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This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.
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Humans , Electronics , Hospitals , Inpatients , Internet of Things , TechnologyABSTRACT
This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.
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Humans , Electronics , Hospitals , Inpatients , Internet , Internet of Things , TechnologyABSTRACT
A clinical information navigation system based on 3D human body model is designed. The system extracts the key information of diagnosis and treatment of patients by searching the historical medical records, and stores the focus information in a predefined structured patient instance. In addition, the rule mapping is established between the patient instance and the three-dimensional human body model, the focus information is visualized on the three-dimensional human body model, and the trend curve can be drawn according to the change of the focus, meanwhile, the key diagnosis and treatment information and the original report reference function are provided. The system can support the analysis, storage and visualization of various types of reports, improve the efficiency of doctors' retrieval of patient information, and reduce the treatment time.
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Humans , Diagnosis, Computer-Assisted , Medical Informatics Applications , Models, Anatomic , SoftwareABSTRACT
Recently in Japan, "transition of care" cases, in which patients are transferred from a medical institution that had once provided medical care to a new one and the medical care provider is therefore changed, are increasing. However, the concept of "transition of care" and "undesirable outcomes in patients accompanied by care transition" have been studied very little in Japan. The concept of "transition of care" consists of factors such as patient background (age, underlying disease, and family's caregiving ability), transfer of clinical information, and tools to transfer clinical information. In Europe and the USA, undesirable outcomes accompanied by care transition, such as "medicamentous adverse events", "clinical examination data taken during hospitalization are not confirmed", and "medical care planned for a patient is not implemented", are reported to have occurred for 19% to 50% of patients who had been discharged from hospitals and transferred to clinics. It is also necessary to understand the state of care transition in Japan and investigate countermeasures compatible with the Japanese medical care system.
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With the public awareness of thyroid disease and the development of ultrasound tech-nology,more attention has been paid to the study of the papillary thyroid microcarcinomas(PTMCs).Most thyroid small papillary carcinomas have good prognosis,but postoperative recurrence and lymph node me-tastasis also occurs.Here,the current status and progress of prognostic factors for papillary thyroid micro-carcinoma are reviewed.The primary coverage includes clinical information,immunological markers and BRAF genes.
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Through collection,recording,integration and sharing of patients′ data,real-time monito-ring of vital signs,digital information system plays a role in simplifying the medical process and supporting decision-making clinically.Meantime,it can improve telemedicine and long-distance learning,boost clinical researches in critical care medicine.The construction and development of clinical information system of ICU will improve working efficiency,decrease medical risk,and accelerate the development of critical care medicine.
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Based on the clinical informatization construction of large comprehensive hospitals , as required by information -based closed-loop management of medical advices , the paper analyzes the objectives and contents of informatization constructization in the closed-loop management of medical advices in modern hospitals , introduces the application effects of closed -loop management of medi-cal advices , and points out that such a management mode is the basis for future development of smart health care .
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Taking Children's Hospital of Fudan University as an example, the paper establishes a patient identity matching model based on the historical treatment data according to features of pediatric patients.It also sets up a uniform indexing mechanism of the his-torical treatment and hospitalization records of the patients by improving the existing business system, providing support patient identity recognition and laying a foundation for establishment of the clinical data center in future.
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Objective To establish a regional medical information sharing platform used to promote the sharing of regional medical data such as electronic medical records( EMR) and medical images in order to improve medical services. Methods With reference to results and experience of the domestic and foreign research and by virtualizing re-establish-ment of the existing medical information resources,a regional medical information sharing platform was established based on cloud computing, SOA,and Web services, and then the heterogeneous information systems in different medical institutions were integrated.Results A novel cloud platform solution was proposed for clinical information exchange between medical institutions based on Web services that exchanged data and ensured the data security and privacy using XML encryption and compression.The prototype developed in a cloud environment was put into use in dozens of military hospitals to enable the sharing of clinical information.Conclusion This cloud computing platform has the advantages of dynamic scalability, distributed and ubiquitous access.It is highly feasible and practical for regional medical informatization.
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〔Abstract〕 The paper introduces the design method of the clinical information multimedia navigation system of Inner Mongolia Medi -cal University and its main functions , and summarizes its application effects .This system can effectively prevent negligence and errors in health care , simplify the work procedure , enhance the work efficiency and reduce the communication cost .
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En los departamentos de diagnóstico por imágenes o áreas imagenológicas de las instituciones hospitalarias, procesar toda la información del paciente consume en tiempo y esfuerzo, sin mencionar la exposición a errores humanos, debido a que la misma es mantenida en papel y manipulada constantemente por técnicos y especialistas. Tras el análisis crítico de los procesos de dichas áreas en hospitales cubanos y de las deficiencias existentes en las versiones anteriores del sistema de información radiológica alas RIS, se determinó como problema a resolver la perfección de la gestión de la información demográfica y clínica de los pacientes en dicho sistema. Se utilizó como metodología de desarrollo el Proceso Unificado Racional (RUP), como lenguaje de modelado el Lenguaje Unificado de Modelado (UML) versión 2.1 y como estándar internacional de modelado de procesos, la Notación para el Modelado de Procesos de Negocio (BPMN) versión 1.1. En la creación de diagramas se empleó la herramienta Enterprise Architect versión 7.5. Entre los beneficios que brinda la solución propuesta se encuentran: la estandarización y depuración de la historia clínica del paciente; así como la reconciliación de los datos demográficos y clínicos del mismo, lo cual minimiza la duplicidad de la información en el sistema. Una vez desarrollada la aplicación se espera lograr una mejor organización de la información y agilizar la prestación de servicios a los pacientes de los departamentos de diagnóstico por imágenes(AU)
In the departments of imagingdiagnosis or imagingareas of hospitals, the processing of all patients´ information consumes time and effort, not to mention the exposure to human error due to the fact that it is held on paper and it is constantly manipulated by technicians and specialists. After the critical analysis of these areas´ processes in Cuban hospitals and of the existing deficiencies in previous versions of the radiologic information system alas RIS, it was established as a problem to be solved the perfection of the management of the demographic and clinical information of the patients in that system. The Rational Unified Process (RUP) was used as the development methodology. Similarly, the Unified Modeling Language (UML) version 2.1 was employed as the modeling language and the Business Process Modeling (BPMN) version 1.1, as an international standard of process modeling. The Enterprise Architect 7.5 was employed as a tool for the creation of diagrams. Among the benefits offered by the solution we are proposing, are the standardization and depuration of the patient´s medical history as well as the reconciliation of the demographic and clinical data of it, which minimizes the duplication of the information in the system. After the development of the application, it is expected to achieve a better organization of the information and to speed up the assistance to the patients in the imaging diagnosis department(AU)
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Humans , Male , Female , Ancillary Services, Hospital , Software , Radiology Information Systems , Information Management/methods , CubaABSTRACT
After the concept of Chinese PLA digital hospitals was described , the current situations in information construction of both Chinese PLA hospitals and local hospitals were comparatively analyzed , which displayed the di-rection of information construction for Chinese PLA digital hospitals, and some measures that should be taken for the construction of Chinese PLA digital hospitals were proposed .
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Introdução: diante do aumento dos gastos com saúde, uma questão importante diz respeito às dificuldades para efetivação dos investimentos nas unidades hospitalares (UHs), com vistas a evitar a deterioração dos serviços. Em face da escassez de recursos para investimento, ainda maior entre as UHs da rede pública de saúde no país, vislumbra-se a busca de solução alternativa, melhorando a gerência do ambiente hospitalar. Objetivos: este estudo testa a associação entre a gerência do ambiente hospitalar e as seguintes funções de organização da acreditação hospitalar (AH): o treinamento; a educação do paciente e do familiar; a governabilidade e a gerência da informação. Métodos: a amostra de conveniência é composta de 33 relatórios da AH, concluídos entre 2004 e 2009. Para tratar o material empírico, foram usados o modelo de regressão múltipla e a análise fatorial, com vistas a avaliar a influência daquelas funções de organização na gerência do ambiente hospitalar. Resultados: os testes da hipótese revelaram associações positivas e significativas entre as funções organizacionais selecionadas, o tipo de propriedade da UH e a gerência do ambiente hospitalar. Conclusões: como contribuição teórica, este trabalho esclareceu os fundamentos econômicos das relações existentes entre funções organizacionais e ambiente hospitalar. Como contribuição metodológica, o modelo estatístico utilizou dados de relatórios da AH, uma fonte de dados inédita na pesquisa sobre economia da gestão. Como contribuição gerencial, identificou fatores que influenciam o desempenho da gerência do ambiente hospitalar, contribuindo para o compromisso de gestores e profissionais de saúde com a mudança na organização.
Introduction: Given the increased expenses on health care, it is important to overcome difficulties in effectively applying investments in hospital units in order to avoid quality degradation of care services. The search of an alternative solution relying on improved management of the organizational environment is crucial to tackle issues of scarce investment resources, especially in public hospitals. Objectives:This study tests the association of hospital environment management with the following functions related to hospital accreditation: training; patients and family members education; governability; and information man agement. Methods:The convenience sample comprises 33 hospital accreditation reports from 2004 through 2009. The empirical data was analyzed using multiple regression and factorial analysis, with a view to assessing the influence of the organizational function on the management of the hospital environment. Results:The hypothesis tests pointed to positive and significant correlations involving the selected organizational functions, the type of hospital ownership, and the management of the hospital environment. Conclusions:As a theoretical contribution, this paper sheds a light into the economical grounds of the associations between organizational functions and the hospital environment. As a methodological contribution, the statistical model relied on data collected from hospital accreditation reports, an original source of data in studies on management economics. As a managerial contribution, this paper identifies factors influencing the management performance within the hospital environment, supporting managers and health professionals to fulfill their commitment to organizational change.
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Humans , Health Services Administration , Public Health Administration , Health Facility Environment/organization & administration , BrazilABSTRACT
OBJECTIVES: To develop dedicated markup language for clinical contents models (CCM) to facilitate the active use of CCM in electronic health record systems. METHODS: Based on analysis of the structure and characteristics of CCM in the clinical domain, we designed extensible markup language (XML) based CCM markup language (CCML) schema manually. RESULTS: CCML faithfully reflects CCM in both the syntactic and semantic aspects. As this language is based on XML, it can be expressed and processed in computer systems and can be used in a technology-neutral way. CONCLUSIONS: CCML has the following strengths: it is machine-readable and highly human-readable, it does not require a dedicated parser, and it can be applied for existing electronic health record systems.
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Computer Systems , Electronic Health Records , Electronics , Electrons , SemanticsABSTRACT
Despite wide acceptance of the idea of 'evidence based medicine (EBM)', there is still a huge gap between evidence and clinical practice. Pre-appraised resources help clinicians find correct answers to clinical questions more easily and rapidly. It will briefly explain the concept and history of EBM. Frequently used pre-appraised resources like as systematic review, evidence based guidelines, health technology assessment, synopses, and clinical information database systems are also introduced.
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Biomedical Technology , Evidence-Based MedicineABSTRACT
OBJECTIVES: X-rays are widely used in medical examinations. In particular, chest X-rays are the most frequent imaging test. However, observations are usually recorded in a free-text format. Therefore, it is difficult to standardize the information provided to construct a database for the sharing of clinical data. Here, we describe a simple X-ray observation entry system that can interlock with an electronic medical record system. METHODS: We investigated common diagnosis indices. Based on the indices, we have designed an entry system which consists of 5 parts: 1) patient lists, 2) image selection, 3) diagnosis result entry, 4) image view, and 5) main menu. The X-ray observation results can be extracted in an Excel format. RESULTS: The usefulness of the proposed system was assessed in a study using over 500 patients' chest X-ray images. The data was readily extracted in a format that allowed convenient assessment. CONCLUSIONS: We proposed the chest X-ray observation entry system. The proposed X-ray observation system, which can be linked with an electronic medical record system, allows easy extraction of standardized clinical information to construct a database. However, the proposed entry system is limited to chest X-rays and it is impossible to interpret the semantic information. Therefore, further research into domains using other interpretation methods is required.
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Humans , Electronic Health Records , Semantics , ThoraxABSTRACT
OBJECTIVE: This paper discusses the development environment that automatically generates software intended to execute arbitrarily defined functions. Software that we develop can be regarded as a kind of development environment or development platform, and its purpose is the automatic generation of the clinical data acquisition system that supports arbitrary clinical researches. METHODS: Basically, the clinical data acquisition system consists of the interface, the data storage and the clinical research protocols. Our development environment generates these components automatically according to the ontology written by the end user, e.g. a clinical researcher. A clinical data acquisition system is then generated. RESULTS: Our development environment consists of the interface generation module, the database generation module, the temporary data storage generation module for CDA (clinical document architecture), and the ontologies. Ontology is a method of expressing structured information and can be regarded as a knowledge base serialized by XML format. These ontologies are constructed by domain experts who want a clinical research support system. Ontology describes clinical data items, the interface design and the database schema of a clinical data acquisition system. The development environment parses these ontologies and secures the information on how to generate a clinical data acquisition system. CONCLUSION: This study can be utilized to develop the clinical data acquisition system in oriental medicine.
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Clinical Protocols , Information Storage and Retrieval , Knowledge Bases , Medicine, East Asian TraditionalABSTRACT
BACKGROUND: physicians' awareness regarding evidence-based medicine (EBM), clinical practice guidelines, and clinical information resources were rarely examined in Japan. We need to know them prior to the initiation of the Medical Information Network Distribution Service (Minds) by the Japan Council for Quality Health Care (JCQHC) .<BR>METHODS: A total of 10, 000 directors/owners of private clinics (CDs: clinic physicians) affiliated with the Japan Medical Association (JMA) and 8682 physicians working for hospitals certified by the JCQHC (HDs: hospital physicians) were randomly selected and surveyed by a mailed questionnaire.<BR>RESULTS: The response rate to the questionnaire was 18.7% (n=1865) among CDs and 67.8% (n=5885) among HDs. The percentage of respondents who uses internet was 39.9% among CDs and 69.3% among HDs. The information resource most commonly used by all respondents was medical journals, followed by textbooks. The percentage of respondents who used medical literature database was 10.8% among CDs and 49.7% among HDs, respectively. Approximately 80% of all respondents approved implementing EBM in daily practice. Fifty percent of all respondents indicated to have used clinical practice guidelines, and 90% of all the guideline users replied that clinical practice guidelines are useful tools for clinical decision-making. Over half of HDs required to access to the abstracts of the literature cited in the guidelines.<BR>CONCLUSIONS: Many physicians who responded to the survey acknowledged that EBM will contribute to improving the quality of medical services. They are positive in using clinical practice guidelines that include a series of recommendations proposed by specialists in the relevant field (s) in accordance to the reviewed evidence.
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Patients often complaint about their health, even if nothing is wrong with them upon concise objective examination. The complaints often imply the symptoms reflect more than one organ. Kampo treatment has the advantage of curing several symptoms at the same time, with only one or a few medicines. Kampo medicines comprise Chinese herbal formulations individually tailored to the patient. Therefore, symptom reduction is one of the most essential outcome parameters in Kampo treatment. However, how these subjective symptoms should be quantified, is controversial. The purpose of the current paper is to introduce an evaluation system for subjective symptoms. The system is referred to as Tokyo Women's Medical University Oriental Medicine Research Active Support System (TOMRASS). Apart from subjective symptoms, this database contains physical examination, laboratory data, clinical diagnosis and prescribed medicines, etc. In this study, 2 cases are shown as examples of practical use with TOMRASS use. One is a case with many complaints, which is effective with one medicine, Toki-shigyaku-ka-goshuyu-shokyo-to. The other is a case, which reveals unexpected outcomes with Sho-seiryu-to.<br>The new approach enables us not only to give more consideration to the patient's perspective, but also to differentiate therapeutic implications. The investigation between the subjective quality of life and therapeutic relationship may contribute to further understanding of Kampo treatment.
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Objective To focus on the expressiveness and flexibility of OpenSDE: an application that supports recording of structured narrative data. Methods OpenSDE enabled data entry with (customizable) forms based on trees of medical concepts. The relevant scope for data entry could be tailored per medical domain by construction of a domain-specific tree. OpenSDE was intended for structuring narrative data to make these available for both care and research. Results The OpenSDE application was used at two departments in aspects of radiology, neurology, pediatrics, and child psychiatry. Conclusion OpenSDE is superior to traditional text entry method in aspects of correct and full expression and clinical decision support.