基于健康档案的医疗系统PKI信任模型研究

随着医疗信息技术的高速发展,我国医疗信息化建设中的信息安全问题显得越来越重要。而基于电子健康档案的医疗系统中身份认证管理已成为解决医疗信息系统中的安全问题中关键的一环。文章以基于电子健康档案的医疗系统中身份认证机制为出发点,分析PKI中各种信任模型的特点,对现有的方式进行研究和分析,设计出符合适合区域医疗信息平台的PKI信任模型,从而使基于电子健康档案的医疗系统中的身份认证机制更为安全、高效。希望给后续研究这一课题的研究者提供参考。     

基于多色集合的电子病历互访模型

随着医疗数据信息化的发展,电子病历在异地就诊以及医学研究方面的作用越来越大.为解决异地就医时电子病历的交互问题,拟提出一个跨组织的多医院间电子病历交互平台;根据平台的业务流程,提取各个组织的活动和资源元素;针对交互过程中各组织的活动和资源之间的关系,结合多色集合和围道矩阵分别从不同组织的不同视角提取各组织的外部交互活动和交互资源;同时,对业务流程进行研究并提出相应的形式化描述模型.     

基于联盟链的电子健康记录隐私保护和共享

医院正在逐渐采用电子健康记录(EHR)的方式去记录患者的医疗信息。然而,医疗数据的隐私性和EHR标准的差异化阻碍了医疗数据在病人和医院之间的共享。因此,针对隐私信息泄露和难于共享的问题,提出了一个基于联盟链的隐私保护数据共享模型。此外,基于匿名算法提出了(p,α,k)匿名隐私算法,能够解决EHR隐私信息泄露的问题。通过理论分析和实验证明,提出的基于联盟链和(p,α,k)隐私匿名算法模型能够在保护数据隐私的前提下,实现病人和医院之间的数据安全共享。对比前人的模型,该模型具有所需节点少、减少主链压力、容错性强和病人对EHR完全控制等优势。     

天然橡胶/氯醚橡胶/相容剂共混物的研究

利用差示扫描量热法（ＤＳＣ）和相差显微镜（ＰＤＭ）对氯化聚乙烯（ＣＰＥ）、丁腈橡胶（ＮＢＲ２６）和环氧化天然橡胶（ＥＮＲ５０）作天然橡胶／氯醚橡胶（ＮＲ／ＥＨＲ）体系的相容剂进行了研究。通过考察共混胶的力学性能，确定了相容剂的适宜用量和共混时间。结果表明，ＣＰＥ，ＮＢＲ２６和ＥＮＲ５０能有效提高ＥＨＲ在ＮＲ中的分散程度，混炼时间１５ｍｉｎ，用量１０—１５份为宜。     

企业如何成功实施EHR项目

实施EHR项目已经成为企业提高人力资源管理水平的重要手段。该文首先介绍了EHR系统的概念,然后对如何规划EHR系统功能、选择实施方案、确定供应商、通过把握项目关键点成功实施项目进行了详细的介绍,最后又介绍了项目实施中存在的各种风险。通过该文的介绍,希望对企业成功实施EHR项目提供有益的参考：     

基于集成信用度评估智能合约的安全数据共享模型

区块链技术是一种新兴技术, 它具备防篡改、去中心化、分布式存储等特点, 可以有效地解决现有数据共享模型中隐私安全、用户控制权不足以及单点故障问题. 本文以电子病历(Electronic health record, EHR)共享为例提出一种基于集成信用度评估智能合约的数据共享访问控制模型, 为患者提供可信EHR共享环境和动态访问控制策略接口. 实验表明所提模型有效解决了患者隐私安全和对EHR控制权不足的问题. 同时就模型的特点、安全性以及性能进行了分析.     

结构化电子病历数据录入方法

以HL7 CDA R2标准作为临床信息的结构化表达方式,提出了一种兼容标准术语的结构化录入（SDE）方法,用来解决由于标准术语的概念划分较粗,不足以通过标准术语编码的结构化内容重建自然语言满足临床日常信息交换需求的问题.该方法抛弃传统的通过标准化结构化结果重建叙述性内容的模式,采用同步生成叙述性内容和标准化结构化内容的模式,因而叙述性内容的生成不受限于结构化内容标准术语的概念划分,从而实现了在结构化数据录入中应用标准术语满足计算机可处理的同时满足临床日常工作对于自然语言信息的人工阅读需要.该方法为标准化结构化电子病历信息模型的数据获取兼容叙述性病历提供了一种新的解决思路.     

Open source EMR software: Profiling,insights and hands-on analysis

Background

The use of open source software in health informatics is increasingly advocated by authors in the literature. Although there is no clear evidence of the superiority of the current open source applications in the healthcare field, the number of available open source applications online is growing and they are gaining greater prominence. This repertoire of open source options is of a great value for any future-planner interested in adopting an electronic medical/health record system, whether selecting an existent application or building a new one. The following questions arise. How do the available open source options compare to each other with respect to functionality, usability and security? Can an implementer of an open source application find sufficient support both as a user and as a developer, and to what extent? Does the available literature provide adequate answers to such questions? This review attempts to shed some light on these aspects.

Objective

The objective of this study is to provide more comprehensive guidance from an implementer perspective toward the available alternatives of open source healthcare software, particularly in the field of electronic medical/health records.

Methods

The design of this study is twofold. In the first part, we profile the published literature on a sample of existent and active open source software in the healthcare area. The purpose of this part is to provide a summary of the available guides and studies relative to the sampled systems, and to identify any gaps in the published literature with respect to our research questions. In the second part, we investigate those alternative systems relative to a set of metrics, by actually installing the software and reporting a hands-on experience of the installation process, usability, as well as other factors.

Results

The literature covers many aspects of open source software implementation and utilization in healthcare practice. Roughly, those aspects could be distilled into a basic taxonomy, making the literature landscape more perceivable. Nevertheless, the surveyed articles fall short of fulfilling the targeted objective of providing clear reference to potential implementers. The hands-on study contributed a more detailed comparative guide relative to our set of assessment measures. Overall, no system seems to satisfy an industry-standard measure, particularly in security and interoperability. The systems, as software applications, feel similar from a usability perspective and share a common set of functionality, though they vary considerably in community support and activity.

Conclusion

More detailed analysis of popular open source software can benefit the potential implementers of electronic health/medical records systems. The number of examined systems and the measures by which to compare them vary across studies, but still rewarding insights start to emerge. Our work is one step toward that goal. Our overall conclusion is that open source options in the medical field are still far behind the highly acknowledged open source products in other domains, e.g. operating systems market share.     

基于主成分分析法的高校EHR系统

主成分分析法是系统分析中一种新型的数学方法,将它应用于EHR系统的多个环节,使人力资源管理的决策实现定性分析与定量分析的有机结合,从而使许多多因素问题得到相对科学的解决。天津大学的实践表明,系统的应用实现了与高校人员相关的数据、过程和资源的集成化管理,提高了管理效率。