Download An Introduction of Pudong`s Progress in Shanghai

An Introduction of Pudong’s
Progress in Shanghai Health
Information Development
Pudong Team
Aug. 2007
Contents
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Basic requirements
Methodology
Present evolvement
Investigation & research of Pudong health
information
Information requirements in Pudong
core set of electrical health archives
Next-step tasks
requirement
Basic requirements
 Project’s name
 Exploring the regional health information sharing
mechanism
 Basic requirements
 Based on real case: Pudong New Area health
Information System, exploring the regional health
information sharing model
 Inner-hospital information integration
 Inter-hospital information sharing model
Methodology
 5W1H
 Why?
 What?
 Where?
 When?
 Who?
 How?
 Investigating & researching
 Theory Model
 Construction Model
5W1H
 What —What do we want to do?
 We underwent two phases in Pudong, first step is hospital developed
its system independently, second step is based on a integrative plan.
 We have established Pudong health information network. But what are
our next tasks? What is our next targets?
 That the relationship between information services and health services
or people is our thoughts.
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People is our focus.
Information services and patient.
Information services and health provider system.
Information services and health services efficiency, veracity etc.
Information services and health management, decision-supporting etc.
Information services and seamless care chains.
 Establishing region-level data sharing and exchange
system
 Implementing universal application on personal electrical
health record and electrical clinical workstation
 Implementing interconnect & communication between
them
 Implementing region-level people health electrical
administration.
 Project’s targets
 Establishing sharing system and model (inner-hospital and inter-
hospital)
 Investigation of Pudong new area health information situation &
foundation
 Share and exchange data set of community electrical health record
 Establishing core data set standard
 Sharing standards and guidelines in regional health care, health
information
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codes, classifications, vocabularies
Hardware and network configuration standard
Basic application software standard (framework, function, interface etc)
Evaluation standard
 WHY?
 The need of people
 The need of medcare evolution
 The need of medical enterprise development
 WHEN?
 The regional health information system
establishment in Pudong new area will be speeded
by Finland cooperation project.
 Presently, foundation condition has been prepared
(hardware, network, basic software)
 Local government’s support
 WHERE?
 Pudong New Area, Shanghai
 WHO?
 Join together, share production
 Government, specialty institution, medcare
organization, manufacturer, neutral evaluating
organization
 HOW?
 Definited targets
 Resoluble targets
 Investigation & research, Literature search,
Discussion
 Theory model
 Information technology
 Experiment & Practice
 Evaluation
Methodology
 What do we share and exchange?
 Inner-hospital
 The community health service center.
 Synthesis hospital：inter-department share and exchange
 Inter-hospital
 The community health service center: personal health archives
 Synthesis hospital：electrical patient record
 Diagnosis and care chain
 The optimization of clinic service workflow
 Bi-directed transfer of patient
 How to share and exchange?
 Message based
 Core data set
 Core service set
 Codes, classifications, vocabularies
 Concentrated Data Management
 Data cleansing and data life-cycle management
 Standard, criterion, interface
 Project progress
 Foundation investigation
 Standard establishment
 core data set
 Application modeling
 Codes, classifications, vocabularies
 Work-flow reconstruction
Present progress
 Foundation investigation (the community
health service center)
 26 community health information systems
 Structure, staff, investment, network configuration,
hardware configuration, software configuration,
security devices and future plan etc.
 Conclusion: all hold basic HIS, but with great
difference in different communities
 Structure and staff
 Every center has set up information department
with one or two staffs
 Mainly provides basic maintenance
 Without structure standard
 Has staff trained, but poor quality
 Investment
 In recent 5 years, 0.5 million RMB at lowest level,
0.8 million RMB at medium level, 1 million RMB
at highest
 Mostly，average cost is about 0.1 million RMB
one year
 Absent system strategic plan in health information
construction
 Without detail content and cause in annual budget
 System function module
 Basic functions (common modules in clinic register,
charge(invoice), admission & leaving management,
pharmacy management, hospital manager query system,
nurse workstation system )
 Half hospitals equipped e-family health archives system
 30% hospitals equipped doctor work stations
 25% hospitals equipped LIS RIS etc
 Few hospitals have EPR system, diagnosis and treatment
monitor system
 Application status
 All basic function are running completely
 Others (including E-health archives system) are
running partly
 Hardware, network
 Average 1 to 2 servers each hospital
 LAN, 1 to 2 Switches
 Connected to Pudong Health information network
 Without storage facilities and special back-up
devices
 1.5 to 3 persons equipped 1 Personal
Computer(avg)
 Investigation of hospital manager’s
expectation
 According to target priority
 1、doctor work station
 2、medical technology related information system
 3、foundation part of HIS
 4、EHR
 5、system’s interconnect (inner-hospital data share)
 6、linkage between health archives and public health
information system
 Foundation investigation in second-level synthesis
hospital (Polyclinic)
 Structure and staff
 Every center has information department with 4 to 7
employees
 Mainly with responsibility for the most basic
administration, other jobs relied on exterior contract
 Normal training for staff, with credible quality
 Without public health information system
 Investment
 Total cost up to 5-10 million RMB
 Mostly, average cost is about 0.4 million RMB
one year
 Absent entire system plan in hospital information
construction
 Without detail content and cause in annual budget
 System function module
 Basic functions (common modules in clinic register,
charge, admission & leaving management, pharmacy
management, hospital manager query system, nurse work
station system )
 Most of hospitals equipped doctor work-station
 Most of hospitals equipped LIS etc. systems.
 Many hospitals have EPR, diagnosis and treatment
monitor system
 All interconnect among different systems complete based
on share database, but without standard interface
 Hardware, network
 Average 4 to 8 servers, most of hospitals equipped
with Small Computer System
 LAN, a lot of Switches, with normal programming
 Connected to Pudong health information network
 With disk storage facilities and without special
back-up devices
 One person equipped one Personal Computer
Kernel set of electrical health archives
 Core data set
 Electrical health record
 Doctor work-station (electrical case history)
 Codes, classifications, vocabularies
 Electrical health record
 The combined electrical record set of personal
and family health
 Records the correlative procedures and factors of
human’s health
 Implements the administration and monitor of whole
people and complete procedure
 Provides services for daily work, administration,
making decision
 1+5x+Y pattern
 3+3 hospital pilot units
 The composite of Chinese electrical health record
 Personal health archives
 Basic status
 Important events
 Main health problems
 Disease administration
 Family health archives
 Basic information
 Family members
 Social and economic status
 Health status
 Family characteristic
 The reduced set of electrical health record
 Personal health archives
 Basic status (including part of health problem, optimal
reduction)
 Important events (optimal reduction)
 Main health problems (integration of public health
system, optimal reduction)
 Disease administration (based on core public health
system)
 Family health archives
 Optimal reduction
 The coordination and coalition of electrical
health archives with other systems
 With doctor work-station
 Event reports (involving disease history home-page)
 Disease reports
 Diagnosis and treatment daily log
 With public sanitation system
 Health administration
 Disease administration
 Health evaluation
 The application of electrical health record
 Data authentication
 Data cleansing
 Data query
 Interface
 The risk of electrical health record
 Authority
 Reality
 Credibility
 Timely
 Integrality
 Feasibility
 Privacy
Core set of Personal health record
 Discussion about personal health record
(see attached pages)
 Synthesis hospital share data set
 As one of the first phase’s targets, we are going to
collect following four kinds of data from hospitals,
which is not involved image operations
 Patient’s diagnosis and treatment record
 Patient’s basic information
 Lab test reports
 Inpatient Case history during staying at hospital
 Patient’s diagnosis and treatment record
includes following four data tables:
 Diagnosis and treatment record table
 Detailed doctor's advice table
 Detailed charge table
 Charge record table
 Patient’s basic information table
 Medical card number
 Identity card number
 Identity card type
 Sex
 Name
 Marriage status
 Birth date
 Birth place
 Lab test reports
 Inpatient
Next-step tasks
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Definition of core data set
Researches on data share model
Standardization of Codes, classifications, vocabularies
Data exchange guidance and standard
Construction standard of community health service center’s
information system
Data share pattern in second-level synthesis hospital
Reconstruction of work-flow
Data query mode
integration specification methods
Needed help
 Hope following helps from Finland collaborator
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Contents and forms of inter-hospital shared information
Application pattern of hospital EPR
Interconnect and integration platform in hospital
Finland localization experience on HL7, especially CDAR2
 vocabularies, category method and standard
 Interconnect standard between hospitals (transmission,
format)
 Data security standard
 Privacy administration criterion
 Electrical health record in Finland
Thanks！
 Personal health archives
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Focus on person’s health
Span whole life-cycle
Cover different factors associated with health
Implement dynamic information collection from multi-channel
Satisfy need from many ways
Provide personal health data for information integration
Mainly includes four parts: basic information, important events, primary
health problem and disease administration
 Family health archives
 All kinds of family member’s valuable health records from family or society
activities
 Reflect family’s primary health characteristic
 Collect every member’s personal health archives
 Mainly includes five parts: basic information, family member’s data, social
and economic status, health status and family’s characteristic
 Community health archives
 Reflect community’s primary health characteristic
 Formed by every family’s health archives
 The important part of community construction
 The real record of community work
 Mainly include eight parts: physical geography,
habitation, economic status, traffic and
communication, population quantity, population
structure, health status, sanitation resource and its
exploitation
 Personal health archives plus family’s
characteristic forms family health archives.
Moreover, family health archives plus
community characteristic forms community
health archives
 Personal health archives is our emphasis in
this project