CN101702187A - Electronic medical record system realizing inter-region medical data sharing - Google Patents
Electronic medical record system realizing inter-region medical data sharing Download PDFInfo
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- CN101702187A CN101702187A CN200910034257A CN200910034257A CN101702187A CN 101702187 A CN101702187 A CN 101702187A CN 200910034257 A CN200910034257 A CN 200910034257A CN 200910034257 A CN200910034257 A CN 200910034257A CN 101702187 A CN101702187 A CN 101702187A
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Abstract
The invention relates to an electronic medical record (EMR) system realizing inter-region individual medical data sharing, belonging to the field of medical informatization. The invention provides an EMR system mode realizing inter-region medical data sharing formed by combining HEMR and PEMR to replace the global general EMR system mode realizing medical data sharing by internet technology at present. The HEMR in the scheme is the basic warrant for realizing the national EMR platform, and mainly can realizes data acquisition, storage and data sharing in hospitals; the PEMR is one of the key links in constructing the national EMR system, and can realize the function of sharing medical data among hospitals. The introduction of the PEMR can avoid the bottleneck for realizing individual medical data sharing among regions or medical institutions, thus being an improved technical mode actually establishing a national EMR system to realize intercommunication and convenient sharing of inter-region individual medical data in various aspects, and producing colossal economic benefit.
Description
Technical field
The present invention relates to a kind of electronic health record EMR system that realizes the inter-region medical data sharing, belong to the medical information field.
Background technology
Country's electronic health record (and health account) system construction is the project of giving priority to that present developed country advances the health care informatization.Perfect electronic medical record system except that the level that can promote whole medical and health services, standard supervision, balance high-quality medical resource skewness, conveniently seek medical advice etc., also have a very important function, good individual medical data is shared can create very high economic worth.
General electronic medical record system construction scheme at present is difficult to really realize the target of national electronic health record (and health account) system construction.Perfect national electronic medical record system must possess three Core Features: data acquisition, data storage and safety, trans-regional convenient the sharing of data.The realization of electronic medical record system should be made of two parts: first be each independently unit (hospitals at different levels, basic unit, community sanitary mechanism) under the prerequisite of unified national disease (health and fitness information) data pattern and standard, realize data sharing function in the collection, safe storage, unit of medical data; Second portion is the convenient sharing functionality that realizes medical data between trans-regional each unit.It is to determine the national standard of electronic health record exploitation earlier that first realizes not having substantially more technical bottleneck, key; Next is when the overall software development of electronic health record design, the standard of the rationality that emphasis is noted designing, unitarity, distinct device data transformation interface.A lot of hospitals possess HIS, only need increase CIS, PACS, LIS system, at present new electronic medical record system exploitation is based under the standard card cage of U.S. HL7 more to be carried out, electronic medical record system after finishing realizes that data acquisition, the safe storage of separate unit inside do not have too many technical matters, in same separate unit LAN (Local Area Network), adopt 100M or above bandwidth, good system software design scheme, interface scheme, server and database scheme, realize the also not more difficulty of data sharing in the separate unit.There is technical bottleneck in the realization of second portion, and the medical data of electronic medical record system is shared design at present, is substantially to take to carry out the shared scheme that data interaction is transmitted, had access to by the central database of setting up different aspects.Concrete technological difficulties are: 1. the speed problem of data transmission.2. the real-time Transmission of data and regularly transmission problem.3. the management of vast capacity database and operation cost problem.4. the incomplete basic medical unit of population coverage rate maximum but basic hardware facility is realized the data sharing problem.5. data sharing problem when electric power and communication system fault.Be embodied in 1. outpatient services and see a doctor the matter of time of having access to individual medical data.If have access to patient data's time more than 5 minutes, will cause difficulty to outpatient service, produce data sharing and share bottleneck.Individual's medical data is different from other data, mainly is that data type complexity (medical data comprises literal, list, image, image data etc.), data volume are big.It is very normal that individual's medical data surpasses 100M, and the data information of a complete MRI just can surpass 100M usually, and the personal illness data are interrelated and increase progressively gradually in addition.Is 6.6 minutes in 2M private network mode in the theoretical value of transmitting a 100M data instance calculation of measured data transmission time with the city, is subjected to multiple factor affecting will be longer than the theoretical transmission time during actual transmissions; The data of transmission 500M are wanted 33 minutes in theory.2. central database construction and handling cost problem.Suppose that a city can provide the special line of unrestricted bandwidth to be used for the construction of electronic health record regional platform, realize the convenient transmission of medical data in network facilities support, under the prerequisite of sharing, medium-sized city contain have jurisdiction over the county population by 2,000,000 calculating, the construction of city level central database will very hugely (be announced 2008 Chinese hygiene industry statistics according to the Ministry of Public Health, do not contain village's clinic data, the outpatient service in 2008 of whole nation medical institutions is gone to a doctor and is add up to 35.32 hundred million person-times, add up to 11,483 ten thousand person-times in hospital), the mutual transmission workload of real time data also will be surprising, even if all can smooth implementation, the operation management cost also will be high surprising.Transmit alternately if can not realize real time data between hospital and the central database, still can't solve the regional interior convenient sharing problem of medical data, the inter-region medical data are convenient shared than convenient shared more difficult in the zone.3. the medical data sharing problem of basic medical unit.The 5th Chinese population reconnaissance information (2000), China's Mainland population 12.658 hundred million, agricultural population is several 8.739 hundred million, accounts for 63.91% of total population, town's level population 1.66 hundred million, urban population 2.926 hundred million.Statistical data shows: most crowds are distributed in medical treatment and the backward following rural area, county of basic communications service.Most places are difficult to set up good secure data storage, transmission system in long-time.4. the burst thing causes the data sharing obstacle.Power failure, communication operator system fault, network backbone fault, hospital database fault or the like take place as zone, down town database area.The confusion that above-mentioned situation will cause overlay area hospital curative activity appears.
The many countries in the whole world or have actively pushed forward the exploitation and the construction of electronic medical record system.Find that U.S.'s electronic health record (health account) system construction at present meets with mortality bottleneck---the storage security and the data transmission problems of individual medical science (health/disease information) data after the present situation of research U.S. electronic medical record system.The research and development of U.S.'s electronic medical record system start early, the infusion of financial resources amount is big, technology maturity is high, has set up unique " electronic health record " national standard-HL7 in the present whole world.The most successful the earliest state of Indiana of electronic health record exploitation, the whole America, existing 30 years history, the maximum technical barrier that faces at present is data sharing.Permanent (Kaiser Permanente) annual turnover of Kai Ze is 34,000,000,000 dollars, has to surpass 8,000,000 patients and the largest electron medical treatment project of entire United States, and it is more than half that they invest 10 yearly plan times of 4,500,000,000 dollars; At present still can't fine breakthrough data security and the technology barrier of sharing.Twice pair of big power failure of whole web influence of the said firm's encountered is autumn in 2005 for the first time, and occurring in is the eastern bank data center of 4 area services.The power failure that another time occurs in California data center in 2006 has then influenced the area, west bank.Can't visit any computer record in lasting 16 to 30 hours, at medical field, in case such problem occurs as being both a bad dream.The research and development of U.S.'s electronic medical record system mainly are in a kind of in a dilemma difficult situation because of being difficult to break through the convenient share technique difficult problem of individual medical data at present.The construction of China national electronic medical record system has just started but the symptom of a trend of similar U.S. problem occurred, and China should receive U.S.'s successful experience, avoids simultaneously following the track of the overturned cart.
Summary of the invention
The present invention is directed to the mortality technical bottleneck that exists during " electronic medical record system of inter-region medical data sharing " built at present, propose to adopt with the electronic health record HEMR of hospital to combine the electronic health record EMR system that constitutes the inter-region medical data sharing with portable individual electronic medical record PEMR, replacing at present, the current Internet technology that adopts in the whole world realizes " electronic medical record system of inter-region medical data sharing " new technic relization scheme.The trans-regional shared electronic medical record system of the individual medical data of realization provided by the present invention is characterized in, a kind of trans-regional shared electronic health record EMR system of individual medical data that realizes, it is characterized in that the electronic medical record system formed by electronic medical record system HEMR of hospital and portable individual electronic medical record system PEMR two parts, hospital's electronic medical record system adopts the hospital information system HIS that sets up in the LAN (Local Area Network) system, clinic information system CIS, laboratory information system LIS, medical image archives and communication system PACS, hospital database, server and each station terminal facility are formed, the portable individual electronic medical record system comprises portable individual electronic medical record, the read-write equipment of portable individual electronic medical record, described portable individual electronic medical record is by hard cards and embed microcontroller in it, storer and reading-writing port thereof constitute, the read-write equipment of portable individual electronic medical record is made of PC and supporting read write line, the microcontroller of described formation portable individual electronic medical record has coding to be identified, its corresponding recognition coding is arranged in the supporting read write line, portable individual electronic medical record can be used as zones of different, medical data transmission and the carrier platform of sharing between the medical institutions, also can on the computing machine that does not have hospital's electronic medical record system, carry out independently medical data input function by supporting read write line, possesses perfect outpatient service operation of diagnosis and treatment function, by the medical science document that carries, the image data conversion adapter changes into the medical data that meets HL7 electronic health record standard with the nonstandardized technique medical data and carries out data storage, can satisfy at different hospital's electronic health records simultaneously, the demand of calling among the HIS and storing.1. will adopt the Internet technology to realize that electronic medical record system design, the construction mode of inter-region medical data sharing are divided into hospital's electronic health record, two partial design of portable individual electronic medical record, construction mode at present.2. scheme institute of traditional Chinese medicine electronic health record is a basic guarantee of realizing national electronic medical record system, mainly realizes medical data sharing functionality in the binomial Core Feature of medical data acquisition, safe storage in the electronic medical record system and the hospital; Portable individual electronic medical record is realized another Core Feature in the electronic medical record system, and medical data transmission between each medical institutions, convenient sharing are one of three big core links of electronic medical record system construction.Introduce the portable individual electronic medical record purpose and be that a variety of causes of avoiding speaking of previously causes the bottleneck problem that individual medical data is shared in the electronic medical record system, make the electronic medical record system construction realize that really individual medical data is trans-regional, each aspect interconnects, convenient shared mature technology pattern.
Electronic health record HEMR system of hospital can adopt ripe at present current techique to realize, is included in compositions such as interior hospital information system HIS, clinic information system CIS, laboratory information system LIS, medical image archives and the communication system PACS that sets up of LAN (Local Area Network) system, hospital database, server, each station terminal facility.
Portable individual electronic medical record PEMR system comprises that the read-write equipment of portable individual electronic medical record, portable individual electronic medical record, described portable individual electronic medical record are made of hard cards and the microcontroller, storer and the reading-writing port thereof that embed in it, and the read-write equipment of portable individual electronic medical record is made of PC and supporting read write line.The microcontroller of described formation portable individual electronic medical record has coding to be identified, and its corresponding recognition coding is arranged in the supporting read write line.Portable individual electronic medical record can be used as zones of different, the carrier platform that medical data is shared between the medical institutions, possess simultaneously and on the computing machine that does not have hospital's electronic medical record system, carry out independently medical data acquisition function, possesses perfect outpatient service operation of diagnosis and treatment function, have the essential characteristic of hospital's electronic health record fully concurrently but simplify function significantly, the key character of data storage is the medical science document by carrying, the image data conversion adapter changes into the medical data form that meets HL7 electronic health record standard with the nonstandardized technique medical data and carries out data storage, and can be at different hospital's electronic health records, share among the HIS and use.
Microcontroller in the hard cards of portable individual electronic medical record is a microcontroller with embedded OS, storer is a NAND FLASH, an encryption logic subregion that is used for the fund computing can be arranged in NAND FLASH, and the space beyond the subregion is used for the storage of medical data information.
Just set the unique identify label code of portable individual electronic medical record possessor before use, the unique identify label code of possessor exists in the logical partition that is used for the fund computing of described NAND FLASH.
Microcontroller in the hard cards of portable individual electronic medical record is a microcontroller with embedded OS, described storer is two, one is NAND FLASH, another is ROM, RAM or EEPROM, and the work of two storeies is by the microprocessor controls in the hard cards.
Microcontroller, microprocessor in the hard cards of portable individual electronic medical record are MCU, MPU+CAU, described storer is two, one is NAND FLASH, another is ROM, RAM or EEPROM, by the work of MCU control NAND FLASH, control the work of another storer ROM, RAM or EEPROM by MPU+CAU.
Also embed a fingerprint Identification sensor in the hard cards of portable individual electronic medical record, fingerprint Identification sensor connects the microcontroller of control ROM, RAM or eeprom memory work.
Portable individual electronic medical record possesses the application safety functional character, the control of doctor's access rights, directory level security control, file attribute security control is set, uses the PKI-CA system.Special disease information does not have the portable individual electronic medical record possessor to authorize, and the doctor can't have access to related data; Historical summary can be read but can not revise, can't delete; Individual's medical data need be obtained the authorization to hospital's electronic health record backup from portable individual electronic medical record; Newly-increased medical data can be revised in the not end of once going to a doctor, and leaves vestige after the modification; Adopt electronic signature, timestamp to guarantee data validity; Possess the non-standard medical data of importing and convert the function that meets national electronic health record standard XML form medical data memory function and derive standard format medical data and PDF or extended formatting file to.
The function that the portable individual electronic medical record that the present invention relates to possesses: 1. portable individual electronic medical record possessor's identity recognition function is divided into two kinds of versatility identification and private identity identifications.Generic identity identification is used for medical data management and two parts of fund computing management, just sets the unique identify label code of portable individual electronic medical record possessor before use.Private identity identification is used for fund computing administrative section.The establishment of generic identity authentication code can be adopted and the I.D. consistance, can guarantee portable individual electronic medical record and the individual medical data uniqueness in hospital's electronic health record database, and the individual medical data of being convenient to elementary cell hospital is retrieved and had access to.Can enter hospital's electronic health record or portable individual electronic medical record system after portable individual electronic medical record is discerned by the workstation PC of medical institutions by supporting read write line, identification is finished automatically, does not need the possessor to import password identification separately.This has extremely important meaning to large tracts of land emergency aid and treatment, particularly timely understanding portable individual electronic medical record possessor's underlying diseases and treatment information in to loss of consciousness patient first aid to striving for comprehensive rescue time.Private identity identification is to be applied in fund computing system, can enter different fund computing systems had the PC identification of fund calculation function by supporting read write line when portable individual electronic medical record after, need carry out special identifying again to the possessor when carrying out fund computing practical operation, adopt password input or fingerprint recognition.Password identification is mainly used in the little fund management systems of number such as medical insurance and individual medical fund, and fingerprint recognition is mainly used in the big bank capital computing system of number.The purpose of private identity identification is the fund security that ensures the individual to greatest extent.2. possesses the application safety function.The essential information of portable individual electronic medical record and general diseases information are not provided with access rights, be provided with special disease possessor granted access function, possessor authorize from portable individual electronic medical record to hospital's electronic health record data backup function, historical data unsuppressible-suppression function, historical data readablely can not rewrite function, newly-increased medical data can be revised but leave the vestige function; Adopt directory level security control, file attribute security control.These functions can be protected the security and the integrality of possessor's the right of privacy, the authenticity that ensures the disease treatment process, assurance medical data to greatest extent; this ensures that to judicial evidence collection in the increasing medical tangle objective reality of material evidence is very helpful.3. simple and easy hospital electronic health record function.Portable individual electronic medical record main function of the shared carrier platform of individual medical data that realizes in electronic medical record system reaches at the basic medical unit that lacks hospital's electronic health record, HIS, or substitute hospital electronic health record outpatient service station can't use hospital's electronic medical record system under special circumstances the time temporarily and realize the Outpatient Department data acquisition function, portable individual electronic medical record possesses following hospital electronic health record function.(1) enters the PC of no hospital electronic health record, HIS after being identified by supporting read write line, in portable individual electronic medical record, finish all kinds of outpatient service medical data acquisitions, data storage, data sharing.(2) portable individual electronic medical record adopts Web Service operation interface.(3) patient module of portable individual electronic medical record and hospital's electronic health record outpatient service station function basically identical ensure that portable individual electronic medical record possesses the function of independently finishing outpatient service diagnosis and treatment work.(4) concordance list function is convenient to consult fast in the portable individual electronic medical record data.(5) possesses the database function of storage, management different classes of medical science and related data.(6) the simple and easy diagnostic and therapeutic system data management function of being in hospital does not have the system practical operational function of being in hospital.After hospitalization process of patient was all over, whole medical datas that hospital can offer the patient in accordance with regulations backuped to the portable individual electronic medical record from hospital's electronic health record.(6) possess conventional inquiry, printing function.(7) possess comprehensive and statistics of single item function, be convenient to different management organizations the standardization and the use of funds rationality of therapeutic process are done assessment.4. possess all kinds of medical data conversion adapter functions.The HIS of each hospital develops under ununified national standard prerequisite at present, widely different on function, data layout, though part hospital has implemented hospital's electronic medical record system construction, but being mostly increases module and interfaces such as CIS, PACS, LIS or RIS on the basis of existing HIS, be not still having and transform, develop under unified national electronic health record standard, the unified technical scheme prerequisite, estimation is in considerable time, and the medical data form of each hospital is difficult to reach unified.Do not have the hospital of electronic medical record system of a great variety especially at all kinds of medical data forms of gathering with storage, this will make the medical data of different hospitals be difficult to each other share and use.In portable individual electronic medical record, implant the conversion adapter that noncanonical format medical science document, image data is converted to general standard format medical data.The data standard XML data layout after the conversion is stored, and carries out the data sharing exchange between portable individual electronic medical record and hospital's electronic health record.The medical data conversion adapter is followed the various electronic health record universal standards such as HL7, DICOM, China national medical data standard, adopts J2EE to develop.5. portable individual electronic medical record possesses medical fund computing management function.6. fund computing extension function.Can pass through extension function.More fund computing management function and the automatic recognition function of identity information be can realize by the secondary development on the embedded OS platform, the function of all kinds of fund compute card such as bank card, social security card, government utility card and the function of automatic identification I.D. in same card, realized.
The present invention is by introducing portable individual electronic medical record as the scheme that realizes the trans-regional shared carrier platform of individual medical data, avoid individual medical data and share bottleneck, realize trans-regional, convenient the sharing of individual medical data of one of electronic medical record system three big Core Features.Electronic health record just can be called electronic medical record system (or being called national electronic medical record system) after having only the trans-regional convenient individual medical data of realization to share.After electronic medical record system built up, medical data was shared the expense expenditure that can reduce many unnecessary recheckings, treatment, and the waste of country and individual citizens fund is reduced, and just can show the huge economic value that the investment electronic medical record system is built.Perfect electronic medical record system can make country become investment-income-reinvest development model capable of circulation in the investment of health care infosystem.If it is trans-regional, convenient shared that electronic health record can not be realized individual medical data, can't finish real electronic medical record system construction, also just can't obtain huge fund and save the income of bringing by resource sharing.Can bring many benefits for country after perfect electronic medical record system builds up: 1. the medical skill resource of high, the middle aspect of realization hospital and basic unit share, and help promoting the overall development of primary care cause.2. good resource sharing can be regulated and control the repetition main equipment investment of each going after profit or gain property of medical institutions, saves substantial contribution.3. the waste that good resource sharing and supervision can avoid all kinds of recheckings, unreasonable treatment to cause reduces individual and national medical funds expenditure significantly, and country can be used to enlarge the covering of national medical security with economizing on the use of funds.4. the electronic medical record system construction of standard covers clinical treatment and capital settlement system, and convenient management organizations all kinds of, at different levels are to the rationality and the rational supervision of medical insurance use of funds of diagnosis and treatment process.5. be convenient to set up lifelong medical science (health/disease information) data information of complete individual, the real realization prevented and treated synchronously, and situation is heavily treated in the light prevention of reversing all the time, advances the prevention work development, and can save a large amount of treatment funds from good diseases prevention.6. write, revise the scarred function in back because electronic health record possesses to put on the skin, guaranteed the true and integrality of individual medical data, the administration of justice of being convenient in the doctor-patient dispute is handled, and helps to strengthen the sense of responsibility of doctor in diagnosis and treatment process simultaneously.7. under the constant prerequisite of total input amount, government can be with the fund of saving in a large number, is used to enlarge national medical treatment and covers and support medical institutions at different levels, helps the holistic health development of medical and health care system.
Description of drawings
Fig. 1 is the electronic medical record system embodiment block diagram of realization inter-region medical provided by the present invention data sharing;
Fig. 2 is portable individual electronic medical record medical data switch mode figure among the present invention;
Fig. 3 is first kind of embodiment structural representation of portable individual electronic medical record among the present invention;
Fig. 4 is first kind of embodiment workflow diagram of portable individual electronic medical record among the present invention;
Fig. 5 is second kind of embodiment structural representation of portable individual electronic medical record among the present invention;
Fig. 5 .1 is a storer NANDFLASH workflow diagram in second kind of embodiment of portable individual electronic medical record among the present invention;
Fig. 5 .2 is a fund computing IC workflow diagram in second kind of embodiment of portable individual electronic medical record among the present invention;
Fig. 6 is the structural representation of band fingerprint identification module in second kind of embodiment of portable individual electronic medical record among the present invention;
Fig. 6 .1 is a workflow diagram of being with fingerprint identification module among the present invention in second kind of embodiment of portable individual electronic medical record;
Fig. 7 is the third embodiment structural representation of portable individual electronic medical record among the present invention;
Fig. 7 .1 is the structural representation of band fingerprint identification module in the third embodiment of portable individual electronic medical record among the present invention;
Fig. 7 .2 is a storer NAND FLASH workflow diagram in the band fingerprint identification module structure in the third embodiment of portable individual electronic medical record among the present invention;
Fig. 7 .3 is a fund computing IC workflow diagram in the band fingerprint identification module structure in the third embodiment of portable individual electronic medical record among the present invention;
Fig. 8 is three generations's portable individual electronic medical record workflow sketch among the present invention;
Embodiment
Below in conjunction with description of drawings enforcement of the present invention.Fig. 1 is the electronic medical record system embodiment block diagram of realization inter-region medical provided by the present invention data sharing.Referring to Fig. 1, the trans-regional shared electronic medical record system of realization individual's medical data proposed by the invention is made up of hospital's electronic medical record system and portable individual electronic medical record system two parts, and hospital's electronic medical record system adopts hospital information system HIS, clinic information system CIS, laboratory information system LIS, medical image archives and communication system PACS, hospital database, server and each station terminal facility set up in the LAN (Local Area Network) system to form; The portable individual electronic medical record system comprises the read-write equipment of portable individual electronic medical record, portable individual electronic medical record, described portable individual electronic medical record is made of hard cards and the microcontroller, storer and the reading-writing port thereof that embed in it, the read-write equipment of portable individual electronic medical record is made of PC and supporting read write line, the coding to be identified that has in the microcontroller on the portable individual electronic medical record, make and on common PC, can not carry out read-write operation, not only guaranteed patient's the right of privacy but also guaranteed the safety of fund.Owing to corresponding recognition coding in the microcontroller with portable individual electronic medical record is arranged in the supporting read write line,, also can carry out exchanges data with hospital's electronic medical record system so, can read and write to portable individual electronic medical record by supporting read write line.
Fig. 2 is portable individual electronic medical record medical data switch mode figure of the present invention.After Fig. 2 illustrates that the noncanonical format medical data imports portable individual electronic medical record from hospital's terminal PC, convert the standard format medical data to through conversion adapter relevant in the portable individual electronic medical record, and generate index file and associated data files for having access to use.In the storer that constitutes portable individual electronic medical record, have and to generate the multimedia electronic file editing machine that meets the HL7 standard document, when the portable individual electronic medical record possessor goes to a doctor, the doctor just can import disease information and therapeutic scheme data in the portable individual electronic medical record by supporting read-write equipment, can generate the multimedia electronic file editing machine that meets the HL7 standard document by what have in the portable individual electronic medical record storer, diagnosis and treatment information is become the medical data storage that meets the HL7 standard, simultaneously owing in portable individual electronic medical record, have nonstandard numbers according to converting the LIS that meets the HL7 normal data to, PACS, the RIS adapter, as the portable individual electronic medical record possessor by read-write device matched with same from hospital's electronic medical record system, HIS station terminal PC goes up the image of deriving oneself, radiation, during medical datas such as chemical examination, these adapters are automatically with off-gauge image, radiation, the chemical examination medical data converts the medical data that meets the HL7 standard to.When the portable individual electronic medical record possessor arrives other hospital admissions in this city or other places, because of diagnosis and treatment information and the image on the portable individual electronic medical record, radiation, medical informations such as chemical examination are the medical datas that meets the HL7 standard, so just can easily be implemented on the portable individual electronic medical record or import hospital's electronic health record by the supporting read write line of the portable individual electronic medical record that is configured in any hospital individual medical data is had access to from portable individual electronic medical record, the medical data that is readily embodied between different hospitals is shared, particularly in grass-roots community, village hospital can be realized with high, the medical skill resource is shared by middle rank hospital, realizes the technological guidance's effect to basic medical unit.
Fig. 3 is first kind of embodiment synoptic diagram of portable individual electronic medical record among the present invention.Microcontroller in the hard cards of first kind of embodiment portable individual electronic medical record is a microcontroller with embedded OS, storer is a NAND FLASH, an encryption logic subregion that is used for fund computing management can be arranged in NAND FLASH, and the space beyond the subregion is used for the storage of medical data.The portable individual electronic medical record of this kind embodiment is realized medical data storage and fund computing in single microcontroller and single memory embodiment.Storer in the hard cards of portable individual electronic medical record adopts NAND FLASH, consider the factor of electronic health record storage data volume, memory capacity is selected 2G or the above NAND FLASH storage chip of 2G, in view of storage chip employing SLC or the MLC of cost reason 2G, as Samsung K9WAG08U1A SLC 2G Samsung K9LAG08U0M MLC 2G; The above storage chip of 2G adopts MLC, also can select SLC after the SLC cost descends; As various brands chips such as Samsung K9HBG08U1M MLC 4G; But the product that microcontroller is can the selectivity price ratio good, possess good secondary developing platform, product as companies such as Microchip, AMD, Chipsbank, Samsung, Micov, be implemented on the NAND FLASH and divide logical partition and, to support the function of portable individual electronic medical record to realize carrying out secondary development on the platform of the built-in system software that microcontroller manufacturer provides medical data memory block, the task management in fund computing district, scheduling, Interrupt Process function.USB interface meets the communications protocol of USB1.1, USB2.0.
Fig. 4 is the operating process of using in possessing hospital's electronic health record, HIS for first kind of embodiment single memory pattern workflow diagram of portable individual electronic medical record of the present invention.
1. portable individual electronic medical record is inserted when being connected the supporting read write line of PC terminal in hospital's electronic health record, the HIS network, at first carry out the identification of generic identity sign, after identification is correct, enter MIMIS (medical security system), other financial account systems that hospital's electronic health record, HIS start individual database simultaneously and can transfer with these systems.
2. be configured in MCU on the supporting read write line single-chip microcomputer on the non-fund computing workstation PC identification to the generic identity sign only is set, after the affirmation prompting entered hospital's electronic health record, HIS operates or enter portable individual electronic medical record operates.Carry out clinical link such as laboratory inspection, static image learn check, dynamic image is learned and is checked, when all kinds of clinical departments check, after only portable individual electronic medical record need being inserted supporting read write line on each workstation PC and discerning, just can finish every inspection according to stand every inspection packet project of passing of doctor.
3. after a diagnosis and treatment item is all finished, when returning initial doctor workstation, after the doctor finishes diagnosis and treatment and whole medical datas is preserved, whether hospital's electronic medical record system will point out data to be done from hospital's electronic health record and back up to portable individual electronic medical record, select YES to begin to carry out the medical data back-up job, select NO to illustrate that this diagnosis and treatment process does not still finish.
4. after back-up job is finished, system will point out whether carry out the fund computing, selection YES system so will carry out accumulation calculating to the fund that all actual finished items use, data are passed on the fund computing workstation PC automatically, adding up of actual artificial situation of drug expenditure, after accepting the portable individual electronic medical record identification by pharmacy station terminal PC, actual drug expenditure expenditure data are passed automatically to fund computing workstation PC go up and carry out the capital investment secondary and add up.When if the patient does not get it filled in hospital, still can arrive on the fund computing workstation PC and finish the fund calculating process that fund is completed a business transaction.(or in invoice of providing at last) do not have the drug expenditure detail in the data but the fund that imports is completed a business transaction.
5. also can be adjusted at fund from hospital's electronic health record to portable individual electronic medical record backup implementation procedure at medical data in addition completes a business transaction and carries out after finishing, need increase the PC that a platform independent is used for data backup in each department's workstation link, after finishing data backup, the doctor workstation terminal can data be passed to the data backup machine automatically, when fund complete a business transaction finish after, data also will be passed this data backup PC automatically and be gone up under the specific data directory of portable individual electronic medical record possessor.The patient completes a business transaction to return from this PC after finishing in fund and backs up out complete data to the portable individual electronic medical record of oneself, can save the time at doctor station and fund computing station like this.Also can adopt the mode of uniform data backup services department or self-service data backup to realize that the medical data in the portable individual electronic medical record backs up.
6. when portable individual electronic medical record inserted the supporting read write line that is configured on the fund computing workstation PC, the MCU on this read write line single-chip microcomputer also possessed private identity identification control function except that possessing the generic identity identification control.After the identification of portable individual electronic medical record generic identity is passed through, automatically enter the overall situation or region-specific identification, by after enter fund computing system, before completing a business transaction, just the fund of reality expenditure is freezed, after the portable individual electronic medical record possessor confirms, just finish fund and complete a business transaction.
7. when carrying out clinical all kinds of item inspection treatment, the fund cumulative number surpass actual when can use the fund amount identification can not pass through, must after supplementing with money, could start identity recognition function.
8. in visiting hospital register first link, when portable individual electronic medical record inserts the supporting read write line that is configured on the fund computing workstation PC, MCU on the read write line single-chip microcomputer opens individual specific medical data and fund system by after the identification of the identification of possessor's generic identity and the overall situation or region-specific is confirmed.If being the medical security system, the possessor will open the computing of MIMIS fund, if be that non-medical security system will be opened the computing of HIS fund.
9. when inserting to be configured in the MIMIS system, portable individual electronic medical record networks, but during the supporting read write line of the single PC terminal that does not have hospital's electronic health record, HIS, by entering the WINDOWS system after the generic identity identification, portable individual electronic medical record is as an independent operation system, and can occur selecting after clicking portable individual electronic medical record: (1) enters MIMIS (2) and enters portable individual electronic medical record.Selection just can be carried out read-write operation after entering portable individual electronic medical record in portable individual electronic medical record, preserve data after finishing all operations, and become common read-only file form to backup among single PC the data-switching, finishing backup closes portable individual electronic medical record and withdraws from, start the MIMIS among single PC, insert portable individual electronic medical record again and carry out after the overall situation or the region-specific identification row fund and complete a business transaction computing.
Fig. 5 is second kind of embodiment structural representation of portable individual electronic medical record among the present invention.Microcontroller in the hard cards of this embodiment portable individual electronic medical record is the microcontroller of an embedded OS, storer is two, one is NAND FLASH, another is ROM, RAM or EEPROM, and the work of two storeies is by the microprocessor controls in the hard cards.
Referring to Fig. 5, in single microcontroller and dual-memory embodiment, realize medical data storage and fund computing.The medical data storage is taked and first kind of NAND FLASH SLC or MLC storage chip that embodiment is consistent; The storer of fund computing can adopt ROM, RAM, EEPROM.The selection of microcontroller is with first kind of embodiment, on the platform of the built-in system software that microcontroller manufacturer provides, carry out secondary development and realize data memory area, the task management in fund computing district, scheduling, Interrupt Process function, support the function of portable individual electronic medical record to realize.USB interface meets the communications protocol of USB1.1, USB2.0.The medical data storage is relatively independent with fund computing system, and security is better than first kind of embodiment.
Fig. 5 .1 is the operating process of using in possessing hospital's electronic health record, HIS for the medical data storage area workflow diagram in second kind of embodiment of portable individual electronic medical record of the present invention.
Fig. 5 .2 is the operating process of using in possessing hospital's electronic health record, HIS for the fund arithmetic section IC workflow diagram in second kind of embodiment of portable individual electronic medical record of the present invention.
Fig. 5 .1, second kind of embodiment traditional Chinese medicine data storage shown in Fig. 5 .2 is identical with the principle of fund computing two part workflows principle basic and Fig. 4 workflow.
Fig. 6 is the structural representation of band fingerprint identification module in second kind of embodiment of portable individual electronic medical record among the present invention.Fig. 6 .1 is the workflow diagram of second kind of embodiment band of portable individual electronic medical record of the present invention fingerprint recognition system.This embodiment adopts second kind of embodiment+living body finger print identification control.The principle of work basically identical of its principle of work and Fig. 4, this embodiment is mainly used in real all-purpose card product, fund computing system more is to be applied to the bank card system, large financial transaction system, in the embedded secondary development of MCU, increase the safe computing of fingerprint recognition system and the logic control management that multiple fund computing system is selected, on workflow, embody different supporting read write line schemes, scheme one is portable individual electronic medical record read write line and the different hardware plan of non-portable individual electronic medical record system read write line, and non-portable individual electronic medical record system read write line is only to bank card system in the fund computing, the logic control that large financial transaction system etc. is discerned; Scheme two is portable individual electronic medical record read write line and the identical hardware plan of non-portable individual electronic medical record system read write line, takes non-portable individual electronic medical record system preferentially to select, and realizes by logic control; Two kinds of schemes just can be carried out after all must be by the encrypting fingerprint computing before carrying out that all funds are actual to complete a business transaction computing.
Fig. 7 is the third embodiment structural representation of portable individual electronic medical record of the present invention.Fig. 7 .1 is the structural representation of band fingerprint identification module in the third embodiment of portable individual electronic medical record among the present invention.This embodiment portable individual electronic medical record is realized medical data storage and fund computing by microcontroller, microprocessor and dual-memory.The medical data storage is taked and first kind of NAND FLASH SLC or MLC storage chip that embodiment is consistent; The logic manage of fund computing adopts the independent CPUs smart card architecture, and control section adopts the microprocessor (MPU+CAU) of band Controlled Access Unit, and storer can adopt ROM, RAM, EEPROM.The third embodiment is compared with first kind of mode, two individual system have increased the security that each system is operated to be to adopt medical data and fund computing fully independently, fund computing system can be expanded into multiple fund computing management system under the prerequisite that security increases, but cost can increase much than first kind of mode.Referring to Fig. 7 .1, portable individual electronic medical record is realized medical data storage and fund computing in this embodiment in the two control of dual-memory fingerprint recognition pattern.The mode of implementing is basic consistent with the embodiment of Fig. 7, has just increased the living body finger print recognizer in fund computing system, and the security of multiple fund computing is risen to top.The present cost height of this embodiment is not used in portable individual electronic medical record in principle.Be mainly used in the various funds that can collect that comprise the portable individual electronic medical record function from now on and be performed on a real all-purpose card product that blocks.
Fig. 7 .2 divide the work process flow diagram for the third embodiment traditional Chinese medicine data store of portable individual electronic medical record of the present invention.Consistent with Fig. 5 .1 workflow.Fig. 7 .3 is fund arithmetic section IC workflow diagram in the third embodiment of portable individual electronic medical record of the present invention.Consistent with Fig. 5 .2 workflow, just when carrying out that fund is actual completes a business transaction computing, become the encrypting fingerprint computing by the logical encrypt computing.
Fig. 8 is the operating process sketch of the three generation products of portable individual electronic medical record of the present invention.Three of portable individual electronic medical record kinds of embodiments have covered three generations's portable individual electronic medical record product among the present invention, first generation product can only possess the medical data memory function, also can realize medical data storage and two kinds of functions of fund computing simultaneously by mark off the encryption logic subregion on NAND FLASH; On the second generation product feature medical data, fund computing dual-memory operation system; Be on second generation product basis, fund computing system to be taked the most reliable at present encrypting fingerprint identification management on the third generation product feature.In second, third,, product can be extended to the real all-purpose card product that comprises portable individual electronic medical record in generation.Fig. 8 brief description first, second and third portable individual electronic medical record on hospital's electronic health record, the HIS system terminal PC and the flow process of operating on the no above-mentioned list PC of system in generation.
The hard cards of making portable individual electronic medical record among the present invention can adopt PVC, ABS, the contour intensity warping resistance of special waterproof hard paper card, waterproof, nonmagnetic substance; The overlay film on card two sides can adopt the flaky material strong, that be easy to print that resistance to wears; Embed the interior microcontroller of hard cards, microprocessor, storer etc. and be the sheet components and parts.
Claims (7)
1. realize the trans-regional shared electronic health record EMR system of individual medical data for one kind, it is characterized in that the electronic medical record system formed by electronic medical record system HEMR of hospital and portable individual electronic medical record system PEMR two parts, hospital's electronic medical record system adopts the hospital information system HIS that sets up in the LAN (Local Area Network) system, clinic information system CIS, laboratory information system LIS, medical image archives and communication system PACS, hospital database, server and each station terminal facility are formed, the portable individual electronic medical record system comprises portable individual electronic medical record, the read-write equipment of portable individual electronic medical record, described portable individual electronic medical record is by hard cards and embed microcontroller in it, storer and reading-writing port thereof constitute, the read-write equipment of portable individual electronic medical record is made of PC and supporting read write line, the microcontroller of described formation portable individual electronic medical record has coding to be identified, its corresponding recognition coding is arranged in the supporting read write line, portable individual electronic medical record can be used as zones of different, medical data transmission and the carrier platform of sharing between the medical institutions, also can on the computing machine that does not have hospital's electronic medical record system, carry out independently medical data input function by supporting read write line, possesses perfect outpatient service operation of diagnosis and treatment function, by the medical science document that carries, the image data conversion adapter changes into the medical data form that meets HL7 electronic health record standard with the nonstandardized technique medical data and carries out data storage, can satisfy at different hospital's electronic health records simultaneously, the demand of calling among the HIS and storing.
2. the trans-regional shared electronic medical record system of the individual medical data of realization according to claim 1, the interior microcontroller of hard cards that it is characterized in that described portable individual electronic medical record is a microcontroller with embedded OS, storer is a NAND FLASH, mark off an encryption logic subregion that is used for the fund computing in NAND FLASH, the space beyond the subregion is used for the storage of medical data information.
3. the trans-regional shared electronic medical record system of the individual medical data of realization according to claim 1 and 2, it is characterized in that just setting before use individual unique identify label code of portable individual electronic medical record, individual unique identify label code exists in the logical partition that is used for the fund computing of described NAND FLASH.
4. the trans-regional shared electronic medical record system of the individual medical data of realization according to claim 1, the interior microcontroller of hard cards that it is characterized in that described portable individual electronic medical record is the microcontroller of an embedded OS, described storer is two, one is NAND FLASH, another is ROM, RAM or EEPROM, and the work of two storeies is by the microprocessor controls in the hard cards.
5. the trans-regional shared electronic medical record system of the individual medical data of realization according to claim 1, interior microcontroller, the microprocessor of hard cards that it is characterized in that described portable individual electronic medical record is MCU, MPU+CAU, described storer is two, one is NAND FLASH, another is ROM, RAM or EEPROM, by the work of MCU control NAND FLASH, control the work of another storer ROM, RAM or EEPROM by MPU+CAU.
6. according to claim 4 or the trans-regional shared electronic medical record system of the individual medical data of 5 described realizations, it is characterized in that also embedding a fingerprint Identification sensor in the hard cards of described portable individual electronic medical record, fingerprint Identification sensor is connected with the microcontroller of control ROM, RAM or eeprom memory work.
7. the trans-regional shared electronic medical record system of the individual medical data of realization according to claim 1, it is characterized in that portable individual electronic medical record possesses the application safety functional character, the control of doctor's access rights, directory level security control, file attribute security control are set, use the PKI-CA system, special disease information does not have the portable individual electronic medical record possessor to authorize, and the doctor can't have access to related data; Historical summary can be read but can not revise, can't delete; Medical data need be obtained the authorization to the backup of hospital's electronic health record from portable individual electronic medical record; Newly-increased disease data are revised when once prescription on individual diagnosis finishes, and leave vestige after the modification; Adopt electronic signature, timestamp; Possess and import the function that non-standard medical data converts standard x ML form medical data memory function and derivation standard data format, PDF or other general format files to.
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