THE CATHOLIC UNIVERSITY OF EASTERN AFRICA

Electronic Health Records Management System:

A Case of Nyeri level 5 hospital

Jerry Ochieng Anyumba

Registration Number: 1046093

CMT 301: RESEARCH METHODOLOGIES

Dr. Nicodemus Ishmael Aketch

A RESEARCH IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE

AWARD OF BACHELOR OF SCIENCE DEGREE IN
COMPUTER SCIENCE

APR 2024
 DECLARATION AND APPROVAL
Student

I, the undersigned, declare that this proposal is my work and has not been presented at any other
university or institution for academic credit.

Signature…………………………………
Date……………………………………….
Student Name: Jerry Ochieng Anyumba
Reg. No: 1046093

Supervisor’s Approval

This research proposal has been submitted for examination with my approval as university
supervisor.

Signature…………………………………
Date……………………………………….
Name: Dr. Nicodemus Ishmael Aketch
Faculty: Faculty of Science

Head of Department’s Approval

Department of Computer and Information Science

This research proposal has been submitted for examination with my approval as university
supervisor.

Signature…………………………………
Date……………………………………….
Name: Mr. Michael Kinyua Ndege
Faculty: Faculty of Science

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 ACKNOWLEDGEMENT
I want to offer my sincere gratitude to God for his protection, guidance, and provision of
strength, which have brought me this far in my academic journey and allowed me to complete
this project.
I am grateful to my project supervisor for sacrificing time to attend to all my questions and needs
regarding the completion of this project.

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 DEDICATION

Dedicated to my brother, Benjamin Eric Onyando.

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 ABSTRACT

This comprehensive case study on Nyeri Level 5 Hospital's implementation of an Electronic

Health Records Management System (EHRMS) addresses a critical problem faced by the
healthcare facility - the urgent need for a modernized health records system. The research
objectives were to meticulously analyze the motivations driving the transition to an EHRMS,
focusing on enhancing patient care, streamlining workflows, and empowering data-driven
decision-making processes. The research detailed the implementation process, including criteria
for EHRMS selection, challenges faced during deployment, and strategic approaches to
overcome obstacles. Stakeholder involvement was vital, capturing perspectives from healthcare
professionals, administrative staff, and IT specialists. The study also addressed resistance
encountered during implementation, shedding light on methodologies applied to assuage
concerns. The impact assessment of the EHRMS was a focal point, systematically analyzing
outcomes such as operational efficiency gains, improved record accessibility, and potential cost-
effectiveness. Furthermore, the case study delved into the experiential narratives of both
healthcare providers and patients, providing invaluable insights into user satisfaction,
challenges adapting to the new system, and the overall perception of technology integration into
healthcare delivery. The research utilized both frontend and backend tools for data collection
and analysis, ensuring a robust methodology. Key results and arguments revolved around the
positive impact of EHRMS on daily operations and patient care. In conclusion, the study reflects
on the lessons learned, elucidating best practices and considerations for similar EHRMS
implementations. This research significantly contributes to the broader discourse on successful
EHRMS integration in regional healthcare settings, with Nyeri Level 5 Hospital serving as an
enlightening case study in the ongoing evolution of healthcare technology.

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 TABLE OF CONTENTS
DECLARATION AND APPROVAL ........................................................................................................... i
ACKNOWLEDGEMENT ............................................................................................................................ ii
DEDICATION ............................................................................................................................................. iii
ABSTRACT................................................................................................................................................. iv
LIST OF FIGURES ...................................................................................................................................... v
DEFINITION OF TERMS .......................................................................................................................... vi
CHAPTER 1: INTRODUCTION ................................................................................................................. 1
1.1 Introduction to Electronic Health Record Management Systems ............................................. 1
1.2 Motivation ....................................................................................................................................... 1
1.3 Background ..................................................................................................................................... 1
1.4 Problem Statement .......................................................................................................................... 2
1.5 Aim of Research ............................................................................................................................. 2
1.6 Research Objectives ........................................................................................................................ 3
1.7 Justification of Research ................................................................................................................. 3
1.8 Scope of Research ........................................................................................................................... 4
CHAPTER 2: REVIEW OF RELATED WORK ......................................................................................... 5
2.1 Introduction ..................................................................................................................................... 5
2.2 History of The Research Topic ....................................................................................................... 5
2.3 Review of Related Prototypes ......................................................................................................... 5
2.4 Research Gap to Be Filled by Research ......................................................................................... 8
2.5 Summary ......................................................................................................................................... 8
CHAPTER 3: RESEARCH METHODOLOGY .......................................................................................... 9
3.1 Introduction ..................................................................................................................................... 9
3.2 Methodology for Literature Review................................................................................................ 9
3.3 Methodology for Requirement Specification, Data Collection, and Analysis Techniques........... 10
3.4 Methodology for System Analysis (Current System) ................................................................... 11
3.5 Methodology for System Design (Proposed System) ................................................................... 11
3.6 Methodology for System Implementation .................................................................................... 17
3.7 Methodology for System Testing.................................................................................................. 18
References ................................................................................................................................................... 20
 LIST OF FIGURES
Figure 1 Home Page of Chart Logic System ................................................................................................ 6
Figure 2 MedBook User Interface ................................................................................................................ 7
Figure 3 DFD (Data Flow Diagram) for Proposed System........................................................................ 12
Figure 4 Flow Chart for proposed System .................................................................................................. 13
Figure 5 Sequence Diagram for Proposed System...................................................................................... 15
Figure 6 Entity Relationship Diagram For Proposed System database ...................................................... 16

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 DEFINITION OF TERMS

Electronic Health Records (EHR): Digital versions of patients’ health information, including
medical history, diagnoses, medications, treatment plans, and test results.

Healthcare Provider: An individual or institution that provides medical services, such as doctors,
nurses, or hospitals.

Interoperability: The ability of different information systems, devices, or applications to access,

exchange, and cooperatively use data in a coordinated manner.

Artificial Intelligence (AI): The simulation of human intelligence processes by machines,

especially computer systems.

Machine Learning (ML): A type of artificial intelligence that allows software applications to
become more accurate in predicting outcomes without being explicitly programmed.

Patient Engagement: The process of involving patients in their own care, often through the use of
technology.

Data Security: Protective measures applied to prevent unauthorized access to computers,

databases, and websites.

Data Privacy: The aspect of information technology that deals with the ability of an individual or
organization to determine what data in a computer system can be shared with third parties.

Database: A structured set of data. In the context of EHRMS, it’s where all patient records and
related data are stored.

Front-End: The interface of an EHRMS that users interact with directly.

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Back-End: The part of an EHRMS that handles data storage and business logic, running on the
server.

User Interface (UI): The space where interactions between humans and machines occur. In
EHRMS, it’s what healthcare providers and patients interact with when using the system.

Cloud Storage: A service model in which data is maintained, managed, and backed up remotely
and made available to users over a network.

Authentication: The process of verifying the identity of a user who is trying to access a system.

Authorization: The process of giving a user permission to access a specific resource or function
in a system.

Encryption: The method by which information is converted into secret code that hides the
information’s true meaning.

API (Application Programming Interface): A set of rules and protocols for building and
interacting with software applications.

Server: A computer or system that provides resources, data, services, or programs to other
computers, known as clients, over a network.

Client: A computer or user that requests data or services from a server.

Network: A group of computers and other devices connected together to facilitate

communication and resource sharing.

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 CHAPTER 1: INTRODUCTION
1.1 Introduction to Electronic Health Record Management Systems
This chapter introduces the concept of Electronic Health Records Management Systems
(EHRMS).

1.2 Motivation
The motivation for examining the implementation of an Electronic Health Records
Management System (EHRMS) at Nyeri Level 5 Hospital stems from a profound
commitment to advancing healthcare services in the Nyeri region. Recognizing the
transformative potential of technology in healthcare, this study aims to unravel the
underlying motivations propelling the hospital toward the adoption of an EHRMS.
The aspiration to enhance patient care, streamline workflows, and empower data-driven
decision-making underscores the urgency for a modernized health records system. By
delving into the motivations driving this technological shift, the study seeks to
contribute valuable insights to the broader narrative on the integration of EHRMS in
regional healthcare settings, fostering a deeper understanding of the evolving dynamics
in healthcare delivery.

1.3 Background
Nyeri Level 5 Hospital operates as a vital healthcare institution in the Nyeri region,
catering to the diverse and evolving healthcare needs of the community. In the context
of the hospital's historical reliance on traditional, paper-based health record systems, an
inherent need for modernization has emerged. The challenges associated with manual
record-keeping, including delays in accessing patient information, potential errors, and
limitations in data analysis, have prompted a reevaluation of the hospital's information
management processes. Amidst the global paradigm shift towards technologically
driven healthcare solutions, the background of this study is framed by the hospital's
recognition of the limitations posed by conventional record-keeping practices. The
inefficiencies inherent in paper-based systems have prompted a strategic shift towards
the adoption of an Electronic Health Records Management System (EHRMS). This
background establishes the context for understanding the hospital's transition,
highlighting the imperative of embracing contemporary healthcare standards and

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leveraging technology to address existing challenges. As the healthcare landscape
continues to evolve, this study seeks to uncover the foundational factors driving the
hospital's adoption of an EHRMS, offering insights into the broader implications of
technological integration in regional healthcare settings.

1.4 Problem Statement

The healthcare journey for many patients involves navigating through a complex system
of primary, secondary, and tertiary care settings. This often-fragmented journey requires
clinicians to have access to accurate and timely patient information to make safe and
informed decisions. However, the required information is frequently not available when
needed, leading to ineffective care, repeated tests, and medical errors. For over a
decade, the Electronic Health Records Management System (EHRMS) has been
proposed as a critical solution to meet the growing demands of healthcare systems. With
patients frequently moving between different healthcare providers, the need for a
centralized collaboration system is more vital than ever (Huang, 2010). Some patients
may struggle with medical jargon or may be illiterate, making it difficult for them to
remember their medical records. Moreover, carrying these records while moving from
one hospital to another can be challenging. In countries like Kenya, where hospital
referrals are common, a patient may start their healthcare journey at a local health center
and end up at a national referral hospital like Nyeri Level 5 Hospital. Given the
progressive nature of patients’ health records, having access to a patient’s medical
history is crucial when handling a case. However, this has been a challenge for most
hospitals due to the lack of a centralized system where providers can retrieve these
medical records as needed. .

1.5 Aim of Research

The main aim is to develop a system owned by the Government of Kenya and managed
by the Ministry of Health for electronically keeping health records and sharing them
with healthcare providers in Kenya, like Nyeri Level 5 Hospital.

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1.6 Research Objectives

The primary objective of this research is to comprehensively drive the research project
titled "Electronic Health Records Management System: A Case of Nyeri Level 5
Hospital." This overarching goal encapsulates the entire research process, including data
collection, analysis, drawing conclusions, and ultimately developing a system. The
research objectives are formulated to guide the systematic progression of the study.
The research objectives include:

i. To review the current state of electronic record keeping and sharing among hospitals in
Kenya.
ii. To analyze the challenges that exist in the record-sharing process that is being used now.
iii. To develop a system that will be used by Nyeri Level 5 Hospital and other related facilities
such as insurance to store and share patient records with each other across Kenya.
iv. To carry out testing of the system to ensure full functionality.

1.7 Justification of Research

Indeed, the rapid advancement of technology has significantly improved various
sectors, including healthcare. Continuous investment in technology has led to robust
solutions for many longstanding challenges in the medical field. The effectiveness of
these solutions largely depends on the reliability and efficiency of the technology.
In the past, implementing technology-based solutions was challenging. However, with
most of these challenges now resolved, the adoption of technology has become more
straightforward. The accessibility of technology has improved, and literacy levels have
increased among the majority of people. The integration of ICT into the CBC
curriculum ensures that children are exposed to computers from a young age.
Moreover, infrastructure has been upgraded, making it more efficient and reliable. The
cost of these devices has significantly decreased, making them affordable for most
people. Various systems are already in operation in hospitals, and the introduction of
this particular system will ensure smooth operations among healthcare providers.
This system transcends the constraints of space and time, making it accessible to all
healthcare providers. As a dynamic system, it allows for necessary adjustments over

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time, ensuring flexibility. This adaptability ensures that the system remains relevant and
effective in the ever-evolving healthcare landscape.
Existing research supports these observations. For instance, a study on the digital
transformation in healthcare highlighted the impact of technological innovation on
transforming healthcare business and operations. Another study discussed the emerging
health technologies and how they can transform healthcare delivery. Furthermore,
research has been conducted on the integration of technology into complex healthcare
settings. These studies underscore the significant role of technology in healthcare and
the potential for further advancements in the field. Therefore, the integration of existing
research into this discussion reinforces the importance and relevance of technological
advancements in healthcare. .

1.8 Scope of Research

The proposed solution will be web based rather than a mobile application. Making the
system web based assumes that the hospital has access to the internet and computers.
The system will be accessible to patients at a limited capacity (A patient in this case can
only ‘READ’ their own data). It will also only be accessible to authorized medical
practitioners and this, the Ministry of Health can ensure in conjunction with the Kenya
Medical Practitioners and Dentist Council (KMPDC). The system will also be primarily
developed for Nyeri Level 5 Hospital as a baseline. .

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 CHAPTER 2: REVIEW OF RELATED WORK
2.1 Introduction
This chapter provides a review of what is known regarding the topic and other points of
view regarding this topic. The review aims at sharing results of other studies closely
related to the study and helping to establish the importance of it which then allows for
better comparisons.

2.2 History of The Research Topic

The world is continuously being affected by pandemics of all proportions. Developing
countries
are the most affected by this for reasons such as inadequate resources to improve their
healthcare facilities. There is still a lot of room for development and deployment of ICT
to improve healthcare services in Africa.
In 2012, a study to document the availability of Electronic Health Records, in sub-
Saharan Africa, and highlight the challenges hindering their wider adoption in the
region was carried out.

2.3 Review of Related Prototypes

2.3.1 ChartLogic
ChartLogic is an electronic health record system that captures the clinical encounter
electronically without making you change your workflow. By combining easy-to-use
technology with a tool that users have been using all along—their voices—they’ve
made charting more efficient than ever.
Everything from medical history to diagnosis codes to referral reply letters can be
accessed from this screen, making it easy for users to complete a comprehensive note
without getting lost in forms and files.

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Figure 1 Home Page of Chart Logic System

2.3.2 Medbook
This is a universal health platform that allows a user to securely store, access and share
their medical records at the touch of a button. Other than record keeping, Medbook
offers its users a variety of other services such as connecting users to insurance plans.
With your digitized medical history standardized to a universally accepted format,
Medbook plugs you into a diverse pool of medical practitioners as well as pairing you
with an insurance provider who will meet your precise needs. It proposes an interactive
medium to allow various stakeholders to access the patient data securely utilizing the
latest technologies in data encryption and access authentication (Forgionne & Kohli,
1995). Medbook can predict, prevent or at the very least, minimize the physical and
financial burden that epidemics and outbreaks cause countrywide. For insurance firms,
the challenge faced is not just that most medical records are paper-based and scattered
in many institutions, but for it, incidences of fraud claims have risen dramatically. With
the Medbook platform, the immediate benefit is the markedly reduced expenditure
commitment to verifying claims. It also replaces the billing system employed making
your operations more effective and efficient. The options to log onto this system are as a
doctor or a patient.

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Figure 2 MedBook User Interface

2.3.3 AfyaEHMS
AfyaEHMS was first implemented in Machakos County in Kenya and later rolled out to
different levels of healthcare facilities within other counties. Machakos County hospital
was using an existing ICT system but were motivated to install a Ministry of Health-
backed system in order to lower costs, improve system performance, and increase
access to technical support (Muinga, 2018) The implementation of this HER in
Machakos encountered some difficulty because of a number of reasons such as; rather
than switching completely over to the new system, the manual paper file 10 system ran
in parallel. This led health workers to choose the paper system over the electronic
system. The challenge was compounded by the feeling that the EHR was complex to
use and health workers had not received adequate training. Also, there were workflow
challenges that made the EHR incompatible with the clinical workflow, making it
difficult to use the system effectively.

3.4 Emerging Trends and Patterns

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The field of Electronic Health Records Management Systems (EHRMS) is rapidly
evolving with advancements in technology.
There is a growing emphasis on the interoperability of EHRMS, enabling seamless
exchange of patient data across different healthcare providers and systems.
These technologies are increasingly being integrated into EHRMS to provide predictive
analytics, improve decision-making, and automate routine tasks.
There is a shift towards more patient-centric EHRMS, with features that allow patients
to access their own health records, schedule appointments, and communicate with
healthcare providers.
As EHRMS handle sensitive patient data, there is an increasing focus on enhancing data
security and privacy measures.

2.4 Research Gap to Be Filled by Research

While there is extensive research on EHRMS, there is a gap in the literature when it
comes to their implementation and use in specific settings such as Nyeri level 5
hospital. This research aims to fill this gap by exploring the implementation and use of
EHRMS in this specific context. It will provide insights into the unique challenges and
opportunities associated with implementing EHRMS in such settings, and contribute to
the development of best practices for similar future implementations.

2.5 Summary

In this chapter, we reviewed previous published works on the topic, existing systems
that relate to the research topic and upcoming trends in technology. EHRMS that exist
have been found very valuable by this research since they have acted as a guide on
which features are existing and work, and the features that need improvement or are
missing. The next chapter will present the findings of the research.

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 CHAPTER 3: RESEARCH METHODOLOGY
3.1 Introduction
This chapter will discuss in detail the research methodology that will be adopted in this
study. We shall discuss the methodology for literature review and requirement analysis.
Therefore, this chapter shall be demonstrating the methods that shall be used to guide
the process during the period of the project and to a successful project.

3.2 Methodology for Literature Review

The literature review is a crucial component of our study on Electronic Health Records
(EHR) Management Systems, focusing on Nyeri Level 5 Hospital. It serves as a means
to contextualize our research within the broader scholarly discourse and to gain insights
from existing knowledge in the field.
To conduct this review, we will utilize documentary analysis and internet searches to
gather relevant information published between 2018 and 2023. This timeframe ensures
that we capture recent developments and trends in EHR implementation and
management. Our sources will include academic databases, healthcare journals,
reputable websites, as well as internal reports and documentation from Nyeri Level 5
Hospital.
The review will encompass various dimensions of EHR systems, starting with adoption
and implementation strategies. We aim to understand the methodologies and best
practices employed in introducing EHR systems within healthcare settings, particularly
focusing on the experiences and strategies relevant to Nyeri Level 5 Hospital.
Furthermore, we will explore the perceived benefits and challenges associated with
EHR systems. By examining empirical studies and practical applications, we seek to
uncover the impacts of EHR adoption on healthcare delivery and patient outcomes at
the hospital. This includes assessing factors such as efficiency gains, improved clinical
decision-making, and potential drawbacks such as workflow disruptions or data security
concerns.
User experience and satisfaction will also be a key focus of our review. We aim to
understand the perspectives of healthcare professionals involved in EHR utilization at
Nyeri Level 5 Hospital, including their views on system usability, training
effectiveness, and the overall impact on their daily workflows.

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Additionally, we will delve into the integration and interoperability aspects of EHR
systems. This involves examining how these systems interface with other healthcare
information technologies and external systems, and the implications for data sharing,
communication, and coordination of care.
Lastly, we will address security and privacy considerations inherent in EHR
management. This includes analyzing the measures implemented to safeguard patient
data and ensure compliance with regulatory standards, such as HIPAA regulations,
within the digitalized environment of Nyeri Level 5 Hospital.
By synthesizing findings from diverse sources, our literature review aims to provide a
comprehensive understanding of the current status and challenges of EHR management
systems, with a specific focus on their application at Nyeri Level 5 Hospital.

3.3 Methodology for Requirement Specification, Data Collection, and Analysis Techniques

3.3.1 Methodology for Requirement Specification

The requirement specification for the Electronic Health Records Management System
(EHRMS) at Nyeri level 5 hospital will involve a detailed collection of all requirements
that will be imposed on the design and verification of the EHRMS. This will include
system requirements, functional requirements, non-functional requirements, and user
requirements. The specification will also contain other related information necessary for
the design, verification, and maintenance of the EHRMS.

3.3.2 Data Collection Methods

Data collection for this research will involve the use of surveys, quizzes, and
questionnaires, interviews, focus groups, and direct observations. These methods will be
used to gather data from various stakeholders including hospital management,
healthcare providers, and patients.

3.3.3.1 Questionnaires
Questionnaires will be used to gather data from a larger group of respondents about
their attitudes, experiences, or opinions regarding the current health records

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management system and the proposed EHRMS. This will help in collecting both
quantitative and qualitative information.

3.3.3.2 Interviews
Interviews will be conducted with key stakeholders such as hospital administrators,
healthcare providers, and IT staff. The aim of these interviews will be to gather in-depth
information about the current health records management system, challenges faced, and
expectations for the new EHRMS.

3.4 Methodology for System Analysis (Current System)

Given the importance of conducting a system analysis to create a desired system for the
user, we shall involve the users in this process. We shall do a feasibility study by
comparing the cost and gains of the current system to others. We then shall gather user
requirements, and functional and non-functional requirements. We shall finally perform
the task analysis and the data flow diagram to show how data flows in the current
system.

3.5 Methodology for System Design (Proposed System)

In line with the insights from Nwakwama Ifeanyi Cosmos, the design methodology will
determine the operational aspects of the Electronic Health Records Management System
(EHRMS) at Nyeri level 5 hospital. This includes the hardware, software, and network
infrastructure; the user interface, forms, and the necessary database. In this phase, we
will design the database, flow charts, sequence diagrams, use cases, context diagrams,
collaboration diagrams, and pseudocodes that will underpin the proposed EHRMS.

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3.5.1 Dataflow Diagram

Figure 3 DFD (Data Flow Diagram) for Proposed System, , Ochieng, J.A.,2024

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3.5.2 Flowcharts

Figure 4 Flow Chart for proposed System, , Ochieng, J.A.,2024

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3.5.3 Sequence diagram

Figure 5 Sequence Diagram for Proposed System, , Ochieng, J.A.,2024

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3.5.5 ERD diagram

Figure 6 Entity Relationship Diagram For Proposed System database, Ochieng,

J.A.,2024

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3.6 Methodology for System Implementation

The actual system will be developed using the following technologies:

3.6.1 Front-end
The front-end, or user interface, is what users interact with directly. It will be built
using:

3.6.1.1 HTML
This is the standard markup language used for creating web pages. It will be used to
structure the content on the web pages of the EHRMS.

3.6.1.2 CSS
This is a style sheet language used to describe the look and formatting of a document
written in HTML. It will be used to style the HTML elements on web pages.

3.6.1.3 JavaScript
This is a high-level programming language that enables interactive web pages. It will
be used to add functionality to the web pages, such as form validation, dynamic content
loading, and user interaction.

3.6.2 Back-end
The back-end, or server-side, is where the application’s data and core logic reside. It
will be built using:

3.6.2.1 Java
This is a versatile and powerful programming language that can be used for developing
a wide range of applications. It will be used to write the server-side logic of the
EHRMS, such as handling HTTP requests, performing CRUD operations on the
database, and implementing authentication and authorization.

3.6.3 Database Technology

3.6.3.1 MySQL
This is a popular open-source relational database management system. It will be used to
store and manage the data for the EHRMS, such as patient records, user accounts, and
medical reports.

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3.7 Methodology for System Testing

3.7.1 Testing Techniques

Testing is a crucial step in the development of the EHRMS to ensure that the software is
free of defects, meets user requirements, and functions as intended.

3.7.1.1 Unit Testing

Each module or component of the EHRMS will be tested independently to verify its
functionality and performance. This involves checking individual components of the
software at the code level to ensure they work as designed. Unit testing can be
conducted manually, but automating the process can speed up delivery cycles and
expand test coverage. It also makes debugging easier because issues found earlier take
less time to fix.

3.7.1.2 Performance Testing

Performance testing is an essential part of the development process to ensure that the
EHRMS can perform its intended functions under various workloads and stress levels.
This involves comparing system performance metrics such as response time,
throughput, and resource utilization to established performance benchmarks.

3.7.1.3 Acceptance Testing

Acceptance testing is conducted to ensure that the EHRMS meets the needs and
expectations of end users and stakeholders. This involves testing the system from the
end user’s perspective and ensuring that it meets all functional, performance, and
usability requirements.

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3.8 Methodology for System Deployment

We will deploy the EHRMS as a web application, which provides several advantages.
Web applications can be accessed from any device with a web browser and an internet
connection. This means that users can access the EHRMS from their computers, tablets,
or smartphones, regardless of their operating system. This can be summed up as
accessibility.
Updates and bug fixes can be rolled out easily and users can access the updated version
immediately, without needing to manually update the software on their devices.
Web applications can be easily scaled to accommodate a growing number of users. This
is particularly important for an EHRMS, which may need to handle a large amount of
data and a high number of concurrent users.
The deployment process will involve several steps, including setting up a web server,
configuring the database, installing the EHRMS on the server, and testing the
deployment to ensure everything works correctly.

3.9 Summary
This section outlined the methodology of study, a longitudinal analysis using
observations, interviews, and documentary analysis for data and requirements
collection. A number of selected technologies, HTML, CSS, JavaScript for the front-
end and Java, MySQL for the back-end will be used to develop the system. We shall
also employ software like Visio Paradigm for UML diagrams. The system will be
deployed as a web application to ensure maximum accessibility for users.

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