基于居民健康档案的新型社区卫生信息化整合平台构建与应用

我国社区卫生信息化已经过20年的探索和发展,国家也出台了政策和标准支持社区卫生信息化和居民健康档案的建设,然而社区卫生信息系统仍面临着居民健康信息未整合、社区信息化顶层设计缺失、信息系统与实际业务脱离等一系列问题。本文以上海彭浦新村社区卫生服务中心为案例介绍以居民健康档案为基础的社区卫生信息化平台发展阶段、应用成效和未来展望,以期为其他社区信息化建设提供经验借鉴。本文首先从基础建设、互联互通、标准集成、系统应用4个阶段总结了以居民健康档案为基础的社区卫生信息化平台的建设历程,形成了以居民健康档案为基础的社区卫生信息化平台,对医院的业务、居民健康及各个部门管理信息进行综合管理。其次,介绍了社区卫生信息化应用成效:实现居民健康信息便捷查询,改善居民医疗就诊流程和服务体验,提高医务人员在健康管理、签约服务、分级诊疗和上门服务等方面的工作效率,从绩效机制、预算机制、管理机制层面助力社区综合改革,推动社区精细化管理。最后,从健康预警、辅助诊疗、医疗智能审核和社区随访4个方面对社区卫生智能化的未来进行展望。笔者认为,社区卫生信息化平台建设需要以居民健康档案为核心,强调互联互通和实践应用的顶层设计,以业务实际需求为导向,以改善服务体验,提高工作效率,提升管理效能为驱动,实现业务系统、信息系统和居民健康的协同发展。 

Construction and application of residents' health records based new community health information integration platform

After 20 years of exploration and development, China has issued policies and standards to support the construction of community health informatization and residents' health records(RHR). However, there are still a series of problems, such as the lack of integration of RHR, the lack of top-level design of community informatization, and the separation of the information system from the actual business. This paper takes Pengpu Xincun Community Health Service Center in Shanghai as an example to introduce the development, application effect and future prospect of RHR-based community health informatization platform, in order to provide experience for other community information construction. Firstly, this paper summarizes the construction process of the informatization platform from infrastructure construction, interconnection, standard integration and system application, and forms a community health information platform based on RHR, which comprehensively manages the hospital's business, residents' health and management information of each department. Secondly, it introduces the application effects include the convenient query of residents' health information, enhancing the residents' experience, improving the working efficiency of community medical staff, contracted service, hierarchical diagnosis and treatment and door-to-door service, promoting comprehensive community reform and delicacy management from the aspects of performance mechanism, budget mechanism and management mechanism. Finally, the future of community health intelligence is prospected from four aspects:health risk warning, computer-assisted system of diagnosis and treatment, intelligent medical quality monitoring and community follow-up. The author believes that the construction of community health information platform needs to take the RHR as the core, emphasize the top-level design of connectivity and practical application, take the actual needs of business as the guide, improve the service experience, improve the work efficiency and enhance the management efficiency as the driving force, to realize the coordinated development of business system, information system and residents' health.