with MySQL. The Software was tested and run to ascertain its
capability. The need for such a system that can electronically store
patient information without fear of fire or danger cannot be

56

overemphasized owing to the nobility of the health care system.

Therefore, the medical record system helps to ensure proper
management of patients medical records. Also, its database can be
easily managed by any administrator, and does not need any special
training for one to be able to do so.
5.3

Recommendations

Having carried out this work thus far, some recommendations are
necessary to ensure its deployment and use, and also for further
research around this work. My recommendation includes:
(1).The addition of more windows that may include other features
(2) The application should be packaged for installation
(3) MySQL server should be available to store the contents
automatically
(4).I use this opportunity to encourage those who will like to develop
software with an object oriented programming language to consider
using Java.

57

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68

APPENDIX
Appendix A:
Questionnaire on EMR implementation to replace PBMR
The interview schedule for patients
Date and time of interview:
Date of interview: ____________/___________/____________
Start time of interview: _____________________ End time of
interview _________________
Hospital name: ___________________________________________
The interview:
1. How is your experience with PBMR like?
2. How would you describe your experience on the time it took to
complete your registration?
3. How would you describe the level of caring by your doctor?
4. How satisfied are you with your treatment today?
5. Can you comment on how long it took the doctor to locate your
information before attending to you?
6. Do you have any technological experience?
7. Can you detail the processes involved in replacing a lost card?
8. How do you rate your hospital?
9. Do you think the PBMR is inefficient?
10. Is there a need to change the PBMR?

69

Appendix B
Questionnaire on EMR implementation to replace PBMR
The interview schedule for Doctors

70

Date and time of interview:

Date of interview: ____________/___________/____________
Start time of interview: _____________________ End time of
interview _________________
Specialty:

________________________

Yrs

of

experience:

____________________________
Hospital name: _________________________________________
The interview:
1. How many patients on average do you see daily?
2. How has PBMR usage affected the time spent on patients by
3.
4.
5.
6.

you?
Do you have technological experience?
Have you heard of EMR?
How do you see ICT in Medicine?
How has PBMR affected your daily work-flow with respect to

productivity?
7. How has PBMR affected transferring of patient data or
information from one department to another?
8. Do you think PBMR should be replaced?
9. Describe your experience on PBMR with respect to getting the
information you need on time?
10. How does the use of PBMR make it easier to consider all
aspects of a patients condition?

71

Appendix C
Questionnaire on EMR implementation to replace PBMR
The interview schedule for record management staffs
Date and time of interview:
Date of interview: ____________/___________/____________
Start time of interview: _____________________ End time of
interview _________________
Hospital name: _________________________________

72

The interview:
1. What is your view on the use of PBMR for recording?
2. Is there inefficiency in PBMR?
3. Can you list the inefficiencies?
4. What do you think can solve the inefficiencies?
5. Do you welcome ICT in medicine?
6. Are you technologically good?
7. How often do patients complain of missing records/
8. How do you deal with legibility problem?
9. Have you ever loosed a record?
10. Have you ever seen a patient record in the wrong hands or
place?
11. Do you know about EMR?

73

Appendix D
Informed Consent Letter
CONSENT FORM
You are invited to take part in a research study on EMR
implementation, as a way to replace PBMR. You are one among the
participants for this survey, comprising of patients, doctors, and record
management staffs drawn from Federal Medical Center Asaba. This is
a formal process of obtaining your written agreement to take part in
this study which is called informed consent, and it is designed to
allow you understand all aspect of this study before making a decision
of taking part. You are selected to be part of the study because you fit
into a group identified as patients waiting in the Out-patient
department, doctors in the Out-patient department or record
management staffs in the Out-patient department. In addition to this,
you were selected because of the following:

74

You came to the hospital on your own as an adult.

You came to the hospital without police escort.
You are not on sick bed
You can speak and understand English
You are a doctor in the Out-patient department, who is a
practitioner in the hospital
This study is being conducted by a researcher named OTUNUYA C.
HENRY, who is an undergraduate student at National Open University
of Nigeria.
Procedure:
If you agree to this study, you will be asked to:

Answer few questions relating to the study.

Take about 20minutes of your time

CONTACT AND QUESTIONS

You may ask any questions you have by calling the researcher phone
Statement of Consent:
I have read the above information and I fell I understand the study well
enough to be a part in the study. By appending below my signature, I
therefore agree to be a participant.
Name of Participant ____________________________________

75

Date of Consent ____________________________________

Participants signature ______________________________
Researchers signature __________________________________

76

SOURCE CODE:
/*
* To change this license header, choose License Headers in Project
Properties.
* To change this template file, choose Tools | Templates
* and open the template in the editor.
*/
package medrecord;
/**
*
* @author 15N
*/
import java.sql.*;
import javax.swing.*;
import javax.swing.table.DefaultTableModel;
import javax.swing.text.Position;

public class MyRecord extends javax.swing.JFrame {

final void Filllist(){
try{

77

String url = "jdbc:mysql://localhost:3306/henry?

zeroDateTimeBehavior=convertToNull";
String username = "root";
String password = "henry";
Connection
DriverManager.getConnection(url,username,password);

con

Statement stmt = con.createStatement()

String Query = "SELECT * FROM PATIENTRECORD";
ResultSet rs = stmt.executeQuery(Query);
DefaultListModel DLM = new DefaultListModel();
while (rs.next()){
DLM.addElement(rs.getString(1));
}
List1.setModel(DLM);
}
catch(SQLException ex){
JOptionPane.showMessageDialog(null, ex.toString()
}
}
public MyRecord() {
initComponents();
Filllist();

78

for(int i=1900; i<=2015; i++){

fldAge2.addItem(i);
}
}
/**
* This method is called from within the constructor to initialize the
form.
* WARNING: Do NOT modify this code. The content of this
method is always
* regenerated by the Form Editor.
*/
@SuppressWarnings("unchecked")
// <editor-fold defaultstate="collapsed" desc="Generated Code">
private void initComponents() {
buttonGroup1 = new javax.swing.ButtonGroup();
jMenuBar2 = new javax.swing.JMenuBar();
jMenu3 = new javax.swing.JMenu();
jMenu4 = new javax.swing.JMenu();
jMenuBar3 = new javax.swing.JMenuBar();
jMenu5 = new javax.swing.JMenu();
jMenu6 = new javax.swing.JMenu();
jLabel1 = new javax.swing.JLabel();

79

jLabel2 = new javax.swing.JLabel();

jLabel3 = new javax.swing.JLabel();
jLabel4 = new javax.swing.JLabel();
jLabel5 = new javax.swing.JLabel();
jLabel6 = new javax.swing.JLabel();
jLabel7 = new javax.swing.JLabel();
jLabel8 = new javax.swing.JLabel();
jLabel9 = new javax.swing.JLabel();
jLabel10 = new javax.swing.JLabel();
jLabel11 = new javax.swing.JLabel();
jLabel12 = new javax.swing.JLabel();
jLabel13 = new javax.swing.JLabel();
Cadm = new javax.swing.JTextField();
Cdoc = new javax.swing.JTextField();
Dtreat = new javax.swing.JTextField();
jLabel14 = new javax.swing.JLabel();
jLabel15 = new javax.swing.JLabel();
Addbtn = new javax.swing.JButton();
Delbtn = new javax.swing.JButton();
Updatebtn = new javax.swing.JButton();
fldName = new javax.swing.JTextField();

80

fldTel = new javax.swing.JTextField();

jScrollPane1 = new javax.swing.JScrollPane();
jTable = new javax.swing.JTable();
fldPatient = new javax.swing.JTextField();
fldDept = new javax.swing.JComboBox();
fldBlg = new javax.swing.JComboBox();
fldGtp = new javax.swing.JComboBox();
fldRf = new javax.swing.JComboBox();
fldSex = new javax.swing.JComboBox();
fldAge = new javax.swing.JComboBox();
fldAge2 = new javax.swing.JComboBox();
fldAge1 = new javax.swing.JComboBox();
jScrollPane2 = new javax.swing.JScrollPane();
List1 = new javax.swing.JList();
SearchText = new javax.swing.JTextField();
SearchBtn = new javax.swing.JButton();
jMenuBar1 = new javax.swing.JMenuBar();
jMenu1 = new javax.swing.JMenu();
jMenuItem1 = new javax.swing.JMenuItem();
jMenu2 = new javax.swing.JMenu();
jSeparator1 = new javax.swing.JPopupMenu.Separator();

81

jMenu3.setText("File");
jMenuBar2.add(jMenu3);

jMenu4.setText("Edit");
jMenuBar2.add(jMenu4);
jMenu5.setText("File");
jMenuBar3.add(jMenu5);
jMenu6.setText("Edit");
jMenuBar3.add(jMenu6);
setDefaultCloseOperation(javax.swing.WindowConstants.EXIT_ON_
CLOSE);
setResizable(false);
jLabel1.setFont(new java.awt.Font("Tahoma", 1, 36)); // NOI18N
jLabel1.setText(" ELECTRONIC MEDICAL RECORD
SYSTEM FOR PATIENTS");
jLabel2.setFont(new java.awt.Font("Tahoma", 3, 14)); // NOI18N
jLabel2.setForeground(new java.awt.Color(51, 51, 255));
jLabel2.setText("PATIENT PERSONAL INFORMATION");
jLabel3.setText("NAME");
jLabel4.setText("Date of Birth");
jLabel5.setText("TEL_NO");

82

jLabel6.setFont(new java.awt.Font("Tahoma", 3, 14)); // NOI18N

jLabel6.setForeground(new java.awt.Color(0, 0, 255));
jLabel6.setText("PATIENT HEALTH NFORMATION");
jLabel7.setText("PATIENT_ID");
jLabel8.setText("SEX");
jLabel9.setText("RHESUS FACTOR");
jLabel10.setText("GENOTYPE");
jLabel11.setText("BLOOD GROUP");
jLabel12.setText("DEPARTMENT");
jLabel13.setText("CAUSE OF ADMISSION :");
Cadm.addActionListener(new java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
CadmActionPerformed(evt);
}
});
Cdoc.addActionListener(new java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
CdocActionPerformed(evt);
}
});
Dtreat.addActionListener(new java.awt.event.ActionListener() {

83

public void actionPerformed(java.awt.event.ActionEvent evt) {

DtreatActionPerformed(evt);
}
});
jLabel14.setText("DURATION OF TREATMENT :");
jLabel15.setText("COMMENT BY DOCTOR :");
Addbtn.setText("INSERT");
Addbtn.addActionListener(new java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
AddbtnActionPerformed(evt);
}
});
Delbtn.setText("DELETE");
Delbtn.addActionListener(new java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
DelbtnActionPerformed(evt);
}
});
Updatebtn.setText("UPDATE");
Updatebtn.addActionListener(new
java.awt.event.ActionListener() {

84

public void actionPerformed(java.awt.event.ActionEvent evt) {

UpdatebtnActionPerformed(evt);
}
});
fldName.addActionListener(new java.awt.event.ActionListener()
{
public void actionPerformed(java.awt.event.ActionEvent evt) {
fldNameActionPerformed(evt);
}
});
fldTel.addActionListener(new java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
fldTelActionPerformed(evt);
}
});
jTable.setModel(new javax.swing.table.DefaultTableModel(
new Object [][] {
},
new String [] {
"Patient_Name", "Patient_Id", "Patient_Phone_NO",
"Department_admitted", "Day of Birth", "Month of Birth", "Year of
Birth", "Blood_Group", "Patient_Sex", "Genotype", "Rhesus_Factor",
"Cause of Adm", "Comment by Dr", "Treatment Dur"

85

}
));
jTable.setColumnSelectionAllowed(true);
jScrollPane1.setViewportView(jTable);
jTable.getColumnModel().getSelectionModel().setSelectionMode(java
x.swing.ListSelectionModel.SINGLE_SELECTION);
fldPatient.addActionListener(new java.awt.event.ActionListener()
{
public void actionPerformed(java.awt.event.ActionEvent evt) {
fldPatientActionPerformed(evt);
}
});
fldDept.setModel(new javax.swing.DefaultComboBoxModel(new
String[] { "Pharmacy", "Out-Patient", "Orthopaedic", "A&E", "Dental
Clinic", "Gynaecology", "Eye Clinic", " " }));
fldDept.addActionListener(new java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
fldDeptActionPerformed(evt);
}
});
fldBlg.setModel(new javax.swing.DefaultComboBoxModel(new
String[] { "A", "B", "AB", "O" }));
fldBlg.addActionListener(new java.awt.event.ActionListener() {

86

public void actionPerformed(java.awt.event.ActionEvent evt) {

fldBlgActionPerformed(evt);
}
});
fldGtp.setModel(new javax.swing.DefaultComboBoxModel(new
String[] { "AA", "AS", "SS", " " }));
fldGtp.addActionListener(new java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
fldGtpActionPerformed(evt);
}
});
fldRf.setModel(new javax.swing.DefaultComboBoxModel(new
String[] { "NONE", "X" }));
fldRf.addActionListener(new java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
fldRfActionPerformed(evt);
}
});
fldSex.setModel(new javax.swing.DefaultComboBoxModel(new
String[] { "Male", "Female" }));
fldAge.setModel(new javax.swing.DefaultComboBoxModel(new
String[] { "Day", "01", "02", "03", "04", "05", "06", "07", "08", "09",
"10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21",
"22", "23", "24", "25", "26", "27", "28", "29", "30", "31" }));

87

fldAge2.setModel(new
javax.swing.DefaultComboBoxModel(new String[] { "Year" }));
fldAge1.setModel(new
javax.swing.DefaultComboBoxModel(new String[] { "Month", "01",
"02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12" }));
List1.addListSelectionListener(new
javax.swing.event.ListSelectionListener() {
Public
valueChanged(javax.swing.event.ListSelectionEvent evt) {

void

List1ValueChanged(evt);
}
});
jScrollPane2.setViewportView(List1);
SearchBtn.setText("Search");
SearchBtn.addActionListener(new
java.awt.event.ActionListener() {
public void actionPerformed(java.awt.event.ActionEvent evt) {
SearchBtnActionPerformed(evt);
}
});
jMenu1.setText("File");
jMenuItem1.setAccelerator(javax.swing.KeyStroke.getKeyStroke(java
.awt.event.KeyEvent.VK_N,
java.awt.event.InputEvent.CTRL_MASK));
jMenuItem1.setText("New");

88

jMenu1.add(jMenuItem1);
jMenuBar1.add(jMenu1);
jMenu2.setText("Edit");
jMenu2.add(jSeparator1);
jMenuBar1.add(jMenu2);
setJMenuBar(jMenuBar1);
javax.swing.GroupLayout
javax.swing.GroupLayout(getContentPane());

layout

new

getContentPane().setLayout(layout);
layout.setHorizontalGroup( layout.createParallelGroup(javax.swi
ng.GroupLayout.Alignment.TRAILING)
.addGroup(layout.createSequentialGroup()
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addGroup(layout.createSequentialGroup()
.addGap(32, 32, 32)
.addComponent(jScrollPane1))
.addGroup(layout.createSequentialGroup()
.addGap(47, 47, 47)
.
addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Align
ment.LEADING)
.addGroup(layout.createSequentialGroup()
.addGap(64, 64, 64)

89

.
addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Align
ment.LEADING)
.addGroup(layout.createSequentialGroup()
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addComponent(jLabel3,
javax.swing.GroupLayout.PREFERRED_SIZE,
60,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel5,
javax.swing.GroupLayout.PREFERRED_SIZE,
60,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel8,
javax.swing.GroupLayout.PREFERRED_SIZE,
60,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel4,
javax.swing.GroupLayout.PREFERRED_SIZE,
75,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addGap(18,
18,
18)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addGroup(javax.swing.GroupLayout.Alignment.TRAILING,
layout.createParallelGroup(javax.swing.GroupLayout.Alignment.LEA
DING)
.addGroup(javax.swing.GroupLayout.Alignment.TRAILING,
layout.createSequentialGroup()
.addComponent(fldSex,
javax.swing.GroupLayout.PREFERRED_SIZE,
99,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(188, 188, 188))
.addGroup(layout.createSequentialGroup()

90

.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addComponent(fldTel,
javax.swing.GroupLayout.PREFERRED_SIZE,
143,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGroup(layout.createSequentialGroup()
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.TRAILING, false)
.addGroup(layout.createSequentialGroup()
.addComponent(Addbtn)
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.REL
ATED,
javax.swing.GroupLayout.DEFAULT_SIZE,
Short.MAX_VALUE)
.addComponent(Updatebtn))
.addGroup(javax.swing.GroupLayout.Alignment.LEADING,
layout.createSequentialGroup()
.addComponent(fldAge,
javax.swing.GroupLayout.PREFERRED_SIZE,
82,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.UN
RELATED)
.addComponent(fldAge1,
javax.swing.GroupLayout.PREFERRED_SIZE,
82,
javax.swing.GroupLayout.PREFERRED_SIZE)))
.addGap(18, 18, 18)
.
addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Align
ment.LEADING)

91

.addComponent(fldAge2,
javax.swing.GroupLayout.PREFERRED_SIZE,
82,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(Delbtn))))
.addGap(21, 21, 21)))
.addGroup(layout.createSequentialGroup()
.addComponent(fldName,
javax.swing.GroupLayout.PREFERRED_SIZE,
195,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(92, 92, 92)))
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addComponent(jLabel7,
javax.swing.GroupLayout.PREFERRED_SIZE,
93,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel12,
javax.swing.GroupLayout.PREFERRED_SIZE,
93,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel11,
javax.swing.GroupLayout.PREFERRED_SIZE,
79,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel10,
javax.swing.GroupLayout.PREFERRED_SIZE,
60,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel9)
.addComponent(jLabel13))
.addGap(51, 51, 51)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)

92

.addGroup(layout.createSequentialGroup()
.addComponent(fldPatient,
javax.swing.GroupLayout.PREFERRED_SIZE,
152,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(90, 90, 90)
.addComponent(jLabel15))
.addGroup(layout.createSequentialGroup()
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addComponent(fldDept,
javax.swing.GroupLayout.PREFERRED_SIZE,
140,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldBlg,
javax.swing.GroupLayout.PREFERRED_SIZE,
99,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldGtp,
javax.swing.GroupLayout.PREFERRED_SIZE,
99,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldRf,
javax.swing.GroupLayout.PREFERRED_SIZE,
99,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(Cadm,
javax.swing.GroupLayout.PREFERRED_SIZE,
196,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addGap(46, 46, 46)
.
addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Align
ment.LEADING)

93

.addComponent(Dtreat,
javax.swing.GroupLayout.PREFERRED_SIZE,
172,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel14,
javax.swing.GroupLayout.PREFERRED_SIZE,
141,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(Cdoc,
javax.swing.GroupLayout.PREFERRED_SIZE,
180,
javax.swing.GroupLayout.PREFERRED_SIZE)))))
.addGroup(layout.createSequentialGroup()
.addComponent(jLabel2,
javax.swing.GroupLayout.PREFERRED_SIZE,
273,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(111, 111, 111)
.addComponent(jLabel6,
javax.swing.GroupLayout.PREFERRED_SIZE,
238,
javax.swing.GroupLayout.PREFERRED_SIZE))))
.addComponent(jLabel1,
javax.swing.GroupLayout.PREFERRED_SIZE,
1133,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addGap(0, 0, Short.MAX_VALUE)))
.addContainerGap())
.addGroup(layout.createSequentialGroup()
.addContainerGap(javax.swing.GroupLayout.DEFAULT_SIZE,
Short.MAX_VALUE)
.addGroup(layout.createParallelGroup(javax.swing.GroupLa
yout.Alignment.LEADING)
.addGroup(javax.swing.GroupLayout.Alignment.TRAILING,
layout.createSequentialGroup()

94

.addComponent(SearchText,
javax.swing.GroupLayout.PREFERRED_SIZE,
253,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(34, 34, 34))
.addGroup(javax.swing.GroupLayout.Alignment.TRAILING,
layout.createSequentialGroup()
.addComponent(SearchBtn,
javax.swing.GroupLayout.PREFERRED_SIZE,
96,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(125, 125, 125)))
.addComponent(jScrollPane2,
javax.swing.GroupLayout.PREFERRED_SIZE,
565,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(130, 130, 130))
);
layout.setVerticalGroup( layout.createParallelGroup(javax.swin
g.GroupLayout.Alignment.LEADING)
.addGroup(layout.createSequentialGroup()
.addContainerGap()
.addComponent(jLabel1,
javax.swing.GroupLayout.PREFERRED_SIZE,
36,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(28, 28, 28)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addComponent(jLabel2,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)

95

.addComponent(jLabel6,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addGroup(layout.createSequentialGroup()
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addGroup(layout.createSequentialGroup()
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addGroup(layout.createSequentialGroup()
.addGap(37, 37, 37)
.addComponent(jLabel5,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addGroup(layout.createSequentialGroup()
.addGap(8, 8, 8)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.BASELINE)
.addComponent(jLabel3,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldName,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE))))
.addGap(12, 12, 12))

96

.addGroup(javax.swing.GroupLayout.Alignment.TRAILING,
layout.createSequentialGroup()
.addPreferredGap(javax.swing.LayoutStyle.Compo
nentPlacement.RELATED)
.addComponent(fldTel,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.UN
RELATED)))
.
addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Align
ment.BASELINE)
.addComponent(jLabel4,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldAge,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldAge1,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldAge2,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(jLabel11,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.UN

97

RELATED)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addComponent(jLabel8,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldSex,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addGap(34, 34, 34)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.BASELINE)
.addComponent(Addbtn)
.addComponent(Updatebtn)
.addComponent(Delbtn)))
.addGroup(layout.createSequentialGroup()
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addGroup(javax.swing.GroupLayout.Alignment.TRAILING,
layout.createSequentialGroup()
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.REL
ATED)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.BASELINE)
.addComponent(fldPatient,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE)

98

.addComponent(jLabel15,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.REL
ATED)
.addComponent(Cdoc,
javax.swing.GroupLayout.PREFERRED_SIZE,
46,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addGap(11, 11, 11))
.addGroup(layout.createSequentialGroup()
.addGap(11, 11, 11)
.addComponent(jLabel7,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.REL
ATED)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.BASELINE)
.addComponent(jLabel12,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldDept,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addComponent(fldBlg,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE)))
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)

99

.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.BASELINE)
.addComponent(jLabel10,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldGtp,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addGroup(layout.createSequentialGroup()
.addGap(15, 15, 15)
.addComponent(jLabel14,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)))
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.UN
RELATED)
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.LEADING)
.addGroup(layout.createSequentialGroup()
.addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Alig
nment.BASELINE)
.addComponent(jLabel9,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(fldRf,
javax.swing.GroupLayout.PREFERRED_SIZE,
javax.swing.GroupLayout.DEFAULT_SIZE,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.UN
RELATED)

100

.
addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Align
ment.LEADING)
.addComponent(jLabel13,
javax.swing.GroupLayout.PREFERRED_SIZE,
26,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addComponent(Cadm,
javax.swing.GroupLayout.PREFERRED_SIZE,
42,
javax.swing.GroupLayout.PREFERRED_SIZE)))
.addComponent(Dtreat,
javax.swing.GroupLayout.PREFERRED_SIZE,
55,
javax.swing.GroupLayout.PREFERRED_SIZE))))
.
addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.REL
ATED, 20, Short.MAX_VALUE)
.addComponent(jScrollPane1,
javax.swing.GroupLayout.PREFERRED_SIZE,
112,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.UN
RELATED)
.
addGroup(layout.createParallelGroup(javax.swing.GroupLayout.Align
ment.LEADING)
.addGroup(layout.createSequentialGroup()
.addComponent(SearchText,
javax.swing.GroupLayout.PREFERRED_SIZE,
42,
javax.swing.GroupLayout.PREFERRED_SIZE)
.addPreferredGap(javax.swing.LayoutStyle.ComponentPlacement.UN
RELATED)

101

.addComponent(SearchBtn,
javax.swing.GroupLayout.PREFERRED_SIZE,
32,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addComponent(jScrollPane2,
javax.swing.GroupLayout.PREFERRED_SIZE,
318,
javax.swing.GroupLayout.PREFERRED_SIZE))
.addContainerGap(344, Short.MAX_VALUE))
);
pack();
}// </editor-fold>
private void CadmActionPerformed(java.awt.event.ActionEvent evt)
{
// TODO add your handling code here:
}
private void CdocActionPerformed(java.awt.event.ActionEvent evt)
{
// TODO add your handling code here:
}
private void DtreatActionPerformed(java.awt.event.ActionEvent
evt) {
// TODO add your handling code here:
}
private void fldTelActionPerformed(java.awt.event.ActionEvent evt)
{
// TODO add your handling code here:

102

}
private void fldNameActionPerformed(java.awt.event.ActionEvent
evt) {
// TODO add your handling code here:
}
private void AddbtnActionPerformed(java.awt.event.ActionEvent
evt) {
DefaultTableModel model = (DefaultTableModel)
jTable.getModel();
model.addRow(new Object[] {fldName.getText(),
fldPatient.getText(),
fldTel.getText(),
fldDept.getSelectedItem(),
fldAge.getSelectedItem(),
fldAge1.getSelectedItem(),
fldAge2.getSelectedItem(),
fldBlg.getSelectedItem(),
fldSex.getSelectedItem(),
fldGtp.getSelectedItem(),
fldRf.getSelectedItem(),
Cadm.getText(),
Cdoc.getText(),
Dtreat.getText()})
try{
String url = "jdbc:mysql://localhost:3306/henry?
zeroDateTimeBehavior=convertToNull";
String username = "root";
String password = "henry";
Connection
DriverManager.getConnection(url,username,password);

con

Statement stmt = con.createStatement();

String Query = "INSERT INTO
PATIENTRECORD(
PATIENT_NAME,
PATIENT_ID,
PATIENT_PHONE_NO, DAY_OF_BIRTH, MONTH_OF_BIRTH,
YEAR_OF_BIRTH, PATIENT_SEX, DEPARTMENT_ADMITTED,

103

BLOOD_GROUP,
GENOTYPE,
RHESUS_FACTOR,
CAUSE_OF_ADMISSION,
COMMENT_BY_DOCTOR,DURATION_OF_TREATMENT
)
VALUES ('"+fldName.getText()+"' , '"+fldPatient.getText()+"' ,
'"+fldTel.getText()+"'
,
'"+fldAge.getSelectedItem()+"',
'"+fldAge1.getSelectedItem()+"', '"+fldAge2.getSelectedItem()+"' ,
'"+fldSex.getSelectedItem()+"',
'"+fldDept.getSelectedItem()+"',
'"+fldBlg.getSelectedItem()+"',
'"+fldGtp.getSelectedItem()+"',
'"+fldRf.getSelectedItem()+"', '"+Cadm.getText()+"', '"+Cdoc.getText()
+"', '"+Dtreat.getText()+"' )";
stmt.execute(Query);
JOptionPane.showMessageDialog(null, "Patient Record added
to database");
fldName.setText(null);
fldTel.setText(null);
fldPatient.setText(null);
fldDept.setSelectedItem("00");
fldAge.setSelectedItem("00");
fldAge1.setSelectedItem("00");
fldAge2.setSelectedItem("0000");
fldBlg.setSelectedItem("00");
fldSex.setSelectedItem("00");
fldGtp.setSelectedItem("00");
fldRf.setSelectedItem("00");
Cadm.setText(null);
Cdoc.setText(null);

104

Dtreat.setText(null);
}
catch(SQLException ex){
JOptionPane.showMessageDialog(null, ex.toString());
}
}
private void UpdatebtnActionPerformed(java.awt.event.ActionEvent
evt) {
DefaultTableModel model = (DefaultTableModel)
jTable.getModel();
model.addRow(new Object[] {fldName.getText(),
fldPatient.getText(),
fldTel.getText(),fldDept.getSelectedItem(),
fldAge.getSelectedItem(),
fldAge1.getSelectedItem(),
fldAge2.getSelectedItem(),
fldBlg.getSelectedItem(),fldSex.getSelectedItem(),
fldGtp.getSelectedItem(), fldRf.getSelectedItem(), Cadm.getText(),
Cdoc.getText(), Dtreat.getText()});
try{
String url = "jdbc:mysql://localhost:3306/henry?
zeroDateTimeBehavior=convertToNull";
String username = "root";
String password = "henry";
Connection
DriverManager.getConnection(url,username,password);
Statement stmt = con.createStatement();

105

con

String Query = "UPDATE PATIENTRECORD SET

PATIENT_NAME = '"+fldName.getText()+"', PATIENT_ID =
'"+fldPatient.getText()+"',
PATIENT_PHONE_NO
=
'"+fldTel.getText()+"',
DAY_OF_BIRTH
=
'"+fldAge.getSelectedItem()+"',
MONTH_OF_BIRTH
=
'"+fldAge1.getSelectedItem()+"',
YEAR_OF_BIRTH
=
'"+fldAge2.getSelectedItem()+"',
PATIENT_SEX
=
'"+fldSex.getSelectedItem()+"',
DEPARTMENT_ADMITTED
=
'"+fldDept.getSelectedItem()+"',
BLOOD_GROUP
=
'"+fldBlg.getSelectedItem()+"',
GENOTYPE
=
'"+fldGtp.getSelectedItem()+"',
RHESUS_FACTOR
=
'"+fldRf.getSelectedItem()+"',
CAUSE_OF_ADMISSION
=
'"+Cadm.getText()+"',
COMMENT_BY_DOCTOR
=
'"+Cdoc.getText()+"',
DURATION_OF_TREATMENT
=
'"+Dtreat.getText()+"'
WHERE
PATIENT_NAME
=
'"+List1.getSelectedValue()+"'";
stmt.execute(Query);
JOptionPane.showMessageDialog(null, " Patient Record
updated ");
Filllist();
}
catch(SQLException ex){
JOptionPane.showMessageDialog(null, ex.toString());
}
}
private void fldDeptActionPerformed(java.awt.event.ActionEvent
evt) {
// TODO add your handling code here:
}

106

private void fldBlgActionPerformed(java.awt.event.ActionEvent

evt) {
// TODO add your handling code here:
}
private void fldGtpActionPerformed(java.awt.event.ActionEvent
evt) {
// TODO add your handling code here:
}
private void fldRfActionPerformed(java.awt.event.ActionEvent evt)
{
// TODO add your handling code here:
}
private void fldPatientActionPerformed(java.awt.event.ActionEvent
evt) {
// TODO add your handling code here:
}
private void DelbtnActionPerformed(java.awt.event.ActionEvent
evt) {
try{
String url = "jdbc:mysql://localhost:3306/henry?
zeroDateTimeBehavior=convertToNull";
String username = "root";
String password = "henry";

107

Connection
DriverManager.getConnection(url,username,password);

con

Statement stmt = con.createStatement();

String Query = "DELETE FROM PATIENTRECORD WHERE
PATIENT_NAME = '"+List1.getSelectedValue()+"'";
stmt.execute(Query);
JOptionPane.showMessageDialog(null, "Patient Record
Deleted From Database");
Filllist();
}
catch(SQLException ex){
JOptionPane.showMessageDialog(null, ex.toString());
}
}
private
void
List1ValueChanged(javax.swing.event.ListSelectionEvent evt) {
try{
String url = "jdbc:mysql://localhost:3306/henry?
zeroDateTimeBehavior=convertToNull";
String username = "root";
String password = "henry";
Connection
DriverManager.getConnection(url,username,password);
Statement stmt = con.createStatement();

108

con

String Query = "SELECT * FROM PATIENTRECORD

WHERE PATIENT_NAME = '"+List1.getSelectedValue()+"' ";
ResultSet rs = stmt.executeQuery(Query);
while (rs.next()){
fldName.setText(rs.getString(1));
fldPatient.setText(rs.getString(2));
fldTel.setText(rs.getString(3));
fldAge.setSelectedItem(rs.getString(4));
fldAge1.setSelectedItem(rs.getString(5));
fldAge2.setSelectedItem(rs.getString(6));
fldSex.setSelectedItem(rs.getString(7));
fldDept.setSelectedItem(rs.getString(8));
fldBlg.setSelectedItem(rs.getString(9));
fldGtp.setSelectedItem(rs.getString(10));
fldRf.setSelectedItem(rs.getString(11));
Cadm.setText(rs.getString(12));
Cdoc.setText(rs.getString(13));
Dtreat.setText(rs.getString(14));
}
}
catch(SQLException ex){

109

JOptionPane.showMessageDialog(null, ex.toString());
}
}
private void SearchBtnActionPerformed(java.awt.event.ActionEvent
evt) {
int result = List1.getNextMatch(SearchText.getText(), 0,
Position.Bias.Forward);
List1.setSelectedIndex(result);
}
/**
* @param args the command line arguments
*/
public static void main(String args[]) {
/* Set the Nimbus look and feel */
//<editor-fold defaultstate="collapsed" desc=" Look and feel
setting code (optional) ">
/* If Nimbus (introduced in Java SE 6) is not available, stay with
the default look and feel.
*
For
details
see
http://download.oracle.com/javase/tutorial/uiswing/lookandfeel/plaf.ht
ml
*/
try {

110

for (javax.swing.UIManager.LookAndFeelInfo info :

javax.swing.UIManager.getInstalledLookAndFeels()) {
if ("Nimbus".equals(info.getName())) {
javax.swing.UIManager.setLookAndFeel(info.getClassName());
break;
}
}
} catch (ClassNotFoundException ex)
{ java.util.logging.Logger.getLogger(MyRecord.class.getName()).log(
java.util.logging.Level.SEVERE, null, ex);
} catch (InstantiationException ex)
{ java.util.logging.Logger.getLogger(MyRecord.class.getName()).log(j
ava.util.logging.Level.SEVERE, null, ex);
} catch (IllegalAccessException ex)
{ java.util.logging.Logger.getLogger(MyRecord.class.getName()).log(j
ava.util.logging.Level.SEVERE, null, ex);
} catch (javax.swing.UnsupportedLookAndFeelException ex) {
java.util.logging.Logger.getLogger(MyRecord.class.getName()).log(ja
va.util.logging.Level.SEVERE, null, ex);
}
//</editor-fold>
/* Create and display the form */
java.awt.EventQueue.invokeLater(new Runnable() {
public void run() {
new MyRecord().setVisible(true);

111

}
});
}
// Variables declaration - do not modify
private javax.swing.JButton Addbtn;
private javax.swing.JTextField Cadm;
private javax.swing.JTextField Cdoc;
private javax.swing.JButton Delbtn;
private javax.swing.JTextField Dtreat;
private javax.swing.JList List1;
private javax.swing.JButton SearchBtn;
private javax.swing.JTextField SearchText;
private javax.swing.JButton Updatebtn;
private javax.swing.ButtonGroup buttonGroup1;
private javax.swing.JComboBox fldAge;
private javax.swing.JComboBox fldAge1;
private javax.swing.JComboBox fldAge2;
private javax.swing.JComboBox fldBlg;
private javax.swing.JComboBox fldDept;
private javax.swing.JComboBox fldGtp;
private javax.swing.JTextField fldName;

112

private javax.swing.JTextField fldPatient;

private javax.swing.JComboBox fldRf;
private javax.swing.JComboBox fldSex;
private javax.swing.JTextField fldTel;
private javax.swing.JLabel jLabel1;
private javax.swing.JLabel jLabel10;
private javax.swing.JLabel jLabel11;
private javax.swing.JLabel jLabel12;
private javax.swing.JLabel jLabel13;
private javax.swing.JLabel jLabel14;
private javax.swing.JLabel jLabel15;
private javax.swing.JLabel jLabel2;
private javax.swing.JLabel jLabel3;
private javax.swing.JLabel jLabel4;
private javax.swing.JLabel jLabel5;
private javax.swing.JLabel jLabel6;
private javax.swing.JLabel jLabel7;
private javax.swing.JLabel jLabel8;
private javax.swing.JLabel jLabel9;
private javax.swing.JMenu jMenu1;
private javax.swing.JMenu jMenu2;

113

private javax.swing.JMenu jMenu3;

private javax.swing.JMenu jMenu4;
private javax.swing.JMenu jMenu5;
private javax.swing.JMenu jMenu6;
private javax.swing.JMenuBar jMenuBar1;
private javax.swing.JMenuBar jMenuBar2;
private javax.swing.JMenuBar jMenuBar3;
private javax.swing.JMenuItem jMenuItem1;
private javax.swing.JScrollPane jScrollPane1;
private javax.swing.JScrollPane jScrollPane2;
private javax.swing.JPopupMenu.Separator jSeparator1;
private javax.swing.JTable jTable;
// End of variables declaration
}

114