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In recent years, the application of mobile computing technology has become more and more mature. With the popularization and low price of handheld mobile terminals (PDA), the wireless, mobile, and intelligent enterprise information systems and management modes are unstoppable. At present, Xu enterprises have taken the lead in introducing enterprise mobile information systems to enhance their competitiveness and optimize management processes. With the release of the new medical reform plan, the mobility and intelligence of the medical industry have been put on the agenda.
Mobile services into medical
“Mr. Zhang, your cholesterol was found to be too high in the last physical examination. Today, we will especially strengthen the examination.” Mr. Zhang was surprised to see that the nursing staff knew his physical condition only through the handheld data terminal. Yes, this is the result of comprehensively promoting the mobility and networking of medical services based on RFID technology. In the past, when the physical examination unit wanted to inquire about the health examination report of the examinee, it was necessary to read the heavy paper. When applying for the addition and withdrawal of the health examination item, there may be omissions in filling in the additional items, or the receipts could not be sent in the first time, etc. Circumstances virtually hinder the fluency of the medical examination process.
The mobile intelligent medical service information integration system refers to the use of wireless local area network technology and RFID technology as the bottom layer, through the use of smart handheld data terminals to provide mobile first-line medical staff with “mobile” portable data applications. In the state of ward rounds or moving, medical staff can use the nursing staff software of the smart handheld data terminal to connect in real time through the Wi-Fi wireless network to interact with the data of the hospital information system data center. An information service system that enables medical staff to obtain comprehensive medical data on a handheld data terminal anytime, anywhere, and the patient can use the RFID-equipped wristband worn on the hand to query the RFID reader connected to the PC to show that the patient is currently The information service system that can obtain comprehensive medical data can compare the changes in the patient’s condition based on historical records and clinical examination results, and promptly consult and formulate treatment plans.
The purpose of the construction of the mobile service information integration system is to improve the operating efficiency of the hospital, reduce the incidence of medical errors and medical accidents, and thereby comprehensively improve the social benefits and competitiveness of the hospital. The construction of a mobile clinical information system is not only an inevitable trend in the development of hospital informatization, but also a guarantee for the hospital’s “people-oriented” medical model, and it is a manifestation of the comprehensive strength of a modern hospital.
System flow
The system realizes the mobilization of medical services through RFID technology. The reason for choosing RFID technology stems from its several advantages:
Reuse: The current bar code cannot be changed after printing, while the RFID tag can repeatedly add, modify, and delete the data stored in the tag to facilitate the update of information;
No barrier reading: The barcode data is read by optical or infrared. The barcode scanner must be at a close distance and there is no obstruction to read the barcode. RFID uses radio waves to transmit information, so there will be no transmission barrier problems;
High storage capacity: the capacity of one-dimensional bar code is 50Bytes, the maximum capacity of two-dimensional bar code can store 2~3000 Bytes, and the maximum capacity of RFID is several million Bytes;
Fast scanning: The barcode can only be scanned one at a time, and the RFID reader can identify and read several RFID tags at the same time.
Durability: Since the barcode is attached to the plastic bag or the outer packaging carton, it is particularly vulnerable to damage, while the RFID tag stores the data in the chip and will not be easily defaced.
Security: Since RFID carries electronic information, its data content can be protected by a password, making its content difficult to forge.
First, when a patient enters the hospital, the hospital will store the patient’s information in the RFID chip, wear the wristband with the RFID chip on the corresponding patient’s wrist, and record the patient number in the hospitalization data of the hospital information system; Wi-Fi can download and read all the patient’s medical record data and transmit it to the nurse’s mobile data terminal. Integrate the existing database and system of the original hospital information system. Using the characteristics of light and thin hand-held data terminal and easy to carry and operate, the staff can input the inventory results directly in the form of electronic data and record them in the hand-held data terminal in a simple and fast way; when the nurse is in the room, the hand-held data terminal can be passed through The reader reads the corresponding patient number in the RFID chip on the patient’s wrist, and can quickly search the patient’s medical record and prescription diagnosis and treatment information in the database in the handheld data terminal; build the IEEE802.11b wireless local area network environment inside the hospital to allow medical staff In the hospital, data can be uploaded and downloaded at any time through a handheld data terminal. Through the wireless data transmission technology of Wireless LAN, the data of the handheld data terminal can be quickly and accurately transmitted to the back-end server. Refer to Figure 1 for the system architecture diagram.
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Figure 1 System architecture diagram
System functions
The main goal of the system is to enhance the relationship between doctors and patients, improve the efficiency of nursing staff, and improve the efficiency of hospital management. This handheld data terminal extension system can be built without affecting the existing information management system and database to strengthen hospital services. The effectiveness of medical care. The system consists of the following three sub-systems:
RFID patient identification system: the handheld data terminal can download the photos of all patients identified by RFID and related medical records and prescription data on the day from the host. The medical staff can operate the handheld data terminal to display the patients they need to find and make related Record work.
Medical handheld data terminal application system: After the identification of the medical care is completed and the medical identity is confirmed, the medical staff can use the medical electronic form on the handheld data terminal integrated with the hospital information system to directly query patient data in real time through Wi-Fi , Directly check and enter the list on the handheld data terminal, and temporarily store it on the handheld data terminal. Batch transmission can be carried out, and it will be transmitted back to the back-end host system after a period of time.
Health diagnosis questionnaire survey system and inspection item query: After completing the body identification, the medical staff can ask the patient’s examination questionnaire items, use the electronic questionnaire of the handheld data terminal, and directly select the handheld data according to the questions answered The list on the terminal is temporarily stored on the handheld data terminal and can be sent back to the back-end host system.
Through the joint cooperation of the above systems, the real medical service mobility has been achieved, and the specific functions are as follows:
Wireless real-time transmission of information: The data is transmitted through the wireless Wireless LAN IEEE 802.11b mechanism, and the information results can be quickly and accurately transmitted to the back-end server. At the time of collection, it is stored in digital form and transmitted back to the server via wireless transmission. The time required for real-time return of a single form will be shortened to within 2 minutes. Wireless transmission is not restricted by region, and digital data can be uploaded or downloaded at any time even when moving or where there is no network cable.
Shorten the work schedule, and provide medical staff to use handheld data terminals to download and store patient data and photos in order to identify medical care. It can greatly reduce the time for staff in the health clinic to find medical care, and can also greatly reduce the chance of misidentification of medical care;
Convenient and effective data input method: The staff enters the data that needs to be recorded into the handheld data terminal, and uses the electronic form to click on the operation, and can use the pen type input operation, which is more convenient than the computer keyboard input. The handheld data terminal is light, thin, short and easy to carry, but it has the same computing function as a PC; and has special functions of handwriting input and recognition, which is very convenient for personnel to carry and operate;
Direct storage, accurate time saving: All data is directly input to the PDA by the first-line users, and then stored as electronic files, and transmitted to the back-end server via the wireless network. There will be no problems that traditional written data is difficult to save or lose; And it can avoid repeated input, time-consuming filling in, and wrong data input;
Reduce paper costs and reduce manpower: Through the handheld data terminal system, paper and printing costs can be saved, and a paperless e-work process can be achieved. At the same time, customers can avoid repeated data copying and computer input work, which greatly saves clinic budget;
Standard operation steps reminder: Design standard operation steps and procedures so that staff who are less familiar with the operation process can also complete the operation step by step with the assistance of the system. The system provides complete input data and steps, which can be designed according to internal specifications .
Problems and challenges
Although an intelligent and mobile medical system can greatly improve the quality of medical services and optimize the management process, there are also some problems that need to be further studied and improved during the implementation process to make mobile medical more perfect.
First of all, there is a lack of accurate reflection on the execution time of nursing behaviors: because nurses work between the nurse station and the ward, it is impossible for nurses to execute a medical order and record one immediately. Generally, the decomposition time of the medical order is regarded as the execution time, which leads to the computer The system does not have a record of the actual execution status of every medical order;
Secondly, there is a lack of objective reflection of the patient’s expense status: because the existing system charges for the decomposed execution items during the doctor’s order transfer stage, whether the patient receives the corresponding treatment? How much sanitary materials are actually consumed? The information in this area cannot be recorded in a timely manner, so billing omissions are prone to occur;
Thirdly, there is a lack of authenticity of the implementation of medical care tasks: the application of existing information systems in the ward is only limited to the decomposition (or entry) of medical orders at the nurse’s station, inquiries, confirmations, and the writing of part of the nursing records. During the execution of a specific medical order, the confirmation of the execution status of the nursing task is advanced or delayed. It is inevitable that there will be some man-made errors or improper execution of the medical order, such as omission to execute a medical order, etc., to a certain extent Security risks;
Fourth, the lack of support for the implementation of the nursing check system: “Three checks and seven pairs” is an important link for nurses to perform medical orders. In the past, the unique check of the patient’s identity mainly relied on the bed number or name, and the confirmation of the treatment content The basis is the treatment sheet, the infusion sheet, etc., so that there is the danger of a patient’s identification error, and it is also impossible to identify the wrong copy of the treatment sheet. Of course, due to the existence of the bedside card, it is obviously insufficient to protect the privacy of patients. There are certain hidden dangers for checking sleep, coma, mental disorders, or newborns;
Finally, there is a lack of support for improving the nursing model: nurses need to spend a lot of time to complete the writing of nursing documents. Even if electronic nursing records are used, there are still more repetitive tasks in traditional situations, such as measuring body temperature and recording them on paper. Going to the nurse’s station to copy again, there is no more time to take care of the patient. At the same time, with the implementation of electronic medical records, the system cannot instantly share the relevant clinical information and electronic medical records of nursing behaviors with each other.
Implementation Effect
Lian An Health Clinic is the first medical examination center in Taiwan. In Lian’an Health Clinic, every patient wears a wristband with an embedded RFID tag on his wrist, which records the patient’s detailed information. From the reception counter to the nurses in the group, they can use handheld data terminals such as PDAs to read the information of each patient in time, and can help doctors and nurses make real-time physical examination procedures through the handheld data terminals, such as item addition and withdrawal and case information Build etc. Greatly improve the service quality of Lian’an Health Clinic.
In order to provide health check services that meet individual needs, Lian An has spent three years integrating RFID and wireless network Wi-Fi technologies, cooperating with the establishment of wireless base stations throughout the hospital, and the application of medical information systems, providing nursing staff with a handheld Data terminal. And build the examinee’s health examination data in the handheld data terminal to replace the original heavy paper medical records and data. Now, nursing staff can immediately access the patient’s past medical record data with just two taps on the screen of the handheld data terminal.
Since the implementation of mobile services in Lian’an, the waiting process is no longer limited by space. Nursing staff can easily access the examinee’s previous health examination reports and quickly understand the examinee’s life style, eating habits, family medical history, etc. In the first time, according to the health needs of the examinee, suggestions for addition and withdrawal of physical examination items will be given, and arrangements will be completed in a short time. In addition, it can more effectively control the physical examination process. Nursing staff can understand the physical examination process and speed of all physical examination subjects at the first time, and appropriately deploy the examination process of the subject, so that the subject can avoid wasting time in the physical examination process.
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