基于Ensemble的医院信息系统集成平台的研究与探索

目的：在医院内部信息系统集成方面,传统点对点接口通信模式存在系统耦合度高,系统整体稳定性和安全性难以预测和控制等隐患。不同业务系统之间难以实现数据交换与资源共享。如何打造一个稳定、高效、安全、可管理的集成平台,以满足不断变化的应用需求是一个亟待解决的问题。方法：将Ensemble集成平台技术引入到医院信息化建设中进行研究是一项非常有意义的工作,在分析传统点对点接口通信模式不足的基础上,文章结合Ensemble集成平台技术,建立了以病人为中心的统一视图,实现了跨平台的数据交换与共享。结果：通过Ensemble集成平台技术建立了以患者就诊流程为核心的内部信息共享交互平台,实现了全院数据交换与共享,消除了“信息孤岛”,实现了新业务应用的快速部署。结论：Ensemble集成平台技术为医院业务变革提供了灵活的、快速实施和部署的系统架构,实现了医疗信息的交换与共享,优化了服务流程,提高了医院运营效率,满足了医院信息化可持续发展。     

全军医疗数据集成与信息共享平台实现机制研究

针对我国医疗信息系统建设分散、标准不统一、系统异构等特点,如何有效实现“医疗联合体”之间的卫生信息资源互联互通是我国区域医疗信息化建设所面临的重大挑战。结合“全军医疗数据集成与信息共享平台”建设项目,将平台建设的架构设计及其中的关键技术进行了系统性分析。该平台实现了相关医疗机构系统间的无侵入式轻便集成及卫生医疗资源的充分共享,在理论和实践上均对我国大规模开展区域医疗信息化建设具有一定的借鉴意义。     

华为“全联接医疗”解决方案鼎力支持新疆维吾尔自治区人民医院

9月5日,华为2014医疗卫生信息化建设研讨会在辽宁省沈阳市隆重召开。本次大会以“联接促进融合数据护卫健康”为主题,充分展示了华为在医疗信息化领域提出的“全联接医疗”理念。华为IT数据中心解决方案部总经理陈世峻在大会主题发言中表示：华为“全联接医疗”解决方案包括区域卫生平台、数字医院、远程医疗,提供了基于医疗角色、医疗数据、医疗业务三种联接,通过医院院区网络联接医院类型繁多的业务系统,统一管理各业务项目之间的数据交换,通过集成平台实现数据共享,通过广域网联接各个医疗机构,并通过区域卫生信息化平台,实现大范围医疗卫生资源共享,实现医疗信息的全联接。“全联接医疗”充分展示出华为在服务器、存储、大容量的交换机、移动计算、智真视讯平台的优势。     

医疗就诊卡信息交换与数据接口的设计与实现

利用计算机网络与软件技术建立医疗就诊卡信息交换平台,设计全市医疗机构之间就诊卡数据交换接口,实现了我市市级医疗机构就诊卡的统一,方便了病人就诊.     

基于医院集成平台的区域医疗交换CDA设计与实现

为实现标准化的区域医疗信息数据交换,以医院集成平台为核心,在现有医院各类信息系统基础上,按照标准的医疗CDA文档格式,将医院各类信息资源集成起来,构建符合区域卫生信息平台技术规范的CDA文档,实现与常熟市区域卫生信息平台数据交换。     

人口健康信息化规划框架下的法定传染病信息报告模式探讨

介绍“十三五”期间国家级医疗信息健康平台总体设计及医疗机构信息化对传染病报告管理的促进作用,分析传染病网络直报面临的问题和挑战,建议国家配合2015年新发布的《传染病信息报告管理规范》配套发布数据交换的工作和技术方案,指导医疗机构或区域人口健康信息平台实现与传染病网络直报系统的数据自动交换。     

基于云计算服务的区级医疗信息系统研究与应用

遵循基于健康档案的区域卫生信息化建设要求,研究面向区域内数量众多的基层医疗机构、多个需要共享协同的业务系统、多种应用业务角色、多类格式的医疗数据,基于云计算技术和区域卫生平台,设计基础设施、数据存储、数据集成、应用系统等多层框架,构建可扩展、高效运行的区级医疗云平台,初步实现了复杂业务系统下,基层医疗机构可连线即用统一服务,又可个性化定制的云服务系统。实验结果表明,该云平台在金山区的示范应用取得了良好的效果,有效实现了动态管理居民健康档案的建设要求,并能更好促进云计算在医疗卫生领域的深入应用。     

基于消息机制的医疗信息平台

以中南大学湘雅医院电子病历系统建设为背景,介绍如何利用集成平台实现医院信息系统的数据集成和应用集成。湘雅医院利用基于消息机制的信息平台,实现了集成化、标准化、智能化、网络化的电子病历系统。通过连接临床信息系统和管理信息系统等医院信息平台,支持医疗质量控制、临床决策支持、医院运营管理、区域医疗信息共享、医疗行为监管等,从而实现医院内不同业务系统之间统一集成、资源整合和高效运转,完成从以收费为中心的旧的信息管理模式向高度集成、信息全覆盖的电子病历重大转变。     

电子临床路径与HIS集成的研究与设计

针对医院HIS、LIS和RIS等各系统问的数据难以交互及共享等问题,利用Web Service技术设计了电子临床路径信息系统与HIS系统集成框架,并提供了数据交换接口,屏蔽了异构系统底层数据的差异,实现了与HIS系统的无缝集成,大大提高了医院医疗质量和服务效率。     

新老医院信息系统并行下的门诊智能发药系统设计与实现

详述武汉市中心医院在两套医院信息系统并行期间门诊智能发药系统的设计思路,实现基于老HIS门诊系统的多渠道缴费途径的发药窗口分配以及基于新HIS药房系统的预配和实时智能发药,利用Ensemble集成平台和Web Service服务实现多系统间的数据交互。系统运行平稳,既可提高效率,又能保证质量。     

Design and development of an international clinical data exchange system: the international layer function of the Dolphin Project

Objective

At present, most clinical data are exchanged between organizations within a regional system. However, people traveling abroad may need to visit a hospital, which would make international exchange of clinical data very useful.

Background

Since 2007, a collaborative effort to achieve clinical data sharing has been carried out at Zhejiang University in China and Kyoto University and Miyazaki University in Japan; each is running a regional clinical information center.

Methods

An international layer system named Global Dolphin was constructed with several key services, sharing patients'' health information between countries using a medical markup language (MML). The system was piloted with 39 test patients.

Results

The three regions above have records for 966 000 unique patients, which are available through Global Dolphin. Data exchanged successfully from Japan to China for the 39 study patients include 1001 MML files and 152 images. The MML files contained 197 free text-type paragraphs that needed human translation.

Discussion

The pilot test in Global Dolphin demonstrates that patient information can be shared across countries through international health data exchange. To achieve cross-border sharing of clinical data, some key issues had to be addressed: establishment of a super directory service across countries; data transformation; and unique one—language translation. Privacy protection was also taken into account. The system is now ready for live use.

Conclusion

The project demonstrates a means of achieving worldwide accessibility of medical data, by which the integrity and continuity of patients'' health information can be maintained.     

CLAIM (CLinical Accounting InforMation)—An XML-Based Data Exchange Standard for Connecting Electronic Medical Record Systems to Patient Accounting Systems

With the evolving and diverse electronic medical record (EMR) systems, there appears to be an ever greater need to link EMR systems and patient accounting systems with a standardized data exchange format. To this end, the CLinical Accounting InforMation (CLAIM) data exchange standard was developed. CLAIM is subordinate to the Medical Markup Language (MML) standard, which allows the exchange of medical data among different medical institutions. CLAIM uses eXtensible Markup Language (XML) as a meta-language. The current version, 2.1, inherited the basic structure of MML 2.x and contains two modules including information related to registration, appointment, procedure and charging. CLAIM 2.1 was implemented successfully in Japan in 2001. Consequently, it was confirmed that CLAIM could be used as an effective data exchange format between EMR systems and patient accounting systems.     

The Development of MML (Medical Markup Language) Version 3.0 as a Medical Document Exchange Format for HL7 Messages

Medical Markup Language (MML), as a set of standards, has been developed over the last 8 years to allow the exchange of medical data between different medical information providers. MML Version 2.21 used XML as a metalanguage and was announced in 1999. In 2001, MML was updated to Version 2.3, which contained 12 modules. The latest version—Version 3.0—is based on the HL7 Clinical Document Architecture (CDA). During the development of this new version, the structure of MML Version 2.3 was analyzed, subdivided into several categories, and redefined so the information defined in MML could be described in HL7 CDA Level One. As a result of this development, it has become possible to exchange MML Version 3.0 medical documents via HL7 messages.     

Enhancement of MML Medical Data Exchange Standard for a Localized Chinese Version

Medical Markup Language (MML) is a standard for the exchange of medical data among different medical institutions. It was developed in Japan in 1995. Since version 2.21, MML has used eXtensible Markup Language (XML) as a meta-language. The latest version, 3.0, conforms to HL7 Clinical Document Architecture (CDA) and contains 14 modules and 36 data definition tables. In China, a standard which structures entire medical records in XML does not yet exist. Taking advantage of MML's flexibility, we created a localized Chinese version based on MML 3.0. Parts of the original specifications have been enhanced; these include a newly developed health insurance information module and 12 additional or redefined data definition tables. The Chinese version takes local needs into account and now makes it possible to exchange medical data among Chinese medical institutions.     

The latest MML (Medical Markup Language) version 2.3--XML-based standard for medical data exchange/storage

As a set of standards, Medical Markup Language (MML) has been developed over the last 8 years to allow the exchange of medical data between different medical information providers. MML version 2.21 was characterized by XML as metalanguage and was announced in 1999, at which time full-scale implementation tests were carried out; subsequently, various information and functional inadequacies were discovered in this version. MML was therefore updated to version 2.3 in 2001. At present, MML contains 12 MML modules including the new referral, test result, and report modules. In version 2.3, the group ID element was added; the access right definition and health insurance module were amended.     

Medical Markup Language (MML) for XML-based Hospital Information Interchange

Medical Markup Language (MML) has been developed over the last 6 years in order to create a set of standards by which medical data, within Japan and hopefully worldwide, can be stored, accessed and exchanged in any number of physical locates. The MML version 2.21 is characterized by XML as meta-language, module structure for each document and enhancement of linking function among documents. Data exchange specification has been also added for query and reply. MML instances are composed of MML header and MML body. The MML header includes information for data transmission, while MML body includes several module items. One module item contains two elements: document information and module content. Nine MML module contents are defined at the present time: patient information, health insurance information, diagnosis information, lifestyle information, basic clinic information, particular information at the time of first visit, progress course information, surgery record information and clinical summary information.     

Dolphin Project—Cooperative Regional Clinical System Centered on Clinical Information Center

In 2001, a system was created to improve patient service, improve the quality of medical care, and achieve efficient medical care. A Data Center was established to accumulate and manage clinical information in the regions and share clinical information safely and appropriately. The system has already been in operation for 3 years. Even though a patient may have been examined at multiple hospitals, his medical record information will be integrated at the Center. This ensures medical care continuity and enables the patient to view his own medical records at home. Its usefulness in obtaining informed consent has been demonstrated as well. XML instances established in the MML standards (MML (Medical Markup Language): http://www.medxml.net/E_mml30/mmlv3_E_index.htm Accessed July 2004; Jpn. J. Med. Informatics (JJMI) 17(3):203–207, 1997; J. Med. Syst. 24(3):195–211, 2000; J. Med. Syst. 27(4):357–366, 2003; J. Med. Syst. 28(6):523–533, 2004) are used for Electronic Medical Record System data exchange between the Data Center and each medical institution. The openness provided by XML makes it possible to connect diverse electronic medical records to the Center. As of the year 2004, over 10 types of electronic medical records have an MML interface, enabling connection to the Center.     

Application of Portable CDA for Secure Clinical-document Exchange

Health Level Seven (HL7) organization published the Clinical Document Architecture (CDA) for exchanging documents among heterogeneous systems and improving medical quality based on the design method in CDA. In practice, although the HL7 organization tried to make medical messages exchangeable, it is still hard to exchange medical messages. There are many issues when two hospitals want to exchange clinical documents, such as patient privacy, network security, budget, and the strategies of the hospital. In this article, we propose a method for the exchange and sharing of clinical documents in an offline model based on the CDA—the Portable CDA. This allows the physician to retrieve the patient’s medical record stored in a portal device, but not through the Internet in real time. The security and privacy of CDA data will also be considered.