NAME: MAFABI PATRICK

COURSE: BACHELORS OF SCIENCE IN INFORMATION

Visit any healthcare facility of your choice and answer the following questions. (The student may

request for an introductory letter to support the study)

a) Describe the clinic processes to facilitate workflow analysis and redesign in the selected
healthcare facility.

SETTING.

This study was conducted at Uganda University University’s Allan Galpin, a Health Care Center, Mukono
District. This study was approved by our Health Informatics Lecturer, Dr. Ssembatya Richard who
granted students permission to examine any health center.

At Allan Galpin data is shared by different medical personnel at the clinic using clinic master, an online
tools and asset for the Health Center operations.

Mentioned are the overseen processes at Allan Galpin health Care of Uganda Christian
University;

Identity Check. Patient data is searched for by the software “Clinic Master.” The presentation of
a registration book, or student identity card is required too for further clarification if the student rises a
claim that they are who they are and they paid for the service. However, if the patient is a student and
they are not registered, they are prompted to register themselves into the system after clearing up with
the accounts at ug shs 20,000. If it’s a non-working staff and they are patients from outside the learning
premises, they are given a Private Services Form, to fill in and pay for the services after being diagnosed.

Data is posted to the clinician via the clinical master software tool. The assigned clinician
additionally takes note of your recent data status through, the temperature recorded, blood pressure,
respiration, and height are checked as well as the age so as to recommend better solutions.

Patient diagnosis by the doctor. The doctor is able to examine the patient thoroughly through a
composed dialogue for example asking about your daily activities, daily meals, to have an insight of the
patient’s sickness. If the problem is identified, prescription of drugs is undertaken and the same is
posted onto clinic master where the doctor will send the patient to the dispensary.

Referral. This is one of the steps taken after a doctor realizes the patient is in a critical condition
that the health care center would consider serious. The patient is referred to Mulago, Mengo, Rubaga,
Mukono Church of Uganda where there are abundant resources. However, if the patient’s condition is
considered treatable by the staff of the health center, there is an exception of being looked after for at
most one day.

Laboratory examination. This is another step teken by a doctor when they further want to know
the cause of the illness. A patient may elaborate their illness in a summarized and confusing way but the
doctor may send the case to the lab technician who happens to take further samples from the patient
such as urine, stool, blood. The doctor uses this knowledge to breakdown the illness and find a sound
solution. The results are posted back to the doctor who oversees them and recommends drugs, or refers
them to a hospital.

The dispensing of drugs. The nurse is able to view the suggested medication by the doctor or
clinician on clinic master and is able to prescribe the right amount for the patient giving them clear and
precise instructions on how they should take the medicine and always come back if they at all use up the
medicine and they are not getting better for more analysis and change in diagnosis.
b) Develop a process map for the identified clinical process workflows within
a selected health care system.
 c) Critically analyse the workflow processes in a selected healthcare
setting, taking into account potential gaps, areas of redundancy, and
delays

Patients at Allan Galpin face a variety of problems, ranging from the mundane to the life-threatening.
Other problems are due to the medical staff, such as communication difficulties, lack of information, and
delays in care. Still other problems are due to the hospital’s policies or procedures, such as length of
stay, discharge planning, and billing as explained below.

Check registration status of patient.

First, payment is demanded for before the students who are the patients, pick medication. However, at
first glance the idea of making payments for patients to take therapeutic drugs seems absurd, but
needed in the long run. However, if the student has not paid yet, they could be given for the students

Time consuming to look up the patient records. A student may be in a critical condition and needs
immediate attention of the doctor. Waiting to check up their registration status is time wasting and
makes the condition of the patient even worse when they discover they are being limited services when
they are not registered.

Possible power outage. With the constant use of Clinic Master which is fully online, the power outage
may disrupt the discovered conditions of a patient by the clinician or doctor, and communication within
the staff via clinic Master will be put on hold, thus manually getting data to different offices which is
prone to be misunderstood if verbally spoken before the backup generator is turned on.

Clinic Master is paid for monthly, if not paid, patient data may not be availed and mostly paper based
will be one of the options to cling onto.

Post data to Clinician.

The clinician at times uses professional language and the patient may not comprehend the question to
tell what exactly may be disturbing their health status.

Clinician for diagnosis

Possible misinterpretation of medical information.

Students tend to prefer a doctor examining their illness over nurses. Doctors leave after 6pm after
working the entire day, and hand over duty to the nurses in the evening till the following morning. Some
patients are critic in that they think their condition is beyond inspection by any other clinician except a
doctor, they could wait till morning hours to visit the doctor other than being examined by the nurses.

Laboratory examination

Turnaround time prevails in that the pre-examination of the lab samples, examination and post-
examination processes of the laboratory testing is longer than expected for a student trying to beat
lecture time. However, results vary according to tests taken, that is, they at least 30 minutes, 1 hour and
probably one hour and a half to posted to the doctor.
There is a redundancy of going back to the doctor after laboratory results have been released. The
laboratory technician after identifying the illness of the patient, could be mandated to suggest a possible
drug or treatment for the patient and they would proceed to the dispensary.

Dispensing of drugs.

Self-treatment may arise. Some patients are likely to receive drugs from the dispensary but however,
would use the drugs for some time. If they don’t find the drugs effective enough, they suggest for
themselves a drug over the internet, instead of going back to Allan Galpin for further analysis.

Patient satisfaction is never met. It’s a try and error process for them. Some come back, some never
come back after the prescription of drugs. Most of the students who come for treatment at Allan Galpin,
usually have the day-to-day sicknesses such as headache, cough, flue. Cases of deadly diseases handled
at Allan Galpin Health Care Center II are very few yet doctors are ready and willing to take upon them
from patients.

Treatment and Observation.

At times the clinician is defeated by the patient’s “illness.” As they try to get information from the
patient, the patient may not show the visual signs and symptoms and this causes a delayed diagnosis.

The questionnaire between the doctor and patient is more of summarized if the lines are long thus not
very interactive. The patient needs time to see the doctor for enough time to try and elaborate more
about their illness and thus the general problem will be identified.

Referral

Complicated conditions cannot be handled at Allan Galpin Health Care Center and higher chances of
being referred to the nearby hospital if the patient’s condition is worse. There is a risk of their health
worsening on their way to the referred hospital

Question Two

The case scenario below explains Dr. Mugaga and his involvement at Mbale referral Hospital. Read it
carefully and answer the questions that follow.

Mugaga is a medical doctor who is attached to Mbale referral hospital as a full-time staff. He however
runs a private clinic with other five medical officers where he refers some of his patients for better
medical services at Mbale referral hospital. At his clinic, he runs some ordinary machines for diagnostic
and treatment which he feels are better because they produce better and real-time results to the
patients. Patients make appointments on phone, e-mail if they really need to meet doctor Mugaga. The
clinic has an open office where each staff seats on independent desks and stand-alone computers as
they attend to clients or patients.

Patient’s details are kept in MS Access Databases of which they feel they are effective and efficient.
Mugaga and staff also feel that the use of Facebook, twitter, Skype, LinkedIn and/or other social media
platforms are the best and easiest way of disclosing or conveying information to the patients. Mugaga
and his colleagues feel that they are in business since they can manage their clients and offering better
services than Mbale referral hospital.
i. By apply the principles of HI in ensuring effective healthcare service delivery, describe the state of
Dr. Mugaga’s implementation of these principles.

Dr. Mugaga implements the health informatics principles in the follow ways;

The Principle of Access is also implemented by Doctor Mugaga. The patient record has the right of
access to that record and the right to correct the record with respect to its accurateness, completeness
and relevance through checking Facebook, Twitter, Skype, LinkedIn. Within the perspective of health
informatics, access is always defined as access to a service, a provider or an institution, thus defined as
the opportunity or ease with which patients are able to use appropriate services in proportion to their
needs.

Dr. Mugaga implements principle of integrity by having his staff with open offices where each staff
member sits on independent desks and stand-alone computers as they attend to clients or patients. In
this principle, whoever is responsible must fulfill that obligation to the best of their ability.

Principle of Autonomy is observed by Dr. Mugaga. Patients are given the right to self-determination.
They can decide whether or not to accept suggested treatment or care by Dr. Mugaga in that patients
make appointments on phone, e-mail if they really need to meet doctor Mugaga. The protection of
patient self-determination entails the elements of the patient’s right to decide what treatment to have
or not to have in which the patient has to make his or her decision.

Dr. Mugaga implements the principle of equality and justice. All patients of his referral hospital are
equal and have a right to be treated accordingly. Dr. Mugaga puts this principle into play by building
offices and pacing each staff member in their respective offices with the necessary resources such as
seats, stand-alone computers and desks to attend to patients in an orderly manner and rendering the
same services to all of them.

Dr. Mugaga also implements the Principle of Openness. The clinic has an open office where each staff
seats on independent desks and stand-alone computers as they attend to clients or patients. Therefore,
patients who enter his referral hospital are aware that their bio data is going to be leaving them beyond
alert of the fact. The reason for this is that the potential subjects of data-gathering might not wish to
have health care data gathered about themselves and who, if they knew that this would take place,
would adjust their behavior to avoid such data being gathered.

ii. Clearly show the gaps and solutions therein.

At Dr. Mugaga’s clinic, him and the staff also feel that the use of Facebook, twitter, Skype, LinkedIn
and/or other social media platforms are the best and easiest way of disclosing or conveying information
to the patients which they see is okay yet it’s not because it may be a threat actor who is pretending to
need personal or financial data to confirm the identity of the patient Dr. Mugaga may be trying to reach
out. A proposal of a Patient-Oriented System that ensures Confidentiality, Integrity and Availability
should prevail to enable authorized patients access their uninterrupted data and anytime thus solving
security.

MS Access Databases does not guarantee safety of patient data. Sometimes MS Access files get
corrupted which does not guarantee the safety and how secure the patient data is. Developing an
Electronic Health Record System would curb this problem and ensuring patient data to always be
available to even the patient on their mobile phone for reference.

Dr. Mugaga and staff also felt that the use of Facebook, twitter, Skype, LinkedIn and/or other social
media platforms are the best and easiest way of disclosing or conveying information and this way a
gap they need to fill since anyone could find patients records and details and use it against them or
use it for research against the patients will. And this can be solved by developing systems that only
patients could use to access their data. Or by not posting patients data on social media.