基于门诊＂一卡通＂系统的医生工作站信息集成

基于面向服务的开放架构和HL7国际标准,构建以临床数据库为核心的集成平台。平台来自不同厂商的HIS、LIS、PACS、门诊“一卡通”等信息系统的数据进行整合,实现信息共享、流程协同,并同步推进门诊信息化建设,为医院信息化建设搭建一个高可靠性、高扩展性、高安全性的基础平台架构。     

基于Web服务的药品供应链管理系统研究

目的：在基层卫生服务机构实行基本药物零差率销售、采购和配送工作。方法：利用SOA架构与Web服务技术,建立基于Web服务的药品供应链管理系统。结果：实现了不同的医院信息系统（HIS）与药品供应链管理系统的无缝集成,消除了“信息孤岛”。结论：HIS与药品供应链管理系统协同工作,进一步提高了药品供应链管理绩效。     

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.     

基于HL7标准的PACS/RIS与HIS集成设计与应用

目的：设计基于HL7标准PAcs／RIS与HIS之间的集成接口,解决两个系统之间数据共享的问题,优化业务流程。方法：介绍了HL7标准的消息格式,分析了PACS／RIS与HIS之间的数据交换流程,在此基础之上,设计了HL7接口引擎,实现了数据共享。结果：通过MIRTH平台,实现了PACS／RIS与HIS2之间基于HL7标准的集成。结论：基于HL7标准的PACS／RIS与HIS之间集成,符合国际标准,扩展性好,大大提高了医院的工作效率,避免了资源浪费。     

医院数字化门诊系统的设计与构建

目的探讨医院数字化门诊的设计构建方案。方法通过对门诊就诊流程的再造,开发基于医院信息管理系统（hospital information system,HIS）的数字化门诊服务系统。结果成功构建包含自助导医、办卡、充值、挂号、排队叫号、计价确认、检验结果短信预约及报告打印、查询及评价等数字化系统,实现了业务流程优化、系统数据共享,改变了传统的门诊就医模式。结论数字化门诊系统创新了就医流程,为患者提供了便捷、舒适、高效、优质的医疗服务环境。     

基于SOA的医院信息系统集成平台建设与思考

医院各信息系统间的信息共享与业务协同是目前医院信息化建设面临的主要问题。分析目前医院信息系统建设现状,提出面向服务架构（SOA）的医院服务总线（HSB）的集成方案,为医院信息系统实现松耦合的集成提供平台。基于HL7、IHE、CDA、DICOM等标准建立各个系统与平台之间交互的消息机制,将系统的各种功能以服务的形式提供给最终用户或者其他服务,以实现医院各信息系统间的信息共享与业务协同。     

Improving Service Accessibility in Service-Oriented HIS

Nowadays, new trend in design and implementation of Hospital Information System (HIS) is towards using Web-based Service-Oriented Architecture (SOA). However, the standard SOA includes an insensitive service store through which the accessibility of some hospital services becomes difficult when their specification or network address are changed or missed. This paper discusses problems of insensitive service store and then presents a model where a sensitive service store is used to mitigate the problems. To show the efficiency of the proposed model, HIS of the Shahid Beheshti Hospital of Kashan including information systems of Admission, Outpatient, Ward, Pharmacy, Medical Document, Discharge and Insurance was designed and implemented with sensitive service store and its performance was considered.     

Design and Implementation of Web-Based Mobile Electronic Medication Administration Record

Patients’ safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System (HIS) to facilitate patients’ safety and to improve the quality of medical care. During the medical care processing, all the tasks are based upon physicians’ orders. In National Taiwan University Hospital (NTUH), the Electronic Health Record committee proposed a standard of order flows. There are objectives of the standard: first, to enhance medical procedures and enforce hospital policies; secondly, to improve the quality of medical care; third, to collect sufficient, adequate data for EHR in the near future. Among the proposed procedures, NTUH decides to establish a web-based mobile electronic medication administration record (ME-MAR) system. The system, build based on the service-oriented architecture (SOA) as well as embedded the HL7/XML standard, is installed in the Mobile Nursing Carts. It also implement accompany with the advanced techniques like Asynchronous JavaScript and XML (Ajax) or Web services to enhance the system usability. According to researches, it indicates that medication errors are highly proportion to total medical faults. Therefore, we expect the ME-MAR system can reduce medication errors. In addition, we evaluate ME-MAR can assist nurses or healthcare practitioners to administer, manage medication properly. This successful experience of developing the NTUH ME-MAR system can be easily applied to other related system. Meanwhile, the SOA architecture of the system can also be seamless integrated to NTUH or other HIS system.     

Design and Implementation of a Telecare Information Platform

For the aging population and for people with dominant chronic diseases, countries all over the world are promoting an "Aging in Place" program with its primary focus on the implementation of telecare. In 2009, Taiwan held a "Health Care Value-Added Platinum Program" with the goal of promoting the development of "Telecare" services by integrating medical treatment, healthcare, information communication, medical equipment and materials and by linking related cross-discipline professions to enable people to familiarize themselves with preventive healthcare services offered in their household and community environments. In addition, this program can be utilized to effectively provide diversified healthcare service benefitting society as a whole. This study aims to promote a diversified telecare service network in Taiwan's household and community environments, establish telecare information platforms, build an internal network of various healthcare service modes, standardize externally interfacing telecare information networks, effectively utilize related healthcare service resources, and complete reasonable service resource links forming an up-to-date health information exchange network. To this end, the telecare information platform based on service oriented architecture (SOA) is designed to promote an open telecare information interface and sharing environment to assist in such tasks as developing healthcare information exchange services, integrating service resources among various different healthcare service modes, accessing externally complex community affairs information, supporting remote physiological information transmissions, and providing diversified remote innovative services. Information system architecture and system monitoring indices of various types of healthcare service modes are used for system integrations for future development and/or expansions.     

Implementation of HL7 to client-server Hospital Information System (HIS) in the University of Tokyo Hospital

In developing a large-scale Hospital Information System (HIS), a client-server architecture has been gaining in popularity. It is important to introduce a standard message protocol that is independent both on the database structure and on the vender's proprietary platform. We introduced Health Level Seven (HL7) to our hospital information system. From our experiences, although we had to modify the original HL7 specifications in order to introduce the protocol to a client-server HIS especially in the area of order entry and record-oriented query, it was found that HL7 can be adopted in a client-server HIS.     

基于IHE XDS／XCA的跨区域医疗信息共享交换系统设计

该系统是在遵循IHE XDS．b（Cross-enterprise documentsharing）和IHE XCA（Cross-Community Access）技术规范基础上,采用SOA（Service Oriented Architecture）和EDA（Event Driving Architecture）技术架构及网格概念。设计和开发的一种跨区域（Cross-Community）医疗信息共享交换（EHR）系统。系统由四个层次组件组成：一个市级注册中心（XDSRegistry）;多个区级域XDS注册中心,每一个对应相应的行政管理域;与域级注册中心相对应的多个文档存储池（XDS Repository）;以及提供病人基本信息的文档源代理（XDS Source Actor Agents）。通过对该系统进行海量医疗文档数据发布、用户查询和图像提取等操作进行的压力测试和评估结果表明。该EHR系统可用于中、大城市多区域、多医疗机构之间的医疗信息共享交换和医疗协同。     

基于微服务的智慧医院底层架构设计和应用

阐述微服务架构概念与工作原理,基于微服务架构建立医院智慧医疗微服务体系门诊叫号系统,解决单体医疗架构开发功能耦合严重、代码臃肿维护困难、上线成本高、业务伸缩性差等问题,为医院智慧医疗服务提供底层架构支撑,为患者提供更加优质便捷的医疗信息服务。     

医疗信息化集成平台在医院的建设与思考

以新华医院医疗集成平台为案例,探讨在现有异源异构信息系统的基础上,基于面向服务(SOA)的开放架构和国际标准,构建以临床数据仓库(CDR)为核心的大型医院统一集成平台,实现来自不同厂商的HIS、LIS、RIS、护理信息系统等的数据整合、信息共享、流程协同,并同步推进临床信息化建设,通过电子病历浏览器和医生门户实现全流程患者信息实时同步共享。结论:为新华医院信息化建设搭建起一个高可靠性,高扩展性、高安全性的基础平台架构,为医院集成平台建设提供了参考[1]。     

基本药物制度实施对江苏省中部某县级市乡镇卫生院运行绩效的影响

目的：研究基本药物制度实施对江苏省中部某县级市乡镇卫生院运行绩效的影响,为完善政策提出建议。方法：基于基本药物制度的回顾性调查,采用资料收集和数据分析的方法,对比分析基本药物制度实施前后关键指标。结果：基本药物制度实施后,财政补助和门急诊次均费用变化存在显著性差异（P＜0．01）,乡镇卫生院门急诊人次不存在显著性差异（P＞0．05）。结论：基本药物制度实施后,政府财政补助增加,而乡镇卫生院诊疗能力并未提高。建议乡镇卫生院进一步改革管理制度,保障基本药物供应,提升服务能力。     

急诊留观信息系统的设计与实现

目的:为满足新政策要求,研制能体现急诊留观特色流程、紧密联系急诊留观工作实际情况的应用软件.方法:在医院信息系统平台上,开发能够满足急诊留观特殊医疗模式的信息系统软件,并能继承医院信息系统的患者主索引功能.结果:急诊留观信息系统包括留观工作站、留观护士工作站等十余个功能模块,可满足新政策要求及急诊留观特殊医疗模式.经临...     

信息流在医院感染管理中的综合应用

目的提高以信息管理为平台的医院感染管理能力。方法综合应用医院信息系统（hospital information system,HIS）数据库和网络架构,开发应用“医院感染监控管理软件”、“药敏信息录入系统”、“发热及腹泻症状监测系统”、“军人出院信息统计”、“抗菌药物应用监测系统”等软件,获取医院感染相关信息。结果HIS数据共享的信息流,可以实时提取每一个在院和出院病人的基本信息和诊疗信息,较好的实现了以医院感染管理相关因素数据查询为主线的数、质量信息管理。结论HIS信息流在医院感染管理中的综合应用,提高了医院感染管理效率和质量。     

Design and Development of a Sharable Clinical Decision Support System Based on a Semantic Web Service Framework

Clinical decision support (CDS) systems provide clinicians and other health care stakeholders with patient-specific assessments or recommendations to aid in the clinical decision-making process. Despite their demonstrated potential for improving health care quality, the widespread availability of CDS systems has been limited mainly by the difficulty and cost of sharing CDS knowledge among heterogeneous healthcare information systems. The purpose of this study was to design and develop a sharable clinical decision support (S-CDS) system that meets this challenge. The fundamental knowledge base consists of independent and reusable knowledge modules (KMs) to meet core CDS needs, wherein each KM is semantically well defined based on the standard information model, terminologies, and representation formalisms. A semantic web service framework was developed to identify, access, and leverage these KMs across diverse CDS applications and care settings. The S-CDS system has been validated in two distinct client CDS applications. Model-level evaluation results confirmed coherent knowledge representation. Application-level evaluation results reached an overall accuracy of 98.66 % and a completeness of 96.98 %. The evaluation results demonstrated the technical feasibility and application prospect of our approach. Compared with other CDS engineering efforts, our approach facilitates system development and implementation and improves system maintainability, scalability and efficiency, which contribute to the widespread adoption of effective CDS within the healthcare domain.     

门诊划价收费应急系统的设计与应用

目的：为保障医院信息系统发生故障停机时,门诊划价收费系统能维持原来的工作任务,设计了一套划价收费应急程序.方法：在工作站安装本地应急数据库管理系统,对必要的基础数据在应急数据库中进行保存.通过应急程序,进行数据下载,在系统恢复正常后将业务数据回传到主服务器.结果：工作站可快速切换到应急状态,进行正常的划价收费.结论：该程序满足了医院门诊信息系统不可停顿性和数据完整性的要求,完善了医院信息化建设.     

门急诊输液管理系统设计与实现

分析了第三军医大学新桥医院门急诊传统输液流程的问题,为改善这些问题采用信息技术和管理手段优化工作流程,并依此详细设计软件功能、数据结构及与HIS的数据接口实现,给出了相应的接口实现SQL语句。对其他医院输液系统的研发方面具有一定的借鉴作用。     

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。