基于医院信息系统的慢性病监测系统的开发和应用

目的 开发和应用基于医院信息系统(hospital information system, HIS)的慢性病监测系统,提高江阴市慢性病监测质量和效率。 方法 开发平台为Windows XP,Windows 2003或Windows 7。开发工具为Power Builder 9.0,Power Designer 15.0。数据库建立采用SQL 2005。系统架构为:C/S结构。开发的慢性病监测系统嵌入全市各级医院的信息系统运行,系统会自动识别、查重、触发慢性病电子报卡,强制医生填报。 结果 2015年江阴市慢性病监测报告率、完整率、准确率、及时率分别为95.06%、99.66%、99.35%、98.67%,较2014年的69.36%、98.30%、81.12%、97.27%显著提高,2016年各率分别为98.28%、99.93%、99.38%、99.11%,较2015年进一步提高。 2015年重报率为1.93%,较2014年的6.57%显著降低,2016年为1.70%,较2015年进一步下降。各率差异均有统计学意义(报告率: χ²=300.87, P＜0.001;完整率: χ²=346.63, P＜0.001; 准确率: χ²=472.36, P＜0.001; 及时率: χ²=326.09, P＜0.001;重报率: χ²=1 293.26, P＜0.001)。 结论 江阴市开发的基于医院信息系统的慢性病监测系统实施后显著提高了该市慢性病监测的质量和效率,成效显著,值得推广。

Development and application of chronic disease surveillance system based on hospital information system

Objective To develop and apply the chronic disease surveillance system (CDSS) based on the hospital information system (HIS) of various hospitals so as to improve the quality and efficiency of surveillance of chronic diseases in Jiangyin City. Methods The suitable computer operating systems were Windows XP, Windows 2003 or Windows 7. The development tools were PowerBuilder 9.0 and PowerDesigner 15.0. The database was established based on Microsoft SQL Server 2005. The construction of the system was C/S. The developed CDSS was embedded in the HIS system of various hospitals in Jiangyin City. The system would automatically recognize chronic diseases, check duplicate content, trigger the electric report of chronic diseases, and compel the clinician to fill in the form. Results The rates of reporting, integrity, accuracy and promptness in Jiangyin City in 2015 were significantly improved as compared with the rates in 2014 (95.06% vs. 69.36%, 99.66% vs. 98.30%, 99.35% vs. 81.12%, 98.67% vs. 97.27%), and were further improved in 2016 (98.28%, 99.93%, 99.38%, 99.11%). The rate of duplicated reporting in 2015 was remarkably decreased compared with that in 2014 (1.93% vs. 6.57%),and further decreased in 2016 (1.70%). The rates of reporting, integrity, accuracy and promptness showed statistically significant differences (χ²=300.87, χ²=346.63, χ²=472.36, χ²=326.09, χ²=1,293.26, all P<0.001). Conclusions Implementing the CDSS based on the HIS system in Jiangyin City significantly improves the quality and efficiency of surveillance of chronic diseases, and the achievements are outstanding. The CDSS is worth popularizing.