体检信息系统在高等学校招生中的应用

介绍北京市体检中心高招体检信息系统的设计思路,阐述该系统人员登记、科室检查、检验结果录入、查询统计等功能,指出它的应用能够提高体检工作质量、管理水平、工作效率,同时总结该中心进行信息化管理的实效。     

信息化在规范护理敏感质量指标提取中的应用

目的 利用信息系统规范护理敏感质量指标的提取。 方法 分别通过完善及应用护理质量管理系统、医院信息网络系统(hospital information system, HIS)、蓝蜻蜓系统、“问卷星”在线调查工具4个信息系统采集变量,采集过程中进行质量控制。 结果 得出不同指标提取的相应信息渠道,规范各指标获取方法。 结论 利用信息系统进行护理敏感质量指标变量采集,保证了指标的可测量性、客观性、有效性和及时性。     

医院总会计师制度是解决“医闹问题”的有益探索：基于委托代理理论的制度分析

目的：当前被推上风口浪尖的医闹问题凸显了由于信息不对称、权力制衡不足而导致的医院内部治理存在较严重问题。从委托代理理论这一源头剖析以上社会矛盾以及医院总会计师制度的有用性。方法用理论分析方法对当前总会计师制度的现状与未来发展前景进行探讨。结果当前医院委托代理问题是导致医闹矛盾的重要原因之一。结论医院践行并完善总会计师制度将是解决医患矛盾的一个科学而有益的探索。     

Automated clinical trial eligibility prescreening: increasing the efficiency of patient identification for clinical trials in the emergency department

Objectives (1) To develop an automated eligibility screening (ES) approach for clinical trials in an urban tertiary care pediatric emergency department (ED); (2) to assess the effectiveness of natural language processing (NLP), information extraction (IE), and machine learning (ML) techniques on real-world clinical data and trials.Data and methods We collected eligibility criteria for 13 randomly selected, disease-specific clinical trials actively enrolling patients between January 1, 2010 and August 31, 2012. In parallel, we retrospectively selected data fields including demographics, laboratory data, and clinical notes from the electronic health record (EHR) to represent profiles of all 202795 patients visiting the ED during the same period. Leveraging NLP, IE, and ML technologies, the automated ES algorithms identified patients whose profiles matched the trial criteria to reduce the pool of candidates for staff screening. The performance was validated on both a physician-generated gold standard of trial–patient matches and a reference standard of historical trial–patient enrollment decisions, where workload, mean average precision (MAP), and recall were assessed.Results Compared with the case without automation, the workload with automated ES was reduced by 92% on the gold standard set, with a MAP of 62.9%. The automated ES achieved a 450% increase in trial screening efficiency. The findings on the gold standard set were confirmed by large-scale evaluation on the reference set of trial–patient matches.Discussion and conclusion By exploiting the text of trial criteria and the content of EHRs, we demonstrated that NLP-, IE-, and ML-based automated ES could successfully identify patients for clinical trials.     

高校实施国库集中支付制度存在问题及对策研究

高校实施国库集中支付制度是一个逐步深化、日趋完善的过程.目前在具体实践中存在资金使用效率不高、会计核算难度加大等问题,同时对高校预算管理和信息化建设提出了更高的要求.为此建议进一步提升高校预算管理水平,完善高校会计核算体系,加强综合信息化建设,提高财务人员素质,充分发挥国库集中支付制度的优势,不断提高学校经费使用效益和财务管理水平,促进学校各项事业的有序发展.     

Physician communication styles in initial consultations for hematological cancer

Objective

To characterize practices in subspecialist physicians’ communication styles, and their potential effects on shared decision-making, in second-opinion consultations.

Methods

Theme-oriented discourse analysis of 20 second-opinion consultations with subspecialist hematologist-oncologists.

Results

Physicians frequently “broadcasted” information about the disease, treatment options, relevant research, and prognostic information in extended, often-uninterrupted monologs. Their communicative styles had one of two implications: conveying options without offering specific recommendations, or recommending one without incorporating patients’ goals and values into the decision. Some physicians, however, used techniques that encouraged patient participation.

Conclusions

Broadcasting may be a suboptimal method of conveying complex treatment information in order to support shared decision-making. Interventions could teach techniques that encourage patient participation.

Practice implications

Techniques such as open-ended questions, affirmations of patients’ expressions, and pauses to check for patient understanding can mitigate the effects of broadcasting and could be used to promote shared decision-making in information-dense subspecialist consultations.