It is one of the priorities of the new round of healthcare reform to develop regional healthcare alliances through vertically integrating resources. This paper reviews the framework and characteristics of Shanghai’s healthcare system, and then analyzes its strengths and weaknesses, underscoring Shanghai’s exploration in the vertical integration of medical resources as a response to the pressing issues in healthcare. The paper outlines the main tasks and groundwork of the Shanghai healthcare alliance initiative and gives an outlook on the expected outcomes. It ends with some thoughts on the problems and challenges confronting regional healthcare alliances in Shanghai.
目的 探讨营销服务理论（8P）在体检信息系统建设中的应用与实践效果。 方法 借鉴8P理论与理念，以现代信息技术为手段,设计和构建以客户为中心的体检信息系统。 结果 体检信息系统的建立，优化了体检流程，提高了服务效率和报告质量，增加了客户满意度，取得良好的经济和社会效益，为健康体检工作的数字化、规范化管理奠定了良好的基础。 结论 加强体检中心的信息化系统建设，能全面提升中心的工作效率和服务质量,增强市场竞争力。
目的:探讨并强调电子病历系统在医院信息化建设中的应用及前景。方法:了解目前国内电子病历系统现状,并结合本科室已建立的结构化电子病历系统应用经验,分析电子病历系统的利弊及在我国发展的需求前景。结果:电子病历系统的运行大大提高了医疗质量和工作效率。结论:以电子病历系统为中心的医院信息化建设势在必行。
To promote dual referral normalized management, West China Hospital of Sichuan University experimented in eight community health service centers under Wuhou District Health Bureau, depending on its advantages of regional medical coordination resources and the present advanced information technology. The experiment covered making appointments for referral, examination, consultation for intractable diseases and so on. The purpose was to explore appropriate mode and normalized management of dual referral between large comprehensive hospital and community health service centers, and promote normalization and systemization for dual referral.
ObjectiveTo design and use adverse nursing events information management system to improve the quality of nursing for high-risk patients and guarantee nursing quality and safety. MethodAdverse nursing events information management system was started from January 2014. Two hundred cases assessed to be nursing adverse events cases from September to December 2013 were chosen to form the control group, and another 200 from the same period in 2014 were designated to be the observation group. Then we compared the two groups in terms of the onset time of nursing assessment, incidence of adverse nursing events and rate of missing reports. ResultsThe onset time of nursing assessment, incidence of adverse events, and the rate of missing reports were significantly lower in the observation group than the control group (P<0.05). ConclusionsThe application of adverse nursing events information management system can improve the quality of nursing management and promote the nursing quality and safety.
The hospital information structure, which is made up of various medical business systems, is suffering from the problems of the "information isolated island". Medical business systems in the hospital are mutually isomerous and difficult to become a whole. How to realize the internal barrier-free interaction of the patients effective medical information in the hospital and further to complete the area sharing of patients longitudinal diagnosis and treatment information has become a question having to be solved urgently in the process of healthcare informatization. Based on the HL7 standard, this paper refers to the IHE technical framework, expounds the overall structure of the interaction in the hospital internal and area sharing of medical information with the medical information exchange platform. The paper also gives the details of the whole process of the complete display of the discrete patient health information using Portal technology, which is saved in the business systems in different hospitals. It interacts internally through the information exchange platform and at last stores the information in the regional cinical data repository (CDR).
There are more than 6 800 urban public hospitals in China, which are the main subject of our country's medical service, but the process and efficiency need to be improved because of the siphon effect of resources and the limit of service scope. The use of internet thinking and technology will solve this problem effectively. Based on the fact, Deyang People's Hospital planned "internet+" system according to the requirement of the medical and health system reform, to solve the problems such as service efficiency, doctor-patient communication, multi-spot disciple, hierarchical medical system, delicacy management, etc. Through the concrete practice of elevating the efficiency of outpatient and emergency care services, it is recognized that the application of internet thinking and technology can not only accelerate the medical and health system reform, but also subvert the traditional medical pattern, integrate the regional medical resource, and enlarge the scope of medical services. It provides a sharp weapon to push forward the reform of urban public hospitals.
ObjectiveTo understand the experiences of out-patient services of the elderly patients, and to analyze the impact factors of the satisfaction of elderly patients, so as to produce evidence for healthcare quality improvement. MethodsBased on the data collected from the out-patient survey of the 2015 Evaluation of the National Healthcare Improvement Initiative, we compared the disparities of patient satisfaction among different age-groups, between different geographic regions and different types of hospitals. We conducted multivariate binary logistic regression analysis to identify factors, associated with the satisfaction of the elderly outpatients. We also compared satisfaction of the Chinese elderly patients with healthcare services with other countries. ResultsSatisfaction scores of the Chinese elderly out-patients were statistically significant higher than that of the young and middle aged out-patients in the domains of hospital environment (satisfaction score=4.42), process efficiency (satisfaction score=4.20), and overall satisfaction (satisfaction score=4.47) (P < 0.001). On the contrary, the elderly out-patients were less satisfied in the domain of hospital informationization experience (satisfaction score=4.25) than the young and middle aged out-patients. This was also the case for the three indicators under this domain, including convenient appointment (satisfaction score=4.27), diversified payment methods (satisfaction score=4.24) and self-service devices (satisfaction score=4.26) (P < 0.001). Western region and traditional Chinese hospitals had significantly lower elderly outpatient satisfaction comparing with eastern and central regions, and general & specialist hospitals (P < 0.05). Trustful doctor-patient relationship (OR=3.45), respected and comfortable care (OR=1.45), clear and reliable mechanism and channel for praise and complain (OR=1.39), length of communication time with doctors (OR=1.35) and length of waiting time until consultation is acceptable (OR=1.29) were the major factors associated with the overall satisfaction of the elderly out-patients. The overall satisfaction of the Chinese elderly out-patients is a bit lower than that in our neighboring country Japan. The satisfaction towards length of communication with doctors of the Chinese elderly patients is lower than that in most of the industrialized countries. ConclusionSpecial demands of the elderly patients should be carefully considered by hospitals in the process of developing new appointment methods and hospital informationization with the aim of healthcare improvement. Longer communication time with doctors, shorter waiting time until consultation, improving human care and building efficiency mechanism and channel for praise and complain are the priorities for future healthcare improvement.