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College of Computing and Informatics

Department of Information technology
Department: System Analysis and Design

Project Title: HU clinical Management System

Name of Group Member ID Numb

1:TESHALE ENDALU 1711/14

2:YOSEPH GUTEMA 3731/14

3:ILILI YAIQOB 2855/14

4:TELAHA MOHAMDSANI 1664/14

5:BETELEM TEGEGNE 1280/14

6:DANIEL FEKADU 2484/14

Date of Submission: May 28: 2024

Submitted To: Mr. Nabyom

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Abstract
This project HU CLINICAL management system in HU clinical
management system medical center as a tool to revolutionize medical
profession. With many writes decrying how patients queue up for hours
in order to receive medical treatment, and some end-up being attended
to as spillover the analyst investigated the manual system in detail with
a view to finding out the need to automate the system. Subsequently, a
computer-aided program was designed to bring about improvement in
the care of individual patients, taking the advantage of computer speed,
storage and retrieved facilities. The system designed will take care of
patient’s registration, treatment and medications.

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TABLE CONTENTS

FIGURES PAGE

Chapter OneError! Bookmark not defined. .............................................................................................................................................................. 4

1.1 Introduction ................................................................................................................................................................................................... 4

1.2 Motivation of The Project .............................................................................................................................................................................. 4

1.4 Statement of The Problem ............................................................................................................................... Error! Bookmark not defined.

1.3 problem as asystem ......................................................................................................................................... Error! Bookmark not defined.

1.4.1 improvement analysis .............................................................................................................................. Error! Bookmark not defined.

1.5.2 Improvement analysis.............................................................................................................................. Error! Bookmark not defined.

1.5,3 Specific object.................................................................................................................................................................................... 11

1.6.4 Scope of the System .............................................................................................................................................................................. 11

1.9.1 Data collection methodologies ............................................................................................................................................................ 12

1.9.2 System development Methodologies ................................................................................................................................................... 12

1.10 Feasibility Assessment............................................................................................................................................................................... 12

1.10.1 Technical Feasibility ............................................................................................................................. Error! Bookmark not defined.

1.10.2 Economically feasibility ........................................................................................................................ Error! Bookmark not defined.

1.11 political feasiblity .......................................................................................................................................... Error! Bookmark not defined.

1.12 legal feasiblity ............................................................................................................................................... Error! Bookmark not defined.

1.13 dataflow diatgaram ........................................................................................................................................ Error! Bookmark not defined.

Chapter 2..................................................................................................................................................................... Error! Bookmark not defined.

2.1 Atributy ........................................................................................................................................................... Error! Bookmark not defined.

2.2 doctor entity..................................................................................................................................................... Error! Bookmark not defined.

Chapter 3................................................................................................................................................................................................................. 22

3.1 behaviour of the system 28

3.1 enternally of the system 29

System Design ................................................................................................................................................................................................... 30

3.1 Layering Models–class type Architecture .................................................................................................................................................... 30

3.3 User Interface Design .................................................................................................................................................................................. 30

3.2 Class Modeling(diagram) ............................................................................................................................................................................ 39

3.2.3 Class Diagram ..................................................................................................................................................................................... 40

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3.3 User Interface Design .................................................................................................................................................................................. 30

3.5 Relational persistent Modeling ........................................................................................................................ Error! Bookmark not defined.

3.7 Deployment Diagram .................................................................................................................................................................................. 41

3.5 Relational persistent Modeling ........................................................................................................................ Error! Bookmark not defined.

Chapter One
1.1 Introduction
A System development has been a game changer for various organizations as it
has led to increased productivity, efficiency and effectiveness. The development
of a system has proven to be a critical aspect in ensuring that organizations are
on top of their game while also providing easy access to timely information. In
light of this, our team set its sights on developing a system for health
organizations, specifically for those in Ethiopia where patient management is
primarily handled manually, adding to the workload of doctors and nurses alike.
This outdated process can lead to delays and errors, ultimately affecting the
quality of care that patients receive. By analyzing the existing problems with the
current system, our team took on the challenge of developing a patient
management system that is efficient, user-friendly, and can provide real-time
data capture and analysis to healthcare providers. Ultimately, our goal is to
improve patient care and outcomes by developing a system that can streamline
processes and provide accurate and up-to-date information, allowing medical
professionals to focus more on their patient.

1.2 Motivation of The Project

The motivation behind our project stems from the evolving landscape of healthcare and the
challenges faced by both patients and healthcare providers in Ethiopia. Here's a more
detailed explanation:

Patients today are becoming increasingly involved in their healthcare journeys. They are
more informed about their health conditions, treatment options, and expect to actively
participate in decisions regarding their care. However, in many healthcare settings,

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including those in Ethiopia, patients often face barriers in accessing their medical
information. This lack of access not only leaves patients feeling dis-empowered but also
hinders their ability to actively manage their health.

By modernizing the doctor-patient relationship through technology, we aim to address

these challenges. Our goal is to develop a patient management system that enables
patients to access their medical records easily. This access empowers patients by providing
them with a comprehensive view of their health history, including diagnoses, medications,
test results, and treatment plans. When patients have access to this information, they feel
more in control of their health, leading to increased satisfaction and better health
outcomes.

Moreover, providing patients with access to their medical records also benefits healthcare
providers. It enhances communication between patients and providers, allowing for more
informed discussions during appointments. When patients can share their medical history
and concerns with their healthcare providers, it enables more personalized care and better
treatment decisions.

Additionally, our system aims to streamline administrative processes for healthcare

providers.

Manual patient management processes, such as paper-based records, are prone to errors
and inefficiencies. They contribute to delays in accessing patient information, which can
impact the quality of care delivered. By automating these processes and providing real-time
data capture and analysis, our system improves efficiency and effectiveness in healthcare
delivery.

Furthermore, our system facilitates better coordination of care across different specialties
and healthcare settings. When patient information is readily accessible and securely shared
between healthcare providers, it ensures continuity of care. This seamless exchange of
information prevents duplication of tests, reduces medical errors, and ultimately leads to
better patient outcomes.

In summary, the motivation behind our project is to empower patients, improve

communication between patients and healthcare providers, streamline administrative
processes, and enhance coordination of care. By developing a patient management system
that is efficient, user-friendly, and capable of real-time data capture and analysis, we aim to
revolutionize healthcare delivery in Ethiopia, ultimately improving patient care outcomes.

SERVICE PROVIDIDED FROM HU CLINICAL CENTER

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Physicians keep these patients at the health center to monitor them more closely. Examples of
inpatient care include:

 Rehabilitation services
 Surgeries
 Childbirth
 Serious Illnesses that require a patient to be monitored overnight in our health center.

We have seven beds in male ward, five beds in female ward, two beds in maternity ward, two beds
in isolation ward and two special beds.

The Laboratory Service Department conducts tests on blood, urine, stool, tissues and body fluids to
assist physicians in the diagnosis and treatment of illness and disease. Laboratory tests are also
used to monitor treatment.

The Department operates 24 hours per day, 365 days per year.

Services are provided to patients in acute and long-term care facilities, to physician offices, and the
student and the surrounding community. Laboratory Services include

 Complete Blood Count(CBC)

 Hematology
 Blood chemistry
 urinalysis all type
 serology-
 parasitology’s

The services provided by pharmacy

 Monitoring of prescription,
 Storage,
 Distribution,
 Drug procurement,
 Counselling of patients,
 Dispensing of medicines, and
 Evaluation for the betterment of patients

1.3 PROBLEM AS SYTEM:

1. Inefficient patient appointment scheduling and management: The system should include features for
easy appointment scheduling, such as an online booking portal or a mobile app. It should allow patients
to select preferred dates and times, view available slots, and receive automated reminders. The system
should also provide tools for healthcare providers to manage and optimize their schedules, such as
setting availability, blocking off time slots, and accommodating urgent or walk-in appointments.

2. Lack of centralized patient records: The system should have a centralized electronic health record
(EHR) system that stores and manages all patient information, including medical history, test results,

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diagnoses, treatment plans, and medication records. It should allow authorized healthcare providers to
access and update the records in real-time, ensuring that all necessary information is readily available
and reducing the need for duplicate tests or incomplete medical histories.

3. Difficulty in tracking and managing patient treatments and medications: The system should include
features for healthcare providers to easily track and manage patient treatments and medications. This
can include functionalities such as medication ordering, dosage tracking, reminders for medication
administration, and alerts for potential drug interactions or allergies. The system should also provide
tools for documenting treatment progress, monitoring outcomes, and adjusting treatment plans as
necessary.

4. Inadequate communication between healthcare providers: The system should facilitate seamless
communication and collaboration between different healthcare providers involved in a patient's care.
This can include secure messaging platforms, shared calendars for coordinating appointments and
procedures, and the ability to share patient information securely and in real-time. The system should
also support the transfer of patient care responsibilities between providers, ensuring continuity of care.

5. Limited access to real-time data and analytics: The system should provide real-time access to data and
analytics for decision-making and performance monitoring. This can include dashboards that display key
performance indicators, such as wait times, appointment cancellations, or medication adherence rates.
The system should also allow for customizable reports and data analysis tools to identify trends,
patterns, and areas for improvement in patient care delivery.

6. Inefficient billing and payment processes: The system should streamline billing and payment
processes by integrating with insurance providers and automating claims submission and processing. It
should generate accurate and timely invoices for services rendered, track payments received, and
provide tools for revenue management and financial reporting. The system should also support multiple
payment options for patients, such as online payments or installment plans.

7. Inadequate tools for monitoring and managing inventory: The system should include inventory
management functionalities to track and manage medical supplies and equipment. This can include
features such as automated reordering based on stock levels, expiration date tracking, and alerts for low
stock or stock outs. The system should also provide tools for inventory forecasting, usage tracking, and
generating reports on inventory costs.

8. Lack of integration with external systems: The system should be able to integrate with external
systems, such as pharmacies or laboratories, to facilitate seamless coordination of care. This can include
features such as electronic prescription transmission to pharmacies, automated test result retrieval from

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laboratories, and real-time updates on medication dispenses or lab results within the EHR system.
Integration with external systems improves efficiency, reduces errors, and enhances the continuity of
care.

9. Insufficient security measures: The system should prioritize data security and privacy by implementing
robust security measures. This can include user authentication protocols,

1.4 Improvement analysis:

The new system developed addresses the following challenges:

1. Efficient patient appointment scheduling and management: The system includes an intuitive online
booking portal and a mobile app that allows patients to easily schedule appointments. Patients can
select preferred dates and times, view available slots, and receive automated reminders. Healthcare
providers have access to a user-friendly interface to manage and optimize their schedules, set
availability, block off time slots, and accommodate urgent or walk-in appointments.

2. Centralized patient records: The system incorporates a centralized electronic health record (EHR)
system that stores and manages all patient information. Authorized healthcare providers can access and
update the records in real-time, ensuring that all necessary information is readily available. This reduces
the need for duplicate tests or incomplete medical histories, improving patient care and efficiency.

3. Tracking and managing patient treatments and medications: The system provides healthcare
providers with tools to easily track and manage patient treatments and medications. It includes features
such as medication ordering, dosage tracking, reminders for medication administration, and alerts for
potential drug interactions or allergies. Healthcare providers can document treatment progress, monitor
outcomes, and adjust treatment plans as necessary.

4. Seamless communication between healthcare providers: The system facilitates seamless

communication and collaboration between different healthcares providers involved in a patient's care. It
includes secure messaging platforms, shared calendars for coordinating appointments and procedures,
and the ability to securely share patient information in real-time. The system supports the transfer of
patient care responsibilities between providers, ensuring continuity of care.

5. Real-time data access and analytics: The system provides real-time access to data and analytics for
decision-making and performance monitoring. It includes dashboards displaying key performance
indicators such as wait times, appointment cancellations, or medication adherence rates. Customizable
reports and data analysis tools help identify trends, patterns, and areas for improvement in patient care
delivery.

6. Streamlined billing and payment processes: The system streamlines billing and payment processes by
integrating with insurance providers and automating claims submission and processing. It generates
accurate and timely invoices for services rendered, tracks payments received, and provides tools for

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revenue management and financial reporting. Multiple payment options are available for patients,
including online payments or installment plans.

7. Efficient inventory monitoring and management: The system includes inventory management
functionalities to track and manage medical supplies and equipment. It automates reordering based on
stock levels, tracks expiration dates, and provides alerts for low stock or stakeouts. Inventory
forecasting, usage tracking, and cost reporting tools help optimize inventory management.

8. Integration with external systems: The system seamlessly integrates with external systems such as
pharmacies or laboratories. It enables electronic prescription transmission to pharmacies, automated
test result retrieval from laboratories, and real-time updates on medication dispenses or lab results
within the EHR system. Integration improves efficiency, reduces errors, and enhances continuity of care.

9. Robust security measures: The system prioritizes data security and privacy by implementing robust
security measures. It includes user authentication protocols, encryption of sensitive data, audit logs to
track access and modifications to patient records, and compliance with privacy regulations such as
HIPAA. Regular security audits ensure that appropriate safeguards are in place to protect patient data
from unauthorized access or breaches.

1.5 Objectives of The Project

1.5.1 General Objective

Automate the management system of Tabor Medical Center.

1.5.2 Specific Objectives

Efficiently manage patient data

Efficient management of patient data involves ensuring that all information related to patients is
accurately recorded, easily accessible, and effectively organized. This objective includes implementing a
system that allows for the seamless capture, storage, and retrieval of patient information. By efficiently
managing patient data, healthcare providers can access relevant information quickly

, leading to better decision-making and improved patient care.

Improve patient care

The primary goal of any healthcare system is to enhance patient care. This objective involves
implementing features and functionalities in the system that contribute to improving the quality of care
provided to patients. For example, the system can include features such as reminders for medication
adherence, alerts for critical test results, and automated appointment scheduling. Improving patient
care ensures that patients receive timely and appropriate medical attention, leading to better health
outcomes.

Enhance communication

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Effective communication is essential for providing coordinated and high-quality healthcare services. This
objective involves implementing communication tools within the system that facilitate seamless
communication between patients and healthcare providers, as well as among healthcare professionals.
For instance, the system can include secure messaging features, medicine capabilities, and patient
portals for easy access to medical information. Enhancing communication ensures that all stakeholders
are informed and involved in the patient's care journey.

Ensure data security and privacy

Protecting patient data is paramount to maintaining trust and confidentiality in healthcare. This
objective focuses on implementing robust security measures to safeguard patient information from
unauthorized access, breaches, and data loss. This includes encryption of data, role-based access
controls, regular security audits, and compliance with data protection regulations such as HIPAA (Health
Insurance Portability and Accountability Act). Ensuring data security and privacy instills confidence in
patients and healthcare providers, encouraging the adoption of the system.

Data analysis plays a crucial role in identifying trends, evaluating performance, and making
informed decisions in healthcare. This objective involves implementing reporting and analytics
features in the system that allow for the generation of comprehensive reports on various aspects
of patient care, resource utilization, and organizational performance. These reports can provide
insights into areas for improvement, facilitate evidence-based decision-making, and support
regulatory compliance.
Improve efficiency and productivity
Efficiency and productivity are key to delivering timely and cost-effective healthcare services.
This objective focuses on implementing features in the system that streamline administrative
tasks, automate workflows, and reduce manual intervention. For example, the system can
automate appointment scheduling, streamline billing processes, and optimize resource
allocation. Improving efficiency and productivity enables healthcare providers to deliver more
services in less time, leading to better resource utilization and improved patient satisfaction.

Reduce administrative burden

Healthcare professionals often face significant administrative burdens that detract from patient
care. This objective aims to alleviate the administrative workload by implementing features that
automate repetitive tasks, streamline documentation processes, and reduce paperwork. By
reducing administrative burdens, healthcare providers can devote more time and attention to
direct patient care, ultimately improving the overall patient experience and outcomes.

By achieving these specific objectives, the project will successfully automate the management
system of Tabor Medical Center, leading to enhanced patient care, improved communication,
increased efficiency, and better overall healthcare outcomes reduce administrative burden

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 1.6 Scope of The Project
The scope of the project is to allow patients to register and create a profile with
their personal and medical information, schedule appointments with healthcare
providers and receive reminders, and manage and access their medical records.
The system should also allow healthcare providers to manage and access patient
medical records, bill and process payments for healthcare services provided to
patients, and provide reporting and analytics capabilities to help healthcare providers
track patient outcomes and identify areas for improvement. Additionally, the system
should comply with regulatory requirements for patient data privacy and security.
1.7 Limitations
The limitation occurred in this projects are:
 It can only be accessed through smartphones
 Due to complicates of the insurance companies’ way of payment for health
related issues and shortage of time we cannot add the billing method using
insurance.
 Cost: Developing and implementing robust clinical management systems can be
expensive. Healthcare organizations may face budget constraints that limit their
ability to invest in comprehensive system development.


1.8 Significance of The Project

The proposed system of Patient Management System has a lot of significances in every
aspect related to Health Institution’s Patient management system. Different health
institutions would be beneficiary by this project in many ways like:

A patient management system can have significant benefits for both health institutions
and patients. For the health care providers, it can streamline administrative tasks, such
as scheduling appointments, managing patient records, and billing. This can save time
and reduce errors, allowing healthcare providers to focus on patient care. It can also
can facilitate communication between healthcare providers, patients, and other
stakeholders. This can improve coordination of care and ensure that everyone involved
in a patient's care is on the same page.

Even more for the patients it can provide with more convenient access to healthcare
services, such as online appointment scheduling. It can also facilitate communication
between patients and healthcare providers, allowing patients to ask questions, receive
updates, and provide feedback.
1.9 Methodologies of the project
In developing patient management system for a health institution the following
development methodologies and tools applied.

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1.9.1 Data collection methodologies
Data collection is one of the important tasks to analyze how activities done in existing
system and developed the new system. Data for developing this system obtained from
different sources. The followings are data collection methods we used:

There are several data collection methodologies that can be used for a patient
management system, including:

1. Electronic health records (EHRs): This involves the use of digital platforms to collect
and store patient information in a systematic manner.
2. Personal health records (PHRs): These are electronic records that patients
themselves can maintain and update. They often include information on personal health
history, allergies, medications, and doctor's appointments.
3. Paper-based records: These involve the use of physical record-keeping systems, such
as paper charts, to document patient data.

4. 1.9.2 System development Methodologies

For a patient management system, the Agile methodology would be the most suitable.
This is because it allows for continuous collaboration between developers and
stakeholders to ensure that the system aligns with users’ requirements throughout its
iterations. The iterative approach of Agile methodology also allows for quick feedback
and adjustments to be made, which is essential in a healthcare setting where patient
care is of utmost importance. Additionally, the Agile methodology is flexible and can
accommodate changes in requirements, which is important in a dynamic healthcare
environment where new regulations and technologies are constantly emerging.

1.10 Feasibility Assessment

1.10.1 Technical Feasibility:The technical feasibility of the system refers to its ability to
function effectively within the technical constraints and requirements of its intended
environment. In our case, the system is designed to be accessible in both remote and
urban areas, addressing the challenges posed by limited resources and infrastructure.

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Minimal Cost
One of the key aspects of the system's technical feasibility is its minimal cost. The system is designed to be
cost-effective, ensuring that it can be implemented and maintained without imposing a significant
financial burden on Tabor Medical Center or its patients.

Open-source software: Leveraging open-source technologies and frameworks can significantly reduce
licensing and development costs. Open-source solutions often offer robust features and community
support without the need for expensive proprietary software.

Cloud-based infrastructure:
Utilizing cloud-based infrastructure, such as platforms like Amazon Web Services (AWS) or Google Cloud
Platform, eliminates the need for expensive on-premises hardware and infrastructure. Cloud services offer
scalable computing resources, allowing the system to adapt to varying workloads and requirements.

Scalable architecture: Designing the system with scalability in mind ensures that it can accommodate
growing data volumes and user traffic without requiring extensive hardware upgrades. This approach
minimizes upfront costs while providing flexibility for future expansion.

Bandwidth Requirements
Another important aspect of the system's technical feasibility is its low bandwidth requirements,
enabling accessibility even in areas with limited internet connectivity.

Optimized data transmission: The system is optimized to minimize data transmission requirements by
employing techniques such as data compression, caching, and asynchronous data synchronization.
This reduces the amount of data transferred over the network, making the system less dependent on
high-speed internet connections.

Offline functionality: Incorporating offline functionality allows users to access and interact with
essential features of the system even when internet connectivity is unavailable. Data synchronization
mechanisms ensure that changes made offline are synchronized with the central database once
connectivity is restored.

technical feasibility is ensured by its minimal cost and low bandwidth requirements. By leveraging
open-source software, cloud-based infrastructure, and scalable architecture, the system can be
implemented cost-effectively. Additionally, optimized data transmission, offline functionality, and PWA
technology enable accessibility in both remote and urban areas, addressing the challenges posed by
limited resources and infrastructure in Ethiopia.
1.10.2 Economic Feasibility

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The economic feasibility of the system is assessed from the hospital's perspective, focusing on the cost-
effectiveness of implementing the system and the resulting benefits.

Cost Effectiveness

Elimination of paperwork: The system eliminates the need for paper-based record-keeping, which
reduces costs associated with paper, printing, and storage. By transitioning to a digital platform,
Tabor Medical Center can save on paper costs and the labor required for manual documentation.

Reduced error rates: Digital records are more accurate and reliable compared to paper-based records.
By minimizing errors and inaccuracies in patient data, the system reduces the risk of medical errors,
which can lead to costly consequences such as misdiagnoses or inappropriate treatments.
Increased Accuracy

Highly accurate data: The system ensures that patient data is recorded accurately and consistently.
With digital records, healthcare providers can easily input, update, and access patient information,
reducing the likelihood of errors caused by illegible handwriting or manual data entry mistakes.
Quality of data: Accurate and up-to-date data improves the quality of care provided to
patients. Healthcare providers can rely on the system to access reliable patient
information, resulting in better treatment decisions and outcomes

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In summary, the system's economic feasibility is evident in its cost-effectiveness and the improved
accuracy of patient data. By eliminating paperwork and reducing error rates, the system offers
significant cost savings for Tabor Medical Center while enhancing the quality of care provided to
patients. These economic benefits make the implementation of the system a viable investment for the
hospital.
Certainly, let's delve into the operational feasibility and the importance of user acceptance:

1.10.3 Operational Feasibility

Operational feasibility assesses whether the proposed system can be effectively integrated into the
organization's operations. A key aspect of operational feasibility is user acceptance, ensuring that the
system is embraced and utilized by its intended users.

User Acceptance

Crucial for success: User acceptance is crucial for the success of the system. If users, including
healthcare professionals and administrative staff, do not accept the system, its implementation may
fail to achieve the desired objectives. Therefore, ensuring user acceptance is paramount.

Proper training and education: Proper training and education are essential to ensure that users
understand how to use the system effectively. Training sessions should be conducted to familiarize
users with the system's features, functionalities, and workflows. This training should be tailored to the
specific roles and responsibilities of different user groups within the organization.

User involvement: Involving users in the development and testing phases of the system fosters a sense
of ownership and involvement. Users can provide valuable feedback during these stages, which can be
used to refine the system and address any concerns or usability issues.

Clear communication:
Clear communication about the benefits of the system and its impact on daily operations is essential.
Users need to understand how the system will improve efficiency, streamline workflows, and
ultimately enhance patient care. Communicating the vision and goals of the system helps build
support and enthusiasm among users.

Addressing resistance: Resistance to change is natural, especially when implementing new

technologies. It's important to identify and address any concerns or resistance among users. This may
involve addressing misconceptions, providing reassurance, and emphasizing the benefits of the
system.

Continuous support: Providing ongoing support and assistance to users is critical. Users should have
access to help resources, such as user manuals, FAQs, and helpdesk support, to address any issues or
questions that arise during system usage.

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Legal Feasibility Study:

1. Compliance with privacy regulations: The system must comply with relevant privacy laws and
regulations, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United
States. This includes ensuring the security and confidentiality of patient data, obtaining informed
consent for data collection and sharing, and implementing appropriate data access controls.

2. Data ownership and control: The system should clearly define the ownership and control of patient
data, ensuring that patients have control over their own health information and that healthcare
providers have appropriate access rights.

3. Intellectual property rights: The system should not infringe upon any existing intellectual property
rights. It should be ensured that all software components used in the system are properly licensed and
legally acquired.

4. Liability and accountability: The system should clearly define the liability and accountability of all
parties involved, including the healthcare providers, software developers, and system administrators.
This includes addressing issues such as data breaches, system failures, and errors in treatment or
diagnosis resulting from the use of the system.

5. Consent and patient rights: The system should provide mechanisms for obtaining informed consent
from patients for the collection, use, and sharing of their health information. It should also respect
patients' rights to access and correct their own health records.

Political Feasibility Study:

1. Stakeholder support: The success of the system depends on gaining support from various
stakeholders, including healthcare providers, patients, insurance providers, and regulatory authorities.
It is important to engage these stakeholders early on and address any concerns or resistance they may
have.

2. Regulatory environment: The system should align with existing healthcare regulations and policies.
It is important to conduct a thorough analysis of the political landscape to understand any potential
barriers or challenges related to regulatory compliance.

3. Funding and budgetary considerations: The implementation and maintenance of the system may
require significant financial resources. It is important to assess the availability of funding and develop
a sustainable financial model that considers factors such as government funding, insurance
reimbursements, and patient contributions.

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4. Interoperability with existing systems: The system should be designed to integrate with existing
healthcare systems and infrastructure. This requires collaboration with other healthcare organizations and
government agencies to ensure compatibility and interoperability.5. Public perception and acceptance:
The success of the system may depend on public perception and acceptance. It is important to
communicate the benefits of the system to the public and address any concerns or misconceptions they
may have about the use of technology in healthcare.

6. Political will and support: The implementation of a comprehensive healthcare system requires
political will and support from government authorities. It is important to engage policymakers and key
decision-makers to gain their support and ensure the necessary resources are allocated for the project.
Conclusion

In conclusion, operational feasibility relies heavily on user acceptance. Proper training, education, user
involvement, clear communication, addressing resistance, and continuous support are essential
strategies to ensure that users embrace and effectively utilize the system. By focusing on user
acceptance, the organization can maximize the benefits of the system and achieve its operational
objectives.

1.12 Cost Breakdown

Cost Category Description Cost

Development Design, Development and testing of the patient 10,000-100,000

management system
Cost ETB

Hardware Costs Servers, storage devices and networking 10,000-70,000

equipment needed to run the system
ETB

Software Costs Operating system, database management system 5000-20,000 ETB

and other software tools required to support the
system

Implementation costs Configuration, installation and training for users 5000-25,000 ETB

Maintenance costs Ongoing support and maintenance for the system, 10,000-50,000
including software updates and hardware repairs
ETB
Per year

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 Integration Costs Integration with other systems such as electronic 10,000-50,000
health records(EHRs) or billing system
ETB

Customization costs Customization of the system to meet specific 10,000-80,000

needs or requirements
ETB

1:12:9 Data Flow diagram

Creating a Data Flow Diagram (DFD) and a Conceptual Data Model for a clinic
management system involves visualizing the flow of information and the data entities
involved in the system. Below is an outline of how the system processes are handled and
the decomposition of DFDs, along with a conceptual data model for the system

Figure
:data flow diagram.

1:13:11 Decomposion of information

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Chapter 2

The logical database design for clinical management system includes four main entities: Patient, Doctor,
Appointment, and Medical Record. Each entity has specific attributes that capture essential information
related to patients, doctors, appointments, and medical records within the clinic.

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 2.1 - Attributes:
- Patient ID: A unique identifier for each patient.

- Name: The name of the patient.

- Date_ of_ Birth: The date of birth of the patient.

- Gender: The gender of the patient.

- Contact_ Number: The contact number of the patient.

- Address: The address of the patient.

2.2 Doctor Entity:

- Attributes:

- Doctor _ID: A unique identifier for each doctor.

- Name: The name of the doctor.

- Specialization: The area of specialization of the doctor.

- Contact_ Number: The contact number of the doctor.

- Email: The email address of the doctor.

2.3. Appointment Entity:

- Attributes:

- Appointment _ID: A unique identifier for each appointment.

- Date _and Time: The date and time of the appointment.

- Patient_ ID: A reference to the patient associated with the appointment.

- Doctor_ ID: A reference to the doctor associated with the appointment.

2.4. Medical Record Entity:

- Attributes:

- Record_ ID: A unique identifier for each medical record.

- Patient _ID: A reference to the patient associated with the medical record.

- Date _of _Visit: The date of the visit for which the medical record is created.

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 - Diagnosis: The diagnosis made during the visit.

- Treatment: The treatment provided to the patient

Table Name:Doctor

Data type length key Default value

Field Name
Doctor_Id VARCHAR 50 Primary key NOT NULL
Name VARCHAR 50 NULL
Specialization VARCHAR 50 NULL
Contact int 50 NULL
_Number
Email VARCHAR 50 NULL

Table name: Staff

Data type length key Default value

Field Name
Staff_Id VARCHAR 20 Primary key NOT NULL
Staff_name VARCHAR 50 NULL
Staff_ Ic_no VARCHAR 50 NULL
Staff_birth_date VARCHAR 50 NULL
Staff_address VARCHAR 50 NULL
Staff_contact VARCHAR 50 NULL
Staff_gender VARCHAR 50 NULL

Table Name:Patient
Data type length key Default value
Field Name
Patient_Id VARCHAR 50 Primary key NOT NULL
Patient_Name VARCHAR 50 NULL
Patient_Gender VARCHAR 50 NULL
Patient_Birth_date int 50 NULL
Patient_Register VARCHAR 50 NULL
date
Patient_Status VARCHAR 50 NULL
Patient_address VARCHAR 50 NULL
Patient_ Ic_no VARCHAR 50 NULL

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Table Name: appointment
Data type length key Default value
Field Name
Appointment_Id VARCHAR length key Default value
Patient_Id VARCHAR 10 Primary key NOT NULL
Contacting VARCHAR 10 Foreign key NULL
Staff_id VARCHAR 10 NULL
Appointment_id VARCHAR 10 Foreign key NULL
Appointment_time DATE TIME - NULL
Bookmark VARCHAR 10 NULL

Table Name: Prescription

Field Name Data type length key Default value
Prescription_Id VARCHAR 10 Primary key NOT NULL

Item_id VARCHAR 10 Foreign key NULL

Quantity INTEGER - NULL
Discount_Price DOUBLE - NULL
Use_method VARCHAR 10 NULL
Use_qty INTEGER - NULL
Use instruction VARCHAR 10 NULL

The First Normal Form – 1NF

For a table to be in the first normal form, it must meet the following
criteria:

.a single cell must not hold more than one value (atomicity)

.there must be a primary key for identification

.no duplicated rows or columns

.each column must have only one value for each row in the table
First NF:Doctor
Doctor_Id Name Specialization Contact_Number Email

201 TELAHA DENTIST 091212167 TGMAIL.COM

202 BETHELEM NERV 0926289 Begmail.com

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 205 Ilili dentist 0912211245 Ilgmail.com

First NF:Staff
Staff_id Name Patient_I c_no Birth_date Address Gender contact

301 lab qixxeessa 19990 jiitu m 09121234

302 ad dabala 1992 jiitu m 09455432

306 da dagafa 1995 dadafo f 09544532

First NF:Patient
Patient_id Name Gender Birth_date Patient_Register Status Address Patient_I
c_no
401 ban m 1212 yes student bate 3443

402 nan m 1999 yes teacher babile 23324

403 dad f 2345 yes teacher arda 7890

First NF:Appointment
Appointment_id Patient_id Contact_no Staff_id Appointment_time Bookmark

101 Patient_id Staff_id 2:30 box

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 102 401 301 3:00 Mail.box

105 404 304 4:30 Mail.box

First NF:Prescription
Patient_id Item_Id Quantity Discount_id Use_method Use_qty Use_Instruction

701 22 100 2224 _ _

702 23 101 2224 _

703 24 101 2234 _ _

The Second Normal Form – 2NF

The 1NF only eliminates repeating groups, not redundancy. That’s

why there is 2NF.

A table is said to be in 2NF if it meets the following criteria:

.it’s already in 1NF

.has no partial dependency. That is, all non-key attributes are fully
dependent on a primary key.

Doctor Table
Doctor_Id Doctor_no Specialization

201 Daniel dentist

202 Teshale nervy

205 Ili midwifer

Staff Table
Staff_id Staff no Patient_I c_no Birth_date

301 201 34 1994

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 302 202 45 1996

306 301 56 1990

Patient Table
Patient_id Patient no Gender Status

401 901 m student

402 902 m student

403 903 f student

Appointment Table
Appointment_id Appointment no Contact_no

101 00 996

102 01 996

ER_Diagram

Figure ER_Diagram:

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Chapter 3

The goal and purpose of a clinical management system revolve around improving the quality of patient
care, enhancing operational efficiency, and ensuring compliance with regulatory requirements. Let's
delve into the details:

3:1 Goal:

- The primary goal of a clinical management system is to streamline and optimize healthcare delivery
processes by leveraging technology to support healthcare professionals in providing high-quality patient
care.

- It aims to centralize patient information, facilitate communication and collaboration among care
team members, enable evidence-based decision-making, and enhance the overall patient experience.

3:2 Purpose:

- Enhancing Patient Care: The system's purpose is to improve patient outcomes by providing
healthcare providers with quick access to comprehensive patient data, including medical history,
treatment plans, and diagnostic results. This enables more informed clinical decisions and personalized
care.

- Increasing Operational Efficiency: By automating routine administrative tasks, such as appointment

scheduling, billing, and inventory management, the system helps healthcare organizations operate more
efficiently, reduce errors, and optimize resource utilization.

- Ensuring Regulatory Compliance: Compliance with healthcare regulations, such as HIPAA (Health
Insurance Portability and Accountability Act) and GDPR (General Data Protection Regulation), is a crucial
purpose of the system. It ensures that patient data is securely managed, privacy is protected, and data
sharing is conducted in a compliant manner.

- Facilitating Communication and Collaboration: The system fosters seamless communication and
collaboration among healthcare providers within the organization by enabling secure messaging, sharing
of patient records, and real-time updates on patient status. This leads to better care coordination and
continuity of care.

- Supporting Decision-Making: By incorporating decision support tools, clinical guidelines, and alerts
for potential issues or interactions, the system helps healthcare professionals make evidence-based
decisions, reduce medical errors, and improve patient safety.

- Enabling Data-Driven Insights: The system's purpose includes providing access to robust reporting
and analytics capabilities that allow healthcare organizations to derive actionable insights from clinical
data. This supports quality improvement initiatives, performance monitoring, and strategic decision-
making.

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In essence, the goal and purpose of a clinical management system are centered around enhancing
patient care delivery, optimizing operational processes, ensuring regulatory compliance, fostering
collaboration among healthcare providers, supporting informed decision-making, and leveraging data
for continuous improvement in healthcare delivery.

3:3 Current Software Architecture for Clinical Management Systems:

The architecture of a clinical management system typically consists of several components that work
together to support various functions and processes within a healthcare organization. Here is an
overview of the common software architecture components found in clinical management systems:

1. Database Management System (DBMS): The DBMS stores and manages patient data, treatment
plans, medical records, and other clinical information. It provides a secure and efficient way to store and
retrieve data.

2. User Interface: The user interface allows healthcare professionals to interact with the system, input
data, access patient records, and perform various tasks. The user interface should be intuitive, user-
friendly, and designed to support the workflow of healthcare providers.

3. Business Logic Layer: The business logic layer contains the core logic and rules that govern how the
system processes data and performs functions. It ensures that the system operates according to
predefined business rules and requirements

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 3:4 Behaviour of the object
The main objective of a clinical management system is to streamline and improve the overall
management and delivery of healthcare services in a clinical setting. The system should exhibit the
following behaviors:

1. Patient Management:

- The system should allow for efficient patient registration, including capturing and storing patient
demographics, medical history, and contact information.

- It should enable easy retrieval of patient records for healthcare professionals, ensuring quick access
to relevant medical information during consultations or treatments.

- The system should support scheduling and managing appointments, including the ability to send
reminders to patients and track their attendance.

2. Appointment Scheduling:

- The system should provide a user-friendly interface for healthcare providers to schedule
appointments based on availability, patient preferences, and urgency.

- It should allow for rescheduling or cancellation of appointments, with appropriate notifications sent
to patients and staff members.

- The system should have the ability to handle multiple appointment types, such as regular check-ups,
follow-ups, or specialized consultations.

3. Billing and Payment:

- The system should support accurate and efficient billing processes, including generating invoices or
statements for patients based on services rendered.

- It should integrate with payment gateways or third-party billing systems to facilitate online payments
and automate payment reconciliation.

- The system should maintain a record of financial transactions, allowing for easy tracking of payments,
outstanding balances, and insurance claims.

4. Inventory Management:

- The system should track and manage inventory levels of medical supplies, equipment, and
medications.

- It should generate alerts or notifications when inventory levels fall below a certain threshold,
ensuring timely replenishment.

- The system should provide insights into inventory usage patterns and facilitate the efficient
procurement and distribution of supplies.

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5. Clinical Documentation:

- The system should support electronic health records (EHRs) or electronic medical records (EMRs) to
capture and store patient health information.

- It should enable healthcare providers to create, update, and access clinical notes, test results,
prescriptions, and other relevant documents.

- The system should facilitate the sharing of patient information securely between healthcare
providers within the same organization or with external entities.

6. Reporting and Analytics:

- The system should generate reports and analytics on various aspects of clinical operations, such as
patient demographics, appointment statistics, revenue generation, and resource utilization.

- It should provide real-time insights to help healthcare administrators make informed decisions and
identify areas for improvement.

- The system should support customizable dashboards and data visualization tools to present
information in a clear and meaningful way.

Overall, the clinical management system should exhibit behaviors that enhance efficiency, accuracy,
collaboration, and patient care within a clinical setting.

3:5 Enternally of the object

Internally, a clinical management system is composed of various components that work together to
facilitate the management and delivery of healthcare services. These internal components include:

1. Database: The system typically has a database that stores and manages patient information,
appointment schedules, billing records, inventory data, and clinical documentation. The database is
essential for storing and retrieving data efficiently.

2. User Interface: The system has a user interface that allows healthcare providers, administrators, and
staff to interact with the system. The user interface provides access to different functionalities such as
patient registration, appointment scheduling, billing, and reporting.

3. Business Logic: The system contains business logic that governs the rules and processes for managing
various aspects of clinical operations. This includes logic for patient management, appointment
scheduling, billing calculations, inventory management, and clinical documentation.

4. Integration Modules

: The system may include integration modules that allow it to connect with external systems or services,
such as payment gateways, insurance providers, laboratory systems, or electronic health record
systems. These modules facilitate seamless data exchange and interoperability.

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 3:6 System Design
3.1 Layering Models–class type Architecture

Layered modeling is an architectural design pattern that divides a system into layers of
abstraction. Each layer is responsible for a specific set of tasks, and the layers are
stacked on top of each other in a way that allows each layer to depend on the layers
below it, but not on the layers above it. This allows for a clean separation of concerns
and makes the system easier to understand, maintain, and evolve.

Figure 3.1 user interface, persistence, controller and business layer7 user interface, persistence, controller and business
layer

3.7 User Interface Design

User Interface Design is the process of designing user interfaces for machines and software, such as
computers, home appliances, mobile devices, and other electronic devices, with the focus on

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maximizing usability and the user experience. The goal of user interface design is to create interfaces
that are easy and efficient for users to use, understand, and learn.

..3:8 System Use Case Description

A System Use Case Description (UCD) is a document that describes the interactions
between a system and its users in order to achieve a specific goal. It is a detailed
description of the system's behavior, including the inputs and outputs, the
preconditions and post conditions, and the alternative flows.

Login system use case description

Use case ID TMC01

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 Use case name Login

Primary actor Doctor

Secondary actor Receptionist

Description Allow the users to login into the system to access the relevant
function according to the user role. The various user roles are
doctor, receptionist, administration to login to the system. All users
have maximum of 3 attempt to login after which their account are
locked and they will have to contact system administrator to unlock
their account upon successful login the system will display the
relevant users homepage.

Pre-Condition User has to have valid account

Post Condition The system displays the homepage

Main flow 1. The user enters the id and password

2. the user submits the id and password
3. the system validates the id and password
4. the system verifies the id and password
5. the system displays the user’s homepage 6. the use case
ends
Alternative flow 3a missing id and/or password
1. The system prompts for id and password
2. Use case resume at main flow step 1
3b Maximum 3 attempts exceeded
1. The system displays “Maximum attempts exceeded
contact the Administrator” message
2. The system locks user account
3. The use case ends
4a Invalid id and/or password
1. The system displays “invalid id and/or password” message
2. The system prompts for id and password
3. Use case resumes at main flow step 1

Table 2.1 System Use Case Description

Manage account use case description

Use case ID TMD02

Use case name Create account

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 Primary actor Administrator

Includes login

Extends Create account

Pre-Condition System administrator must login

Post Condition System administrator will create new patient

account
Main flow Admin Visits admin page
2. System display admin page
3. The system admin selects
“manage user account” option
4. System displays Manage option
(Edit Account, Deactivate Account, create
account, activate)
5. System admin selects create
account
6. System displays create account
form
7. System admin fills the form and
clicks submit
8. System Checks form
9. System creates account 10.
Success message sent to the System Admin.

Alternative flow 7a: If form is incorrectly filled 9a.

System displays error message and asks to
refill 10a. Go to step 6 11.
End of use case

Table 2.2 Manage account use case description

3.8 Use Case Modeling

3.1.2 Essential Use Case Modeling

Essential use case modeling is a powerful tool for understanding the requirements of a
patient management system. By identifying the essential features of the system and the
relationships between these features, essential use case modeling can help to ensure
that the system meets the needs of its users.

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Figure 3 Essential Use Case Modeling

2.6.2 System Use Case Modeling

System use cases are typically written in a narrative format that describes the user's
goals and how the system can help them achieve those goals. They are typically divided
into two parts: the main success scenario and the alternative scenarios

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Table 2.2 Manage account use case description

3:9 Sequence Diagram

A sequence diagram is a type of UML (Unified Modeling Language) diagram that shows
the interactions between objects in a system. It is a graphical representation of the
sequence of messages that are exchanged between objects over time.

35
36
 Sequence diagramming for staff:

Sequence Diagram FOR Appointment

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 3:10 Activity Diagram
Activity diagrams can be used to show the flow of control in any system or process. They
are a valuable tool for understanding how a system works and for identifying any
potential bottlenecks or areas for improvement.

Login activity diagram

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3.11 Class Modeling(diagram)
It is utilized for common conceptual modeling of the structure of the application, and for
nitty gritty modeling, deciphering the models into programming code. Class chart
utilized to appear the diverse objects in a framework, their properties, their operations
and the connections among them.

Association & Dependency Techniques

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Figure 8 Association & Dependency Techniques Diagram

3:12Class Diagram

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3.14 Deployment Diagram
A deployment diagram is a type of UML (Unified Modeling Language) diagram that
shows the physical components of a system and how they are deployed. It is used to
show the hardware and software compoents of a system.

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3.15 persistent Modeling
Persistent modeling is a way of designing a database schema for a HU clinical
management system that stores information about patients, doctors, medications,
appointments, and other related entities. It is based on the concept of Object-Relational
Mapping (ORM) and allows developers to map objects to tables and columns in
relational databases.

1.Identify Entities: In Patient management system the main entities are patients,
doctors and receptionist.

2.Deifne the relations: The relationships between these entities will determine how
they are connected in the database. For instance, the patient entity may have a relation
with the appointment, doctors, and also Medication. Appointments are scheduled
between a patient and a doctor, and they have a time, date, and reason for the
appointment. Each appointment is associated with a single doctor and one or more
patients. Also Doctors provide medical care to patients and are associated with multiple
appointments. In addition to appointments, doctors can also prescribe medications or
diagnose medical conditions.

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 3. Create the tables: Based on the Entities and the relations identified we create a set
of tables to store the data. For example, under the patient column we have Name, user
ID, Sex. Under the doctor column we can get Doctor ID, name, specialty and others.
4. Define the primary and foreign keys: primary and foreign keys are used to establish
relationships between tables in a database. For examples; for patient table primary key
patient _id`. This uniquely identifies each patient in the table. Under Appointment table
primary key is `appointment _id`. This uniquely identifies each appointment in the table.
The foreign keys in this table are `patient_id` and `doctor_id`, which reference the
corresponding primary keys in the Patient and Doctor tables, respectively.
5. Implement the database: Once the tables have been designed, they can be
implemented in a database management system (DBMS).

Referencce :

reference-books-system-analysis-design:
https://www.tutorialspoint.com/system_analysis_and_design/system_analysis_and_design:

https://www.haramaya.edu.et/clinic-service/

https://www.haramaya.edu.et/health-and-clinic-contact/Thank you

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