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Background: Medical record document explains all the details about the patient’s history, clinical findings, diagnostic test results, pre- and post-operative care, patient’s progress, and medication given. If written correctly, notes will support the doctor about the correctness of treatment. Aim and Objectives: Our objective was to study effectiveness and utility of medical record department at our medical college affiliated tertiary care institution. Materials and Methods: We did an observational study to determine various parameters of medical records such as consent, history and examination findings, pre-operative and intraoperative records, investigation documentation, nursing care chart, and concerned medical person’s signature. The study included 300 files. A medical record checklist was used as a tool for data collection. The study was conducted between January 2021 and January 2022. Data were collected, entered in Microsoft Excel spread sheet, and analyzed using percentage. Results: Out of the 300 files, 186 files belonged to different surgical specialties while the rest were of non-surgical fields. It was found that nursing assessment document was present in 78%, while discharged card copy was found attached in 75.33% files. Furthermore, surgical safety checklist was found in 89.24%, while signature of faculty was absent in 38.3% files. Conclusion: Medical record maintaining and keeping is an essential and vital part of health-care infrastructure, not only for data collection but also for calculating use of resources needed for better delivery of quality services to patients.
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Objective:To analyze the medication rules in the ancient book Pu Ji Fang for the external treatment of acne based on data mining method. Methods:By screening out the methods of treating acne externally in Pu Ji Fang and establishing a standardized medical record database, this paper adopted the web version of Ancient and Modern Medical Record Cloud Platform to calculate the frequency, properties, flavors, and meridians of those medicines, and conduct cluster analysis by using IBM SPSS Modeler 18.0 software to analyze the association rules. Results:A total of 87 prescriptions were selected, including 164 kinds of Chinese materia medica, among which. Radix Angelicae, Ligusticum Wallichii, Rhizoma Typhoni and lead powder are frequently appeared. The properties of those medicines are mainly warm, cold and mild; the flavors of those medicines are mainly spicy, acrid, sweet and bitter, and the meridians mainly belongs to lung, spleen, stomach and liver meridians. The medical pair and group with the strongest associationion are Ligusticum Wallichii- Radix Angelicae and Rhizoma Typhonii- Radix Angelicae- Ligusticum Wallichii. Those freuently appeared medicines could be grouped into three categories. The paste dosage that was frequently appeared has strong correlation with tallow, mercury and lead powder, while the powder dosage that was frequenctly appeared has strong correlation with Angelica Dahurica, Radix Saponicae, Gleditsia sinensis, Radices Ligustici Sinensis and Ligusticum Wallichii. Conclusions:The application of data mining method could preliminarily reveal the medication rules of Pu Ji Fang for the external treatment of acne. The main treatment method is XinSanFaYue. The three categories of Chinese materia medica are used to treat the syndrome of asthenic habitus attacked by exogenous pathogenic factors, exterior attacked by wind heat and hot blood stasis respectively, showing the rules of treating acne externally before Ming Dynasty and providing references for the clinical treatment of acne.
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【Objective】 To determine the value of quality assessment system in supervising standard clinical blood use and improving the quality of clinical blood transfusion medical records. 【Methods】 The clinical blood transfusion records of Children′s Hospital, Zhejiang University School of Medical every quarter from January 2019 to December 2022 were selected and extracted for evaluation by 5% to 10% for the current season. These blood transfusion medical records were scored and graded A(≥90 points)/B(80-89 points)/C(<80 points)according to the Evaluation Table of Clinical Science Rational Use of Blood in Children′s Hospital of Zhejiang University, and the annual A rate was statistically analyzed. After summarizing the deduction points, a rectification plan was submitted to the medical department and publicized on the hospital network. 【Results】 A total of 1 975 blood transfusion medical records were analyzed from January 2019 to December 2022, including 343 in 2019 (17.37%), 517 in 2020 (26.18%), 556 in 2021 (28.15%) and 559 in 2022 (28.30%), with Grade A rates at 67.06%, 92.07%, 93.17% and 91.06%, respectively. According to Pearson Chi-square test, the Grade A rates of blood transfusion records in 2020, 2021 and 2022 were significantly higher than those in 2019 (P<0.000 1). In the assessment, the main reasons for deduction of points were missed pre-transfusion immunization tests and missed blood transfusion course records. From 2019 to 2022, the missed rates of pre-transfusion immunization tests were 22.68%, 6.47%, 1.26% and 2.49%, and the missed rates of blood transfusion course records were 32.21%, 10.59%, 5.57% and 6.61%, respectively. 【Conclusion】 The regular and reasonable assessment and publicity system of blood transfusion medical records is conducive to improving the quality of blood transfusion medical records, promoting rational blood use and ensuring the safety of blood use for children.
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In order to assist in the standardization and maturity evaluation of national hospital information interconnection, and further standardize the application and management of hospital medical record data, a hospital carried out the practice of design of structured medical records and the corresponding quality management from April 2021. Based on the six sigma quality management method, the hospital had developed universal templates for electronic medical records and a list of candidate electronic medical record templates. The problems faced by medical record data had been analyzed, and improvement strategies had been proposed from three levels: template design, software functionality and management services. The clinical departments were guided to design and develop various structured electronic medical record templates for specialties and specialized diseases, and established a medical record template design and quality management method. The hospital had ultimately designed a total of 614 structured electronic medical record templates that met the actual needs of the hospital. This practice enhanced the scalability of structured templates and quality of the data, and achieved localization and specialization of medical record templates while meeting the requirements of information interconnection and sharing, providing reference for promoting the interconnection and sharing of electronic medical records of hospitals in China.
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Blockchain technology has the advantages of decentralization, secure sharing and tamper resistance, and high privacy, which can solve the current problem of sharing electronic medical records in medical institutions in China. A tertiary hospital established an electronic medical record sharing services convenience service platform based on blockchain in collaboration with China mobile gansu company in September 2021. The hardware architecture of the platform consisted of a hospital data warehouse, a local front-end computer and a blockchain platform. The functional architecture included platform front-end services, the blockchain electronic medical record archiving and service platform. The technical architecture included the underlying blockchain, service layer, interface layer and application layer, which was embedded with asymmetric encryption technology, hash algorithm, smart contract and other technical means, ensuring data ownership and on-demand, controllable, real-time and secure sharing of data. Since the operation of the platform in September 2021, as of October 2022, a tertiary hospital had accumulated 21 545 patient medical records on the chain. The overall operation of the platform was smooth, achieving reliable storage and secure sharing of patient electronic medical records, providing reference for further promoting the interconnection trusted sharing of electronic medical records in medical institutions in China.
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Objective:To explore the establishment of a surgical complication monitoring mode based on data on the medical record homepage, and analyze its impact on the trend of changes in surgical complication incidence.Methods:A monitoring mode of surgical complication was developed based on the " structure-process-results" framework by using surgical complication rates derived from performance appraisal for a tertiary general hospital in Guangzhou. The number of surgical complications and the number of discharged surgical patients was collected from the hospital from January 2019 to June 2022 through the home page collection system for performance appraisal of national tertiary public hospitals. Descriptive analysis was used to analyze the incidence of surgical complications, and Joinpoint regression was used to analyze the trend of changes in the incidence of surgical complications. Monthly percentage change ( MPC) and average monthly percentage change ( AMPC) were calculated. Results:Since the hospital began implementing the surgical complication monitoring mode in May 2021, the incidence of surgical complications had decreased from 2.55% in June 2021 to 0.82% in June 2022, with an MPC of -5.58% ( P=0.024), which was better than the changes from January 2019 to May 2021 ( MPC=0.18%, P=0.755). Conclusions:The surgical complication monitoring mode constructed by the hospital can effectively reduce the incidence of surgical complications, providing reference for optimizing hospital′s medical quality management process and decision-making mode.
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Objective:To analyze the disease characteristics and hospitalization burden of elderly inpatients with cerebrovascular disease, so as to provide basis for disease prevention, diagnosis, treatment and rehabilitation of elderly patients with multiple chronic conditions.Methods:The data of the first page of medical records of elderly inpatients with cerebrovascular disease from 2015 to 2020 in a comprehensive tertiary hospital in Jiangsu Province were retrospectively collected.Descriptive analysis, variance analysis and multiple linear regression analysis were carried out for the research objects using SPSS statistics and Python complex network methods.Results:A total of 14 657 elderly inpatients with cerebrovascular disease were included.From 2015 to 2020, the number of hospitalizations increased from 1 268 to 4 733, the average number of hospitalizations increased from 2.0 to 2.9, the average length of stay decreased from 11.9 days to 9.1 days, and the average number of illnesses increased from 1.9 to 4.9.The five most common comorbidities associated with cerebrovascular diseases were hypertension, diabetes, ischemic heart disease, other types of heart disease and other respiratory diseases.From 2015 to 2020, the average hospitalization costs of elderly cerebrovascular inpatients decreased from 20588.1 Chinese yuan(CYN)to 15580.9 Chinese yuan(CYN). The hospitalization cost was mainly composed of drug cost(46.6%), diagnosis cost(28.2%)and treatment cost(20.2%). There were significant differences in the average hospitalization expenses among patients with different gender, age, number of admissions, length of stay and number of diseases( P<0.05 for all). Gender, age, number of hospitalizations and length of stay had an impact on hospitalization expenses. Conclusions:The number of inpatients, comorbidities, and hospitalized times of elderly patients with cerebrovascular disease showed an increasing trend, while the number of hospitalization days and the average hospitalization cost showed a downward trend.Comorbidities associated with cerebrovascular diseases should be one of the concerns of chronic disease management in the elderly.
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La gestión de la información de salud del paciente, así como de los diferentes servicios que se brindan en los centros de atención de salud, constituyen elementos cruciales para prestar un servicio de salud de buena calidad. El Sistema de Información Hospitalaria XAVIA HIS, constituye una solución integral para la gestión médica de hospitales y centros de salud. En el módulo de Consulta externa se gestiona la información referente a la atención a pacientes ambulatorios en diferentes especialidades. El objetivo del presente trabajo es describir las principales funcionalidades y especialidades médicas incluidas en el módulo Consulta externa del sistema XAVIA HIS. El desarrollo estuvo guiado por la metodología de desarrollo Proceso Ágil Unificado. variante UCI y fueron empleadas las tecnologías, herramientas y lenguajes que forman parte de la arquitectura del sistema definida por el Centro de Informática Médica, entre las cuales se pueden mencionar: Java Enterprise Edition 6 como plataforma de programación para el desarrollo y la ejecución del sistema, como sistema gestor de base de datos se empleó PostgreSQL 10, como herramienta de modelado Visual Paradigm para UML, la notación BPMN 2.0 (Business Process Management Notation) y el Lenguaje Unificado de Modelado (UML) y el estándar HL7 CDA® (Clinical Document Architecture) para homogeneizar la arquitectura de los documentos clínicos. El desarrollo de este módulo refuerza la base de conocimientos necesaria para la toma de decisiones clínicas y administrativas, mejora el acceso a la información y la calidad de la asistencia a los pacientes.
The patient's health information management, as well as different services provided in health care centers, constitutes crucial elements to provide a good quality health service. The Hospital Information System XAVIA HIS establishes a comprehensive solution for hospitals and health centers medical management. The Outpatient module manages the information regarding outpatient care in different specialties. This paper aims to describe the main functionalities and medical specialties included in the Outpatient module of the XAVIA HIS system. The development was guided by the AUP development methodology (an UCI variant), and to achieve it, the technologies, tools and languages used are part of the system architecture defined by the CESIM and mentioned as follow: Java Enterprise Edition 6 platform as the Runtime Environment, PostgreSQL 10 as the database management system, Visual Paradigm as modeling tool for UML, the BPMN 2.0 notation (Business Process Management Notation), the Unified Modeling Language (UML) and the HL7 CDA® (Clinical Document Architecture) standard to standardize the architecture of clinical documents. This module development reinforces the knowledge base necessary for clinical and administrative decision-making, improves access to information and patients' care quality.
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La elaboración del expediente clínico es una actividad rutinaria dentro del consultorio dental, éste es la materialización del acto médico, a tra- vés del cual se registra el estado de salud inicial del paciente, así como toda la información relativa al tratamiento recibido. Desde hace algunos años comenzó a promocionarse el expediente clínico electrónico como una herramienta alternativa y novedosa para elaborar este importante documento; sin embargo, la implementación de esta herramienta electrónica no ha podido lograrse en México, dada la gran cantidad de dudas que los odontólogos tienen respecto al conjunto de leyes y normas que regulan al expediente clínico, lo cual genera renuencia por parte de los odontólogos para utilizar esta modalidad de expediente dentro de su consulta diaria. El objetivo del presente artículo es realizar una revisión de la literatura, así como de las leyes y normas vigentes que regulan el expediente clínico en México para esclarecer así la viabilidad de implementarlo dentro del consultorio dental
The preparation of the electronic medical record is a routine activity in the dental office, this is the materialization of the medical act, through which the initial health status of the patient is recorded, as well as all the information related to the received treatment. A few years ago, the electronic clinical record began to be promoted as a novel alternative tool to prepare this important document, however, the implementation of this electronic tool has not been achieved in Mexico, given the large number of doubts that dentists have regarding the set of laws thar regulate the clinical record, which generates reluctance on the part of dentists to use this record modality within their daily consultation. The aim of this article is to carry out a review of the literature, as well as the current laws that regulate the clinical record in Mexico, in order to clarify the feasibility of implementing it within the dental office
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Humans , Clinical Record , Dental Records/legislation & jurisprudence , Electronic Health Records/legislation & jurisprudence , Legislation, Dental/standards , MexicoABSTRACT
Purpose: To describe the process development of a multimodal intervention and the pre- and postintervention results on the completeness of case records of patients with penetrating ocular trauma in a high-volume tertiary eye care hospital in south India. Methods: A multimodal intervention including an objective-validated case sheet template, an education program, a physical template case record reminder, a continuous near-real time audit process, and a feedback system was developed. Analysis on the completeness of the case records of patients with ocular trauma from October 2020 to December 2020 (preintervention) and from January 2021 to March 2021 (postintervention) was performed. These case records and the personnel involved in the documentation, were given scores based on the scores assigned to the subsections of the validated template case sheet. The mean total score of the case records and of the personnel involved were analyzed. Results: One hundred and eleven case records of patients with ocular trauma who underwent primary wound repair were included in the study. Of these 111 case records, 46 belonged to preintervention group and 65 belonged to postintervention group. The mean total score for preintervention group during the study period was 57.93 ± 24 out of 100 and for postintervention group was 99.07 ± 4.49 out of 100. The temporal trend of postintervention group showed a consistent improvement every month (97.14, 100,100) during the 3-month study period. Postintervention improvement was noted in all the sections of case records completed by both fellows and consultants. Conclusion: A sustained improvement in ocular trauma case record documentation among all levels of medical professionals was noted following the five-component multimodal intervention
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Resumen: Objetivo: Evaluar los factores relacionados con el uso del Expediente Clínico Electrónico (ECE) desde la percepción de los usuarios médicos y enfermeras de los servicios de salud de un hospital de 2do nivel en Morelos, México. Material y métodos: Se realizó el análisis cualitativo de 22 entrevistas semiestructuradas a personal médico, enfermeras, directivo y administrativo de un hospital de 2do nivel en Morelos, México, tomando como referencia de análisis las dimensiones de normatividad, operatividad y capacitación en la implementación del ECE. Resultados: Se identificó un número insuficiente de computadoras y personal capacitado para operar el ECE. Cuando se logra operar el expediente éste es lento o presenta fallas sistemáticas frecuentes debido a las redes de navegación dependen del navegador central que brinda soporte estatal a la plataforma del ECE sin una resolución pronta cuando hay fallas, las unidades hospitalarias trabajan 24 horas y a nivel central las operaciones del ECE tienen horarios de lunes a viernes de 8 horas. Esto incrementa la resistencia a adoptar el expediente como herramienta de trabajo. La organización colabora a la resistencia al no proporcionar un soporte técnico suficiente y permanente para afrontar las fallas de operatividad del ECE. Los usuarios consideran que el expediente es seguro y confiable, lo cual incrementaría la posibilidad de uso del ECE. Conclusiones: La falta de recursos e ineficiencias en la operación del ECE colaboran a una baja y lenta adopción del expediente; así como la resistencia a utilizarlo. La organización colabora a aumentar la resistencia si la capacitación no es eficiente. Falta le da soporte continuo y suficiente en la infraestructura técnica y recurso humano. A pesar la limitada e ineficiente adopción del ECE se identificaron áreas y personal donde se presenta una mayor utilización (hospitalización y personal médico). Éstas podrían ser las experiencias de aprendizaje positivo que pueden utilizarse para instruir a toda la organización
Abstract: Objective: To evaluate the factors related to the use of the Electronic Medical Record (ECE) from the perception of medical users of health services Morelos, Mexico. Material and methods: The qualitative analysis of 22 semi-structured interviews with medical personnel, nurses, managers and administrators of a 2nd level hospital in Morelos, Mexico was carried out, taking as a reference for analysis the dimensions of regulations, operability and training in the implementation of the ECE. Results: An insufficient number of computers and trained personnel were identified to operate the ECE. When it is possible to operate the file, it is slow or presents frequent systematic failures due to the navigation networks, they depend on the central browser that provides state support to the ECE platform without a prompt resolution when there are failures, the hospital units work 24 hours and centrally. ECE operations have 8-hour hours from Monday to Friday. This increases resistance to adopting the file as a working tool. The organization contributes to the resistance by not providing sufficient and permanent technical support to face the operational failures of the ECE. Users consider that the file is safe and reliable, which would increase the possibility of using the ECE. Conclusions: The lack of resources and inefficiencies in the operation of the ECE contribute to a low and slow adoption of the file; as well as the resistance to use it. The organization helps increase resistance if training is not efficient. Lack gives you continuous and sufficient support in the technical infrastructure and human resources. Despite the limited and inefficient adoption of ECE, areas and personnel were identified where there is greater use (hospitalization and medical personnel). These could be positive learning experiences that can be used to educate the entire organization
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Objective:To develop and test a software which can get and count the medical exposure frequency automatically.Methods:This study was based on the investigation of the frequency of radiodiagnostic medical procedures in China over the past by reference to the experience gained from the Electronic Medical Record Sharing and Reporting System in Beijing. The core elements for collecting the number of medical procedures and radiodiagnostic categories were determined. The collection process was then designed and the collection program software was written in a way for deployment on the front-end computer system of a general hospital for trial.Results:The field table to collect the number of medical procedures and the corresponding data structure were generated, and the data collection and statistics of the above fields were realized based on the survey data of DR and CT diagnostic examination frequency in a hospital in 2021. It took 15 s on average, and the statistical result are consistent with the manual statistical result using RIS source table.Conclusions:The software can realize the automatic acquisition and reporting of the number of radiodiagnostic medical procedures in hospital on a regular basis, which is worth promoting.
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Objective:To analyze the hospitalization expenses of elderly patients with hypertension and its influencing factors, so as to provide reference for optimizing the medical service management of elderly patients with hypertension.Methods:Medical record home page data of all hypertension inpatients of elderly patients at two tertiary general hospitals in Jiangsu province from 2017 to 2020 were retrieved. These data were used to analyze the basic information, hospitalization expenses and their influencing factors. Descriptive analysis was used for all data, variance analysis was used for one-way analysis, and multiple linear regression was used for multivariate analysis.Results:A total of 20 596 elderly inpatients with hypertension were included in this study. The number of patients was increased from 1 476 in 2017 to 10 771 in 2020. Among them, the number of inpatients with≥2 diseases increased from 1 105(74.86%) to 10 564(98.08%); From 2017 to 2020, the average hospitalization expenses of elderly inpatients with hypertension were 11 500 yuan, 13 600 yuan, 13 800 yuan and 14 100 yuan respectively, increasing year by year; Gender, age, number of hospitalizations, hospitalization days and number of diseases were the influencing factors of hospitalization expenses( P<0.05), and the hospitalization expenses increased with the increase of hospitalization days, number of diseases and age. Conclusions:The number of elderly patients with hypertension, the incidence of comorbidity, and the average hospitalization cost in tertiary hospitals in Jiangsu province were increasing year by year. There were many factors affecting the hospitalization cost. The author suggested that the treatment of elderly patients with hypertension should be shifted to prevention, so as to reduce the economic burden of disease and improve their quality of life.
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Objective:To explore the effect of comprehensive accusation intervention on the use of antibacterial drugs and the writing of medical records in elderly patients with closed fracture.Methods:A total of 120 elderly patients (aged ≥60 years) with fracture were enrolled from January 2017 to June 2019 in the department of orthopaedics and traumatology of the Second Hospital of Tangshan University and the Affiliated Hospital of North China University of Technology. According to random number table method, 120 patients were divided into intervention group (61 cases) and non intervention group (59 cases) by computer random number method. The patients in the intervention group received pharmaceutical care and quality control management intervention during the perioperative period; The patients in the non intervention group were routinely treated with antibiotics and wrote medical records. The use effect of antibiotics, the cost of antibiotics and the effect of standardized writing of medical documents were compared between the two groups. Independent sample t-test was used for comparison between measurement data groups with normal distribution, and χ 2 test was used for comparison between counting data groups. Results:Compared with the non-intervention group, the rate of perioperative use of antibiotics (49.2% (30/61)), the rate of drug use without indication (4.9% (3/61)), the rate of irrational drug selection (6.6% (4/61)), the rate of irrational drug use (6.6% (4/61)), and the proportion of irrational combined use of antibiotics (3.3% (2/61)) were significantly lower than that in the non-intervention group (81.4% (48/59), 16.9%(10/59), 22.0% (13/59), 20.3% (12/59), 18.6% (11/59)), the difference was statistically significant (χ 2 values were 13.65, 4.49, 5.91, 4.93 and 7.33, respectively; P values were <0.001, 0.034, 0.015, 0.026 and 0.007,respectively). The cost of antibiotics in the intervention group ((283.86±59.86) yuan) was lower than that in the non intervention group ((820.45±136.27) yuan), and the difference was statistically significant ( t=27.478, P<0.001). The eligible rate of the pre-operative informed consent document signing was 100% (61/61) in the intervention group, and the eligible rate of the operative record completion time was 100% (61/61) higher than that in the non-intervention group (84.7% (50/59), 79.7% (47/59)), the difference was statistically significant (χ 2 values were 7.98 and 13.79; P values were 0.005 and <0.001). The loss rate of preoperative alternative therapy (0) and postoperative communication (0) were significantly lower than those of non-intervention group (11.9% (7/59), 10.2% (6/59)) (χ 2 values were 5.68 and 4.56; P values were 0.017 and 0.033). Conclusion:The implementation of comprehensive quality control intervention mode reduced the application of unreasonable antibiotics and standardized the writing of inpatient medical records. It is of great significance for the rational use of antibiotics and the standardization of medical record writing in the elderly patients with closed fracture.
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Background@#Health information systems (HIS) such as Electronic Medical Record (EMR) systems are essential in the integration of fragmented local health systems. Investing in HIS is crosscutting; it can address multiple interrelated health system gaps. However, public health authorities, especially those in resource-constrained communities, are often faced with the dual challenge of upgrading and digitalizing local HIS and addressing other more apparent health system gaps. @*Objectives@#The study aimed to identify and document strategies that not only motivate policy change towards adoption of electronic HIS but also address other health system gaps. @*Methodology@#The author, in his capacity as a local health official in a resource-constrained community, developed, implemented, and documented a social marketing strategy wherein community stakeholders were influenced to invest in an electronic medical record (EMR) system because it was shown to also have the capacity to address other priority health system gaps identified. @*Results@#The strategy, based on situational, stakeholder, and risk analyses, prompted local governance to first invest in improving the delivery of services accredited by the national health insurance program (PhilHealth), for which reimbursements would require electronically submitted claim forms. Community stakeholders then supported the proposal to invest in an EMR system because they were persuaded that it can facilitate increased financing from PhilHealth claims reimbursements, which could be used to enable not only improvement in existing health services but to also initiate other health programs.@*Conclusion@#Social marketing using the perspective of health as an investment influenced stakeholders to invest in an EMR system.
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Public Health , Health Information Systems , Health Communication , Social MarketingABSTRACT
The beginning of EHR (Electronic Health Record) can be traced back to the development of the Medical Markup Language (MML) from 1995 to 2000. In 2001, EHR with MML as a database structure was developed and expanded to Kumamoto, Miyazaki, Tokyo, and Kyoto (Dolphin Project). After that, the need for medical information management at the national level was recognized, and the need for secondary use of medical information was also recognized, and in 2015, the national level version of the EHR, the “Millennial Medical Record Project” began. The number of connected medical institutions reached 106 in the four years up to FY2018. In December 2019, the Life Data Initiative, a general incorporated association, became the first certified company under the Next Generation Medical Infrastructure Law, and is operating with the aim of achieving independent profitability, including the EHR department, which does not depend on subsidies.
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Objective:The medical records collected on the Ancient and Modern Medical Record Cloud Platform were used to explore the medication rules of Traditional Chinese Medicine for the treatment of ulcerative colitis.Methods:By selecting the medical cases of the modern medical database and medical cases of famous doctors in the ancient medical database on the cloud platform to analyze the frequency, attribution, association, and complex network of those medicines.Results:A total of 209 medical records were obtained, including 319 Traditional Chinese Medicines, of which the core medicines were Rhizoma Coptidis, Radix Aucklandiae, Poria, Radix Paeoniae Alba, and Radix Glycyrrhizae. The properties of those medicines were warm, mild, and cold. The main taste is bitter and sweet, and most of them attibute to spleen, stomach, and liver meridians. The core pair medicine is Radix Aucklandiae-Rhizoma Coptidis. The core prescription was composed of nine herbs including Rhizoma Atractylodis Macrocephalae, Radix Paeoniae Alba, Radix Scutellariae, Radix Aucklandiae, Rhizoma Coptidis, Radix Glycyrrhizae, Radix Pulsatillae, Poria, and Radix Codonopsis. Conclusion:The treatment of ulcerative colitis with Traditional Chinese Medicine mainly include Sijunzi Decoction and Xianglian Pill, accompanied with those medicines which could clear heat with detoxication function, cool the blood and stop diarrhea, By doing so, ulcerative colitis could be treated both in the surface and the root.
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Objective:Based on the Ancient and Modern Medical Record Cloud Platform, we aimed to analyze the rules of TCM compound patents for the treatment of acute pancreatitis.Methods:Compound patents for acute pancreatitis were retrieved from the National Patent Database. After the steps of data screening, data entry, and data specification, a database of compound patents treated for acute pancreatitis was established. The frequency analysis, attribute analysis, association analysis, cluster analysis, and complex network analysis were performed by using the Ancient and modern medical record cloud platform.Results:A total of 87 compound patents were obtained, comprising 213 herbs, of which the core drugs were Rhei radix et rhizoma, Bupleuri radix, Aurantii fructus immaturus, Glycyrrhizae radix et rhizoma, Magnoliae officinalis cortex, Corydalis rhizoma, Scutellariae radix, Aucklandiae radix, Natrii sulfas, Coptidis rhizoma. The drugs were mainly warm, cold and slightly cold, and the drugs taste mostly bitter and spicy, and the drugs mainly belonged to the spleen meridian and liver meridian. The cluster analysis results contained 5 categories. The associations of drugs included Bupleuri radix - Rhei radix et rhizoma, Aurantii fructus immaturus - Rhei radix et rhizoma, Magnoliae officinalis cortex - Rhei radix et rhizoma, for which complex network analysis yielded a core composition of Rhei radix et rhizoma, Bupleuri radix, Glycyrrhizae radix et rhizoma, Natrii sulfas, Aurantii fructus immaturus, Corydalis rhizoma, Scutellariae radix, Magnoliae officinalis cortex. Conclusion:The eliminating stasis by purging for acute pancreatitis is dominated by Rhei radix et rhizoma, channeling Fu Qi method is based on Aurantii fructus immaturus and Bupleuri radix, and eliminating stasis by purging combined with channeling Fu Qi methods can be used with Magnoliae officinalis cortex, Natrii sulfas, etc.
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ObjectiveBased on the medical cases of Qi and blood co-treatment of traditional Chinese medicine（TCM） masters， to discover the syndrome and treatment rules and medication experience of Qi and blood co-treatment through data mining. MethodFrom December 1999 to November 2020， the Qi and blood treatment cases of TCM masters were retrieved from China National Knowledge Infrastructure （CNKI）. Frequency statistics， association rules， cluster analysis and other methods were used for data mining. ResultThe analysis of 591 medical cases of 57 national medical master found that blood stasis， Qi deficiency， Qi stagnation， blood deficiency and phlegm were the most common syndromes. The tongue was reddish， pale or dark， the moss was white or thin， and the pulse was thin， stringy， heavy and slippery. In the treatment of Qi and blood， the disease in the early stage is mostly in Qi and blood itself. At this time， the emphasis should be on regulating Qi and blood， or tonic or attack or both. At the same time， attention should be paid to invigorating the spleen， soothing the liver and tonifying the kidney. Core drugs include Danggui Buxuetang， Buyang Huanwutang， Huangqi Guizhi Wuwutang， Taohong Siwutang， Si Junzitang， Linggui Zhugantang， Xiaoyaosan， Danggui Shaoyaosan and other chemical cut. ConclusionWhen treating Qi and blood together， Chinese medical masters attach great importance to the relationship between Qi and blood and the development stage of diseases， and emphasize the precision and dynamic differentiation of treatment. Their theories and experience of diagnosis and treatment are worthy of clinical application and promotion.
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The outpatient and emergency electronic medical record system is an important part of the hospital information system. By analyzing the current outpatient and emergency electronic medical record system in hospitals in China, this paper rounded up weaknesses in the development of the outpatient and emergency electronic medical record system in terms of management standards, support, technology bottleneck, data sharing and security. On such basis, the authors suggested to improve the policy standards, clarify the construction objectives, increase the support, optimize the system functions and strengthen the security management, which aimed at promoting the high-quality development of the construction of outpatient and emergency electronic medical record system in China′s hospitals.