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。     

大型城市医疗信息共享服务研究概述

通过调研上海医院信息系统的基础情况,以及文献检索借鉴国内外的相关经验,专家咨询、专题小组讨论等方法制定医疗信息系统方案。明确了医疗信息共享的业务需求,完成了系统设计,在国内首先对医疗信息共享中的法律问题进行了研究,率先在23所市级医院进行了应用示范,建立了跨医院临床信息系统。     

论基于信息标准的临床数据中心构建

结合国内外医疗信息化的现状，介绍了临床数据中心的发展历程和构建框架，该框架基于HL7RIM模型表达，同时通过各种医学信息标准和HIT技术的实现，构建基于信息标准的临床数据中心体系结构和基础架构，用以实现具备统一和开放性的系统集成框架，推动医院内异构医疗信息系统的交互，并对临床数据中心在医疗信息化过程中发挥的作用和未来发展趋势进行了展望。     

论医疗设备、资产管理和财务政务的整合

随着信息产业迅猛发展.医疗信息结构 正朝着零散型向统一型、从本土化向全球化的 方向发展.医院设备、物资信息化建设进程中 出现了大量的数据,但这些数据难以共享,不 能支持辅助决策,已经成为我国医院信息化建 设进一步发展的主要障碍.我们通过对医院设 备、物资信息系统数据结构化,把异构数据转 化为可透明访问的共享信息,使得这些数据得 以扩展和集成,盘活了这些数据在各个职能部 门间的"信息孤岛",开创了医院信息化建设 的新局面.     

中国医院信息化状况调查2008／09年度（摘录）医院信息技术负责人调研报告-总报告

前言 为了更真实的反映国内医疗行业的信息化现状及行业对信息化的需求，了解医疗行业信息化需求方在信息化建设方面的投入、所关注的应用与技术、以及信息化项目过程中遇到的各种瓶颈，更好的把握医疗行业信息化的特点和发展趋势，中国医院协会信息管理专业委员会（CHIMA）花费大量资源，于2006年启动了中国医院信息化状况年度调查项目，依托CHIMACIO俱乐部的平台每年都在全国范围开展该项调查。     

中国医院信息化状况调查2008/09年度(摘录)

医院信息技术负责人调研报告-总报告 前言 为了更真实的反映国内医疗行业的信息化现状及行业对信息化的需求,了解医疗行业信息化需求方在信息化建设方面的投入、所关注的应用与技术、以及信息化项目过程中遇到的各种瓶颈,更好的把握医疗行业信息化的特点和发展趋势,中国医院协会信息管理专业委员会(CHIMA)花费大量资源,于2006年启动了中国医院信息化状况年度调查项目,依托CHIMA CIO俱乐部的平台每年都在全国范围开展该项调查.     

区域卫生信息平台建设方案研究

区域卫生信息共享是医疗信息化发展的必然趋势,是我国卫生事业发展的需要和必然趋势。阐述了国内外区域卫生信息化发展现状,介绍了区域卫牛信息化的建设目标、建设内容,进而提出了区域卫生信息平台的总体建设方案。     

HL7 V3在区域医疗交换平台中的应用研究

区域医疗交换平台是所有医疗信息系统中覆盖数据量最大、涉及信息系统种类最多的系统之一。HL7（HealthLevelSeven）标准的出现为异构医疗信息系统之间的信息数据交换与共享提供了基础条件和重要的应用价值。针对区域交换平台在国内外的研究现状以及HL7发展,概述了HL7 V2．x版本与HL7 V3版本,结合HL7 V2在区域交换平台的应用,借助HL7 V3的RIM模型及V3消息,设计了基于HL7 V3标准的区域医疗交换平台,实现了医院之间、医院与卫生机构之间的信息交换与共享。     

江苏省基层医疗机构信息化调查研究

目的：调查分析江苏省基层医疗机构信息化现状,并提出对策。方法：通过问卷方式对江苏省209所基层医疗机构信息化建设情况进行调查,包括医院信息系统建设、健康档案信息化、医疗信息共享、便携式智能设备使用等内容,并比较乡镇卫生院和社区卫生服务中心之间,以及南京、苏北、苏中、苏南地区之间的信息化差异。结果：江苏省基层医疗机构信息化全面普及,但信息系统的完整性、家庭医生签约信息化、院外患者信息共享、便携式智能化设备普及等方面有待完善。乡镇卫生院和社区卫生服务中心在医院信息系统的完整性、电子病历的建设方面存在差异（P<0.05）。南京在院外医疗信息共享、便携式智能化设备普及方面优于其他地区（P<0.05）。结论：江苏省的卫生水平高于全国平均水平,但某些机构信息模块建设不完整,存在医疗“信息孤岛”等现象,有待进一步改进。     

新形式下医院图书馆管理现状和措施分析

我国医疗卫生行业随着经济水平和科技的进步也得到了发展,医疗事业的进步对广大人民生活产生重大影响,医院图书馆是医疗人才和医疗技术相结合的媒介,有利于医疗行业的发展。而如今医院图书管理仍存在一些问题,比如:医院图书馆藏书量及规模均较小、计算机未发挥充分作用、缺乏共享信息意识、管理效率低及整改经费缺乏。本次研究从加大经费投入、实行管理信息化和服务化等方面着手提高医院图书管理效率。     

我国医学情报研究机构网站建设与服务研究

目的：分析我国医学情报研究机构网站建设及服务情况,进行分析研究,为改进我国医学情报研究机构的网站建设与服务。网站建设和促进信息服务向数字化、网络化与智能化转型提供参考。方法：逐一调查国家、省、市三级医学情报研究机构。结果：我国医学情报研究机构网站建设呈现多元化特点,既有传统的服务内容,又有新兴的服务内容;网站服务形式较单一,以单向信息发布为主;医学情报研究机构的中文资源建设开展充分,但整合度不高,有机构自建或引进了特色数据资源平台或数据库。结论：医学情报研究机构应重视用户需求,提高服务意识;积极拓展服务广度与深度,开展以决策支持服务为主的情报工作,整合共享医学信息资源,提高信息保障水平和信息检索利用效率。     

部属等14所医学院校十年科技成果统计分析

本文的目的在于通过对上医、北医、中山医、华西、同济、中国、西安、山东、湖南、白医大10所卫生部直属高等医学院校和上二医、哈医大、浙医大、天津医大4所非部属院校,1978～1987年10年间申报并获得卫生部科技成果奖、国家教委科技成果奖、国家发明奖、国家自然科学奖、国家科技进步奖和国家专利(发明与实新专利)6大指标,作一较完整、系统的综合统计分析,以求从一个侧面去反映和评价有关医学院校的科学技术研究水平。为各校知己知彼和有关部门了解和比较获奖科技成果的情况,提供一些较客观的参考数据,以改进和提高科技管理。     

Building Clinical Data Groups for Electronic Medical Record in China

This article aims at building clinical data groups for Electronic Medical Records (EMR) in China. These data groups can be reused as basic information units in building the medical sheets of Electronic Medical Record Systems (EMRS) and serve as part of its implementation guideline. The results were based on medical sheets, the forms that are used in hospitals, which were collected from hospitals. To categorize the information in these sheets into data groups, we adopted the Health Level 7 Clinical Document Architecture Release 2 Model (HL7 CDA R2 Model). The regulations and legal documents concerning health informatics and related standards in China were implemented. A set of 75 data groups with 452 data elements was created. These data elements were atomic items that comprised the data groups. Medical sheet items contained clinical records information and could be described by standard data elements that exist in current health document protocols. These data groups match different units of the CDA model. Twelve data groups with 87 standardized data elements described EMR headers, and 63 data groups with 405 standardized data elements constituted the body. The later 63 data groups in fact formed the sections of the model. The data groups had two levels. Those at the first level contained both the second level data groups and the standardized data elements. The data groups were basically reusable information units that served as guidelines for building EMRS and that were used to rebuild a medical sheet and serve as templates for the clinical records. As a pilot study of health information standards in China, the development of EMR data groups combined international standards with Chinese national regulations and standards, and this was the most critical part of the research. The original medical sheets from hospitals contain first hand medical information, and some of their items reveal the data types characteristic of the Chinese socialist national health system. It is possible and critical to localize and stabilize the adopted international health standards through abstracting and categorizing those items for future sharing and for the implementation of EMRS in China.     

中华医学会历届医学信息学术会议获奖论文分析

统计分析了中华医学会历届医学信息学术会议获奖论文的作者、作者单位、研究主题等指标,讨论了获奖论文的研究与创新特色,研究结果对揭示我国医学信息领域的学术研究状况、提高我国医学信息领域的学术研究水平有借鉴意义。     

Integrating Hospital Information Systems in Healthcare Institutions: A Mediation Architecture

Many studies have examined the integration of information systems into healthcare institutions, leading to several standards in the healthcare domain (CORBAmed: Common Object Request Broker Architecture in Medicine; HL7: Health Level Seven International; DICOM: Digital Imaging and Communications in Medicine; and IHE: Integrating the Healthcare Enterprise). Due to the existence of a wide diversity of heterogeneous systems, three essential factors are necessary to fully integrate a system: data, functions and workflow. However, most of the previous studies have dealt with only one or two of these factors and this makes the system integration unsatisfactory. In this paper, we propose a flexible, scalable architecture for Hospital Information Systems (HIS). Our main purpose is to provide a practical solution to insure HIS interoperability so that healthcare institutions can communicate without being obliged to change their local information systems and without altering the tasks of the healthcare professionals. Our architecture is a mediation architecture with 3 levels: 1) a database level, 2) a middleware level and 3) a user interface level. The mediation is based on two central components: the Mediator and the Adapter. Using the XML format allows us to establish a structured, secured exchange of healthcare data. The notion of medical ontology is introduced to solve semantic conflicts and to unify the language used for the exchange. Our mediation architecture provides an effective, promising model that promotes the integration of hospital information systems that are autonomous, heterogeneous, semantically interoperable and platform-independent.     

Exchange of Computable Patient Data between the Department of Veterans Affairs (VA) and the Department of Defense (DoD): Terminology Mediation Strategy

Complete patient health information that is available where and when it is needed is essential to providers and patients and improves healthcare quality and patient safety. VA and DoD have built on their previous experience in patient data exchange to establish data standards and terminology services to enable real-time bi-directional computable (i.e., encoded) data exchange and achieve semantic interoperability in compliance with recommended national standards and the eGov initiative. The project uses RxNorm, UMLS, and SNOMED CT terminology standards to mediate codified pharmacy and allergy data with greater than 92 and 60 percent success rates respectively. Implementation of the project has been well received by users and is being expanded to multiple joint care sites. Stable and mature standards, mediation strategies, and a close relationship between healthcare institutions and Standards Development Organizations are recommended to achieve and maintain semantic interoperability in a clinical setting.     

中华医学会第1-15次全国医学信息学术会议大会专题报告分析

统计分析了中华医学会第1-15次全国医学信息学术会议应邀做大会专题报告的专家、所属单位和报告的研究主题,讨论了我国医学信息领域权威专家的群体分布、学术影响及其变化趋势,揭示了我国医学信息事业的发展特点,提出了增进国内外医学信息领域学术交流与合作的对策与建议。     

临床信息系统间基于语义的数据交换方案设计与实现

随着信息技术的不断发展和医疗服务需求的日益增加,医院信息化建设已成为医疗卫生事业发展的重要趋势。目前医院中使用的各种信息系统,如电子病历系统、放射科信息管理系统等,所用的系统平台、技术接口和标准规范各不相同,使这些异构临床信息系统产生的信息资源在格式、语法、术语的含义等很多方面存在差异,从而难以实现系统间的数据交换。针对这一问题,引入语义互操作的概念,设计并提出了异构临床信息系统间的语义互操作三层架构模型。并以眼科信息系统与其他异构系统之间的数据交换为例,验证临床信息系统间的语义互操作模型,部分解决了系统间的语义异构问题,为异构临床信息系统间的整合模式提供了新的思路和方法。     

Improving the governance of health research

Australia has so far been spared serious mishaps in health research, but rising pressures on researchers, deemed to have contributed to two deaths of research participants in the United States, clearly also exist in Australia. Health research investment in our institutions is large and represents an often overlooked area of risk by boards of management. Research governance (the framework through which institutions are ultimately accountable for the scientific quality, ethical acceptability and safety of research conducted in the institutions) has not received sufficient attention. An adequate governance framework requires institutions to have policies and procedures in place to meet national ethical, legal and research practice standards. We suggest that many institutions presently do not have such frameworks in place and inappropriately rely too heavily on human research ethics committees. To ensure ongoing adequate protection of research participants, we recommend some simple improvements for research governance and suggest ways by which institutions can demonstrate adherence to agreed national standards.