A Scalable Healthcare Information System Based on a Service-oriented Architecture

Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.     

医院信息管理中的数据备份研究

如今医院信息系统面临着许多前所未有的难题,其中最难应付的挑战是如何保护、存储和管理数据。这对于医院信息系统来说可谓生死攸关。结合浙大二附院的实际情况,提出一套解决方案。     

论医院信息管理系统

医院信息管理系统是医院管理现代化的必备条件。目前，医院信息管理系统已应用于医院管理、临床医疗及信息服务等方面，并且取得了一定的经济效益和社会效益，其今后的发展方向应以临床、远程医疗和大规模一体化医院信息系统为重点。     

基于Web服务的药品供应链管理系统研究

目的：在基层卫生服务机构实行基本药物零差率销售、采购和配送工作。方法：利用SOA架构与Web服务技术,建立基于Web服务的药品供应链管理系统。结果：实现了不同的医院信息系统（HIS）与药品供应链管理系统的无缝集成,消除了“信息孤岛”。结论：HIS与药品供应链管理系统协同工作,进一步提高了药品供应链管理绩效。     

医疗信息化集成平台在医院的建设与思考

以新华医院医疗集成平台为案例,探讨在现有异源异构信息系统的基础上,基于面向服务(SOA)的开放架构和国际标准,构建以临床数据仓库(CDR)为核心的大型医院统一集成平台,实现来自不同厂商的HIS、LIS、RIS、护理信息系统等的数据整合、信息共享、流程协同,并同步推进临床信息化建设,通过电子病历浏览器和医生门户实现全流程患者信息实时同步共享。结论:为新华医院信息化建设搭建起一个高可靠性,高扩展性、高安全性的基础平台架构,为医院集成平台建设提供了参考[1]。     

综合性医院开展健康管理服务的难点及对策

笔者结合解放军总医院健康医学中心几年来的探索与实践,重点分析了综合性医院在开展健康管理服务过程中易遇到的难点问题,有针对性地提出了成立健康管理培训基地、建设与医院HIS系统相兼容的健康管理信息化平台、嫁接尖端健康管理软件、建设优秀的健康管理服务团队、建立亚健康干预基地、利用专业化的呼叫中心保证全天候沟通服务、无缝连接本院特需医疗服务体系等一系列应对措施。     

网络环境下的医院药学信息服务工作实践

目的：利用网络信息优势,促进医院药学信息服务工作发展。方法：利用医院HIS系统建立局域网药学信息服务平台,及建立药学网站开展药学信息服务工作。结果：形成网络环境下的医院药学信息服务新模式。结论：网络环境下的医院药学信息服务工作更加科学与扎实,在医院药学的发展中将有更重要的地位。     

Design and Implementation of Web-Based Mobile Electronic Medication Administration Record

Patients’ safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System (HIS) to facilitate patients’ safety and to improve the quality of medical care. During the medical care processing, all the tasks are based upon physicians’ orders. In National Taiwan University Hospital (NTUH), the Electronic Health Record committee proposed a standard of order flows. There are objectives of the standard: first, to enhance medical procedures and enforce hospital policies; secondly, to improve the quality of medical care; third, to collect sufficient, adequate data for EHR in the near future. Among the proposed procedures, NTUH decides to establish a web-based mobile electronic medication administration record (ME-MAR) system. The system, build based on the service-oriented architecture (SOA) as well as embedded the HL7/XML standard, is installed in the Mobile Nursing Carts. It also implement accompany with the advanced techniques like Asynchronous JavaScript and XML (Ajax) or Web services to enhance the system usability. According to researches, it indicates that medication errors are highly proportion to total medical faults. Therefore, we expect the ME-MAR system can reduce medication errors. In addition, we evaluate ME-MAR can assist nurses or healthcare practitioners to administer, manage medication properly. This successful experience of developing the NTUH ME-MAR system can be easily applied to other related system. Meanwhile, the SOA architecture of the system can also be seamless integrated to NTUH or other HIS system.     

基于SCRUM模型的医院信息系统项目开发

医院信息系统（HospitalInformationSystem,HIS）是现代医院运营的必要技术支持环境和基础设施建设,但HIS项目的开发还有许多难点,对HIS开发项目难点进行分析,提出了基于TFS平台PScrum模型开发HIS的方法。     

基于商业智能的医院决策支持系统应用

分析目前医院信息系统建设状况和传统数据资源应用存在的问题，基于商业智能（Business Intelligence）建立医院决策支持系统，介绍系统架构和数据仓库模型，阐述系统应用的难点和对策，为医院的科学管理和决策提供支持。     

医院客户关系管理模型的研究与应用

针对医院客户关系管理(CRM)的问题,本文首先分析了医院在市场经济条件下,医院服务方式的转变的必要性,然后以医院统一客户资源管理和医院关系管理建设为核心,提出了一种医院客户关系管理的模型,并结合医院信息系统(HIS),利用计算机信息集成技术,在网络环境下集成医院客户关系管理系统(HCRM)。     

SOA分布式服务在数字图书馆服务模式中的应用

介绍SOA的体系结构、技术特点和当前数字图书馆服务模式的主要转变,建立基于SOA的数字图书馆服务架构模型,并对其中的个性化服务和知识型服务进行详细说明,包括个性化服务组件、学科馆员服务组件的建立等。     

“互联网+健康保险”模式下云平台与医院信息系统对接方案设计及应用

依托互联网技术实现"就医服务+保险金融服务+数据服务"一体化第3方在线服务平台,基于"互联网+健康保险"模式阐述云平台与医院信息系统对接方案设计,对平台应用及其成效进行讨论,指出该平台的使用将提升沟通效率及合作成效。     

The model of "taking electronic medical records as the core for information construction in hospitals"

The development of hospital information has been carried out for nearly 50 years,and originally started as the hospital information system (HIS).1 So far HIS is the most widely and deeply used management system for hospitals in China.2 "General function standard for hospital information system" issued by China's Ministry of Health in 2002 defined that "The hospital information system refers to using of computer hardware and software technology,network communications technology,and other modem technology to comprehensively manage personnel,logistics,and finance in various departments in hospital.Gather,store,treat,extract,transport,aggregate,and process data in various stages of the medical activities,so that provide comprehensive and automatic information management and service to the hospital." As a result,comprehensive management based on personnel,logistics,finance,and hospital overall operation management are always the focus of hospital information construction.3,4     

基于医院信息系统的感染质量考核系统构建

以河南省洛阳正骨医院为例，分析现有感染监测软件特点与存在的问题，阐述基于医院信息系统的感染质量考核系统设计与开发，指出该系统有助于降低感染风险、提高感染管理工作效率。     

基于C/S、B/S混合模式的医院门诊信息系统的设计与实现

通过对门诊信息管理系统需求和门诊业务特点的分析,将门诊信息管理系统分成门诊业务管理和信息查询两部分。由于门诊业务管理部分对系统实时性和安全性的要求较高,因此,设计实现时采用了两层C/S结构,它包括门诊挂号管理系统、门诊划价收费管理系统和门诊药房管理系统。信息查询部分完成专家门诊、特色门诊、门诊医师和门诊科室等信息的查询任务,采用B/S结构。     

LOINC® Codes for Hospital Information Systems Documents: A Case Study

Hospital Information Systems (HIS) handle a large number of different types of documents. Exchange and analysis of data from different HIS is facilitated by the use of standardized codes to identify document types. HL7's Clinical Document Architecture (CDA) uses LOINC (logical observation identifiers names and Codes) codes for clinical documents. The authors assessed the coverage of LOINC codes for document types in a German HIS. The authors analyzed document types that occurred more than 10 times in approximately 1.3 million documents in a commercial HIS at a major German University Hospital. Document types were mapped manually to LOINC using the Regenstrief LOINC Mapping Assistant (RELMA). Each document type was coded by two physicians. In case of discrepancies a third expert was consulted to reach consensus. For 76 of 86 document categories a LOINC code was identified, but for 38 of these categories, the LOINC code was not specific as deemed necessary. More than 93% of our local HIS documents had local document types that could be assigned a LOINC code.     

基于Fuzzy-AHP的医院HIS供应商选择评价

医院信息系统供应商的正确选择是医院信息化成功的关键因素之一,本文通过HIS供应商选择为研究对象,在建立相应评价指标体系基础上,利用层次分析法对不同指标的权重进行赋值,然后在该指标下应用模糊综合评价对不同HIS供应商进行综合评价,根据综合评价的结果,医院可以选择合适的供应商,提高HIS实施成功率。选择评价结果对医院选择HIS供应商具有一定的指导意义。     

医院信息安全分析及措施

随着信息化系统在医院不断深入发展和广泛应用,对医院信息安全提出了更高的要求,本文通过分析医院信息系统建设在物理环境安全、网络安全、主机安全、数据安全、应用安全方面存在的问题,根据国家信息安全等级保护制度提出了医院信息安全防护措施,采用安全技术与管理手段相结合的方法,建立医院信息安全防护体系,最终达到保护医院信息系统安全,更好的为患者提供医疗服务的目的 .     

HIS课程教学体系的研究

医院信息系统(HIS)是一门技术性、实践性很强的新兴学科,是医学信息学专业的核心课程。为促进我国HIS的研究和教学,介绍HIS在医学信息学的地位和作用,分析目前HIs课程教学体系存在的问题,并提出5点具体的改进措施。