数字化病案信息技术在医院工作中的应用实践

Application of digital medical record information technology in hospital work

目的探究数字化病案信息技术在医院工作中的应用。方法选取本院2016年3月至2018年3月2 000份病案进行研究,2016年3月至2017年3月1 000份病案作为参照组,2017年3月至2018年3月1 000份病案作为研究组。参照组采用常规管理,即按照医院规定实施管理。研究组采用病案信息技术进行管理,即实施数字化病案信息技术。比较两组工作质量、利用率。结果研究组书写不规范、书写错误、病案归档返修率均低于参照组,差异有统计学意义(P<0.05)。研究组医院病案利用率明显高于参照组,差异有统计学意义(P<0.05)。结论在医院工作中应用数字化病案信息技术可促进提高各机构的利用率,改善工作质量,应用效果显著,可广泛应用于临床。

Objective To explore the application of digital medical record information technology in hospital work.Methods 2000 medical records of our hospital from March 2016 to March 2018 were selected for study.From March 2016 to March 2017,1000 cases of medical records were under routine management,which is regarded as the reference group.From March 2017 to March 2018,1000 cases of medical records were under digital medical record information technology,which was regarded as the research group.The work quality and utilization rate of the two groups were compared and statistically analyzed.Results Irregular writing,writing errors,and medical record filing and repair rates in the study group were lower than those in the reference group,and the difference was statistically significant(P<0.05).The utilization rate of hospital medical records in the study group was significantly higher than that in the reference group,and the difference was statistically significant(P<0.05).Conclusion The application of digital medical record information technology in hospital work can promote the utilization rate of various institutions,improve the quality of work,and the application effect is significant,which can be widely used in clinical practice.