利用信息共享提高病案首页质量

Using Information Sharing to Improve the Quality of First Page of Medical Records

介绍医院根据现有的条件,利用信息系统共享,自行制定并实施一套病案首页管理实施方案,全院取消手工填写病案首页。结果表明,有利于临床医师规范填写和及时完成病案首页,提高了工作效率。

According to the current conditions, the information system sharing was used to formulate and implement a plan of medical records management. The cancellation of manual fill in the medical record was carried out in the whole hospital. The results show that it can help the doctors normatively till in the first page of medical records on time and the work efficiency is improved.