CHAPTER TWO

LITERATURE REVIEW
2.1 BACKGROUND THEORY OF STUDY
A Hospital is a place where Patients come up for general diseases. Hospitals provide facilities
like: -
 Consultation by Doctors on Diseases.
 Diagnosis for diseases.
 Providing treatment facility.
 Facility for admitting Patients (providing beds, nursing, medicines etc.)
 Immunization for Patients/Children.
Various operational works that are done in a hospital are: -

 Recording information about the Patients that come.

 Generating patient bills.
 Recording information related to diagnosis given to patients.
 Keeping record of the immunization provided to children/patients.
 Keeping information about various diseases and medicines available to cure them.
These are the various jobs that need to be done in a hospital by the operational staff and Doctors.
All these works are done on papers.
The work is done as follows: -

 Information about Patients is done by just writing the Patients name, age and gender.
Whenever the Patient comes up his information is stored freshly.
 Bills are generated by recording price for each facility provided to patient on a separate
sheet and at last, they all are summed up.
 Diagnosis information to patients is generally recorded on the document, which contains
Patient information. It is destroyed after some time period to decrease the paper load in the
office.
 Immunization records of children are maintained in pre-formatted sheets, which are kept
in a file.
 Information about various diseases is not kept as any document. Doctors themselves do
this job by remembering various medicines.
All this work is done manually by the receptionist and other operational staff and lot of papers
are needed to be handled and taken care of. Doctors have to remember various medicines
available for diagnosis and sometimes miss better alternatives as they can’t remember them at
that time.

2.2. RELATED WORKS

 Electronic Health Records (EHR) and Clinical Decision Support Systems (CDSS):
Wang, Y., & Kung, L. (2018). Clinical information systems: A review on technology adoption
research. IEEE Transactions on Engineering Management, 65(1), 48-64. Ludwick, D. A., &
Doucette, J. (2009). Adopting electronic medical records in primary care: Lessons learned from
health information systems implementation experience in seven countries. International Journal
of Medical Informatics, 78(1), 22-31.

 User Experience and Human-Computer Interaction (HCI) in Healthcare:

Borycki, E. M., Kushniruk, A., & Carvalho, C. (2018). Human-computer interaction in

healthcare. In Handbook of Human-Computer Interaction (pp. 1-18). Springer, Cham. Ratwani,
R. M., & Hettinger, A. Z. (2016). Human factors of health information technology: Current
challenges and future directions. Yearbook of Medical Informatics, 25(01), S163-S167.

 Telemedicine and Remote Patient Monitoring:

Bashshur, R. L., Shannon, G. W., Krupinski, E. A., Grigsby, J., & Kvedar, J. C. (2016).
Telemedicine manifesto: A consensus statement about the impact of telemedicine on healthcare
delivery. Telemedicine and e-Health, 22(5), 376-380. Omboni, S., Guarda, A., McManus, R. J.,
& Mule, G. (2015). Mobile health applications for the management of arterial hypertension.
Journal of Clinical Hypertension, 17(4), 308-314.

 Health Information Exchange (HIE) and Interoperability:

Vest, J. R., & Kern, L. M. (2015). Campsite telehealth, partnerships, and the journey from
benchmarking to implementation: Lessons from a US national demonstration project.
Telemedicine and e-Health, 21(8), 603-609. Vest, J. R., & Gamm, L. D. (2010). Health
information exchange: Persistent challenges and new strategies. Journal of the American Medical
Informatics Association, 17(3), 288-294.

 Mobile Health (mHealth) Applications:

Zhang, M. W., Ho, C. S., Fang, P., Lu, Y., & Ho, R. C. (2017). Usage of social media and
smartphone application in assessment of physical and psychological well-being of individuals in
times of a major air pollution crisis. JMIR mHealth and uHealth, 5(2), e2. Krishna, S., Boren, S.
A., & Balas, E. A. (2009). Healthcare via cell phones: A systematic review. Telemedicine and e-
Health, 15(3), 231-240.

2.3. CURRENT METHOD IN USE

Paper-based records have been in existence for centuries and their gradual replacement by
computer-based records has been slowly underway for over twenty years in western healthcare
systems. According to Gunter and Terry (2005), just like any other record keeping, moving
patients’ records from paper and physical filing systems to computer and their super storage
capabilities create great efficiencies for patients for their providers, as well as health payment
systems.
According to Russell and Potts (2010), in the past, diagnosis was done on patients by asking the
patient questions such as: allergies, past treatment, and medications. Each time a patient visited
the hospital, he was asked for an appointment card that was issued during the last visitation and
the patient file is retrieved, then the doctor takes a review of the patient past medication before
administering treatments.
However, with the use of Hospital Interactive System, the doctor only needs to ask of the
patient’s name, and other pieces of identifying information which helps to easily pull up a
patient’s record from the electronic storage space and all the information the doctor needs to see
will be there. Before treatment, it is important for the doctor to know the history of the patient
(past medications, drugs he reacts to, his allergies, etc.). Diagnosis and treatment decision might
then be altered based on the information supplied by this system (Hospital Interactive System).
Hospital Interactive system is a computerized version of patient paper medical record. It delivers
a more complete picture of patient medical history, allowing doctors to provide the best
recommendations about a patient’s medical care. The system also includes patient health
insurance and contact information. Doctors can view a complete medical history of any patient,
which is a function of the fast access to information provided by the system. Also, the new
system automatically cross-checks any new prescriptions the physician is giving, to ensure that
there are no negative reactions with your current medications.
Over the past decade, the need for change in almost all western countries has become
stronger. Incontrovertible evidence has increasingly shown that current systems are not
delivering sufficiently safe, high quality, efficient and cost-effective health services, and that
computerization of the health care system with the Hospital Interactive System, is an effective
way forward. As Tony Abbott (2005) said, “better use of IT is no panacea, but there’s scarcely a
problem in the health system it can’t improve”. For the first time, the responses have been
national and coordinate.
Linda Kloss, executive vice president and CEO of American Health Information Management
Association (AHIMA), defines the three essential capabilities of a hospital Interactive System as
follows:
1. To capture data at the point of care
2. To integrate data from multiple internal and external sources
3. To support care giver decision making.
Physicians are expected to document encounters they have with patients to ensure crucial
information for decision making. The idea of recording patient information electronically instead
of using paper has been around since the late 1960’s, when Larry Weed introduced the concept of
the Problem Oriented Medical Record into medical practice. Until then, doctors usually recorded
only their diagnoses and the treatment they provided on paper. Weed’s innovation was to
generate a record that would allow a third party to independently verify the diagnosis. In 1972,
the Registries Institute developed the first Hospital Interactive System. Although the concept was
widely hailed as a major advance in medical practice, physicians did not flock to the technology.
In 1991, United States Institute of Medicine recommended that by the year 2000, every physician
should be using computers in their practice to improve patient care and the health system in
general.
Silver (2009), discussed the benefits of Hospital al Interactive System database over manual
medical database as below:
 Replace paper-based medical records which can be incomplete, fragmented (different
parts in different locations), hard to read and hard to find.
 Support for continuing medical education.
 Maintain a data and information trail that can be readily analyzed for medical audit,
research and quality assurance.
 Potential for automating, structuring and streamlining clinical workflow.

2.4. APPROACHED TO BE USED IN THIS STUDY

The Hospital Interactive System is designed for any hospital to replace their existing manual
paper based system. The new system is to control the information of patients. Room availability,
staff and operating room schedules and patient invoices. These services are to be provided in an
efficient, cost effective manner, with the goal of reducing the time and resources currently
required for the following task:
l. Employee Details: The new proposed system stores and maintains all the employees details.
2. Calculations: The new proposed system calculates salary and income tax automatically and
it is very fast and accurate.
3. Registers: There is no need of keeping and maintaining salary and employee register
manually. It remembers each and every record and we can get any report related to employee
and salary at any time.
4. Speed: The new proposed system is very fast with 100% accuracy and saves time.
5. Manpower: The new proposed system needs less manpower. Less people can do the large
work.
6. Efficiency: The new proposed systems complete the work of many salespersons in less time.
7. Past details: The new proposed system contains the details of every past doctor and patients
for future assistance.
8. Reduces redundancy: The most important benefit of this system is that it reduces the
redundancy of data within the data.
9. Work load: Reduces the work load of the data store by helping in easy updates of the
products and providing them with the necessary details together with financial transactions
management.
10. Easy statements: Month-end and day-end statement easily taken out without getting
headaches on browsing through the day end statements.
NEED:
I have designed the given proposed system in the JSP to automate the process of day to day
activities of Hospital like Room activities, Admission of New Patient, Discharge of Patient,
Assign a Doctor, and finally compute the bill etc., online facilities to the multiple users etc.

The complete set of rules & procedures related to Hospital’s day to day activities and generating
report is called “HOSPITAL INTERACTIVE SYSTEM”. My project gives a brief idea
regarding automated Hospital activities.
The following steps that give the detailed information of the need of proposed system are:
Performance: During past several decades, the hospital interactive system is supposed to
maintain manual handling of all the hospital daily activities. The manual handling of the record
is time consuming and highly prone to error. To improve the performance of the hospital
management system, the computerized hospital interactive system is to be undertaken. The
computerized hospital project is fully computerized and user friendly even that any of the
hospital’s members can see the patient’s report and the doctor’s report.
Efficiency: The basic need of the project is efficiency. The project should be efficient so that
whenever a new patient is admitted, and automatically a bed is assigned and also a doctor is
assigned to the patient according to the patient’s disease. And if any patient is getting discharged,
the bed assigned to him/her should automatically free in the computer.
Control: The complete control of the project is under the hands of authorized person who has the
password to access this project and illegal access is not supposed to deal with. All the control is
under the administrator and the other members have the rights to just see the records not to
change any transaction or entry.
Security: Security is the main criteria for the proposed system. Since illegal access may corrupt
the database and it will affect not only the hospital but also it also affects the patient’s life. So
security has to be given in this project.