专业创造价值 第三届“金如意奖”中国优秀医院服务商品牌揭晓

作为医疗服务链条中不可或缺的一环。医院服务商不仅要为医院提供安全高效的产品．还需要用专业服务为用户创造更大的价值。除此之外．很多企业已经开始尝试拓展自身的服务半径,将服务内涵延伸到医疗服务的方方面面。     

PubMed新的检索工具--NCBI Search Toolbar及其应用

NCBI Search Toolbar是美国国立医学图书馆（NLM）新近推出的专用搜索工具,本文介绍该工具的特点、使用方法等.     

A Knowledge Based Search Tool for Performance Measures in Health Care Systems

Performance measurement is vital for improving the health care systems. However, we are still far from having accepted performance measurement models. Researchers and developers are seeking comparable performance indicators. We developed an intelligent search tool to identify appropriate measures for specific requirements by matching diverse care settings. We reviewed the literature and analyzed 229 performance measurement studies published after 2000. These studies are evaluated with an original theoretical framework and stored in the database. A semantic network is designed for representing domain knowledge and supporting reasoning. We have applied knowledge based decision support techniques to cope with uncertainty problems. As a result we designed a tool which simplifies the performance indicator search process and provides most relevant indicators by employing knowledge based systems.     

GIS-EpiLink: A Spatial Search Tool for Linking Environmental and Health Data

One inherent characteristic of both environmental data and health data is that they have a location component. This characteristic makes Geographic Information Systems (GIS) an ideal and sometimes indispensable tool for analyzing environmental and health data. Indeed, the past decade witnessed significant efforts in developing GIS tools for supporting epidemiologic research. Despite these efforts, the availability of accessible GIS tools that can be easily used by epidemiologists to link environmental and health data has remained a problem. We present a simple spatial search tool—GIS-EpiLink—that can be used to link environmental and health data when distance between an environmental site and the location of the maternal address of a case or control is used as a proxy for exposure. The tool was used in a research project and it successfully provided the necessary data for epidemiological analyses. This tool should be very useful to epidemiologists in environmental health research.     

Shopping in the Healthcare Information Systems Market—A Search for Well-Camouflaged Land Mines

The selection of a healthcare information system is analogous to a big game hunt. The buyers perceive themselves as the hunters while the truth is just the opposite. To strip away the carefully crafted facade of corporate marketing is an art form and requires due diligence on the part of the shopper. Suggestions are offered to the consumer on how to pierce the shell of corporate silence and find the facts that will make a significant difference in product selection. The objectives on the seller's side are to make as much profit as possible and give as little as required to make the sale. The buyer is looking for the best product, the best company, and the most painless installation. The ground between these two vastly different goals is the battlefield of healthcare computer procurement. May the best shopper win! Caveat emptor.     

Designing a Model of a Digital Ecosystem for Healthcare and Wellness Using the Business Model Canvas

Wellness is a term often used to talk about optimal health as “dynamic balance of physical, emotional, social, spiritual, and intellectual health.” While healthcare is a term about care offered to patients for improving their health. We use both terms, as well as the Business Model Canvas (BMC) methodology, to design a digital ecosystem model for healthcare and wellness called DE4HW; the model considers economic, technological, and legal asymmetries, which are present on e-services beyond geographical regions. BMC methodology was embedded into the global project strategy called: IBOT (Initiate, Build, Operate and Transfer); it is a methodology to establish a functional, integrated national telemedicine network and virtual education network; of which we took its phases rationale. The results in this work illustrate the design of DE4HW model, into the first phase of IBOT, enriched with the BMC, which enables us to define actors, their interactions, rules and protocols, in order to build DE4HW, while IBOT strategy manages the project goal, up to the transfer phase, where an integral service platform of healthcare and wellness is turned over to stakeholders.     

Domestic violence: a Resource Manual for Healthcare Providers for the State of Delaware. Part 3: Health Care Provider's Response

The Medical Subcommittee of the Delaware Domestic Violence Coordinating Council (DVCC) has worked on and completed Domestic Violence: A Resource Manual for Healthcare Providers for the State of Delaware. It is both an educational tool and a handy resource for documentation and reference, with many examples of clinical guidelines, screening questions and checklists for safety screening. It is intended for all healthcare providers, not just physicians. The Delaware Medical Journal will be reprinting three very important chapters from this manual: Understanding Domestic Violence (October 2000), Legal issues (November 2000), and Health Care Provider's Response.     

A Roadmap for National Action on Clinical Decision Support

This document comprises an AMIA Board of Directors approved White Paper that presents a roadmap for national action on clinical decision support. It is published in JAMIA for archival and dissemination purposes. The full text of this material has been previously published on the AMIA Web site (www.amia.org/inside/initiatives/cds). AMIA is the copyright holder.     

A Data-Mining Framework for Transnational Healthcare System

Medical resources are important and necessary in health care. Recently, the development of methods for improving the efficiency of medical resource utilization is an emerging problem. Despite evidence supporting the use of order sets in hospitals, only a small number of health information systems have successfully equipped physicians with analysis of complex order sequences from clinical pathway and clinical guideline. This paper presents a data-mining framework for transnational healthcare system to find alternative practices, including transfusion, pre-admission tests, and evaluation of liver diseases. However, individual countries vary with respect to geographical location, living habits, and culture, so disease risks and treatment methods also vary across countries. To realize the difference, a service-oriented architecture and cloud-computing technology are applied to analyze these medical data. The validity of the proposed system is demonstrated in including Taiwan and Mongolia, to ensure the feasibility of our approach.     

现代医院图书馆的个性化信息服务

个性化信息服务是医院图书馆开展信息服务工作的发展方向。探讨医院图书馆的个性化信息服务的涵义、方式、模式和措施等。     

A Point of Care Clinical Documentation System for Hospice Care Providers

This article identifies two areas of hospice care that may benefit the most from a point-of-care (POC) clinical documentation system: documentation for recertification and symptom/pain management. Applications as solutions for the hospice POC clinical documentation system need two documentation support tools: (1) knowledge-based external or internal reference data available to physicians or medical staff right at the bedside and (2) assisting medical staff in filling out electronic forms for clinical measurements by providing real-time prompts, clues, alerts, or other types of feedback, along with the common features such as pre-defined values in specific fields. Our study may encourage more software vendors to include clinical documentation support tools in their solutions.     

The State of Medical Informatics in India: A Roadmap for Optimal Organization

In India, the healthcare delivery systems are based on manual record keeping despite a good telecommunication infrastructure. Unfortunately, Indian policy makers are yet to realize the importance of medical informatics (including tele-health, which comprises e-Health and Telemedicine) in delivering healthcare. In the medical curriculum also, nowhere is this treated as a subject or even as a tool for learning. The final aim of most of the medical and paramedical students should be to become good users, and if possible, also experts for advancing medical knowledge base through medical informatics. In view of the fast changing world of medical informatics, it is essential to formulate a flexible syllabus rather than a rigid one for incorporating into the regular curriculum of medical and paramedical education. Only after that one may expect all members of the healthcare delivery systems to adopt and apply medical informatics optimally as a routine tool for their services.     

医疗信息系统集成自动化的一种概念模型

医疗信息化的深入发展给应用集成不断带来新的挑战.本文结合主流的IT技术、行业标准和IHE集成框架的应用,提出医疗信息系统集成自动化的一种概念模型,以求用统一的方法解决多种尺度下日益复杂的应用集成问题.     

A Reliable RFID Mutual Authentication Scheme for Healthcare Environments

Connected health care provides new opportunities for improving financial and clinical performance. Many connected health care applications such as telecare medicine information system, personally controlled health records system, and patient monitoring have been proposed. Correct and quality care is the goal of connected heath care, and user authentication can ensure the legality of patients. After reviewing authentication schemes for connected health care applications, we find that many of them cannot protect patient privacy such that others can trace users/patients by the transmitted data. And the verification tokens used by these authentication schemes to authenticate users or servers are only password, smart card and RFID tag. Actually, these verification tokens are not unique and easy to copy. On the other hand, biometric characteristics, such as iris, face, voiceprint, fingerprint and so on, are unique, easy to be verified, and hard to be copied. In this paper, a biometrics-based user authentication scheme will be proposed to ensure uniqueness and anonymity at the same time. With the proposed scheme, only the legal user/patient himself/herself can access the remote server, and no one can trace him/her according to transmitted data.     

A Scalable Healthcare Information System Based on a Service-oriented Architecture

Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.     

基于标准化患者法评价四川农村基层医生两种慢性病诊断准确性及其影响因素

目的 运用标准化患者法评估四川农村地区基层医生不稳定型心绞痛和2型糖尿病两种慢性病诊断准确性现状,探讨基层医生两种慢性病诊断准确性的主要影响因素,为提升基层医生两种慢性病诊断准确性提供科学依据。方法 采用多阶段随机整群抽样方法,抽取四川省自贡市5个区/县50个乡镇100个村为研究现场,以调查当日在岗的全科及内科医生作为研究对象。共进行两轮数据采集,第1轮采集样本乡镇卫生院和村卫生室医生的基本信息;第1轮调查完成1个月后,运用标准化患者法开展第2轮调查,收集农村基层医生对不稳定型心绞痛和2型糖尿病诊断结果信息。运用Logistic回归分析农村基层医生不稳定型心绞痛和2型糖尿病诊断准确性的影响因素。结果 共纳入172名农村基层医生,完成186次标准化患者访问,正确诊断率为48.39%。其中不稳定型心绞痛的正确诊断率为18.68%(17/91),2型糖尿病的正确诊断率为76.84%(73/95)。Logistic回归分析显示,具有执业医师资质的农村基层医生更有可能做出正确诊断(OR=4.857,95%CI=1.076~21.933,P=0.040)。农村基层医生在诊断过程中涉及的必要问诊和检查条目越多,做出正确诊断的概率越高(OR=1.627,95%CI=1.065~2.485,P=0.024)。与不稳定型心绞痛相比,农村基层医生对2型糖尿病做出正确诊断的可能性更高(OR=6.306,95%CI=3.611~11.013,P<0.001)。结论 四川农村基层医生不稳定型心绞痛和2型糖尿病诊断准确性整体较差,建议以基层医生慢性病诊断过程质量改善为突破口,提升基层医生执业水平,进而提高慢性病诊断准确性。     

嵌入式系统设计的一种协同仿真方法

提出了一种基于C 平台的嵌入式系统设计的协同仿真方法。嵌入式系统的软件成分由C 实现，硬件成分由Verilog刻划。该方法的基本思路是将Verilog模块转化为C 程序，然后将软件成分与转化后的硬件成分连接，形成一个完整的仿真环境。