A Health Examination System Integrated with Clinical Decision Support System

Health examinations play a key role in preventive medicine. We propose a health examination system named Health Examination Automatic Logic System (HEALS) to assist clinical workers in improving the total quality of health examinations. Quality of automated inference is confirmed by the zero inference error where during 6 months and 14,773 cases. Automated inference time is less than one second per case in contrast to 2 to 5 min for physicians. The most significant result of efficiency evaluation is that 3,494 of 4,356 (80.2%) cases take less than 3 min per case for producing a report summary. In the evaluation of effectiveness, novice physicians got 18% improvement in making decisions with the assistance of our system. We conclude that a health examination system with a clinical decision system can greatly reduce the mundane burden on clinical workers and markedly improve the quality and efficiency of health examination tasks.     

构建临床决策支持系统的良性生态

在电子病历得到应用后,临床决策支持系统(CDSS)是进一步提升医疗安全与质量的重要手段。但是当前CDSS的应用却遇到许多困难。文章根据我国当前电子病历应用水平评估的情况归纳了临床决策支持应用的6种类型和5种常见的应用场景,分析了技术上促进CDSS应用需要解决的4个主要问题,提出了以优先解决电子病历系统与CDSS接口的标准化作为入手推动临床决策支持应用的方案。通过扩大CDSS的应用带动知识描述标准的建立,进而引导市场化方式发展通用的知识库,由此形成临床决策支持系统良性发展的生态。     

Allocation of surgical procedures to operating rooms

Reduction of health care costs is of paramount importance in our time. This paper is a part of the research which proposes an expert hospital decision support system for resource scheduling. The proposed system combines mathematical programming, knowledge base, and database technologies, and what is more, its friendly interface is suitable for any novice user. Operating rooms in hospitals represent big investments and must be utilized efficiently. In this paper, first a mathematical model similar to job shop scheduling models is developed. The model loads surgical cases to operating rooms by maximizing room utilization and minimizing overtime in a multiple operating room setting. Then a prototype expert system which replaces the expertise of the operations research analyst for the model, drives the modelbase, database, and manages the user dialog is developed. Finally, an overview of the sequencing procedures for operations within an operating room is also presented.     

A study on building data warehouse of hospital information system

Background  Existing hospital information systems with simple statistical functions cannot meet current management needs. It is well known that hospital resources are distributed with private property rights among hospitals, such as in the case of the regional coordination of medical services. In this study, to integrate and make full use of medical data effectively, we propose a data warehouse modeling method for the hospital information system. The method can also be employed for a distributed-hospital medical service system.

Methods  To ensure that hospital information supports the diverse needs of health care, the framework of the hospital information system has three layers: datacenter layer, system-function layer, and user-interface layer. This paper discusses the role of a data warehouse management system in handling hospital information from the establishment of the data theme to the design of a data model to the establishment of a data warehouse. Online analytical processing tools assist user-friendly multidimensional analysis from a number of different angles to extract the required data and information.

Results  Use of the data warehouse improves online analytical processing and mitigates deficiencies in the decision support system. The hospital information system based on a data warehouse effectively employs statistical analysis and data mining technology to handle massive quantities of historical data, and summarizes from clinical and hospital information for decision making.

Conclusions  This paper proposes the use of a data warehouse for a hospital information system, specifically a data warehouse for the theme of hospital information to determine latitude, modeling and so on. The processing of patient information is given as an example that demonstrates the usefulness of this method in the case of hospital information management. Data warehouse technology is an evolving technology, and more and more decision support information extracted by data mining and with decision-making technology is required for further research.

     

Quality and Cost Improvement of Healthcare via Complementary Measurement and Diagnosis of Patient General Health Outcome Using Electronic Health Record Data: Research Rationale and Design

In this evolving ‘third era of health’, one of the US Health Care Reform Act’s goals is to effectively facilitate the primary care physician’s ability to better diagnose and manage the health outcome of the outpatient. That goal must include research on the complementary quantitative-qualitative assessment and rating of the patient’s health status. This paper proposes an overview of the rationale and design of a research program for a balanced measurement and diagnostic clinical decision support system (CDSS) of the changing general health status of the patient -including disease- using electronic health record (EHR) data. The rationale, objectives, health metric-diagnostic tools architecture, simulation-optimization, and clinical trials are outlined. Resources, time frames, costs, feasibility, healthcare benefits and data-integration of the project are delineated. The basis and components of the research program to achieve an automated-CDSS to complement physician’s clinical judgment, calculating a mathematical ‘health equation’ from each patient’s EHR database, assisting physician-patient collaboration to diagnose, and improve general health outcomes is described. Use of multiple dimensional index, ways of classification, and causal factors’ assessments, to arrive at the EHR-based CDSS algorithm-software providing a general health level and state rating of the patient are proposed. Its application could provide a compass for the general practitioner’s best choice and use of the myriad of healthcare educational and technological options available with lower costs for everyday clinical practice and research. It could advance the approaches and focus of the ‘eras of diseases’, to the promising ‘era of health’, in an integrated, general approach to ‘health.’     

Recommendations for the school health physical examination in Lebanon

School health developed gradually over the years; starting with efforts to keep contagion out of schools to global programs of comprehensive services. One of its components, school medicine, covers screening examinations, record maintenance, emergency care, immunization monitoring and health counseling. This paper proposes the essential health activities to be performed during a screening school examination in Lebanon. The recommendations are based on a combination of international literature review of evidence and the existence of Lebanese epidemiological reports identifying specific problems. Vaccination record review, tuberculin testing, vision, hearing, dental and skin disorders screening procedures are proposed as essential activities of the school physical examination.     

依托数字化医院平台优化体检工作流程

随着社会的进步,体检越来越受到人们的重视。医院体检工作涉及部门多,存在信息沟通不及时、易与患者发生就医冲突的矛盾;体检项目随需求而变,随体检过程而变,造成体检项目结果手工汇总费时、费力、易出差错。依托数字化医院平台,合理规范体检流程是提高体检工作效率和服务质量的必然选择。本文分析了人们时健康体检工作的要求,给出由登记工作站、体检单元工作站、主检医生工作站、健康档案分发工作站、体检系统维护工作站组成的体检信息系统的功能模型和岗位模型。并提出从登记工作站发出体检项目指令。依托全院范围的LIS、PACS系统实现体检检查、检验与就医检查、检验在流程、数据和软件平台的一致;在门诊医生工作站和住院医生工作站硬件上安装体检单元工作站,供分科医生使用,实现体检单元虚拟化;由主检医生工作站导入检查诊断报告和检验结果报告。汇总各体检单元项目结果,对各科病史、阳性体征、异常结果、分科小结、分科建议的浏览、审核和摘录,形成体检建议指导和体检总结;由健康档案分发工作站打印分发体检者健康档案。最后。给出了优化后的健康体检流程。     

A Hybrid Fuzzy-Neural System for Computer-Aided Diagnosis of Ultrasound Kidney Images Using Prominent Features

The objective of this work is to develop and implement a computer-aided decision support system for an automated diagnosis and classification of ultrasound kidney images. The proposed method distinguishes three kidney categories namely normal, medical renal diseases and cortical cyst. For the each pre-processed ultrasound kidney image, 36 features are extracted. Two types of decision support systems, optimized multi-layer back propagation network and hybrid fuzzy-neural system have been developed with these features for classifying the kidney categories. The performance of the hybrid fuzzy-neural system is compared with the optimized multi-layer back propagation network in terms of classification efficiency, training and testing time. The results obtained show that fuzzy-neural system provides higher classification efficiency with minimum training and testing time. It has also been found that instead of using all 36 features, ranking the features enhance classification efficiency. The outputs of the decision support systems are validated with medical expert to measure the actual efficiency. The overall discriminating capability of the systems is accessed with performance evaluation measure, f-score. It has been observed that the performance of fuzzy-neural system is superior compared to optimized multi-layer back propagation network. Such hybrid fuzzy-neural system with feature extraction algorithms and pre-processing scheme helps in developing computer-aided diagnosis system for ultrasound kidney images and can be used as a secondary observer in clinical decision making.     

Methods to Evaluate Health Information Systems

为了保证卫生信息系统引进的顺利进行,达到预期的目的,有必要在系统引进的每个阶段对影响系统成功引进的关键因素进行评估.基于系统性的文献分析研究和自身多年对卫生信息系统评估工作的经验,提出一个以笛伦和麦克伦信息系统成功模型为基础的整合多元方法的评估方案.这个方案的优势在于它不仅能分辨决定卫生信息系统成功引进的因素,而且能将不同因素的影响程度量化,从而产生对影响因素有轻重缓急之分的评估结果.该结果有利于决策者及时处理解决系统引进不同时期出现的关键问题.这种有量化证据支持的决策行为将有效地降低卫生信息系统引进失败的可能性,进而增大卫生信息系统的投入产出回报.     

基于区域卫生信息平台的管理决策支持系统需求研究

介绍了区域卫生信息平台概况,并设计了卫生管理决策支持系统架构,主要由数据源、数据仓库、决策信息层、应用服务、门户网站等几部分组成。从业务、功能两个角度重点讨论了卫生管理决策支持系统的需求状况,并提出了决策支持系统的功能模型。     

国人健康档案卡管理信息系统开发

介绍健康档案卡管理信息系统的基本架构,功能组件与技术实现,健康档案卡管理信息系统作为区域医疗信息共享平台的必不可少的组成部分,完成健康档案卡全生命周期包括制卡、发行、应用、管理、回收等环节的信息管理与流程管理.同时,管理信息系统提供查询并上报各类与健康档案卡的流通相关的统计数据,为卫生行政部门提供决策依据.     

浅析现代远程教育考试改革

考试是确保远程教育教学质量的重要环节。文章分析了远程教育在考试观念、考试命题、考试方式、考试安排与考试评阅等方面存在的问题，论述了远程教育考试的内涵及远程教育考试应遵循的原则、远程教育的教学模式、人才培养目标与成人学习规律，在此基础上提出远程教育考试改革的建议并讨论了其应用状况。     

关于电子病历系统发展的几点思考

随着医院信息化的不断发展,电子病历系统已成为信息化建设中的重要部分。从数据集成、信息共享、病历质量控制、临床决策支持、移动医疗及安全性几个方面出发对电子病历系统发展进行研究,希望对医院信息化建设有一定的借鉴意义。     

医院信息化发展对信息部门和主管提出的挑战与要求

首先提出医院信息系统发展方向是数字化医院,核心内容是基本信息系统、临床信息系统、电子病历系统、决策支持系统、区域协同系统和患者服务系统,医院信息化发展对信息部门和信息主管提出了新的挑战和要求,从目标、职责、流程优化和信息管理、核心能力和组织架构等5个方面对信息部门提出新要求,并提出信息主管应具备6个方面的能力。     

基于统一信息模型的CDSS与EMR接口技术研究与实现

临床决策支持系统(CDSS)的实施和应用具有重要的临床意义,也是医院电子病历系统(EMR)应用水平评价的重要内容.由于CDSS和EMR接口开发的困难,CDSS的部署成本高、效率低,阻碍了CDSS的广泛应用.本文在分析接口开发挑战的基础上,提出了一种基于统一信息模型的接口实现技术,并在临床案例中验证了方法的可行性.     

Promoting and supporting breastfeeding for optimal nutrition during infancy

As general physician one can significantly influence a mother's or family's decision to optimally feed their baby and good feeding practices during first year greatly reduce the risk of a child being sick and being malnourished. It is recommended that health personnel should focus on exclusive breastfeeding for first six months and continued breastfeeding for up to two years along with appropriate and timely complementary foods that are started at the age of six months. Mothers need breastfeeding information and support during antenatal time; during hospital stay or at health care facility, and during postpartum visits. Encouragement especially during antenatal period increases breastfeeding rates. Subsequent paediatric and matemal visits are also important for promotion of breastfeeding. In this paper we would provide you new and updated information on recommended feeding practices, how you can support and help mothers, and what kind of skilled help is needed to initiate breastfeeding early, maintain exclusive breastfeeding and avoid artificial feeding. We will also discuss some strategies to support mothers.     

移动互联网环境下的社区卫生服务信息系统设计与实现

指出当前社区卫生服务信息化中存在的问题,阐述社区卫生服务信息系统发展现状,提出构建基于移动互联网的社区卫生服务信息系统。从系统架构和支撑系统两方面探讨系统设计情况,以健康档案管理和健康信息服务为例论述系统环境和系统实现。     

剖析考试作弊原因 加快考试制度改革

考试作弊现象在高校普遍存在,严重影响了高校的学风、校风,干扰了正常的教学秩序。本文从复杂的现实原因和社会背景两方面对大学校园考试作弊现象进行了分析,提出了要加强心理引导,树立正确的考试观念,改革考试制度,防止和减少考试作弊。     

基于共享编码策略的医学对话阴阳性判别系统

介绍临床发现阴阳性判别任务研究现状,提出一种基于预训练模型的临床发现阴阳性判别系统,详细阐述系统构建方法,分析实验结果,该方法在2021年度中国健康信息处理大会(CHIP 2021)医学对话临床发现阴阳性判别任务的测试集上模型集成Macro-F1值达77.87%。     

人羊膜上皮细胞通过抑制中性粒细胞胞外诱捕网促进糖尿病创面愈合

软件定义网络（software defined network,SDN）作为一种新型网络架构,其转控分离及集中控制的架构思想为网络带来了显著的灵活性,同时为感知全局网络状态提供了便利。分布式拒绝服务攻击（distributed denial of service,DDoS）是一种典型的网络攻击方式。针对SDN网络中进行DDoS攻击检测的问题,提出了一种基于条件熵和决策树的DDoS攻击检测方法,利用条件熵判断当前网络状态,通过分析SDN中DDoS攻击特点,提取用于流量检测的6项重要特征,使用C4.5决策树算法进行网络流量分类,实现对SDN中的DDoS攻击的检测。实验表明,相比于其它研究方法,文中提出的方法不仅具有较高检测精确率和召回率,而且明显缩短了检测时间。