眼科检查信息管理系统的构建及应用研究

Refinement and implementation of an information management system for ophthalmic examinations

目的构建眼科门诊专科检查信息管理系统,建立连接检查端、医师端、数据管理端三方的管理运行信息化平台,探讨影像归档和通信系统(PACS)在眼科门诊专科检查中的应用效果。设计单组前测-后测设计。研究对象眼科检查信息管理系统及江苏省人民医院眼科门诊应用该系统就诊的500例患者。方法由眼科、医院信息中心、研发公司组成项目小组,研发PACS眼科影像管理分析系统,并与现有的海泰电子病历系统对接。将该系统应用于眼科门诊,记录患者从导医台报到开始到就诊完全结束的总就诊时间、患者在诊室内与医生沟通检查的时间,采用自制问卷调查患者以及医生的满意度。主要指标总就诊时间、医患沟通时间、患者及医生满意度。结果应用该系统后患者平均总就诊时间由(0.92±0.46)h缩短至(0.72±0.42)h(t=7.096,P<0.001)。平均医患沟通时间由(0.54±0.35)h缩短至(0.43±0.19)h(t=6.283,P<0.001)。患者满意度由80.6%上升至95.2%(χ^(2)=50.104,P<0.001),医生满意度由83.33%上升至95.83%(χ^(2)=4.019,P=0.045)。结论PACS系统提升了眼科专科检查结果反馈的实时性及动态性,医生看诊效率提高,患者就诊时间缩短,医生及患者满意度均有明显提升。

Objective To construct the information management system of ophthalmic outpatient specialist examination,and establish an information management platform that connects three terminals for examination,physician,and data management,and explore the application and efficiency of picture archiving and communication systems(PACS)during ophthalmology outpatient specialized examination.Design One-group pretest-posttest design.Participants The PACS and a total of 500 patients applied the system from the ophthalmic outpatient clinic in Jiangsu Provincial People's Hospital.Method A project team consisting of ophthalmology,hospital information center and R&D company,developed a PACS ophthalmic image management and analysis system,which will be integrated with the existing Haitai electronic medical record system.This system was applied to ophthalmic clinics.The total patients'visit time from check-in to the end of the visit,as well as the duration of the patient communicating with the doctor in the consulting room were recorded.Patients and doctors were surveyed on their satisfaction using self-made questionnaire.Main Outcome Measures Average waiting time,average consulting time,satisfaction of the patients and doctors.Results After application of PACS system,the average waiting time was decreased from(0.92±0.46)h to(0.72±0.42)h(t=7.096,P<0.001),the average consulting time was decreased from(0.54±0.35)h to(0.43±0.19)h(t=6.283,P<0.001),and the patient satisfaction increased from 80.6%to 95.2%(χ^(2)=50.104,P<0.001),the doctors'satisfaction increased from 83.33%to 95.83%(χ^(2)=4.019,P=0.045).Conclusions PACS system improved the real-time and dynamic feedback of the ophthalmic specialist examination results,improved the work efficiency of doctor,shortened the patients’visiting time,and improved the satisfaction rates of both doctors and patients significantly.