HRPS数字化医院信息管理系统整合的研究
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摘要
21世纪是一个高度信息化世纪。人民生活水平的日益提高要求改革落后、低效的传统医疗模式,目前已有少量的、分散的、相对独立的医疗信息应用系统需要数字化技术改造,以发挥其巨大的效力。随着信息技术和我国医疗卫生事业的发展,我国的数字化医疗进程将大大加快。数字医疗是把当代计算机技术、信息技术应用于医院的整个医疗过程的一种新型的现代化医疗方式。其优点是可以实现先进的科技与高水平专家的资源共享,不断地提高诊疗水平,方便诊疗、科研和教学,以提高医院的竞争能力。
数字化医院指数字医疗应用于整个医疗过程的一种现代化医院信息管理模式。数字化医院信息管理系统是医学影像与计算机及现代信息技术互相渗透、密切结合产生的现代化医院信息管理系统。包括医院信息系统(HIS)、放射信息系统(RIS)、数字化医学影像归档及传输系统(PACS)三个部分。其基本目的是实现医学资源信息共享和医学影像存储方式数字化,有效地提高医学影像诊断的精确度和查询检索速度,使医师能够及时、方便、完整地获取这些资源,提高对病人的服务质量。基于国际医学信息交换标准(DICOM和HL7)整合医院内不同信息系统(HIS、RIS和PACS),可共享医学影像学检查的图像数据及诊断信息,为医院整体效率的提高以及医疗服务范畴的扩展和应用提供可靠的技术支持和保障,是保证医院内外医疗文本和影像信息交换以及实现远程医疗(Telemedicine)和远程放射学(Teleradiology)的关键。
本文依据国内医疗环境与法令为基础,遵循国际医疗信息交换标准发展,运用现代科学技术,研究符合国际标准并适应本土化实现环境的数字化医学信息管理系统。分析了数字医疗、数字化医院、HRPS、HIS、RIS、PACS等的概念以及实现的关键技术,提出了HRPS数字化医院管理系统、郑州市第五人民医院PACS医学影像系统,DTEIS数字化远程急救信息系统和MFPS城市紧急救助联动信息系统。研究了数字化医院信息系统整合及工作流的实现技术,解决了HIS、RIS和PACS之间的跨平台数据交换,提高了系统的实时性和保证数据的可靠性,实现了接口通信标准化,应用功能模块化,工作流程科学化,中心化管理,网络化使用和信息资源共享,适应本土化的实现环境,并满足后续设备联入系统。在系统地分析医学影像设备的各类接口的基础上提出了基于非DICOM医疗影像设备接口标准化转换技术,是
HRPS数字化医院管理系统网络内各系统互联的关键技术,它对现有非DICOM标准接口设备的标准化转换具有一定的意义。
HIS(Hospital Information System)是一个用来管理医院信息的客户机/服务器和浏览器/服务器混合体系模块化结构的大型数据库应用系统。有机整合了管理信息系统(Managerment Information System)和临床信息系统(Clinical Information System),其功能是用计算机和通讯设备来收集、存储、处理、检索和传输病人诊疗和医院管理数据,满足在医院的相关事务中的所有被授权用户的需求。RIS(Radiology Information System)是基于医院放射科和医学影像学部门工作流程和任务执行过程管理的计算机信息系统,其功能主要实现医学影像学检查整体流程的计算机网络化控制管理。
PACS(Picture Archiving and Communication System)是临床医学、医学影像学、数字化图像技术与计算机技术、网络通讯技术结合的产物。本文提出了郑州市第五人民医院PACS医学影像系统,解决了医学图像的获取、显示、存储、传输和管理等问题。提升了医院诊断会诊、存储归档、办公管理和科研教学手段,实现了数字化、网络化和无胶片化的现代化医学影像诊断与管理,显著提高了诊疗质量和工作效率,降低了医疗成本,提高了医疗质量、工作效率和管理水平,降低了诊断成本,并为病人减轻了经济负担。其结果达到了我们预期的目标,证明了采用方法与技术的可行性,对其它医院实现数字化进程也具有一定的借鉴意义。
本文应用计算机技术、信息技术、医学图像和数据库技术,采用模块化结构,将HIS、RIS和PACS的各个功能模块有机整合和组网,提出了HRPS(Hospital Information, Radiology Information, Picture Archiving and Communication System)数字化医院信息管理系统。其中HIS包括HIS服务器、管理终端和临床终端,RIS包括各种影像设备、PACS和影像网络中心。硬件构架采用Web的多层体系结构Browse/Server模式,网络采用ATM技术,信息交换标准为DICOM3.0,数据库为Oracle,开发工具为PowerBuilder。系统具有共享性、安全性、开放性、可扩展等特点,可在一个完整的平台上实现系统功能、管理功能、信息处理功能和通讯功能,符合DICOM3.0和HL7标准,其结构模块化可随机组合、扩展方便,支持分阶段分模块实施,可实现信息共享和数字化管理,并适合本土化的实现环境,可满足不同层次医院的需要。
基于HRPS的DTEIS(Digital Tele-emergency Information System, DTEIS)数字化远程急救信息系统是一个能实时动态地获取院外远距离的各种危重和疑难病人信息,并利用计算机技术和通讯技术有效发挥远程的专家和医疗资源的计算机网络系统。
其独特性是基于CORBA/JAVA的浏览器/服务器/数据库服务器三层结构模式,采用了模块化设计,以HRPS作为中心站,有机地结合数字化医院信息系统与远
In the 21st century, a highly informationized era, the elevation of people’s living standard requires the reform of the outdated and inefficient traditional medical modes which. At present, a small number of scattered and relatively independent medical information application systems need to be updated with digital technique in order to play greater function. Domestic digital medicine will make much greater progress as the information technology and medical and hygienic causes develop. Digital medicine is a new modern medical mode, which applies computer and information technology to the whole medical process in hospitals. It also possesses such advantages as the realization of resource sharing between advanced techniques and high-level experts and the rise of diagnostic level. It facilitates diagnosis and treatment, scientific research and teaching so as to advance hospital competence.
Digital hospital is a modern hospital information management mode with digital medicine applied to the whole medical process. Digital hospital information management system is a modern hospital management system in which medical imaging, and computer and modern information technology are intercrossed and combined with each other. It includes 3 parts: HIS (medical information system), RIS (radiography information system) and PACS (Picture Archiving and Communication System). The basic object of digital hospital is to realize information sharing of medical resources and digitalization of storage pattern of medical images, which helps efficiently raise the accuracy and speed of query and retrieve of medical image diagnosis so that doctors acquire these resources timely, conveniently and entirely and improve medical services. The integration of different information system (HIS, RIS and PACS) based on international standards of medical information exchange (DICOM and HL7) supports sharing of medical image data and diagnostic information, provides reliable technical support and guarantee for the elevation
of general hospital efficiency and the extension of medical service range. It is the key technique to guarantee information exchange of medical texts and images inside and outside hospitals and to realize Telemedicine and Tele-radiology.
Based on domestic medical environments, laws, modern science and technology and the development of international medical information exchange standards, this paper discussed digital hospital information management system which not only conforms to international standards but also adapts to local realization environment. In this paper, the concepts of digital medicine, digital hospital, HRPS, HIS, RIS, PACS and key technique of the realization were discussed. It put forward the HRPS digitalized hospital management system, the 5th people’s hospital PACS medical imaging system in Zhengzhou, the DTEIS digital hospital management system and MFPS city emergency-aid blocking information system. The realization technique of integration and working procedure on digital hospital information system were studied. The cross-platform data exchange among HIS, RIS and PACS was solved, which enhanced the capacity of real-time of system and guarantee the reliability of data. This technique realized standardization of interface communication, modularization of application-function, rationalization of working procedure, centered management, use of network and information resource sharing, which accommodated local environment of realization and satisfied link of sequent devices to the system. Based on systematical analysis of all kinds of interfaces of medical imaging devices, this paper put forward that HRPS-based standardized conversion technique of Non-DICOM medical imaging equipments interface is the key technique of interconnection among systems in HRPS digital medical management system network, which has certain significance to the standardized transfer of devices of NON-DICOM interfaces.
HIS (Hospital Information System) is a huge database application system of a mixed modularized structure of both client/s
数字化医院指数字医疗应用于整个医疗过程的一种现代化医院信息管理模式。数字化医院信息管理系统是医学影像与计算机及现代信息技术互相渗透、密切结合产生的现代化医院信息管理系统。包括医院信息系统(HIS)、放射信息系统(RIS)、数字化医学影像归档及传输系统(PACS)三个部分。其基本目的是实现医学资源信息共享和医学影像存储方式数字化,有效地提高医学影像诊断的精确度和查询检索速度,使医师能够及时、方便、完整地获取这些资源,提高对病人的服务质量。基于国际医学信息交换标准(DICOM和HL7)整合医院内不同信息系统(HIS、RIS和PACS),可共享医学影像学检查的图像数据及诊断信息,为医院整体效率的提高以及医疗服务范畴的扩展和应用提供可靠的技术支持和保障,是保证医院内外医疗文本和影像信息交换以及实现远程医疗(Telemedicine)和远程放射学(Teleradiology)的关键。
本文依据国内医疗环境与法令为基础,遵循国际医疗信息交换标准发展,运用现代科学技术,研究符合国际标准并适应本土化实现环境的数字化医学信息管理系统。分析了数字医疗、数字化医院、HRPS、HIS、RIS、PACS等的概念以及实现的关键技术,提出了HRPS数字化医院管理系统、郑州市第五人民医院PACS医学影像系统,DTEIS数字化远程急救信息系统和MFPS城市紧急救助联动信息系统。研究了数字化医院信息系统整合及工作流的实现技术,解决了HIS、RIS和PACS之间的跨平台数据交换,提高了系统的实时性和保证数据的可靠性,实现了接口通信标准化,应用功能模块化,工作流程科学化,中心化管理,网络化使用和信息资源共享,适应本土化的实现环境,并满足后续设备联入系统。在系统地分析医学影像设备的各类接口的基础上提出了基于非DICOM医疗影像设备接口标准化转换技术,是
HRPS数字化医院管理系统网络内各系统互联的关键技术,它对现有非DICOM标准接口设备的标准化转换具有一定的意义。
HIS(Hospital Information System)是一个用来管理医院信息的客户机/服务器和浏览器/服务器混合体系模块化结构的大型数据库应用系统。有机整合了管理信息系统(Managerment Information System)和临床信息系统(Clinical Information System),其功能是用计算机和通讯设备来收集、存储、处理、检索和传输病人诊疗和医院管理数据,满足在医院的相关事务中的所有被授权用户的需求。RIS(Radiology Information System)是基于医院放射科和医学影像学部门工作流程和任务执行过程管理的计算机信息系统,其功能主要实现医学影像学检查整体流程的计算机网络化控制管理。
PACS(Picture Archiving and Communication System)是临床医学、医学影像学、数字化图像技术与计算机技术、网络通讯技术结合的产物。本文提出了郑州市第五人民医院PACS医学影像系统,解决了医学图像的获取、显示、存储、传输和管理等问题。提升了医院诊断会诊、存储归档、办公管理和科研教学手段,实现了数字化、网络化和无胶片化的现代化医学影像诊断与管理,显著提高了诊疗质量和工作效率,降低了医疗成本,提高了医疗质量、工作效率和管理水平,降低了诊断成本,并为病人减轻了经济负担。其结果达到了我们预期的目标,证明了采用方法与技术的可行性,对其它医院实现数字化进程也具有一定的借鉴意义。
本文应用计算机技术、信息技术、医学图像和数据库技术,采用模块化结构,将HIS、RIS和PACS的各个功能模块有机整合和组网,提出了HRPS(Hospital Information, Radiology Information, Picture Archiving and Communication System)数字化医院信息管理系统。其中HIS包括HIS服务器、管理终端和临床终端,RIS包括各种影像设备、PACS和影像网络中心。硬件构架采用Web的多层体系结构Browse/Server模式,网络采用ATM技术,信息交换标准为DICOM3.0,数据库为Oracle,开发工具为PowerBuilder。系统具有共享性、安全性、开放性、可扩展等特点,可在一个完整的平台上实现系统功能、管理功能、信息处理功能和通讯功能,符合DICOM3.0和HL7标准,其结构模块化可随机组合、扩展方便,支持分阶段分模块实施,可实现信息共享和数字化管理,并适合本土化的实现环境,可满足不同层次医院的需要。
基于HRPS的DTEIS(Digital Tele-emergency Information System, DTEIS)数字化远程急救信息系统是一个能实时动态地获取院外远距离的各种危重和疑难病人信息,并利用计算机技术和通讯技术有效发挥远程的专家和医疗资源的计算机网络系统。
其独特性是基于CORBA/JAVA的浏览器/服务器/数据库服务器三层结构模式,采用了模块化设计,以HRPS作为中心站,有机地结合数字化医院信息系统与远
In the 21st century, a highly informationized era, the elevation of people’s living standard requires the reform of the outdated and inefficient traditional medical modes which. At present, a small number of scattered and relatively independent medical information application systems need to be updated with digital technique in order to play greater function. Domestic digital medicine will make much greater progress as the information technology and medical and hygienic causes develop. Digital medicine is a new modern medical mode, which applies computer and information technology to the whole medical process in hospitals. It also possesses such advantages as the realization of resource sharing between advanced techniques and high-level experts and the rise of diagnostic level. It facilitates diagnosis and treatment, scientific research and teaching so as to advance hospital competence.
Digital hospital is a modern hospital information management mode with digital medicine applied to the whole medical process. Digital hospital information management system is a modern hospital management system in which medical imaging, and computer and modern information technology are intercrossed and combined with each other. It includes 3 parts: HIS (medical information system), RIS (radiography information system) and PACS (Picture Archiving and Communication System). The basic object of digital hospital is to realize information sharing of medical resources and digitalization of storage pattern of medical images, which helps efficiently raise the accuracy and speed of query and retrieve of medical image diagnosis so that doctors acquire these resources timely, conveniently and entirely and improve medical services. The integration of different information system (HIS, RIS and PACS) based on international standards of medical information exchange (DICOM and HL7) supports sharing of medical image data and diagnostic information, provides reliable technical support and guarantee for the elevation
of general hospital efficiency and the extension of medical service range. It is the key technique to guarantee information exchange of medical texts and images inside and outside hospitals and to realize Telemedicine and Tele-radiology.
Based on domestic medical environments, laws, modern science and technology and the development of international medical information exchange standards, this paper discussed digital hospital information management system which not only conforms to international standards but also adapts to local realization environment. In this paper, the concepts of digital medicine, digital hospital, HRPS, HIS, RIS, PACS and key technique of the realization were discussed. It put forward the HRPS digitalized hospital management system, the 5th people’s hospital PACS medical imaging system in Zhengzhou, the DTEIS digital hospital management system and MFPS city emergency-aid blocking information system. The realization technique of integration and working procedure on digital hospital information system were studied. The cross-platform data exchange among HIS, RIS and PACS was solved, which enhanced the capacity of real-time of system and guarantee the reliability of data. This technique realized standardization of interface communication, modularization of application-function, rationalization of working procedure, centered management, use of network and information resource sharing, which accommodated local environment of realization and satisfied link of sequent devices to the system. Based on systematical analysis of all kinds of interfaces of medical imaging devices, this paper put forward that HRPS-based standardized conversion technique of Non-DICOM medical imaging equipments interface is the key technique of interconnection among systems in HRPS digital medical management system network, which has certain significance to the standardized transfer of devices of NON-DICOM interfaces.
HIS (Hospital Information System) is a huge database application system of a mixed modularized structure of both client/s
引文
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R. Glicksman. Image Quality Concepts for PACS. Proc. of SPIE.1994, 2165: 694-703
何清华, 胡建华, 欧晓光等. 在构建医院PACS时应该注意的一些技术问题[J]. 中国医疗器械杂志, 2002, 26(6): 420-423
沈兰荪, 魏海. 图像的无损压缩研究[J]. 数据采集与处理, 1999, 14(4): 485-491
WeinbergerMJ, SeroussiG, SapiroG. A low Complexity, Context Based, Lossless Image Compression Algorithm [Z]. Hewlett Packard Laboratories, Palo Alto, CA94394
宋健宁. 试论医学影像存档与通讯系统的诊断价值[J]. 中华放射学, 1999: 33(12): 801
M. Fabrizio, et al. The standard ‘Healthcare Information Systems Architecture’ and the DHE middleware.J. International Journal of medical informatics, 1998, 52: 39-51
J. Rohan. Managing information systems for health services in a developing country: a case study using a contextualist framework.J. International Journal of Information Management, 1999, 19: 335-349
F.S. Maria, P. Vicenzo. Combining High-performance Computing and Networking for Advanced 3-D Cardiac Imaging.J. IEEE Transactions of information technology in biomedicine, 2000, 4(1)
National Electrical Manufacturers Association(NEMA). DICOM supplement 11, Radiotherapy objects. 1997, Washington, DC
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O.E.V. Syckle, et al. “Successful Integration Between Information Systems and Imaging Systems – Integrating the Healthcare Enterprise (IHE)”.J. Proceedings of CARS 2000, 377-382
P.J. Toussaint, H. Lodder. Component-based development for supporting workflows in hospitals. J. International Journal of Medical Informatics 1998, 52: 53-60
H.K. Huang. PACS: Basic Principles and Applications. 1999, New York: Wiley-Liss
National Electrical Manufacturers Association (NEMA). Digital imaging and
communication in medicine (DICOM) Draft standard, 2000
W. Kurt, W. Nelson, M. Linda. Distributed Object Technology with CORBA and JAVA: Key Concepts and Implications. Technical Report CMU/SEI – 97 – TR – 004, ESC – TR – 97 – 004, June, 1997
Mandates in the building and civil engineering field leading to harmonized European standards. CEN N 070 Revision 16, 2000, 1, 31
A. Santos, et al. Multimodality image integration for radiotherapy treatment: an easy approach. Medical Imaging 2001: Visualization, Display, and Image-Guided Procedures, S.K. Mun (ed.), Proceedings of SPIE. 2001, 4319: 715-723
P. Francesco, M. Mario, et al. A communication architecture for hospital information systems .J. Computer Methods and Programs in Biomedicine, 2000
ACR-NEMA. Digital Imaging and Communications in Medicine (DICOM) Part1~14: Introduction and Overview, 1999, 8, 26
National Electrical Manufacturers Association (NEMA). DICOM, No PS3. 1999, Washington, DC
A. Duerinckx et al. Integrating SICOM Conformant Imaging Equipent with a PACS. Proc. Of SPIE. 1998, 3339: 540-555
Tang Chengliang, Yuan Huang. Implementation method of medical image data transmission service of PACS based on DICOM .J. Journal of Zhengzhou Insititute of Light Industry (Natural Science) Jun. 2001, 16(2): 65-67
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Maldjian, J.A.; Listerud, J.; Khalsa, S. Integrating postprocessed functional MR images with picture archiving and communication systems. AJNR Am.J.Neuroradiol, 2002, 23(8): 1393-1397. E2
Langer, S.G. OpenRIMS: an open architecture radiology informatics Management system.J.Digit.Imaging, 2002, 15suppl 1:246-249. E4
Ingeholm, M.L.; Levine,B.A.; Fatemi,S.A.; Moser,A.H. A pragmatic discussion on establishing a multicenter digital imaging network, J. Digit.Imaging, 2002, 15 suppl 1: 180-183. E5
M. Frost et al. A DICOM Server for CT and MR Acquisition to an Archive. Proc. Of SPIE, 1994, 2165: 70-77
Peters, K.R.; Ramsby,G.R. Natural display mode for digital DICOM-conformant diagnostic imaging. Acad. Radiol. 2002, 9(9): 1025-1035. E1
Chen Xu, Qin Binjie, Zhuang Tiange. Comparison of Image Acquiring Methods in PACS, J. Chinese Journal of Medical Instrumentation. 2002,26(3): 207-209
Zhao Xiping, Zheng Chongxun, Mao Songshou. The Tendency of PACS. Chin J Radiol, January, 1998, 32(1): 5~7
Willis J. Tompkins. Biomedical Digital Signal Processing. Prentice Hall 1993[M]. 林家瑞, 徐邦荃等译, 华中科技大学出版社, 2001, 11
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高文著. 多媒体数据压缩技术[M]. 北京: 电子工业出版社, 1994; 4
张系国. 图像信息系统设计原理[M]. 北京: 科学出版社, 1990; 8
吕晓琪, 徐萍萍, 杨炳儒. 医院信息系统设计[J]. 生物医学工程学杂志 2000; 18(1): 163～166
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Digital Imaging and Communication in Medicine (DICOM PS3.1), National Electrical Manufactures Association, 1998
H.K Huang, PACS Basic Principles and Applications, Wiley-liss, New York, 1999
Phoebe S. The use of high technology for HHC: issue and implications .J. Medical Instrumentation, 1996, 22(5): 222
Chen HS, Guo FR, Lee RG. Recent advances in telemedicine .J. J Formos Med Assoc. 1999, 98(11): 767-72
Xin Li, John WD. Aldishttp. The first international telemedicine trial to China: Zhu Ling’s Care. http://www.radsci.ucla.edu/telemed/ahuling/, 1997
Wright D. Telemedicine and developing countries. A report of study group 2 of the ITU Development Sector. J Telemed. Telecare. 1998, 4Suppl. 2 1-85
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