数字化医院的网络安全问题及对策探究

数字化管理和一流的医疗设备是医院现代化的两个主要组成部分,通过计算机网络,PACS系统实现了各类医疗图像信息的集中管理和共享,HIS系统则把医院的事务管理和医疗业务进行信息化管理,计算机网络和数字化管理在医院中的作用显得日益重要。为加强网络管理,保障数字化、信息化管理的安全,本文在分析医院信息网络安全所面临问题的基础上,探讨了解决计算机病毒、信息系统崩溃、数据遗失等问题的措施。     

浅析新医改环境下的医院信息化建设

医学服务于人类,而信息技术使医学能够更好地服务于人类。随着计算机软硬件技术的发展,卫生行业的信息化建设正在中国的大地上轰轰烈烈地展开。国内各级医院纷纷在信息化的浪潮中,耗资建立了各自的信息系统。众多医院信息系统的建立,在某种程度上,确实解决了院内管理的部分问题,比如,各级管理层查询数据方便了,各业务部门的工作效率提高了,费用信息更透明了……然而,这远远没有达到信息化的目标。世界诸多国家越来越一致地认识到,唯有通过广泛采用以电子病历系统（EMR）为核心的临床信息系统,才能把彼此相互分割的各医疗信息系统有机地连通为可相互交换分享使用对方数据的医疗信息网络,方能促成医疗卫生服务领域整体变革的实现,满足广大病患对医疗服务质量与方式不断更新的需要,并有效应对医学知识及临床信息爆炸性增长的冲击。     

一种医疗公共接口平台集成模型研究*

为了在医院内部及医院之间实现医疗平台的数据交换与共享,根据HL7标准协议进行医疗公共接口的模型研究。通过对医院应用现状的分析,提出了基于HL7标准的电子病历与其他医疗信息系统的对接方式,形成了基于公共接口的平台集成方案,根据公共接口结构及功能的设计方法实现了医院平台数据的交换与共享。最后通过理论及实践证明医疗公共接口平台集成模型的方案是可行的。     

医院档案信息化建设面临的问题与对策刍议

随着计算机技术和网络系统的不断发展,信息化建设在医院档案管理(本文主要就文书档案)中的地位日益提高;医院档案的信息化管理可以提高工作效率、实现信息共享、节约成本,使医院管理工作充分利用档案信息资源,为制定医院工作质量评价、医疗、护理、教学、科研、论文撰写等提供了坚实的平台。在医院文书档案的信息化建设中也存在着电子文件保密性受限制,系统运行的稳定性和安全性不可靠,医院文档的多样性、复杂性、专业性,档案综合管理人员的素质难以达到专业化、信息化要求等实际问题。解决这些问题需要从规范统一标准入手,采取主动管理方式,提高档案管理人员素质,注重网络维护和安全设置及档案部门之间的广泛联系。     

医院信息网络安全管理

随着医院构建以电子病历为核心的信息化系统和医院办公自动化、远程医疗、区域医疗等信息网络系统的应用,信息网络系统的安全更加突出。就医院信息网络系统安全管理策略从医院管理、网络及硬件组成、操作系统及其安装、数据备份与恢复、病毒和黑客防范等进行了初探。     

基于混序组织的信息管理模型

信息资源的整合与共享管理是当前电子政务建设中的难题之一。应用迪伊·霍克(Dee Hock)混序组织理念和方法构建了一种资源共享的信息管理模型,以期为电子政务的信息资源整合与共享提供一种实现途径。通过对混序组织原理的分析和混序组织成员协作关系的分析,构建混序组织成员之间信息沟通与资源共享的管理模型,并将其应用于电子政务信息资源整合与共享的系统设计之中,进而创建了一种通用的信息资源整合与共享模型,也用此模型分析了政府部门行政审批系统、社会信用管理体系等信息资源整合与共享问题,为具有混序组织特征的电子政务信息资源整合与共享管理提供一种软系统架构模型和过程方法。     

医院信息系统项目管理的现状与突破

自20世纪90年代以来,我国医院信息系统发展迅速。到目前为止,全国绝大部分医院实现了信息化管理,并且逐步向区域医疗信息资源共享模式迈进。在医院信息化建设进程中,随着信息系统规模日益庞大,信息管理部门对它的驾驭能力捉襟见肘,原有粗放式的管理模式已远不能适应工作需要。有必要重新审视医院信息系统项目管理模式,实现新的突破。本文以医院信息科为视角,探讨将项目管理九大手段运用到医院信息系统项目建设过程中的作用及效果。     

Medical Chain:联盟式医疗区块链系统

医疗数据共享、防篡改、防泄漏一直是困扰医疗行业的难题.一位患者在转诊时,往往无法提供以往的就诊信息,原因在于国内各医院医疗信息大多数情况下无法共享,而仅能通过病历、检验单等极易丢失的纸质信息来实现一部分医疗信息的共享.同时,患者的医疗信息极易造成泄露,在出现医疗纠纷时所提供的医疗信息也无法保证真实性与公正性.本文设计了一个基于实用拜占庭容错算法（Practical Byzantine fault tolerance,PBFT）的联盟式医疗区块链系统,该系统是一个多节点共同维护与共享的,并且能够防止医疗数据被篡改、泄露的医疗系统,可用来解决这些医疗难题.与现有医疗区块链系统相比,本系统具有一定的优越性与较好的适用性.     

域间路由协同监测中的信息共享机制

路由协同监测通过在自治系统之间共享路由监测信息来形成更为完整的全局监测视图,从而克服域间路由系统自治性的制约,提高单个自治系统的路由监测能力.针对路由协同监测的核心问题——监测信息共享,基于自组织思想设计了信息共享机制CoISM.该机制利用BGP路由策略引起的信息局部性对路由监测信息的传播范围进行裁减和控制,在被动查询的基础上增加了信息"反射"行为,利用路由监测信息之间的相关性实现信息的主动推送,将自治系统的利益建立在主动信息共享这一利他行为的基础上.CoISM能够引导自治系统实现路由监测信息的自组织聚合与按需共享,具有激励性,能够促进自治系统之间的协同.该机制采用分布式体系结构,具有良好的扩展性和较低的通信开销,不需要修改BGP协议,支持可渐进部署,适用于域间路由协同监测、路由故障协同分析、协同入侵检测等多种跨域协同管理应用.     

Exploring Patients’ Use Intention of Personal Health Record Systems: Implications for Design

Abstract

Personal health record (PHR) systems offer a technology for personal health information management (PHIM) activities. Despite efforts to increase the use of PHR systems as a mechanism to support better patient-centered care and improve information management across the continuum of care, PHR adoption remains low. The purpose of this study was to explore how to design a PHR system that can adequately support personal health information management activities. Using a mixed-methods approach (questionnaires and interviews), we identified the factors affecting a person’s intention to use PHRs and also described the personal health information management activities among people from a wide age range in the United States. Results indicated that the intention to use PHR systems was affected by system-related factors, such as perceived usefulness, health information understandability, personalization, and patient–clinician communication support, and user-related factors, such as social influence, self-efficacy, and willingness to share. Furthermore, five types of personal health information management activities were found, including storage, organization, maintenance, retrieval, and sharing. Informed by the study findings, we developed seven design recommendations to improve PHR systems. Future studies can focus on further validating these findings using other methods and be based on larger and more representative PHR users.     

Theoretical and practical applications of blockchain in healthcare information management

A primary objective of blockchain technology is to address information security and efficiency issues related to existing information sharing systems. For the sharing of health records, little is known about the application of blockchain in management information systems. There are strict regulations for sharing health information due to insecure systems and privacy concerns. To significantly and effectively improve medical diagnosis, it is beneficial to have efficient, reliable, and accurate accessibility to a patient's full medical history. Due to concerns with the security of health systems and privacy concerns, medical histories are not always accessible to healthcare providers. To help increase accessibility options, this research proposes a blockchain-based model that facilitates sharing medical records in a manner that is beneficial to both healthcare providers and patients. Social exchange theory provides the theoretical support for the conceptual model presented. Experimental findings based on 151 participants revealed that the blockchain technology can provide a secure information system and increase patient motivation to share medical records. To show the applicability of the proposed use of blockchain from a practical managerial perspective, we show feasibility by developing an Android software application.     

Integrated clinical pathway management for medical quality improvement – based on a semiotically inspired systems architecture

Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems.     

基于物联网的医患管理系统的设计与实现

在科技日益发达的今天,物联网技术得到越来越广泛的应用。医院信息管理的计算机化、网络化、实时化将是建设现代化医院必不可少的重要手段。医院必须实现全面的信息化管理,为病人提供现代化的服务,提高对病人的服务水平,方便、准确、快捷地为病人提供医疗服务和医疗费用信息,进而增强病人对医院的信任和支持。系统基本功能包括了门诊挂号、门诊病区、门诊结算、住院登记、住院病区、医技科室、管理员部分以及其他设置部分八个方面,充分运用计算机技术、物联网技术、数据库技术;采用灵活的模块化结构设计方法进行设计,为用户提供强大的数据操纵功能,界面友好、使用简单方便。     

基于CIM XML/CORBA的水电厂异构数据库系统集成研究

从水电厂的实际应用背景出发,在对现有应用系统的现状进行分析的基础上,提出了水电厂的异构数据库系统的集成方案。在水电厂异构系统的数据集成的实现方法上,采用了CIMXML来充当共享数据的交换载体,用CORBA技术实现异构数据库系统之间的通信和交互平台,并提出了将两者结合的水电厂系统集成架构,实现系统之间通用信息的共享和部分功能的整合,为提高企业整体的管理和决策能力提供了更好的信息平台。     

Medical wireless IoT system and nursing intervention of chronic bronchitis based on clinical data

According to the WHO (World Health Organization), the chronic obstructive pulmonary disease has become the third leading cause of death in the group. The associated health sector related to 2030 based on the curve and the long-term cost of medical expenses. Age is the leading cause of a significant occurrence. The management of stable COPD patients to mitigate the attack, it is based on his system. Chronic obstructive pulmonary disease management system, portable spirometer and things mobile applications handheld, is a clinical information database. The Internet has established the configuration. The database, one of the MBOX format, through the Zhongshan hospital, collects data from the branch of the largest medical service provider in the region, located in the stable state of the 11 pieces of data from the main hospital of the patient follow-up. Lung function data is tested via a handheld portable spirometer and can be uploaded in real time. Other smartphone applications have been developed to establish direct communication between patients and physicians to improve disease management. It is worth noting that it classifies patient clinical data, sends it, stores it anonymously, and encrypts it for protection and privacy. What is useful in treating chronic diseases based on remote monitoring is that it significantly provides health information such as medical and biosensor data volume management and big data technology, this vast new medical technology. It can be increased. The application that needs to be processed. A potential solution for new services based on the Internet of Things is used to create the concept of big data processing.     

A hospital integrated framework for multimodality image basemanagement

The trend in healthcare information technology is increasingly digital and multimedia oriented. The next generation of health care information systems will consist of a vast network of heterogeneous, autonomous, and distributed imaging scanners, databases, information systems, knowledge intensive applications, and large quantities of multimedia medical data. A key challenge facing system researchers and builders is to provide a new organizational framework that can integrate this varied collection of resources into what appears to be a uniform and logical conglomeration of data and knowledge store in order to increase the availability of global or previously nonaccessible information and to address demanding new information processing requirements for diverse image-assisted medical applications. The purpose of this paper is to present the authors' research toward the development of a hospital integrated framework of multimodality image base management (MIBM) for digital radiology of the future. This evolutionary framework consists of three hierarchical components: a hospital-integrated picture archiving and communication system (HI-PACS), a medical image database system (MIDS), and a set of image-based medical applications that relies on the support of MIDS and PACS. In this paper, the authors describe the system architecture, guiding principles, and design specifications of HI-PACS and MIDS and illustrate their functions and capabilities with three implemented applications, namely, patient folder workflow, distributed object management, and multimodality imaging studies. In addition, the authors conclude their findings with a summary of challenges and research directions     

零库存流程管理在医院成本核算中的应用

随着各类医用耗材、消毒品数量和种类的增加,医院物资管理在医院运营中的作用越来越显著。在提倡以患者为中心,提高患者满意度的宗旨下,与患者直接接触的HIS、LIS、PACS、CIS等医疗系统发展十分迅速,而医院内部使用的物资管理系统却比较落后。针对在医院实际医用物资管理中,时常发生医疗物资积压和医疗耗材缺货导致医疗时机延误等问题,对现有物资管理系统中的不足进行分析,并提出一种以零库存管理为基础的新工作流程,以解决现有的一些问题,并在继续深入探讨和研究。     

全国取用水管理信息系统建设

针对目前取用水应用系统繁多、信息资源分散、业务协同不足、数据标准不一、资源共享不畅等问题，依托全国一体化在线政务服务平台，提出全国取用水管理信息系统建设思路、目标及原则。采用“统一身份认证、统一事项服务、统一数据标准、集中与分散部署相结合”的模式，建设全国取用水管理信息系统，自下至上分为基础设施层、数据支撑层、应用支撑层、业务应用层和用户层，并以安全保障、标准规范 2 个体系贯穿整体。同时，在数据、应用、安全、管理等标准的建立，取用水相关系统的整合，数据的融合共享及分析应用等方面提出建设方案，为各省开展省级取用水管理信息系统建设提供借鉴，加快推进取用水管理相关信息系统整合共享与应用推广。     

基于CIM XML／CORBA的水电厂异构数据库系统集成研究

从水电厂的实际应用背景出发,在对现有应用系统的现状进行分析的基础上,提出了水电厂的异构数据库系统的集成方案。在水电厂异构系统的数据集成的实现方法上,采用了CIMXML来充当共享数据的交换载体,用CORBA技术实现异构数据库系统之间的通信和交互平台,并提出了将两者结合的水电厂系统集成架构,实现系统之间通用信息的共享和部分功能的整合,为提高企业整体的管理和决策能力提供了更好的信息平台。     

构建DICOM中间件实现远程医学影像信息的异地共享

针对目前医院信息化建设中急待解决的影像信息共享的问题,围绕医学图像的国际标准DICOM这一技术核心,提出并构建一种基于DICOM标准的中间件软件,成功实现多家医院PACS间医学影像信息的远程存储和远程通讯,有效地解决不同PACS之间医学图像数据的兼容性问题,满足传输过程中的安全性和可靠性的要求,从而达到了多家医院PACS系统之间医学影像资源异地共享的目的.