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让医疗大数据成为医院品牌价值

提交者：jiuding发表时间：2017-4-24点击次数：3703来源:本站整理

　　2017年1月，新年伊始，南京医科大学附属逸夫医院（以下简称：南医大逸夫医院）迎来快速发展的一年。就在刚刚过去的2016年6月28日，南医大逸夫医院隆重开业。短短七个月里，该院的日门诊量突破1100人次，日均住院患者达350人，总住院人数已达7000人，平均住院日在9天之内，每天20台手术，开展义诊服务300多场共服务近万名患者，产科开业4个月来共诞生近700个新生儿，急诊抢救危重病人1200多人。

　　对于一家规划建设中的“三甲”公立医院来说，也许这些数字不足为奇，然而与南京市区那些有名气的大医院相比，还处在婴儿期的南医大逸夫医院能有这样的一串串数字，不免令人振奋和欣慰！院长鲁翔说：“这看似简单的数字体现了患者对我院的信任！”

　　记者了解到，在这些数字背后有着一套完整的信息系统支撑。该院从2016年2月开始基础数据准备，4月住院系统上线试运行，5月门诊系统上线，三十几个功能模块全面上线用时不到3个月，保证了医院开业时业务流程平稳运转。目前，信息化建设正随着医院的整体建设步伐，有计划地快速进行着。

　　一家远离南京市区的新医院，是靠什么与有历史、有名气的大医院竞争的？本刊记者就该院的发展战略与信息化建设思路等问题，独家专访了南京医科大学副校长、南京医科大学附属逸夫医院院长鲁翔。

　　知己知彼，确立差异化发展战略

　　南京医科大学附属逸夫医院系省属公立综合医院，是以三级甲等及国际JCI认证为标准建设的综合性医院，是南京医科大学直属附属医院（又名南京医科大学第三附属医院）。医院因获得香港邵逸夫基金2亿元港币无偿捐赠而经国家教育部港澳台办公室批准正式冠名为“逸夫医院”。医院依托南京医科大学及其第一附属医院（江苏省人民医院）、第二附属医院、南京市第一医院、南京儿童医院及南京市妇幼保健院等兄弟院校多方专家和技术人员支持，汇聚了来自全国、省内多家医院近百名高级职称专业技术人员，学科齐全，实力雄厚。

　　谈到定位，鲁翔院长说：“我们是一家新医院，客观上讲在知名度和人气上有着不足，但是新医院也有‘新’的优势，‘一张白纸’可以借鉴国内外成熟经验，高起点、高水准地建设医院。”

　　鲁翔院长还谈到：“我院是百分之百的公立医院，是一家具有医疗、科研、教学功能的综合性医院，是按三甲和JCI标准建立的新医院。相比老三甲医院而言，在医疗环境、硬件设备、医疗技术、管理理念、服务标准等方面能给患者更好的服务和体验。我院地处南京市新开发区和南京医科大学江宁校区近旁，远离市中心，周边没有大型综合性医院，具有地理优势。目前服务人群主要是周边的年轻人和开车族，他们对高科技的便捷服务模式接受度高。根据这样一些特点，我院决定用国际化理念、先进的医疗水平、高科技手段打造出自己的特色，有效实施差异化的错位竞争。南医大逸夫医院院训是‘传承创新、知行合一’，我们将在学科特色、专家特色、科研教学特色、管理特色上不断创新。”

　　南医大逸夫医院学科分科模式是以器官、系统来划分的，既是与国际接轨，也是新技术所在。该院既有传统医院的呼吸科、消化科、血液科、内分泌科、感染科、神经内科、心脏科等细致分科，也有特色整合，例如：神经脑病中心就是整合了神经内科、神经外科、康复科，老年病中心整合了心血管、神经内科、康复科，这意味着一个科里有多个专业的医生，患者可以得到更全面的会诊式服务。

　　学科建设上的另一特色就是资源整合。比如，病理与临床检验中心主任苏东明教授，是南京医科大学基础医学院病理系的系主任，该科室既开展医院临床工作，同时也承担学校的教研工作。目前科室已经配备国际先进的罗氏生化发光流水线、贝克曼血球仪、希森美康血凝仪、BD血培养仪等，检测过程全程实现自动化检测，实现江苏省检验结果互认，同时检测数据与医院信息系统实现互联互通。还有一种整合就是临床、预防、健康管理的整合，源于在临床中发现，很多老年病人基本状况很差，需要医院把医疗、养老、居家护理整合起来。

　　另外，还有一些特色学科是根据目标患者群需求而建的。例如，南医大逸夫医院远离市区，周边开车族居多，如果发生交通事故送到市区大医院需要40分钟。因此南医大逸夫医院急诊抢救和创伤骨科方面引进专家团队，并配备先进的医疗设备，目前已成功抢救1700多位患者，其中交通事故近500例，急诊抢救和创伤骨科两个学科已成为该院的特色。

　　再有，该院同样面临二胎生育高峰和儿科患者量大的情况，周边的孕妇和儿科患者远离市区有就近求医的需要。该院妇产科和儿科的专家团队，加上新医院有着先进设备和良好环境的优势，吸引了大量孕产妇和儿科患者，目前产科床位数35张，单间3间，套间2间，一体化产房1间，每月孕产妇建卡130左右。为方便小儿就医，还特别设立了单独的儿科门诊专区，入口近临停车场，除了环境布置成小朋友喜爱的颜色和图案，还专门在诊区设立儿科药房和挂号收费处，就诊时间延长到21:30。

　　鲁翔院长说：“我院还有其他特色科室正在陆续迎来更多的患者。”

　　做好信息化规划，配合战略发展步伐

　　全院所有开业的科室，特色学科建设的同时，信息化也在同步进行中。正如鲁翔院长所说，一开业有关医疗质量安全和便捷医疗服务的信息系统就上线了。例如，临床路径、单病种管理系统对医疗质量起到保障作用；而通过完善住院病历、护理病历质控系统规范了医疗行为。为配合学科建设，在科室间医生护士具有病人信息共享的权限，在EMR的基础上建立长期随访，方便病人就医，减少重复检查，同时把病人数据变成院内有效的科研资料。为改善就诊流程，实现了门诊一站式预约，开展了多渠道预约挂号、预约检查、续诊预约；同时实现诊间一站式结算，减少患者挂号、缴费来回奔波，缩短在院等候时间；并拓展了收费方式，实现收费窗口、诊间扫码支付、自助设备扫码付。

　　鲁翔院长对信息化表示出了高度重视，他谈到：“信息化和智能化对医院发展不仅仅是技术支撑，更是医院发展战略的重要组成部分。未来，医疗大数据将会成为医院品牌价值之一。”

　　信息化建设在南医大逸夫医院筹备期间就是重点。信息化建设目标是加强数据标准化建设，为精准医疗、大数据夯实基础，为三级医院建设、JCI认证打好信息基础，进一步加快数字化医院建设，为临床、患者提供高质量的服务。阶段规划是开业1年保证医院的基本运行，2-3年提高患者就医流程，利用3-5年完成三级医院的评审，5-8年完成大型综合医院、教学医院的建设。建设原则是标准先行、顶层设计、分步实施。建设标准是以患者为中心、无纸化为基础、信息化为手段、精细化管理为目标，达到规范诊疗过程，提高医护质量，降低医疗费用，缩短住院天数，促进科室间协作，加强医患沟通，减少医疗纠纷，提高医院的核心竞争力。

　　快速上线是该院信息化建设的一个特点，之所以开业时三十几个功能模块全面上线用时不到3个月，信息中心郭玲说：“选择成熟度高、应用客户数多、可复制的产品，是快速上线的基础。另外，医院成立了数字化医院建设领导小组、实施小组，并在各科室设置了专门的信息联络员，院内各科室紧密筹划与高度配合是保证。新医院新系统没有老系统升级改造的困扰，医护人员有大医院工作经验，对医院信息系统接受度高，稍加培训即可，这也是能快速上线的重要因素。”

　　目前南医大逸夫医院信息化投资预算：硬件3000万，软件1000万，已经实施了四十个模块。鲁翔院长说：“有很多先进的信息系统对医院都有帮助，但经费毕竟有限，钱要用在刀刃上。比如，产科作为全院的特色专科，为让妈妈们放心，产科一开业就部署了婴儿防盗系统，而移动终端PDA系统由于医院刚刚开业，病人整体还不是很多，所以目前并没有启动。再比如，我院紧邻高校和开发区，医疗服务人群年轻化、知识化，具有对新技术高科技接受程度高的特点，我院开业之初就和相关公司合作开发了掌上APP，患者在手机端就可实现挂号、预约、缴费、查报告等功能，目前用户数已近4000。另外还开通了微信、支付宝、自助机服务、诊间刷卡缴费等服务模式，为患者提供门诊预约挂号、移动支付、实时查询、院外随访、宣传教育等多个服务流程的便捷。”

　　建立医疗大数据，提升医院品牌价值

　　鲁翔院长认为，医疗大数据未来将成为医院品牌价值。从信息化起步之时医院就明确标准先行，所有上线系统形成互联互通和数据共享，为今后大数据打下基础。医疗大数据不仅仅是院内临床数据，还包括院外患者随访和体检中心的健康数据，未来希望形成完成的健康医疗大数据。

　　记者在走访中得知，大数据的理念不仅仅是院长的想法，已贯穿在临床科室负责人的头脑中。健康体检中心杨主任对于健康数据便有着自己长远的思考。他说：各家体检机构的体检项目和诊疗信息自成体系，造成“信息孤岛”的局面。医院的体检系统中最有价值的数据目前还未被开发利用，体检系统中所积累的海量用户大数据仍处于沉睡中。而未来2-3年计划将客户的体检异常数据通过信息平台推送给各个相关科室，由各个科室，由科室医生点到点地对客户给出治疗方案、健康指导、随访跟踪。将智能可穿戴设备等移动互联网技术与体检中心系统对接对病人的健康数据进行实时监测，对数据进行对比分析，引导客户健康生活，科学膳食。让更多的客户享受从体检到健康管理到医疗服务，再到康复甚至是养老。建立预约信息、健康大数据等共享，为“体检信息孤岛”打开了通路，依托体检医疗的大数据，逐步将体检数据与广大健康需求人群连接在一起。用互联网技术实现健康体检的深度融合和信息共享。

　　为扩大诊疗服务范围，促进分级诊疗落实，南医大逸夫医院与江苏省人民医院等多家大医院合作，在南医大逸夫医院设立了江苏移动4G智慧医疗展示中心，开展远程医疗服务，中心主要职责是对产生的数据和服务行为进行监控，这对未来医疗大数据的形成也很有帮助。远程医疗服务中有逸夫基金支持的公益项目。

　　鲁翔院长在采访中一直强调公益性，他说：“南医大逸夫医院坚持公益性，这是一个公立医院的义务更是经营理念。一些突然路倒昏迷不知姓名也没有钱的患者，或者一些经济特别困难以及特殊病种的病人，他们同样应该得到医治。我们特别在民政部门申请成立了一个逸夫医疗救助基金，希望在邵逸夫基金主旨基金以外，还能通过个人、企业的赞助来扩大基金的总盘子。我院最近与南京市佑安医院（南京市青龙山精神病院）开展合作，这个项目发挥了我院脑病中心学科优势，是医养结合战略需要，更是公益性对口帮扶所在。这个对口合作项目的开展中产生的医疗数据，将会纳入整体数据管理中。鲁翔院长最后谈到：“南医大逸夫医院信息化建设按着规划伴随着医院业务快速发展而前行，未来各项数字将会变成更有价值的数据，医疗大数据将会开放给患者，服务医疗，为研究型临床工作提供帮助。”

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_SERVER["SystemRoot"]	C:\Windows
_SERVER["TEMP"]	C:\Windows\TEMP
_SERVER["TMP"]	C:\Windows\TEMP
_SERVER["USERDOMAIN"]	WORKGROUP
_SERVER["USERNAME"]	iZ4r4b31413jd2Z$
_SERVER["USERPROFILE"]	C:\Windows\system32\config\systemprofile
_SERVER["windir"]	C:\Windows
_SERVER["ORIG_PATH_INFO"]	/admin.php/index/view/aid/2187.html
_SERVER["URL"]	/admin.php
_SERVER["SERVER_SOFTWARE"]	Microsoft-IIS/10.0
_SERVER["SERVER_PROTOCOL"]	HTTP/1.1
_SERVER["SERVER_PORT_SECURE"]	1
_SERVER["SERVER_PORT"]	443
_SERVER["SERVER_NAME"]	www.yyjg.net
_SERVER["SCRIPT_NAME"]	/admin.php
_SERVER["SCRIPT_FILENAME"]	D:\wwwroot\yyjg.net\wwwroot\admin.php
_SERVER["REQUEST_URI"]	/admin.php/index/view/aid/2187.html
_SERVER["REQUEST_METHOD"]	GET
_SERVER["REMOTE_USER"]	no value
_SERVER["REMOTE_PORT"]	3753
_SERVER["REMOTE_HOST"]	216.73.216.229
_SERVER["REMOTE_ADDR"]	216.73.216.229
_SERVER["QUERY_STRING"]	no value
_SERVER["PATH_TRANSLATED"]	D:\wwwroot\yyjg.net\wwwroot\admin.php\index\view\aid\2187.html
_SERVER["PATH_INFO"]	/index/view/aid/2187
_SERVER["LOGON_USER"]	no value
_SERVER["LOCAL_ADDR"]	172.16.121.93
_SERVER["INSTANCE_META_PATH"]	/LM/W3SVC/1
_SERVER["INSTANCE_NAME"]	WWWROOT
_SERVER["INSTANCE_ID"]	1
_SERVER["HTTPS_SERVER_SUBJECT"]	CN=www.yyjg.net
_SERVER["HTTPS_SERVER_ISSUER"]	C=PL, O=Asseco Data Systems S.A., CN=Certum DV TLS G2 R39 CA
_SERVER["HTTPS_SECRETKEYSIZE"]	2048
_SERVER["HTTPS_KEYSIZE"]	256
_SERVER["HTTPS"]	on
_SERVER["GATEWAY_INTERFACE"]	CGI/1.1
_SERVER["DOCUMENT_ROOT"]	D:\wwwroot\yyjg.net\wwwroot
_SERVER["CONTENT_TYPE"]	no value
_SERVER["CONTENT_LENGTH"]	0
_SERVER["CERT_SUBJECT"]	no value
_SERVER["CERT_SERIALNUMBER"]	no value
_SERVER["CERT_ISSUER"]	no value
_SERVER["CERT_FLAGS"]	no value
_SERVER["CERT_COOKIE"]	no value
_SERVER["AUTH_USER"]	no value
_SERVER["AUTH_PASSWORD"]	no value
_SERVER["AUTH_TYPE"]	no value
_SERVER["APPL_PHYSICAL_PATH"]	D:\wwwroot\yyjg.net\wwwroot\
_SERVER["APPL_MD_PATH"]	/LM/W3SVC/1/ROOT
_SERVER["IIS_UrlRewriteModule"]	7.1.0871.0
_SERVER["HTTP_USER_AGENT"]	Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
_SERVER["HTTP_HOST"]	www.yyjg.net
_SERVER["HTTP_ACCEPT_ENCODING"]	gzip, br, zstd, deflate
_SERVER["HTTP_ACCEPT"]	/
_SERVER["HTTP_CONNECTION"]	close
_SERVER["FCGI_ROLE"]	RESPONDER
_SERVER["PHP_SELF"]	/admin.php/index/view/aid/2187.html
_SERVER["REQUEST_TIME_FLOAT"]	1789705681.5227
_SERVER["REQUEST_TIME"]	1789705681

PHP Authors
Contribution	Authors
Zend Scripting Language Engine	Andi Gutmans, Zeev Suraski, Stanislav Malyshev, Marcus Boerger, Dmitry Stogov, Xinchen Hui, Nikita Popov
Extension Module API	Andi Gutmans, Zeev Suraski, Andrei Zmievski
UNIX Build and Modularization	Stig Bakken, Sascha Schumann, Jani Taskinen
Windows Port	Shane Caraveo, Zeev Suraski, Wez Furlong, Pierre-Alain Joye, Anatol Belski
Server API (SAPI) Abstraction Layer	Andi Gutmans, Shane Caraveo, Zeev Suraski
Streams Abstraction Layer	Wez Furlong, Sara Golemon
PHP Data Objects Layer	Wez Furlong, Marcus Boerger, Sterling Hughes, George Schlossnagle, Ilia Alshanetsky
Output Handler	Zeev Suraski, Thies C. Arntzen, Marcus Boerger, Michael Wallner

SAPI Modules
Contribution	Authors
AOLserver	Sascha Schumann
Apache 1.3 (apache_hooks)	Rasmus Lerdorf, Zeev Suraski, Stig Bakken, David Sklar, George Schlossnagle, Lukas Schroeder
Apache 1.3	Rasmus Lerdorf, Zeev Suraski, Stig Bakken, David Sklar
Apache 2.0 Filter	Sascha Schumann, Aaron Bannert
Apache 2.0 Handler	Ian Holsman, Justin Erenkrantz (based on Apache 2.0 Filter code)
Caudium / Roxen	David Hedbor
CGI / FastCGI	Rasmus Lerdorf, Stig Bakken, Shane Caraveo, Dmitry Stogov
CLI	Edin Kadribasic, Marcus Boerger, Johannes Schlueter, Moriyoshi Koizumi, Xinchen Hui
Continuity	Alex Leigh (based on nsapi code)
Embed	Edin Kadribasic
FastCGI Process Manager	Andrei Nigmatulin, dreamcat4, Antony Dovgal, Jerome Loyet
ISAPI	Andi Gutmans, Zeev Suraski
litespeed	George Wang
NSAPI	Jayakumar Muthukumarasamy, Uwe Schindler
phpdbg	Felipe Pena, Joe Watkins, Bob Weinand
phttpd	Thies C. Arntzen
pi3web	Holger Zimmermann
Sendmail Milter	Harald Radi
thttpd	Sascha Schumann
tux	Sascha Schumann
WebJames	Alex Waugh

Module Authors
Module	Authors
BC Math	Andi Gutmans
Bzip2	Sterling Hughes
Calendar	Shane Caraveo, Colin Viebrock, Hartmut Holzgraefe, Wez Furlong
COM and .Net	Wez Furlong
ctype	Hartmut Holzgraefe
cURL	Sterling Hughes
Date/Time Support	Derick Rethans
DB-LIB (MS SQL, Sybase)	Wez Furlong, Frank M. Kromann
DBA	Sascha Schumann, Marcus Boerger
DOM	Christian Stocker, Rob Richards, Marcus Boerger
enchant	Pierre-Alain Joye, Ilia Alshanetsky
ereg	Rasmus Lerdorf, Jim Winstead, Jaakko Hyvätti
EXIF	Rasmus Lerdorf, Marcus Boerger
fileinfo	Ilia Alshanetsky, Pierre Alain Joye, Scott MacVicar, Derick Rethans
Firebird driver for PDO	Ard Biesheuvel
FTP	Stefan Esser, Andrew Skalski
GD imaging	Rasmus Lerdorf, Stig Bakken, Jim Winstead, Jouni Ahto, Ilia Alshanetsky, Pierre-Alain Joye, Marcus Boerger
GetText	Alex Plotnick
GNU GMP support	Stanislav Malyshev
Iconv	Rui Hirokawa, Stig Bakken, Moriyoshi Koizumi
IMAP	Rex Logan, Mark Musone, Brian Wang, Kaj-Michael Lang, Antoni Pamies Olive, Rasmus Lerdorf, Andrew Skalski, Chuck Hagenbuch, Daniel R Kalowsky
Input Filter	Rasmus Lerdorf, Derick Rethans, Pierre-Alain Joye, Ilia Alshanetsky
InterBase	Jouni Ahto, Andrew Avdeev, Ard Biesheuvel
Internationalization	Ed Batutis, Vladimir Iordanov, Dmitry Lakhtyuk, Stanislav Malyshev, Vadim Savchuk, Kirti Velankar
JSON	Omar Kilani, Scott MacVicar
LDAP	Amitay Isaacs, Eric Warnke, Rasmus Lerdorf, Gerrit Thomson, Stig Venaas
LIBXML	Christian Stocker, Rob Richards, Marcus Boerger, Wez Furlong, Shane Caraveo
mcrypt	Sascha Schumann, Derick Rethans
MS SQL	Frank M. Kromann
Multibyte String Functions	Tsukada Takuya, Rui Hirokawa
MySQL driver for PDO	George Schlossnagle, Wez Furlong, Ilia Alshanetsky, Johannes Schlueter
MySQL	Zeev Suraski, Zak Greant, Georg Richter, Andrey Hristov
MySQLi	Zak Greant, Georg Richter, Andrey Hristov, Ulf Wendel
MySQLnd	Andrey Hristov, Ulf Wendel, Georg Richter, Johannes Schlüter
OCI8	Stig Bakken, Thies C. Arntzen, Andy Sautins, David Benson, Maxim Maletsky, Harald Radi, Antony Dovgal, Andi Gutmans, Wez Furlong, Christopher Jones, Oracle Corporation
ODBC driver for PDO	Wez Furlong
ODBC	Stig Bakken, Andreas Karajannis, Frank M. Kromann, Daniel R. Kalowsky
OpenSSL	Stig Venaas, Wez Furlong, Sascha Kettler, Scott MacVicar
Oracle (OCI) driver for PDO	Wez Furlong
pcntl	Jason Greene, Arnaud Le Blanc
Perl Compatible Regexps	Andrei Zmievski
PHP Archive	Gregory Beaver, Marcus Boerger
PHP Data Objects	Wez Furlong, Marcus Boerger, Sterling Hughes, George Schlossnagle, Ilia Alshanetsky
PHP hash	Sara Golemon, Rasmus Lerdorf, Stefan Esser, Michael Wallner, Scott MacVicar
Posix	Kristian Koehntopp
PostgreSQL driver for PDO	Edin Kadribasic, Ilia Alshanetsky
PostgreSQL	Jouni Ahto, Zeev Suraski, Yasuo Ohgaki, Chris Kings-Lynne
Pspell	Vlad Krupin
Readline	Thies C. Arntzen
Recode	Kristian Koehntopp
Reflection	Marcus Boerger, Timm Friebe, George Schlossnagle, Andrei Zmievski, Johannes Schlueter
Sessions	Sascha Schumann, Andrei Zmievski
Shared Memory Operations	Slava Poliakov, Ilia Alshanetsky
SimpleXML	Sterling Hughes, Marcus Boerger, Rob Richards
SNMP	Rasmus Lerdorf, Harrie Hazewinkel, Mike Jackson, Steven Lawrance, Johann Hanne, Boris Lytochkin
SOAP	Brad Lafountain, Shane Caraveo, Dmitry Stogov
Sockets	Chris Vandomelen, Sterling Hughes, Daniel Beulshausen, Jason Greene
SPL	Marcus Boerger, Etienne Kneuss
SQLite 3.x driver for PDO	Wez Furlong
SQLite3	Scott MacVicar, Ilia Alshanetsky, Brad Dewar
Sybase-CT	Zeev Suraski, Tom May, Timm Friebe
System V Message based IPC	Wez Furlong
System V Semaphores	Tom May
System V Shared Memory	Christian Cartus
tidy	John Coggeshall, Ilia Alshanetsky
tokenizer	Andrei Zmievski, Johannes Schlueter
WDDX	Andrei Zmievski
XML	Stig Bakken, Thies C. Arntzen, Sterling Hughes
XMLReader	Rob Richards
xmlrpc	Dan Libby
XMLWriter	Rob Richards, Pierre-Alain Joye
XSL	Christian Stocker, Rob Richards
Zip	Pierre-Alain Joye, Remi Collet
Zlib	Rasmus Lerdorf, Stefan Roehrich, Zeev Suraski, Jade Nicoletti, Michael Wallner

PHP Documentation
Authors	Mehdi Achour, Friedhelm Betz, Antony Dovgal, Nuno Lopes, Hannes Magnusson, Georg Richter, Damien Seguy, Jakub Vrana, Adam Harvey, Peter Cowburn
Editor	Philip Olson
User Note Maintainers	Daniel P. Brown, Thiago Henrique Pojda
Other Contributors	Previously active authors, editors and other contributors are listed in the manual.

Websites and Infrastructure team
PHP Websites Team	Rasmus Lerdorf, Hannes Magnusson, Philip Olson, Lukas Kahwe Smith, Pierre-Alain Joye, Kalle Sommer Nielsen, Peter Cowburn, Adam Harvey, Ferenc Kovacs, Levi Morrison
Event Maintainers	Damien Seguy, Daniel P. Brown
Network Infrastructure	Daniel P. Brown
Windows Infrastructure	Alex Schoenmaker