数字化医疗基本要素与应用系统体系架构构建

The Basic Elements of Digital Healthcare and Its framework of Application Information System

目的通过数字化医疗基本要素分析,构建数字化医疗应用系统体系架构,为国内外数字化医疗应用系统比较和建立数字化医疗应用系统的信息标准体系和评价体系提供依据。方法通过文献调查、专家咨询和问卷调研,提出数字化医疗的概念架构。通过对美国退伍军人医院(United States Department of Veterans Affairs,VA)和我国华北地区17家样本医院数字化医疗应用系统及功能模块的调查,提出数字化医疗应用系统的领域和系统功能的分类体系。结果(1)数字化医疗的概念框架是在医疗系统(医疗服务机构、医疗服务机构人员、医疗服务对象、医疗服务管理等)的基础上,增加3个信息化基本要素:计算/通信技术、智能化/数字化设备、计算分析技术/通信介质;(2)医院数字化医疗应用系统分类框架,一级类目4个,分别为临床服务、管理服务、患者服务和公共基础;(3)样本医院应用系统(功能模块)调研结果显示,临床服务45个功能模块;管理服务37个功能模块;患者服务18个功能模块;公共基础31个功能模块;(4)美国VA医院4级一级类目的功能模块数量依次为63,24,9,47。结论数字化医疗的概念框架中信息化3个要素是数字化医疗应用系统开发、应用及评价的基本出发点。数字化医疗应用系统分类框架为建立数字化医疗的信息标准体系、技术标准体系和安全标准的评价提供了基础。

Objective Aims to establish the framework of digital healthcare＇s application information system by analyzing the basic elements of digital healthcare, to provide the evidence for the comparison of the information system among different countries and for evaluation of information standardization. Method The conceptual framework of digital healthcare was provided through searching for literatures, consulting to experts and investing with questionnaire. The domain and basic model of application information system were provided through the comparison between the United States Department of Veterans Affairs and the 17 hospitals of North China. Results （ 1 ） Digital healthcare was concerned about the development of interconnected health systems, so as to improve the use of computational technologies, smart devices, computational analysis techniques and communication media. Health systems included the medical institutions; medical staff, medical objects and medical management. （ 2 ） There were 4 categories, including clinical services, administrative services, patient services and infrastructure ＆ repositories, of application information system of digital healthcare. （3） The investing results from sample hospital suggested that the clinical services category included 45 models, administrative services included 31, patient services included 18 and infrastructure ＆ repositories included 37. （4） Each category of United States Department of Veterans Affairs had 63, 24, 9 and 47 models, respectively. Conclusion Three elements of the framework of digital healthcare is the fundamental for the development, application and evaluation of application information systems. And the framework of application information systems＇ category provided the basis for evaluation of information standard system, technical standard system and safety standard system.