CN105787262A - Traditional Chinese medicine clinical digital evaluation system and evaluation method thereof on basis of big data analysis - Google Patents
Traditional Chinese medicine clinical digital evaluation system and evaluation method thereof on basis of big data analysis Download PDFInfo
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Abstract
The invention relates to a traditional Chinese medicine clinical digital evaluation system.The system includes five first-grade indexes including a clinical treatment effect index, a preponderant disease index, a traditional Chinese medicine diagnosis and treatment method index, a work attitude index and a workload index.The ability of a doctor can be graded and analyzed through the big data analysis technology on the basis of the traditional Chinese medicine clinical digital evaluation system.Evaluation is conducted layer upon layer from sub-index evaluation to comprehensive evaluation, internal evaluation and external evaluation are organically combined, and clinical treatment effects, preponderant disease categories, traditional Chinese medicine diagnosis and treatment methods and work efficiency and work attitude of doctors are comprehensively analyzed.By means of the big data processing technology, the indexes are subjected to detailed weight calculation to obtain a data conclusion with bases, and accordingly work ability and level of traditional Chinese medicine doctors are scientifically evaluated.
Description
Technical field
The present invention relates to tcm clinical practice technical field, particularly relate to a kind of tcm clinical practice Digital evaluation system and the evaluation methodology based on big data analysis thereof.
Background technology
Using " clinical skill " " evaluation " or " examination " as key word full-text search 1995-2015 Wanfang Database, hit more than 500 bars, wherein relevant to " traditional Chinese medical science " hit only more than 40 bar.Domestic scholars is still few for the research of doctor's Clinical competent evaluation of tcm characteristic.Setting up more complete traditional Chinese medical science appraisement system and the scholar by a lot of modern means and technique study is few, what be combined with Computerized Information Processing Tech is very few.
Represent document " design of certain Big General Hospitals Physician Global quality and performance evaluation index system " [12], " design of MB hospital doctor overall evaluation system " [15], " Hefei liang institute public hospital doctor performance appraisal satisfaction investigation and analysis of Influential Factors " [14] " based on the experience that the research institute of traditional Chinese medicine of doctor's ability quality model builds " [16] etc., mainly through " moral " " energy " " duty " " achievement " " honest and clean " comprehensive capacity and quality as the foundation examining doctor, wherein " energy " mainly reflects the ability in clinical of doctor, but the feature of differentiation of tcm do not furtherd investigate by major part document, and the ability of doctor is not evaluated by concrete quantizating index, if things go on like this will hinder the innovation and development of Chinese medicine.
River Chinese medicine send out doctor in (2015) No. 12 files " Sichuan Province's Chinese medicine declared the relevant requirement of high professional title job requirements in 2015 " clear and definite the whole province promote high title evaluation condition mainly include doctor's paper require and quantity, scientific research, coordinated cooperation basic unit service, further study, judge the height of doctor's ability in clinical by these indexs, still need perfect.December in 2015 South Daily on the 16th points out that current domestic doctor's evaluation of professional titles and examination are with Scientific Articles, problem for Main Basis, it is meant that even if the ability in clinical of a doctor of traditional Chinese medicine is strong again, without article, be difficult to promote.
Start State Council in October, 2009 and implement performance pay in public health and primary care Health Institutions, hospital in China 96% is public hospital, the 7%-8% of year financial allocation Jin Zhan public hospital total income, all the other 90% must lean on fees for medical services and medicine income, and economic benefit is necessarily placed on [5] on highly important position by Partial Hospitals in this case.Doctor's performance appraisal and appraisement system that some institute of traditional Chinese medicine formulates rely primarily on the economic benefit etc. created into hospital.
Economize member of the CPPCC National Committee in January, 2015,2nd Affiliated Hospital Zhejiang University School of Medicine president Wang Jianan proposes " the domestic system to doctor evaluation seldom considers the defect of its professional practical ability ", and he points out that doctor's conferring of academic titles should more Beijing South Maxpower Technology Co. Ltd's power.
Summary of the invention
Current domestic science, media, policy document are very few for the evaluation study of the ability in clinical of doctor of traditional Chinese medicine, and existing appraisement system puts emphasis on scientific research, paper, attention economic benefit etc. exist drawback, but be continually striving to improve in.Social Media, hospital doctor etc. takes much count of the ability in clinical of doctor, but still famine can verify that data supporting, refinement evaluation index.Having evaluation refinement only, and have exercisable implementing mechanism, the evaluation mechanism building on tcm clinical practice ability just can walk still farther, and realize doctor and return the original intention of its professional value itself.
It is desirable to provide a kind of tcm clinical practice Digital evaluation system, establish scientific and reasonable assessment indicator system.
For reaching above-mentioned purpose, the technical scheme that the present invention presses is as follows:
Including five first class index: clinical efficacy indexes, advantage disease kind index, Chinese traditional medical diagnose method index, working attitude index and workload index.
Further, the two-level index of described clinical efficacy indexes includes: further consultation rate, consultation rate, symptom are improved, patient's positive rating；
The two-level index of described advantage disease kind index includes: Single diseases further consultation rate ranking, Single diseases consultation rate ranking, consultation hours, symptom are improved, patient's positive rating；
The two-level index of described Chinese traditional medical diagnose method index includes: principle-method-recipe-medicines Symptomatic medicine coincidence rate, combination of Chinese and Western medicine utilization rate；
The two-level index of described working attitude index includes: upload case history star, patient's positive rating；
The two-level index of described workload index includes: consultation rate, upload case history quantity.
Further, to described setup measures weight, arranging weight preferential with clinical efficacy, Chinese traditional medical diagnose method is auxiliary, and workload and working attitude are secondary.
Further, described principle-method-recipe-medicines Symptomatic medicine coincidence rate utilizes doctor's prescription to be determined by the method for meridian distribution of property and flavor, described meridian distribution of property and flavor method refers to according to drug combination usage data, analyze the goodness of fit of pattern of syndrome and medication, generate a meridian distribution of property and flavor and sick position is returned and schemed by contrast, return figure by contrast to weigh the coincidence rate of doctor's Symptomatic medicine by meridian distribution of property and flavor and sick position.
Further, the weight of described index is divided and is provided that
Based on the tcm clinical practice Digital evaluation method of big data analysis, comprise the following steps:
The first step, sets up tcm clinical practice Digital evaluation index system framework: described appraisement system framework includes five first class index: clinical efficacy indexes, advantage disease kind index, Chinese traditional medical diagnose method index, working attitude index and workload index；
The two-level index of described clinical efficacy indexes includes: further consultation rate, consultation rate, symptom are improved, patient's positive rating；
The two-level index of described advantage disease kind index includes: Single diseases further consultation rate ranking, Single diseases consultation rate ranking, consultation hours, symptom are improved, patient's positive rating；
The two-level index of described Chinese traditional medical diagnose method index includes: principle-method-recipe-medicines Symptomatic medicine coincidence rate, combination of Chinese and Western medicine utilization rate；
The two-level index of described working attitude index includes: upload case history star, patient's positive rating；
The two-level index of described workload index includes: consultation rate, upload case history quantity；
Second step, sets the weight of each index: first set the weight of first class index, resets the weight of two-level index；
3rd step, uses big data analysing method centering doctor's ability to make evaluation analysis, it was therefore concluded that；
Described big data analysing method includes: gather clinical electronic health record data, the data gathered are carried out pretreatment, integrate pretreated data, set up Data Analysis Model, the score of parameter, make reasonable dismissal and evaluation for described score, present evaluation result by effect of visualization.
Further, in described 3rd step, patient's positive rating index carrying out classification, and give each fraction partition value, score value that every one-level is corresponding and the score of patient's positive rating index, the score value of each grade of distribution divides less than the weight of patient's positive rating index；Classification is carried out to uploading case history quantitative index, and give each fraction partition value, namely score value corresponding to every one-level upload the score of case history quantity, described in upload case history quantitative index be upload the quantity of case in the unit time, the score value of each grade of distribution divides less than the weight uploading case history quantitative index.
Further, described data prediction, it is carried out including to clinical electronic health record data, changes, loads, in conjunction with traditional Chinese medical science principle-method-recipe-medicines specification sheet, four diagnostic methods information to clinical: symptom, pattern of syndrome, prescription, drug data carry out combing, including: the positive different name process of Chinese medicine, pattern of syndrome structuring process and symptom process；
The positive different name of Chinese medicine processes: wrong word, omission word are processed method by clean system, cutting and big gun and processed；
Pattern of syndrome structuring processes: content carries out compound or fractionation, removal is appointed in punching；
Symptom: by word deconsolidation process.
Further, in described 3rd step, process data acquisition SQLServer2008R2 data base and digging tool ETL；Clean data acquisition with based on the reflection technology of programming language and Python script technology.
Further, in described 3rd step, calculate the score of further consultation rate or consultation rate index by formula (1):
In formula (1), Further: further consultation number score or medical number score, p: the average further consultation rate of similar section office doctor or consultation rate, q: doctor's further consultation rate or consultation rate, m: hospital's further consultation or medical number, n: doctor's further consultation or medical number, Q: the weight of further consultation rate or consultation rate is divided；
The PTS of Single diseases further consultation rate ranking and Single diseases consultation rate ranking is calculated by formula (2):
Advantage=(A+B) * Q*2 (2)
In formula (2), Advantage: the summation of Single diseases further consultation rate Rank scores and Single diseases consultation rate Rank scores, A: Single diseases further consultation rate Rank scores, B: Single diseases consultation rate Rank scores, sg: the medical amount of Single diseases, stg: with hospital with the medical amount of section office's Single diseases, k: the whole province's Single diseases doctor's total quantity, n: the provincial ranking of Single diseases doctor, m: further consultation number or medical number, Q: the weight of Single diseases further consultation rate ranking or Single diseases consultation rate ranking is dividedMaximum consultation rate；
The score of principle-method-recipe-medicines Symptomatic medicine coincidence rate index is calculated by formula (3):
In formula (3), 0 < pn < 1, symptomatic: principle-method-recipe-medicines Symptomatic medicine coincidence rate score, total: doctor always uploads case history number, P: the medication of single medical record and the goodness of fit of symptom, n: medical record quantity, Q: the weight of principle-method-recipe-medicines Symptomatic medicine coincidence rate is divided；
The score of combination of Chinese and Western medicine utilization rate index is calculated by formula (4):
Unite=ratio*Q*2 (4)
In formula (4), 0 < ratio < 1, unite: the score of combination of Chinese and Western medicine utilization rate index, ratio: the combination of Chinese and Western medicine uses coincidence rate, Q: the weight of combination of Chinese and Western medicine utilization rate is divided；
The score uploading case history star is calculated by formula (5):
In formula (5), UP: upload case history star score, total (n): doctor uploads the case history sum that star is n, total: doctor always uploads case history number, n: representing and upload the star that case history reaches, 1≤n≤5, n is integer.
Compared with prior art, the method have the advantages that
1. specification doctor fills in electronic health record, plays electronic health record supporting function in curative activity better, promotes that the Hospital Informatization being core with electronic health record works, and for in-depth health services system reform, pinner is paved the way；
2. by doctor formula, by the composition of medicine and quantity, positivity between the property of medicine attribute such as analytical, taste, Gui Jing or the reciprocal action of negativity, nature and flavor are utilized to return through method, judge the science of tcm prescription, the characteristic of prominent differentiation of tcm, there is promotional value；
3. according to clinical case, gather science, diagnosis and treatment data accurately, by Data Warehouse Design, adopt decision analysis algorithm etc. to doctor's advantage disease kind mining analysis, show the advantage between hospital and difference, further specification traditional Chinese medical science Single diseases diagnosis and treatment；
4. the Data Source being evaluated is true and reliable, and evaluation conclusion has with looking into, and provides foundation for rewarding distribution；
5. realize medical information Real-Time Sharing, drive raising and the distillation of doctor's clinical experience, doctor is in treatment process, the medical information that doctor owing to obtaining other hospitals provides, creating condition for correct diagnosis, doctor is the supplier of information, is also the direct user of information, appraisement system not only improves quality of medical care, and can significantly reduce malpraxis；
6. in appraisement system by big data analysis technique to indexs such as the further consultation number of doctor, advantage disease kind, patient's positive ratings, show the clinical skill of doctor intuitively, find outstanding tcm clinical practice doctor, appraisement system makes whole medical procedure transparence simultaneously, doctor is had higher restraining forces, responsibility is also definitely, promote medical institutions and doctor's rational use of drug, legitimate check, reasonable diagnosis and treatment, improve medical service quality, effectively control the excessively rapid growth of medical expenses, original " drug dependents in the medical " are become " supporting doctor with skill "；
7. the present invention builds the digitized appraisement system of tcm clinical practice technical ability, the basis of architectural framework adopts data analysis and algorithm, going deep into layer by layer from point metrics evaluation to overall merit, the combination of desk evaluation and external evaluation, analyze the clinical efficacy of doctor, advantage disease kind, Chinese traditional medical diagnose method and the work efficiency of doctor, working attitude comprehensively, and adopt big data processing technique, the weight calculation that each index is detailed, draw evidence-based data conclusion, thus the ability to work of doctor and level in scientific evaluation.
Accompanying drawing explanation
Fig. 1 is the framework of tcm clinical practice Digital evaluation index system；
Fig. 2 is the flow chart of data processing figure of big data analysing method；
Fig. 3 is Single diseases consultation rate and the flow chart of further consultation rate Rank scores algorithm；
Fig. 4 is advantage disease kind figure A；
Fig. 5 is advantage disease kind figure B；
Fig. 6 meridian distribution of property and flavor and sick position are returned and are schemed by contrast.
Detailed description of the invention
In order to make the purpose of the present invention, technical scheme and advantage clearly understand, below in conjunction with accompanying drawing, the present invention is described in further detail.
Embodiment 1
As it is shown in figure 1, tcm clinical practice Digital evaluation system disclosed by the invention, the first class index of doctor's clinical skill in weighing including 5: be working attitude and the workload of clinical efficacy, advantage disease kind, Chinese traditional medical diagnose method and doctor respectively.Attitude determines action, promotion method of taking action, and method determines effect, and effect determines effect, and five indexs are judged by multiple two-level index respectively.
The two-level index of clinical efficacy indexes includes: further consultation rate, consultation rate, symptom are improved, patient's positive rating；
The two-level index of advantage disease kind index includes: Single diseases further consultation rate ranking, Single diseases consultation rate ranking, consultation hours, symptom are improved, patient's positive rating；
The two-level index of Chinese traditional medical diagnose method index includes: principle-method-recipe-medicines Symptomatic medicine coincidence rate, combination of Chinese and Western medicine utilization rate；
The two-level index of working attitude index includes: upload case history star, patient's positive rating；
The two-level index of workload index includes: consultation rate, upload case history quantity.
Advantage disease kind is improved by the symptom of the treated disease of doctor, Single diseases medical amount ranking, and the further consultation rate ranking of Single diseases, consultation hours and patient's favorable comment are comprehensively analyzed, and is used for weighing doctor and is good at the sick kind (see accompanying drawing 4 and accompanying drawing 5) for the treatment of.Put into practice by data, the conclusion that accompanying drawing 4 draws is opened Xiang doctor and is good at treatment infantile cough, the conclusion Li Xiaolin doctor that accompanying drawing 5 draws is good at treatment dizziness, it coincide with practical situation, advantage disease kind index can accurately illustrate medical treatment and certain sick advantage planted of research, is a core index of evaluation doctor's clinical skill.
Consultation hours refers to the time used by diagnosis patient, the difference of outpatient service time started and outpatient service end time obtain.Whether the length of consultation hours, illustrate that this disease is planted by doctor and be familiar with and be good at, it is possible to the advantage that reflection doctor plants in this disease, this index is also the index judging working doctor efficiency simultaneously.
Consultation rate can calculate doctor's diagnosis and treatment number number, consultation rate is high, illustrates that the patient seen a doctor at this doctor place is relatively more, by the Algorithm Analysis of consultation rate and patient assessment's time, it can be determined that whether doctor works overtime, is the important indicator judging working doctor amount.Medical number sick plants medical ranking index for a certain, is called for short Single diseases consultation rate ranking, be one of the index of calculating advantage disease kind.
Further consultation rate, refers to that patient more than twice is in same hospital, and same doctor locates, and the continuous number examined in a period of time, the further consultation number of doctor is more many, and patient's trust to doctor is described, repeatedly arrives this doctor place and sees a doctor.Further consultation rate is the Microscopic Indexes in appraisement system, is also an important indicator, it is possible to the attitude of doctor, medication curative effect etc. are described to a certain extent.Doctor's Single diseases further consultation number is also the index of the advantage disease kind evaluating doctor, and the ability in clinical of doctor also can be described from further consultation rate.
Symptom improvement refers to after doctor's medication, is stopped by the filling in symptom before judging further consultation of case history or is decreased.System by symptom number, symptom order of severity combination parameter, the weighting table of corresponding symptom, generate the numerical value representing the order of severity, judge whether symptom is improved by this numerical value.This index can prove and evaluate the clinical skill of doctor significantly, and clinical efficacy has very strong cogency.
Uploading case history star is the grade scoring that in the calculating time period, doctor uploads electronic health record quality.Case history is the summary of clinical practice work, is again explore disease rule and process the legal basis of medical tangle, and medical treatment, prevention, teaching, scientific research, hospital management etc. are had important effect by case history." the medical record writing fundamental norms " that appraisement system issues with reference to Ministry of Public Health, according to integrity degree, accuracy and verity that actual case history parameters is filled in, are divided into five star criterias.Completely, careful case history be the most basic foundation of clinical diagnosis and treatment, therefore in system using upload case history star as evaluation doctor practical, serious and conscientious, scientific and precise, precise working attitude index.
Combination of Chinese and Western medicine utilization rate, it is possible to whether reflection doctor of traditional Chinese medicine utilizes doctor trained in Western medicine technology, uses the method processes to patient treatment such as doctor trained in Western medicine Clinical Laboratory, Western medicine.Chinese and western medicine is respectively arranged with length, and the combination of Chinese and Western medicine may advantageously facilitate medical science applied progress, this index can be used to evaluate doctor whether by modern scientific method to study Chinese medicine.
Principle-method-recipe-medicines Symptomatic medicine coincidence rate weight score value is relatively larger, is the core index evaluating doctor of traditional Chinese medicine's clinical skill.This index utilizes doctor's prescription, by meridian distribution of property and flavor method, according to data such as drug combination consumptions, analyze the goodness of fit of pattern of syndrome and medication, generate one meridian distribution of property and flavor and sick position is returned and schemed (see accompanying drawing 6) by contrast.Meridian distribution of property and flavor and sick position return through comparison diagram, refer to 46 codings by disease and medication, contrast on block diagram, accurately to judge sick position and the characteristic of disease of patient, and the improvement of the state of an illness and development.Different medicines, the position for the treatment of and drug effect are all different.Single or multiple pattern of syndrome, can know that impaired position and impaired situation.Thus weigh the coincidence rate of doctor's Symptomatic medicine.Principle-method-recipe-medicines Symptomatic medicine coincidence rate highlights the characteristic of the traditional Chinese medical science " determination for the treatment of based on pathogenesis obtained through differentiation of symptoms and signs ", has investigated science and the reasonability of doctor's medication.
Patient's positive rating is as the Microscopic Indexes of appraisement system, also it is an external indicator simultaneously, patient's evaluation is the contrast of patients' feeling value and expected value, formed working doctor attitude by empirical value, the satisfaction evaluation of the clinical skill levels such as medical services, appraisement system objectively and impartially collects patient's opinions and suggestions to hospital, doctor's each side, and clears up gathering data, forms doctor is true, effective external evaluation.The evaluation of patient's positive rating, for improving doctor's clinical treatment technical ability further, improves attitude, examines for section office, the management of hospital and development provide feasible foundation.
Appraisement system constitutes clinical efficacy, advantage disease kind, Chinese traditional medical diagnose method and the workload of doctor, five first class index of working attitude by above-mentioned two-level index, the clinical skill of doctor of traditional Chinese medicine is evaluated, between each index separate, communication with one another again, form an indivisible entirety.This index system has level, going deep into layer by layer from point metrics evaluation to overall merit, and the combination of desk evaluation and external evaluation is analyzed comprehensively, collectively formed the appraisement system of an organic unity.This appraisement system, Preliminary Applications is close in the doctor evaluation of institute of traditional Chinese medicine of In Chengdu county, evaluation result and actual effect at present, achieves good effect, obtains the consistent favorable comment of hospital, has good application and popularization value.
Needing each setup measures weight in evaluation procedure, arrange weight preferential with clinical efficacy, Chinese traditional medical diagnose method is auxiliary, and workload and working attitude are secondary to principle.
Based on the tcm clinical practice Digital evaluation method of big data analysis, doctor's ability is carried out score calculation and analysis by big data analysis technique by the present embodiment on the basis of tcm clinical practice Digital evaluation system.Specifically include following steps:
The first step, sets up tcm clinical practice Digital evaluation architecture as shown in Figure 1；
Second step, sets the weight of each index: first set the weight of first class index, resets the weight of two-level index；
3rd step, uses big data analysing method centering doctor's ability to make evaluation analysis, it was therefore concluded that；
As in figure 2 it is shown, big data analysing method includes: gather clinical electronic health record data, data prediction, Data Integration, set up Data Analysis Model, reasonable dismissal and visualization.
Gathering clinical electronic health record data: in the present embodiment, clinical electronic health record data refer to the general collection of all medical information systems of hospital, including HIS, doctor reports, doctor's advice, the systems such as chemical examination, clinical electronic health record, as data acquisition object, is the most important ingredient of the big data of medical treatment.The clinical case data of hospital is adopted xml document formal layout by information system, provide unified, upload interface easily, support the inquiry of real-time files disposition, upload batch management and a problem data rollback, simultaneously compatible other data format analysis processing and interface sides.
Data prediction: be carried out gathering the clinical electronic health record data come, change, load.The magnanimity medical data collected is analyzed there is many challenges.First, medical information system is frequently not in order to scientific research and data analysis design.From the angle of data analysis, medical data is usually relatively complex, and the isomery degree of data is relatively big, there is a lot of missing information and inconsistent information；Secondly, understand medical data and typically require the knowledge of different field.For problem above, the present embodiment is set up Distributed Computing Platform and provides the pretreatment ETL of clinical data, including the cleaning of data, conversion, loading, and further combined with traditional Chinese medical science principle-method-recipe-medicines specification sheet, clinical four diagnostic methods information symptom, pattern of syndrome, prescription, drug data are carried out combing: 1. the positive different name of Chinese medicine processes, adopt clean system, cutting and big gun to process method wrong word, omission word etc. and process；2. pattern of syndrome structuring processes, and content carries out compound or fractionation, removal is appointed in punching；3. symptom part adopts word deconsolidation process etc. so that whole preprocessing process meets dispatching automation and maintainability, extracts useful information again through batch quantity analysis and visualization tool, makes correct decision-making to evaluating.
Data Integration: subregion stores pretreated data, indexes and caching mechanism.Preferably, according to keywords section partitioned storage, set up partition data block generally according to time parameter.SQLServer2008R2 data base and outstanding digging tool ETL that performance is higher is adopted during system processes data, mass data is carried out division operation, reduce system loading, index and caching mechanism, strengthening virtual memory etc. and improve access speed, adopting the reflection technology based on programming language and Python script technology to realize data cleansing on this basis thus fundamentally solving mass data error that may be present.
Set up Data Analysis Model: on the basis of Data Integration, carry out data mining algorithm, draw the score of evaluation index in tcm clinical practice Digital evaluation system.
Reasonable dismissal and visualization: make reasonable dismissal and evaluation for described score, present evaluation result by effect of visualization.
The algorithm calculating each index is as follows:
Patient's positive rating index carrying out classification, and gives each fraction partition value, score value that every one-level is corresponding and the score of patient's positive rating index, the score value of each grade of distribution divides less than the weight of patient's positive rating index；Classification is carried out to uploading case history quantitative index, and give each fraction partition value, namely score value corresponding to every one-level upload the score of case history quantity, and uploading case history quantitative index is upload the quantity of case in the unit time, and the score value of each grade of distribution divides less than the weight uploading case history quantitative index.
The score of further consultation rate or consultation rate index is calculated by formula (1):
In formula (1), Further: further consultation number score or medical number score, p: the average further consultation rate of similar section office doctor or consultation rate, q: doctor's further consultation rate or consultation rate, m: hospital's further consultation or medical number, n: doctor's further consultation or medical number, Q: the weight of further consultation rate or consultation rate is divided；
The PTS of Single diseases further consultation rate ranking and Single diseases consultation rate ranking is calculated by formula (2):
Advantage=(A+B) * Q*2 (2)
In formula (2), Advantage: the summation of Single diseases further consultation rate Rank scores and Single diseases consultation rate Rank scores, A: Single diseases further consultation rate Rank scores, B: Single diseases consultation rate Rank scores, sg: the medical amount of Single diseases, stg: with hospital with the medical amount of section office's Single diseases, k: the whole province's Single diseases doctor's total quantity, n: the provincial ranking of Single diseases doctor, m: further consultation number or medical number, Q: the weight of Single diseases further consultation rate ranking or Single diseases consultation rate ranking is dividedMaximum consultation rate；
The score of principle-method-recipe-medicines Symptomatic medicine coincidence rate index is calculated by formula (3):
In formula (3), 0 < pn < 1, symptomatic: principle-method-recipe-medicines Symptomatic medicine coincidence rate score, total: doctor always uploads case history number, P: the medication of single medical record and the goodness of fit of symptom, n: medical record quantity, Q: the weight of principle-method-recipe-medicines Symptomatic medicine coincidence rate is divided；
The score of combination of Chinese and Western medicine utilization rate index is calculated by formula (4):
Unite=ratio*Q*2 (4)
In formula (4), 0 < ratio < 1, unite: the score of combination of Chinese and Western medicine utilization rate index, ratio: the combination of Chinese and Western medicine uses coincidence rate, Q: the weight of combination of Chinese and Western medicine utilization rate is divided；
The score uploading case history star is calculated by formula (5):
In formula (5), UP: upload case history star score, total (n): doctor uploads the case history sum that star is n, total: doctor always uploads case history number, n: representing and upload the star that case history reaches, 1≤n≤5, n is integer.
Embodiment 2
The present embodiment passes through big data analysis acquisition platform, have collected a large amount of clinical electronic health record data of multiple district 30 Yu Ge institute of traditional Chinese medicine of Sichuan Province, tcm clinical practice technical ability Digital evaluation system based on big data analysis, consider in all directions from clinical efficacy, advantage disease kind, the method for Chinese traditional medical diagnose, working attitude, workload, build tcm clinical practice Digital evaluation System Framework (see accompanying drawing 1) and index accounting (see table 1).And in this evaluation frame foundation, utilize data acquisition platform and data mining analysis intelligent platform, by clearing up the collection data of evaluation object, systematically to evaluation object measurement and analysis, the evaluation finally evaluation object notarized, draws scientific and reasonable evaluation conclusion.
The index accounting of table 1 tcm clinical practice Digital evaluation system
The principle of weight setting and ratio in table 1:
First the performance assessment criteria of doctor's ability in clinical is enumerated out, then pass through the method contrasted between two these indexs are ranked up according to importance, before more coming, weight is corresponding also more big, and it is preferential with clinical efficacy, Chinese traditional treatment method is auxiliary, and work efficiency and working attitude are secondary principle, considers when each index weights is set:
1. weight is typically between 5%-30%, it is to avoid occur that high weight makes the risk of Evaluation excessively concentrate, and low weight makes the Working quality indexes of other influences evaluation is not concerned with；
2. the weight arranged generally takes the multiple of 5, it is simple to calculate；
3., on evaluating doctor's ability importance strong index strong, comprehensive and affecting direct and significant index, weight arranges higher, such as advantage disease kind, symptom improvement, principle-method-recipe-medicines Symptomatic medicine coincidence rate etc..
Big data analysis algorithm in the present embodiment is as follows:
1. calculate clinical efficacy (full marks 30 points): patient's positive rating 10 points, symptom improvement 10 points, further consultation rate 5 points, consultation rate 5 points.
1.1 patient's positive rating scoring methods, as shown in table 2:
Table 2: patient's positive rating scoring method
| Sequence number | Condition | Score |
| 1 | Positive rating >=90% | 10 points |
| 2 | 70%≤positive rating < 90% | 8 points |
| 3 | 50%≤positive rating < 70% | 6 points |
| 4 | 30%≤positive rating < 50% | 4 points |
| 5 | 10%≤positive rating < 30% | 2 points |
| 6 | 0 < positive rating < 10% | 1 point |
| 7 | Positive rating=0 | 0 point |
1.2 symptoms are improved: in system, it does not have the index that symptom is improved, so when calculating, unified to doctor's full marks.
1.3 consultation rate or further consultation rate scoring method, as shown in table 3:
Table 3: consultation rate or further consultation rate scoring method
2. calculate advantage disease kind (full marks 25 points): Single diseases consultation rate or further consultation rate ranking 5 points, patient's positive rating 5 points, symptom improvement 5 points, consultation hours 5 points.
2.1 Single diseases consultation rate or further consultation rate Rank scores algorithm, as shown in table 4:
Table 4: Single diseases consultation rate or further consultation rate Rank scores algorithm
As it is shown on figure 3, in the process calculating Single diseases consultation rate, calculating the medical total accounting of number of Single diseasesAfter, carry out screening and filter out maximum consultation rate, whereinReferring to maximum consultation rate, system can be realized by bubble sort program.
The ratio x=sg/tsg of medical amount in hospital, is to solve because regional superiority difference is to being brought unfair problem when the whole province's ranking.Getting rid of on the basis of geographic difference, sequence filters out maximum consultation rate.
2.2 patient's positive rating scoring methods, as shown in table 7.
3. calculate Chinese traditional medical diagnose method (full marks 20 points): principle-method-recipe-medicines Symptomatic medicine coincidence rate 15 points, combination of Chinese and Western medicine utilization rate 5 points.
Principle-method-recipe-medicines Symptomatic medicine coincidence rate and combination of Chinese and Western medicine utilization rate scoring method, as shown in table 5:
Table 5: principle-method-recipe-medicines Symptomatic medicine coincidence rate and combination of Chinese and Western medicine utilization rate scoring method
4. evaluation work attitude (full marks 10 points): case history star 5 points, patient's positive rating 5 points.
4.1 upload case history star scoring method, as shown in table 6:
Table 6: upload case history star scoring method
4.2 patient's positive rating scoring methods, as shown in table 7:
Table 7: patient's positive rating scoring method
| Sequence number | Condition | Score |
| 1 | Positive rating >=90% | 5 points |
| 2 | 60%≤positive rating < 90% | 4 points |
| 3 | 30%≤positive rating < 60% | 3 points |
| 4 | 0%≤positive rating < 30% | 1 point |
| 5 | Positive rating=0 | 0 point |
5. amount of calculation (full marks 15 points): case history uploads quantity 10 points, consultation rate 5 points
5.1 case histories upload quantity scoring method, as shown in table 8:
Table 8: case history uploads quantity scoring method
| Sequence number | Condition | Score |
| 1 | Case history quantity >=200 are uploaded in unit interval | 5 points |
| 2 | Case history quantity < 200 is uploaded in 100≤unit interval | 4 points |
| 3 | Case history quantity < 100 is uploaded in 50≤unit interval | 3 points |
| 4 | Case history quantity < 50 is uploaded in 0≤unit interval | 1 point |
5.2 consultation rate scoring methods, as shown in table 3.
Certainly; the present invention also can have other numerous embodiments; when without departing substantially from present invention spirit and essence thereof; those of ordinary skill in the art can make various corresponding change and deformation according to the present invention, but these change accordingly and deformation all should belong to the scope of the claims appended by the present invention.
Claims (10)
1. a tcm clinical practice Digital evaluation system, it is characterised in that: include five first class index: clinical efficacy indexes, advantage disease kind index, Chinese traditional medical diagnose method index, working attitude index and workload index.
2. tcm clinical practice Digital evaluation system as claimed in claim 1, it is characterised in that:
The two-level index of described clinical efficacy indexes includes: further consultation rate, consultation rate, symptom are improved, patient's positive rating；
The two-level index of described advantage disease kind index includes: Single diseases further consultation rate ranking, Single diseases consultation rate ranking, consultation hours, symptom are improved, patient's positive rating；
The two-level index of described Chinese traditional medical diagnose method index includes: principle-method-recipe-medicines Symptomatic medicine coincidence rate, combination of Chinese and Western medicine utilization rate；
The two-level index of described working attitude index includes: upload case history star, patient's positive rating；
The two-level index of described workload index includes: consultation rate, upload case history quantity.
3. tcm clinical practice Digital evaluation system as claimed in claim 2, it is characterised in that: to described setup measures weight, arranging weight preferential with clinical efficacy, Chinese traditional medical diagnose method is auxiliary, and workload and working attitude are secondary.
4. tcm clinical practice Digital evaluation system as claimed in claim 2, it is characterized in that: described principle-method-recipe-medicines Symptomatic medicine coincidence rate utilizes doctor's prescription to be determined by the method for meridian distribution of property and flavor, described meridian distribution of property and flavor method refers to according to drug combination usage data, analyze the goodness of fit of pattern of syndrome and medication, generate a meridian distribution of property and flavor and sick position is returned and schemed by contrast, return figure by contrast to weigh the coincidence rate of doctor's Symptomatic medicine by meridian distribution of property and flavor and sick position.
5. tcm clinical practice Digital evaluation system as claimed in claim 3, it is characterised in that: the weight of described index is divided and is provided that
6. based on the traditional Chinese medical science technical ability clinic Digital evaluation method of big data analysis, it is characterised in that: comprise the following steps:
The first step, sets up tcm clinical practice Digital evaluation system: described appraisement system framework includes five first class index: clinical efficacy indexes, advantage disease kind index, Chinese traditional medical diagnose method index, working attitude index and workload index；
The two-level index of described clinical efficacy indexes includes: further consultation rate, consultation rate, symptom are improved, patient's positive rating；
The two-level index of described advantage disease kind index includes: Single diseases further consultation rate ranking, Single diseases consultation rate ranking, consultation hours, symptom are improved, patient's positive rating；
The two-level index of described Chinese traditional medical diagnose method index includes: principle-method-recipe-medicines Symptomatic medicine coincidence rate, combination of Chinese and Western medicine utilization rate；
The two-level index of described working attitude index includes: upload case history star, patient's positive rating；
The two-level index of described workload index includes: consultation rate, upload case history quantity；
Second step, sets the weight of each index: first set the weight of first class index, resets the weight of two-level index；
3rd step, uses big data analysing method centering doctor's ability to make evaluation analysis, draws evaluation result；
Described big data analysing method includes: gather clinical electronic health record data, the data gathered are carried out pretreatment, integrate pretreated data, set up Data Analysis Model, the score of parameter, make reasonable dismissal and evaluation for described score, present evaluation result by effect of visualization.
7. the tcm clinical practice Digital evaluation method based on big data analysis as claimed in claim 6, it is characterized in that: in described 3rd step, patient's positive rating index is carried out classification, and give each fraction partition value, score value that every one-level is corresponding and the score of patient's positive rating index, the score value of each grade of distribution divides less than the weight of patient's positive rating index；Classification is carried out to uploading case history quantitative index, and give each fraction partition value, namely score value corresponding to every one-level upload the score of case history quantity, described in upload case history quantitative index be upload the quantity of case in the unit time, the score value of each grade of distribution divides less than the weight uploading case history quantitative index.
8. the tcm clinical practice Digital evaluation method based on big data analysis as claimed in claim 6, it is characterised in that: in described 3rd step, process data acquisition SQLServer2008R2 data base and digging tool ETL；Clean data acquisition with based on the reflection technology of programming language and Python script technology.
9. the tcm clinical practice Digital evaluation method based on big data analysis as claimed in claim 6, it is characterized in that: described data prediction, it is carried out including to clinical electronic health record data, changes, loads, in conjunction with traditional Chinese medical science principle-method-recipe-medicines specification sheet, four diagnostic methods information to clinical: symptom, pattern of syndrome, prescription, drug data carry out combing, including: the positive different name process of Chinese medicine, pattern of syndrome structuring process and symptom process；
The positive different name of Chinese medicine processes: wrong word, omission word are processed method by clean system, cutting and big gun and processed；
Pattern of syndrome structuring processes: content carries out compound or fractionation, removal is appointed in punching；
Symptom: by word deconsolidation process.
10. the tcm clinical practice Digital evaluation method based on big data analysis as claimed in claim 6, it is characterised in that: in described 3rd step, calculate the score of further consultation rate or consultation rate index by formula (1):
In formula (1), Further: further consultation number score or medical number score, p: the average further consultation rate of similar section office doctor or consultation rate, q: doctor's further consultation rate or consultation rate, m: hospital's further consultation or medical number, n: doctor's further consultation or medical number, Q: the weight of further consultation rate or consultation rate is divided；
The PTS of Single diseases further consultation rate ranking and Single diseases consultation rate ranking is calculated by formula (2):
Advantage=(A+B) * Q*2 (2)
In formula (2), Advantage: the summation of Single diseases further consultation rate Rank scores and Single diseases consultation rate Rank scores, A: Single diseases further consultation rate Rank scores, B: Single diseases consultation rate Rank scores, sg: the medical amount of Single diseases, stg: with hospital with the medical amount of section office's Single diseases, k: the whole province's Single diseases doctor's total quantity, n: the provincial ranking of Single diseases doctor, m: further consultation number or medical number, Q: the weight of Single diseases further consultation rate ranking or Single diseases consultation rate ranking is divided；Maximum consultation rate；
The score of principle-method-recipe-medicines Symptomatic medicine coincidence rate index is calculated by formula (3):
In formula (3), 0 < pn < 1, symptomatic: principle-method-recipe-medicines Symptomatic medicine coincidence rate score, total: doctor always uploads case history number, P: the medication of single medical record and the goodness of fit of symptom, n: medical record quantity, Q: the weight of principle-method-recipe-medicines Symptomatic medicine coincidence rate is divided；
The score of combination of Chinese and Western medicine utilization rate index is calculated by formula (4):
Unite=ratio*Q*2 (4)
In formula (4), 0 < ratio < 1, unite: the score of combination of Chinese and Western medicine utilization rate index, ratio: the combination of Chinese and Western medicine uses coincidence rate, Q: the weight of combination of Chinese and Western medicine utilization rate is divided；
The score uploading case history star is calculated by formula (5):
In formula (5), UP: upload case history star score, total (n): doctor uploads the case history sum that star is n, total: doctor always uploads case history number, n: representing and upload the star that case history reaches, 1≤n≤5, n is integer.
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