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In terms of its service purpose, the hospital provides medical services to patients. Regardless of whether the hospital has established a hospital information system (HIS), the hospital manages patient information through ID numbers without realizing the “real-name system” for medical treatment. However, in practice, there are often cases where a patient has multiple ID numbers, which makes it impossible for the hospital to archive and aggregate patient medical records, medical treatment information, and cost information, and it is also not conducive to patients’ inquiries on information, especially new ones. After the “Regulations on Handling of Medical Malpractices” were issued, hospitals are required to implement “upside-down of proof”, which is even more detrimental to the hospital’s protection of itself. Whether a hospital can provide patients with convenient, fast, and high-quality services, a variety of different information inquiries are effective means for hospitals to enhance their competitiveness. Here we introduce the design and application of our hospital using IC card as the electronic ID card of patients in the hospital to realize the functions of patient consultation, information inquiry, electronic money and so on.
The so-called “all-in-one card” is how to build the application platform of the IC card as a whole, so as to bring all independent application systems into unified management. The all-in-one card technology involves various aspects, such as network technology, communication technology, database technology, automatic control technology, etc. But its core is still IC card technology and reading and writing equipment. It can be said that IC cards and reading and writing equipment are the supporting points of all-in-one card technology. In 1997, our hospital was the first batch of “Military No. 1” pilot hospitals. In 2000, the goal of establishing a digital hospital was formally put forward. More than 30 million yuan was invested successively to complete the construction of PACS, office automation, hospital health “all-in-one card”, etc. There are nearly 100 subsystems in more than 10 systems, and the prototype of a digital hospital has been built. Our hospital’s health “card” is to use IC cards to store patient ID numbers, funds and other information on the digital hospital platform to realize patient registration, medical treatment, charging, drug distribution, inspection and inspection application and report query, touch screen and Internet query, and in-hospital meal ordering. With shopping, online and telephone appointment registration, medical insurance patient management and other functions.
1. Key technology
1. IC card issuance and recharge software design: establish a series of tables in the Oracle database to record patient ID number, IC card number, expenses, card issuance date, card issuer and other information, and manage the patient’s card issuance and recharge status through software design Record. The software also has the functions of returning the card, reporting the loss, resolving the loss, replenishing the card, and statistics to solve the daily management needs of the IC card. In the hospital information system, the patient’s ID number is the key word for various information resources of the patient. How to effectively manage the patient’s ID number is the key to achieving multiple visits and information aggregation for the patient. For this reason, we have realized the one-to-one correspondence between the patient ID number and the IC card number through the design of IC card issuance and recharge software, so that one ID number can only correspond to one card, and one card can only correspond to one ID number. This effectively reduces the occurrence of a patient having multiple ID numbers in the hospital. We configure the card issuance software in the outpatient and emergency registration rooms, the first part of the patient’s visit to the hospital. It is used to handle daily card issuance, loss reporting, consultation and other services; the recharge software is configured in the special windows of the outpatient and inpatient charging rooms for Willing to deposit funds into the IC card to deal with the needs of this part of the patient.
2. IC card interface software design: using the API functions provided by WINDOWS, the corresponding information in the IC card can be extracted by swiping the card in any module in the hospital where there is an input ID number, IC card number, and medical insurance account number. The software is resident in memory when Windows starts, so that the IC card system does not need the source code of the information system software when it is connected to the hospital information system, which lays the foundation for the popularization and application of the system. Using the IC card interface program can make the IC card be used in the management of the entire digital hospital. In order to improve the efficiency of the hospital and alleviate the contradiction of patients’ visits, IC card readers have been connected to the links related to the patient’s identity, such as registration, outpatient doctor workstations, outpatient clinics, hospitalization charges, medicine distribution, blood draws, examinations, and report collections. , So that the staff of these departments can extract the patient ID number by swiping the card, achieving the purpose of fast, accurate and convenient, effectively reducing the occurrence of patient queuing, and realizing the purpose of the IC card as the patient’s electronic ID card in the hospital.
2. The design and realization of several functions of the health “all-in-one card”
1. The design and realization of the consumption function of IC card: using the storage function of the IC card, the funds and password can be pre-stored in the IC card and the database at the same time, so that patients can receive medical treatment, dining, shopping, online and telephone appointments in the hospital. The expenses are deducted from the IC card and the database to realize the function of the hospital’s IC card electronic money. In terms of management measures, in order to cultivate and encourage patients to use the IC card electronic money function, the hospital temporarily stipulated: Anyone who pays for medical consumption through an IC card can implement a 5% preferential charge on the inspection fee and the inspection fee. Through the above technology and management measures, more patients can use the electronic currency function of the health “all-in-one card”, thus laying the foundation for online and telephone appointment registration, and has been recognized by some surrounding units that have not joined the basic medical insurance. When they signed the agreement with the hospital, they all included the employees’ medical expenses into the employees’ personal accounts, and stipulated that in principle, they can only conduct medical treatment in our hospital. The funds in the accounts can only be used for the payment of medical expenses. During the design, special funds for medical consumption and living consumption are used exclusively.
2. Realization of online and telephone appointment function: When a patient sees a doctor in a hospital, the hospital shall charge the patient’s registration fee and diagnosis and treatment fee. When there is no IC card electronic currency as a payment method, it is often the case that patients make online or telephone appointment registration without going to the hospital for treatment, resulting in a waste of limited number meter resources in the hospital and the hospital not receiving registration fees and diagnosis and treatment fees. , Even if the patient arrives at the hospital, there is still the trouble of going to the registration room to pay. With IC card electronic money as a payment method, the above phenomenon can be overcome. The system can automatically deduct the patient’s medical expenses from the database, and prevent malicious online or telephone appointment registration. Make an appointment for registration through the Internet or telephone. After arriving at the hospital, the patient no longer passes through the registration room, and can directly insert IC cards on the 4 touch screens set up in the outpatient department, and then the printer connected to the touch screen will print out the patient’s consultation information sheet, prompting the patient to visit the department. , The serial number of the consultation, the patient can wait for consultation in the waiting room according to the prompt information on the display screen of the “Automatic Centralized Triage System” independently developed by our hospital.
3. The realization of the IC card medical insurance function: A comprehensive medical insurance system in a region supports medical insurance IC cards, and the medical insurance center relies on the “medical insurance number” to manage the medical insurance patient’s identity, benefits, medical consumption and other data. Since the hospital and the medical insurance center have implemented a network, the medical insurance patient only needs to write the medical insurance patient’s “medical insurance number” into the IC card of our hospital when the medical insurance patient comes to the hospital for the first visit. Card instead of the IC card issued by the medical insurance center.
4. The management of IC card continuing education credits: The service quality of a hospital is the basis for the survival and competition of the hospital, and the improvement of the service quality requires long-term continuing education and training for employees. In order to effectively control the quality of continuing education, the hospital has adopted a continuing education credit system. For this reason, we have developed two modes of IC card online and offline to control the collection of continuing education credits.
5. The realization of the IC card query function: (1) The realization of the IC card touch screen query system: The hospital has a touch screen connected to the network in the outpatient department and each inpatient ward building, which is used to introduce the general situation of the hospital, medical guidance, specialties and expert characteristics Public information such as patient diagnosis, medical consumption, examination and inspection results, one-day list and other private patient information can be queried by inserting the patient’s IC card to ensure the patient’s demand for information and the protection of their privacy rights. (2) Inquiry of IC card Internet information: In addition to inquiring about their own information in the hospital, patients also need to inquire about their own information on the Internet. Log in to our hospital website WWW. SWHOSPITAL.COM, enter the patient’s ID in the user name in the medical record query, and enter the last 4 digits of the IC card number in the password. , Test results, medical expenses usage and other information, provide an online health file for the patients hospitalized in our hospital. Patients can find their own health files all over the world, a time-saving and labor-saving value-added service. It also provides patients with money-saving services based on inspections and test results, which reduces the financial burden of patients.
3. Effects and discussion
Since our hospital issued health IC cards for inpatients on February 1, 2000, and issued the card for each outpatient on November 15, 2002, a total of 656,089 patients have been issued “Southwest Hospital Health Friend Card”. The following effects:
1. Standardize the ID number of patients: the hospital issues IC cards for each patient who visits; uses IC cards in registration, visits, charges, and medicines related to the patient’s identity; uses IC cards for medical treatment and daily consumption; in hospitals The internal and external networks provide a variety of related functions that can be realized by IC cards, so as to cultivate and guide patients to regard the IC card as a citizen ID card to cherish and preserve the IC card, so that the hospital can ensure that there is only one patient. The purpose of the ID number. Through the analysis of the basic information of 50,000 patients, the phenomenon that a patient has multiple ID numbers has been reduced by 98%, and the purpose of hospital management has been achieved.
2. Optimize the medical treatment process: The outpatient service is the most important window of the hospital to the society, and the portal for the patients to test the quality of the hospital’s medical services. The implementation of the “All-in-One Card” for health has solved the problem of the hospital using limited outpatient resources and improving the efficiency of each link in the outpatient department. Paperless, filmless and wireless networks are the three major characteristics of building a digital hospital in the future. The digital construction of our hospital is also moving towards the goal of a “three noes” hospital. Clinicians can apply directly online without printing the examination application form. The patient shows his health IC card in the examination department, and the staff can use the card to retrieve the application form from the Internet to do the examination for the patient, thus saving paper for the hospital and improving efficiency .
3. Provide a variety of value-added services: the functions such as query and electronic money provided by the health “all-in-one card” system have shortened the distance between patients and the hospital. Patients can learn about the hospital’s dynamics and their own health files without leaving their homes; realize a series of value-added services such as online or telephone appointment registration, online medical treatment, and psychological consultation. Since its implementation in 2002, a total of 260,000 people have inquired about and downloaded patients’ own health files through the Internet; 36,000 people have made appointments online or by telephone, and 107,000 people have used the electronic money function.
4. Insufficiency of the “One Card for Health”: The “One Card for Health” system mainly records the patient ID number. Under the premise that the hospital does not implement the “real-name system” for seeing a doctor, the ID number is not the recorded patient ID number, so there is also a patient Owning multiple ID numbers occurs. In other words, the health “all-in-one card” cannot fundamentally eliminate the situation where a patient has multiple ID numbers.
The implementation of the “all-in-one card” for health in digital hospitals improves the efficiency of patient consultation, reduces the waste of human resources and the labor intensity of staff, strengthens the orderly management of patient information and funds, optimizes the patient consultation process, and provides patients A variety of information query methods are used to enrich the connotation of digital hospitals.We believe that the realization of the hospital health “all-in-one card” system brings not only convenient, hygienic and efficient services to patients, but also intelligent and informatized management in the hospital.
Successful application will surely have bright prospects.
references
1 Wu Luxia. A Preliminary Study on the All-in-One Card for Hospital Visits. Scientific and Technological Information Development and Economics, 2002, 12(5): 126-127.
2 Wang Hui. Application of “One Card” in Digital Community. Golden Card Project, 2003, 3:14-20.
3 Li Ping, Qu Cheng. Strengthen the standardized management of outpatient clinics and strengthen the awareness of quality service. Chinese PLA Hospital Management Journal, 2001, 8(6): 444-445.
4 Liu Xiongfei, Chen Jinxiong, Wang Qingsen. The status quo and development thinking of hospital digital construction. Chinese PLA Hospital Management Journal, 2003, 10 (4): 349-352.
5 Mu Yunqing, Li Guixiang, Zhang Yong. IC card multimedia touch screen medical consultation system. Medical Information, 2001, 14 (2): 77-78.
about the author:
Southwest Hospital of Chongqing Third Military Medical University Mu Yunqing Liu Guoxiang Wu Hao Li Gangrong
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