Knowledge Based System for Pre-Medical Triage Treatment at Adama University Asella Hospital

Health problems touch every aspect of human life such as health condition, working environment, family life, social relations, economic and political activities of every endeavor. However, health care services are not efficient throughout the world as it is required to be. While the burden of chronic disease in sub-Saharan Africa is very high, the current density and distribution of the health workforce suggested that sub-Saharan Africa can't respond to the growing demand of chronic disease care. Ethiopia is one of the developing countries in sub- Sahara Africa. In Ethiopia the health problems are a hot issue for every stakeholder, to minimize the death of citizen by different chronic diseases. In the health domain the gap exists due to low patient handling capacity of health institutions and the growing demand of individuals who need response from the health sectors. The major challenge for health service in the country is shortage of skilled manpower in the health sector. In Ethiopia the number of health professionals and patients' demand are disproportionate. Some indicators of these problems are holding capacity mismatch, which includes emergency department (ED) over-crowded by number of patients', ambulance service problem and boarding of admitted patients due to lack of hospital beds. Most patients experience very lengthy wait before receiving care, and some leave without getting treatment. Lacks of enough knowledge among primary health care workers, allocation of insufficient budgets for health sectors and the absence of adequate awareness about epidemic illnesses are the other challenges that create obstacles to address the health care services satisfactorily. The factors are the challenges that affect the quality of health care service in hospitals and reduce the quality of decisions made by physicians in the domain area. As a result, objective of the study was to investigate the applicability of rule-based reasoning approach in the development of knowledge based system for hospital triage service so as to improve the quality of decision made by general practitioners, to provide effective and efficient services to the patients and to improve shortage of human expert in specific domain area. To achieve this objective, domain knowledge is acquired using semi-structured interview technique is implemented. Domain experts are selected from Adama University Asella hospitalHealth problems touch every aspect of human life such as health condition, working environment, family life, social relations, economic and political activities of every endeavor. However, health care services are not efficient throughout the world as it is required to be. While the burden of chronic disease in sub-Saharan Africa is very high, the current density and distribution of the health workforce suggested that sub-Saharan Africa can't respond to the growing demand of chronic disease care. Ethiopia is one of the developing countries in sub- Sahara Africa. In Ethiopia the health problems are a hot issue for every stakeholder, to minimize the death of citizen by different chronic diseases. In the health domain the gap exists due to low patient handling capacity of health institutions and the growing demand of individuals who need response from the health sectors. The major challenge for health service in the country is shortage of skilled manpower in the health sector. In Ethiopia the number of health professionals and patients' demand are disproportionate. Some indicators of these problems are holding capacity mismatch, which includes emergency department (ED) over-crowded by number of patients', ambulance service problem and boarding of admitted patients due to lack of hospital beds. Most patients experience very lengthy wait before receiving care, and some leave without getting treatment. Lacks of enough knowledge among primary health care workers, allocation of insufficient budgets for health sectors and the absence of adequate awareness about epidemic illnesses are the other challenges that create obstacles to address the health care services satisfactorily. The factors are the challenges that affect the quality of health care service in hospitals and reduce the quality of decisions made by physicians in the domain area. As a result, objective of the study was to investigate the applicability of rule-based reasoning approach in the development of knowledge based system for hospital triage service so as to improve the quality of decision made by general practitioners, to provide effective and efficient services to the patients and to improve shortage of human expert in specific domain area. To achieve this objective, domain knowledge is acquired using semi-structured interview technique is implemented. Domain experts are selected from Adama University Asella hospital using purposive sampling instrument. In addition, secondary data is acquired from different sources such as journal articles, health care guidelines, manuals, books and different websites. The conceptual model of the knowledge based system used a decision tree structure which is easy to understand and interpret the procedures involved in patient diagnoses. Based on the conceptual model, the prototype is developed with LPA WIN prolog by using 'if – then' rules. The prototype developed uses backward chaining to infer the rules and provide appropriate recommendations. Generally, the performance of the prototype knowledge based system has got good acceptance by the system evaluators. According to the system evaluators 85% of the users are satisfied with the prototype. In addition, the performance of the system is evaluated by using predictive validation techniques with twenty test cases. The results of the validation test case indicate that the prototype is about 80% accurate. In the end, some recommendations are forwarded such as the integration of rule based reasoning with case based reasoning to improve the performance of the inference engine, to develop the knowledge based system in different local languages to enable the users to communicate using their own local language and to further strengthen the study in the domain area.