HIS平台升级改造及数据保护方案设计

目的：对医院的HIS平台进行升级,解决医院信息系统满负荷运行的问题和医疗数据存在的安全隐患.方法：对信息系统服务器平台的历史、现状及发展进行分析,对HIS数据面临的安全问题进行分类整理,并且提出异地双机热备的解决方案.结果：HIS平台升级改造后的系统能够满足3a内医院业务稳定、高效的运行.结论：及时对医院HIS平台进行升级改造才能满足医院信息化建设发展的需要.     

HIS服务器及数据库升级的实现

目的：改善医院原有HIS服务器响应速度慢、内存不足的现状。方法：将医院HIS原有32位Windows服务器升级到64位Unix服务器;Oracle8数据库升级到Oracle11g数据库。结果：系统性能得到了大幅提升。结论：为确保升级快速、顺畅,必须重视升级测试工作,细化操作脚本。     

医院信息系统运行安全策略

随着医院业务不断发展，其信息系统应用范围也日渐扩大，医院信息系统是医院的主要经济支柱和命脉，因此保障医院信息系统运行安全非常重要。本文分别从划分VLAN、使用组策略、病毒服务器、网管软件、VNC软件的使用五个策略对保障HIS系统的安全运行进行探讨。     

医院综合信息查询系统的设计与应用

目的：为患者就医提供指导，实现医药收费公开化、透明化，增强患者对医院的信任感。方法：采用三层结构的模块划分方法．在原有的HIS系统主服务器、门诊工作站服务器的基础上，连接1台查询服务器、3台服务器和多台查询终端组成一套医院综合信息查询系统。结果：在院使用的系统功能齐全，兼容性强、数据准确、安全可靠、使用简便．方便了患者就医。结论：开发使用的综合查询系统兼顾了不同层次患者的实际需求。     

利用数据库分布技术改善HIS的应用性能

由于医院信息系统的应用及用户不断增加,导致HIS核心数据库服务器不堪重负,严重影响整个系统的运行性能。本文介绍了解放军总医院如何利用现有设备,采用数据库的分布技术,将医院数据的存储与处理从单一的服务器划分到多个服务器,使系统资源得到合理使用,简便有效地解决了困扰HIS应用的性能问题。     

临床采供血信息管理系统的建立与应用

目的通过建立临床采供血信息管理系统,规范医院采供血流程,确保临床用血安全。方法系统采用C/S(客户端/服务器)架构,基于可视化编程语言PowerBuilder10.5开发,操作界面友好。系统与医院信息系统(HIS)和实验室信息管理系统(LIS)建立数据接口,实现了医疗数据共享。结果各系统间互联互通、血液信息资源共享,并可对每袋血液从采集到临床使用进行全程实时监控和追踪。结论输血科实时对HIS输血子系统进行维护,可进一步保证血液质量和临床用血安全。     

医院HIS系统SQLServer数据库性能优化

医院HIS系统数据库性能的优化是通过调节规划将数据库服务器的网络流量、磁盘I／O和CPU时间减到最小。使每个查询的响应时间最短并最大限度地提高整个数据库服务器的吞吐量。性能问题的考虑应贯穿于HIS开发阶段的全过程。而不应只在最后实现系统时才考虑性能问题。许多使性能得到显著提高的事宜可通过开始时仔细设计得以实现。为达到此目的，需要了解HIS应用程序的需求和数据的逻辑和物理结构，并在相互冲突的数据库使用之间进行权衡，实现医院HIS系统数据库性能的最优化。     

医院HIS网络与医保网络间数据交换安全解决方案

目的如何在为地方医保病人提供医疗服务的同时,保证军队医院军人就诊信息和相关医疗信息的安全,是本方案重点解决的内容。方法通过对各军队医院抽样调研,反复论证,提出了采用隔离网闸和安全网关部署在医保前置服务器与HIS网络之间,在需要访问医保网络的客户端上安装主机安全防御套件等多种安全手段,全面保护军队医院内网的网络安全和信息安全。结果通过2年多的应用,表明此方案,能够有效保证医院HIS网络和数据的安全。结论应用效果满意,此方案完全达到了预期的设计要求。     

LIS系统与HIS系统连接的关键点

HIS系统和LIS系统是两个相对独立的系统，它们分别有各自的服务器，各自的数据库，大部分信息是保存在自己的服务器中。虽然LIS系统与HIS系统是相互独立但又是密不可分的。LIS系统作为医院信息化系统的一部分，与HIS系统之间的兼容性十分重要，通过LIS与HIS的整合，     

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.     

Nutritional composition of commonly consumed traditional Apache foods in Arizona

PRIMARY OBJECTIVE: To provide nutritional composition data for commonly consumed traditional Apache foods to enable an assessment of dietary intake and to evaluate a food-store based intervention aimed at reducing risk of chronic disease. METHODS AND PROCEDURES: Weighed recipes were collected in Apache households on the White Mountain Apache reservation in Arizona. The nutritional composition was calculated using the U.S. Department of Agriculture National Nutrient Database. MAIN OUTCOMES AND RESULTS: A total of 47 weighed recipes were collected for 13 traditional Apache dishes; five were breads, five were chicken or meat-based stews, two were tortilla-based dishes and the remaining one was a traditional Indian dumpling. The calculated energy, macronutrient content and micronutrient content of these traditional foods are provided. CONCLUSIONS: We have provided for the first time the nutritional composition per 100 g for 13 traditional Apache foods. These data are essential for determining dietary intake and diet-disease associations and for developing and evaluating the effectiveness of a food-store-based intervention in this population.     

WEB双向DICOM传输在远程会诊中的应用

本文探讨DICOM格式的PACS图像在WEB上的远程传输应用，提出一种基于医生间的B／S构架远程双向会诊模式，并就与远程会诊相关的HIS与PACS的HL7后台关联技术、远程SSLVPN技术、无线网络应用技术、图像无损压缩、多点会诊应用以及虚拟网络隔离技术等做一阐述。WEB双向DICOM传输的应用，为医疗信息突破局域网限制、充分利用医疗资源，提供了一种新型技术方案。     

医院感染病例监测网络信息系统的研发与应用

目的 采用计算机网络系统直接收集、统计及反馈医院感染病例监测（HIS）资料，提高报告的及时性和准确性，实现医院感染实时监控。方法 利用大型数据库SQL server 2000和先进的面向对象的软件开发工具Delphi7．0，开发一套功能强大的医院感染病例监测系统，并将该系统嵌入院内的HIS中。结果 该系统可在医院范围内将医院感染管理科及各临床科室的终端通过HIS连接在一起，实现了全院范围内的医院感染病例网络报告、实时监控及监测数据共享。结论 该系统提高了医院感染病例资料上报、统计及反馈的及时性和准确性，减轻了临床医生的工作负担，提高了医院感染管理专职人员的工作效率和工作质量，具备一定的推广应用价值。     

建立以医疗为中心的现代医院信息管理系统

医院信息系统（HospitalInformationSystem，简称HIS）是以计算机技术为基础，以医疗信息为内涵的现代医院管理系统。以医疗为中心的HIS，前提是以病人为中心的医院管理核心，基本理论是“以病人、医嘱作为医院信息系统的中心”，从而导向和驱动医院管理中所有其他系统。医院内部信息高速公路，让病人在预检、挂号处开始，信息资料就随信息高速公路而运动至任何一个有关部门，医嘱、处方信息高速公路先于病人直达收费处，再至药房。始终让病人感到服务措施领先一步。以医疗为中心的HIS特征是：一种医疗信息输入，多处可提取，而一处输入又受到多项监控，因此其准确程度相对较高。     

Linking the integrated management of childhood illness (IMCI) and health information system (HIS) classifications: issues and options

Differences in the terms used to classify diseases in the Integrated Management of Childhood Illness (IMCI) guidelines and for health information system (HIS) disease surveillance could easily create confusion among health care workers. If the equivalent terms in the two classifications are not clear to health workers who are following the guidelines, they may have problems in performing the dual activities of case management and disease surveillance. These difficulties could adversely affect an individual's performance as well as the overall effectiveness of the IMCI strategy or HIS surveillance, or both. We interviewed key informants to determine the effect of these differences between the IMCI and HIS classifications on the countries that were implementing the IMCI guidelines. Four general approaches for addressing the problem were identified: translating the IMCI classifications into HIS classifications; changing the HIS list to include the IMCI classifications; using both the IMCI and HIS classification systems at the time of consultations; and doing nothing. No single approach can satisfy the needs of all countries. However, if the short-term or medium-term goal of IMCI planners is to find a solution that will reduce the problem for health workers and is also easy to implement, the approach most likely to succeed is translation of IMCI classifications into HIS classifications. Where feasible, a modification of the health information system to include the IMCI classifications may also be considered.     

Problems regarding the integration of medical images into the total hospital information system

Since 1989, the integration of medical images into the total hospital information system (HIS) has been investigated and developed at Kochi Medical School. The basic concept of the integration is that, in the same way they can view text based data, doctors can retrieve and view images using the PC terminals of the total HIS. The possibility of utilizing the PC terminals of the total HIS as image viewing stations was investigated. A test run was performed in the period from October 1995 to July 1997. The test run revealed that fast image access is crucial in order for the system to be useful for doctors. After making various improvements, the final system became well used in the clinical practice. However, in order to progress to the film-less stage, the final system still has three problems that must be solved: quality of the image display, operation of multi-exams, and quality assurance of the digital image.     

Contextual factors affecting health information system strengthening

At the turn of the century, several major efforts were initiated to combat HIV/AIDS and other major epidemics affecting low- and middle-income countries (LMICs). They were accompanied by initiatives to enable recipient countries to collect and use data to guide their public health programmes. These health information systems (HIS) typify systems in that they have multiple interacting components, and they are embedded within larger systems. Components of a larger system act as the context for all lower-level systems. Their effects can be pervasive, and thus be taken for granted or regarded as unchangeable. We identify four contextual factors that affect efforts to strengthen HIS: hierarchical roles, aid funding, corruption, and competing priorities. We provide examples of each as experienced by those working to strengthen HIS in LMICs. Each of these contextual factors can seriously diminish the effectiveness of HIS strengthening efforts and their long-term sustainability. We propose research questions about each that would enable those engaged in HIS strengthening to work effectively and sustainably.     

一种通用型医院信息系统与新农合外挂接口程序的实现

目的:通过医院信息系统(HIS)与新农合系统的联网,使二者之间信息共享和数据交换,实现农合患者住院费用实时结算。方法:开发一种通用的外挂接口程序,不需要对医院信息系统进行改造,只在HIS数据库中新建中间表,两系统通过中间表进行数据交互,即可实现信息共享和数据交换。结果:实现双方数据交互的完整和准确。结论:提高了合管中心和医院的工作效率,具有良好的功能可扩展性和对农合政策的灵活适应性,值得借鉴使用。     

基于SSL的远程医疗系统安全性设计与实现

随着多媒体及计算机网络技术的高速发展,基于Internet的远程医疗系统面临着严重的网络安全问题。目前,国外著名的商用浏览器和Web服务器都内嵌支持SSL（Secure Socket Layer,安全套接字层）协议,但其核心密码算法都有出口限制,并且协议源代码不公开,根本无法满足我国远程医疗网实际应用的安全需求。本文着重分析了SSL握手协议及SSL协议各部分的安全性和抗攻击能力,详细介绍了一个基于JAVA的SSL安全远程医疗系统的设计方案、技术特点与实现方法,测试结果能够满足需要。     

Graduate education in health decision support systems (HDSSs): reconfiguring the health information system (HIS) basket or putting HDSS Humpty Dumpty together again?

Building on previous discussions in graduate health information system (HIS) education, this article focuses on the design of a course in health decision support systems (HDSSs). The goal here is not simply to add to existing prospectives of HIS theories and methodologies, but to prepare these students for changing trends in HIS technologies and applications and for new challenges in HIS administration and impacts arising from these emerging, more advanced, and complex technologies. Specifically, advancing HDSS technology: (1) promises to close the gap between theory and practice, (2) creates a new perspective for the application of information technologies in health care organizations, and (3) enhances innovations in the management and implementation of health information technologies. This paper highlights the need for graduate education in HDSS domain knowledge and how such knowledge can be taught in preparing students for managing change in the future health care environment.