全息电子病案的概念和应用

我院于1998年底开发研制的全息电子病案管理系统,经过一年多的使用,共扫描病案一万六千余份,刻录光盘90余张,可方便快捷进行病案查询,检索和统计,有效提高病案使用率,节约了存贮空间,充分发挥了病案在临床、医疗、科研、社会保险等方面的作用和价值。     

浅谈电子病案在病案管理中存在问题及对策

电子病案的实施提高了工作效率、提高医疗质量、避免在病案借阅中丢失、达到病案信息资源共享,对电子病案管理中存在问题进行分析,并通过提高认识、增强法律意识、完善制度来提高病案管理水平,从而实现新一代的医院管理模式。     

我院电子病案及其资源应用初探

病案是医院的财富,医院电子病案是医疗技术和信息技术发展的必然结果。病案的丰富资源借助电子化的手段得以充分应用,病案的作用得到更好地发挥。     

应用电子病案,规范病案信息管理

病案是医务人员从事诊断治疗过程的记录及其临床经验的总结，是完整的医疗档案及医疗法律文献。病案信息的准确、完整、及时、科学不仅直接影响医院的医疗、教学和科研，而且对患者，对公、检、法、基本医疗保险、商业保险等部门都有影响，为此我院加强对病案信息的全方位管理，基本上满足了各方面对病案信息的需求，现将病案管理的一些基本情况介绍如下，同大家一起探讨，做好此项工作。     

电子病历病案工作站的设计与应用

为加强电子病历的安全管理,本文针对电子病历的管理需求,设计了一套与电子病历相连接的病案工作站,对系统目标、功能需求、详细功能设计等进行详细探讨,并对应用情况进行评估分析.对提高电子病历在医院的应用有一定的指导意义,对医院规范医疗行为和提高病案质量具有深远的现实意义.     

临床电子病案系统的建立与思考

电子病案是医院信息化建设的核心竞争，它的建设和实施涉及较多相关问题。本文就目前国内情况，对电子病案建设的思路和实践进行了探索，同时对电子病案的认识、难点、建议也进行了较为深刻的阐述。     

基于Web的电子病案系统设计

计算机网络技术和数据库技术的发展，使得医院的信息化程度不断得到提高，也使得电子病案的发展越来越得到重视。本文阐述了电子病案在国内外的发展趋势以及如何运用B／S和C／S相结合的模式设计基于Web的电子病案系统，并结合实际对设计电子病案系统过程中必须注意的几个问题进行了探讨。     

加速和规范电子病案的发展实现现代化病案管理

随着计算机信息网络技术在医疗领域的应用越来越广泛,电子病案是已经成为现代化病案管理的必然产物和必然趋势.电子病案使用方便、成本低廉、内容丰富,非常有利于网络化管理、统计分析等,对于远程会诊、信息共享等更是具有独特的优势.因此,加速和规范电子病案的发展是实现现代化病案管理的重中之重.     

电子签名在我院病案存储管理中的应用

病案的存储和管理是当今病案管理的两大主题.我院实行电子病历电子签名是现代病案存储和管理技术实现的方法之一.实践证明,施行电子签名后,解决了我院病案存储的一些难题,在病案管理方面起到了很大的作用.     

Xindice在EMR中的应用研究

在对基于XML文档的EMR进行有效存储和查询的解决方案中,本文认为作为具有代表性的开源的纯XML数据库系统的信息服务器,Xindice因其优良的系统架构可以高效地对XML文档进行存储和获得各类型医疗数据,是今后构建EMR系统结构中存储层的不错的选择对象.并依据医疗病案的结构特点,提供了可行的存贮优化方案.     

Inactivation of the EGF-TM7 receptor EMR4 after the Pan-Homo divergence

We here report on the identification of a novel human EGF-TM7 receptor, designated EMR4. Like most EGF-TM7 receptor genes, EMR4 is localized on the short arm of chromosome 19, in close proximity to EMR1. Remarkably, due to a one-nucleotide deletion in exon 8, translation of human EMR4 would result in a truncated 232-amino acid protein lacking the entire seven-span transmembrane region. This deletion is not present in nonhuman primates, including chimpanzees, suggesting that EMR4 became nonfunctional only after human speciation, about five million years ago. Thus, EMR4 surprisingly accounts for a genetic difference between humans and primates related to immunity.     

Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS

Evaluating and selecting software packages that meet the requirements of an organization are difficult aspects of software engineering process. Selecting the wrong open-source EMR software package can be costly and may adversely affect business processes and functioning of the organization. This study aims to evaluate and select open-source EMR software packages based on multi-criteria decision-making. A hands-on study was performed and a set of open-source EMR software packages were implemented locally on separate virtual machines to examine the systems more closely. Several measures as evaluation basis were specified, and the systems were selected based a set of metric outcomes using Integrated Analytic Hierarchy Process (AHP) and TOPSIS. The experimental results showed that GNUmed and OpenEMR software can provide better basis on ranking score records than other open-source EMR software packages.     

Comparative domain modeling of human EGF-like module EMR2 and study of interaction of the fourth domain of EGF with chondroitin 4-sulphate

EMR2 is an EGF-like module containing mucin-like hormone receptor-2 precursor,a G-protein coupled receptor (G-PCR).Mutation in EMR2 causes complicated disorders like polycystic kidney disease (PKD).The structure of EMR2 shows that the fifth domain is comprised of EGF-TM7 helices.Functional assignment of EMR2 by support vector machine (SVM) revealed that along with transporter activity,several novel functions are predicted.A twenty amino acid sequence MGGRVFLVFLAFCVWLTLPG acts as the signal peptide responsible for posttranslational transport.Eight amino acids are involved in N-glycosylation sites and two cleavage sites are Leu517 and Ser518 in EMR2.The residue Arg241 is responsible for interaction with glycosaminoglycan and chondroitin sulfate.On the basis of structure,function and ligand binding sites,competitive EMR2 inhibitors designed may decrease the rate of human diseases like Usher’s syndrome,bilateral frontoparietal polymicrogyria and PKD.     

The impact of residents’ training in Electronic Medical Record (EMR) use on their competence: Report of a pragmatic trial

Objectives

Even though Electronic Medical Records (EMRs) are increasingly used in healthcare organizations there is surprisingly little theoretical work or educational programs in this field. This study is aimed at comparing two training programs for doctor–patient–computer communication (DPCC).

Methods

36 Family Medicine Residents (FMRs) participated in this study. All FMRs went through twelve identical simulated encounters, six pre and six post training. The experiment group received simulation based training (SBT) while the control group received traditional lecture based training.

Results

Performance, attitude and sense of competence of all FMRs improved, but no difference was found between the experiment and control groups. FMRs from the experiment group evaluated the contribution of the training phase higher than control group, and showed higher satisfaction.

Conclusion

We assume that the mere exposure to simulation served as a learning experience and enabled deliberate practice that was more powerful than training. Because DPCC is a new field, all participants in such studies, including instructors and raters, should receive basic training of DPCC skills.

Practice implication

Simulation enhances DPCC skills. Future studies of this kind should control the exposure to simulation prior to the training phase. Training and assessment of clinical communication should include EMR related skills.     

基于卫生信息平台的电子病历信息共享研究和实现

研究信息共享的关键技术,通过电子病历的标准化和结构化处理、传输和交换,实现电子病历信息的共享。在卫生部电子病历数据标准的基础上,结合采用情景分析法和层次分析法,通过Delphi法专家咨询确定电子病历可以结构化的数据项,实现电子病历的标准化和结构化处理;然后运用SWOT分析法,结合应用可扩展标记语言（XML）和临床文档结构标准（CDA）两项技术,实现电子病历的标准化传输和交换,使得电子病历信息在传输和交换过程中能够被机器自动识别,实现数据的自动化传输和交换;最后,研发电子病历完整性测试系统,实现电子病历完整性的自动测试。完成电子病历信息标准化和结构化处理、传输和交换全流程的技术研究,形成技术规范。有123家医院实现电子病历标准化上传省级卫生信息平台,有16家电子病历提供商具备了电子病历标准化和结构化处理、传输和交换能力。初步实现了电子病历的信息共享,电子病历数据传输技术规范作为浙江省地方标准正式颁布实施。     

电子病历的数据登录技术

近年来医院中采用的电脑化的信息系统大大提高了医护工作的质量和效率。电子病历(EMR)作为现代医院信息系统的基础吸引了许多研究工作者的注意。但是人机界面,文字处理,机密安全尺度以及不完善的数据交换标准是EMR能够实现的主要技术障碍[1]。这篇论文中我们主要涉及到了几种主要的数据登录技术。这些技术包括结构化的数据登录(structureddataentry),自然语言处理(naturallanguageprocessing),扫描技术(scanning),光学字符识别(OCR)和语音识别技术(speechrecognition)。     

Impact of PACS-EMR Integration on Radiologist Usage of the EMR

The purpose of this study was to objectively quantify the impact of implementing picture archiving and communication system-electronic medical record (PACS-EMR) integration on the time required to access data in the EMR and the frequency with which data are accessed by radiologists. Time to access a clinic note in the EMR was measured before and after integration with a stopwatch and compared by t test. An IRB-approved, HIPAA-compliant retrospective review of EMR access data from security audit logs was conducted for a 14-month period spanning the integration. Correlation of these data with report signatures identified the studies in which the radiologist accessed the EMR to obtain additional clinical data. Proportions of studies with EMR access were plotted and compared before and after integration using a chi-square test. Time to access the EMR decreased from 52 to 6 s (p?<?0.001). Proportion of studies with EMR access increased from 36.7% (10,175/27,773) to 44.9% (10,843/24,153) after integration (p?<?0.001). Integrating PACS and the EMR substantially decreases the time to access the EMR and is associated with a significant increase in the proportion of studies for which radiologists obtain additional clinical data.     

Interventional Radiology Workflow Management in the Electronic Medical Record

The electronic medical record (EMR) has significantly improved efficiency in many areas of radiology workflow. Following implementation of an electronic protocol selection process for cross-sectional imaging at the University of Colorado Hospital, the interventional radiology (IR) division desired to have a similar tool. Evaluation of the IR workflow demonstrated the need for a multilayered solution, which accounted for consultation, physician review, authorization and scheduling, pre-procedural nursing evaluation, physician rounding, and resource allocation and prioritization. This paper outlines the rationale for and components of this process.