基于HIS系统的临床路径在股骨颈骨折中的设计应用

发布时间：2019-07-08 15:56

【摘要】：临床路径(clinical pathway,CP)是由医学及相关学科人员针对某个特定疾病制定的针对诊治、护理、康复锻炼、检验检测最适当的,最易于接受采纳的诊疗计划。采用临床路径能够有效的降低某个单病种的平均住院时间同时也能够降低医疗费用,而最终仍然能够达到预期的治疗效果。但目前临床路径仍未形成一套完整的、确切可行的理论体系,因为程序设计人员不懂医学,而临床医生又不懂计算机编程、数据库,跨学科的融合很少,目前的系统设计和临床应用存在着一定分离,不能很好地实现程序与实际应用的无缝连接,影响了临床医生的使用积极性,导致临床路径的最终使用效果不佳。本文从临床应用角度出发并结合网络工程的思想和方法,以卫计委下发的临床路径表单为基础指导,实现股骨颈骨折的临床路径数据管理,临床路径应用执行,临床路径跟踪统计分析等重要功能。以股骨颈骨折为研究对象,对临床路径系统的需求分析、表单设计、映射策略、数据管理、统计分析等进行了研究和讨论,以此为基础,进行系统的分析、设计和实现,重点从临床和网络技术相结合的角度,研究股骨颈骨折临床路径的临床应用与实施,使股骨颈骨折临床路径在试点医院临床实践中得到了有效应用。通过本文的分析和论证,能够使计算机工程人员了解临床人员、管理人员对临床路径的具体需求,从而开发出更加适合临床实际的系统软件；使医护人员能够对临床路径有一个深入、完整的了解,并且能够参照基于现有HIS系统的股骨颈骨折临床路径搭建过程,从无到有的创建新病种的临床路径。截止目前,本文所研究的股骨颈骨折临床路径系统已经在试点医院的骨室投入使用,运行效果良好。该临床路径操作比较简便,规范了试点医院骨科医生的诊疗行为,满足了管理部门政策要求,又在很大程度上减轻了医护人员的工作强度,最终提高医院的整体医疗质量。
文内图片：

图片说明：图２－１传统诊疗管理摸式逡逑
[Abstract]:The clinical pathway (CP) is the most appropriate and easy-to-accept diagnostic and treatment plan for the diagnosis and treatment, care, rehabilitation and detection of a particular disease by the medical and related subjects. The adoption of the clinical pathway can effectively reduce the average hospital stay time of a single disease, and also can reduce the medical expense, and finally, the expected treatment effect can still be achieved. But the current clinical path still does not form a complete, exact and feasible theoretical system, because the programmer does not know the medicine, and the clinician does not know the computer programming, the database, the interdisciplinary fusion is very small, the present system design and the clinical application have a certain separation, The seamless connection between the program and the practical application can not be well realized, the use enthusiasm of the clinician is influenced, and the final use effect of the clinical path is not good. This paper, from the point of clinical application and combined with the thought and method of network engineering, is based on the clinical path form issued by the CDPC, and realizes the important functions of clinical path data management, clinical route application execution and clinical path tracking and analysis of the femoral neck fracture. Taking the fracture of the femoral neck as the research object, the demand analysis, the form design, the mapping strategy, the data management and the statistical analysis of the clinical pathway system are studied and discussed, based on this, the analysis, design and implementation of the system are carried out. The clinical application and application of the clinical pathway of the femoral neck fracture were studied from the angle of the combination of clinical and network, so that the clinical pathway of the femoral neck fracture was effectively applied in the clinical practice of the pilot hospital. Through the analysis and demonstration of the paper, the computer engineering personnel can be informed of the specific requirements of the clinical personnel and the management personnel on the clinical path, so that the system software more suitable for clinical application is developed; and the medical personnel can have an in-depth and complete understanding of the clinical path, And can be used for establishing a clinical path of a new disease type from the existing HIS system according to the clinical path construction process of the femoral neck fracture based on the existing HIS system. At present, the clinical pathway system of the femoral neck fracture studied in this paper has been put into operation in the bone room of the pilot hospital, and the operation effect is good. The operation of the clinical route is simple and convenient, the diagnosis and treatment behavior of the bone doctor of the pilot hospital is standardized, the policy requirement of the management department is met, the working intensity of the medical staff is greatly reduced, and the overall medical quality of the hospital is finally improved.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R683.4;TP311.52

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