Contents CHAPTER 1: INTRODUCTION TO THE STUDY4 PROJECT TITLE4 BACKGROUND4 Rationale8 Tangible Benefit8 Intangible Benefits9 AIMS AND OBJECTIVES10 CORE10 ENHANCEMENT10 SPECIAL10 JUSTIFICATON FOR THE RESEACH11 METHODOLOGY11 CONCLUSION12 CHAPTER 2: LITERATURE REVIEW. 13 DOMAIN RESEARCH13 Review of Past Research Works and Identification of Gaps14 WIRELESS TECHNOLOGIES16 WHY WE NEED WIRELESS NETWORK16 COMPARISON BETWEEN WIRELESS STANDARDS AND TECHNOLOGIES17 COMPARISON BETWEEN BLUETOOTH AND WIFI17 PERSONAL DIGITAL ASSISTANCE (PDAs)19 INTRANET20
COMMUNICATION PROTOCOL21 TCP/IP IN CLIENT/SERVER MODEL21 CLIENT/SERVER ARCHITECTURE21 Data Synchronization22 ELECTRONIC MAILS (E-MAIL)26 Simple Mail Transfer Protocol (SMTP)26 MOBILE PRINTING27 MONITORING IP ADDRESS28 TECHNICAL RESEARCH29 LANGUAGE29 C sharp (C#)29 DATABASE31 Proposed Database31 Microsoft SQL Server 200531 Oracle Database 10g31 Justification for chosen System Database32 METHODOLOGY34 What is need for a Methodology? 34 Comparison of Methodologies34 Rational Unified Process (RUP)34 Advantages of RUP:35 Disadvantages of RUP:36 Waterfall Model36
Advantages of Waterfall Model:37 Disadvantages of Waterfall Model:38 Spiral Methodology38 Advantages of the Spiral Model:39 Disadvantages of the Spiral Model:39 Critical Evaluation & Analysis for Project Methodologies39 Justification for the chosen Methodology – RUP41 CHAPTER 3: RESEARCH METHODOLOGY44 Research Approach44 Questionnaires44 Interview47 Chapter 4: PRESENTATION AND ANALYSIS OF DATA49 Introduction49 FINDING FROM QUESTIONNARES50 FINDING FROM INTERVIEW60 Conclusion61 CHAPTER 5: SYSTEM DESIGN62 Modeling Tools62 Justification for UML64
Use Case description64 Use Case Diagram for PDA-Rehabilitation Management System65 The Use Case Specification66 CHAPTE 6: CONCLUSSION74 References75 APPENDIX79 ? CHAPTER 1: INTRODUCTION TO THE STUDY PROJECT TITLE PDA-Rehabilitation Management System BACKGROUND According to (L. Leape, 2003) stated that every year, millions of sick and injured people go to hospitals, putting their trust in medical staff to do whatever is necessary to help them. While the majority of the patients received the level of help and care required, others were not so fortunate.
In fact, hospital errors occur more frequently than generally known. Even worse, when they do occur, hospital errors can have devastating, potentially fatal, consequences. Medical error generated increase the attention to the issue of patient safety in the health care system. Among hospital inpatients, medications are a leading cause of adverse events, and errors involving medications are frequent. (Rosen-bloom, 2003) has mentioned in his article of medical error that medical dosage error continue to contribute heavily to thin ongoing health care crisis and cause high percentage of death every year.
The reputation of the entire healthcare industry is at stake, as patient confidence continues to proportionately erode. After all fragile patient –doctor relationship is a bond of trust around which any healthcare system must revolve. There is potential for a hospital error at many stages of the patient’s hospital visit of stay. Everyone – from the first nurse to check a patient in, to the doctor, to the x-ray technician, to the surgeon, to the pharmacist, must be diligent about his or her work in order to ensure that patients have an error-free visit.
Unfortunately, hospitals especially government hospital or local hospitals are often busy, short-staffed, and resources are often scarce. This creates an environment conductive to hospital errors. An erroneous medication use history may result in failure to detect drug-related problems as the cause of hospital admission or lead to interrupt or inappropriate drug therapy during hospitalization. Either occurrence may adversely affect patient safety. Following hospital discharge, the perpetuation of these errors may result in drug interactions, therapeutic duplication, other unintended dverse events and additional cost. In a recent study (Rosen-bloom, 2003) claimed that from the opposite side of the bed, healthcare professionals are often equally frustrated. To err is indeed human, yet physicians, more so than most professionals, are expected to make no mistakes. Pressures mount as ongoing medical research and technological advances produce a virtual mountain of information for healthcare professionals to incessantly monitor. As a result, fragmented and varied care can produce inconsistencies in healthcare emphasis and service, to which medical professionals are held accountable.
Combine this avalanche of information with the day-to-day stress of a working medical environment, and mistakes, regardless of intent, become inevitable. Some of these common hospital errors are shown in the table 1 below; ProblemsDescription Doctor’s mistakes Doctors are not infallible, no matter how much we would like them to be. Sometimes doctors make mistakes unintentionally. These mistakes are actually more common than generally known because doctors are reluctant to report them out fear of liability-making doctor’s mistakes one of the most underreported types of medical malpractice.
Medical malpractice, including medical mistakes and negligence, is one of the leading causes of death and injury. Medical malpractice may involve serious errors such as wrong site surgery, labor mismanagement, a botched procedure, or other gross mistakes. Yet most cases, the negligence is less obvious, though equally detrimental. Many medical mistakes occur when a doctor or other health practitioner absentmindedly prescribes the wrong medicine, do not check into a patient’s medical background thoroughly, and otherwise fail to meet the acceptable standards of providing prudent and skilled medical care.
Nurses Mistakes Nurses are also constantly challenged by the availability of information resources at the point of care. Evidence supports that clinically relevant questions may be answered by performing queries in electronic bibliographic databases such as MEDLINE. One study addressed information needs and communication difficulties for nurses and physicians. It has been found that, nurses had specific information needs related to patient diagnoses, laboratory and other test results, drug information, patient/caregiver teaching, this causes them to perform error the to patients.
Surgical errors (J. Krizek, 1999) Mentioned sometimes Surgeons do make mistakes regardless of intent. Sadly, surgical errors are not uncommon. Non-fatal surgical errors occur at an equally alarming rate and often result in serious injury, like paralysis or permanent disability, to the patient. Causes Inattentiveness Fatigue Miscommunication Poor Handwriting Recklessness Confusion of one patient with another When the doctors, or nurses have got a lot of patient in the hospital, he might be confused in providing the right service to the right patient. Improper diagnoses
It occurs when a patient is treated for a disease he or she does not have or a disease goes untreated because of the failure of a doctor to recognize a threatening condition. Medical Error This can include over-or under-medication, administering the wrong drug or incorrect diagnosis. Etc. Drug ordering problems This is due to failed communication, including poor handwriting, name confusion, decimal paint errors, inappropriate abbreviation, ambiguous or incomplete orders. Table 1 The way of discharge medication lists at hospitals contributes very much in the evolution of errors.
As we can see there is a disadvantage of time consuming (time wastage), possibility of increasing medication errors, inconvenient accessibility of information with a patient. The system needs improvement in order to prevent or at least reduce the occurrence of these errors to avoid harm. A medication error is any preventable event that may cause or lead to inappropriate medication use of patient harm while the medication is in the control of the health care professional, patient, or consumer.
Such events may be related to professional practice, health care products, procedures and systems. Rationale The use of PDA technology for medical application is opening a new field to research in recent years. This technology appears to be very useful for collecting data and data entry at point of care providing tools to enter data in an efficiency and consistent way to nurses, physicians and doctors. New information technologies, particularly personal digital assistants (PDA), will be able to provide readily accessible medical information at the point of care.
Bedside use of these portable electronic devices, equipped with relevant, reliable and accurate drug and medical reference can help to reduce the prevalence of medical errors in hospitals and improve patient safety at point of care. Tangible Benefit Improve quality of management and hence, improve patient safety PDA application will help nurses to manage the patient information. Check the medical order and recording the nursing care plan at point of care. Ward in Hand to computerize clinical record by connecting the PDA to the wireless connection directly to the central database.
It application should collect clinical and relevant patient information like test and labs at the bedside. The system will be able to display and update patient problems and treatments, medication, ordering and print the documents. The interface will have the prototype application that stats the importance of usability and human computer interaction on the PDA. The system will provide graphical user interface for east use and learn. The other benefit is its portability and ease of use. Since these devices are generally small, they can be placed in a suit jacket pocket or in a purse.
This allows user nurses to have the patient’s information at their fingertips. PDA have the ability to share the information, they are not the devices unto themselves. Most of them have the ability to talk to the PC or each other. The system provides ubiquitous access, allows making editing patient information easier, and provides easier patient archiving. DPA are light weight device that can access a server anywhere, anytime. With the help of wireless technology integrated with the medical field can form an extensive frame work that can significantly aid health care providers.
Intangible Benefits Reduction of Medication Error Convenience of using the system, the use of technology in medical field. Health care information is becoming a more popular are of research and development because doctors are in need of new technology so they can attend their patients in a more efficient way. The system will save the time. When the nurse simply held a cell phone in her hand and accessed the patient’s information from a built in system, it would be much quicker and less time would be wasted. Degree of usefulness AIMS AND OBJECTIVES
Prior to developing a system, the aims and objectives for the system development have to be set. An application developed without a goal would lead to nothing and more likely result to a disastrous outcome. CORE To manage patients and drug information based on PDA. This will determine the optimal rehabilitation information available on PDA by the use of wireless technology used in daily hospitalization activities to meet the goal of reducing possible errors. The PDA will have the application that would have access to the database where all drug and patient information would be kept there.
ENHANCEMENT 1. To provide wireless communication between nurses and doctors, the system must be able to support communication between users through PDA and support multiple users to connect to the database and share the available information. Nevertheless, the system should provide electronic prescription using PDA tool which will avoid illegible prescriptions and transcription error would be avoided with machine text and transmission via either wireless network of fax i. e. allow user to fax and print copies of medication list. 2. To provide email alert. SPECIAL
The System should be able to monitor the network in the work place. JUSTIFICATON FOR THE RESEARCH The system that would be created would be web-base system During testing the system, we might test it by using emulator if the PDA device itself will be unavailable. There should be wireless network along the place that we expect to test the system. The wireless network is unavailable then the system cannot be tested. Battery life must be least as long as a typical medical workday. Most PDAs have battery lives of 1 to 4 weeks (depending on usage, and whether the device is rechargeable or uses disposable alkaline batteries)
A minimum of 16 MB is recommended for medical applications and e-texts, which tend to be relatively large (1 to 5 MB). However, 8 MB would be sufficient if the device is expandable through compact flash, secure digital or memory stick cards METHODOLOGY The methodology chosen for the development of this system is Rational Unified Process (RUP) establishing four phases of development. Each of the phases is organized into number of iterations that must satisfy defined criteria before the next phase is undertaken.
In the first phase, named inception phase, the scope of this project is defined as well as its business case; in the second phase known as elaboration phase, the project’s needs are analyzed in detail; in the third phase known as construction phase, the system design is created as well as the source code; and finally, in the last phase known as transition phase, the system is delivered to users. CONCLUSION After medical student or practitioner decide to take advantage of this ongoing PDA revolution. Several important factors must first be considered. After all, efficient point-of-care computing demands:
Portability Practicality Screen clarity PC synchronization For improving the performance of users as well as providing accurate results, adopting Rational Unified Process (RUP) methodology for the development of proper PDA and resident software have been chosen, any healthcare practitioner will have the necessary point-of-care information required to help minimize the risk of medical error. CHAPTER 2: LITERATURE REVIEW Today there are many hospitalization systems that have been developed to help the safety of hospital patients and reduce hospitalization error.
However, data are consistent with recent reports that patient safety progress is slow and is a cause for great concern. As (R. Longo,2010) mentioned that medical error as primarily an organizational issue resulting from inadequate or non-existence systems that evidence suggested would reduce the probability of error; from this perspective, problem in care are largely the result of poorly organized care systems in which breakdowns occur in the transfer of complex information from physician orders to the patient bedside, with many clinicians and systems involved from start to completion, the hospitalization systems needs improvement.
Clearly, the time is long overdue for not only addressing this nationwide crisis in healthcare, but providing tangible and effective solutions at the point-of-care. The new Information Technologies (IT), particularly personal digital assistants (PDAs), will be able to provide readily accessible medical information at point of care. Although definitive study are all necessary, the bedside use of those electronic devices, equipped with relevant, reliable and accurate drug, medical reference, email alert and monitoring IP addresses of the devices connected to the network, can help to reduce the prevalence of medical errors.
DOMAIN RESEARCH PDA- Rehabilitation management system is a system that would be able to provide readily accessible medical information at point of care to reduce medication errors in hospitals or any other clinic environment. The implementation of this system will require the combination of several technologies from the first stage of development to end. According to the research, a researcher has tried to choose the best technologies that would fulfill the requirement of the proposed system. Review of Past Research Works and Identification of Gaps
Comparison and contracts with the positions developed by other research (Cacace et al, 2004) They have conducted a project of Hospital Information System for Students (HISS), run by Campus Bio-Medico University of Rome, students of Medicine. They were trained to use handled devises connected through a WLAN to record patients’ data. Beside learning the new technology and applying it for freely accessing teaching resources from any place in the campus, the students were able to design new user interfaces for accomplishing daily tasks.
The project have been able to meet the following goals: enhance the hospital level of technology by improving the accessibility to the information system at different level (student, nurse, and physician) through mobile technologies, improve teaching and learning in the wards through a faster access to clinical data; designing new interfaces for small devices for collecting and examining data at the bedside; a deeper comprehension of security issues; analysis of geographical mobility needs; performance evaluation. Cacace et al, 2004) also mentioned the most critical approach was by Medicine students. The complexity of the tasks and the different approach in data entry contributed to a very low degree of acceptance of the new technology. Therefore, after an ineffective extensive phase (all the students in all the wards), they tried an intensive approach. A pilot project started in the departments that had shown a more positive attitude during the first phase: general surgery and cardiology. All the medical staffs were involved, not only the students and their tutors.
This phase showed that the presence of a leading figure is a key element for the acceptance of innovation: the fact that the directors of both departments were keen on using the devices motivated all the staff. According to the other research that has been carried out by (Chang et al, 2004), they were involvement in the Development and Pilot Evaluation of User Acceptance of Advanced Mass-Gathering Emergency Medical Services PDA Support System. The support systems for the Emergency Medical Services (EMS) in the mass gatherings, such as the local marathon or the large international baseball games, had underdeveloped.
The purpose for their research was to develop triangle-based EMS personal Digital Assistant (PDA) support system for the mass gathering and to evaluate users’ perceive ease use and use fullness of the systems in terms of Technology Acceptance Model (TAM). The systems were developed based on an established intelligent triage PDA support system and two other forms, the general EMS form from the Taipei EMT and the customer-made Mass Gathering Medical form used by a medical center. 3 nurses and 6 physicians in the medical center, who had ever served in the mass gatherings, were invited to examine the new systems and answered the TAM questionnaire. (Chang et al, 2004) have come out with the result that shows that PDA systems included as many 450 information items inside 42 screens under 6 categories and the great potential of using triage-based PDA systems in the mass gatherings. Overall, most of the subjects agreed with that the systems were easy to use and useful for the mass gatherings, and they were willing to accept the systems.
The results showed the potentially values of new PDA systems in supporting the EMS in the mass gatherings. Overall, most of the subjects more than agreed with that the systems were easy to use and useful for the mass gatherings, and they were willing to accept the systems. The results also assured that the interface of PDA could. The above two system are successful system and are two different systems where they are applied in two different environment. With the help of smart devices that can be either PDA or smart phones we have seen their application in health care are now increasing at different angle.
Many applications are now increasingly using PDA as an additional means of data capture and enquiry. Many applications now have PDA based solutions to enhance existing applications. Based on user requirements, these applications differ. Looking at the comparison between the projects conducted above i. e. (Cacace et al, 2004) and (Chang et al, 2004), compared to the proposed PDA-Rehabilitation management System we can see that here is a huge similarities.
They all involve managing the information system by the use of PDA through wireless technology and have gap or varies in the implementation according to the user requirement and the environment applied. In the country like Malaysia, PDA rehabilitation management system will be very useful when applied in private and government hospitals by reducing hospitalization error. (Sapiah Binti Sulaiman et all, 2006) were having seminar in Malaysia paperless hospital because of the variability of human behavior due to the dynamic nature of cyber space.
They have been discussed that currently Malaysia hospitals are using computer information system as their medium to improve their operation efficiently. In spite the application of these system there are still some problems that are unsolved, and one of those is unavailability of quality healthcare centers in remote areas and still error are there which cause more effects and death to the patients. Therefore, the application of mobile wireless management system as proposed will likely help the operation of hospitals to be performed better than it was before.
WIRELESS TECHNOLOGIES Data in the good old days was only the stepchild of telephone network, the speech being the main child. This scenario gradually changed with data acquiring important place and this gave rise to access technologies. Data volumes to be transported were constantly on the rise due to computers becoming more and more sophisticated and graduating from mainframe to PCs and necessitating ever growing need for computer- to- computer communication at higher and higher bit rates.
All this led to wireless data communication technologies like Wi-Fi and WiMax which combine the techniques developed for modems, LANs, WANs, MANs with the wireless technologies. WHY WE NEED WIRELESS NETWORK According to (Matthew, 2005) has mentioned in his book that “wireless networks are an excellent complement to fixed networks, but they are not a replacement technology. Just as mobile telephones complement fixed-line telephony, wireless LANs complements existing fixed networks by providing mobility to users”.
Servers and other data center equipment must access data, but the physical location of the server is irrelevant. As long as the servers do not move, they may as well be connected to wires that do not move. At the other end of the spectrum, wireless networks must be designed to cover large areas to accommodate fast-moving clients. For this reason the wireless network will bring lots of benefit and speed up the work done in the hospital environment. COMPARISON BETWEEN WIRELESS STANDARDS AND TECHNOLOGIES
We are going to compare between wireless standards to see which one will be the best when coming to apply to the hospital or clinic environment and the one which will be more compatible to the personal digital assistant (PDA). COMPARISON BETWEEN BLUETOOTH AND WIFI The following Table summarizes the comparison between Wi-Fi and Bluetooth BluetoothWi-Fi Frequency Band2. 4 GHz2. 4 GHz, 5 GHz Coexistence mechanismAdaptive frequency hoppingTransmit power control MultiplexingFHSSDSSS, CCK, OFDM Future MultiplexingUWBMIMO Noise adaptationLink layerPhysical layer
Typical output power1-10 mW (1-10dBm)30-100 mW (15-20 dBM) Nominal range10m100m Max one-way data rate732 kb/s31. 4 Mb/s Basic cellPiconetBSS Extension of basic cellScatternetESS TopologiesVarious analogies Maximum signal rate1 Mb/s54Mb/s Channel access methodCentralized: pollingDistributed: CSMA/CA Channel efficiencyConstantDecreasing with offered traffic Spatial capacityFrom 0. 1 to 400 kb/s. m^2About 15 kb/s. m^2 Data protection16-bit CRC(ACL links only)32-bits CRC Max number of devices in the basic cell8 active devices; 255 in park modeUnlimited in ad hoc networks (IBSS); up to 2007devices in infrastructure networks.
Procedures used for the network setupInquiry, Pagead hoc networks: Scan, Authentication infrastructure: Scan, Authentication, Association AuthenticationShared secret, pairingShared secret, challenge-response EncryptionE0 stream cipherRC4 stream cipher Table 2 (IEEE: FERRO, POTORTI, 2004) CONCLUSION OF THE COMPARISON The table below gives us a broad overview of the two most popular wireless standards, with comparison in terms of capacity, network topology, security, quality of service support, and power consumption. However, one of these technologies is better than the other according to the requirements of where they are implemented.
In this project WI-FI will be the best standard to be implemented in hospital environment than Bluetooth because of the noisy is adopted in physical layer not link layer, broad range of connectivity, quality of services, cannot easily affected by obstacles, it is distributed and so many other advantages than a blue tooth as we have seen from the comparison. PERSONAL DIGITAL ASSISTANCE (PDAs) A PDA is a handheld device with organizer and basic computing functions. There are many benefits of using PDA on patient rehabilitation system at point of care; some of the most important advantages are as follows; The ublic healthcare environment is very information intensive (Li. Chang, Fu. Hung, 2005) Doctors and nurses do most of their work at the point of care, which is the patient. This means that they move around between wards, outpatient clinics, diagnostic and therapeutic departments and operating theatres. This movement, together with the fact that most of public hospitals usually only have one central computer terminal per ward, makes it extremely difficult to service all the needs of the doctor and nurse. The use of an ICT in support of this point of care activity of the doctors and nurses is what is relevant to this research.
Mobile device technologies as PDA are quite suitable for supporting the doctors and nurses at the point of care. They are small, lightweight, can be carried around with doctors and nurses, and at the middle of the range devices usually come with some form of networking protocol built into the device. Mobile device technologies are also becoming affordable and offer more processing power and storage capabilities (Andersen, 1997) . Mobile technology ranges from cellular telephones, pagers and PDAs, to very sophisticated tablet computers.
For the mobile computers to be used in a healthcare environment it should have the following characteristics; An interface that supports input via a stylus Expandable memory Software upgradability A method of developing custom built software for the device and network connectivity. PDA-Rehabilitation Management System will be able to bring some solutions that would reduce medication errors, some of the advantages of implement this system are; Making paper records of patients obsolete Such a device (PDA) would make the need for paper record obsolete.
All patient information would be stored electronically and accessed from PDA device and not from only PC assigned to an entire ward. This will make missing folders and folders not containing up-to-date patient information a thing of the past. Not having to struggle with reading illegible notes and other information Generally, doctor’s hand writing is generally quite poor and illegible. This device would be able to make incorrect prescriptions due to bad writing a thing of the past Mobility Patient information would be delivered to PDA device when the nurse or doctors walk into the ward.
This will alleviate the need to consult the slow, outdated PC assigned to the floor. As decision support tool There will be the latest available patient management information and with this can ensure that the patient is treated correctly. INTRANET According to (Goles & Hirschheim, 1997) defined intranet as “private computing networks, internal to an organization, allowing access only to authorized users”. They also mentioned that Intranet may include an internal `web along similar lines to the World Wide Web with multiple websites and web pages, electronic mail, newsgroups, online meeting facilities and any number of applications.
Web browsers are used to navigate across information on the network and, whilst authorized users can cross into the Internet, those outside the organization cannot cross into the Intranet. As the distribution of information is not restricted by time or geographical location and can be viewed by any employee within an organization, the intranet `provides global communication within the corporate environment internally rather than externally. The application of intranet technology in hospital network refers to a private network that is installed within the hospital environment.
The benefit of intranet in the hospital or clinic environment is to allow the organization’s members such as doctors, nurses, physicians or other corporation with authorization. Intranet is installed for the benefit of sharing the company information and shares the company resources among the staff. COMMUNICATION PROTOCOL The most communication protocol that is applied in hospital is TCP/IP, abbreviation for transmission control panel/ Internet Protocol. The use of TCP/IP will be able to increase the security and only authorized person can be able to read the message.
This is because when intranet member send message will be considered as a private message and the content of this message is gone through the process of encryption. Nevertheless, there will be firewalls installed within the intranet for the security purpose mainly for intranet website. Because of this reason the security of the organization will be maintained well when every user of the intranet that would access the internet will have to go through the firewall server. TCP/IP IN CLIENT/SERVER MODEL
Client/Server model is where a client sends a request to the server and the server response to the client within a network. The communication of TCP/IP is taken place in Client/Server is mainly in concept of point-to-point. In other words TCP/IP communicates from one point to another point. It is considered as “stateless” who means the request from the previous is not related to the next request. These allow anyone to use them continuously. CLIENT/SERVER ARCHITECTURE The new feature of the new proposed system may be hardly useful, unless they are fully integrated within the existing hospital information system.
Let us consider in more details the underlying ward architecture: It is a client-server one, where mobile clients on a PDA will have to interact via a web-based interface, communication with the ward server by means of XML documents. The electronic patient record itself is kept as an XML document, divided into three different parts: Personal Data, clinical history, stay. As described by (Lee et al, 2004) that TCP/IP provides a sequenced, reliable, two-way communication mechanism when a mobile device is connected to the network. The TCP/IP server application listens on a specific network port for incoming client requests.
The client application initiates communication with the server by sending a request packet. When the server receives the request, it processes it and responds. After this initial sequenced message exchange, the client and server can exchange data as shown in figure 1 below; Figure 1 (Lee et al, 2004) To exchange data, the server application creates a new socket, which it binds to a particular IP address and port. Then the server waits for incoming requests.
When a new request is received, it spawns a new worker thread to process that request and send a response. The client application also opens a socket and connects to the server on the given IP address and port. The client then sends and receives messages over the network as arrays of bytes. In order to demonstrate the transfer of data between a mobile client and a server using TCP/IP, have developed a simple communication server that receives data from a remote client and echoes it back. This communication server listens for client connections and starts up new threads as needed to handle the client communications.
Each thread is an asynchronous TCP/IP listener. When a client program connects to the communications server, the server creates a new thread and a new state object to hold the data sent by the client. Once the client enters an end marker string, the data is echoed back to the client. Data Synchronization In the proposed system the database server will offers support for mobile subscribers to data publication. The client server will run the database server for the synchronization of data with the mobile device. The synchronization procedure uses the HTTP protocol for data transport in order to be easily accessible on highly secured platforms.
The mobile server will deliver the functionalities necessary to a relational database, transported to a lower scale: robust information storage, query preparation, and connectivity capabilities. The following Figure 2 illustrates the architecture and integration with hospital management software. Integration of hospital management software Figure 2 (IEEE: Bolyai, 2007) The connection type affects the way in which you can synchronize data between the mobile device and back-end systems. Synchronization is possible in two ways: continuously or through a store and-forward method.
Continuous Communication When the connectivity between the client and server is continuous, the synchronization of data between client and server is continuous and can be achieved through synchronous or asynchronous means. The Figure 3 shown in the next page illustrates the continuous synchronization. Continuous synchronization Figure 3 (Lee et al, 2004) Synchronous communication occurs when a request to store data is sent to the server followed by the data to be stored. The data is then placed in a storage area, such as a database, on the server.
In synchronous communication, all data is completely stored before the server acknowledges receipt of the data and frees up the client user interface. In asynchronous communication, however, the data does not have to be completely stored before the server acknowledges the client. Indeed, the server typically acknowledges the request immediately and only subsequently carries out the store request. Subsequently, when the store request is actually complete, the server will initiate a conversation to tell the client it is done.
Store-and-Forward Synchronization When connectivity between a client and server cannot be guaranteed, it is still possible to store and transmit information safely using a method called “store-and-forward. ” Store-and-forward is a powerful method that allows mobile users the ability to work even when they are not connected to a server. The synchronization mechanisms occur when using mobile device, as it allows the automatic and independent data update on both the mobile device and the server.
As soon as the device connected, the data is synchronized, changes being sent from the client to the server, along with the new information being pushed from the server to the mobile device. According to (Bolyai, 2007) described that PDA devices needs more server configurations and maintenance than its alternative method needs more server configurations and maintenance than its alternative method (Remote Data Access), but it is more advantageous for application that involve several mobile devices. As already mentioned, the synchronization method uses HTTP as transport protocol.
HTTP is used because of its high implementation availability on all platforms and because it allows easier through Firewall communication. ELECTRONIC MAILS (E-MAIL) E-mail is a transition of message over communication network; it refers to apply the computer concept to send a letter. Email is used by large number of people on the internet. It handles and manipulates email services on the internet which is done by using SMTP, abbreviation for Simple Mail Transfer Protocol. Email message is usually encoded in ASCII form before it being sent out. Simple Mail Transfer Protocol (SMTP)
It is the protocol which provides the electronic mail service. It is able to transfer the message or mail from one host to another until the mail is arrived to its destination. Mailing list, returning mail and forwarding mail are some of important features of SMTP. When a message or a mail is created, The SMTP will accept it. Then the SMTP will make the use of TCP protocol to send this mail/message to another host. Then, the mail /message will be sent to the local host into the user’s mail account. The basic operation occurs in three stages; Connection set up Mail Transfer Connect closing
Companies that have switched to electronic mail to improve the systems speed communications by avoiding telephone tag and ”flatten” organizations by permitting anyone to communicate regardless of rank. Advocates of electronic mail cite studies showing that it encourages workers at different levels of a company to communicate informally, cutting through layers of corporate bureaucracy, more than does the telephone or paper mail. A middle-level manager is more likely to send a message to the chief executive over the computer than to telephone or place a note in the office mail.
As a result, in many corporations electronic mail is becoming a significant alternative to the fax machine, the telephone and to what electronic mail advocates like to call snail mail, or paper mail. (John, M 1989) The emailing technology was suggested for the system . this is due to the fact that in most hospital, many individuals need to be alerted or reminded of the operation schedule (time, location and any other information that is needed in order for a smooth flow of the operation procedures. and to know well their task and reduce confusion. The doctor, patient and /or patients guardians will be sent an email a day before the operation to avoid any inconveniences that usually tend to occur due to unawareness of the precise information or right information about the operation MOBILE PRINTING From the article that is available at URL www. zebra. com, it has been explained from the article that modern mobile printing systems offer quality and convenience necessary to provide documentation for internal operations and customer service.
Modern mobile printers can create compliance shipping labels, print receipts, invoices and tickets, conduct price audits and markdowns, process credit card payments, connect to wireless networks and even receive print jobs by e-mail-a dramatic evolution from receipt printers whose output quickly faded and curled at the edges. By handling select print jobs with small, mobile printers instead of centrally located stationary units, businesses are improving staff productivity, lowering overall printing expenses and efficiently satisfying their customers at the point of service.
Mobile printers can use a wireless network to receive print jobs, label formats, variable data and information from host systems. The printer has an IP address and appears like any other device in the network, which lets users take advantage of the many excellent software products available for network management and security. Wireless network printing is possible even if the mobile devices such as PDA and other portable smart phones. In the proposed system there have been introduced the use of PDA for directly print out discharge medication lists as an integral part of the daily clinical activities of the medical stuff.
The stuff will be able to send the current medication list and dosages directly from the PDA to the printer via wireless technology port at the time of each patient’s discharge. The patient’s discharge medication list and dosages will be then printed out in user friendly-format, preventing the transcription errors that occurred when this process is being done traditionally by hands. MONITORING IP ADDRESS The explosive growth of varieties of internet and intranet applications has increased the demand for high network system reliability.
Although network managers can improve reliability by adding alternate routing paths before outages occur, a more effective way to manage and ensure the converged network reliability is early detection. As (Sham, J. Jenny, 2010) mentioned that, available statistical data shows that the cost of finding and repairing network system components rises dramatically as detection time increases. The need has emerged for network system monitoring and mobile anywhere-anytime failure notification. It should allow network managers to access network health status through a wireless mobile device.
In the proposed system, administrator will be able to monitor the IP address of the device that are current and have been connected before in the network. The aim of including this monitoring system in hospital environment is for security manner as well as the need to know who is using which device at the hospital network. As we know we will need to protect the patient’s information and their health, also the referred scheme is base on the monitoring of the source IP addresses of the incoming packets from providing any defaults or attacks.
We used a wireless mobile monitoring (WMM) method to monitor an IP network behavior and performance and to notify network managers of any failures through wireless mobile devices. TECHNICAL RESEARCH LANGUAGE C sharp (C#) For the development of PDA-Rehabilitation Management System many languages were compared in order to come up with the one which would be the best and help in the development process of the proposed system. C# is the language that have been chosen because of its modernity, flexibility, type-safety, onsistency, object-oriented, version support, compatibility, scalability support and lots of other features that make developing solution faster and easier. The following are the reasons that made the developer to C# languages; According to (Harvey et al, 2000) has mentioned that Microsoft Visual C# is a powerful but simple language aimed primarily at developers creating applications by using Microsoft . Net framework. It inherits many of the best features of the C++ and Microsoft Visual Basic but few of the inconsistencies and anachronisms, resulting in cleaner and more logical language.
For example, C# uses operator overloading and type-safe enumerations, features that java completely dispensed with. Another thing that made the developer to choose C# over other languages is that C# supports the introduction of XML comments. Far from being just another way to add comments to code, XML comments can actually turn into the developer’s documentation, states (Craig, 2002). Furthermore, the C# compiler has the option to automatically produce XML-formatted code documentation (Harvey et al, 2000) which is using special comment syntax.
C# is also a type- safe, which will help the developer to be fast while developing as uninitialized variables cannot be used and the C# compiler gives notification if any variable is used before it is initialized to some valid value. “Another significant plus for C# is the ease” (Harvey et al, 2000) with which it can make calls to the windows API as an advantage to the developer. While many would argue that C++ is object oriented, C# goes to another level. Even simple data types can be treated as objects, meaning that an int has methods associated with it.
While C++ is an extremely powerful language, it has not typically been considered easy. C# attempts to simplify the syntax to be more consistent and more logical while also removing some of the more complex features of C++. For example, C# does away with pointers. As a type-safe language, C# doesn’t allow direct memory manipulation, so pointers are no longer needed in C#. Header files have also been removed from C#. The namespace and reference operators, and respectively, have been replaced with a single operator, the period (. ). C# also removes memory management issues from the developer by using .
NET’s garbage collection scheme. Items no longer referenced are marked for garbage collection, and the Framework can reclaim this memory as needed. (Craig, 2002) C# contains wireless communication library . Net edition which contain the power features of Bluetooth, IrDA and Wi-Fi technologies to the . Net applications. The Wi-Fi technology is the one that will be able to support the connection between PDA and the server that would be applied in domain area. Discover devices, send and receive files, bulk fide sending and lots of other features like enumerating Wi-Fi networks, measure Wi-Fi networks signal quality etc.
With the release of visual studio 2005, Microsoft delivers on this commitment by applying a single IDE for native, managed, and server-side application development that enables targeting windows Mobile 2003, and windows mobile 5. 0 platforms. Visual Studio 2005’s Smart Device Programmability features offer the most productive Windows Mobile development environment yet. Visual Studio 2005 integrates the best device development features from previous tools and adds several new features including a new, faster ARM emulator, a faster debugger, new data and UI designers, and multiple-platform support.
Developers can target Windows Mobile natively with Visual C++, or they can target the . NET Compact Framework with managed code by using C#. The other reason is programming in C# saves the developer time not only in code writing but also in eliminating errors from that code, as stated by ( jared,2001), C# empowers the user with exceptional debugging abilities through the Microsoft intermediate viewer. This allows the developer to more or less see assembly code, MSIL, for all programming chunks created and therefore create code that is extremely efficient for a given task.
However, java does not provide low level debugging support. Even though C# programming language and java programming language are both garbage –collected runtime-compiled languages with syntax derived from C and C++, C# is described as a hybrid of C++ and java, which was a strong point for the developer to chose it as the language to be used for the development of this system, as it combines some features from C++ and others from java and with its additional features and changes. DATABASE Proposed Database Microsoft SQL Server 2005
It is a relational database management system produced by Microsoft for applications that run on mobile devices and desktop. Its primarily query language, is transact-SQL, an implementation of the ANSI/ISO Standard Query Language (SQL) used by both Microsoft and Sybase. (Microsoft, 2005). SQL (Structured Query Language) is a standard language used to communicate with a relational database. The name may be pronounced either as the letters S-Q-L or as the word “sequel. ” A query is simply a request that is sent to the database for which the database sends some form of response back to the sender.
SQL is the most common language used to form database queries. SQL is considered a nonprocedural or declarative language, which means that you tell the computer the results you want without telling it how to achieve them. For example, if you want the average of a column of numbers, you simply use the AVG function to ask for it. There is no need to count how many numbers are in the column and to divide by that count. The SQL language processor in the DBMS handles all of that for you. (Oaborne, 2005 P. 38).
Oracle Database 10g Oracle has long had a commitment to the IBM mainframe environment. Beginning in 1986, every major release of the Oracle database has been delivered on the mainframe, and Oracle’s most current release, Oracle 10g, is now available on z/ OS 1. 4. The Oracle database is implemented in a large kernel, written in C, which is identical on all platforms. This database kernel gets operating system function through a layer of code (called the “port-specific” layer) that is specific to the platform.
In September 2000 the Oracle database on the mainframe was researched to make a significant improvement in the z/ OS port-specific layer. This chapter introduces the Oracle architecture on z/ OS and how it exploits z/ OS features. Justification for chosen System Database The proposed system database were reviewed and compared with one another to determine the most appropriate database to be used for the proposed system. Microsoft SQL Server 2005 was chosen as the most suitable database to be implemented in this project. There were few factors involved in choosing the most appropriate database for the system.
One of it is that SQL Server 2005 on Microsoft Windows Server provides a platform for enterprise-class relational database and analysis solutions that outstrip Oracle 10g in security, availability, integration with Microsoft Visual Studio, and scalability from small businesses to the largest, and at lower costs which are among the instances need to be built in Uni-made Mobile Edu-Portal. (Microsoft, 2005. ) Beside the above mentioned factors. After an in-depth analysis of Oracle 10g RAC and SQL Server 2005, at Performance Tuning Corporation; the author concludes that: Oracle 10g RAC is an interesting technology with great potential.
However, its high-cost and excessive administrative complexity offsets any potential hardware cost savings obtained by using commodity hardware. SQL Server 2005 on SMP servers with Database Mirroring for high availability is a more cost effective and easier to manage solution than Oracle 10g RAC. SQL Server 2005 can meet the scalability requirements of 99% of customers’ real-world applications, while providing the desired levels of availability. For situations where scale-out architectures are the only choice, both Oracle 10g RAC and SQL Server 2005 should be considered as equally viable options. Thomas, 2005) The developer can make use of SQL server CE or SQL server Mobile edition as a complement to the development tools when. Extending enterprise data management capabilities to Windows Mobile–based devices. Developing applications that store and manipulate significant amounts of data on a mobile device. Needing reliable data replication with mobile devices in environments with intermittent connectivity. But the developer will use SQL Server Mobile Edition includes the largest number of new and improved features in any version of SQL Server CE since the original version, SQL Server CE 1. . SQL Server Mobile Edition includes enhancements over SQL Server CE 2. 0 including: Support for Smartphone devices Integration with SQL Server 2005 and Visual Studio 2005 Synchronization enhancements Increased reliability and performance Faster development of mobile applications METHODOLOGY What is need for a Methodology? Early applications development was not up to the acceptable level in terms of timeliness completion, end product quality and lack in deliverables of the system.
The main problem was that entire application depends on the programmer skills and experience, due to discrepancy among the programmer attitude and lack of communication which jeopardize the company success and fame. This is the main cause to introduce methodology which act as a barrier against the issues and helped the software development to deliver the application on time with high quality (Pressman, 2001). Methodology can be defined as “A collection of procedures, techniques, tools and documentation aids which help the system developers in their efforts to implement a new information system” (Maddison, 1983).
For the justification of the project development methodology chosen, Rational Unified Process is compared to other methodologies to show the limitations of each of the methodologies as well as the advantages and disadvantages relating to the project goals. Comparison of Methodologies Rational Unified Process (RUP) The Rational Unified Process (RUP) was developed by International Business Machines (IBM) and has been in use in major software Development Company which includes IBM itself.
This process defines the development of software to be in bits and as the development continues, additional features are being incorporated into the development process. The process further stated that each bit developed is being tested as though it is a complete application to ensure full functionality of the bit. IBM thus conclude that the time spent to complete the full development life cycle of a single bit in an application development can be referred to as an iteration. (K. Weinmeis & C. VanEpps, 2005 IBM) The figure 4 below shows the architecture of rational unified process.
Figure 4 (Source: http://www. ibm. com/developerworks/rational/library/05/0816_Louis/) Advantages of RUP: Effective risk management as risks involve are discovered at the beginning of the project. Iterative process allows for developing the most critical aspect of the project first and not the entire project. Regular feedbacks to stake holders. Effective management of development processes and occurring changes. Effective quality control of the developed system as a result of iterative process which requires managing development in bits rather than as a whole.
Disadvantages of RUP: Before development, an elaborate documentation is required to analyze the different phases involved. System test processes are repeated for iterations. (Rational Software Corporation, 1998) Waterfall Model The waterfall model gives a development process whereby each phase of the development are developed one after the other, that is, stages in the development process are done successively. Basically, the waterfall model consists of two distinctive improvements: Identify and monitor feedback loops between successive stages to limit the amount of rework to be done.
Implementation of a system prototype in the development process to flow along with the analysis and design. (W. Boehm, 1998) Water Fall Model Figure 5 (Source: W. Boehm, TRW Defence System Group) Advantages of Waterfall Model: The development processes of the system is based on experience, thereby making development to be straight forward as known issues can easily be avoided. Developers can perform better as they can easily see what they want to build. There is flexibility to certain extent. Disadvantages of Waterfall Model:
Responses to unforeseen problems are not defined in this model. The waterfall model is too linear in the development process. There is no flexibility to change resulting code. (W. Boehm, 1998 IEEE) Spiral Methodology The spiral model of software development is based on the refinements of waterfall model and its being used by the department of defense. Individual cycle in the spiral model identify the core objectives of the project. In most cases, emphasis is placed on the elaborated phase, which includes system performance and functionality, and its flexibility to accepting changes.
The contingency plans and the constraints of the project to be developed are also considered. (K. Schwaber, SCRUM Development Process) Spiral Software Methodology Figure 6 (Source: Ken Schwaber, SCRUM Development Process) Advantages of the Spiral Model: The complete cycle of the spiral model is based on the organization goals on the project. Previous projects and future plans on the project are taken into consideration to ensure each development phase meets the designed goals. The spiral model accommodates mixture of other methodologies to achieve the goals of the project, and also ensure that potential risks have been avoided.
This model identifies errors and irrelevant alternatives at the initial stage of the project. Create availability for unexpected changes. Quality objectives are defined in developmental process. There is easy integration of software and hardware to an existing framework. Disadvantages of the Spiral Model: There is need for further elaboration of the model in other to be applicable to the development process. Deliverables are based on risk involved in the project. The spiral model is never complete. (W. Boehm, 1998 IEEE) Critical Evaluation & Analysis for Project Methodologies
Having identified the capabilities of the three methodologies, evaluation could be based on the basic requirements for the development process required for this project. This project is the kind of project which requires its core functionality to be developed first and there can be future additional features. Identified methodologies could be analyzed as follows in the following page: Waterfall model defines a situation whereby stages of the development are done successively which means that if applied; the first stage of the system development must be completed as a prerequisite to the next stage of the system development.
However, it is not the case for the current situation, for the case of this project, as long as a crucial aspect is identified; it can then be the first to be developed. Though the spiral model also focuses on the functionality aspect of development, but it has not clearly stated when development process should end. The spiral model has shown that once a potential risk could be identified, the development process continues until a risk free phase can be identified using other methodologies.
The development of this project would not only focus on the risk involved but also what can be achieved to solve a defined problem within the period of time that has been allocated for the project. Rational Unified Process (RUP) involves a development process whereby project core functionality as identified by the requirements, is being done completely before an additional feature is considered. It allows building the most difficult aspect of the project first, thereby putting the risk in the project into consideration at the earlier stage of the development. Other factors which could be considered include:
The functionality of each component in the system can be ascertained as each bit of the system would undergo a complete development process which is referred o as iteration. For this project, the Timetable/Scheduling aspect would be completely developed and tested while other services would be added thereafter. Additional bits are introduced into the project as the development progresses. Justification for the chosen Methodology – RUP Considering the above methodologies, it could be observed that only Rational Unified Process has a unique approach to developing the system based on the goals and specifications defined.
Consideration can also be given in terms of the phase components of the RUP methodology. The inception component ensures the project is still within budget; elaboration component ensures the complete functionality of each chunks of the system; construction ensures application can at a stage be tested in the user’s environment while the transition components reflects the development in a well documented format which may not be limited to all paper works and brainstorming sessions.
This gives a complete procedure that defines the design and analysis section of the project and it gives a complete and specific approach to this project, unlike the spiral and waterfall models. Moreover, the figure 7 below compares the risk involved between RUP and Waterfall model. Risk comparison between RUP and Waterfall Figure 7 (Source: B. Benyo et al, 2006) RUP constitutes four phases of development, each of that is organized into a number of separate iterations that must satisfy defined criteria before proceeding to next phase.
Inception Phase The primary objective is to scope the system adequately as a basis for validating initial costing and budgets. (Stephen, 2004) The activities which can be done in this phase for this project are: idea generation initial research Drafting up of Project proposal Completion of the project specification form Domain and Technical research Apply fact finding techniques justification of programming language used Learning on programming language chosen Elaboration Phase The elaboration phase is where the project starts to take shape.
In this phase the problem domain analysis is made and the architecture of the project gets its basic form. (Stephen, 2004) Concerning this project, the main activity would be the initial design of the system. Construction Phase The primary objective is to build the software system. In this phase, the main focus goes to the development of components and other features of the system being designed. This is the phase when the bulk of the coding takes place. (Stephen, 2004) Transition Phase The primary objective is to ‘transition’ the system from the development into production, making it available to and understood by the end user.
The activities of this phase include training of the end users and maintainers and beta testing of the system to validate it against the end users’ expectations. The product is also checked against the quality level set in the Inception phase. (Stephen, 2004) Applying to this project, testing of the system and finalize documentation and user manual, would be the main activities. (Word 8,811) (Words in table 549) CHAPTER 3: RESEARCH METHODOLOGY
Research methodology is a way to systematically solve the research problem by logically adopting various steps. Methodology helps understanding not only the products of scientific inquiry but the process itself. Research method aims to describe and analyze methods, throw light on their limitations and resources, clarify their presuppositions and consequences, relating their potentialities to the twilight zone at the ‘frontiers of knowledge’. (Goode et al. , 1981) output helps to inculcate the ability to evaluate and use results of earlier research with reasonable confidence and take rational decisions Doing Benefits of research methodology
Advancement of wealth of human knowledge ‘Tools of the trade’ to carry out research; provides tools to look at things in life objectively Develops a critical and scientific attitude, disciplined thinking or a bent of mind to observe objectively; skills of research will pay –off in long term particularly in the ‘ age of information’ Enriches practitioner and his practices; provides chance to study in depth; Enable us to make intelligent decisions; understand the material which no other kind of work can match As a consumers of research is the best way to learn, to read and think critically, etc. (Cohen et al. , 1980) Research Approach
Questionnaires The methodology that has been adopted to conduct the research for this project involves questionnaires. Selection of questions has been well done and those questions will be addressed to Hospital PDA-Rehabilitation Management System. This method of gathering information,’ questionnaire’, was chosen to be used because it is easy to prepare and questionnaires are a less expensive way to reach people, including people at some distance, as nowadays they can be sent online. Because of the mode of distribution chosen (Through online), this will be done quickly and the data analysis can begin right away.
Kothari (1990) states that: ‘The questionnaire avoids interviewer bias, guiding, and cues that can impact the validity, and reliability of the data collection. Anonymity insures more valid responses. Response quality is better because respondents may gather and consult sources needed to respond well. Below is the sample of the proposed questions and justifications for the questions to be asked: Question1: Age Less than 17 18-21 22-31 32-51 More than 51 Justification: To investigate different age views Question 2: Gender Male Female Justification: To investigate different gender views Question3: Highest Education Primary school
Secondary school High school College Pre-university Univer