Challenges brought to hospitals by the development of information technology
With the development of the times and China's accession to the WTO, hospital information management has become one of the standards to measure the level of hospital management, and information management has gradually entered the field of medical and health care. According to the data of the Ministry of Health of China, more than 90 hospitals in the country have invested in informatization construction to varying degrees, and 40 large and medium-sized hospitals have paid special attention to informatization construction and invested even more. Even so, compared with the international practice of investing in informatization as a total of 2% of hospital revenue4, there is a huge gap between Chinese hospitals, with an average of only 01 or so.
Unlike other industries, hospital informatization cannot stop at internal applications. According to the division method generally recognized at home and abroad, hospital informatization generally has to go through three stages: hospital management information system centered on people, property and property, patient-centered clinical information system, and local medical and health service system centered on community service.
The establishment of these integrated information management systems ensures the normal development of hospital informatization construction, but how to effectively manage so many systems has become a new topic of medical informatization, and only by making many integrated information systems operate well can we ensure the normal provision of various medical services in hospitals. With the rapid development of IT technology, the construction of hospital informatization from the basic network construction, application system construction, and gradually entered a period of application and network integration development, network and application system complexity and scale continue to mature and expand, it is urgent to effectively and scientifically manage, by giving full play to the role of IT infrastructure built over the years, reflecting that IT technology can promote the external service level of the organization, and continuously improve the service quality to bring great benefits to the hospital
The complexity of the hospital IT environment and its problems
At present, China's medical informatization is based on the hospital management information system and the development of the patient-centered clinical information system, and the clinical information system system is still the focus of the industry when paying attention to medical informatization. In the past decade, with the support of the Ministry of Health and other leading institutions, the construction of CIS system in China's medical industry has entered a stage marked by the development and adoption of C S structure or B S structure and GUI interface.
For most hospitals, due to many reasons such as capital and information cognition, the hospital informatization construction has not carried out an overall and long-term development plan, but has the characteristics of gradually increasing and improving the hospital informatization with the continuous development of the hospital's medical business and the continuous progress of medical informatization technology. This has led to the increasingly complex information environment of hospitals. The following questions are a direct reflection of the increasing complexity of hospital IT environments
1) All kinds of infrastructure such as computers and networks come from the construction of various projects over the years, and their resource information is scattered, the records are incomplete, and it is difficult to know various details of each equipment at any time, such as use, maintenance and warranty. Many software systems have been gradually implemented for many years, with their own research and development, local medical insurance supporting, and software company development, which are diverse, and the specific application distribution is scattered, and it is difficult to achieve comprehensive statistics, analysis and judgment on the operation status of each information system. It is difficult for managers to have a timely and comprehensive understanding of IT resource usage, and the ability to make system management decisions is insufficient.
2) There is no clear division of responsibilities. For a large information management system, it is impossible for a single person to maintain it, and in a maintenance team composed of many people, because there is no clear division of responsibilities, everyone seems to be in charge of everything, and it seems that they don't care about anything. No one keeps track of the problem, and if something goes wrong, no one cares about it in the end.
3) There is no maintenance priority system in place. When encountering some problems that occur in a concentrated manner, there is no reasonable priority of the problem, and the response is often in order, and some relatively important things that occur later may be delayed.
4) The feedback of statistical information is not timely. Unable to obtain detailed statistical information in time, each person has their own records, and the writing is not standardized, which will inevitably lead to omissions and statistical difficulties.
5) Failure analysis and failure analysis are not possible. Since the faults are not recorded and classified, it is impossible to analyze the faults that have occurred, and measures cannot be taken to avoid the recurrence of similar faults, let alone discover potential faults.
6) There is no way to quantify the work of maintenance personnel, and it is impossible to conduct a reasonable assessment. It is not possible to measure the performance of maintainers, and it is impossible to evaluate the input and output in system maintenance.
7) Without maintaining a database, information cannot be saved and shared in a timely manner. Because the maintenance knowledge and experience are not sorted out and shared, the fault handling method is only mastered by the maintenance personnel at that time, and the same fault is handled by different personnel or from scratch, which reduces the work efficiency. If the resignation of key personnel will affect the normal progress of work.
MedicineThe construction requirements of the operation and maintenance management system of the hospital's information platform
With the continuous development of hospital business and medical informatization, most hospitals have realized the development of medical business through IT systems such as electronic triage and electronic drug dispensing. The use of these business systems effectively reduces the waiting time of patients, accelerates the medical treatment process of patients, and alleviates it to a certain extent"It is difficult to seek medical attention"problems. The implementation of electronic archives also provides conditions for the sharing and mutual recognition of regional medical information, which is alleviated"Expensive medical treatment"It provides the basis for solving problems, relying on network and electronic systems to work, improving work efficiency and helping patients save waiting time in all aspects. On this basis, hospitals put forward higher requirements for the safe and stable operation of network and business systems. If the business is interrupted or suspended, it will cause very serious consequences, so one of the core concerns of the hospital is how to ensure the uninterrupted and stable operation of the hospital's clinical business 24/7. With the continuous expansion of medical business, the hospital information system is becoming more and more complex, and the dependence of medical business on the information system is becoming more and more closeIf the information system collapses, the impact on the medical business will be fatal, therefore, how to clearly grasp the operation of the system, eliminate possible failures in the bud, ensure the stable operation of the hospital information network through the management of the standard, provide reliable technical support services for the core business of the hospital, satisfy the business department, and keep the staff of the hospital information department busy'Firefighting'This is a problem faced by the hospital's information department.
The IT industry and information application have entered a critical period of deepening, integration, transformation and innovation, and the impact of information technology and information system on the organizational form, governance structure, management system and operation process of hospitals is deepening day by dayHospitals are becoming increasingly reliant on information technology and information systems;The security, management, risk and control of information systems have become increasingly prominent issuesThe convergence of IT and business applications is at the heart of future developmentThe key to the application of information technology is sustainability, value creation, risk and control, integration, and performance management. In this period of development, various eyes are focused on areas such as governance, audit, service management, risk and control, and security. These fields are opening up new horizons for the IT industry and informatization, and have become the institutional guarantee for the IT industry and informatization to operate on a healthy and standardized track.
Hospitals want their IT systems to run 5x8 or 724 hours a day to ensure the normal use of the medical business systems they host. In order to ensure that the IT infrastructure as a whole runs without failure, the hardware and software that make up these systems need to function as they should. Establish an IT service management platform and a unified operation and maintenance management mechanism with unified technology and management, realize centralized monitoring of IT infrastructure and rational use of IT resources through standardized management processes and operation and maintenance organization models, and provide end-to-end IT services for business systems, so as to improve the quality of IT service management and operation and maintenance services.
The construction method of the operation and maintenance management system of the hospital information platform
The information operation and maintenance management requirements of the medical industry are similar to those of other industries, and they are also the management and services of business systems and IT infrastructure. In general, the following steps should be followed in the construction of the operation and maintenance management system of the hospital information platform:
1) Determine the content of the system.
2) Combined with the current situation of hospital informatization operation and maintenance and medical resource constraints or planning goals, form a focused and feasible management strategy.
3) Regularly review the development of the medical business and make continuous improvements.
Establish the element method of hospital information platform operation and maintenance management system
Hospital information platform IT infrastructure: This part is the most basic part of the operation and maintenance management of the hospital information platform, and it is also the core object of all IT services, mainly including host system (terminal, server, operating system), storage system (DAS NAS SAN, etc.), network environment (basic network, internal and external network environment, Internet, etc.), security environment (firewall, IDS IPS, traffic control, anti-virus and anti-attack, etc.), business system (HIS LIS PACS). EMR, etc.), middleware, database environments, and various configuration parameters of each device and system.
The core content of daily operation and maintenance management: It mainly refers to the unified management of events, problems, changes, releases, configurations and other service behaviors of the IT environment based on the CMDB (configuration management database). In order to ensure the effective implementation of the above-mentioned service behaviors, it is necessary to ensure from two aspects: comprehensive monitoring system and process control.
The goal of daily operation and maintenance management: to achieve the three goals of hospital informatization through effective operation and maintenance management: to ensure the stable operation and efficiency of the IT system, to calmly respond to various emergencies, and to design a reasonable IT system architecture.
System architecture and technical implementation of unified monitoring platform for hospital information resources
1) System logic architecture
From a software architecture perspective, the system can be divided into the following four layers:
A: Data collection and **: This layer is composed of various protocol adapters, which provides a unified interface access management stack (SNP CMIP TL1, etc.) to the upper layer, obtains management information (including event information, log information, performance information and topology information, etc.), and builds an information model as a driving module in the initial discovery.
b: Data aggregation: Unified description of the underlying data collected and organized as a management information base. Provides a unified management semantics and invocation interface. It makes each business module face a unified data model, makes the management of resources consistent and under a single controllable path, facilitates the management of resources, mutual exclusive access and other operations, and makes transaction-oriented concurrent management possible.
C: Data processing layer: focus on the implementation of management business, and no longer care about the differences of the underlying protocol. Respond to the request of the foreground application, complete data query, processing and other functions
d: Data presentation layer: the front interface, which obtains data from the data processing layer for display. It is the interface between the administrator and the network management system
Architectural design ideas
The division of the main software modules is determined according to the functional requirements specifications. The whole software system is divided into four layers: data acquisition layer, data abstraction layer, data processing layer and data presentation layer: the function of each layer relies on the implementation of the next layer, and generally does not make calls across the functional level.
Distributed buses are used to realize communication between individual modules. Modules are interoperable through interfaces using message buses.
In the overall design, the functional module is first decided, and then the service interface is designed according to the functional module: the deployment mode and communication mode are determined according to the characteristics of the functional module, the data flow and the flow direction: the middleware and object service are selected according to the performance requirements and the comprehensive consideration of portability and development intensity.
With the rapid development of network technology and the deepening of informatization construction in the medical industry, the application of medical informatization in the medical industry is increasing, and the application is becoming more and more complex. The medical business is becoming more and more dependent on informatization. There is also increasing pressure on hospital information departments. "Manage the network, the computer room, and the application"This may seem like the most basic task of the information service sector, but it is becoming more and more difficult to do. On the one hand, employees in the information sector are exhausted;On the other hand, the business unit is not satisfied. This contradiction is becoming more and more prominent in the information service of the medical industry, and the operation and maintenance management of the hospital information platform is to combine medical informatization with business.
In the future development process of medical informatization, hospital information operation and maintenance management should be combined with the actual situation of China's hospital business, establish a hospital information service management process, and streamline the hospital information service management, so that the information department can change from passive to active when dealing with intermediate problems. So as to ensure that the information service process can provide better technical and service support for the business operation of the hospital, and improve the service efficiency of the information department.