整合型医疗卫生服务体系的探索与实践

Exploration and Practice of Integrated Medical Health Service System

以信息技术为支撑平台，通过实现各级医疗机构间的资源共享及信息共享，对整合型医疗卫生服务模式及其运行机制进行探索与实践，从而缓解患者“看病难、看病贵”的问题。方法是采用J2EE技术体系，结合SOA面向服务架构。WebSen，ices和MQ消息机制技术构建整合型医疗信息交互平台系统；并以此为基础建立整合型医疗卫生服务的协作体系及专家团队，对整合型医疗卫生服务的综合功能进行可行性研究。整合型医疗卫生共同体成员医疗机构在利用信息交互平台进行双向转诊、预约资源、视频会诊、慢病管理等综合医疗服务功能的探索与尝试后，对运营数据抽样分析表明：利用信息技术，通过预约转诊、EMR互传及处方共享等方式，可为患者节省72．3％的在院诊疗用时、12％的同类处方药品费用，患者满意度达98％。因此可以说，基于信息支撑平台的整合型医疗卫生服务体系的实现缓解了患者“看病难、看病贵”问题，有利于三级甲等医院专注于疑难病症的治疗和研究，同时有助于一、二级医院提高患者信任度及医生业务水平，是一种可以给共同体内患者和各医疗机构都带来切实利益的良性、多赢运行模式。

Taking information technique as the support platform, through the methods of realizing the resources sharing and information sharing of medical institutions of all levels, rationalizing the distribution of medical resources and so on, to relieve the problem of inadequate and unaffordable medical services. It is the method that to build the integrated delivery system of information interactive platform of regional medical, to construct collaboration system and team of regional medical and health services, to realize the comprehensive function of regional medical and health services. The information interactive platform based on message passing mechanism was established. The comprehensive functions of medical services such as two-way referral, resource reservation, video consultation and chronic diseases management was explored and attempted. Sample analysis of operating data： through the ways of referral reservation, EMR reciprocal passing, and prescription sharing, 52.3% time of patients waiting in hospital and 12% cost of similar prescription drugs was saved. The percentage of patient satisfaction achieved 98%. Under the cooperation of regional medical and health services mode, the application of comprehensive functions of medical services relieves the problem of inadequate and unaffordable medical services, in favor of third-level hospitals focusing on the treatment and research of difficult and baffling diseases. At the same time, it helps first and second level hospitals to improve confidence in patients and the business level of general practitioner. The operation of the mode is a benign and multi-win operation mode, which can provide real benefits to patients and medical institutions within the community.