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罗马尼亚优秀的实践案例:E‐健康和互操作性‐医疗服务提供者的角度来看

Good Practice Case of Romania: e‐Health and Interoperability ‐ Healthcare Provider Perspective
课程网址: http://videolectures.net/seehealth2010_taslitchi_gpcr/  
主讲教师: Cristian Taslitchi
开课单位: 信息世界传媒集团
开课时间: 2010-02-19
课程语种: 英语
中文简介:
罗马尼亚医疗保健系统正在对健康相关文件和流程进行数字化处理。这导致医疗保健系统中的许多参与者创建他们自己的数据交换模型。最近变得明显的问题是如何确保这些独立系统之间的通信以及如何将交换的数据暴露给最终用户,即患者。传统方法–鉴于需要转移的数据量,纸质文件交换已经过时。从医疗服务提供者的角度来看,互操作性需要根据具体业务分散在不同的方向:医疗服务提供者之间的互操作性,与付款人的互操作性以及与卫生部(MoH)公共卫生报告的互操作性。关于医疗保健提供商之间的互操作性,合适的解决方案应使用一种技术,使其用户能够与多个异构系统进行交互,同时使用全面的数据合同进行通信。基于服务器的与HL7 v3的通信,作为数据合同的CDA 2.0文档是医疗服务提供者之间数据交换的选择解决方案。应用该解决方案的核心参与者是Medcenter,这是罗马尼亚最重要的私营医疗保健提供商之一,遍布全国的许多诊所和实验室。该解决方案的次要参与者是来自国家医疗保健系统的许多医院,他们将实验室和放射学活动外包给Medcenter,National Health Insurance House(NHIH)以及通过门户网站可视化医疗数据的患者。 Medcenter需要一种方法来汇集患者的信息,在诊所进行的检查结果,在实验室进行的检查结果以及放射检查的结果。此外,来自属于国家医疗保健系统的医院的实验室测试和放射检查的要求以及相应的结果必须集成在同一工作流程中。基于CDA的解决方案的主要受益者是:\ - 作为[url][url][url].medipedia.ro用户的患者–他们可以访问他们的个人健康记录的网站,并可视化他们的测试结果,体检结果,放射学检查等; \ - 医生(Medcenter诊所的专家,将实验室活动外包到的医院) Medcenter或全科医生)–因为有可能管理从多个医疗保健信息系统编制的患者的纵向健康记录,允许更快和更准确的诊断; \ - Medcenter的护士–因为可以同时处理来自不同来源的多个请求,同时提高效率。已实施的基于HL7 CDA的解决方案是异构信息系统的通用语言,同时提供了构建信息的独特方式。在更实际的层面上,使用HL7 CDA解决方案为患者提供了在线查看他们的检查,测试和调查结果的可能性,并要求对所接受的诊断提出第二意见。另一方面,Medcenter作为CDA解决方案的受益者已经能够利用基于模板的解决方案,并在不中断其日常流程的情况下对正在使用的模板进行更改。这导致提高效率和降低操作成本,同时保持检查交换文档的语义完整性的可能性。关于与付款人的互操作性,我们需要提到核心业务流程也与电子索赔相关。目前,NHIH的所有县办事处,罗马尼亚最重要的医疗保健服务支付者,使用共同系统(SIUI),负责保险政策管理的系统,医疗服务提供者和保险公司之间的合同,电子索赔和报销。该系统为所有医疗保健专业实现扩展的电子索赔功能,目前Medcenter能够以批处理模式为受益患者提供所有执行的医疗保健服务。
课程简介: The Romanian healthcare system is in the process of digitizing the health related documents and processes. This leads to many actors in the healthcare system creating their own data exchange models. The problem that has become evident lately is how to ensure the communication between these independent systems and how to expose the exchanged data to the end‐user, the patient. The traditional approach – the paper document exchange has become obsolete in the light of the volume of data that needs to be transferred. The interoperability from the healthcare provider perspective needs to spit in separate directions according to the business specific: interoperability between healthcare providers, interoperability with payers, and interoperability with Ministry of Health (MoH) for Public Health Reporting. Regarding interoperability between healthcare providers, a suitable solution should use a technology that would enable its users to interact with multiple heterogeneous systems while at the same time using a comprehensive data contract for communication. The server based communication with HL7 v3, CDA 2.0 documents as a data contract was the chosen solution for the data exchange between healthcare providers. The central actor to apply the solution is Medcenter, one of the most important private healthcare providers in Romania with many clinics and laboratories all over the country. Secondary actors of the solution are a number of hospitals from the national healthcare system that have outsourced their laboratory and radiology activity to Medcenter, National Health Insurance House(NHIH) and the patients for visualizing their medical data through a portal. Medcenter needed a way to bring together the information about the patients, the results of the examinations performed in the clinics, the results of the tests performed in its laboratories as well as the results of radiology exams. Also, the requests of lab tests and radiology exams coming from hospitals belonging to the national healthcare system and the correspondent results had to be integrated within the same workflow. The main beneficiaries of CDA based solution are:\ ‐ the patients as users of [url] – the website where they can access their personal health record and visualize the results of their tests, the results of the medical examinations, radiology exams etc;\ ‐ the doctors (either specialists in the Medcenter clinics, the hospitals that have outsourced the labs activity to Medcenter or General Practitioners) – because of the possibility to manage the patient's longitudinal health record compiled from multiple healthcare information systems, allowing faster and more accurate diagnosis;\ ‐ the Medcenter’s nurses – because of the possibility to process multiple requests from different sources simultaneously with increased efficiency. The HL7 CDA based solution that has been implemented is the common language of the heterogeneous information systems and offers at the same time a unique way of structuring the information. On a more pragmatic level, using the HL7 CDA solution empowers the patients by offering them possibility to visualize online the results of their examinations, tests and investigations and to ask for a second opinion on the diagnostic received. On the other hand, Medcenter as beneficiary of the CDA solution has been able to take advantage of the template based solution and operate changes on templates in use without disrupting its daily processes. This resulted in increased efficiency and reduced operating costs while at the same time maintaining the possibility of checking the semantic integrity of the exchanged documents. Regarding interoperability with payers, we need to mention that core operational flows are related also to the electronic claiming. Currently, all the county offices of NHIH, the most important payer for healthcare services in Romania, are using a common system (SIUI), system in charge with insurance policy management, contracts between healthcare providers and insurance house, electronic claiming and reimbursement. The system implements extended electronic claiming capabilities for all healthcare specialties and currently Medcenter is able to claim in a batch mode all the performed healthcare services for the beneficiary patients.
关 键 词: 医疗保健系统; 公共卫生; 医疗服务
课程来源: 视频讲座网
最后编审: 2021-08-28:zyk
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