浅谈综合医院与社区卫生服务共享信息平台的信息化建没

本文主要介绍利用信息网络技术实现综合性医院与社区卫生服务共享平台的信息化建设,为老百姓真正感受小病进社区,大病进医院提供了有力的保障,而且能更好地推动社区卫生医疗服务质量的迅速有效提高.     

谈我院医疗信息共享系统的建设

目的通过笔者所在医院医疗信息共享系统建设的研究,解决医院之间由于临床信息不能共享造成的重复检查、化验和重复配药等问题．缓解“看病难、看病贵”的社会焦点问题。提升医疗质量和效率,合理控制医疗费用。方法运用系统工程及管理信息系统的理论和方法．采用在医院信息系统中加入中间件的方法,进行该项目的研究。结果医疗信息共享系统的实现促进医疗决策效率与医院管理水平的提高和医疗成本的降低,将促进临床科学研究的进一步深入。结论该课题的研究不仅具有很强的现实意义．而且体现了先进性、前瞻性、可操作性和潜在的社会经济价值。     

对入院出院诊断符合率的思考

诊断符合率是医院医疗统计工作中常用到的反映医院诊断质量和医疗水平的指标。具体指标计算如下:入院诊断与出院诊断符合人数入院诊断与出院诊断符合率=×100%出院病人数在实际工作中,我们会遇到一些具体问题。比如,我们计算的时候涉及到各科室,分母为该科出院病人数,分子为该科入院诊断与出院诊断符合人数,其中包含了从其他科室转入的病人,而入院诊断和出院诊断往往不符,如果计入该科室,固然不影响全院的符合率,但却使该科的符合率降低,并不能反映该科的医疗水平。关于这一点,我们采取了以下做法,与各位同行探讨。分母为该科出院病人数+转…     

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。     

探索基于信息化平台的医疗设备零备件储备共享模式应用思考

通过建立基于信息化平台的医疗设备零备件储备共享模式,降低医院对于医疗设备零备件的库存压力,提升物流速度,增加采购的工作效率和效益.总结医疗设备零备件现有的供给规律、辅助信息共享的模式,同时开发出信息化共享平台,这样就建立一套基于信息化的且包含储备共享模式的平台.随着零备件信息共享平台的建立,可以实现相关信息的共享,科学...     

区域医疗影像数据中心系统架构设计研究

通过对影像数据交换场景、交换模式、功能需求等方面的分析,提出了通过影像数据共享和交换,建立区域医疗影像数据中心的系统框架.     

应用DICOM标准实现放射治疗计划系统的共享

我们基于医学数字图像通讯标准 (DICOM) ,设计了 RT S.S,RT Plan及 RT Image 3个 DICOM对象 ,完成了不同放射治疗计划系统之间的信息共享 ,实现不同设备厂商不同放射治疗计划系统之间的信息交换和共享。     

中小型图书馆区域性跨系统信息资源共建共享探讨

对中小型图书馆实现区域性跨系统信息资源共建共享在可行性、首要解决问题、模式的构想等三方面进行了分析探讨.     

浅谈我院信息共享的实现方式

随着医院信息化的高速发展,医院信息共享显得越来越至关重要。本文通过我院信息系统共享的设计案例,讨论了在不同信息环境下采取的信息共享的方式和快速、稳定、安全的原则。     

区域性医学文献资源共享建设与利用的探讨

本文针对本地区医学图书馆在管理上存在的问题,部门之间相互封闭,各自为政的弊端,加上医学文献资源的不足,为满足广大医务人员对医学文献的需求和医学科研工作的开展,提出建立健全区域性医学文献资源共享的服务模式,总结了实践经验和效果,对区域性文献资源共享工作深入发展有一定的指导意义。     

数据挖掘与医学数据资源开发利用

通过对目前医学数据资料状况的分析,提出了数据挖掘与医学数据资源开发利用的方法。文章首先介绍了聚类分析、关联分析、决策树三个数据挖掘方法及实例。实例资料结果说明通过分析疾病的分类、疾病与药物之间的关联,可以为疾病的早期预测,为相关疾病的诊疗路径提供帮助。因此聚类分析、关联分析以及决策树是医学数据挖掘中的主要方法,三者的结合可以对某一类疾病进行系统的分析。     

群体病例管理数据库的开发研究——含样品管理的新型医学病例信息管理系统

针对当前病例临床信息与样品管理存在交叉需求的空缺,开发一种将临床信息与样品管理相结合的医学病例信息管理系统。以MS SQL Server 2000建立数据库,以Visual C++6.0开发基于Client/Server模式的客户端应用程序,以实现对病例资料及相关样品信息的录入、浏览、查询选择、分级统计、样品管理及自动生成病例信息综合文档等功能,从而达到按科研所需对群体病例资料及其样品的管理。该系统有助于提高临床科研工作的效率、质量及管理水平,为医学病例及样品信息的综合动态管理提供了新的技术平台。     

A New Coding System for Metabolic Disorders Demonstrates Gaps in the International Disease Classifications ICD‐10 and SNOMED‐CT,Which Can Be Barriers to Genotype–Phenotype Data Sharing

Data sharing is essential for a better understanding of genetic disorders. Good phenotype coding plays a key role in this process. Unfortunately, the two most widely used coding systems in medicine, ICD‐10 and SNOMED‐CT, lack information necessary for the detailed classification and annotation of rare and genetic disorders. This prevents the optimal registration of such patients in databases and thus data‐sharing efforts. To improve care and to facilitate research for patients with metabolic disorders, we developed a new coding system for metabolic diseases with a dedicated group of clinical specialists. Next, we compared the resulting codes with those in ICD and SNOMED‐CT. No matches were found in 76% of cases in ICD‐10 and in 54% in SNOMED‐CT. We conclude that there are sizable gaps in the SNOMED‐CT and ICD coding systems for metabolic disorders. There may be similar gaps for other classes of rare and genetic disorders. We have demonstrated that expert groups can help in addressing such coding issues. Our coding system has been made available to the ICD and SNOMED‐CT organizations as well as to the Orphanet and HPO organizations for further public application and updates will be published online ( www.ddrmd.nl and www.cineas.org ).     

Development and Evaluation of an Inter-professional Education Course at a Medical School in Korea

BackgroundInterprofessional collaborative practice (IPCP) is emphasized in medical care for patient safety. As patient care is provided by teams, interprofessional competence is required to ensure the quality and safety of care and should be taught as early as possible. In this study, we introduced a 2-week interprofessional education (IPE) curriculum and attempted to describe and evaluate its effectiveness among medical students.MethodsWe developed a 2-week IPE course and gave it to third- or fourth-year medical students (n = 166) from 2018 to 2019. The curriculum was composed of interactive lectures, discussions, small-group discussions, and simulation and was given to diverse medical students. Students were asked to report their satisfaction with the IPE program, write a reflection paper, and complete readiness for interprofessional learning scale (RIPLS) questionnaires before, immediately after, and 4 months after the curriculum. We also obtained 360° evaluations of the students by other health professionals 1 year after the training.ResultsThe IPE program changed students'' attitudes about interprofessional learning, from less favorable to more favorable. The 360° evaluation by nurses revealed that students became more favored as teammates (overall satisfaction with them as teammates increased from 3.1/5 to 3.4/5) compared to medical interns before IPE training, and complaints from nurses about medical interns were significantly less frequent 1 year after the training.ConclusionThe IPE program was effective in preparing medical students for team based collaborative practice even though it was short and exposed once in the curriculum. Further extension to other medical schools is recommended.     

医学图像三维重建系统的数据结构表达及表面模型的构建

医学图像三维重建在诊断、放射治疗规划及医学研究中均有着重要应用，本文论述了医学图像三维重建系统程序流程，设计了自动及手工轮廓勾画两种分割方法，并提出了建立了合理的系统数据结构。该数据结构能较好地描述系统数据的层次关系和表达重建的几何模型。对由自动分割和手工勾画出的组织，用MT算法构建其三维表面几何模型 。实现了网格简化的边收缩算法，并对由MT算法生成的表面模型进行了网格简化处理。模型网格经简化90％，依然能较好地保持模型的特征，大大加快了绘制速度。     

Exploring Concordance of Patient-Reported Information on PatientsLikeMe and Medical Claims Data at the Patient Level

BackgroundWith the emergence of data generated by patient-powered research networks, it is informative to characterize their correspondence with health care system-generated data.ObjectivesThis study explored the linking of 2 disparate sources of real-world data: patient-reported data from a patient-powered research network (PatientsLikeMe) and insurance claims.MethodsActive patients within the PatientsLikeMe community, residing in the United States, aged 18 years or older, with a self-reported diagnosis of multiple sclerosis or Parkinson’s disease (PD) were invited to participate during a 2-week period in December 2014. Patient-reported data were anonymously matched and compared to IMS Health medical and pharmacy claims data with dates of service between December 2009 and December 2014. Patient-level match (identity), diagnosis, and usage of disease-modifying therapies (DMTs) were compared between data sources.ResultsAmong 603 consenting patients, 94% had at least 1 record in the IMS Health dataset; of these, there was 93% agreement rate for multiple sclerosis diagnosis. Concordance on the use of any treatment was 59%, and agreement on reports of specific treatment usage (within an imputed 5-year period) ranged from 73.5% to 100%.ConclusionsIt is possible to match patient identities between the 2 data sources, and the high concordance at multiple levels suggests that the matching process was accurate. Likewise, the high degree of concordance suggests that these patients were able to accurately self-report their diagnosis and, to a lesser degree, their treatment usage. Further studies of linked data types are warranted to evaluate the use of enriched datasets to generate novel insights.     

医学生成就动机、择业效能感与就业力的关系

目的:探讨医学生成就动机、择业效能感与就业力的关系。方法:利用成就动机、择业效能感和就业力量表对261名在校医学生进行调查。结果:医学生就业力自评分为(3.58±0.42),高于量表中间值3;医学生就业力总分及自我发展、人际沟通、就业自信、实践力在性别、生源地和是否独生子女上无显著差异(P0.05),医学生就业适应力在生源地和是否独生子女上差异显著(t=2.48,2.09;P0.05);医学生成就动机总分和追求成功维度在性别上差异显著(t=2.28,3.68;P0.05);择业效能感在生源地和是否独生子女上差异显著(t=2.11,2.02;P0.05);就业力及各维度与择业效能感、成就动机总分追求成功显著正相关(P0.01),与避免失败显著负相关(P0.01);择业效能感和成就动机显著预测就业力(P0.05),预测量达45%。结论:人口学因素对医学生就业力的影响甚小,高成就动机和择业效能感有助于提升医学生就业力。