康复医疗信息系统的设计和实现
摘要
医院信息系统已从重在费用信息管理的阶段逐渐发展到面向临床医疗信息管理的阶段,临床信息系统的目标是为医院的临床诊疗活动提供一个自动化的操作平台,达到减轻劳动强度、提高工作效率、整合医疗资源、积累医疗知识、降低操作差错、改善诊疗质量、提高服务水平、辅助临床决策的目的。医院里很多疾病需要配合康复理疗,因此康复理疗医护人员需要与其他科室的临床医生建立长期、密切的沟通和联系。目前国内外尚无用于康复医学的临床专科信息系统,导致康复理疗的一些宝贵的治疗信息无法采集、存储和共享,造成医疗信息的严重丢失。
针对上述的实际问题,本课题以广州军区总医院的康复医疗信息管理为研究对象,利用先进的微软可视化开发平台Visual Studio 2008结合大型数据库技术Oracle 10g,设计和开发了一个基于B/S结构用ASP. NET 3.5 (C#)实现的临床信息系统,旨在为医院康复理疗科的日常治疗处理、数据统计分析和辅助决策参考提供一套完整且经济可行的解决方案。建立以病人为中心的康复医疗信息管理和共享,作为电子病历的一部分,不仅可以在一定程度上减轻医护人员的劳动强度,提高工作效率和工作质量,而且可以更及时、准确、有效地分析统计各种工作量数据及管理数据,供上级主管部门做出科学的管理决策,促进医院管理水平的进一步提高,本系统的开发具有一定的创新和实用意义。
本文首先对医院信息系统的发展现状和本系统开发背景进行必要的说明,本系统定义为“康复医疗信息系统”,属于面向诊疗信息的临床信息系统,存储的数据将作为电子病例中康复理疗部分的检索数据,明确了开发的意义、思路后着重对本系统的功能和性能方面做了需求分析。通过和康复理疗科医护人员的探讨,深入了解医院康复理疗科的业务流程后,从两类用户的角度分析不同的角色对系统的功能需求和性能需求。康复科治疗师需求有：治疗师拥有自己的登录账号、密码和权限；在查看病人和治疗项目的相关信息之后,对已收费的治疗项目录入治疗方案；治疗结束时录入治疗评估信息；可按时间段统计门诊量、工作量；可按时间段生成门诊量、工作量、病种统计、治疗项目统计、治疗效果等报表。临床医生需求有：通过医生工作站向本系统为病人申请康复治疗；可定期查看病人做康复治疗报告。
根据需求分析,接着进行概要设计和详细设计,概要设计中对本系统体系结构做了分析,通过对比B/S和C/S的结构模式,确定网络部署方案为三层B/S架构,选择了开发平台为ASP. NET 3.5和C#语言,同时论证了技术可行性。模块功能设计中将系统划分为个人信息管理、个人工作量管理、用户信息管理、科室工作量管理、科室门诊量管理、发送治疗申请单、查看治疗报告单、挂号病人治疗管理、住院病人治疗管理九个模块,通过图表说明了各模块的功能和关系。根据模块功能定义了系统的操作流程,接着对用户页面进行设计,页面的排版采用了HTML中层叠样式表(Cascading Style Sheet, CSS),综合了用户的建议和要求,对新兴的AJAX技术在系统中的适用性进行了研究,通过使用AJAX技术,界面功能和友好度得到增强,用户体验大为改善,且系统性能也得到提高,尽量使页面布局清晰、美观和友好。在数据库设计中,先后做了逻辑结构和物理结构设计,介绍了数据库与应用程序的连接原理和操作。在详细设计中,着重阐述各模块的流程设计和相关算法。围绕系统设计,在微软Visual Studio 2008集成开发环境中,以C#为开发语言进行系统开发,利用ASP. NET 3.5的优势特性和强大功能,显著减少代码编写量,提高了开发效率,缩短了开发周期,并保证了代码规范化和标准化,根据设计方案实施编码,文中列出了若干函数实现代码,其他代码将在附录中展现,实现部分还着重介绍了AJAX、当用户在应用程序的Web页之间跳转时的会话Session、CSS和水晶报表的应用。测试是软件系统质量保证的重要环节,对系统的开发质量做出评价并进行修改,通过了黑盒测试、白盒测试和压力测试,测试过程中发现错误和缺陷后进行改进,尽可能地完善系统,然后设想了系统在运行过程中可能出现的一些故障和解决方案以供维护人员参考。
最后对课题研究的成功和不足之处进行了总体评价,并提出了下一步工作的研究内容和方向。本课题的研究和应用符合医院康复理疗科的治疗管理要求,操作简单方便,不仅使宝贵的医疗信息得以采集、存储和共享,而且提高了医护人员的工作效率,得到医院康复理疗科医护人员的好评。
Hospital information system has gradually developed from information management focus on charge to clinical information management. Clinical information system's goal is to provide the automatic operation platform for the hospital clinical diagnosis activities, in order to reduce labor intensity, improve work efficiency, integrate medical resources, accumulate medical knowledge, reduce operating mistakes, improve the clinical diagnosis quality and the service level, aid to clinical decision-making. In the hospital, many treatments of the diseases need to be cooperated with rehabilitation physical therapies, therefore the doctors of the rehabilitation department need establish a long-term and close communication with the clinical doctors of other departments. There is no the clinical specialized subject information system for the rehabilitation physical therapy at home and abroad, cause that a lot of precious rehabilitation physical therapy treatment information cannot be collected, stored and shared, lead to the serious loss of the medical information.
According to the above actual problems, the subject take the rehabilitation medical information management of General Hospital of Guangzhou Military Command of PLA as the research object, using advanced Microsoft visualization development platform Visual Studio 2008 combined with the large database technology Oracle 10g, was designed and developed based on B/S structure using asp.net 3.5 (c#) to implement clinical information system, designed to provide a complete and economically feasible solutions for hospital rehabilitation physiotherapy daily treatment, data statistics analysis and aided decision-making reference. Establishing patient-centered medical information management and sharing, as part of the electronic medical records, not only can reduce labor intensity, enhance work efficiency and the work quality to a certain extent, but also can analyze statistical data, workload and management data more timely, accurately, effectively for superior departments'scientific management decision-making and promoting hospital management level. The development of this information system has certain innovation and practical significance.
In this paper, firstly, the development status of hospital information system and the development background of this information system are stated, this system is defined as "Rehabilitation Medical Information System", belong to the clinical information system. The data stored will be as retrieving data of rehabilitation physical therapy part in the electronic medical records. After making sure the developing significance and ideas, requirements analysis was made on functionality and performance. Through the discussion with the doctors, we understood deeply of the business process of hospital rehabilitation physiotherapy department and analysed the function requirements and performance requirements of the system for different roles from two kinds of users. Rehabilitation department's therapists demand:therapists have their own login name, password and privileges; After the view of the information of the patients and treatment projects, they can type-in the therapy of the charged treatments; When the end of therapy treatment, they can input the evaluation information; This information system can make statistics about the amount of out-patients and the workload; This information system can create the reports about the amount of out-patients, the workload, the diseases, treatment effect and treatment projects so on. Clinicians demands:they can apply rehabilitation therapy for patients to this system by the doctor workstation and look up patients' rehabilitation therapy reports.
According to the requirement analysis, then start the general design and detailed design. In the general design, analyzed the structure of this system, through comparing B/S and C/S structure modes, made sure the network is three layers B/S architecture and chose asp.net 3.5 and C# as the development platform, and demonstrated the technical feasibility. In the module function design, the system was divided into nine modules:personal information management, personal workload management, users'information management, the department workload and amount of out-patients management, sending treatment requisitions, checking treatment reports, registered- patients' care management and inpatients'care management, the charts illustrates the function of each module and relationship. According to the module's function, we defined system operation process, then design the user page, the layout of the page adopted HTML and Cascading Style Sheets (CSS),on the user's comprehensive suggestions and demands, we studied the emerging AJAX technology and researched its applicability in the system. By the use of AJAX, interface functions and friendly degrees have been improved, the users'experience and the performance of the system have been enhanced. We tried to make the pages' layout clear, beautiful and friendly. In the design of database, we made the logical structure and physical structure design, introduced the connection principle and operation of the database and the application. In the detailed design, this paper illustrates the flow of each module design and algorithm. Based on the design of the system, in Microsoft Visual Studio 2008 integrated development environment, using ASP.NET 3.5 advantage characteristics and powerful function, took C# as developing language to develop, so that significantly reduce coding quantity, improve the efficiency of development, shorten the development cycle and ensure the standardization of the code. We implemented coding according to the design, this paper lists several functions, other code will be shown in the appendix, realization part introduced emphatically the application of AJAX, Session, CSS and crystal report. Testing is the important link of the software system development to ensure the quality, gives evaluation and modification. Through black-box testing, white-box testing and pressure testing, after finding errors and defects as soon as possible, we improved and perfected the system, then conceived some fault and solutions during the operation of the system for maintenance personnel.
In the end, the paper gives the overall evaluation on the success and the deficiencies of this research subjects, and put forward the further research contents and direction. This research and application apply to rehabilitation treatment management requirements, are operated simply, not only make the valuable medical information collected, stored and shared, but also improve the working efficiency of the medical staff, and get the medical staff's praises.
针对上述的实际问题,本课题以广州军区总医院的康复医疗信息管理为研究对象,利用先进的微软可视化开发平台Visual Studio 2008结合大型数据库技术Oracle 10g,设计和开发了一个基于B/S结构用ASP. NET 3.5 (C#)实现的临床信息系统,旨在为医院康复理疗科的日常治疗处理、数据统计分析和辅助决策参考提供一套完整且经济可行的解决方案。建立以病人为中心的康复医疗信息管理和共享,作为电子病历的一部分,不仅可以在一定程度上减轻医护人员的劳动强度,提高工作效率和工作质量,而且可以更及时、准确、有效地分析统计各种工作量数据及管理数据,供上级主管部门做出科学的管理决策,促进医院管理水平的进一步提高,本系统的开发具有一定的创新和实用意义。
本文首先对医院信息系统的发展现状和本系统开发背景进行必要的说明,本系统定义为“康复医疗信息系统”,属于面向诊疗信息的临床信息系统,存储的数据将作为电子病例中康复理疗部分的检索数据,明确了开发的意义、思路后着重对本系统的功能和性能方面做了需求分析。通过和康复理疗科医护人员的探讨,深入了解医院康复理疗科的业务流程后,从两类用户的角度分析不同的角色对系统的功能需求和性能需求。康复科治疗师需求有：治疗师拥有自己的登录账号、密码和权限；在查看病人和治疗项目的相关信息之后,对已收费的治疗项目录入治疗方案；治疗结束时录入治疗评估信息；可按时间段统计门诊量、工作量；可按时间段生成门诊量、工作量、病种统计、治疗项目统计、治疗效果等报表。临床医生需求有：通过医生工作站向本系统为病人申请康复治疗；可定期查看病人做康复治疗报告。
根据需求分析,接着进行概要设计和详细设计,概要设计中对本系统体系结构做了分析,通过对比B/S和C/S的结构模式,确定网络部署方案为三层B/S架构,选择了开发平台为ASP. NET 3.5和C#语言,同时论证了技术可行性。模块功能设计中将系统划分为个人信息管理、个人工作量管理、用户信息管理、科室工作量管理、科室门诊量管理、发送治疗申请单、查看治疗报告单、挂号病人治疗管理、住院病人治疗管理九个模块,通过图表说明了各模块的功能和关系。根据模块功能定义了系统的操作流程,接着对用户页面进行设计,页面的排版采用了HTML中层叠样式表(Cascading Style Sheet, CSS),综合了用户的建议和要求,对新兴的AJAX技术在系统中的适用性进行了研究,通过使用AJAX技术,界面功能和友好度得到增强,用户体验大为改善,且系统性能也得到提高,尽量使页面布局清晰、美观和友好。在数据库设计中,先后做了逻辑结构和物理结构设计,介绍了数据库与应用程序的连接原理和操作。在详细设计中,着重阐述各模块的流程设计和相关算法。围绕系统设计,在微软Visual Studio 2008集成开发环境中,以C#为开发语言进行系统开发,利用ASP. NET 3.5的优势特性和强大功能,显著减少代码编写量,提高了开发效率,缩短了开发周期,并保证了代码规范化和标准化,根据设计方案实施编码,文中列出了若干函数实现代码,其他代码将在附录中展现,实现部分还着重介绍了AJAX、当用户在应用程序的Web页之间跳转时的会话Session、CSS和水晶报表的应用。测试是软件系统质量保证的重要环节,对系统的开发质量做出评价并进行修改,通过了黑盒测试、白盒测试和压力测试,测试过程中发现错误和缺陷后进行改进,尽可能地完善系统,然后设想了系统在运行过程中可能出现的一些故障和解决方案以供维护人员参考。
最后对课题研究的成功和不足之处进行了总体评价,并提出了下一步工作的研究内容和方向。本课题的研究和应用符合医院康复理疗科的治疗管理要求,操作简单方便,不仅使宝贵的医疗信息得以采集、存储和共享,而且提高了医护人员的工作效率,得到医院康复理疗科医护人员的好评。
Hospital information system has gradually developed from information management focus on charge to clinical information management. Clinical information system's goal is to provide the automatic operation platform for the hospital clinical diagnosis activities, in order to reduce labor intensity, improve work efficiency, integrate medical resources, accumulate medical knowledge, reduce operating mistakes, improve the clinical diagnosis quality and the service level, aid to clinical decision-making. In the hospital, many treatments of the diseases need to be cooperated with rehabilitation physical therapies, therefore the doctors of the rehabilitation department need establish a long-term and close communication with the clinical doctors of other departments. There is no the clinical specialized subject information system for the rehabilitation physical therapy at home and abroad, cause that a lot of precious rehabilitation physical therapy treatment information cannot be collected, stored and shared, lead to the serious loss of the medical information.
According to the above actual problems, the subject take the rehabilitation medical information management of General Hospital of Guangzhou Military Command of PLA as the research object, using advanced Microsoft visualization development platform Visual Studio 2008 combined with the large database technology Oracle 10g, was designed and developed based on B/S structure using asp.net 3.5 (c#) to implement clinical information system, designed to provide a complete and economically feasible solutions for hospital rehabilitation physiotherapy daily treatment, data statistics analysis and aided decision-making reference. Establishing patient-centered medical information management and sharing, as part of the electronic medical records, not only can reduce labor intensity, enhance work efficiency and the work quality to a certain extent, but also can analyze statistical data, workload and management data more timely, accurately, effectively for superior departments'scientific management decision-making and promoting hospital management level. The development of this information system has certain innovation and practical significance.
In this paper, firstly, the development status of hospital information system and the development background of this information system are stated, this system is defined as "Rehabilitation Medical Information System", belong to the clinical information system. The data stored will be as retrieving data of rehabilitation physical therapy part in the electronic medical records. After making sure the developing significance and ideas, requirements analysis was made on functionality and performance. Through the discussion with the doctors, we understood deeply of the business process of hospital rehabilitation physiotherapy department and analysed the function requirements and performance requirements of the system for different roles from two kinds of users. Rehabilitation department's therapists demand:therapists have their own login name, password and privileges; After the view of the information of the patients and treatment projects, they can type-in the therapy of the charged treatments; When the end of therapy treatment, they can input the evaluation information; This information system can make statistics about the amount of out-patients and the workload; This information system can create the reports about the amount of out-patients, the workload, the diseases, treatment effect and treatment projects so on. Clinicians demands:they can apply rehabilitation therapy for patients to this system by the doctor workstation and look up patients' rehabilitation therapy reports.
According to the requirement analysis, then start the general design and detailed design. In the general design, analyzed the structure of this system, through comparing B/S and C/S structure modes, made sure the network is three layers B/S architecture and chose asp.net 3.5 and C# as the development platform, and demonstrated the technical feasibility. In the module function design, the system was divided into nine modules:personal information management, personal workload management, users'information management, the department workload and amount of out-patients management, sending treatment requisitions, checking treatment reports, registered- patients' care management and inpatients'care management, the charts illustrates the function of each module and relationship. According to the module's function, we defined system operation process, then design the user page, the layout of the page adopted HTML and Cascading Style Sheets (CSS),on the user's comprehensive suggestions and demands, we studied the emerging AJAX technology and researched its applicability in the system. By the use of AJAX, interface functions and friendly degrees have been improved, the users'experience and the performance of the system have been enhanced. We tried to make the pages' layout clear, beautiful and friendly. In the design of database, we made the logical structure and physical structure design, introduced the connection principle and operation of the database and the application. In the detailed design, this paper illustrates the flow of each module design and algorithm. Based on the design of the system, in Microsoft Visual Studio 2008 integrated development environment, using ASP.NET 3.5 advantage characteristics and powerful function, took C# as developing language to develop, so that significantly reduce coding quantity, improve the efficiency of development, shorten the development cycle and ensure the standardization of the code. We implemented coding according to the design, this paper lists several functions, other code will be shown in the appendix, realization part introduced emphatically the application of AJAX, Session, CSS and crystal report. Testing is the important link of the software system development to ensure the quality, gives evaluation and modification. Through black-box testing, white-box testing and pressure testing, after finding errors and defects as soon as possible, we improved and perfected the system, then conceived some fault and solutions during the operation of the system for maintenance personnel.
In the end, the paper gives the overall evaluation on the success and the deficiencies of this research subjects, and put forward the further research contents and direction. This research and application apply to rehabilitation treatment management requirements, are operated simply, not only make the valuable medical information collected, stored and shared, but also improve the working efficiency of the medical staff, and get the medical staff's praises.
引文
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