CN110766332A - Comprehensive quality index monitoring system for regional sanitation - Google Patents

Abstract

The invention provides a regional health comprehensive quality index monitoring system which comprises an identity identification module, an interconnection module, a data integration module, a data utilization module, a service management module, a comprehensive quality index monitoring module, a regional coordination module and a data center. The invention can establish the foundation of regional health informatization, integrates medical health information resources by realizing interconnection and intercommunication of medical health institutions in the whole city and builds a regional medical data center.

Description

Comprehensive quality index monitoring system for regional sanitation

Technical Field

The invention relates to the field of medical information monitoring, in particular to a regional health comprehensive quality index monitoring system.

Background

The Hospital information management system (HIS for short) is a marginal science integrating multiple disciplines of medicine, information, management, computer and the like, is widely applied to the medical field at home and abroad, and creates good social and economic benefits. However, at present, the development and use of most hospital information management systems at home and abroad are limited to the recording, the medical order inputting and processing, the generation, the sending, the receiving and the like of the medicine in the ward. In particular, there is no comprehensive and systematic system for monitoring the overall quality index of regional hygiene.

Disclosure of Invention

The invention provides a system for monitoring the overall regional health quality index, aiming at the defects of the prior art and solving the problems in the prior art.

According to one aspect of the invention, a regional health comprehensive quality index monitoring system is provided, which comprises an identity identification module, an interconnection module, a data integration module, a data utilization module, a service management module, a comprehensive quality index monitoring module, a regional coordination module and a data center;

the identity recognition module is used for uniquely recognizing the identity of the resident, acquiring the personal basic information of the resident and calling the information related to the health of the resident;

the interconnection module is used for connecting various interfaces to realize interconnection with an external system, information sharing with other modules and service cooperation;

the data integration module is used for realizing integration of various data through extraction conversion, quality control and modeling modes so as to support the operation of a data center;

the data utilization module is used for integrating various medical data to form unified classified data, and the data classification and integration are carried out according to the disease category, age, sex and data structure;

the business management module is used for analyzing according to health resources, medical services, public health, medical guarantees, drug management and health statistics by utilizing industrial production data, electronic medical records and health file data so as to promote management decision index display and analysis application construction, drive performance assessment and salary approval and realize public health information supervision of the mobile terminal;

the comprehensive quality index monitoring module is used for being in butt joint with a superior comprehensive quality index monitoring system according to a preset interface standard so as to realize data exchange and intercommunication of an upper platform and a lower platform, appointing an exchange standard specification through a unified data exchange platform, realize sharing of population health information with a superior platform and provide data resources for comprehensive management of a superior health administration;

the regional coordination module is used for assisting a management department to perform regular assessment on subordinate hospitals and community health service centers, including index management, scheme management, plan management and assessment management, and scoring the subordinate hospitals and the community health service centers;

the data center is used for managing and formulating the standards of the exchange data and the shared data in a unified way, each business department establishes a respective interface according to the data interface standard, and provides the data to the data exchange server in time according to the regulations so that the data exchange server can send the data to the data receiver to realize the access of the shared data.

Further, the public health information supervision comprises medical service operation supervision, basic medicine supervision, public health service supervision and regional performance assessment management;

the medical service operation supervision is used for collecting medical service operation data from subordinate medical institutions, wherein the medical service operation data comprises human resource service data, financial income and expenditure service data, and medicine, material, equipment and fixed asset service data, so that abundant service data query and statistical functions, analysis and arrangement functions are provided for the system to realize KPI monitoring and service operation alarming of the medical institutions, and data support is provided for macro policy making and management;

the basic medicine supervision is used for managing a national basic medicine catalog according to a national basic medication system, carrying out data acquisition integration and decision analysis support to realize supervision and management of the medicine use condition in the national basic medicine catalog of a medical institution in the whole area, and forming analysis on the medicine use amount, the money amount and the use frequency by using data processing and data analysis means to realize inquiry of individual medication condition and comparison of the medicine use condition;

the public health service supervision is used for carrying out statistical analysis on basic public health service conditions of community health service institutions in the jurisdictions, including health file management, disease prevention management, rehabilitation and nursing management, chronic disease management, maternal and child health care management, planned immunization, child health care, pregnant and lying-in woman follow-up visits, adult health physical examination, infectious disease reports, public health emergencies, disease deaths, birth population, infectious disease prevention and treatment, occupational disease prevention and treatment, toxic and harmful operations, health supervision and the like, and provides functions of inquiry, statistics, audit, printing and export so that managers can better master the health conditions of residents in the jurisdictions;

the regional performance assessment management is used for assisting the management department in periodically assessing subordinate hospitals and community health service centers, has the functions of index management, scheme management, assessment management and the like, and scores all assessed institutions according to a preset scheme.

Further, the comprehensive quality index monitoring module comprises disease monitoring management;

the disease monitoring management comprises diabetes management, hypertension management, cardiovascular and cerebrovascular management, tumor management, tuberculosis management and death management.

Further, the data exchange comprises medical service data exchange, medical care data exchange, public health data exchange and population information exchange.

Furthermore, the sharing means that mapping, extraction, caching, filtering and conversion of the acquired data are completed through a front ETL, a front data quality control, an application service agent, a message route and a DICOM gateway so as to realize the control of the uploaded data quality.

Furthermore, the comprehensive quality index monitoring module comprises a general city reservation diagnosis and treatment resource pool and a bidirectional referral system, a general medical doctor contract signing service management system in the general city is built to promote the comprehensive quality index monitoring in the general city, and a general city remote medical service platform is built to realize remote consultation, remote image diagnosis and remote electrocardio diagnosis facing public medical and health service institutions in the city and the district so as to realize the intercommunication and sharing of the examination images and the reports of the general city medical and health service institutions.

Compared with the prior art, the invention has the beneficial effects that:

the invention can establish the foundation of regional health informatization, integrates medical health information resources by realizing interconnection and intercommunication of medical health institutions in the whole city and builds a regional medical data center.

Additional aspects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention.

Drawings

The foregoing and/or additional aspects and advantages of the present invention will become apparent and readily appreciated from the following description of the embodiments, taken in conjunction with the accompanying drawings of which:

FIG. 1 is a schematic diagram of a system for monitoring regional health overall quality indicators according to an embodiment of the present invention;

FIG. 2 is a schematic diagram of a main flow of a patient seeking medical advice in an embodiment of the present invention;

fig. 3 is a schematic diagram of upward referral of a community to a county hospital in the embodiment of the invention.

Detailed Description

In order to make the technical solutions of the present invention better understood, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention.

In some of the flows described in the present specification and claims and in the above figures, a number of operations are included that occur in a particular order, but it should be clearly understood that these operations may be performed out of order or in parallel as they occur herein, with the order of the operations being indicated as 101, 102, etc. merely to distinguish between the various operations, and the order of the operations by themselves does not represent any order of performance. Additionally, the flows may include more or fewer operations, and the operations may be performed sequentially or in parallel. It should be noted that, the descriptions of "first", "second", etc. in this document are used for distinguishing different messages, devices, modules, etc., and do not represent a sequential order, nor limit the types of "first" and "second" to be different.

The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and are not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.

It will be understood by those skilled in the art that, unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the prior art and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein.

Examples

As shown in fig. 1, a system for monitoring a regional health overall quality index according to an embodiment of the present invention is provided, including an identity identification module a101, an interconnection module a102, a data integration module a103, a data utilization module a104, a service management module a105, an overall quality index monitoring module a106, a regional coordination module a107, and a data center a 108;

the identity recognition module A101 is used for uniquely recognizing the identity of a resident, acquiring the personal basic information of the resident and calling the information related to the health of the resident;

the interconnection module A102 is used for connecting various interfaces to realize interconnection with an external system, information sharing with other modules and service cooperation;

the data integration module A103 is used for realizing various data integration through extraction conversion, quality control and modeling modes so as to support the operation of the data center A108;

the data utilization module A104 is used for integrating various medical data to form unified classification data, including data classification and integration according to the disease category, age, sex and data structure;

the business management module A105 is used for analyzing according to health resources, medical services, public health, medical guarantees, drug management and health statistics by utilizing industrial production data, electronic medical records and health archive data so as to promote management decision index display and analysis application construction, drive performance assessment and salary approval and realize public health information supervision of the mobile terminal;

the method has the advantages that real and objective industrial production data gathered by a population health area information platform are utilized, electronic medical records and health archive data are fully utilized, multi-class KPI indexes are formed, index analysis of health resources, medical services, public health, medical insurance, drug management, health statistics and the like is achieved, management decision index display and analysis application construction are promoted, performance assessment and salary verification are driven, and a dynamic and scientific supervision and evaluation model is built step by step. In addition, public health information supervision of mobile terminals such as mobile phones is achieved.

The health resource management mainly realizes the statistical analysis functions of health institutions, health personnel and medical equipment, such as providing the basic conditions of various levels and various medical and health institutions for statistical analysis; the conditions of various sanitary personnel of various levels and various sanitary institutions are counted and analyzed; the conditions of various large-scale medical equipment of various levels and various health institutions are counted and analyzed; and various fixed asset conditions of various medical and health institutions are counted and analyzed.

In addition, the statistical analysis function of the natural economic condition of the region is realized, and basic conditions of population, social economy, geography and the like of the region are statistically analyzed.

The comprehensive quality index monitoring module A106 is used for butting with a superior comprehensive quality index monitoring system according to a preset interface standard so as to realize data exchange and intercommunication of an upper platform and a lower platform, appoints an exchange standard specification through a uniform data exchange platform, realizes sharing with superior population health information, and provides data resources for comprehensive management of superior health counseling;

the regional coordination module A107 is used for assisting a management department to perform regular assessment on subordinate hospitals and community health service centers, including index management, scheme management, plan management and assessment management, and scoring the subordinate hospitals and the community health service centers;

and the data center A108 is used for uniformly managing and formulating the standards of the exchanged data and the shared data, and each business department establishes a respective interface according to the data interface standard and provides the data to the data exchange server in time according to the regulations so that the data exchange server can send the data to a data receiver to realize the access of the shared data.

The public health information supervision comprises medical service operation supervision, basic medicine supervision, public health service supervision and regional performance assessment management;

the medical service operation supervision is used for acquiring medical service operation data from subordinate medical institutions, wherein the medical service operation data comprises human resource service data, financial income and expenditure service data, and medicine, material, equipment and fixed asset service data, so that abundant service data query and statistical functions, analysis and arrangement functions are provided for the system to realize medical institution KPI monitoring and service operation alarming, and data support is provided for macro policy making and management; the method specifically comprises the following steps:

medical service administration

The clinic visit condition is as follows: the number of times of outpatient and emergency treatment, the rate of return visits, the rate of out-calls, etc.;

clinic medical expenses: the total cost of outpatients, the cost of outpatients drugs, the outpatient drug cost, the average cost of outpatients, the success rate of rescue of critical patients and the like;

hospitalization and hospitalization conditions: hospital times, times of using antibacterial drugs, total bed days, average bed days, fatality rate of discharged patients and the like;

hospitalization medical expenses: the total cost of hospitalization, the average cost of hospitalization, the cost of hospitalization medicines, the hospitalization medicine charge ratio, the amount of hospitalization base medicines, the antibacterial medicine charge rate, the hospitalization medical insurance cost, the hospitalization medical insurance individual charge ratio and the like;

supervision of operation conditions: the number of operative persons (first, second, third and fourth), the number of day operative persons, the number of unplanned reoperation cases, the number of phase-selecting operative cases and the like;

and (3) supervision of operation cost: total surgical costs, mean surgical costs, implant amount, and the like.

Medical quality supervision

The quality supervision functions of clinical quality control, medicine quality control, diagnosis and treatment supervision, medical and technical inspection supervision, nursing quality and the like are realized.

Clinical quality control: medical record quality control, clinical pathway quality control, emergency rescue reports, and critical rescue reports.

Controlling the quality of medicine: prescription comment and reasonable medication management.

Diagnosis and treatment supervision: diagnosis quality, operation quality, intensive care quality, emergency treatment quality and consultation quality management.

And (3) medical and technical inspection and supervision: blood transfusion quality, clinical examination quality, pathology quality and medical image quality management

And (4) nursing quality supervision: care quality management and adverse event reporting.

Medical safety supervision

Monitoring, early warning and reporting of high-risk medical safety events such as hospital infection, medical errors and the like in an area are realized; wherein, the hospital infection and disease control supervision comprises: infectious disease reporting and monitoring, nosocomial infection reporting and monitoring, tumor reporting and neonatal death reporting; medical risk administration includes: medical error management, medical accident management, emergency management and supervision data reporting.

Medical expense supervision

The operation condition of the hospital is comprehensively mastered, the overall cost accounting, benefit analysis and performance management of the hospital in the area are enhanced, the medical expense supervision is realized, and the increase of the medical expense is reasonably controlled.

Hospital blood transfusion supervision

The in-bed blood safety monitoring and evaluation, and the early warning and disposal of the blood consumption of each hospital in the area are realized.

Medical quality analysis

The method comprises single disease quality analysis, hospital or department medical comprehensive evaluation, single case medical quality condition evaluation, physician medical quality evaluation, analysis of main reason analysis of bad cases and the like.

The basic medicine supervision is used for managing a national basic medicine catalog according to a national basic medication system, carrying out data acquisition integration and decision analysis support so as to realize supervision and management of the medicine use condition in the national basic medicine catalog of a medical institution in the whole area, and forming analysis on the medicine use amount, the money amount and the use frequency by using data processing and data analysis means so as to realize inquiry of individual medication use condition and comparison of the medicine use condition;

the method is characterized in that a national basic medication system is followed, a national basic drug catalog is managed, data acquisition integration and decision analysis support are taken as main means, supervision and management of the use condition of the drugs in the national basic drug catalog of the medical institution in the whole area are finally realized, and the analysis of the drug use amount, the drug amount and the drug use frequency is formed by using data processing and data analysis means, so that inquiry of the personal medication condition and comparison of the drug use condition are realized. According to the requirements of different use levels, the analysis level is refined to departments, doctors, even age, gender and the like. The method specifically comprises the following steps:

the overall use condition of the medicine is as follows: summary of drug use for display institutions

The type of drug used: number of medicine usage and average type of medicine usage of display mechanism

The number of medicines: medicine using number and average number of display mechanism

Drug income condition: drug use amount and average amount of money of display mechanism

The drug types are: displaying the medication type condition summarized according to the medicine type

Frequency of use: the condition of the use times of the medicines summarized according to the medicine categories in a certain period of time of the display mechanism

Fluctuation range: comparative analysis of difference summarized according to medicines in two periods of time by display mechanism

The public health service supervision is used for carrying out statistical analysis on basic public health service conditions of community health service institutions in the jurisdictions, including health file management, disease prevention management, rehabilitation and nursing management, chronic disease management, maternal and child health management, planned immunization, child health care, pregnant and lying-in woman follow-up visits, adult health physical examination, infectious disease reports, public health emergencies, disease deaths, birth population, infectious disease prevention and treatment, occupational disease prevention and treatment, toxic and harmful operations, health supervision and the like, and provides functions of inquiry, statistics, auditing, printing and exporting so that managers can better master the health conditions of residents in the jurisdictions;

the regional performance assessment management is used for assisting the management department in performing regular assessment on subordinate hospitals and community health service centers, comprises the functions of index management, scheme management, assessment management and the like, and scores all assessed institutions according to a preset scheme.

Index management

The method realizes the management of indexes used by assessment, customizes and maintains a calculation formula of a certain index, and can inquire according to the superior-subordinate relation of the index, including the detailed information of an index list and the index, and if the index is a comprehensive calculation index, the formula can be edited by a calculation formula editor.

Project management

The method and the system realize the simultaneous management of a plurality of evaluation schemes, can perform the operation of adding, deleting, modifying and checking the approved items (index items) in the schemes aiming at one scheme, and can query all mechanism evaluation scheme lists according to the combination condition and the starting state, wherein the contents comprise scheme names, evaluation frequency, scheme total scores, starting states, customizers, customization dates and the like.

Plan management

The assessment plans can be managed simultaneously, the assessment organization can be subjected to increasing, deleting, modifying and checking operation aiming at a certain plan, all organization assessment plan lists can be inquired according to combination conditions, enabling states and assessment schemes, and the contents comprise plan names, execution years, assessment frequency, starting time, scheme names, enabling states, customization dates and the like.

Assessment management

Indicator data filling confirmation

The method comprises the steps that manually collected assessment indexes used in assessment are collected, filled and reported according to index permissions, a manager audits reported data of all organizations according to actual conditions, if the reported data are inconsistent with the actual conditions, the index data can be returned to the subordinate assessed organizations to be reportedly, if the reported data are consistent with the actual conditions, data confirmation is carried out, and the reported data cannot be changed any more after the data confirmation.

Trial calculation of scores

After all the reported data are confirmed, the manager can perform scoring trial calculation. In the trial calculation process, the system automatically completes the filling of the index values counted by the system, calculates the index values calculated comprehensively according to the index calculation formula, and simultaneously performs trial calculation on the scores of all the assessment indexes according to the assessment index scoring formula (at the moment, the index scores cannot be queried in sections such as scoring query, scoring audit and the like). And finally, confirming the scoring result of trial calculation, if no objection exists, scoring the system, otherwise, adjusting the index value according to the situation (only manually acquiring the index value can be adjusted), and performing scoring trial calculation until the scoring result has no objection.

Scoring review

After the system scores, the manager can perform scoring audit. When the scoring result is not objected, the scoring result can be approved. And if the result of the audit is objected, selecting the audit not to pass. And re-scoring returned positions which fail to pass the audit.

Statistics of scoring results

After the grading audit is passed, the subordinate mechanism can confirm the grading result and carry out filing processing, and all data can not be changed after filing. Meanwhile, an analysis report is generated, and analysis is performed from different latitudes such as basic conditions, organization comparison, classification details, project details to organization details and the like.

The comprehensive quality index monitoring module A106 comprises disease monitoring management;

the disease monitoring management comprises diabetes management, hypertension management, cardiovascular and cerebrovascular management, tumor management, tuberculosis management and death management.

Diabetes management

Diabetes management subjects can be divided into high risk groups for diabetes, people with dysregulation of sugar and diabetic patients. The system realizes the whole-course informatization of the diabetes management work flow of the diabetes management objects in the secondary and tertiary hospitals according to different managed business rules by acquiring the information of the diabetes management objects in the secondary and tertiary hospitals, registering and finding and reporting diseases of the diabetes management objects of the patients with abnormal sugar regulation in the secondary and tertiary hospitals, carrying out daily follow-up management on high-risk groups of diabetes, the patients with abnormal sugar regulation and the diabetes patients in community health service, and managing the diabetes prevention and treatment work flow at the city level and the district level.

Application in market-level disease control center

The method is mainly provided for a regional disease prevention control center to be used, and is used for completing auditing and spot check quality control of diabetes prevention and control work in the whole city, checking and re-checking management of management objects between districts and counties, management of change management objects between districts and counties (immigration and emigration management), data statistics and report making, comprehensive query and information exchange and the like.

Regional and county level disease control center application

The application of the diabetes management district level mainly realizes the auditing and spot check quality control of the diabetes prevention and treatment work of the district level, the management of change management objects inside and outside the district (immigration and emigration management), data statistics and report making, comprehensive query and information exchange and the like.

Application in health yard of villages and towns

The management and screening of high-risk groups of diabetes, the registration and follow-up management of patients with diabetes and abnormal glucose regulation, data statistics and report making, comprehensive inquiry, information exchange and the like are realized.

Hypertension management

The system dynamically links the information of the hypertension management object in the second-level and third-level hospitals and the information of the pressure of residents in the 35 years of diagnosis in the medical institution with a health file by acquiring the information of the hypertension management object in the second-level and third-level hospitals and the information of the pressure of residents in the medical institution, regularly and interactively shares the information, and realizes the evaluation, follow-up visit and self-management of the hypertension management object and the hypertension patient by a community health service center according to different management business rules; and the disease control center performs quality control and dynamic management of the whole process of statistical analysis.

Application in market-level disease control center

The system is mainly provided for a disease prevention and control center in a city to be used for finishing the auditing and spot check quality control of the hypertension prevention and control work in the whole city, the check and duplication check management of management objects between districts and counties, the management of change management objects between districts and counties (immigration and emigration management), data statistics and report making, comprehensive inquiry, information exchange and the like;

regional and county level disease control center application

The quality control of auditing and spot check of hypertension control work in the district is realized, and the patient immigration and immigration management, data statistics and report making, comprehensive query and information exchange and the like in and out of the district are realized.

According to a population health area information platform, first-time-visit pressure measurement information of 35-year-old residents, blood pressure of all the hypertension patients who see a doctor, partial laboratory examination information and other information are acquired from a hospital and transmitted to a district disease control department.

Application in health yard of villages and towns

The method realizes the first-visit pressure measurement of residents in the community at 35 years, the management of community hypertensive high-risk groups, the registration and follow-up management of hypertensive patients, the data statistics and report making, the comprehensive inquiry, the information exchange and the like.

Cardiovascular and cerebrovascular management

The system realizes the whole-process informatization of the cardiovascular and cerebrovascular management object registration discovery and follow-up visit verification management and the city-level and county management cardiovascular and cerebrovascular prevention and treatment work flow by acquiring the information of the cardiovascular and cerebrovascular management object in the second-level and third-level hospitals according to different management business rules. Meanwhile, information of related systems such as hospital information systems, health files and the like is exchanged and shared by depending on a population health area information platform, pushing of the related information of cardiovascular and cerebrovascular cases of all levels of medical institutions in the whole city is completed, automatic sorting, exchange and quality control of the cardiovascular and cerebrovascular case information in the whole city are completed, the cardiovascular and cerebrovascular statistical analysis information required by all related departments is completed, and utilization and automatic pushing of data among related business lines are completed.

Application in market-level disease control center

The system is mainly provided for a disease prevention and control center in the city to use, and realizes spot check quality control of a brain stroke report card in the city, statistics and report making of data in the city, comprehensive inquiry and information exchange, data archiving and the like;

regional and county level disease control center application

Managing and controlling the quality of the cardiovascular and cerebrovascular report card and the information verification table managed in the district, inquiring and counting the occurrence condition of the cerebral apoplexy in the district, generating a report, printing and filing data.

Application in health yard of villages and towns

The method realizes the verification registration, report, audit, initial visit and death supplementary report management of the cardiovascular and cerebrovascular management objects, data statistics, report making, comprehensive inquiry, information exchange and the like.

Hospital: realizing the registration report of the stroke management object;

tumor management

The method mainly realizes the report and audit of the second-level and third-level hospitals to the tumor patients and the management of the community health service center to the initial visit, follow-up visit and death supplementary report of the tumor patients, further obtains accurate and complete information data, provides basic data for the research of tumor etiology, evaluates the effect of tumor prevention and treatment measures and provides basis for the establishment of working strategies for administrative departments; by regularly tracking, follow-up and managing tumor patients, basic community medical service is provided for the tumor patients, the life quality of the tumor patients is improved, and the survival rate is improved.

Application in market-level disease control center

The system mainly realizes the functions of directly acquiring electronic tumor case registration information from a second-level hospital and a third-level hospital, cooperating with death registration service, auditing tumor registration management information of a whole city, performing quality control of spot check, performing migration management between counties and emigration management, managing reports, comprehensively inquiring and the like.

Regional and county level disease control center application

The system has the functions of auditing and sampling inspection quality control of tumor registration management in the region, cooperation with death registration service, migration-in and migration-out management in the region, report management, data statistics, comprehensive query and the like.

Application in health yard of villages and towns

The generation or the input of the report card and the follow-up visit card, the immigration, the emigration and the query of the report card, the reminding and the printing of the initial visit and the follow-up visit, the association and the association cancellation of the multi-part original report card are realized, the cooperation with the death registration service, the data statistics and the report making, the comprehensive query and the information exchange, the quality control and the like are realized;

tuberculosis management

Tuberculosis management objects can be divided into ghost cases, suspected cases of tuberculosis and tuberculosis cases. The system is based on the business process informatization construction of hospital data push, disease control business management and community supervision follow-up visit of a city-county two-stage platform, acquires the information of the tuberculosis management object for visiting in the community, non-fixed-point hospitals and fixed-point hospitals, realizes the whole-process informatization of the tuberculosis management object registration discovery and follow-up visit management and the city-county level tuberculosis control work flow according to different managed business rules, and also realizes the whole-process management of tuberculosis cases from suspected discovery to confirmed diagnosis and treatment to community supervision.

Application in market-level disease control center

The quality control of auditing and spot check of tuberculosis prevention and treatment work in the whole city is realized, the functions of inter-district immigration and emigration management, report management and the like are realized, and the dynamic management of the whole process of real numbering, quality control, statistical analysis is performed.

Regional and county level disease control center application

And the functions of auditing and sampling inspection quality control of tuberculosis prevention and treatment work in the district and county, migration-in and migration-out management in the district, report management and the like are completed, and the dynamic management of the whole process of actual numbering, quality control, statistical analysis is performed.

Application in health yard of villages and towns

Tracking suspected case patients, tracking tuberculosis patients, signing contract, follow-up visit, cost reduction, screening and implementation of close contacts and the like.

Hospital

General hospitals (second and third level hospitals outside tuberculosis fixed-point hospitals): the functions of case management with different shadows in chest radiography inspection results, report of suspected tuberculosis cases, referral of suspected tuberculosis cases and the like are realized.

Tuberculosis prevention and cure fixed-point hospital: the management of initial diagnosis cases, confirmed diagnosis cases and multi-drug resistant cases of tuberculosis patients can be realized.

Death management

The collection and the comprehensive management of the death information of residents are important components of health statistics and even whole disease control work, and are subjects for researching the death rate, the death reasons and the change rule of the death factors. The system realizes the registration, printing, auditing and management of the death medical certificate of the second-level and third-level hospitals; the community health service center registers, prints and audits and manages death medical certificate, death medical inference book and death medical confirmation book for death reasons ICD-10; and (4) auditing death report information ICD-10, auditing the logic of the death cause and carrying out dynamic management of the whole process of statistical analysis by the disease control center.

The data exchange comprises medical service data exchange, medical care data exchange, public health data exchange and population information exchange.

The data exchange and sharing platform mainly aims at realizing the functions of acquisition, exchange, merging, sharing and the like of sanitary data in an area, centralizes the data dispersed in application systems of various medical institutions into a unified data center according to needs, and performs unified data processing, information integration and management on the data. On one hand, business data are managed in a centralized mode, and on the other hand, the data are integrated to meet the requirements of application systems of different levels.

The data exchange and sharing platform is an important component of the comprehensive quality index monitoring system. The data sharing and exchanging platform adopts a service-oriented architecture, is a comprehensive quality index monitoring system, a comprehensive quality index monitoring system of Guangxi province and a service bus interacting with various heterogeneous business application systems of various medical institutions, and provides a unified gateway for any authorized application service access.

The data exchange and sharing platform follows a uniform standard specification and consists of an exchange front-end system deployed in an access hospital, an exchange transmission system deployed at a platform end and an exchange management system. The access hospital data exchange system supports deployment in a cluster environment of a cloud data center, has good expansion capability, and guarantees high-reliability and high-expansibility operation of the exchange center, the data exchange platform is deployed in a data center application virtualization platform, and the resource of the data exchange platform is uniformly distributed as required through resource unified management of a virtual machine, so that data exchange cloud service is provided for the access hospital, meanwhile, the application load balancing technology is utilized to intelligently distribute service pressure to different servers, reliability and high-performance response capability of the system are guaranteed, meanwhile, the load balancing is matched with the virtualization technology, so that horizontal expansion of the data exchange platform resource is achieved, and good expansibility is provided for future service development.

The data exchange and sharing platform has expandability, manageability, safety, reliability and high efficiency:

the expandability of the information exchange platform is mainly embodied in that: the data interface with unified standard is provided for each business department, the interface has strong expandability, and various modes are provided to integrate various business systems to the information exchange platform, so that the business department can transparently exchange data with other business departments only through one standard data interface.

Manageability is mainly reflected in: the data center can perform centralized control and management on data exchange in the whole system through a data exchange control/transmission layer.

The safety, reliability and high performance are mainly reflected in that: firstly, advanced and mature data exchange technology (for example, advanced technologies such as message mechanism combined middleware technology, data routing and the like are adopted); secondly, a reasonably designed and optimized exchange data structure and data session strategy.

Data exchange content

Medical service data

The medical service data is derived from internal information systems (such as HIS, LIS, RIS, CIS systems) of each hospital. The medical service business covers outpatient services and hospitalization services. The outpatient service is as follows: the general outpatient service, the emergency treatment, the expert outpatient service, the special outpatient service are specially needed; hospitalization services refer to: the patients need to be hospitalized in ordinary and emergency observation. The patient refers to a person who obtains medical services, and the patient includes a social insurance card, a medical insurance card, an agricultural contract card, a self-fee diagnosis and treatment card and other medical staff.

The medical service information acquisition mainly comprises basic information of a patient, a patient clinic record, a laboratory test report, an image diagnosis report, image data, a hospital-related medical record, an outpatient/hospital diagnosis report and the like.

Medical support data

The medical insurance data refers to diagnosis and treatment transaction data of medical insurance personnel in medical institutions. Medical support data comes from HIS systems of various hospitals, and services comprise outpatient services and hospitalization services. The data comprises six types of data such as diagnosis and treatment record data, outpatient registration data, charging detail data, hospitalization discharge and admission data, charging detail data and the like.

Public health data

Public health data is generated in daily business of professional institutions such as women and children health care centers, community health service centers (stations), and village and town health centers, and mainly comprises health archive management, preventive health care management, rehabilitation management and health education management.

Other kinds of data

The platform also needs to exchange data with other administrative institutions in the area, for example, acquiring birth population information and family entrance population information from a public security system, and triggering health file filing work of newly-added people (birth and family entrance); acquiring death population information from a public security system, and triggering the health file filing settlement corresponding to the death population; and acquiring population information of the user who moves out from the public security system, and triggering a sealed data access mode of health file filing corresponding to the user who moves out.

The service systems of all medical institutions use a data exchange platform uniformly to exchange data, the platform consists of data exchange servers distributed in all departments, and is uniformly managed by a data center, the data exchange platform provides a uniform interface standard and has the functions of data encryption and decryption, compression and decompression, breakpoint retransmission and the like, and the data exchange is ensured to be safe, reliable and efficient.

The data center manages and makes the standard of exchanging data and sharing data in a unified way, each business department follows the data interface standard to establish respective interface system, and provides the data to the data exchange server in time according to the regulation, and the data exchange server sends the data to the data receiver (sharing database or other departments); and the service department needs to take out the received data from the data exchange server in time for service processing, and the access to the shared data is completed through the information exchange platform.

The data exchange and sharing platform comprises a unified exchange platform system deployed in a data center, a front-end processor system deployed in a medical institution and an interface end of each other application system. Each medical institution front-end processor is deployed with a data exchange system, is respectively butted with systems of HIS, LIS, electronic medical record, health file, medical guarantee, health card and the like of the medical institution in the modes of an adapter, a service interface and the like, and is uploaded to a platform in a real-time/timing mode; data to be issued are sent to the preposed libraries of all medical institutions and are respectively sent to the corresponding medical institution application systems through adapters, service interfaces and the like; meanwhile, the medical institution application system can also call a service interface in the front-end system to acquire platform-related service functions, such as electronic health file retrieval and the like.

The data exchange platform completes data exchange among business departments and also completes data acquisition work of a shared database and a public service database.

Data exchange mode

1) Batch data timing exchange

Applicable scenarios are as follows: it is most used for platforms as the origin or destination of data exchange. Such as platform-platform, platform-system.

Exchanging contents: result data of the health service production system (clinical diagnosis, medical service, hospital operation, drug warehousing and use, public health, medical insurance, medical guarantee information, etc.).

The exchange mode is as follows: relational database intermediate tables or XML document approaches.

2) Small/single data (quasi-) real-time exchange

Applicable scenarios are as follows: and is mainly used for cooperative linkage in or among business application systems, and the systems need to utilize data or service support of a platform. E.g., intra-system (remote settlement for medical care, etc.); between systems (regional medical, regional public health, etc.).

The exchange mode is as follows: the HL7 standard protocol is adopted for exchange, and the real-time transaction settlement adopts a message mechanism.

Main function

In the regional health informatization construction, high-quality information is acquired, the intercommunication and sharing of the interconnected medical health service institutions are important links, and the whole process relates to interaction with each accessed medical health service institution, so that whether the regional health informatization construction is successful or not, the exchange front end plays a key role.

The exchange front-end finishes mapping, extracting, caching, filtering and converting of collected data through various front-end applications such as a front-end ETL, a front-end data quality control, an application service agent, a message route and a DICOM gateway, realizes control of uploaded data quality, and supports message exchange of cooperative services such as a shared retrieval, intelligent prompting, a comprehensive quality index monitoring system and the like. The cooperative service message exchange is realized by respectively selecting application agents, message routing, DICOM gateways and other preposed application services according to the requirements of service scenes.

Front ETL

The front ETL realizes mapping, extraction, caching, filtering, conversion and the like of relevant data accessed to the information system of the medical institution, and data subjected to data quality control and verification is subjected to standardized conversion before being uploaded to the central end, so that support is provided for future application expansion of the data resource center.

1) Data mapping

Data mapping is the task that the data collection job task needs to be completed first. The data mapping function is that a mapping relation is defined for corresponding items in the data conversion standard in the service system, the mapping relation comprises a structure mapping part and a value domain mapping part, the items pay attention to the fact that a preposed data mapping structure is established according to requirements of a platform for data acquisition of a medical institution, and a basis is provided for acquiring medical relevant information. The project provides a visual data conversion mapping tool to improve the accuracy of data mapping and improve the efficiency of data acquisition and reporting.

And (3) data structure mapping: mapping data structures of business systems to corresponding platform data structures is provided.

Value domain mapping: the method provides complete mapping processing for the existing value range in the service system.

2) Data extraction

The data extraction mainly comprises two modes of full-quantity extraction and incremental extraction.

And (3) total extraction: the full extraction is to extract all the service data of the source database into the target database at one time. The full extraction of the comprehensive quality index monitoring system is generally used for the historical information migration of the medical institution and is generally performed once in a centralized way. Technically, an exchange mode or a database direct export and import mode can be used, and the data exchange mode is used under the condition of large historical data quantity, so that large resources are occupied, the consumed time is long, and the data exchange mode is not recommended. The time of extraction typically occurs at a hospital non-outpatient time.

And (4) incremental extraction: the incremental extraction is to extract only the fresh data which is subjected to the addition, deletion and modification into the target database. The comprehensive quality index monitoring system generally adopts an incremental extraction mode for regularly uploading daily information of a medical institution. In addition, an increment extraction mode is also adopted for the situations that data is required to be uploaded again, such as data quality inconsistency, transmission task failure and the like. The time of extraction typically occurs at a hospital non-outpatient time.

Data extraction is generally accomplished by relying on sophisticated data extraction components. The medical information data is complex, the data extraction assembly needs to support an adapter technology, the existence forms of various data sources are fully considered, a data adaptation function needs to be provided for various data sources, the platform can be adapted to respective related services, and the integration capability of supporting a future heterogeneous application system is achieved.

The requirements of different types of business application requirements on data extraction are different, and in order to meet the different business requirements, the data extraction component supports multiple data extraction modes.

Various extraction time processes are supported, including timed extraction, real-time extraction, and event-triggered extraction.

And various extraction content processes are supported, including full amount extraction and incremental amount extraction.

(1) Full volume extraction

The data extraction component supports full extraction, is responsible for data migration or data copying, extracts the data of the table or the view in the data source from the database without changing the data, and converts the data into a format which can be recognized by a platform. The full extraction is predefined by an extraction rule of the data source, the extraction logic is directly executed through the module, and the extracted data is correspondingly inserted into a target data source of the resource center, so that the whole process of the full extraction is completed.

In a service scene, the full extraction is applied to the extraction of historical data, dictionary tables and other conditions, and can be suitable for statistical analysis or service requirements without secondary updating. The method can be used in combination with an increment extraction module in a scene with real-time change data extraction.

(2) Incremental decimation

The data extraction component supports incremental extraction, extracting only new or modified data from the table to be extracted in the database since the last extraction. In the process of business operation, incremental extraction is more widely applied than full extraction. How to capture the changing data is the key to incremental extraction.

The extraction component pair capture method provided by the project meets the following two requirements:

the accuracy is as follows: the change data in the service system can be accurately captured according to a certain frequency;

performance: the system can not be stressed too much, and the existing service is influenced.

And a trigger mode, a timestamp mode, a full-table deletion insertion mode, a full-table comparison mode and a log file mode are supported.

3) Data caching

The exchange front-end system carries out front-end ETL on various types of data of the uploading platform of the medical institution, and then transmits standard information with excessive quality to the platform, so that a buffer library needs to be established in the front-end system to cache the data uploaded by the hospital information system manufacturer and empty the data regularly.

4) Data filtering

The data filtering mainly pre-processes data uploaded to a front-end processor by a medical institution, selectively controls the uploaded data according to a platform data acquisition standard, and uploads most data in principle. Data filtering requires rules to be set in advance to specify which types of packets are allowed to pass and which types of packets are to be blocked.

5) Data standard translation

The uploaded data of the medical institution is subjected to standardized conversion before being uploaded to the platform, and the data is merged, split, enriched and the like mainly according to the platform data access standard. And support is provided for future application expansion of the data resource center.

Data merging and splitting: reorganizing and arranging the data structure, and combing the data according to the platform unified standard to complete the overall planning of the heterogeneous data.

Data enrichment and cutting: according to the standard data requirements of the platform, different business system heterogeneous data contents are filled and cut, standard unified required contents are added, and business irrelevant contents are deleted. The data enrichment is to analyze the data content and enrich the data content, and the enriched data is transmitted to the application for processing. And the data cutting is to analyze the data content, cut the data content and transmit the cut data to the application for processing. The rule enrichment and cutting are realized by flexibly enriching and cutting data according to the data enrichment and cutting rules in the data enrichment and cutting rule base.

And (3) data vacancy filling and replacement: aiming at the content which is required by the standard in a unified way and can not be provided by a service system, a unified vacancy filling and replacing function is provided, for example, value ranges such as data source department mechanism information, normally bright information and the like are set in a conversion link in advance to obtain a default value.

Pre-data quality control

Data quality control work such as data verification and data cleaning is carried out at the source of data extraction, and only qualified data passing through the verification is uploaded to a data center, and after secondary verification and cleaning are carried out at the data center, formed data can be directly used by a platform, high-quality data support is provided for the platform, and query and display are directly carried out at a platform end. The method specifically comprises various types of errors and accidental processing in the data extraction process, a perfect data backup mechanism and the like.

The preposed data quality control comprises the data quality guarantee of the whole process of pre-data verification, in-process exchange monitoring and post-analysis feedback, all monitorable and computable data indexes are uniformly managed in a source, and the name and the calculation method of each index are formulated. The quality control is carried out on the collected data of each medical institution according to the monitoring index, and the range covers the integrity, relevance, constraint, specification (accuracy) and timeliness of the data.

Integrity: monitoring whether each mechanism uploads the data in the service date completely;

relevance: monitoring whether the service sub-event report can be traced back to a service parent event report according to a certain rule;

constraint: monitoring whether a service father event report of a service sub-process has at least one service sub-event report;

consistency: monitoring whether the statistical indexes uploaded by each organization are consistent with the summary value of the detail report;

specification (accuracy): whether the data meets the data specification (accuracy) requirements defined in the interface;

timeliness: and whether the data is uploaded in time after the service data is generated or not.

Application service broker

The platform acquires and integrates the relevant data of the medical health of the whole area, provides services such as retrieval and intelligent prompting of medical institutions, and is embedded into the diagnosis and treatment links of doctor workstations of the medical institutions to assist doctors in acquiring health files and various medical knowledge of patients and reminding, and medical quality and safety are improved. The platform interconnects the medical institutions, the service use pressure is high, and therefore through packaging and caching of platform services, application service agents such as retrieval and intelligent prompt are realized at the front end of the medical institutions, the coupling between the platform and the platform is reduced, the application robustness and the expansion capability are improved, and the reliability and the safety of the services are improved.

1) Platform application access agent

For part of applications (such as health record browser application) provided by the platform, a unified application access proxy service is adopted in the exchange front-end system for accessing, so as to reduce the load of the original WEB server. The application access proxy server undertakes the request of the static page of the original WEB server, and the original server is prevented from being overloaded. It processes all requests to WEB server, if the page requested by client has cache on proxy server, proxy server directly sends the cache content to user. If the cache is not available, a request is sent to the WEB server, the data is retrieved, and the data is sent to the user after local cache. This reduces the load on the WEB server by reducing the number of requests to the WEB server.

The application access agent is positioned at the front end of the Web server, the connection of an external user to the Web server needs to pass through the reverse agent firstly, then the reverse agent determines which Web server processes the user request, and the request is routed to the corresponding Web server. Static content can be cached at the reverse-proxy and thus no longer routed to the Web server.

In addition to caching and load balancing, the application access proxy can provide the following functions:

safety: the reverse proxy isolates the user and the Web server and avoids the attack to the specific server

Data encryption/SSL acceleration some Web servers may not have SSL encryption function, but the reverse proxy with encryption function can provide data encryption for the Web server, and the reverse proxy server equipped with SSL acceleration hardware can also provide high-speed encryption channel for Web application

2) Platform service broker

By packaging the services (such as intelligent prompt services) provided by the platform, the coupling degree of the platform and medical institution applications is reduced, and the compatibility, reliability and safety of the services are improved.

The service agents provided by the platform include the following classes:

service adaptation: expanding access form of service to adapt to different medical institution heterogeneous information architectures

Performance optimization: the front-end multi-level cache of the medical institution is added, and the service performance is improved

Safety control: effectively isolating direct access to platform services and avoiding potential safety hazards

Privacy protection: according to the service specification and the management requirement of the platform, the information encryption and protection are realized

Messaging service

The platform realizes the whole-area interconnection and intercommunication, develops all collaborative services such as a comprehensive quality index monitoring system and the like, and can frequently trigger the intercommunication and message transmission between the platform and the hospital service system, so that a message service support needs to be provided in the exchange front-end system to route and forward messages of related services, and the safety and the expandability of the system are improved.

The middleware provided by the project supports the message routing work, supports static routing realized based on hard codes such as transaction, target address and the like, provides configurable dynamic routing based on message content, and achieves the purpose of separating the routing from the shared switching service in any routing mode.

In addition, the message service of the project conforms to the specification of IHE and the like and supports the HL7 standard.

DICOM gateway

DICOM refers to digital medical imaging and communications, i.e., in the biomedical field, the communication of digital medical images and their information in clinical diagnosis and treatment. The DICOM standard is a collaborative standard that is effectively compatible with related standards developed by other international standards organizations (ANSI, CEN, HL7, ISO and JIRA). The image system and other information systems are effectively compatible in the world health field, and the process efficiency is improved.

The image information is used as an important component of resident diagnosis and treatment information and plays an important role in regional medical application such as a comprehensive quality index monitoring system, telemedicine and the like, so that a DICOM gateway needs to be configured at a preposed exchange end, the interaction of medical digital images and information thereof between a medical equipment system and a PACS system is realized, and the safety of image information exchange and transmission is supported.

The DICOM gateway provided by the preposed exchange end can meet the following requirements:

the data flow monitoring service is realized as follows: monitoring the data uploading and downloading conditions of the medical institution and recording the data through a log; the medical institution equipment port response is monitored regularly and recorded through a log.

And realizing operation service management: the management of all medical institutions, users, authorities and the like in the area is supported; supporting background log management; and the backup and recovery management of the uploaded data is supported.

And a 64-bit operating system is supported, and the image data processing device has higher data operation processing capacity. The system supports a non-Windows operating system, and has better safety and higher image large file processing capacity.

The DICOM gateway can be used as a security isolation gateway of a medical equipment network and a hospital work network, and the security of medical equipment is ensured.

Key scenario

1) Timing data collection class

The timing data acquisition mainly aims at the migration of historical medical related information and the acquisition of all diagnosis and treatment information of patients every day, the data acquisition range of the timing data covers resident health files, electronic medical records and basic information of the patients, and in addition, the timing data acquisition also comprises result data meeting the supervision requirements of a management organization on medicine supervision, public health monitoring, comprehensive data analysis and the like. The acquisition time is generally set at a non-outpatient time period of a medical institution to relieve hospital system and transmission network pressure.

2) Class of real-time data collection

The real-time data acquisition mainly aims at data provided by a management organization for the supervision requirements of medical services of medical institutions, such as the real-time outpatient service volume, the doctor seeing situation, the bed situation, the large prescription situation and the like of hospitals.

3) Business collaboration classes

The system meets the transmission of various cooperative messages in the process of regional unified reservation registration, telemedicine, public health linkage and other regional medical cooperation, and is mainly supported by a message route. In addition, the data packets related to the collaborative service may be transmitted in the form of packets.

4) Retrieval, intelligent prompt and the like

The platform acquires the relevant data of medical health of the whole area, integrate with the patient as the core, provide services such as medical institution health file retrieval and all kinds of intelligent prompts, call to such services needs to be realized through the mode with agent service in the exchange front-end system, need to install trigger software at the doctor workstation, when the doctor is diagnosing the in-process of operation to a certain patient, can initiatively retrieve this patient's health file information, also can realize the suggestion to all kinds of information such as repeated use of medicine, repeated inspection and inspection through the mode that pops out the prompt box, see a doctor with the assistance, improve medical quality and safety.

The comprehensive quality index monitoring module A106 comprises an integrated city reservation diagnosis and treatment resource pool and a bidirectional referral system, a city general medical doctor signing service management system is built to promote city comprehensive quality index monitoring, and a city remote medical service platform is built to realize remote consultation, remote image diagnosis and remote electrocardio diagnosis facing to public medical health service institutions in cities and districts so as to realize image examination and report intercommunication and sharing of the city medical health service institutions.

For example, the deployment application range of the comprehensive quality index monitoring system informatization support system is as follows: in the region, 13 administrative districts, 3 development districts, 78 public hospitals with more than two levels and 201 base-level medical and health service institutions (133 community health service centers and 68 hometown health hospitals).

System design of comprehensive quality index monitoring system

Basic medical institution: commonly, the diagnosis and treatment of common diseases and frequently encountered diseases. Generally outpatient and inpatient cases with stable illness condition and cases adapted to technical level and facility equipment condition

The visit scope of the secondary hospital in county: and the cases which need emergency treatment but only have general emergency treatment and complex disease conditions or complex complications, serious acute and chronic patients and poor prognosis due to diagnosis and treatment, and the cases which are suitable for the technical level and the facility equipment condition.

The clinic scope of the third-level hospital in the city: mainly used for treating serious illness, life danger at any time, one of circulatory, respiratory, liver, kidney and central nervous function failure diseases and part of serious diseases which are adaptive to technical level and facility equipment condition and determined by the country.

The general contract signing and comprehensive quality index monitoring system service information system based on the comprehensive quality index monitoring system is based on the existing health informatization foundation in the local city, improves the existing comprehensive quality index monitoring system in the local area, integrates information resources of related systems such as a medical resource reservation platform, a basic medical institution health file system and the like, establishes a complete system facing general doctor contract signing, service and assessment, forms the comprehensive quality index monitoring system between the basic medical institution and a large hospital, and promotes ordered medical treatment in the area.

The system construction starts from several modules of signing management, appointment management, diagnosis and treatment management, referral management, an interactive platform and comprehensive management to perfect software development and system design, and builds an application system which is standard and uniform, has reasonable flow and is simple and convenient to operate, and assists in the implementation of a comprehensive quality index monitoring system.

Integrated framework

The construction of a general quality index monitoring system for general practitioners relates to three roles of a city-level hospital, a district-level hospital and a basic medical institution service organization. There is a need for modification of hospital information systems, primary care information systems (public health, medical services), regional information platforms (data centers). Meanwhile, a comprehensive quality index monitoring system service is newly established on a regional information platform so as to support the realization of the comprehensive quality index monitoring system.

Application scenario design

The implementation of a comprehensive quality index monitoring system requires the implementation of a first-diagnosis system of a basic-level medical and health institution, and encourages patients to seek medical advice in a nearby community by contracting with general doctors of the community for common diseases, chronic diseases and frequently encountered diseases. The county level hospital mainly undertakes diagnosis and treatment of difficult and complicated diseases, patients are firstly diagnosed through the basic level, the requirements of disease conditions are met according to certain referral indication, then the patients go to the county level hospital to see a doctor, the conditions of the patients are stable after treatment, and the patients needing to be treated are returned to the basic level rehabilitation treatment. So as to realize the goals of 'small diseases entering hospitals and big diseases recovering to communities'.

As the principle of patient's own will is adopted, if the patient directly visits the county hospital to see a doctor without a referral or passing through a community, the flow is not different from the original flow, and the main difference is the difference between the medical expense and the medical insurance reimbursement ratio. If the patient arrives at the first visit of the community, the medical procedure of the patient is different from the original procedure of directly visiting the hospital. The following lists the procedure and typical scene of the patient hospitalizing after implementing the comprehensive quality index monitoring system, wherein the typical scene comprises the upward transfer of the community to the county hospital, the downward transfer of the county hospital to the community for the rehabilitation of the patient and the medical insurance control fee of the community.

The main flow of the patient's hospitalization is shown in fig. 2:

a general practitioner of a community signs a contract with residents in a management district, and undertakes the work of diagnosis and treatment, health management, cost management and the like of the signed residents;

after the resident is ill, the resident visits a diagnosis in the community through an appointment platform provided by the community after appointment, and a new diagnosis and treatment mode of diagnosis and treatment and payment after the diagnosis and treatment is adopted;

a longitudinal cooperation mechanism is formed between the community and the superior hospital, when a general practitioner finds that a patient is a disease which can not be handled by the community, the general practitioner can transfer the disease to the superior hospital for treatment according to the condition of the patient;

the upper hospital transfers the patients with stable illness state after treatment to the community for rehabilitation;

typical scenario for patient hospitalization-community referral to county hospital, as shown in fig. 3:

after the signed patient makes an appointment and registers, a general practitioner calls an electronic health file of the patient from an information platform of the comprehensive quality index monitoring system to diagnose, treat and dispense medicines for the patient;

when the general practitioner finds that the patient has serious or special illness and cannot be handled by the community or needs a superior hospital to further diagnose, the general practitioner sends a referral request to the information platform of the comprehensive quality index monitoring system. Here, three cases are included:

requiring further diagnosis, directly reserving the numbers of the departments corresponding to the registration to the superior hospital by the comprehensive quality index monitoring system information platform, and returning diagnosis and treatment results and related electronic medical record contents through the comprehensive quality index monitoring system information platform after diagnosis and treatment;

the community does not have required inspection and inspection equipment, the comprehensive quality index monitoring system information platform directly makes an appointment with a superior hospital for inspection and inspection, and the comprehensive quality index monitoring system information platform returns the inspection and inspection result;

and further treatment, including dispensing medicines, is required, because the community does not have a required treatment means or medicines, the comprehensive quality index monitoring system information platform directly applies for treatment appointment or medicines to the superior hospital, and treatment results are returned through the comprehensive quality index monitoring system information platform.

In the embodiments provided in the present application, it should be understood that the disclosed systems, modules and/or units may be implemented in other ways. For example, the above-described method embodiments are merely illustrative, and for example, the division of the modules is only one logical functional division, and other divisions may be realized in practice, for example, a plurality of modules or components may be combined or integrated into another system, or some features may be omitted, or not executed. The units described as separate parts may or may not be physically separate, and parts displayed as units may or may not be physical units, may be located in one place, or may be distributed on a plurality of network units. Some or all of the units can be selected according to actual needs to achieve the purpose of the solution of the embodiment.

The foregoing is only a partial embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and decorations can be made without departing from the principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.

Claims (6)

1. A regional health comprehensive quality index monitoring system is characterized by comprising an identity identification module, an interconnection module, a data integration module, a data utilization module, a service management module, a comprehensive quality index monitoring module, a regional coordination module and a data center;

the identity recognition module is used for uniquely recognizing the identity of the resident, acquiring the personal basic information of the resident and calling the information related to the health of the resident;

the interconnection module is used for connecting various interfaces to realize interconnection with an external system, information sharing with other modules and service cooperation;

the data integration module is used for realizing integration of various data through extraction conversion, quality control and modeling modes so as to support the operation of a data center;

the data utilization module is used for integrating various medical data to form unified classified data, and the data classification and integration are carried out according to the disease category, age, sex and data structure;

the business management module is used for analyzing according to health resources, medical services, public health, medical guarantees, drug management and health statistics by utilizing industrial production data, electronic medical records and health file data so as to promote management decision index display and analysis application construction, drive performance assessment and salary approval and realize public health information supervision of the mobile terminal;

the comprehensive quality index monitoring module is used for being in butt joint with a superior comprehensive quality index monitoring system according to a preset interface standard so as to realize data exchange and intercommunication of an upper platform and a lower platform, appointing an exchange standard specification through a unified data exchange platform, realize sharing of population health information with a superior platform and provide data resources for comprehensive management of a superior health administration;

the regional coordination module is used for assisting a management department to perform regular assessment on subordinate hospitals and community health service centers, including index management, scheme management, plan management and assessment management, and scoring the subordinate hospitals and the community health service centers;

the data center is used for managing and formulating the standards of the exchange data and the shared data in a unified way, each business department establishes a respective interface according to the data interface standard, and provides the data to the data exchange server in time according to the regulations so that the data exchange server can send the data to the data receiver to realize the access of the shared data.

2. The system of claim 1, wherein the administration of public health information comprises administration of medical services operations, administration of primary medications, administration of public health services, management of regional performance assessment;

the medical service operation supervision is used for collecting medical service operation data from subordinate medical institutions, wherein the medical service operation data comprises human resource service data, financial income and expenditure service data, and medicine, material, equipment and fixed asset service data, so that abundant service data query and statistical functions, analysis and arrangement functions are provided for the system to realize KPI monitoring and service operation alarming of the medical institutions, and data support is provided for macro policy making and management;

the basic medicine supervision is used for managing a national basic medicine catalog according to a national basic medication system, carrying out data acquisition integration and decision analysis support to realize supervision and management of the medicine use condition in the national basic medicine catalog of a medical institution in the whole area, and forming analysis on the medicine use amount, the money amount and the use frequency by using data processing and data analysis means to realize inquiry of individual medication condition and comparison of the medicine use condition;

the public health service supervision is used for carrying out statistical analysis on basic public health service conditions of community health service institutions in the jurisdictions, including health file management, disease prevention management, rehabilitation and nursing management, chronic disease management, maternal and child health care management, planned immunization, child health care, pregnant and lying-in woman follow-up visits, adult health physical examination, infectious disease reports, public health emergencies, disease deaths, birth population, infectious disease prevention and treatment, occupational disease prevention and treatment, toxic and harmful operations, health supervision and the like, and provides functions of inquiry, statistics, audit, printing and export so that managers can better master the health conditions of residents in the jurisdictions;

the regional performance assessment management is used for assisting the management department in periodically assessing subordinate hospitals and community health service centers, has the functions of index management, scheme management, assessment management and the like, and scores all assessed institutions according to a preset scheme.

3. The system of claim 1, wherein the comprehensive quality indicator monitoring module comprises disease monitoring management;

the disease monitoring management comprises diabetes management, hypertension management, cardiovascular and cerebrovascular management, tumor management, tuberculosis management and death management.

4. The system of claim 1, wherein the data exchange comprises a healthcare data exchange, a medical care data exchange, a public health data exchange, and a demographic information exchange.

5. The system of claim 1, wherein the sharing means mapping, extracting, caching, filtering and converting the collected data through a pre-ETL, a pre-data quality control, an application service agent, a message routing and a DICOM gateway to realize the control of the uploaded data quality.

6. The system of claim 1, wherein the overall quality index monitoring module comprises an integrated city-wide reservation medical resource pool and a bidirectional referral system, a city-wide general doctor contract service management system is built to promote overall quality index monitoring of the city, and a city-wide remote medical service platform is built to realize remote consultation, remote image diagnosis and remote electrocardiographic diagnosis of public health service institutions facing the city and the district, so as to realize intercommunication and sharing of examination images and reports of the city-wide medical health service institutions.

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