Must not be seen, the new version of the electronic medical record rating standard explanation meeting on the six core points
On October 30 and 31, 2018, the China Hospital Authority organized a new edition of the electronic medical record rating standard interpretation meeting, which is the summary learning experience brought by the founder of Duchang Information Yuan Yongfu.
Yuan Yongfu, founder of Duchang Information
The scope of electronic medical records
In the information released by the conference, the scope of the electronic medical record system continued to expand, and some hospitals had an emergency system of integration and a whole game. All information modules related to medical behavior belong to electronic medical records.
Moreover, the scope of the electronic medical record has been extended to the outside of the hospital, and is linked to first aid and resident health records. A wider range of applications will be implemented. My personal opinion is that the development of traditional pure financial HIS has stagnated and the demand for procurement has shrunk. The traditional HIS company can only die naturally if it is eaten.
Electronic medical records are patient-centered, and patients are most concerned about money, so future electronic medical records may be filled with a lot of cost information. In addition, the medical insurance control fee is getting stronger and stronger, and the control fee is closely related to the diagnosis and clinical path. The electronic medical record is also more and more related to the cost. These will further encroach on the space of traditional HIS.
First-hand project
Lecture experts have repeatedly stressed that the construction of electronic medical record system is the number one project, led by the dean, the medical department, the business department, and the information technology support. Moreover, the lecture was organized by the Hospital Authority and improved the political level of informatization. In this process, the Information Section changed from the original technical department to the functional department, becoming the Dean's information staff; participating in the top-level design of the digital hospital.
I understand why information technology is the number one project.
The difficulty of the informationization process is process transformation. Transform the previous extensive manual process into a fine, automated process. This process involves the re-division of interests and the easy offending of people. Most hospital information departments do not have the ability and courage to complete this process, making the results of informatization not satisfactory. The first-hand project has the executive power of executive power, can re-divide this interest to be re-divided, and the process can be transformed.
In addition, the process of informatization is to integrate the flow chart from the wall into the computer and the human brain. It is easier to integrate into the computer, and it is difficult to integrate into the human brain. Most information departments are weak, unable to insert the flow chart into the brains of the business departments, and the top-level project can force the flow chart from top to bottom into the business department. In the human brain.
In addition, let the top leaders take the lead and transform the informationization from the individual soldier's individual combat to the people's war with full participation, in order to get the work solid and get more practical results.
Ultimate goal of rating
In the current process of informationization in many hospitals, the Information Section has given all tasks to the manufacturers, and the manufacturers have arranged them in one hand, and even the rating process has been given to the manufacturers. I don’t know the scale of the software and hardware assets of my own hospital. I don’t know the usage.
Lecture experts despise this behavior. Experts have repeatedly stressed that the Information Section should play a subjective initiative and can no longer be lazy. And actively participating in this number one project can also improve the position of the Information Section in the hospital.
Experts also mentioned that when the information is not seriously involved, if the manufacturer copies the application materials of other hospitals, and the result material or picture has the name of another hospital, the application process will suddenly die, and There will also be ratings for other hospital customers who influence the manufacturer.
Experts also stressed that a customer's customer has passed the electronic medical record rating, and may not be able to over-rated the hospital. Because at the time of rating, manufacturers are auxiliary, mainly relying on the hospital's own efforts.
I understand this, the original intention of the new rating is to ask the hospital to be no longer lazy, and to be able to act. Promote construction by evaluation. Just like treating a doctor, doctors and drugs are all auxiliary, and the key is to rely on the body's own resistance.
The rating is only the beginning, and the continued improvement in the quality of the follow-up is the real goal of the rating. The content of the rating itself should change in the future, but the real goal should be the same. Therefore, the experts unanimously reminded the hospital to do it yourself and promote the construction.
The rise of data
For the first time, the conference identified the fundamental position of the data itself in the new rating. The author has written a series of articles such as "The Rise of Data", emphasizing the importance of data, and foreseeing that data should be stored and utilized separately from specific business systems. As a result, the new rating has raised the status of the data in a high profile and provided a number of implementation details.
Some lecture experts also reminded that when the hospital applies for funds to the government for informationization, if it can clearly state that the system can be used to make subsequent large-scale data assets for subsequent use, it can increase the probability of successful allocation.
The government used to only care about the software and hardware functions of the system. Now it pays attention to the value of the data itself, and believes that the data itself is also an important core asset.
In reality, vendors use private encrypted data formats to bind hospitals. Previously, as long as the hospital could complete the data entry, display and printing, the problem of data being encrypted privately was not exposed.
The subsequent use of data has received widespread attention, and privately encrypted data is difficult to obtain for subsequent use. At this time, the problem of data format is exposed. Therefore, with reference to my suggestion, the new level 5 specifies that “01.06.5: electronic medical record content should be stored in a common format. It can be called by a third party authorized by the hospitalâ€, that is, the medical record data must be in a common format. Storage, third parties can obtain the information under the supervision of the hospital. This is to eliminate this problem in the bud.
Experts pointed out that data governance can cure chaos, but it can't be cured.
In this regard, I believe that the data in the private encryption format is equal to no data. Private encrypted data seriously affects subsequent data interconnection and data reuse.
The data can be stored encrypted, but the hospital must know the decryption password and have the ability to decrypt without relying on the original manufacturer. The data belongs to hospitals and patients, not manufacturers. Vendors should correct their values ​​and not use the ignorance of hospitals to abduct hospitals. Hospitals should also change from ignorance to knowledge, master basic information expertise, and carefully inventory and protect their data assets.
Integrated platform
With the rise of data, independent data centers have become just-needed, and an important means of implementing data centers today: the integration platform is starting to heat up. Many experts have demonstrated the application of the system integration platform in their own hospitals.
A few days ago, I chatted with the chief information officer of a central regional hospital. They had 600 beds in the hospital and wanted to integrate the platform. I said that the integration platform might exceed 10 million yuan. He did not mean that the price was expensive, and he was interested in searching everywhere. Manufacturer information for the integration platform. A large company I contacted did a large hospital project in East China, with an electronic medical record of 8 million, and a large number of people to stay in the field for a long time; the integration platform was 20 million, and the implementation amount was less than the electronic medical record. A director of information at a Shanghai hospital said that the hospital is absolutely willing to spend money on information technology, that is, it can not find a satisfactory product.
My understanding of this is that the spring of the integration platform is coming. In the higher electronic medical record system rating, the integration platform is almost just needed. The central government proposed the hospital information construction centered on electronic medical records. Then the electronic medical record is a cylinder, and everything can be loaded. Therefore, the value of the integrated platform is also in the scope of the electronic medical record system.
But it is not worthwhile to be worthwhile. It is very important and useful. Good medicine may not be expensive. Your medicine may not be good. For the hospital, it is still necessary to keep a cool head, learn basic information technology knowledge, carefully inventory their digital assets, formulate their own development strategies, and buy and use information products. However, the kind of arsenic can save people, and the phenomenon that ginseng kills people without sin should still emerge.
Hospital independent research and development
Many of the rating demonstration hospitals represented by today's lecture experts are self-developed. Beijing Yuwai, Tsinghua Chang Gung, Edong Medical Group, Shanghai Ruijin, Jiangsu Provincial People's Hospital, etc. Some well-known hospitals that have not taken lectures, such as Wenzhou Hospital, Dongyang Hospital, Zhangjiagang People's Hospital, etc., have more or less independent research and development. This indicates that hospital independent research and development software contributes to high ratings.
Now the hardware technology is more standardized and specialized, it can be outsourced, and the switch manufacturers are more convenient, the price is more transparent, and the management is convenient. But software technology is not standardized enough, and hospitals that require high levels of software require deep customization. On the one hand, software vendors maintain multiple hospitals and have a lack of skills. On the other hand, they try to pursue the generalization of software. This makes the factory want all hospital customers to use only one version of the software. Therefore, deep customization software functions need to rely on the game between the hospital and the manufacturer, and sometimes the two sides will be unhappy. At this time, independent research and development of the hospital has become an auxiliary means to achieve high ratings.
The biggest advantage of the hospital's independent research and development software is to get a team of its own information technology. This team can be integrated with the business department, and can be called a brother and sister with medical staff. For a long time, they only customize and maintain software for their own hospitals. They have the willingness and obligation to maintain the core interests of the hospital when purchasing the system. Turn the hospital's ignorance of informationization into knowledge.
According to the author's nearly 20 years of software development experience, informatization is a professional technology. It requires theory to be more practical. It requires long-term coding to obtain the true meaning. Without coding experience, it will not really understand the software. Even if there is only one person who really understands the software and understands the hospital business, the hospital can avoid many pits when purchasing software, avoiding a lot of waste and reducing the frequent replacement of software systems. And this kind of person can only be cultivated through the process of actually writing the hospital's own software. The technicians introduced from the outside know the software but do not understand the hospital business process, and the effect is not great in the short term.
However, the hospital's information needs are too vast, and it is difficult to completely research and develop independently. At this time, some core software can be independently developed, and peripheral software outsourcing is done to manufacturers. Try to purchase software that provides a secondary programming interface to facilitate the hospital to modify and integrate the software itself. Moreover, the database structure of the software package must be made public, and if the manufacturer privately encrypts the data, it will be rejected.
Conditional source code can be obtained from the manufacturer. Note that the source code here must be exactly matched with the hospital project. The hospital should request the latest local version of the source code after each modification of the vendor's field project team. Because the source code management of some vendors is not good enough, the source code of the manufacturer's headquarters is not necessarily exactly matched with the hospital project.
When the hospital independently researches and develops, it can purchase programmable software components/middleware to avoid the underlying research and development of high-tech difficulty, such as third-party controls such as electronic medical record editor, which reduces development difficulty and saves work.
Hospital independent research and development is only an auxiliary means of high rating, and most hospitals have no conditions to implement, but hospital staff to learn as much information technology expertise as possible is still an important aid for high ratings. It is also necessary to go to the Brothers Hospital for a visit to the hospital. It is also essential to sit on the cold bench and pick up the night light.
summary
For this new electronic medical record rating, I think it is the biggest event in the 2018 HIT industry. For the pursuit of advanced hospitals, we must carefully study and understand the new rating, and conscientiously do a good job in hospital information construction with electronic medical records as the core. Upgrade the informationization to the number one project, break the existing interest framework, carry out smooth transformation, and fill the flow chart from the wall into the computer and the human brain, and participate in the whole staff. Most importantly, the rating is only the beginning, and the continuous improvement of medical quality is the never-ending long march.
For IT manufacturers, the new rating is a big plus, and there are a lot of business opportunities worth exploring. But the prosperous world is also declining, and the world can rise. At any time, enterprises should maintain correct values, grasp the trend, show the spirit of the new enterprise, and get rid of the suffocation of the old enterprise, in order to win a bigger win and win greater victories.
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