An application study of a new pharmacy service system based on data center

Introduction. Exploring the application of a new data center-based pharmacy service system. By collecting data from business systems for standardized transformation, it forms a clinical data center and an operational data center, thus meeting the business needs of new pharmacy services. It improves the rationality and safety of prescriptions, ensures patient medication safety, and achieves the goal of assisting hospitals in medication management. The construction of a new pharmacy service system based on the data center will provide complete and unified data for medical clinical and scientific research and improve the efficiency of hospital operations.

1 Introduction

As hospital information technology continues to evolve, hospital operations are increasingly dependent on information systems, and the number of hospital information systems continues to grow. However, the more systems there are, the more information silos there are, and as a direct result, information systems are generating and accumulating more and more junk data, making it difficult to achieve business synergy and subsequently to improve operations effectively. To avoid the formation of information silos and to make full use of these data resources, a data center was introduced, and based on this platform, a unified data standard was established to unify the identification and content of data shared by various hospital systems, thus providing a better information base for hospital management.

2 Background of the study

Clinical Data Centre (CDR)so-called Clinical Data Centre (CDR) It is the patient-centered, Integration of data for medical operations and hospital management according to standard data formats, Establishment of an institution-wide information resource centre, and open up various standards on the basis of this、 Data access services that comply with legal norms and security requirements, Regional cross-institutional medical information sharing and business collaboration, Ultimately, to achieve assisted improvement Medical services quality、 Reducing medical errors、 Improving clinical research, Supporting information for decision making and reducing healthcare costs。

Construction of the data centre platform The clinical service systems currently in use are: HIS, Electronic Medical Record System, RIS/PACS, LIS, Ultrasound Imaging System, ECG System, Surgical Anesthesia System, etc. Through the application of an intelligent data collection platform, the data generated by all business information systems in the hospital will be brought together, thus building a hospital-wide data center and promoting the secondary use of medical data. The hospital-wide data center is built to form a set of standardized data models, which can easily build various data presentation and utilization views, thus adapting to the changing clinical, management, quality control and research needs of various hospital users with different roles.

3 System logical framework design

Based on the principle of data integration and cross-institutional collaboration, the data center platform collects data from business systems for standardization and conversion, forming a clinical data center and an operation data center to achieve integrated data integration of internal hospital application systems and inherit existing data resources and services internally, and interoperability with branch hospitals and subordinate medical institutions externally. The information planning framework takes the hospital information platform as the core, integrates business system data downward, and provides various platform applications upward for different users. The framework is implemented based on SOA, with the loosely coupled nature of SOA service-oriented architecture, enabling the platform to add new services or update existing services in a modular way with good scalability, thus meeting new business needs in the future and allowing existing applications to be used as services. Its general framework is shown in Figure 1.

Figure 1 General framework of the system

Data Center Information Extraction ComponentThe main applications of the platform, such as electronic medical record quality control, disease surveillance, and medical record research statistics, invariably require the descriptive content of the medical record to be structured. Specifically, the keywords in the medical record need to be extracted and organized semantically into a tree structure through information extraction techniques, including both extraction and organization processes. The processed data can be displayed directly to the user, indexed for retrieval of original information, or stored in a database or spreadsheet for further analysis later.

How data integration is achievedIn the construction of hospital information platform, heterogeneous data integration is a key and difficult point. The construction of the information platform requires interfacing with different developers of multiple business applications within and outside the hospital, using different operating systems, different development environments, different software architecture, different data formats, etc. The data sources, environments and formats are extremely complex. The traditional way of health care integration is generally to have each system supplier of the hospital transform the original system and submit the data to the platform, which makes the success or failure of the project extremely dependent on the subjective cooperation willingness and technical cooperation ability of each system supplier, making the project extremely uncontrollable. In order to break through the above bottlenecks, a "top-down, proactive and timely" integration model is adopted, in which the initiative is handed over to the hospital, and the hospital decides at what time, what data to extract and in what standard format to convert.

The data integration is realized by self-developed ETL middleware and post-structuring technology. Through the data integration platform, the data from relatively independent software systems are collected, cleaned and converted according to the data standard requirements, forming a unified clinical document library in the hospital and providing a unified view of the patient's medical record for clinical medical staff.

4 Application of a pharmacy service system based on normalized data

Aggregation and normalization of data through the data centre platform, Data involved in pharmacovigilance,99% The above was successfully acquired by the data center platform。 Previously non-uniform data is stored in the database as normalized data sets, Leverage the range of data analysis and presentation tools available through the data centre platform, The required use cases can be easily developed。 Its applications are mainly in Medical services、 scientific management harmony Public Services three aspects。

Medical services In order to standardize the hospital prescription evaluation work, improve the quality of prescriptions, promote rational drug use, to ensure medical safety, with reference to the Ministry of Health promulgated a series of medical institutions reasonable drug use indicators, such as the number of drugs per visit, per visit per capita cost, the percentage of antimicrobial drugs used in the hospital, the percentage of essential drugs in prescription drugs, etc., according to the needs of the integrated platform for visual display. Clinical medical service personnel through the hospital-wide electronic medical records to consult the service object in all medical activities generated information, through the platform data exchange, message push and other functions, can avoid repeated diagnosis, repeated medication, repeated examination, while the system platform according to the patient's information, remind clinicians to carry out timely medical treatment, regulate medical behavior, reduce medical risks, reduce the intensity of doctors' work.

In order to make the prior management of clinical drug use more intelligent and humane, different monitoring measures are adopted at three levels according to the harm level of clinical drug use: prompting, intervention and interception. And for certain complex situations, there are certain medication hazards, the doctor needs to weigh the pros and cons according to the actual condition to decide whether to use the drug, can be used by filling out the reason for the drug to select the prompt box, all operations background can be recorded pending investigation. The implementation of this innovative hospital medication management system with medication safety monitoring interventions has significant implications for hospitals to achieve prior intervention in clinical medication use. After the medication pre-information intervention system went online, the number of unreasonable medication orders in outpatient clinics dropped significantly, with the number of warning lights at the most serious level dropping by 31.16% and the number of warning lights at the not recommended level dropping by 42.56% (see Figure 2).

Figure 2 Overall design of the portal

The implementation of this technology is conducive to the prior detection of potential irrational drug use problems and the prevention of adverse drug events, and can also contribute to improving the rationality and safety of physician prescribing, reducing hospital costs due to drug use disputes, and ensuring the safety, rationality and economy of patient drug use.

scientific management The platform enables accurate management of drug use and more comprehensive, scientific and multi-dimensional analysis of relevant medication data. The hospital management can manage the scientific quality, safety, efficiency and effectiveness of the hospital based on objective, real and valid data. The hospital information platform contains rich, continuous and real clinical information, and through data analysis and data mining of the data center, it can provide an important basis and necessary support for clinical pharmacists and drug management.

Public Services To make the patient experience more convenient during and before and after the consultation、 quicker、 discreet、 Careful service, while relieving pressure on hospital services, Data centre based, Medical portals were constructed, that is, inInternet in the context of, Putting together various application systems、 Unified integration of data and Internet resources under the healthcare portal, Depending on the usage characteristics and roles of each user, Forming different application interfaces, and organically connects users through the transmission of processing events and messages。 It's not just limited to building a medical website, Provide some Medical services information, More importantly, it requires the ability to integrate multiple business systems、 Ability to respond quickly to a variety of user requirements、 And it is possible to have a good understanding of the entire Medical services The nodes are managed centrally( see chart3)。

Figure 3 Overall design of the portal

The mobile intelligent terminal based on the medical portal provides comprehensive information services for patients externally, so that patients can check information related to their previous hospitalization and consultation; internally, it provides timely and comprehensive patient treatment information for medical workers, and supports physicians and pharmacists to view the treatment information of patients under their management through the mobile terminal, accept remote consultation to respond to patient consultation, and follow up patients as long as their authority allows.

Construction of a hospital data centre platform, Improved patient experience, realize Medical services Innovation in the model, Personalized care for each patient, Building a Lifetime Customer Concept, Improving hospital competitiveness。

The hospital data center platform integrates the business system data of the hospital department and the branches, and establishes the hospital information platform and data center based on the multi-hospital area. Realize the clinical application of "patient-centered", provide public service, facilitate health consultation and information retrieval of patients, the focus of hospital pharmacy work changes from drug-guaranteed to technical service-oriented, standardizes drug use behavior, reduces medical risk, reduces the intensity of medical staff's work, enables medical staff to have more time to serve patients, achieves the precision of diagnosis and treatment, service sincerity, hospital management refinement, supports leadership decision-making, supports future clinical decision-making, Applications such as clinical research and analysis provide strong data support.

Journal of Chinese Digital Medicine, Vol. 01, 2018, by and with Yanke Hu, Bin Zhou, Hao Wang, Wei Zhuang, Wei Liu, Computer Management Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.

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