System Automation

Automation of Health Record Management using selected hospitals in Southwestern Nigeria

International Journal of Computer Science & Engineering Technology (IJCSET);

Published: June 01, 2016

By: Kola Ayanlowo, O. Shoewu, Segun O. Olatinwo; Department of Computer Science, Moshood Abiola Polytechnic, Abeokuta, Nigeria; Department of Electronic and Computer Engineering, Lagos State University, Epe Campus, Nigeria; Department of Computer Engineering, Moshood Abiola Polytechnic, Abeokuta, Nigeria

Purpose

Manual systems are becoming obsolete and are being replaced by e-platforms for enhanced efficiency and better productivity.  Forms and papers have become tedious and unprofessional.

Method

Record systems of five hospitals in south-west were used for a robust comprehensive design of an electronic database.  The application offers numerous advantages over manual record keeping system, among which are data integrity, consistency, ease of retrieval, record integration, data mining, etc.

Result

An Electronic Medical Record (EMR) system that eases process of searching through cabinets for patient’s files was successfully implemented. The system was designed to provide doctors access to the patient medical history from his personal system.

Conclusion & Recommendation

EMR is highly recommended for medical health records keeping, because it is professional, saves time, reliable, efficient, etc. It will help health practitioners to access medical health record of patient with ease and facilitates smooth workmanship.

Electronic Medical Records (EMR)

Patient Database Management System – General Hospital, North Bank, Makurdi

March 2013; By: Asabe, S. A., Department of Computer Science Modibbo Adama University of Technology Yola; Oye, N. D. Faculty of Computer Science Department of Information Systems University Teknologi Malaysia & Monday Goji Department of Maths/Computer Science, MAUTECH Yola– Nigeria

Purpose

Healthcare in Nigeria is confronted with ever-growing demands for medical treatment and services. This study on the hospital patient datable management system was designed to transform manual way of searching, sorting, keeping and accessing patient medical information into Electronic Medical Record (EMR), in order to solve the problem associate with manual method.

Method

The existing system (manual) was studied and computer based application was provided to replace this manual method. The computer based system generated patient report as the patient register in and out of the hospital.

Result

The study portrayed the importance and indispensable nature of computer. Critically indentified the accuracy, reliability, security, and efficiency of computer method of patient’s record keeping; to eliminate missing files and enhance speedy retrieval. It also reduced paper work in the reception area and time wasted by patients waiting for their files to be retrieved

Conclusion & Recommendation

The study concluded that computer designed patient database system is the solution to manual method of keeping patient medical record. The system must have appropriate patients’ medical history.

Hospital Management System (HMS)

Assessment of Patient Healthcare Record Management Practices in Tertiary Health Institution

International Journal of Advanced Technology in Engineering & Science 

Published: May 05, 2016

By: Nasiru Sani, Haruna Abdullahi Ibrahim, Idris Muhammed Ango, Suleiman Hussaini, Bashir Maina Saleh; Institute of Management & Computer Science, Nursing College, School of Humanities & Social Science, Department of library & Information Science, Department of Computer Science, NIMS University Jaipur.

Purpose

The aim of study is to assess the management of health information system best practices for effective healthcare service delivery in Jigawa state.  The objectives aimed at assessing the health information systems, best practices for effective healthcare service delivery in hospitals.

Method

Literature was reviewed on health information and management systems and related scholarly articles, and views. A cross sectional explorative design was used for the study to assess the patient record management practices in the facilities.

Samples were selected using simple random sampling technique where a total of 50 subjects were selected and data was collected using interview & observation. The study results indicate that the hospitals use traditional manual systems to capture and transmit patient records as revealed by 91.4% of respondents.

Conclusion

The result reveals the relevance for unprecedented e-health investments. Also, the need to adhere to best practices as identified, to improve patients knowledge and management, in all health related data and public health outcomes in general.

Re-Hospitalization

Predictors of Rehospitalization in patients admitted with heart failure in Abeokuta, Nigeria

Data from the Abeokuta Heart Failure Registry

Received on April 6, 2014; Revised on August 20, 2014 and Accepted on August 21, 2014

By: Okechukwu S Ogah. MBBS, MSc, FWACP, FESC, FACC, Simon Stewart. PhD, NFESC, FAHA; Ayodele O Falase. MBBS, FWACP, FMCP, FRCP; Joshua O Akinyemi. BTec, Msc; Gail D Adegbite. MBBS; Albert A Alabi. MBBS; Akinlolu A Ajani MBBS; Julius O Adesina. MBBS; Amina Durodola.MBBS; Karen Sliwa. MD, PhD, FESC, FACC.

Affiliations: Division of Cardiology, Department of Medicine, University College Hospital, Ibadan; Soweto Cardiovascular Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease Baker IDI Heart and Diabetes Institute,  Australia; Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan; Department of Medicine, Sacred Heart Hospital, Lantoro, Abeokuta; Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria

Purpose

We sought, for the first time, to examine the rate and predictors of readmission in patients discharged from hospital after an episode of heart failure.

Methods

This was a hospital-based, prospective, observational study that used data from the Abeokuta heart failure registry.

Conclusion

  • Overall, 1.53% of patients, respectively, were re-hospitalized at least once within 30 days and 6 months (5.3% had multiple readmissions);
  • A total of 11 (4.2%) also died (all of whom had been re-hospitalized).

NEUROLOGY

Neurologic Diseases

Pattern of In-patient Neurologic Review: 

An experience from a Tertiary Hospital Northwestern Nigeria

Annals of African Medicine

Date of Publication: April 5, 2016 

By: Aliyu Ibrahim, Lukman Femi Owolabi, Baba Maiyaki Musa, Salisu Aliyu, Musbahu Rabiu, Ahmed Maifada Yakasai;  Department of Medicine, Neurology Unit, Aminu Kano Teaching Hospital, Bayero University Kano; Department of Medicine, Katsina General Hospital, Katsina; Infectious Disease Unit, Public Health and Diagnostic Institute, College of Medical Sciences Northwestern University, Kano, Nigeria

Increase in neurologic diseases burden has increased the demand for neurology services globally, despite the shortcomings of shortage and mal-distribution of neurologists, placed significant pressure on the few to provide optimal and effective services in the resource-challenged settings.

  • Neurology referrals were prospectively reviewed over a period of 3 months.
  • Socio-demographic characteristics of patients, the initial diagnosis by requesting team, reasons for consult / referral, requesting personnel, duration of hospital stay before request, time interval between receiving request and review, working and final diagnosis after review, and diagnostic outcome of neurologic review were analyzed
  • Fifty-three hand written in-patient requests were reviewed over period of study given an average rate of 4.4/week.
  • Mean age was 50.8 ± 16.1 years, and median length of stay was 1 day (inter-quartile range: 1–2.5 days).
  • Diagnostic outcome of reviews were; new diagnoses in 4 (11.3%), incorrect diagnosis changed in 8 (15.1%), contribution to differential diagnosis in 15 (28.3%), and to management plans in 24 (45.3%) patients.
  • Association between diagnostic outcomes and mortality was not statistically significant (χ2= 6.66, P = 0.08).

Study showed that in-patient neurologic reviews led to significant improvement in diagnostic and management plans. Appropriate policy guidelines should focus on efficient ways of maximizing benefits of reviews to patients without overburdening neurologists.

Childhood Autism

Knowledge of Childhood Autism & Challenges of Management among Medical Doctors in Kaduna State:

Autism Research & Treatment

Received September 12, 2014; Revised February 1, 2015; Accepted March 10, 2015   

By: E. E. Eseigbe, F. T. Nuhu, T. L. Sheikh, P. Eseigbe, K. A. Sanni, and V. O. Olisah; Department of Paediatrics, ABUTH, Shika-Zaria 810001; Federal Neuro-Psychiatric Hospital, Kaduna; Department of Family Medicine, ABUTH, Shika-Zaria 810001; Department of Psychiatry, ABUTH, Shika-Zaria 810001, Nigeria

Autism is a neuro-developmental disorder with serious implications in childhood. There is significant gap in the identification and provision of health and social services for autism. The knowledge of autism among health care providers and identifying challenges associated with its management could facilitate bridging the gap and ensuring better outcomes.

  • A self-administered tool, the Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaire, was used in assessing knowledge of autism among 175 medical doctors (participants) attending an annual scientific meeting.
  • Other parameters assessed were socio-demographic and professional characteristics of the participants and challenges encountered in the management of autism.
  • Out of 175 questionnaires distributed, 167 (95.4%) were returned.
  • Good knowledge (KCAHW score ≥15) was significantly associated with being a pediatrician or psychiatrist and practicing in a tertiary health facility (), while poor knowledge (KCAHW score <15) was significant among general practitioners ().
  • The highest knowledge gap was associated with onset of autism and its comorbidities (KCAHW Domain 4) while the least was concerning communication impairments (KCAHW Domain 2).

Major challenges encountered in autism management were dearth of specialist services, cost of evaluation, and poor caregiver perspectives of autism.

Stroke Mortality

Stroke Mortality & It’s Predictors in a Nigerian Teaching Hospital

African Health Science

March 2015: US National Library of Medicine; National Institute of Health

Stroke is the third leading cause of death; stroke mortality is noted to be higher in blacks in biracial studies; Study examines mortality of stroke predictors at Jos University Teaching Hospital:

  • 120 stroke patients admitted into medical wards within one year were assessed, demographic data was recorded.
  • Patients were examined and ancillary investigations were carried out. Deaths Predictions recorded.
  • Multivariate logistic regression was used to identify independent predictors of mortality.
  • Of the 120 patients, 42 (35%) died and most (76.2%) deaths occurred within the first week.
  • Predictors of mortality on uni-variate analysis were age ≥ 60 years, male sex, loss of consciousness, high NIHSS score (≥16), the presence of co-morbid conditions and presence of complications.
  • On multivariate analysis, predictors of mortality were the presence of co-morbid conditions, GCS <10 and high NIHSS score.

Stroke mortality was very high, especially during acute phase. Important predictors of mortality found were presence of comorbid conditions, NIHSS score and loss of consciousness, indices of severity of the disease.  Improved care with acute assessment, monitoring and investigation is seriously needed.

Pediatric Disorder

Pattern of Pediatric Neurological Disorder in Port Harcourt, Nigeria

International Journal of Biomedical Science  

Published June 2011; by: A. I. Frank-Briggs & E. A. D Alikor

Pediatric Neurological disorders in developing countries are very challenging, due to its chronicity, late presentation and unavailability of modern diagnostic facilities, which contribute significantly to increased morbidity and mortality.  This was a retrospective hospital based analysis of neurological disorders seen in the Pediatric neurology unit of the University of Port Harcourt Teaching hospital.

  • A total of 35,473 patients were seen in the Pediatric unit; 2,379 had neurological disorders.
  • This gave a prevalence of 6.7% of Pediatric neurological disorders.
  • The age ranged from 3 months to 15 years.
  • The age group 1->5 years accounted for the most affected age group constituting 87.7%.
  • The most frequent Pediatric neurological disorders were epilepsy (24.6%), cerebral palsy (15.4%), and central nervous system infections (9.5%).
  • Wide spectrum of neurological disorders occurred in the environment.

High incidence of epilepsy and cerebral palsy suggests efforts should be geared towards educating the populace about early diagnosis & prompt management.

Heart Failure

Contemporary Profile of Acute Heart Failure (AHF) in Southwestern Nigeria

American College of Cardiology JACC Journal 

June 1, 2016

Data from Abeokuta Heart Failure Clinical Registry; Dept of Epidemiology & Medical Statistics, College of Medicine, University of Ibadan; Dept of Medicine, Sacred Heart Hospital, Abeokuta; Dept of Medicine, Federal Medical Centre, Abeokuta, Nigeria

To determine contemporary profile, clinical characteristics, and intra-hospital outcomes of Acute Heart Failure (AHF); comprehensive detailed clinical and socio-demographic data was collected from 452 consecutive patients, with AHF presented to tertiary hospital in Abeokuta.

  • The mean age was 56.6 ± 15.3 years (57.3 ± 13.4 for men, 55.7 ± 17.1 for women), and 204 patients (45.1%) were women. Overall, 415 subjects (91.8%) presented with de novo AHF.
  • The most common risk factor for heart failure was hypertension (pre-existing in 64.3% of patients)
  • Type 2 diabetes mellitus was present in 41 patients 10.0%
  • Hypertensive heart failure was the most common etiological cause of heart failure for 78.5% cases.
  • Dilated cardio-myopathy 7.5%, cor-pulmonale 4.4%, pericardial 3.3%, rheumatic heart disease 2.4%.
  • Majority of subjects 71.2% presented with left ventricular dysfunction (left ventricular ejection fraction 43.9 ± 9.0%, with valvular dysfunction and abnormal left ventricular geometry frequently documented.
  • The mean duration of hospital stay was 11.4 ± 9.1 days, and intra-hospital mortality was 3.8%.

Compared to those in high-income countries, patients presenting with AHF are relatively younger and still of working age and more common in men with severe symptoms.

Hypertension is projected to rise by 89% between 2000 and 2025.

Stroke

Pattern of Neurological Admissions in the Tropics: 

Experience at Abakaliki South-Eastern Nigeria: 

Journal of Biology, Agriculture & Healthcare: 

Published November 13, 2014

By: Chukwuemeka O Eze, Uma A Kalu Department of Internal Medicine, Federal Teaching Hospital Abakaliki, Ebonyi State Nigeria

The study determined the pattern of neurological admissions in a tertiary Federal Teaching Hospital Abakaliki, compared it with other parts of the country.  A review of admissions into the medical wards from July 2012 to June 2013, using the register of admissions and discharges:

  • Out of 1247 patients admitted in medical ward over the study period, 267 (21%) had neurological disorders with mean age of 55.1±20.2years.
  • There were 154(58%) males and 113(42%) females, with a sex ratio of 4:3.
  • Seventy two percent of the patients were between 30 and 69years. Stroke accounted for 62% (166) of the neurologic admissions.
  • Others were central nervous system (CNS) infections, seizure disorders, hypertensive encephalopathy, myelopathies, CNS tumors and neurodegenerative disorders in descending order of frequency.

The burden of neurological disorders is high with male preponderance mainly of productive population. Stroke and CNS infections were the most prevalent neurological disorders identified which are both largely preventable. Needed is a good health planning to address the enormous neurological disease burden and emphasize preventive health.

NEUROLOGY EDUCATION

Course Difficulty

Neuroanatomy Course: A nightmare for Nigerian Medical Students

The Federation of American Societies for Experimental Biology

Published 2017

By: Muhammad Musa, Muhammad Danfulani and Sanusi Bello

Appreciating basic neuro-anatomy by medical students plays a vital role in their understanding of neurological diseases and illnesses. This study was conducted to ascertain perception of medical students about neuro-anatomy compared to other aspects of human anatomy course.

  • Participants were third year students from 2 medical schools in Northwestern Nigeria.
  • Anonymous and voluntary questionnaire was distributed to the randomly selected participants.
  • 120 questionnaires were distributed, 116 were completed and returned.
  • Information obtained were, after which relevant descriptive and inferential statistics was applied.
  • Preliminary findings from the completed and returned questionnaires, revealed that majority of the medical students perceived neuro-anatomy course as the most difficult aspect of human anatomy:
  • 60% of the respondents consider poor teaching methodology employed by the neuro-anatomy tutors as the main reason for their negative perception and suggested the use of models as well as teaching aids to enhance learning.

This study would probably give a hint as to why most medical graduates never considered picking up careers in neurology or neuroscience related fields, thus making it difficult to address health challenges noticed in these fields of endeavors.

Students Performance

Students Performance & Perception of Neurophysiology

Feedback for Innovative Curricular Reform in a Nigerian Medical School:   

Nigerian Journal of Physiological Sciences

By: Ed Nwobodo, U. B. Anyaehie,   N. Nwobodo, C. Awiwa, E. Ofoegbu, C. Okonkwo, C. Aligekwe and B. Burdick;  Faculty of Medicine, Nnamdi Azikiwe University at Nnewi. Nigeria, College of Medicine, University of Nigeria, Enugu Campus;  Faculty of Medicine, University of Benin, Nigeria; FAIMER Institute, Market Road Philadelphia, USA.

Study aimed at ascertaining the status of students’ performances and their perception of the learning of neurophysiology. The goal was to determine ways of addressing negative perceptions for the purpose of improving overall learning and use neurophysiology knowledge by structured curricular reform.

  • Analysis and comparism of the performances of students in 3 areas of physiology at the second professional examinations over a 3 year period (n=300). Surveyed also learning experience of a batch of graduating doctors in neurosciences (n=50) and surveyed the staff and students’ perception of the teaching of neurophysiology.
  • Student’s performances were comparatively poorer than in cardiovascular and endocrinology aspects at the second professional examinations. The reported student’s perception of their neurophysiology learning included uninteresting, abstract concepts, lack of real examples and conflicting facts with their prior basic knowledge.
  • Over 50% of graduates rated their learning experiences as poor, very poor, or below average for neuroscience courses.

The analysis of curricular contents of neurophysiology in the preclinical departments indicted asynchrony and redundancy in topics that may reduce the learning and teaching time efficiency. It is suggested that learning experiences of students be structured to ensure that graduate doctor is able to understand and transfer learned experiences into clinical studies and practice; a horizontally integrated curriculum to raise students knowledge, attitude and skills in neuroscience courses.

Students Interest

Interest in Neurology during Medical clerkship in 3 Nigerian Medical Schools

BMC Med Education   

Published online May 20, 2010

By: Emmanuel O Sanya, Olugbenga E Ayodele and Timothy O Olanrewaju

To ascertain perception of medical students of neurology in comparison with 7 other major medical specialties to determine whether neurology was the specialty students consider most difficult, and to appraise their opinion on how neurosciences and neurology were taught in their different universities.

  • Self-administered questionnaires were used to obtain information from randomly selected clinical students from 3 medical colleges: University of Ibadan, University of Ilorin & Ladoke Akintola University of Technology, Osogbo.
  • Of the 320 questionnaires, 302 responded a 94% rate.
  • Students felt they knew neurology least of the 8 specialties and were not confident with neurological diagnoses.
  • About 82% indicated they learnt best independent of teaching and medical textbooks, 15% found online resources very useful and 6% indicated group discussions.
  • Histology and biochemistry were the preclinical subjects participants opined least useful in learning neurology.
  • The most frequent reasons students felt neurology was difficult were problems with; about 49% with understanding neuroanatomy, 41% with insufficient exposure to neurological cases, 32% with too many complex diagnoses, and 32% with inadequate neurology teachers.

Students perceived neurology as the most difficult specialty and were not interested in specializing in it. Neurology education could be improved upon by provision of more bedside tutorials and Increased availability of online resources to enhance learning.