Hospital Information System (Hospital InformaTIon System, HIS) refers to the use of electronic computers and communication equipment to provide the collection, storage, processing, extraction and data exchange of patient diagnosis and treatment information and administrative management information for all departments of the hospital, and meet all authorization The functional requirements of the user. With the rapid development of medical technology and information technology, hospital information systems are also constantly developing and improving. It is foreseeable that the scope and level of application of hospital information systems in hospitals will have an increasingly important impact on the reform and modernization process of hospitals .
1. Problems
(1) The functional department of the hospital information system is not sound enough. Among the large and medium-sized hospitals, some hospitals have set up special functional departments (such as information department, computer center, network center, microcomputer center, medical engineering department, etc.), but the functional departments of smaller hospitals are not perfect.
(2) The application scope of the hospital information system is not wide enough. Most hospitals have established simple small local area networks of related business departments, such as financial management, medical record management, outpatient fees, drug management, equipment management, etc. Statistics show that only one-third of domestic hospitals have systematically developed and applied hospital information systems.
(3) The management and maintenance of the hospital information system is insufficient. Some hospital leaders lack a strong awareness of informatization, cannot adapt to the requirements in management thinking, and are accustomed to the old management model. They do not understand the importance of hospital information management and the important role of HIS in the management of the entire hospital. It caused a slow progress in the entire HIS construction process, which affected the effective construction of the hospital information system.
(4) The safety of hospital information system cannot be ignored. There are hidden security risks in network operating systems, development platforms, and database systems.
2. Application recommendations
(1) Continue to expand clinical information systems. Including: (1) Clinical monitoring information system: To develop and apply clinical monitoring information system, it must be able to connect with clinical monitoring equipment, directly obtain various signs information of patients, and provide auxiliary diagnosis and treatment information for the treatment of diseases. (2) Surgical anesthesia information system: The surgical anesthesia information system will meet the needs of anesthesiologists for information management of surgical patients, and can provide support for the information management of the three stages of preoperative, intraoperative and postoperative. (3) Nursing information system: Under the overall nursing model, it is required to comprehensively record the patient's condition and comprehensively evaluate the patient's health status; propose a nursing diagnosis for the problem; based on the diagnosis, take corresponding physiological and psychological nursing measures to reduce the number of nursing documents Working time, improve the quality of nursing work.
(2) Adhere to the management-oriented HIS information integration design. Including: (1) Resource system framework design: divide the hospital HIS network information resources into two categories from the acquisition and application of resources, one is the business application information generated by the transaction processing system, and the other is the induction and reorganization based on the business information. Management, decision-making and application information. (2) Framework design of statistical indicator system: Based on hospital HIS data resources, the hospital statistical indicator system under the network environment is constructed according to a three-dimensional framework and expanded in a tree structure according to management application requirements. The three-dimensional framework is the basic index, link index and terminal index. (3) Technical platform framework design: The main contents include business information management application model design, information integration platform design, integrated information service application design, statistical index standardized database design and Web-based technical service platform design. (4) Information model design for management applications: The management application information model is composed of four core classes, namely: management activity class, participant class, participating role class :, and information topic class. (5) Build a statistical data resource base based on ODS: Building a statistical data resource base based on ODS (OperaTIonal Data Store, ODS) is the data foundation for developing management applications. Its biggest feature is that it has the characteristics of transaction processing and analytical processing at the same time. On the one hand, it is relatively close to the existing business data. On the other hand, it is separated from the business data collation. It is organized according to the purpose of serving management and decision-making. .
(3) Establish and improve the medical insurance system. In general, it can be divided into two categories: the first category is contracting. The second category is the detailed examination system: but no matter which method, the outpatient reimbursement system is not much different. After the implementation of medical insurance, for large hospitals, due to the increase in the proportion of outpatient expenses, it is estimated that it will have a greater impact on the number of outpatients. From the analysis of disease types, it should be that the number of ordinary patients is reduced more, and the large-scale examination of ordinary patients will be significantly reduced, and the number of serious and difficult patients is not affected. The total income of outpatients and inpatients in general hospitals accounts for half of each. The reduction in outpatients will have a greater impact on the total income of hospitals.
(4) Establish a telemedicine consultation group. Telemedicine will gradually move towards a grouped structure, and then realize medical consultations and information exchange with all countries across the country and even through the Internet. The remote consultation technology will realize that patients can get consultation and treatment from famous experts without leaving the house, which saves a lot of costs for patients.
(5) Study laws and regulations suitable for China. The establishment of HIS is still being improved. In order to avoid unnecessary medical disputes and protect the legitimate rights and interests of patients and medical staff, we can learn from advanced foreign experience, combine with China's actual conditions, and study relevant HIS related to the characteristics of our hospital management. Laws and regulations.
3. Future trends
(1) Continue to expand three types of technology. The first is the doctor-patient relationship management system; the second is the application of various self-service equipment, such as automatic registration machine, payment machine, self-service test machine, etc .; the third is the automatic drug placement system. With the continuous deepening of the reform of the medical system, the medical market environment has undergone tremendous changes. For decades, based on welfare, the stable and stable medical pattern has been broken and replaced by "three-funded" hospitals.
(2) Guarantee the optimization of medical quality. Expand to two key points of clinical path system and intelligent knowledge base.
(3) Mobile medical workstation. Taking full advantage of the existing information platform, centralizing various modern communication technologies such as wireless networks, PDAs, and automated equipment such as automatic pendulum dispensers and laboratory automation systems into the digital construction of hospitals can reduce work intensity and improve work efficiency. Mobile medical workstation will be a magic weapon to improve work efficiency.
(4) The medical records will be electronic. Such as: (1) Electronic medical records are not simple electronic paper records; (2) Research must focus on top-level design; (3) Electronic medical records research must ensure the safety of medical records; (4) Electronic medical records research should promote the construction of laws and regulations; (5) Establish an electronic medical record validity certification system.
(5) Build software and hardware architecture, and realize regionalization of the network. With the development of hospital information construction, the establishment of a regional medical information system has gradually been put on the agenda.
(6) The data warehouse promotes the scientific decision-making of the dean. First of all, the work efficiency has been improved, the work process has been optimized, manpower and time have been saved, and the utilization level of health resources has been improved. The second is the improved service quality. The hospital has regular and orderly management, transparent and reasonable charges, and convenient and fast medical treatment, so that patients can really get benefits, increase the public trust of the hospital, and improve the social image of medical staff. The third is that the management level has been improved.
In short, the hospital information system will develop in four areas: (1) establish a sound electronic medical record system; (2) establish a medical image archiving and communication system (PACS); (3) establish a telemedicine system; (4) integrate with a medical insurance system . At the same time, with the rapid development of domestic hospital information systems, it is the development trend of hospitals to use bar code technology, radio frequency identification technology, wireless network technology, computer prescription input and reasonable medication monitoring systems to enhance medical safety.
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