网络环境下门诊系统的设计及关键实现技术—数据库部分

1、.毕 业 设 计（论 文）外 文 参 考 资 料 及 译 文设计(论文)题目：网络环境下门诊系统的设计及 关键实现技术数据库部分 学生姓名： 赵海 学 号： 0921414021 专 业： M09计算机科学与技术（专转本） 所在学院： 龙蟠学院 指导教师： 李广水 职 称： 教授 2010 年 12 月 18日医院信息管理系统的建设随着社会的发展，人们对健康越来越关注，医院的业务不断增长，处理越来越复杂，简单的人工经营管理，已无法满足医院的需要, 成为医院发展的瓶颈，人们对医疗服务的要求也越来越高。传统的手工操作模式,病人帐目繁杂，病人查帐困难, 病区和药房的药品浪费现象严重且无法追踪, 人工

2、传送各种记帐单容易漏、错帐，人工划价收费差错难以避免，因此,如何提高服务水平、提高工作效率，成为迫待解决的问题。医院管理信息化不仅能提高医务人员的工作效率和医疗水平，而且能提高医院的服务质量和管理水平,因此，医院对管理信息系统有着强烈的需求。信息管理平台，辅助企业进行现代化管理。它具备数据处理、计划、控制、预测和辅助决策功能。医院管理系统（Hospital management system）的目的就是为了减轻业务劳动强度，减少了差错，科学管理药品，节省人力，提高医院的财、物管理水平，增加经济效益，改善患者的就医环境，方便患者就医和查询，提高医院的服务效率和服务质量，提高医院的医疗质量和管理水

3、平，去除传统人工管理的瓶颈。所以，一个现代化的适应社会发展需要的医院，除了具备一流的医疗队伍、一流的服务设施之外，还应具备一流的管理信息系统。生活水平的提高与用户需求的增长将推动着MIS信息管理系统应用与HIS医院信息管理系统功能的不断完善与增强。随着信息时代的到来，计算机在各行各业得到了越来越广泛的应用。建设现代化的医院，信息管理的计算机化、网络化和数据高度共享化将是必不可少的条件。医院每天产生的信息量非常大，随着医院业务量的不断扩大，如果还用手工来处理的原始方法来处理医院每天产生的巨大的数据量，这将是一件非常困难的事情，也容易产生由人为因素引起的错误，给医院的日常管理带来了非常大的不便。这

4、时医院迫切需要一套功能完善、操作简单、界面美观的医院管理系统来满足医院日常管理的需要，这也是时代发展的需要。电子计算机在医院的应用已有四十多年的历史，60年代初，美国便开始了HIS的研究。著名的麻省总医院<MGH>开发的COSTAR系统是60年代初开始并发展到今天成为大规模的临床病人信息系统。随着计算机技术的发展，70年代，HIS进入大发展时期，美日欧各国的医院，特别是大学医院及医学中心纷纷开发HIS，成为医药信息学的形成和发展的基础。7080年代，美国的HIS产业已有很大发展。1985年美国全国医院数据处理工作调查表明，100张床位以上的医院，80%实现了计算机财务收费管理，70

5、%的医院可支持病人挂号登记和行政事务管理。25%的医院有了较完整的HIS，即实现了病房医护人员直接用计算机处理医嘱和查询实验室的检验结果。10%的医院(2530)有全面计算机管理的HIS。计算机70年代末期就进入了我国医疗行业，当时以IBM的M340小型机为主，只有少数几家大型的部属综合医院和教学医院拥有，如北京协和医院、北京肿瘤医院、301医院等，主要应用于科研和教学，还没有应用于HIS的管理。80年代初期，随着苹果PC机的出现和BASIC语言的普及，一些医院开始开发一些小型的管理软件，如工资软件等；80年代中期，随着XT286的出现和国产化，以及DBASEIII和UNIX网络操作系统的出现

6、，一些医院开始建立小型的局域网络，并开发出基于部门管理的小型网络管理系统，如住院管理，药房管理等。进入90年代，NOVELL网和FOXBASE、FOXFRO数据库日益盛行，完整的医院网络管理系统的实现已经成为可能，于是一些有计算机技术力量的医院开始开发适合自己医院的医院管理系统。一些计算机公司也不适时机的开发HIS,如HP公司（与301医院合作）、IBM公司、微软公司、浪潮公司。但这些系统都存在如下一些问题：软件水平较低，一般只能做些初级的事务处理，也有的软件开发之后用了一段时间就停下了，坚持不下去，其原因是：(1)各医院计算机专业人才缺乏，技术力量薄弱，特别是缺少高层次系统分析人员和跨专业复

7、合型人才。(2)项目多，力量分散。(3)医院经费有限，很难建立起理想的软、硬件支撑环境不可能实现。通过使用医院信息管理系统，规范了业务处理流程，堵塞了管理中的漏洞。全院信息通过计算机软件系统连接成一个整体，实现数据高度共享，降低管理成本，提高了管理数据的准确性和实时性。为了配合国家医疗卫生行业信息化建设，以及现行医院管理中实际存在的问题，我确立了本次课题。在此研究中我得到了医院部门的大力支持。希望通过此次课题的研究来解决当今医院管理系统存在的问题，推动国内医疗卫生行业信息化建设，并且拓展医疗卫生行业的系统集成市场。 随着社会的发展，人们对健康越来越关注，医院的业务不断增长，处理越来越复杂，简单

8、的人工经营管理，已无法满足医院的需要, 成为医院发展的瓶颈， 人们对医疗服务的要求也越来越高。传统的手工操作模式,病人帐目繁杂，病人查帐困难, 病区和药房的药品浪费现象严重且无法追踪, 人工传送各种记帐单容易漏、错帐，人工划价收费差错难以避免，因此,如何提高服务水平、提高工作效率，成为迫待解决的问题。医院管理信息化不仅能提高医务人员的工作效率和医疗水平，而且能提高医院的服务质量和管理水平,因此，医院对管理信息系统有着强烈的需求。美国著名教授Morris.Collen于1988年曾著文为医院信息系统(HIS)下了如下定义：利用电子计算机和通讯设备，为医院所属各部门提供病人诊疗信息和行政管理信息的

9、收集、存储、处理、提取和数据医交换的能力，并满足所有授权用户的功能需求。 开发医院管理信息系统(HIS)的目标就是立足医院应用实际，着眼院未来发展，以强化医院管理，提高医疗质量，方便患者就医和查询，提高医院的服务效率和服务质量，设计一套符合国家功能规范要求，安全稳定，操作简便的医院信息系统，为医院提供一套全方位的解决方案。作为一个完整的HIS系统，至少应包含住院管理子系统，病区管理子系统，病案管理子系统和院长查询子系统。完整的医院信息系统对信息的处理大体上可分为三个不同的层次：数据的收集过程；数据的集中加工、处理与分析过程和决策咨询与决策支持过程。一般来说，数据的收集过程与基层科室的事务处理活

10、动相联系；数据的集中处理与分析过程与中层科室的工作任务相联系；决策、支持过程则与高层领导相联系。医院管理系统是根据医院信息系统（HIS）设计的轻巧，而且实用的病人就诊管理系统其中药功能包括：门诊管理、处方管理、药房管、基本信息的维护、对系统信息的管理和维护。实用性是评价医院信息系统的主要标准。它应该符合现行医院体系结构、管理模式和管理程序，系统的建立和运行应该成为医院日常管理工作中不可缺少的组成部分，并且对医院带来一定的经济效益和社会效益。医院信息系统是现代化医院必不可少的基础设施与技术支撑环境。医院信息系统属于迄今世界上现存的企业级信息系统中最为复杂的一类，这是医院本身的目标、任务和性质决定

11、的。它不仅要同其他所有管理信息系统（MIS）一样追踪、管理伴随人流、财流、物流所产生的管理信息，从而提高整个系统的运行效率，而且还应该支持以病人医疗信息记录为中心的整个医疗、教学、科研活动。现阶段不允许医院信息系统代替人们作出任何决策。医院信息系统只能为人们的管理决策提供各式各样尽可能充足可靠的数据、信息，然后由人们作出最终的选择与决策。无论这种管理决策是直接或者间接影响病人医疗事务，还是直接或间接影响医院管理事务。医院信息系统不是简单地模拟现行的管理方法，而是根据医院管理模式采用科学化、信息化、规范化、标准化理论设计建立起来的。因此在现阶段，医院信息系统与手工管理方法是互为依据、互为支持的，

12、医院信息系统为科学化、信息化、规范化管理提供了可靠依据。建立医院信息系统是一项艰巨的系统工程。它涉及了现代管理科学、系统化、信息化、计算机技术、网络通信技术、医院管理学和各部门管理业务、医学科学技术等多学科的范畴。现代化医院管理体系，必须要有信息系统支持，以便适应新的医院运行机制转变，即由社会福利型向经营核算型转变，要求医院管理者由经验管理向现代化科学管理转变。因此，必须建立医院信息系统。主要是对项目的经济效益进行评价，本系统开发经费对于个人在经济上是可以接受的。所以本系统在经济上是可行的。2. 技术可行性：技术上的可行性分析主要分析技术条件能否顺利完成开发工作，硬、软件能否满足开发者的需要等

13、。该管理系统采用了当前新兴的Browser/Server模式进行开发。三层的Browser/Server体系结构具有许多传统Client/Server体系结构不具备的优点，而且又紧密的结合了Internet/Intranet技术，是技术发展的大势所趋，它把应用系统带入了一个崭新的发展时代。数据库服务器选用微软的SQL Server 2000数据库，它能够处理大量数据，同时保持数据的完整性并提供许多高级管理功能。它的灵活性、安全性和易用性为数据库编程提供了良好的条件。因此，系统的软件开发平台已成熟可行。硬件方面，科技飞速发展的今天，硬件更新的速度越来越快，容量越来越大，可靠性越来越高，价格越来越

14、低，其硬件平台完全能满足此系统的需要。综上所述，此系统开发目标已明确，在技术和经济等方面都可行，并且有良好的效益。因此系统的开发是完全可行的。美国著名教授Morris.Collen于1988年曾著文为医院信息系统(HIS)下了如下定义：利用电子计算机和通讯设备，为医院所属各部门提供病人诊疗信息和行政管理信息的收集、存储、处理、提取和数据医交换的能力，并满足所有授权用户的功能需求。 开发医院管理信息系统(HIS)的目标就是立足医院应用实际，着眼院未来发展，以强化医院管理，提高医疗质量，方便患者就医和查询，提高医院的服务效率和服务质量，设计一套符合国家功能规范要求，安全稳定，操作简便的医院信息系统

15、，为医院提供一套全方位的解决方案。而根据卫生部制定本医院信息系统（HIS）软件基本功能规范第三条中医院信息系统的定义为：医院信息系统（HIS）是指应用电子计算机和网络通信设备，为医院及其所属各部门提供病人医疗信息、财务核算分析信息、行政管理信息和决策分析统计信息的收集、存储、处理、提取和数据通讯的能力，并能满足所有授权用户对信息的各种功能需求的计算机应用软件系统。作为一个医院信息管理系统一般具有如下特点：1. 实用性实用性是确定系统需求和选择技术的首要原则。医院信息系统的建设是一个不断发展的过程，而软件技术在快速发展。首先需要将目标定位在一个合理需求的基础上，应该能满足未来35年的应用需要。其

16、次需要充分地利用技术手段解决应用中的问题。解决问题水平的高低应体现在合理利用技术的程度、资源的利用水平上，并不是只有采用先进的网络技术才能体现系统建设的先进水平。2. 通用性虽然各医院有不同的组织机构和管理模式，但系统能够适应多种实际情况。系统在设计时，就充分运用计算机能实现的科学的管理模式和合理的信息流程来设计系统，保证系统能够满足多种需要。而门诊医疗作为医院信息系统建设的一部分是医院管理的门面，流量大，手续较繁锁，在手工方式下，医护人员要做大量不必要的重复工作、效率低、准确性差、不方便管理，影响工作效率，造成了很多就诊病人得不到合理有效的快捷就诊服务，甚至影响医疗质量，为此，越来越多的医院

17、加快了信息化建设的步伐，以提高了服务效率和质量、树立了医院的良好形象，使门诊工作可以高效有序的运转，提高了医院的经济效益，促进医院的发展。附件：外文原文Hospital information management system of constructionWith the development of society, people pay more and more attention to health, the hospital growing business, handling more and more complex, simple artificially manageme

18、nt, already cannot satisfy the needs of hospital, become the bottleneck of hospital development, people on medical service request more and more is also high. The traditional manual operation mode, the patient accounts multifarious, patient auditorial difficulties, ward and pharmacy drugs waste is s

19、erious and unable to track, artificial transfer various remember bill easily leak, miscalculation charge accurately, artificial errors to be avoided, so, how to improve the service level, improve working efficiency, be forced to solve the problem. Hospital information management not only can improve

20、 the medical personnel working efficiency and health care, but also improve the hospital, the service quality and management level, therefore, hospital of management information systems have a strong need. Information management platform, auxiliary enterprise of modernized management. It has data pr

21、ocessing, plan, control and predictive and aided decision-making function. The Hospital management system (Hospital management system) is the purpose of business in order to reduce labor intensity, reduce the mistake, scientific management, improve the drug, save manpower Hospital financial, materia

22、l management level, increase the economic efficiency, improve the patients medical environment, convenient and was hospitalized and query, improving Hospital service efficiency and service quality, improve the quality of medical care and Hospital management level, remove the traditional manual admin

23、istration of bottleneck. So, a modern adapt to the needs of social development of hospital, besides first-class medical team, the first-class service facilities, but also should have the first-class management information system. The improvement of living standards and customer demand growth will pu

24、sh the MIS information management system application and HIS hospital information management system function constantly improve and enhance. With the advent of the information age, the computer in all walks of life have been applied more and more. Construction of modern hospitals, information manage

25、ment of computerized, network and data highly sharing will is an imperative. The hospital every produce information is very large, as hospitals behavior.by continues to expand, if we still use manual to handle the primitive way to deal with the hospital every tremendous amount of data, this will be

26、a very difficult thing, also easy to produce by human-induced error to the hospital routine management brought great inconvenience. Then hospital urgently needs a set of complete functions, the operation is simple, interface aesthetics of hospital management systems to satisfy the needs of hospital

27、daily management, this also is the need of the time. The application of electronic computers in hospital has 40 years of history, the beginning of the 1960s, American began HIS research. Massachusetts general hospital of famous > < MGH COSTAR system is developed in the early 1960s began and de

28、velopment today become large-scale clinical patient information system. With the development of computer technology, in the 1970s, HIS entry into the great development period, us-japan European countries of the hospital, especially university hospital and medical centers in succession, become medica

29、l informatics HIS development the formation and development foundation. 70-80 time, America's HIS industry have made great progress. 1985 the national hospital data processing work, according to a survey of 100 beds above hospital, 80% has realized the computer finance charges administration, 70

30、% of the hospital can support patients registered registration and administrative affairs management. 25% of the hospital had relatively complete HIS, namely realized ward medical personnel directly processed by computer orders and query laboratory test results. 10% of the hospital (2530) have compr

31、ehensive computer management of HIS. Computer since late 1970s have entered China's medical industry, when in IBM's M340 minicomputer primarily, only a few large-scale subordinates' general hospitals and teaching hospitals have, if Beijing union medical college hospital, Beijing tumor ho

32、spitals, 301 hospital etc, mainly used in scientific research and teaching, also not applied to HIS management. In the early 1980s, with the apple PC's appearance and the popularization of BASIC language, some hospital began developing some small management software, such as salary software etc;

33、 The 1980s, with the emergence of XT286 localization, and DBASEIII and with UNIX network operating system appear, some hospitals began to establish small local area network, and developed based on the management of department of small network management systems, such as hospital management, drugstor

34、e management etc. In the 1990s, NOVELL network and FOXBASE, FOXFRO database is rife in complete hospital network management system implementation is possible, so some computer technology strength of hospital began developing suit oneself hospital hospital management system. Some computer companies a

35、re developing HIS timing, such as HP corporation (with 301 hospital cooperation), IBM and Microsoft, wave company. But these systems exist the following problems: Software level is low, only commonly do some primary transaction processing, also some software development with a period of time after t

36、hey stopped, hold down, its reason is: (1) the hospital computer professionals lack, technical force is weak, especially lack of high-level system analysis personnel and cross major inter-disciplinary talent. (2) project, scattered forces. (3) hospital limited budget, it difficult to establish a ide

37、al of software and hardware, the supporting environment may not happen. Through the use of hospital information management system, regulating the business processing flow, and blocked the loopholes in management. Prepares information through computer software system is connected into one whole, and

38、realize data high share, reduce the management cost and improve the management the accuracy of the data and real-time. In order to match the national healthcare industry informatization construction, and the current hospital management of practical problems, I established this topic. In this study I

39、 got hospital department support. Hope that through this topic research to solve the current problems existing in the hospital management system, promote domestic medical industry informatization construction, and expand the healthcare industry of system integration market. With the development of s

40、ociety, people pay more and more attention to health, the hospital growing business, handling more and more complex, simple artificially management, already cannot satisfy the needs of hospital, become the bottleneck of hospital development, people on medical service request more and more is also hi

41、gh. The traditional manual operation mode, the patient accounts multifarious, patient auditorial difficulties, ward and pharmacy drugs waste is serious and unable to track, artificial transfer various remember bill easily leak, miscalculation charge accurately, artificial errors to be avoided, so, h

42、ow to improve the service level, improve working efficiency, be forced to solve the problem. Hospital information management not only can improve the medical personnel working efficiency and health care, but also improve the hospital, the service quality and management level, therefore, hospital of

43、management information systems have a strong need. The famous American professor Morris. Collen in 1988 was written civil of hospital information system (HIS) under the following definition: use electronic computers and telecommunication equipment for hospital departments to provide the patient with

44、 medical information and administrative management information collection, storage, processing, extraction and data medical exchange ability and satisfy all authorized users of functional requirements. Development of hospital management information system (HIS) goal is based on hospital practical, f

45、ocus on the court for future development, with aggrandizement hospital management, improve the quality of medical treatment, medical treatment and inquiries, convenient patients raise hospital service efficiency and quality of service, design of an accord with national function specification require

46、ments, safety and stability, simple operation of hospital information system, for the hospital provides a comprehensive range of solutions. As a complete HIS system, at least should contain in hospital management subsystem, clastic management subsystem, the medical records management subsystem and P

47、resident inquiry sub-system. Complete the hospital information system of information processing substantially can be divided into three levels: the collection of data process, Data of centralized processing, processing and analyzing process and decision consultation and decision support process. Gen

48、erally speaking, the collection of data process and basic conformation of transaction activity associated; The data processing and analysis process and centralized middle department tasks associated; Decision-making, support process is associated with top leaders. The hospital management system is b

49、ased on the hospital information system (HIS) design lighter, and practical patients' clinical management system its herbal features include: outpatient service management, prescription management, pharmacy tube, the basic information of system maintenance, information management and maintenance

50、. Practicality is the main hospital information system evaluation standard. It should be consistent with existing hospital system structure, management mode and management procedures, system establishment and operation should become the daily management work in hospital indispensable component to th

51、e hospital, and brings certain economic benefits and social benefit. Hospital information system is a modern hospital essential infrastructure and technical support for the environment. Hospital information system belong to the world so far in the information system of existing enterprise-level most

52、 complex kind, it is the hospital own goal, task and nature. It should not only with all other management information system (MIS) the same track and manage with people and money flow, logistics generated management information, so as to improve the running efficiency of the whole system, but also s

53、hould support to the patient medical record information center for the whole medical treatment, teaching and scientific research activities. Hospital information system at present not allowed to make any decision instead of people. Hospital information system can only for people's management dec

54、ision provides various as adequate and reliable data, information, then the people to make a final choice and decision. Whether this management decision is directly or indirectly affect patients' medical affairs, or directly or indirectly influenced hospital management aspects. Hospital informat

55、ion system is not simply the simulation current methods of management, but according to the hospital management mode to use scientific and informationization, normalization, standardization of the theoretical design built. So at this stage, the hospital information system and manual management metho

56、ds are respectively the basis and mutual support, the hospital information system for scientific, informationization, standardized management and provide reliable basis. Establish the hospital information system is an arduous system engineering. It involves a modern management science, systematic an

57、d informationization, the computer technology, network communication technology, hospital management and each department management business, medical science and technology multidisciplinary category. Modern hospital management system, must want to have information system support, so that adapt to t

58、he new hospital operation mechanism change by social welfare, namely to business accounting type transformation, the requirements by hospital administrators to modern scientific management experience management transformation. Therefore, must establish the hospital information system. Is mainly to t

59、he project of the economic benefits of evaluation, this system development funds for personal economically is acceptable. So this system are economically feasible. 2. Technical feasibility: Technical feasibility analysis mainly analyzes the technical conditions can be successfully complete development, hardware, software developers could meet the need of etc. This management system USES a current emerging is clicked/Serv