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CN102509000A - Method and system for centralized data transmission and display of clinical pathway - Google Patents

Method and system for centralized data transmission and display of clinical pathway Download PDF

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CN102509000A
CN102509000A CN2011103117136A CN201110311713A CN102509000A CN 102509000 A CN102509000 A CN 102509000A CN 2011103117136 A CN2011103117136 A CN 2011103117136A CN 201110311713 A CN201110311713 A CN 201110311713A CN 102509000 A CN102509000 A CN 102509000A
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clinical path
ward
outpatient service
ward node
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黄勋文
栾文宪
胡儿罗
鄢盛伟
李景强
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GUANGDONG JULONG INFORMATION TECHNOLOGY CO LTD
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Abstract

本发明公开了一种临床路径集中数据传输显示的方法和系统,本发明设置临床路径集中数据枢纽、门诊/病房节点、普通检索显示节点、高级手动查询/显示/修改节点,对于门诊/病房节点诸如①不遵守医疗行为时限、②不控制使用贵重药品、③超规定使用医疗耗材、④不合理变更等问题,本发明通过构建一个实时监控和预警反馈有机结合的临床路径集中数据传输显示的系统,由自动检测模块和普通检索显示节点提供数据信息支持,解决上述弊端。从而使临床路径的实施得以完善。

The present invention discloses a method and system for centralized data transmission and display of clinical pathways. The present invention sets a centralized data hub for clinical pathways, outpatient/ward nodes, common search and display nodes, and advanced manual query/display/modification nodes. For problems such as ① non-compliance with medical behavior time limits, ② uncontrolled use of expensive drugs, ③ excessive use of medical consumables, and ④ unreasonable changes in outpatient/ward nodes, the present invention solves the above-mentioned drawbacks by constructing a system for centralized data transmission and display of clinical pathways that organically combines real-time monitoring and early warning feedback, and data information support is provided by an automatic detection module and common search and display nodes. Thus, the implementation of clinical pathways can be improved.

Description

临床路径集中数据传输显示的方法和系统Method and system for centralized data transmission and display of clinical pathway

技术领域 technical field

本发明涉及一种计算机数据传输显示的方法和系统,尤其涉及一种临床路径集中数据传输显示的方法和系统。 The invention relates to a method and system for computer data transmission and display, in particular to a method and system for centralized data transmission and display of clinical pathways.

背景技术 Background technique

临床路径(Clinical pathway)是指针对某一疾病建立一套标准化治疗模式与治疗程序,是一个有关临床治疗的综合模式,以循证医学证据和指南为指导来促进治疗组织和疾病管理的方法,最终起到规范医疗行为,减少变异,降低成本,提高质量的作用。 Clinical pathway (Clinical pathway) refers to the establishment of a set of standardized treatment models and procedures for a certain disease. It is a comprehensive model of clinical treatment, guided by evidence-based medical evidence and guidelines to promote treatment organization and disease management. Ultimately, it plays a role in standardizing medical behavior, reducing variation, reducing costs, and improving quality.

临床路径是相对于传统路径而实施的,传统路径也即是每位医师的个人路径;不同地区、不同医院,不同的治疗组或者不同医师个人针对某一疾病可能采用不同的治疗方案,因此,传统路径因人而异。 The clinical pathway is implemented relative to the traditional pathway, which is the personal pathway of each doctor; different regions, different hospitals, different treatment groups or different individual physicians may adopt different treatment plans for a certain disease. Therefore, Traditional paths vary from person to person.

采用临床路径后,可以避免传统路径使同一疾病在不同地区、不同医院,不同的治疗组或者不同医师个人间出现不同的治疗方案,避免了随意性,高费用性等弊端。 After adopting the clinical pathway, it is possible to avoid the traditional pathway causing different treatment plans for the same disease in different regions, different hospitals, different treatment groups or different physicians, avoiding the disadvantages of arbitrariness and high cost.

同时,相对治疗指南,临床路径的内容更简洁,易读、适用于多学科多部门具体操作,是针对特定疾病的诊疗流程,临床路径更注重治疗过程中各专科间的协同性、治疗效果和时间性。 At the same time, compared with the treatment guidelines, the content of the clinical pathway is more concise, easy to read, applicable to multidisciplinary and multi-department specific operations, and is a diagnosis and treatment process for specific diseases. timeliness.

临床路径的制定是综合多学科医学知识的过程,这些学科包括临床、护理、药剂、检验、麻醉、营养、康复、心理以及医院管理。 The development of clinical pathways is a process of integrating multidisciplinary medical knowledge, including clinical, nursing, pharmacy, laboratory, anesthesia, nutrition, rehabilitation, psychology, and hospital management.

临床路径在使用过程中会不断更新,要力求与疾病的最新治疗标准或治疗指南保持一致,同时临床路径有自己的记录模式,该模式允许治疗方案根据病人的具体情况进行恰当的调整。 The clinical pathway will be constantly updated during use, and it must be consistent with the latest treatment standards or treatment guidelines for the disease. At the same time, the clinical pathway has its own recording mode, which allows the treatment plan to be adjusted appropriately according to the specific conditions of the patient.

当前许多发达国家已广泛采用临床路径,随着我国医疗保险制度的进行,临床路径也将被认识和推广。 At present, clinical pathways have been widely adopted in many developed countries. With the implementation of my country's medical insurance system, clinical pathways will also be recognized and promoted.

 临床路径的具体执行包含以下几方面内容:患者病历及病程记录,以日为单位的各种医疗活动多学科记录,治疗护理及相关医疗执行成员执行相关医疗活动后签字栏,变异记录表。 The specific implementation of the clinical pathway includes the following aspects: patient medical records and course records, multidisciplinary records of various medical activities on a daily basis, treatment and nursing and related medical executive members' signature column after performing relevant medical activities, and variation record form.

临床路径实施以来,效果显著,但是当前临床路径实施过程中,最急需解决的是:门诊/病房节点诸如①不遵守医疗行为时限、②不控制使用贵重药品、③超规定使用医疗耗材、④不合理变更等问题得不到有效的实时监控,从而使临床路径的实施流于形式。 Since the implementation of the clinical pathway, the effect has been remarkable. However, during the implementation of the current clinical pathway, the most urgent problems to be solved are: outpatient/ward nodes such as ① not complying with the time limit for medical behaviors, ② not controlling the use of expensive drugs, ③ exceeding the prescribed use of medical consumables, ④ not Problems such as reasonable changes cannot be effectively monitored in real time, thus making the implementation of clinical pathways a mere formality.

以上弊端在电子表单的数据传输和存储中,能够检测出来。 The above disadvantages can be detected in the data transmission and storage of the electronic form.

因此构建一个实时监控和预警反馈有机结合的临床路径系统是当务之急。 Therefore, it is imperative to construct a clinical pathway system that combines real-time monitoring and early warning feedback.

发明内容 Contents of the invention

为了解决临床路径实施过程中门诊/病房节点不遵守医疗行为时限、不控制使用贵重药品、超规定使用医疗耗材、不合理变更的问题,本发明提出一种临床路径集中数据传输显示的方法和系统,及时发现上述问题,在电子表单的数据传输和存储中,检测出相关信息,并及时处理,规范临床路径,优化临床路径。 In order to solve the problems that outpatient/ward nodes do not abide by the time limit for medical behavior, do not control the use of expensive medicines, use medical consumables beyond the regulations, and unreasonably change problems during the implementation of clinical pathways, the present invention proposes a method and system for centralized data transmission and display of clinical pathways , discover the above problems in time, detect relevant information in the data transmission and storage of the electronic form, and deal with it in time, standardize the clinical pathway, and optimize the clinical pathway.

进入患者实时临床路径库的临床路径表单分为病人管理、医嘱管理、路径管理、变异管理、统计分析五个部分,在最新更新的患者实时临床路径表单上出现上述记录差异时,表单自动生成差异消息钩子和提示数据包,此差异消息钩子和提示数据包只有在高级手动查询/显示/修改节点,才可以显示。 The clinical pathway form entering the patient's real-time clinical pathway database is divided into five parts: patient management, doctor's order management, pathway management, variation management, and statistical analysis. When the above-mentioned record differences appear on the latest updated patient's real-time clinical pathway form, the form will automatically generate a difference Message hook and prompt data package, the differential message hook and prompt data package can only be displayed in advanced manual query/display/modify nodes.

而在门诊/病房节点,看不到差异消息钩子和提示数据包。 In the outpatient/ward node, the difference message hook and prompt data package cannot be seen.

高管及时发现差异消息钩子和提示数据包,并及时处理,并有预警信息反馈给门诊/病房节点,实现规范临床路径,优化临床路径的目的。 The executives discover the difference message hooks and prompt data packets in time, and deal with them in a timely manner, and the early warning information is fed back to the outpatient/ward node, so as to achieve the purpose of standardizing and optimizing the clinical path.

在普通检索显示节点,患者持病员卡调用该卡号的临床路径数据进行显示,可以看到本卡对应最新的数据,如有疑问,可以放映给高管。 At the general retrieval display node, the patient holds the patient card to call the clinical path data of the card number for display, and can see the latest data corresponding to the card. If in doubt, it can be shown to the executives.

由高管和患者人为共管,由临床路径自动检测模块和普通检索显示节点提供数据信息支持,本发明解决了现有技术中所存在的弊端。 Co-management by executives and patients, and data information support provided by the clinical path automatic detection module and common retrieval display nodes, the present invention solves the drawbacks in the prior art.

本发明是通过采用以下的技术方案来实现的: The present invention is achieved by adopting the following technical solutions:

实施临床路径集中数据传输显示的方法,所述方法包括步骤: Implementing a method for data transmission and display in a clinical pathway set, the method includes the steps of:

a). 首先在医院设置临床路径集中数据枢纽,所述数据枢纽与呼吸内科门诊/病房节点、消化内科门诊/病房节点、神经内科门诊/病房节点、心脏内科门诊/病房节点、血液内科门诊/病房节点、肾内科门诊/病房节点、内分泌门诊/病房节点、普通外科门诊/病房节点、神经外科门诊/病房节点、骨科门诊/病房节点、泌尿外科门诊/病房节点、胸外科门诊/病房节点、心脏外科门诊/病房节点、妇科门诊/病房节点、产科门诊/病房节点、儿科门诊/病房节点、小儿外科门诊/病房节点、眼科门诊/病房节点、耳鼻喉科门诊/病房节点、口腔科门诊/病房节点、皮肤科门诊/病房节点、肿瘤科门诊/病房节点中的至少一个,通过通信链路进行数据通信连接; a). First, set up a centralized data hub for clinical pathways in the hospital. Ward node, nephrology clinic/ward node, endocrinology clinic/ward node, general surgery clinic/ward node, neurosurgery clinic/ward node, orthopedic clinic/ward node, urology clinic/ward node, thoracic surgery clinic/ward node, Cardiac surgery clinic/ward node, gynecology clinic/ward node, obstetrics clinic/ward node, pediatric clinic/ward node, pediatric surgery clinic/ward node, ophthalmology clinic/ward node, ENT clinic/ward node, stomatology clinic/ At least one of the ward node, the dermatology clinic/ward node, and the oncology clinic/ward node is connected through a communication link for data communication;

b).然后将所述临床路径集中数据枢纽与临床路径标准模型库、患者实时临床路径库、临床路径自动检测模块中的至少一个进行数据通信连接; b). Then, the centralized data hub of the clinical pathway is connected to at least one of the clinical pathway standard model library, the patient's real-time clinical pathway library, and the clinical pathway automatic detection module for data communication;

所述临床路径集中数据枢纽还与至少一个普通检索显示节点通过通信链路进行数据通信连接; The clinical pathway centralized data hub is also connected to at least one general retrieval display node through a communication link for data communication;

c).然后在各门诊/病房节点设置医生读卡器,该读卡器对应医生卡,通过打卡启用医生主机,或是在医生键盘上录入医生密码启用医生主机进行包括建立患者临床路径表单,以日为单位的表单更新,医生护士医疗护理检验记录签字,变异记录,分析记载的操作; c). Then set up a doctor card reader in each outpatient/ward node. The card reader corresponds to the doctor card. The doctor host can be activated by punching the card, or the doctor’s password can be entered on the doctor’s keyboard to enable the doctor host, including the establishment of the patient’s clinical path form. Update the form on a daily basis, sign the medical care inspection records of doctors and nurses, change records, and analyze and record operations;

d).然后在普通检索显示节点,设置病员读卡器,患者持病员卡,通过打卡开通普通主机,普通主机通过通信链路连接临床路径集中数据枢纽,临床路径集中数据枢纽连接患者实时临床路径库,调用该卡号的临床路径数据进行显示; d). Then set up a patient card reader at the general retrieval display node. The patient holds a patient card and opens the general host by punching the card. The common host connects to the centralized data hub of the clinical path through the communication link, and the centralized data hub of the clinical path connects the real-time clinical path of the patient. Library, call the clinical pathway data of the card number for display;

e).再设置一临床路径自动检测模块与临床路径集中数据枢纽通信连接,并实时检测患者实时临床路径库中各个表单更新标记、医疗护理检验记录、变异记录,形成差异消息钩子和提示数据包。 e). Set up a clinical path automatic detection module to communicate with the clinical path centralized data hub, and detect each form update mark, medical care inspection record, and variation record in the patient's real-time clinical path library in real time to form a difference message hook and prompt data package .

所述通信链路是工业控制总线、互联网、局域网、无线网络中的至少一种。 The communication link is at least one of an industrial control bus, the Internet, a local area network, and a wireless network.

所述所述临床路径集中数据枢纽还与至少一个高级手动查询/显示/修改节点通过通信链路进行数据通信连接; The centralized clinical pathway data hub is also connected to at least one advanced manual query/display/modification node through a communication link for data communication;

在高级手动查询/显示/修改节点,设置有高管读卡器,该读卡器对应高管卡,通过打卡启用高管主机,或是在高管键盘上录入高管密码启用高管主机,高管主机启用后,发给临床路径集中数据枢纽一高管在线信号,然后临床路径集中数据枢纽将患者实时临床路径库中的差异消息钩子和提示数据包,发给高管主机接收,并显示,使能进行下一步操作的命令提示。 In the advanced manual query/display/modification node, there is an executive card reader, which corresponds to the executive card, and the executive host can be enabled by punching the card, or by entering the executive password on the executive keyboard to enable the executive host. After the executive host is enabled, it will send an executive online signal to the centralized clinical path data hub, and then the centralized clinical path data hub will send the difference message hook and prompt data package in the patient's real-time clinical path library to the executive host to receive and display , to enable a command prompt for the next step.

所述建立患者临床路径表单,包括从临床路径标准模型库调用该患者病种的国家标准模型表单数据以及从患者实时临床路径库中调用至少一个相同病例的表单数据,进行比对后,选其一录入患者信息及路径信息,然后将该临床路径表单存入患者实时临床路径库。 Said establishment of the patient's clinical path form includes calling the national standard model form data of the patient's disease from the clinical path standard model library and calling the form data of at least one identical case from the patient's real-time clinical path library. 1. Enter patient information and path information, and then store the clinical path form in the patient's real-time clinical path database.

所述病员卡、医生卡、高管卡是RFID标签、碰触卡中的一种。 The patient card, doctor card and executive card are one of RFID tags and touch cards.

实现上述方法的临床路径集中数据传输显示的系统,所述系统包括: A system for centralized data transmission and display of clinical pathways for realizing the above method, the system comprising:

一临床路径集中数据枢纽,所述数据枢纽与呼吸内科门诊/病房节点、消化内科门诊/病房节点、神经内科门诊/病房节点、心脏内科门诊/病房节点、血液内科门诊/病房节点、肾内科门诊/病房节点、内分泌门诊/病房节点、普通外科门诊/病房节点、神经外科门诊/病房节点、骨科门诊/病房节点、泌尿外科门诊/病房节点、胸外科门诊/病房节点、心脏外科门诊/病房节点、妇科门诊/病房节点、产科门诊/病房节点、儿科门诊/病房节点、小儿外科门诊/病房节点、眼科门诊/病房节点、耳鼻喉科门诊/病房节点、口腔科门诊/病房节点、皮肤科门诊/病房节点、肿瘤科门诊/病房节点中的至少一个,通过通信链路进行数据通信连接; A centralized data hub for clinical pathways, the data hub is related to respiratory medicine outpatient/ward node, gastroenterology outpatient/ward node, neurology outpatient/ward node, cardiology outpatient/ward node, hematology outpatient/ward node, nephrology outpatient /ward node, endocrinology clinic/ward node, general surgery clinic/ward node, neurosurgery clinic/ward node, orthopedic clinic/ward node, urology clinic/ward node, thoracic surgery clinic/ward node, cardiac surgery clinic/ward node , Gynecology clinic/ward node, obstetrics clinic/ward node, pediatric clinic/ward node, pediatric surgery clinic/ward node, ophthalmology clinic/ward node, ENT clinic/ward node, stomatology clinic/ward node, dermatology clinic At least one of the /ward node and the oncology clinic/ward node is connected through a communication link for data communication;

所述临床路径集中数据枢纽还与临床路径标准模型库、患者实时临床路径库、临床路径自动检测模块中的至少一个进行数据通信连接; The clinical pathway centralized data hub is also connected to at least one of the clinical pathway standard model library, the patient's real-time clinical pathway library, and the clinical pathway automatic detection module for data communication;

所述临床路径集中数据枢纽还与至少一个普通检索显示节点通过通信链路进行数据通信连接; The clinical pathway centralized data hub is also connected to at least one general retrieval display node through a communication link for data communication;

在各门诊/病房节点,设置有医生读卡器,该读卡器对应医生卡,通过打卡启用医生主机,或是在医生键盘上录入医生密码启用医生主机进行包括建立患者临床路径表单,以日为单位的表单更新,医生护士医疗护理检验记录签字,变异记录,分析记载的操作; In each outpatient/ward node, a doctor card reader is set up. The card reader corresponds to the doctor card. The doctor host is activated by punching the card, or the doctor’s host is enabled by entering the doctor’s password on the doctor keyboard, including the establishment of the patient’s clinical path form. Form update for the unit, doctors and nurses medical care inspection record signature, variation record, analysis record operation;

在普通检索显示节点,设置有病员读卡器,患者持病员卡,通过打卡开通普通主机,然后通过通信链路连接临床路径集中数据枢纽,调用该卡号的临床路径数据进行显示; In the general retrieval display node, a patient card reader is set up, and the patient holds the patient card, opens the general host by punching the card, and then connects the clinical path centralized data hub through the communication link, and calls the clinical path data of the card number for display;

一临床路径自动检测模块与临床路径集中数据枢纽通信连接,并实时检测患者实时临床路径库中各个表单更新标记、医疗护理检验记录、变异记录,形成差异消息钩子和提示数据包。 A clinical path automatic detection module communicates with the clinical path centralized data hub, and detects each form update mark, medical care inspection record, and variation record in the patient's real-time clinical path library in real time, forming a difference message hook and a prompt data package.

所述通信链路是工业控制总线、互联网、局域网、无线网络中的至少一种。 The communication link is at least one of an industrial control bus, the Internet, a local area network, and a wireless network.

所述临床路径集中数据枢纽还与至少一个高级手动查询/显示/修改节点通过通信链路进行数据通信连接; The clinical pathway centralized data hub is also connected to at least one advanced manual query/display/modification node through a communication link for data communication;

在高级手动查询/显示/修改节点,设置有高管读卡器,该读卡器对应高管卡,通过打卡启用高管主机,或是在高管键盘上录入高管密码启用高管主机进行下一步操作。 In the advanced manual query/display/modification node, there is an executive card reader, which corresponds to the executive card, and the executive host can be enabled by punching in the card, or the executive host can be activated by entering the executive password on the executive keyboard. Next step.

所述病员卡、医生卡、高管卡是RFID标签、碰触卡中的一种。 The patient card, doctor card and executive card are one of RFID tags and touch cards.

与现有技术相比较,本发明由电子技术的硬件设置三级权限,对临床路径实施过程中迫切需要解决的门诊/病房节点不遵守医疗行为时限、不控制使用贵重药品、超规定使用医疗耗材、不合理变更的问题,由高管和患者人为共管,由临床路径自动检测模块和普通检索显示节点提供数据信息支持,解决了上述弊端。 Compared with the existing technology, the present invention sets three levels of authority by the hardware of electronic technology, and the outpatient/ward nodes that urgently need to be solved during the implementation of the clinical path do not abide by the time limit for medical behavior, do not control the use of expensive medicines, and use medical consumables beyond the regulations , The problem of unreasonable changes is jointly managed by executives and patients, and the data information support is provided by the clinical path automatic detection module and ordinary retrieval display nodes, which solves the above-mentioned drawbacks.

本发明完善了临床路径的管理,真正实现提高医院的运行效率,改善医护质量,降低医疗费用的目的。 The present invention improves the management of clinical pathways, and truly realizes the purpose of improving hospital operation efficiency, improving medical care quality, and reducing medical expenses.

本发明具有成本低、效率高,方便、可信、安全的优点。 The invention has the advantages of low cost, high efficiency, convenience, reliability and safety.

附图说明 Description of drawings

图1是本发明临床路径集中数据传输显示的方法和系统的系统设置示意图; Fig. 1 is a schematic diagram of the system setting of the method and system for centralized data transmission and display of clinical pathways of the present invention;

图2是本发明临床路径集中数据传输显示的方法和系统中普通检索显示节点的示意图; Fig. 2 is a schematic diagram of common retrieval and display nodes in the method and system for centralized data transmission and display of clinical pathways of the present invention;

图3是本发明临床路径集中数据传输显示的方法和系统中高级手动查询/显示/修改节点示意图; Fig. 3 is a schematic diagram of high-level manual query/display/modification nodes in the method and system for centralized data transmission and display of clinical pathways of the present invention;

图4是本发明临床路径集中数据传输显示的方法和系统中门诊/病房节点示意图; Fig. 4 is a schematic diagram of outpatient/ward nodes in the method and system for centralized data transmission and display of clinical pathways of the present invention;

图5是本发明临床路径集中数据传输显示的方法和系统中临床路径标准定义界面的示意图; Fig. 5 is a schematic diagram of the clinical pathway standard definition interface in the method and system for centralized data transmission and display of clinical pathways of the present invention;

图6是本发明临床路径集中数据传输显示的方法和系统中临床路径执行界面的示意图; Fig. 6 is a schematic diagram of the clinical path execution interface in the method and system for centralized data transmission and display of the clinical path of the present invention;

图7是本发明临床路径集中数据传输显示的方法和系统中临床路径使用查询界面的示意图; Fig. 7 is a schematic diagram of the clinical path use query interface in the method and system for the centralized data transmission and display of the clinical path of the present invention;

图8是本发明临床路径集中数据传输显示的方法和系统中临床路径差异查询界面的示意图; Fig. 8 is a schematic diagram of the clinical path difference query interface in the method and system of the present invention for centralized data transmission and display of clinical paths;

图9是本发明临床路径集中数据传输显示的方法和系统中临床路径常用数据统计界面的示意图。 FIG. 9 is a schematic diagram of the common data statistics interface of clinical pathways in the method and system for centralized data transmission and display of clinical pathways of the present invention.

具体实施方式 Detailed ways

下面结合附图所示的最佳实施例对本发明作进一步详尽的描述,如图1~图9所示: Below in conjunction with the preferred embodiment shown in the accompanying drawings, the present invention will be further described in detail, as shown in Figures 1 to 9:

一个本发明临床路径集中数据传输显示的系统如图1,图1中门诊节点按照中华人民共和国卫生部最新下发临床路径标准病种分为22个科室共有317种疾病。 A system for centralized data transmission and display of clinical pathways according to the present invention is shown in Figure 1. In Figure 1, the outpatient nodes are divided into 22 departments with a total of 317 diseases according to the latest clinical pathway standard diseases issued by the Ministry of Health of the People's Republic of China.

这22个科室为:呼吸内科门诊/病房节点、消化内科门诊/病房节点、神经内科门诊/病房节点、心脏内科门诊/病房节点、血液内科门诊/病房节点、肾内科门诊/病房节点、内分泌门诊/病房节点、普通外科门诊/病房节点、神经外科门诊/病房节点、骨科门诊/病房节点、泌尿外科门诊/病房节点、胸外科门诊/病房节点、心脏外科门诊/病房节点、妇科门诊/病房节点、产科门诊/病房节点、儿科门诊/病房节点、小儿外科门诊/病房节点、眼科门诊/病房节点、耳鼻喉科门诊/病房节点、口腔科门诊/病房节点、皮肤科门诊/病房节点、肿瘤科门诊/病房节点。 The 22 departments are: respiratory medicine clinic/ward node, gastroenterology clinic/ward node, neurology clinic/ward node, cardiology clinic/ward node, hematology clinic/ward node, nephrology clinic/ward node, endocrinology clinic /ward node, general surgery clinic/ward node, neurosurgery clinic/ward node, orthopedics clinic/ward node, urology clinic/ward node, thoracic surgery clinic/ward node, cardiac surgery clinic/ward node, gynecology clinic/ward node , Obstetrics clinic/ward node, Pediatric clinic/ward node, Pediatric surgery clinic/ward node, Ophthalmology clinic/ward node, Otorhinolaryngology clinic/ward node, Stomatology clinic/ward node, Dermatology clinic/ward node, Oncology Outpatient/ward node.

使用中,选择何种疾病进入临床路径管理可以因地制宜,选择其中至少一个通过通信链路进行数据通信连接; In use, the choice of which disease to enter into clinical pathway management can be tailored to local conditions, and at least one of them is selected for data communication connection through a communication link;

可以将“检查”另外设置节点,其权限等级与门诊/病房节点平级,也可以在门诊/病房节点录入检查的信息。 "Examination" can be set as another node, and its authority level is the same as that of the outpatient/ward node, and the inspection information can also be entered in the outpatient/ward node.

临床路径集中数据枢纽100,可以是一组导线接口,可以是包括智能控制器和导线接口的设备。 The centralized clinical pathway data hub 100 may be a set of wire interfaces, or a device including an intelligent controller and wire interfaces.

智能控制器担负网络运行驱动的任务,或是工业控制总线系统,或是局域网,或是无线局域网;采用什么网,就用什么网络的驱动设备和接口。 The intelligent controller is responsible for the task of driving the network operation, or the industrial control bus system, or the local area network, or the wireless local area network; whatever network is used, the drive equipment and interface of the network are used.

智能控制器还有一个任务是负责临床路径数据信息的传递。 Another task of the intelligent controller is to be responsible for the transmission of clinical path data information.

智能控制器可以称为服务器,临床路径标准模型库50可以设在其中,也可以另外设置,通过通信链路99连通。 The intelligent controller can be called a server, and the clinical path standard model library 50 can be set in it, or can be set separately, and communicated through the communication link 99 .

患者实时临床路径库60可以设在其中,也可以另外设置,通过通信链路99连通。上述两库以设置在服务器中为佳。 The patient's real-time clinical pathway library 60 can be set in it, or can be set separately, and communicated through the communication link 99 . It is better to set the above two libraries in the server.

普通检索显示节点7A可以设置一个以上,方便患者及家属查询,通过通信链路99与临床路径集中数据枢纽100连通。 There can be more than one general search display node 7A, which is convenient for patients and family members to inquire, and communicates with the clinical path centralized data hub 100 through the communication link 99 .

高级手动查询/显示/修改节点8A通过通信链路99与临床路径集中数据枢纽100连通。 The advanced manual query/display/modification node 8A communicates with the clinical pathway centralized data hub 100 through the communication link 99 .

临床路径自动检测模块90最佳的设置在服务器中,也可以设置在高级手动查询/显示/修改节点8A中。 The clinical path automatic detection module 90 is optimally set in the server, and can also be set in the advanced manual query/display/modification node 8A.

如图2所示,在一个普通检索显示节点7A中,病员卡311可以是RFID无线电子标签,也可以是碰触卡,在此应用,二者的功能基本相当,但RFID无线电子标签价格要低很多。 As shown in Figure 2, in a common search and display node 7A, the patient card 311 can be an RFID wireless electronic tag or a touch card. In this application, the functions of the two are basically the same, but the price of the RFID wireless electronic tag is higher. much lower.

普通检索显示节点有普通显示器411、普通主机451、普通打卡器441。在此节点没有键盘,不能录入/修改数据。普通打卡器441的权限等级是最低的。 Common retrieval display nodes include common display 411 , common host 451 and common puncher 441 . There is no keyboard at this node, and data cannot be entered/modified. The permission level of the common puncher 441 is the lowest.

如图3所示,高级手动查询/显示/修改节点8A中的高级打卡器443权限等级最高,只有高管卡313才可以打卡成功,才能启用高管主机423,高管显示器413、高管键盘433用于显示和录入/修改。 As shown in Figure 3, the advanced manual check/display/modify advanced check-in device 443 in node 8A has the highest authority level, and only the executive card 313 can punch in successfully, and then the executive host 423, executive monitor 413, and executive keyboard can be enabled. 433 is used for display and entry/modification.

如图4所示,门诊/病房节点示出了22对,实际使用时会少于这个数字,如前所述,检查节点可以归类于门诊/病房节点,医生卡312,只可以在本门诊/病房节点上的医生打卡器442上使用,不能去其他门诊/病房节点使用,也不能去检查节点和高级手动查询/显示/修改节点使用,但可以在普通打卡器441上普通打卡器441打卡使用。 As shown in Figure 4, the outpatient/ward node shows 22 pairs, which will be less than this number in actual use. As mentioned above, the check node can be classified into the outpatient/ward node, and the doctor card 312 can only be used in this outpatient It can be used on the doctor's punch card 442 on the /ward node, and cannot be used on other outpatient/ward nodes, nor can it be used on inspection nodes and advanced manual query/display/modify nodes, but it can be used on the normal clock 441 on the normal clock 441 use.

医生卡312由医生、护士、检验师持有。 The doctor card 312 is held by doctors, nurses, and examiners.

医生显示器412、医生主机422、医生键盘432是标准配置。 Doctor display 412, doctor host 422, doctor keyboard 432 are standard configurations.

如图5所示,图5定义了临床路径的步骤及项目。以及临床路径可关联的临床文档,项目,且可设置各种信息,如执行路径后医嘱为长嘱还是临嘱设置。 As shown in Figure 5, Figure 5 defines the steps and items of the clinical pathway. And the clinical documents and items that can be associated with the clinical path, and various information can be set, such as whether the doctor's order is long-term or temporary after the path is executed.

每个路径可有多个版本,定义完后发布做为一个版本,若路径标准有变化,可再次定义发布存新的版本。 Each path can have multiple versions. After definition, publish it as a version. If the path standard changes, you can define and release a new version again.

如图6所示,图6显示路径中患者采用是否路径患者标志显示。 As shown in Fig. 6, Fig. 6 shows that the patients in the path are displayed with the whether path patient sign.

医嘱录入模块中准入路径后,在此模块按路径定义的步骤执行,可从临床路径中定义的项目选择需要执行的步骤。 After the path is entered in the doctor's order entry module, this module will be executed according to the steps defined in the path, and the steps to be executed can be selected from the items defined in the clinical path.

路径有变异时,填写路径差异说明,如路径准出,路径调整等原因。 When there is a variation in the path, fill in the path difference description, such as the reason for the path to be out, path adjustment, etc.

执行后自动产生相关联的医嘱。 After execution, the associated medical orders are automatically generated.

如图7所示,可根据科室,路径,日期查询路径的使用情况。 As shown in Figure 7, the use of the path can be queried according to the department, path, and date.

如图8所示,可根据科室,路径,日期查询路径的差异及差异说明。 As shown in Figure 8, the differences and descriptions of the paths can be queried according to departments, paths, and dates.

可查项目差异,时间差异。 You can check project differences and time differences.

不同的路径版本使用统计。 Different path version usage statistics.

如图9所示界面,可以根据日期,科室,路径名称来统计人数,入径率、变异率、退出率、平均值。 The interface shown in Figure 9 can count the number of people, entry rate, variation rate, exit rate, and average value according to date, department, and path name.

变异的定义:变异是假设的标准临床路经与实际过程出现了偏离,与任何预期的决定相比有所变化的称为变异。变异的分类:实施临床路径时有时会产生变异,即任何不同于临床路径的偏差。变异有正负之分,负变异是指计划好的活动没有进行(或结果没有产生),或推迟完成,如延迟出院、CT检查延迟;正变异是指计划好的活动或结果提前进行或完成,如提前出院、CT检查提前等。变异可分为病人/家庭的变异、医院/系统的变异、临床工作者/服务提供者的变异。 Definition of Variance: Variance is the deviation between the assumed standard clinical pathway and the actual process, compared with any expected decision. Classification of Variations: Variation, ie any deviation from the clinical pathway, is sometimes introduced when implementing the clinical pathway. Variation can be divided into positive and negative. Negative variation means that the planned activities are not carried out (or the results are not produced), or the completion is delayed, such as delayed discharge, CT examination delay; positive variation means that the planned activities or results are carried out or completed ahead of schedule. , Such as early discharge, CT examination, etc. Variance can be divided into patient/family variation, hospital/system variation, and clinician/provider variation.

应对变异的措施包括:收集、记录变异,在临床路径变异记录单上记录与病人有关的变异,其他变异记录在科室的变异记录本上;分析变异,确定是不是变异,引起变异的原因,同一变异的发生率是多少,是否应该修改临床路径等。 Measures to deal with variation include: collecting and recording variation, recording patient-related variation on the clinical pathway variation record sheet, and recording other variation in the variation record book of the department; analyzing the variation to determine whether it is a variation, the cause of the variation, the same What is the incidence of variation, should the clinical pathway be modified, etc.

临床路径是一种新的医院管理模式,它可以提高医院的运行效率,改善医护质量,降低医疗费用,因此许多发达国家已广泛采用。我国临床路径也将大力推广。 The clinical pathway is a new hospital management model, which can improve the operating efficiency of the hospital, improve the quality of medical care, and reduce medical expenses, so it has been widely adopted in many developed countries. my country's clinical pathway will also be vigorously promoted.

实施临床路径,要求在实际应用中,不断遵循疾病指南、循证医学的进展调整路径的实施细则,使之符合医学科学的发展,从而提供给患者最新的治疗手段与最优化的治疗方案;实施临床路径,可以加强学科之间、医护之间、部门之间的交流;保证治疗项目精细化、标准化、程序化,减少治疗过程的随意化;提高医院资源的管理和利用,加强临床治疗的风险控制;缩短住院周期,减低费用;实施临床路径,还可以为无相关经验人员提供教育学习机会;同时,改善病人教育,提高病人及家属参与治疗过程的主动性也是实施临床路径的内容。 The implementation of the clinical path requires that in practical application, the implementation rules of the disease guidelines and the progress adjustment path of evidence-based medicine should be continuously followed to make it conform to the development of medical science, so as to provide patients with the latest treatment methods and optimized treatment plans; implementation The clinical path can strengthen the communication between disciplines, between doctors and nurses, and between departments; ensure the refinement, standardization, and stylization of treatment items, reduce the randomization of the treatment process; improve the management and utilization of hospital resources and strengthen the risk of clinical treatment Controlling; shortening the hospitalization period and reducing costs; implementing clinical pathways can also provide educational and learning opportunities for people without relevant experience; at the same time, improving patient education and increasing the initiative of patients and their families to participate in the treatment process is also the content of implementing clinical pathways.

 对于门诊/病房节点诸如①不遵守医疗行为时限、②不控制使用贵重药品、③超规定使用医疗耗材、④不合理变更等问题,本发明通过构建一个实时监控和预警反馈有机结合的临床路径集中数据传输显示的方法和系统,从而使临床路径的实施得以完善。 For outpatient / ward nodes such as ① non-compliance with the time limit for medical behaviors, ② non-control of the use of expensive medicines, ③ excessive use of medical consumables, ④ unreasonable changes, etc., the present invention builds a centralized clinical path that combines real-time monitoring and early warning feedback. Methods and systems for data transfer display, thereby enabling the implementation of clinical pathways to be refined.

以上内容是结合具体的优选实施方式对本发明所作的进一步详细说明,不能认定本发明的具体实施只局限于这些说明。对于本发明所属技术领域的普通技术人员来说,在不脱离本发明构思的前提下,还可以做出若干简单推演或替换,都应当视为属于本发明的保护范围。 The above content is a further detailed description of the present invention in conjunction with specific preferred embodiments, and it cannot be assumed that the specific implementation of the present invention is limited to these descriptions. For those of ordinary skill in the technical field of the present invention, without departing from the concept of the present invention, some simple deduction or replacement can be made, which should be regarded as belonging to the protection scope of the present invention.

Claims (9)

1. the method for a clinical path intensive data transmitting and displaying is characterized in that, said method comprises step:
A). at first clinical path intensive data hinge is set in hospital; In said data hinge and Respiratory Medicine outpatient service/ward node, GI Medicine outpatient service/ward node, Neurology Clinic/ward node, heart internal medicine outpatient service/ward node, blood internal medicine outpatient service/ward node, Nephrology dept.'s outpatient service/ward node, endocrine outpatient service/ward node, General Surgery Clinic/ward node, Neurosurgery Clinic/ward node, Orthopaedics Clinic/ward node, Urologic Surgery Clinic/ward node, Thoracic Surgery Clinic/ward node, department of cardiac surgery's outpatient service/ward node, gynaecology's outpatient service/ward node, obstetrics' outpatient service/ward node, Pediatric Clinic/ward node, pediatric surgery's outpatient service/ward node, ophthalmology outpatient service/ward node, ear-nose-throat department outpatient service/ward node, Stomatology Clinic/ward node, dept. of dermatology's outpatient service/ward node, the oncology outpatient service/ward node at least one carried out data communication through communication link and connected;
B). then in said clinical path intensive data hinge and clinical path master pattern storehouse, the real-time clinical path of patient storehouse, the automatic detection module of clinical path at least one carried out data communication and be connected;
Said clinical path intensive data hinge also shows that with at least one common retrieval node carries out data communication through communication link and is connected;
C). at each outpatient service/ward node doctor's card reader (442) is set then; The corresponding doctor's card (312) of this card reader is launched doctor's main frame (422) through checking card, or goes up typing doctor password at doctor's keyboard (432) and launch doctor's main frame (422) and comprise and set up patient's clinical path list; With the day is the list renewal of unit; The signature of doctors and nurses's medical treatment and nursing inspection record, the operation of record analyzed in the variation record;
D). show node in common retrieval then; Patient's card reader (441) is set; The patient holds patient's card (311), opens normal hosts (451) through checking card, and normal hosts (451) connects clinical path intensive data hinge through communication link (99); Clinical path intensive data hinge connects the real-time clinical path of patient storehouse, and the clinical path data of calling this card number show;
E). the automatic detection module of a clinical path is set again communicates by letter with clinical path intensive data hinge and be connected; And detect each list update mark in the real-time clinical path of the patient storehouse, medical treatment and nursing inspection record, variation record in real time, form difference message hook and reminder-data bag.
2. the method for clinical path intensive data transmitting and displaying according to claim 1 is characterized in that:
Said communication link is at least a in industrial-controlled general line, internet, LAN, the wireless network.
3. the method for clinical path intensive data transmitting and displaying according to claim 1 is characterized in that:
Said clinical path intensive data hinge also carries out data communication with at least one senior manual queries/demonstration/modification node through communication link and is connected;
At senior manual queries/demonstration/modification node, be provided with senior executive's card reader (443), the corresponding high pipe clamp (313) of this card reader; Launch senior executive's main frame (423) through checking card; Or go up typing senior executive password at senior executive's keyboard (433) and launch senior executive's main frame (423), after senior executive's main frame (423) is launched, issue the online signal of clinical path intensive data hinge one senior executive; Clinical path intensive data hinge is with difference message hook and reminder-data bag in the real-time clinical path of the patient storehouse then; Issue senior executive's main frame (423) and receive, and show the command cue that enables to carry out next step operation.
4. the method for clinical path intensive data transmitting and displaying according to claim 1 is characterized in that:
Said patient's clinical path list of setting up; Comprise from sick national standard model form data of planting of this patient of clinical path master pattern library call and the form data that from the real-time clinical path of patient storehouse, calls at least one identical case; After comparing; Select one of which typing patient information and routing information, deposit this clinical path list in the real-time clinical path of patient storehouse then.
5. according to the method for claim 1 or 3 described clinical path intensive data transmitting and displaying, it is characterized in that:
Said patient's card (311), doctor's card (312), high pipe clamp (313) be the RFID label, touch a kind of in the card.
6. the system of a clinical path intensive data transmitting and displaying is characterized in that, said system comprises:
One clinical path intensive data hinge; In said data hinge and Respiratory Medicine outpatient service/ward node, GI Medicine outpatient service/ward node, Neurology Clinic/ward node, heart internal medicine outpatient service/ward node, blood internal medicine outpatient service/ward node, Nephrology dept.'s outpatient service/ward node, endocrine outpatient service/ward node, General Surgery Clinic/ward node, Neurosurgery Clinic/ward node, Orthopaedics Clinic/ward node, Urologic Surgery Clinic/ward node, Thoracic Surgery Clinic/ward node, department of cardiac surgery's outpatient service/ward node, gynaecology's outpatient service/ward node, obstetrics' outpatient service/ward node, Pediatric Clinic/ward node, pediatric surgery's outpatient service/ward node, ophthalmology outpatient service/ward node, ear-nose-throat department outpatient service/ward node, Stomatology Clinic/ward node, dept. of dermatology's outpatient service/ward node, the oncology outpatient service/ward node at least one carried out data communication through communication link and connected;
Said clinical path intensive data hinge also with clinical path master pattern storehouse, the real-time clinical path of patient storehouse, the automatic detection module of clinical path at least one carry out data communication and be connected;
Said clinical path intensive data hinge also shows that with at least one common retrieval node carries out data communication through communication link and is connected;
At each outpatient service/ward node, be provided with doctor's card reader (442), the corresponding doctor's card (312) of this card reader; Launch doctor's main frame (422) through checking card; Or go up typing doctor password at doctor's keyboard (432) and launch doctor's main frame (422) and comprise and set up patient's clinical path list, be that the list of unit upgrades with the day, the signature of doctors and nurses's medical treatment and nursing inspection record; The operation of record analyzed in the variation record;
Show node in common retrieval; Be provided with patient's card reader (441), the patient holds patient's card (311), opens normal hosts (451) through checking card; Connect clinical path intensive data hinge through communication link (99) then, the clinical path data of calling this card number show;
The automatic detection module of one clinical path is communicated by letter with clinical path intensive data hinge and is connected, and detects each list update mark in the real-time clinical path of the patient storehouse, medical treatment and nursing inspection record, variation record in real time, forms difference message hook and reminder-data bag.
7. the system of clinical path intensive data transmitting and displaying according to claim 6 is characterized in that:
Said communication link is at least a in industrial-controlled general line, internet, LAN, the wireless network.
8. the system of clinical path intensive data transmitting and displaying according to claim 6 is characterized in that:
Said clinical path intensive data hinge also carries out data communication with at least one senior manual queries/demonstration/modification node through communication link and is connected;
At senior manual queries/demonstration/modification node; Be provided with senior executive's card reader (443); The corresponding high pipe clamp (313) of this card reader is launched senior executive's main frame (423) through checking card, or launches senior executive's main frame (423) at the last typing senior executive password of senior executive's keyboard (433) and carry out next step operation.
9. according to the system of claim 6 or 8 described clinical path intensive data transmitting and displaying, it is characterized in that:
Said patient's card (311), doctor's card (312), high pipe clamp (313) be the RFID label, touch a kind of in the card.
CN2011103117136A 2011-10-14 2011-10-14 Method and system for centralized data transmission and display of clinical pathway Pending CN102509000A (en)

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