分布式环境下的临床信息交换与决策支持

发布时间：2018-01-03 00:11

本文关键词：分布式环境下的临床信息交换与决策支持　出处：《湖北工业大学》2017年硕士论文　论文类型：学位论文

【摘要】：随着信息技术的发展,当前医疗机构电子化越来越普及,为了更好地提供或得到医疗服务,实现临床信息的共享和交换必不可少。但是目前医疗系统间异构,数据标准、传输格式、数据格式不统一的问题严重阻碍了临床信息传递与交换,患者的临床信息无法得到充分利用,造成了医疗机构之间无法进行沟通。临床信息的交换与共享,可以使医疗服务人员获得病人任何时间、任何地点的相关信息。并且,临床数据的集成是实现分布式环境下临床决策支持系统的前提,各个医疗机构的临床医生可以根据集成的病人临床信息数据对病人做出更合理的管理决策,从而有效地降低医疗差错,全方位的对病人提供医疗服务。本文基于HL7 CDA标准定义了通用型的临床文档结构模板以及CDA和数据库的映射解决了临床信息交换这一问题。此外,医疗机构的临床医生存在知识局限性和人为疏忽的问题,临床决策支持系统的使用可以有效地解决此类问题,并且临床决策支持系统的应用可以提供更好的医疗服务,同时降低医疗费用。因此,在医疗服务中,充分发挥知识库和临床决策支持的优势,可以提高临床医生使用临床支持系统积极性,提高医疗服务水平。本文以高血压作为案例,设计了高血压用药的知识库,研究并设计了分布式环境下高血压患者用药的临床决策支持系统。本文首先通过研究HL7医疗信息传输标准和临床文档结构CDA标准,用CDA标准对临床信息文档进行包装,基于CDA和数据库的双向转换思想,实现了CDA文档的生成与解析,从而实现了异构系统中临床信息的交换。其次,本文在实现异构系统数据集成和互操作的基础上,设计了一种通用的分布式环境下的临床决策支持系统的整体框架,并对其中的关键组成模块进行了介绍。最后,为了验证设计的正确性,本文在湖北省人口健康信息平台的基础上,使用多代理技术协调各个医疗机构之间的工作,选取高血压作为案例,对知识库和数据库进行了定义,对患者的临床场景进行了描述,实现了分布式环境下的临床信息交换和临床决策支持。实现的结果证明了本文提出的方法可以为分布式环境下的临床决策支持系统提供病人的集成数据,结合知识库做出更准确的决策,同时,对于解决分布式环境下临床决策过程中的临床信息的获取的问题具有重大的意义。
[Abstract]:With the development of information technology, electronic medical institutions are becoming more and more popular. In order to better provide or get medical services, it is necessary to share and exchange clinical information. But at present, medical systems are heterogeneous. The problem of data standard, transmission format and data format is not uniform, which seriously hinders the transmission and exchange of clinical information, and the patient's clinical information can not be fully utilized. The exchange and sharing of clinical information enables medical service personnel to obtain relevant information about the patient at any time, anywhere. And. The integration of clinical data is the premise of realizing the clinical decision support system in the distributed environment. The clinicians in various medical institutions can make more reasonable management decisions on patients according to the integrated patient clinical information data. In order to effectively reduce medical errors. To provide medical services to patients. This paper is based on HL7. The CDA standard defines the generic clinical document structure template and the mapping between CDA and database to solve the problem of clinical information exchange. Clinical doctors in medical institutions have the problems of limited knowledge and human negligence. The use of clinical decision support system can effectively solve such problems. And the application of clinical decision support system can provide better medical services and reduce medical costs. Therefore, in medical services, the advantages of knowledge base and clinical decision support can be brought into full play. It can improve the enthusiasm of clinical doctors to use the clinical support system and improve the level of medical service. This paper studies and designs the clinical decision support system for patients with hypertension under distributed environment. Firstly, this paper studies the HL7 medical information transmission standard and the clinical document structure CDA standard. The clinical information document is packaged with CDA standard. Based on the idea of bidirectional conversion between CDA and database, the generation and parsing of CDA document are realized. In order to achieve the heterogeneous system of clinical information exchange. Secondly, this paper realizes the heterogeneous system data integration and interoperability on the basis of. A general framework of clinical decision support system in distributed environment is designed, and the key modules are introduced. Finally, in order to verify the correctness of the design. On the basis of population health information platform in Hubei province, this paper uses multi-agent technology to coordinate the work among medical institutions, selects hypertension as a case, and defines the knowledge base and database. The clinical scene of the patient was described. The clinical information exchange and clinical decision support in the distributed environment are realized. The results show that the proposed method can provide integrated patient data for the clinical decision support system in the distributed environment. It is of great significance to make more accurate decisions based on the knowledge base and to solve the problem of obtaining clinical information in the process of clinical decision in distributed environment.
【学位授予单位】：湖北工业大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：TP399-C8

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