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Objective:To investigate the utilization status and awareness of digital hospital construction among medical staff in critical care department of primary hospitals, so as to promote the process of digital medical health.Methods:One to two doctors and nurses (in the department on that day) from public hospitals in 88 counties and urban areas in 9 cities of Guizhou Province were enrolled of field investigation. The questionnaires form were filled in on-site and sorted out and analyzed by special personnel.Results:A total of 297 medical staff from the department of critical care medicine of 146 hospitals were included. All the questionnaires were filled in with their real names, including 152 doctors and 145 nurses. There were 24 class Ⅲ Grade A hospitals and 122 class Ⅱ and all the hospitals had implemented digital information management. The awareness of hospital digital information management system was generally low among the surveyed medical staff, and the awareness of hospital information system (HIS) was the highest (86.5%), followed by laboratory information management system (LIS, 41.4%) and image archiving and communication system (PACS, 40.7%). The awareness of hospital management system (HERP) was the lowest (7.7%). The total number of remote consultations conducted by hospitals using big data Internet was 25 428 times in 2020, with a median of 24.5 (88.0, 240.0) times in each hospital. From 2018 to 2020, the total number of patients admitted to the intensive care unit of the hospital was 50 473, 57 565 and 57 907, respectively, of which the number of patients over 65 years old accounted for 37.47%, 41.26% and 43.31%, respectively (all P > 0.05). There were 4 242 cases of remote consultation using big data Internet in the department every year, with a median of 257.50 (96.50, 958.25) cases. 12.12% of the departments had independent critical monitoring systems, and 8.75% of them could capture data automatically to form tables. 96.30% of the medical staff participated in systematic and professional training on basic knowledge, basic theory and basic medical care skills through the Internet platform, and the number of meetings, studies and training in the provinces and prefectures were 282 and 357 times per year, respectively. More than 90% of the departments initiated remote consultation, arranged referral or admitted patients who had improved status after treatment in superior hospitals through the Internet platform. Most of the patients (69.02%) were from the lower level of the hospital. The total number of out-patient consultations was 2 959 times per year, with a median of 296 (185 473) times. 54.79% of the departments had fixed service villages, and 28.08% of the departments had fixed service population. The median furthest visit distance was 52.5 (30.0, 80.0) kilometers, and the median average visit distance was 30.0 (20.0, 50.0) kilometers. 54.88% of medical staff believed that the biggest difficulties encountered during house visits were insufficient energy and too large service groups or regions. More than 90% of medical staff had been exposed to cloud learning and cloud training, and most of the surveyed medical staff believed that cloud learning and cloud training greatly improved medical service capacity and service efficiency of medical institutions (71.04% and 67.01%, respectively). Meanwhile, they believe that "Internet + health big data" projects from various aspects brought advantage to medical institutions, but there are also low utilization rate of Internet medical equipment by village doctors, low acceptance for telemedicine and mobile hospitals by farmers. Conclusions:Guizhou public hospitals have implementation of digital information management at the grass-roots level, the surveyed health care workers have a relatively low awareness of the digital information management system, hospital use big data Internet for remote consultation is uneven, intensive care medicine is a clinical discipline used in most remote consultation information system, and can complete two-way referrals. In the past three years, the discipline operation showed an upward trend year by year. Medical staff use artificial intelligence devices such as cloud learning and training to improve medical service capacity and efficiency. The digital transformation of primary hospitals is being continuously improved.
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Os procedimentos invasivos que envolvem agulha são capazes de provocar dor e ansiedade nas crianças, em função de implicarem uma expectativa de sofrimento físico e perda de controle da situação. A utilização de atividades lúdicas visa minimizar os efeitos dos processos dolorosos, se constituindo como estratégias de humanização para o contexto hospitalar. Este trabalho investigou os efeitos do serious game "Hospital Mirim" como estratégia de enfrentamento ao procedimento invasivo de coleta de sangue. Participaram 40 crianças com idade entre seis e 10 anos, sendo 20 do grupo controle e 20 do grupo experimental (intervenção), sorteadas aleatoriamente. Os instrumentos incluíram: (a) Entrevista semiestruturada; (b) Jogo digital Hospital Mirim; (c) Escala de dor; (d) Escala de observação de procedimento invasivo. Os resultados permitiram verificar que: (a) o grupo controle na etapa de pós-procedimento invasivo apresentou maior percepção de nível de dor comparado ao grupo experimental; (b) houve diferença significativa nos grupos entre a percepção da dor e os comportamentos apresentados durante o procedimento; (c) não houve diferença entre os grupos em relação aos comportamentos durante o procedimento invasivo. De modo geral, o jogo foi um instrumento facilitador ao enfrentamento da coleta de sangue pelas crianças, diminuindo a percepção da dor. (AU)
Invasive procedures involving a needle are capable of causing pain and anxiety in children, as they imply an expectation of physical suffering and loss of control of the situation. The use of playful activities aims to minimize the effects of painful processes, constituting humanization strategies for the hospital context. This paper investigated the effects of the serious game "Hospital Mirim" as a strategy for coping with the invasive blood collection procedure. Forty children aged between six and 10 years participated, being 20 from the control group and 20 from the experimental group (intervention), randomly drawn. The instruments included: (a) Semi-structured interview, (b) "Hospital Mirim" digital game, (c) Pain scale and (d) Invasive procedure observation scale. The results showed that: (a) the control group in the post-invasive procedure stage presented a higher perception of pain level compared to the experimental group; (b) there was a significant difference in the groups between pain perception and behaviors presented during the procedure; (c) there was no difference between groups regarding behaviors during the invasive procedure. In general, the game was a facilitating instrument to cope with the blood collection in children, reducing the perception of pain. (AU)
Los procedimientos invasivos que implican una aguja son capaces de causar dolor y ansiedad en los niños, ya que conllevan una expectativa de sufrimiento físico y pérdida de control de la situación. El uso de actividades lúdicas tiene como objetivo minimizar los efectos de los procesos dolorosos, constituyendo estrategias de humanización para el contexto hospitalario. Este artículo investigó los efectos del juego serio "Hospital Mirim" como una estrategia para hacer frente al procedimiento invasivo de extracción de sangre. Participaron cuarenta niños de entre 6 y 10 años, 20 del grupo control y 20 del grupo experimental (intervención), seleccionados al azar. Los instrumentos incluyeron: (a) Entrevista semiestructurada, (b) Juego digital del Hospital Mirim, (c) Escala de dolor y (d) Escala de observación de procedimientos invasivos. Los resultados mostraron que: (a) el grupo de control en la etapa de procedimiento posinvasivo presentó una mayor percepción del nivel de dolor en comparación con el grupo experimental; (b) hubo una diferencia significativa en los grupos entre la percepción del dolor y los comportamientos presentados durante el procedimiento; (c) no hubo diferencia entre los grupos con respecto a los comportamientos durante el procedimiento invasivo. En general, el juego fue un instrumento facilitador para hacer frente a la extracción de sangre por parte de los niños, reduciendo la percepción del dolor. (AU)
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Humans , Male , Female , Child , Anxiety Disorders , Play and Playthings/psychology , Humanization of AssistanceABSTRACT
Objective To explore the effective strategies of clinical pathway construction in intensive care unit (ICU).Methods From January 2016 to July 2018,1 488 patients were discharged from ICU of Liuzhou Worker's Hospital of Guangxi Zhuang Autonomous Region.The pilot project of "postoperative monitoring of heart disease" with simpler route and less variation was selected first,and then the pilot project was promoted to "post-operative monitoring" after its success.The implementation of the clinical pathway was divided into three stages:the first stage,January 2016 to May 2017,for the pilot phase,a total of 87 patients were enrolled in the clinical pathway trial;the second stage,June 2017 to December 2017,surgical ICU "postoperative monitoring of heart disease" was put into the pathway 111 times;the third stage,January 2018 to July 2018,surgical ICU "postoperative monitoring of heart disease" was entered in the path 116 times;comprehensive ICU "postoperative care" was put into the path 96 times.After carefully analyzed the reasons and sum up the experience,internet+medical treatment (Liuzhou Worker's Hospital became the fifih deep partner of Tencent Inc in the internct+medical field,and carried out the plan and practice of "WeChat wisdom hospital 3.0" in 2017) was used,four aspects of connection,payment,security and ecological cooperation were upgraded,and the construction of 6 level of electronic medical record (EMR) was accelerated.At the same time,through diagnosis related groups system (DRGs),the concept of evidence-based medicine,quality management and continuous improvement as the leading factor,and combined with the construction status of hospital information system (HIS) and EMR system,step by step implementation and design of information management platform for clinical pathway were formulated.The completion rate of clinical pathway,average length of hospital stay,average cost,cure rate and improvement rate were the main observation parameters.Results In the first stage,none of the 87 patients who entered the clinical pathway completed the clinical pathway.In the second stage,the completion rate of surgical ICU clinical pathway was increased from 33.33％ in June 2017 to 94.44％ in December 2017,and up to 100％ in October 2017,and the average completion rate from January to July 2018 was 94.00％.The completion rate of ICU clinical pathway was increased from 81.82％ in January 2008 to 92.86％ in July 2008.There was a significant difference in the overall clinical pathway completion rate from 2016 to 2018 (x2 =204.300,P =0.000).After the effective implementation of clinical pathway in June 2017,the length of hospital stay of patients was significantly shortened as compared with that before implementation (days:2.96 ± 0.43 vs.6.66 ± 0.75,P ＜ 0.01),and the daily cost was significantly reduced (Yuan:3 550.92 ± 755.51 vs.6 171.48 ± 377.29,P ＜ 0.01).The average length of hospital stay was shortened by about 3.84 days (P ＜ 0.01),and the average daily cost was reduced by about 2 108.39 Yuan (P ＜ 0.01) after the implementation of clinical pathway by surgical ICU "postoperative monitoring of heart disease" as compared with those before implementation.The average length of hospital stay was shortened by about 2.98 days (P ＜ 0.01) and the average daily cost was reduced by 5 094.13 Yuan (P ＜ 0.01) after the implementation of clinical pathway by comprehensive ICU "post-operative monitoring" as compared with those before implementation.At the same time,the cure rate was increased from 1.16％ (7/603) to 42.26％ (105/227),and the improvement rate was decreased from 94.36％ (569/603) to 52.86％ (120/227,both P ＜ 0.01) after the implementation of surgical ICU clinical pathway,but there was no significant difference in the cure rate or the improvement rate after the implementation of comprehensive ICU [2.77％ (33/1 193) vs.2.22％ (2/90),79.21％ (945/1 193) vs.97.78％ (88/90),both P ＞ 0.05].Conclusions Application of clinical pathway to control ICU quality and guide diagnosis and treatment,more refined diagnosis and treatment schemes including clinical guidelines,average length of stay,average cost of hospitalization,cost-efficiency ratio and so on were completed,which confirmed that the improvement of clinical pathway management strategy originated from clinical were needed.Informatization,intellectualization,standardization and effective control of medical cost of clinical pathway could improve medical quality and accurate management.The integration of ICU clinical pathway construction and HIS could promote the development of digital hospitals.
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Objective To explore the construction and operation of digital hospital to optimize medical resources application.Methods The concept and objective of digital hospital were introduced,and its problems were analyzed in service mode,key links,institutions and etc.Results Digital hospital made full use of scattered mobile medical services and realized data sharing between levels of hospitals,so that the traditional medical service mode was changed.Conclusion The operation mode contributes to convenient and effective hospital service to the patient.
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Taking Guigang People's Hospital of Guangxi Province as an example,the paper introduces the implementation background of cloud computing and the operation status of Hospital Information System (HIS) on the desktop cloud,points out the problems of the application of cloud computing in the hospital environment and provides solution ideas,states the process of virtual environment system management,provides valuable reference for hospitals.
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Objective To execute informatized management of ophthalmic equipment archives with modern information technology and Internet.Methods The classification of ophthalmic equipment archives was described,and then the present situation of ophthalmic equipment archives management and the necessity for involving in informatization were analyzed.Informatized management of ophthalmic equipment archives was performend from 4 aspects of basic project management,project management,warehouse management and in-use affairs management.Results Informatization standardized ophthalmic equipment archives management.Conclusion Remote informatized management and resource sharing of ophthalmic equipment archives contributes to construction of digital ophthalmic hospital.
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Information security is the key in construction of digital hospitals and determines the successful diagno-sis and treatment of diseases in hospitals with information as a tool.The major problems in our hospital were imper-fect information security system , weak technique support , and insufficient implementation of regulations .The infor-mation security can be assured by constructing the security systems-for computer room, networks, data and their management , respectively .
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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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Objective: Establishment of information system can contribute to the integration of resources and process optimization of the hospital, so that it can reduce operating costs and improve service quality, work efficiency and the management level. It is helpful to realize the digital hospital and is the new trend of modern medical development. Methods: Information systems using C/S and B/S mode with full module function. The navigation is clear, flexible and easy to use;which have reserved for special interface data platform for easy to expand. Results:Through the implementation of information systems to solve a single asset management tools, please collar complex, information isolated, accounting information lag and other issues, to improve efficiency of hospital equipment and patient satisfaction guarantee, to achieve a transparent, integration, dynamic, precise management of hospital assets. Conclusion: The system realizes quality and safety control to the assets of whole process, specialization and informatization. The system adapts to the real service of hospital asset management, to meet the requirements of asset information management in the hospital.
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Objective: Through the application of network and information technologies, the functions in the Anesthesia Department including equipments control, data collection, surgery demonstration, remote diagnosis, multimedia management, integration of information systems can be implemented. Methods: Through the combination of the reconstruction in Anesthesia Department with network information technology, a variety of devices can be linked as far as possible to establish the clinical information system, service system and management system in digital operating Anesthesia Department. Results:The working process of clinical information systems can be standardized by integrating and sharing the data. The systems of medical service become smooth and interactive, which brings the benefits for doctors, nurses and patients. The resources in Anesthesia Department can be utilized comprehensively, which promotes the hospital management and improves the medical services. Conclusion:As an inevitable trend for the development of digital hospital, the construction and application of the digital Anesthesia Department promotes the development of anesthesiology and information construction for Anesthesia Department, which creates economic and social benefits for hospital and improves the core competitiveness for hospital.
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The in-depth development of digital technologies has brought new changes to surgery.In the new era,surgeons need to know not only the operating skills of the scalpel,but also the manipulation of new digital medical equipments and new information systems.The application of new technologies of the digital operating room,computer-assisted surgical navigation and robotic surgical systems directs the development of surgery in the path of intelligence,minimal invasiveness and safety.Digital technologies have helped to shape the further develop ment of the surgery.
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Along with the widely utilization of information technology and network technology, hospital libraries are gradually becoming the center for digital information resources and scientific research base. The paper analyzes the importance of digitalized hospital libraries in medical treatment, teaching and scientific research, and further discusses how to improve the service quality.
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Obiective To construct the manageable, stable and reliable computer terminal environment for the hospital. Technology was successfully applied to the outpatient doctor workstation and the student electronic reading room in one hospital, and the system was running well.Conclusion The technical application can not only ensure the system security and stability, but also realize centralized management and improve efficiency.
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Obiective To introduce the design and implementation of system for health examination and health monitoring according to the needs and workflow of the Health Examination Center. Methods The system has an effective configuration based on HL7 and smart client technology. Results The system can truly meet the actual needs and realize the digitizing management of the health examination center. Conclusion The system plays an important role in optimizing the wotkflow and can improve service quality and efficiency of health examination to promote digital construction in hospital.
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A digital customer service platform in hospital wards is equivalent to a platform to provide convenient, value-added and fine bedside services to in-patients as customers (customers admitted into hospitals and those for physical check inclusive).These services are provided via a set-top box and/or TV set installed with corresponding software.This platform supports such services as bills check, food order, non-medical services, VOD, games and entertainment, as well as commercial services from outside the hospital This article introduces the system structure, functionality, as well as the outcome and value of this platform, pointing out that this platform is an innovation of information technology, and that of hospital management and service mode as well
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It is inevitable for hospitals to introduce the concept of hospital client relationship management in order to upgrade service quality．The large population and number of visits of patients have been the bottle-neck for hospitals to implement management of hospital client relationship．Digital technologies make it possible for the hospital to utilize the internal clinical data systems inside the hospital and the communication platforms outside the hospital so as to implement functions of instant interaction and collective management such as one-to-one conversation,SMS,voice messages,emails,etc．This paper has addressed the features of hospital client relationship management,the structure and major functions of a digital platform for hospital client relationship management and its implications and conclusions.
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Objective To explore the theory and measures of armymen's clinical flow through information technology based on an exclusive armymen clinical area.Methods On the basis of No.1 Military Medical Project,such system was developed as automatic medical service classification & guide system,clinic backstage & auto-medicine provision system and comprehensive clinical service system in order to optimize medical service for armymen.Results By integrating the armymen's clinical information system,Navy General Hospital optimized comprehensively the clinical flow of registration,waiting,diagnosis,pricing,medicine pick-up,etc.Therefore,the efficiency of medical service for the army was greatly improved.Conlusion The full application of information technology will make an improvement in clinical flow and provide better service to army patients.
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The hospital information system(HIS)is processed in digital standardization for information sharing.In this way,all medical information in different hospitals can be compiled and compared,which provides sufficient and reliable information for the fundamental research on public health and medicine.
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In this paper,we focus on how to planning and implementing CRM system in hospital,and address this topic in three main sections.Firstly, The comprehending and urgent need of hospital leaders and managers about CRM are the most important.Secondly,before implementing CRM,the status of information management in hospital and characteristic of relationship between customers(or patients) and hospital should be sufficiently understood.Thirdly,which kind of CRM,and how much investment what you need should be analyzed.A general principle is put forward,that is "clear aim,macro planning,(uniform) disposal and stepping into implementing".
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Objective To explore the construction of military digital hospital.Methods The status quo of military digital hospital was analyzed.Results The strategy and ways to construct of military digital hospital were put forward.Conclusion The problems encountered during digitalization of military hospitals are resolved,and hospital management and efficiency are all improved greatly.