面向病人全生命周期医疗信息系统构架和关键技术的研究

文章分析了现有的医疗信息系统在医疗信息的组织管理方面的重大缺陷。借鉴CIMS这种信息集成和管理优化的先进管理理念,提出了面向病人全生命周期医疗信息系统的思想和信息集成与运行机制、系统构架以及其实现方法,通过对病人医疗信息的合理组织,可以充分实现医院的内部信息集成和全社会相关信息的集成与运行,实现大区域甚至全国的医疗信息的全方位的集成。     

基于HL7 v3消息的医学图像信息交换的研究

HL7 v3消息标准的出现为解决异构医疗信息系统之间的信息交换的难题提供了基础条件,通过研究HL7数据交换实现原理和HL7v3消息标准的结构,分析了使用HL7v3消息交换医学图像信息的可行性,探讨了两种情况下使用HL7v3消息进行医学图像信息交换的解决方案,提出了基于该方案的电子病历信息交换的框架,为实现异构医疗信息系统间的电子病历信息共享提供了重要的应用价值.     

基于HL7标准的HIS网关的研究

医疗信息系统的设计与开发过程中重要问题是与外部系统进行数据交换.为医疗信息系统设计一套与外部系统进行数据交换的接口是整个系统开发中的核心的工作.简述了HL7标准及其数据交换的基本原理,通过对一个完整的医疗信息交换系统的研究,对其中的消息交换任务管理模块、HL7消息传输模块的原理进行了阐述.提出了一种基于HL7标准的医院信息系统网关的设计方案,同时给出一个完整的网关实现框架.     

一种基于OSGi的医疗设备集成框架

医疗设备与医疗信息系统的无缝集成以及协同互操作是实现数字化医院亟待解决的问题,传统的解决方案在可维护性与可扩展性、数据共享等方面尚存在不足。提出了一个应用于数字化医院的医疗设备集成框架,该框架以OSGi为基础,通过虚拟设备机制抽象出医疗设备功能接口,应用SOA的设计思想把设备作为服务发布,将各种设备数据统一到国际医疗标准HL7（Health Level Seven）和DICOM（Digital Imaging and Communication of Medicine）标准。还讨论了集成框架的原型系统实现及其应用。     

CryptoAPI在医疗信息系统开发中的应用

随着信息科技的进步、互联网以及智能终端的逐渐普及,现代医疗环境随之发生了很大变化。医院信息系统正向着开放化、互联化、移动化的方向发展。为了保证通信的安全性、保密性等,防范信息传递过程中的欺诈行为.必须在网上建立一种信任机制。基于数字证书的身份认证系统是目前用于验证用户合法性最有效的解决方案.被广泛应用于多个领域。在参考相关文献的基础上,结合在医疗信息系统中的实际应用,通过文字描述和图表对CryptoAPI原理及使用方法进行了详细介绍。实践证明,CryptoAPI为医疗信息系统的开发带来了极大便利,使得方便快捷地构建网络安全通信平台成为可能。     

基于PML的移动电子病历数据模型初探

目的移动医疗信息系统是医疗信息化研究的重点,为了解决移动医疗系统中信息表示和信息交换问题。方法通过对移动电子病历信息交换的要求以及物联网技术的分析。结果提出了一种基于PML的移动电子病历系统数据模型。结论与医疗物品及病人相关的数据可以更好的在该环境中进行交换,更好地提高医疗服务质量。     

基于“互联网+医疗”的可信医疗电子认证服务

论文以医院医疗信息平台系统为研究对象,介绍深圳市电子商务安全证书有限公司(简称深圳CA)针对"互联网+医疗"的业务环境建设需求、应用模式及关键基础设施建设,提出利用电子认证服务作为医院智慧医疗系统的基础建设,强化互联网医疗数字身份管理,构建全国统一标识的医疗卫生行业信息平台,提供可信医学数字身份、电子实名认证、电子签名应用、数据访问控制信息系统、可追溯管理系统等功能服务,实现可信医疗数据平台的"可信身份、可信行为、可信数据和可信时间",积极推动医疗网络可信体系建设。     

数据挖掘隐私保护在医疗信息系统中的思考

数据挖掘是指从大量的信息数据中,通过算法对隐藏其中的信息进行搜索的过程,在医疗信息系统中数据挖掘有着一定的问题,有泄露病人信息的可能.本文对数据挖掘隐私保护进行分析,并对医疗信息系统中信息的隐藏提出算法和流程.     

网络环境下医院单点登录与授权管理系统的构建研究

随着国家医疗改革的深入推进,医院信息系统的建设应用对于提升医疗服务水平起着关键作用,同时为医院信息化建设带来了崭新契机。在医院各种信息系统集成化管理的过程中,用户身份的合法性和访问权限的验证是目前亟待解决的关键问题。由此,本文提出了一套基于互联网的医院单点登录与授权管理系统构建方案,能够有效保护医院信息系统的数据资源,防止了患者信息泄露、病例信息篡改等安全事件的发生。     

医院信息系统体系框架与分类规范的探讨

分析当前医院信息系统体系框架以及分类的规范性.对目前医院信息系统的体系框架进行了针对性的分析,从中找出医院信息系统分类规范性的好坏,并从中总结出改进办法.医院信息系统的框架应该是医院管理信息系统、医院临床信息系统以及医院服务信息系统构成,对其进行规范分类后能够较好地保证到医院信息化的稳定前景以及健康快速发展.将医院信息系统的体系框架进行规范性分类对医院发展有着重要意义.     

IHE标准下的数字化医院集成及实现机制研究

现阶段我国医院管理信息系统（HIS）正处在综合集成阶段,文章根据医院信息化建设的实际情况,提出了一种现阶段数字化医院系统集成框架,该框架是在医院IHE集成标准模型与方法范畴下,进行建模与细化,是IHE的子集。同时对该框架下的数据中心、集成平台、应用实现的实现机制进行了研究。采用HL7 V3开发框架下参考信息模型RIM对医院相应角色进行建模与集成,最后在“军卫一号HIS”基础上进行了集成医生工作站的功能实现。     

面向集团医院的区域患者主索引EMPI实现

基于IHE PIX集成模式研究了患者身份的在线快速匹配法和离线辅助调整方法,设计并实现了集团医院级患者主索引EMPI服务,得到实际验证。     

Modelling alarm management workflow in healthcare according to IHE framework by coloured Petri Nets

Ensuring patient safety in medical device networks by managing alarms and related clinical data is a life-critical issue. The Integrating the Healthcare Enterprise (IHE) initiative emerged to discuss and solve the interoperability and integration problems among medical information systems, vendors and users in order to improve patient care and healthcare system dependability. This paper models and analyzes the IHE Alarm Communication Management by using the Unified Modelling Language and Coloured Timed Petri nets. Aiming at generality, the model does not refer to a specific healthcare context but it is based on a general scheme where the message transactions are integrated with the nurse responses. In order to show the potentialities of the model, a real case study is simulated and different scenarios with different levels of workload are analyzed. The results illustrate that the model is able to provide support for structured and comprehensive analysis of the healthcare system management.     

Generic integration of content-based image retrieval in computer-aided diagnosis

Content-based image retrieval (CBIR) offers approved benefits for computer-aided diagnosis (CAD), but is still not well established in radiological routine yet. An essential factor is the integration gap between CBIR systems and clinical information systems. The international initiative Integrating the Healthcare Enterprise (IHE) aims at improving interoperability of medical computer systems. We took into account deficiencies in IHE compliance of current picture archiving and communication systems (PACS), and developed an intermediate integration scheme based on the IHE post-processing workflow integration profile (PWF) adapted to CBIR in CAD. The Image Retrieval in Medical Applications (IRMA) framework was used to apply our integration scheme exemplarily, resulting in the application called IRMAcon. The novel IRMAcon scheme provides a generic, convenient and reliable integration of CBIR systems into clinical systems and workflows. Based on the IHE PWF and designed to grow at a pace with the IHE compliance of the particular PACS, it provides sustainability and fosters CBIR in CAD.     

E-EPR: a workflow-based electronic emergency patient record

Emergency care is, politically and socially, one of the highest priorities in society today. Increasing patient expectations and the advancement of scientific and medical knowledge has had a dramatic effect on the provision of emergency care. Emergency medical services (EMSs) perform pre-hospital and in-hospital emergency care activities, operate 24 h a day/7 days a week and constitute an important link between the community (primary care) and the hospital (secondary and tertiary care). Managing emergency care involves assessing individual needs to create a coordinated plan of care that is consistent with agreed priorities and is designed to bring optimal outcomes using cost-effective care. Emergency care is vital for avoiding death and chronic suffering by the elderly and the homeless, but its overall positive effect on the long-term health and overall well-being of these people can only be improved significantly by applying holistic principles, going beyond basic medical care to offer psychological and social support as far as possible. Thus, creating appropriate emergency care plans requires collaboration and coordination among EMS and social care providers, giving rise to a more holistic approach to emergency care management. In turn, this requires the availability of integrated patient information to authorized individuals of health and social care providers when and where needed. On these grounds, the development of a workflow-based electronic patient record (E-EPR) for emergency care is described which is provided as a service on a cloud. The E-EPR aims at supporting the execution of EMS workflows by providing integrated patient information to EMS process participants and to make this information shareable to health and social care professionals. Due to the heterogeneity of the participating organizations’ information systems, the E-EPR is built on top of an Integrating the Healthcare Enterprise (IHE)-based collaborative network consisting of EMS agencies and health and social care providers who share patient documents using IHE-based profiles. An experimental implementation of the E-EPR is also described.     

EHR临床检验结果共享的实现

为提高临床文档的利用率,满足随时随地获取患者临床信息的业务需求,在充分参考HL7 RIM标准的基础上,遵循IHE实验室检验报告交易及互操作规范,利用SOA体系框架和Web Service技术,构建共享数据中心和共享临床检验结果CDA文档.实现了特定区域范围内的电子病历EHR临床检验结果的互联互通,为EHR临床文档的全面共享进行一次概念验证.     

The O3-Vet project: a veterinary electronic patient record based on the web technology and the ADT-IHE actor for veterinary hospitals

A veterinary electronic patient record, compliant with the IT standards (HL7, DICOM and IHE), was developed at the School of Veterinary Medicine, University of Milan (Italy) in order to improve the veterinary hospital workflows, making the stored clinical data more homogenous and sharable, thereby increasing the integration with current and future software applications. The system was developed by open-source software in order to reduce the implementation and maintenance costs and to make the system sharable with other veterinary hospitals or research centers without additional costs. The system was tested from May to October 2006. Results show that the majority of the veterinarians involved in the test agreed on the advantages obtained by the use of application software concerning the availability of all the useful clinical data [71.4%], the quality of the diagnostic procedures [78.58%] and the efficiency [85.58%] of hospital activities.     

CARE 2000 program refocuses on patients at Mercy in San Diego

Two patient floors are now up and running with Mercy Hospital and Medical Center's CARE 2000 plan for restructuring and decentralizing patient care, and patient satisfaction has already made measurable leaps forward. The new management plan at the San Diego hospital increases nursing time with patients, moves formerly centralized services right onto the patient floor, decreases the number of caregivers a patient must see and makes "care partners" of ancillary staffers. Also, bedside information systems design goes hand-in-glove with new management concepts that are working well.     

Fingerprint verification on medical image reporting system

The healthcare industry is recently going through extensive changes, through adoption of robust, interoperable healthcare information technology by means of electronic medical records (EMR). However, a major concern of EMR is adequate confidentiality of the individual records being managed electronically. Multiple access points over an open network like the Internet increases possible patient data interception. The obligation is on healthcare providers to procure information security solutions that do not hamper patient care while still providing the confidentiality of patient information. Medical images are also part of the EMR which need to be protected from unauthorized users. This study integrates the techniques of fingerprint verification, DICOM object, digital signature and digital envelope in order to ensure that access to the hospital Picture Archiving and Communication System (PACS) or radiology information system (RIS) is only by certified parties.     

Anaesthesia record system on handheld computers--pilot experience and uses for quality control and clinical guidelines

This paper describes a mobile information system to collect patient information for anesthesia quality control. In this system, a mobile database program was designed for use on handheld computers (Pocket PC). This program is used to collect patient data at the bedside on the handhelds, with a daily synchronization of the data between the anaesthesiologists' handhelds with the anaesthesia database. All collected data are later used for quality control analysis. Furthermore, clinical guidelines will be included on these same handhelds. During the pilot phase, data from a sample set of about 300 patients were incorporated. The processes and interfaces of the system are presented in the paper. The current mobile database system has been designed to replace the original paper-based data collection system. The individual anaesthesiologist's handheld synchronizes patient data daily with anaesthesia database center. This information database is analyzed and used not only to give feedback to the individual doctor or center, but also to review the use of the guidelines provided and the results of their utilization.