PACS与HIS融合方法的研究

目的：探讨PACS与HIS的融合方法。方法：首先介绍PACS与HIS融合的意义和具体目标,然后详细阐述直接访问接口或数据库、基于中间表、基于中间件、基于HL7、基于CORBA的分布式集成等5种PACS与HIS融合方法。结果：5种方法各有特点,可以实现PACS与HIS的信息交换和数据共享。结论：各个医院要根据具体情况选取不同的融合方法。随着国内HIS和PACS产品的不断标准化．基于HL7和基于CORBA的分布式集成这2种融合方法将是未来的发展趋势。     

PACS系统与校园网的融合

PACS与HIS融合组成医院信息系统,附属医院信息系统与校园网无缝连接形成校园网体系,三者都是“军字一号工程”的重要组成部分。本文着重就PACS在校园网中的作用与地位,如何与校园网有机融合以及融合中的技术关键与要求,进行阐述。     

医院信息集成平台的构建与应用

本文详细阐述了以中间件为解决方案的医院信息集成平台的架构及平台建设过程,并以医院信息系统(HIS)与医学影像系统(PACS)/放射学信息系统(RIS)集成为例,介绍各系统间的信息交换流程以及符合HL7标准的流程消息定义。该平台有效突破了HIS点对点的互联方式的局限性。     

PACS在应用中的功能维护

PACS(Picture archive and communication system，医学影像存档和转输系统)是现代医院综合化信息管理中的一个重要组成部分。我院已在2000年通过“军卫一号”信息工程系统初步实现医院信息化(HIS，Hospital information system)建设，继而实施影像数字化管理，最终“军卫一号”信息系统与PACS合并，实现医院全面综合化信息管理。我院于2003年开始PACS建设，现总结该系统在我院这一段时期应用中的常见故障以及功能维护经验，以进一步提高医院PACS的使用效果及全面建设。     

我院HIS/PACS软件集成方案的设计和应用

做好医院信息系统（HIS）与医学影像与传输系统（PACS）整合,增强医院各信息系统之间的信息交互,提高工作效率,是PACS应用成功与否的关键。本文阐述了我院HIS与PACS集成后具备的典型操作流程,介绍了以中间表方式实现了HIS与PACS的集成,该集成方法开发效率高、简单。集成后的系统运行稳定,得到了临床医生的一致好评。     

体检信息系统和“军卫一号”无缝链接的实现

目的:为全面配合体检中心工作,实现引进的医院体检信息系统与"军卫一号"系统的无缝链接。方法:通过视图等方法实现该系统和医院HIS、PACS、LIS的无缝链接。结果:系统实现了体检业务管理的自动化、规范化、网络化、数字化。结论:在完成和医院HIS、LIS、PACS接口时注重实现简单化、效率化,使体检信息传输过程流畅、更有条理,极大地提高了体检工作效率。     

浅谈基于“军卫一号”的PACS

目的：探讨、研究PACS与＂军卫一号＂工程（HIS）的融合方法。方法：通过创建中间表、触发器、视图等,将PACS的表结构整合到＂军卫一号＂工程使用的Oracle数据库中。结果：PACS与＂军卫一号＂工程数据同步,硬件投入少,简单可行。结论：医院在实施PACS前,必须要做好需求分析、业务流程的优化,高层次地发挥HIS的可扩展性。     

PACS建设和应用中的几个关键问题

为适应医院改革和医院信息化建设新形势,作者单位于1999年与北京天健公司合作建成了全军中心医院的第一个PACS系统,并与HIS完满融合,形成了规模较大的医院信息系统,实现了管理信息与图像间的顺畅交流。笔者从所在单位PACS运行两年来的实践,探讨了PACS建设和应用中的几个关键问题。     

PACS与HIS的融合技术

目的:探讨基于国际通用DICOM标准的PACS与HIS的融合技术.方法:将标准DICOM设备直接连接到影像服务器,非DICOM的数字设备,使用相应的DICOM网关或接口连接到影像服务器;使用RIS接口将DICOM中的病人信息与HIS中的病人检查信息匹配,并在HIS中嵌入PACS的OCX控件.结果:全院信息网络中的任何一个工作站,在浏览病人图像的同时均可查看此病人相应的临床信息;同样,在HIS中增加了病人的影像信息,临床科室作医嘱或诊断时,可打开病人的影像信息作参考.讨论:与HIS融合是建设PACS的关键,因为通过与HIS融合可以解决医学影像的传输、管理和应用等问题.福州总医院成功建设全院性PACS表明,国内医院已完全有条件建设全院性的PACS,国产PACS也完全能够实现与HIS的完全融合.     

探讨HL7标准在HIS与PACS/RIS集成中的应用

目的在医院信息系统(HIS)与PACS/RIS(Picture Archiving and Communication System/Radiology Information Systen)中实施HL7医疗信息数据交换标准,解决系统间数据共享的问题,同时对HL7标准的优缺点进行分析讨论。方法分析HL7消息格式,结合医院现有的HIS与PACS/RIS数据交换流程,设计基于HL7标准的HIS与PACS/PIS接口引擎,通过实际应用来分析HL7标准的优缺点。结果实现了HIS与PACS/RIS的集成,方便了医院各科室信息的统一管理与共享,提高了影像科的工作效率。结论 HL7标准可进行多应用系统间的文件和数据交换,使集成的系统可扩展性和可维护性大大提高,但仍存在一些规定含糊不清,有待进一步发展和完善。     

HL7应用研究与数字医院建设

本文简述了目前我国医院信息系统之间数据交换与信息共享存在的问题,在研究和分析国际医疗卫生领域信息系统指标体系及交换协议（HL7）的组成与数据结构基础之上,提出了采用HL7消息构造器/解析器的方法,实现HL7本土化应用并保持与国际接轨,以解决我国医院信息系统之间数据交换与信息共享;建议以本土化HL7为基础,全面进行我国数字医院的建设.     

基于XML的HL7消息处理技术

随着医院信息系统的规模扩张,其各个子系统间的通讯需求引发了异质系统间的信息整合1"-7题。解决这一问题的有效途径是,在建设医院信息系统时,引入国际通行的医疗信息交换标准HL7。新版协议HL7 v3是在面向对象的方法学指导下构造的,它将XML作为首选的消息编码方式。论文研究了HL7 v3的消息机制,阐述了一种基于XML的消息处理技术,并通过实例验证其可行性。     

基于HL7的LIS与HIS集成改造

本文介绍了我院的实验室信息系统（LIS）与医院信息系统（HIS）的集成改造过程。此次集成改造采用HL7引擎的中间件进行异构系统之间的集成,即在数据共享双方各增加一个应用服务器,安装服务组件,实现数据存取、数据加工、TCP通信和HL7通信等功能。此次集成方式与以往的中间库模式集成相比,大大提高了系统的规范性和独立性。基于HL7引擎这一中间件的异构系统之间的集成,必将成为今后的发展趋势。     

医学影象信息一体化的发展

随着整个社会和医疗信息化和网络化的发展,HIS和RIS已成为医院信息化和网络化的重要组成部分,二十多年来PACS从无到有,从小型的PACS到整个医院及地域性广义的PACS,发展非常迅速。美国的PACS建设起步早,目前已趋向于不同成像模式和所有医院科室都使用同一信息系统、共通的登录网点和一致的用户界面,其地域性医疗信息系统一体化进程均发展非常迅速。PACS今后将成为医院和社会整体信息网络一个重要组成部份,这将是数字化放射学发展的基础。     

The Brazilian Drug Information System--SISMED

This paper describes the professional profile of pharmacists as specialists in drug information. Drug Information (DI) and Drug Information Centers (DIC) are defined. The fundamental activity of a DIC should be that of providing passive information or answering questions. The advantage of a DIC network is discussed, and strategies to implement the Brazilian Drug Information System (SISMED) are presented: investment in professional specialization and regular meetings of DIC coordinators to exchange experiences. The different DICs work within a cooperative protocol. Four training courses have been held, resulting in the rapid development of Brazil's national DIC network. Two national meetings of DIC professionals have helped strengthen the Brazilian Drug Information System.     

Messages for communication of electronic health care records in diabetic care

This paper summarises the current status of work to develop a European Standard message for communication information from Electronic Health Care Records. This is part of the current work programme of the Technical Committee of the European Standardization Committee concerned with Health Informatics. This Standardization process is aimed at providing a general solution to the requirements for electronic communication between a diversity of clinical information systems. However, the two priority areas chosen for initial validation are Primary Care and Diabetes Care. The second of these areas is being addressed in close liaison with a messaging sub-group of the Diabetes Optimization through Information Technology study group of the European Association for the Study of Diabetes. Good early progress has been made and the timetable for completion of this work is short. The project team hopes to complete their work by the end of 1998 and formal adoption as a European Standard is scheduled for mid 1999. At this stage suppliers of clinical information systems will be able to implement Standard messages to support the communication of Electronic Health Care Record information. Once the Standard has been widely implemented, diabetologists, general practitioners, other specialists and health professionals from other disciplines should be able to exchange clinical information in a safe and useful manner.     

Assessing the readiness of Turkish health information systems for integrating genetic/genomic patient data: System architecture and available terminologies,legislative, and protection of personal data

Advances in genetic/genomic research and translational studies drive the progress on molecular diagnosis, personalised treatment, and monitoring. Healthcare professionals and governments are encouraged to set administrative regulations and implement structured and interoperable representation to utilise the genetic/genomic data, which will support precision medicine approaches through Health Information Systems (HIS). Clear regulations and careful legislation are also crucial for the security and privacy of genetic/genomic test data. In this article, we present a review of the National Health Information System of Turkey (NHIS-T) about interoperable health data representation for genetic tests. We discuss the content of rules and regulations related to genetic/genomic testing and structured data representation in Turkey. A brief comparison of the Turkish “Law on the Protection of Personal Data” (LPPD) in genetic/genomic data privacy with its counterparts is presented. The final discussion about the shortcomings of Turkey is transferable to health information systems worldwide. Constructing a national reference database and IT infrastructure to enable data integration and exchange between genomic data, metadata, and health records will improve genetics studies’ utility and outcomes. The critical success factors behind integration are establishing broadly accepted terminologies and government guidance. The governments should set clear a transparent policy defining the legal and ethical framework, workforce training, clinical decision-support tools, public engagement, and education concurrently.     

开发临床信息系统应注意的问题

研制和开发临床信息系统是建立高质量信息系统的重要基础和组成部分。通过开发临床信息系统过程中的体会，提出应该注意的问题：（1）数据格式；（2）数据的获取，显示和分析；（3）计算机的网络系统；（4）伪像处理；（5）电子病历的设计；（6）人机交互界面。     

Integrated Care Programme for older adults: Analysis and improvement

Objective

We aimed to in-depth analyse the Integrated Care Programme for older in- and out-patients implemented for more than 25 years at the Hospital Universitario de Getafe, in Madrid, Spain. We identify the strengths and barriers hindering the full operation, and we proposed a technological solution that overcame these constraints and facilitated integration.

Design

First, we carried out a comprehensive analysis of the integrated care program at the HUG following Case Study Research; the primary unit of analysis was the Geriatrics service and its clinical units. Secondary sources of analyses were professionals’ insights (obtained thought direct observation and interviews) and statistics on the service. After the identification of the barriers preventing complete success; we designed a Health Information System and developed a mock-up that was validated with the professionals. Finally, we passed the specifications to the Information System Unit at the Hospital to develop and integrate the system into the hospital one.

Setting

The Geriatrics Service of the University Hospital of Getafe, pertaining to the public Healthcare System of the Region of Madrid (Spain).

Participants

No patient participated in the study. All staff from the Geriatrics Service and the ICT manager of the hospital contributed to the design of the Health Information System; and 3 geriatricians from the Service and 1 primary care physician validated it.

Measurements

First, we qualitative analysed the Integrated Care Program taking as dimensions eight facilitators towards integrated care. In response, we proposed an integrated information system solution. Later, we interviewed the staff geriatricians to analyse the Integrated Care Programme. Finally, we validated our proposed system in terms of usability and user experience using the System Usability Score-SUS and the User Experience Questionnaire-UEQ, respectively.

Results

The Integrated Care Program has demonstrated a high impact since its launch; however, the lack of integration in terms of information system was hindering the full deployment. We have designed an integrated information system which has been validated by physicians and nurses from the Geriatrics Service in terms of usability. We obtained a SUS score of 81 (68 is considered to be the cut-off point for usable systems). Besides, the perception of these professionals on our system was ‘Excellent’ in 5 out of the 6 items covered by UEQ (Attractiveness, Perspicuity, Dependability, Stimulation and Novelty) and ‘Good’ in terms of the 1 remaining (Efficiency), where there is still room for improvement.

Conclusions

Our dedicated Health Information System is a robust solution to bridge information gaps and facilitate the complete integration of our Integrated Care Programme for older in- and outpatients.