A review on systematic reviews of health information system studies

The purpose of this review is to consolidate existing evidence from published systematic reviews on health information system (HIS) evaluation studies to inform HIS practice and research. Fifty reviews published during 1994–2008 were selected for meta-level synthesis. These reviews covered five areas: medication management, preventive care, health conditions, data quality, and care process/outcome. After reconciliation for duplicates, 1276 HIS studies were arrived at as the non-overlapping corpus. On the basis of a subset of 287 controlled HIS studies, there is some evidence for improved quality of care, but in varying degrees across topic areas. For instance, 31/43 (72%) controlled HIS studies had positive results using preventive care reminders, mostly through guideline adherence such as immunization and health screening. Key factors that influence HIS success included having in-house systems, developers as users, integrated decision support and benchmark practices, and addressing such contextual issues as provider knowledge and perception, incentives, and legislation/policy.     

试论计算机在医院管理中的应用

目的：通过探讨计算机在医院管理中的应用,论述医院信息系统在医院中的可行性;方法：结合医院业务流程,介绍医院信息系统各模块功能,进行分析,结果：医院信息系统是强化医院管理,提高医院工作效率,改进医疗质量的一种很有效的工具;结论：医院信息系统是未来医院发展的必然趋势。     

基于HIS 系统疾病知识库集成的接口设计

中国疾病知识总库(CDD)是以疾病知识为核心,将与之相关的知识点联接为一个有机的知识体。通过Web Service接口将CDD的知识单元集成到HIS系统的信息流中,可有效提升HIS的知识服务能力和信息化水平。本文介绍了HIS系统和CDD,论述了基于Web Service系统集成的设计思路和实现。     

基于B／S组件的HIS系统设计与实现

为了使基于Web的HIS系统具有可扩展性、重用性,提高开发效率,提出了一种基于组件实现的HIS系统设计方案。该组件系统将Web页面抽象成组件,在生成页面时进行解析。随着HIS系统不断实施,开发人员可以不断开发组件。任意进行拼装组件实现用户需求,形成具有医院特色的HIS系统。     

基于HIS统计集成数据环境的医疗运营监测系统设计与应用

基于HIS统计集成数据环境研究设计了医疗运营监测系统模型框架，构建了基于HIS统计集成与管理决策支持系统的ODS资源库，医院统计指标监测模型库、监测准则构成的知识库和由历史数据估计得到的模型参数库，旨在实现对医疗运营常规统计指标的实时监测，达到及时发现医疗问题的目的。并以住院日指标监测为例，测试系统应用，收到良好成效。     

Review: Measuring value for money: a scoping review on economic evaluation of health information systems

Objective

To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations.

Materials and methods

We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed.

Results

Forty-two papers were selected and 33 were deemed high quality (scores ≥8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative.

Conclusions

We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified.     

论医院业物流程重组及其方法

本文探讨改革重组医院业务流程,应用HIS改善医疗服务质量和效率的问题.医院管理模式更新,离不开HIS系统的支撑.采取合理方法,选择关键流程,加快业务流程的优化,完善HIS系统,是建设数字化医院的基础.     

护士工作日志填报系统的设计与实现

目的实现护士工作日志全电脑管理,提高工作效率。方法针对医院信息系统（HIS）应用之后,部分护士工作日志数据仍需要护士人工填报,费时费力,并且HIS系统自动生成的数据也经常与实际不一致,查对非常困难。医院计算机人员结合HIS数据库,设计并开发出护士工作日志网上填报及查对系统,建立网上查询、核对和监督机制。结果彻底实现了护士工作日志所需全部数据的网上采集、录入、修改和核对,取消了纸质日志的填报。结论结合HIS,开发实用软件,弥补HIS不足,大大提高了工作效率。     

Quantifying the impact of health IT implementations on clinical workflow: a new methodological perspective

Health IT implementations often introduce radical changes to clinical work processes and workflow. Prior research investigating this effect has shown conflicting results. Recent time and motion studies have consistently found that this impact is negligible; whereas qualitative studies have repeatedly revealed negative end-user perceptions suggesting decreased efficiency and disrupted workflow.We speculate that this discrepancy may be due in part to the design of the time and motion studies, which is focused on measuring clinicians'' ‘time expenditures’ among different clinical activities rather than inspecting clinical ‘workflow’ from the true ‘flow of the work’ perspective. In this paper, we present a set of new analytical methods consisting of workflow fragmentation assessments, pattern recognition, and data visualization, which are accordingly designed to uncover hidden regularities embedded in the flow of the work. Through an empirical study, we demonstrate the potential value of these new methods in enriching workflow analysis in clinical settings.     

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。     

Struts框架技术在医院信息系统开发中的应用

基于JSP技术开发的HIs系统应用程序经常将数据库层代码、页面显示代码以及控制流代码混在一起,实际上,这种混合开发方式会使大型医院信息系统的开发和系统后期维护变得异常困难,而通过分层的思想开发应用系统可以有效解决这些问题。在HIS应用程序开发过程中采用MVC三层架构可以实现对系统的分层开发,MVC三层架构的逻辑层实现业务逻辑代码部分,视图层实现页面设计代码部分,控制层实现流程控制代码部分。Struts为实现基于MVC架构的web应用程序开发提供了一个优秀的框架,利用Struts框架开发的应用程序具有程序结构清晰、后期维护工作量少、开发效率高等优点,特别适合应用于大型HIS系统的开发。     

谈HIS功能的自主拓展与应用

目的提高HIS资源的有效利用和提高医院工作效率。方法医院网络管理人员详细了解HIS数据结构,结合现有HIS系统,对HIS进行功能拓展,开发出病区工作日志等实用小软件。结果实现了HIS功能扩充,提高了工作效率。结论用户结合HIS系统数据结构,自主开发一些小的模块或查询统计工具,进行HIS功能拓展,不失为一种灵活实用的好办法。     

构建医院内外网互通的途径探讨

国内许多医院在拥有自己的内部局域网基础上,开始建立医院对外的互联网体系.出于对安全的考虑,一般医院会将HIS网络与Internet网物理隔离,互不通信.随着社会的进步、数据的膨胀、知识的交流,人们急需将HIS网络与Internet网进行互相通信.文章在介绍多种实现模式的基础上,指出通过Linux防火墙机制,构架一个安全的FTP服务器模式来实现两网的有效通信是一种简单可行的方法.     

Essential hypertension in childhood

Fifteen patients, aged 8 to 17 years, were found to have hpertension and were studied from February 1974 to Decemober 1975. Hypertension was defined as supine diastolic blood pressure repeatedly above 90 mm Hg. Five patients had a family history of hypertension. Extensive diagnostic evaluation performed in all cases failed to show an underlying cause for the hypertension. Patients with target-organ involvement were treated with hydrochlorothiazide; five of them are currently normotensive. Of the remaining nine untreated patients, four became spontaneously normotensive within eight to 14 months of the initial evaluation. These results suggest that extensive studies in children with hypertension may not be necessary in every case if clinical findings meet the critiera for the diagnosis of essential hypertension. These studies might be desirable, however, if target-organ involvement is present.     

The Impact of the Security Competency on “Self-Efficacy in Information Security” for Effective Health Information Security in Iran

The security effectiveness based on users’ behaviors is becoming a top priority of Health Information System (HIS). In the first step of this study, through the review of previous studies ‘Self-efficacy in Information Security’ (SEIS) and ‘Security Competency’ (SCMP) were identified as the important factors to transforming HIS users to the first line of defense in the security. Subsequently, a conceptual model was proposed taking into mentioned factors for HIS security effectiveness. Then, this quantitative study used the structural equation modeling to examine the proposed model based on survey data collected from a sample of 263 HIS users from eight hospitals in Iran. The result shows that SEIS is one of the important factors to cultivate of good end users’ behaviors toward HIS security effectiveness. However SCMP appears a feasible alternative to providing SEIS. This study also confirms the mediation effects of SEIS on the relationship between SCMP and HIS security effectiveness. The results of this research paper can be used by HIS and IT managers to implement their information security process more effectively.     

从医院信息系统提取临床科研数据的研究

目的：从医院信息系统中提取临床科研数据。方法．以对病毒性肝炎后肝硬化门静脉高压症患者中,脾切除对HCC（肝细胞肝癌）的发生率影响研究为例,共需收集每个病人的就诊信息106条。使用电子病历信息检索、人工筛选等方法收集从2002年至2008年出院诊断为肝炎后肝硬化患者信息。结果：共检索到符合纳入标准的病）,．5359例,因数据缺失、记录的数据不准确及排除标准等原因,最后有效病历数据为2300例。其中数据缺失及无法入组的数据约为57．08％。结论：现有HIS系统的数据尚不能很好满足临床科研对数据的需求,为收集到完整的临床科研数据,今后应加大结构化电子病历的推广和使用,并加强临床研究的科研设计。     

我国电子病历的应用现状

自2009年医疗信息化被确定为医药卫生体制改革“四梁八柱”之一后,各地医疗机构对自身的信息化建设和区域信息平台的建设展开了多方探索,在取得良好成效的同时也暴露出许多问题。电子病历作为医院信息系统的核心组成部分,其应用倍受关注。通过对目前国内电子病历系统的应用现状及存在问题的梳理,了解电子病历在我国的发展情况,为更好地发挥其作用、规范其管理、减少其弊端提供参考和借鉴。     

电子临床路径与HIS集成的研究与设计

针对医院HIS、LIS和RIS等各系统问的数据难以交互及共享等问题,利用Web Service技术设计了电子临床路径信息系统与HIS系统集成框架,并提供了数据交换接口,屏蔽了异构系统底层数据的差异,实现了与HIS系统的无缝集成,大大提高了医院医疗质量和服务效率。     

HIS系统代理检查检验总体设计与实现

代理检查检验是HIS系统功能的延伸,使病人在就医过程中不受物理位置的限制,实现连续性医疗,提高效率,减少重复的、不必要的医疗资源消耗,降低医疗活动整体成本。根据医院HIS系统现状,项目采用离线方式方案,与云平台之间采用混杂的安全通讯机制确保信息安全。代理检查检验系统中的互联网端部分,具有通用性、独立性,不局限于在某款HIS系统上运行。     

医院信息系统开发研制的思考

信息技术的快速发展和医院管理理念的更新,要求医院信息系统的建设与之相适应的发展和更新。作者认为医院信息系统应从传统的人、财、物管理为主的模式逐步转向面向管理、面向医疗、面向病人三位一体的管理模式。强调经济核算、业务技术汇集、交流与信息共享、支持导医咨询、费用查询等便民服务,进一步提高医院工作质量、效率和现代化管理水平。