CAJ | 학술논문

目的：实现医院病案首页信息的自动准确上报。方法分析病案首页数据上报需求，设置数据规则校验引擎，开发病案首页上报数据对接程序。结果基于医院数据平台开发的数据对接程序实现了病案首页信息的自动准确上报，并实现了上报数据对应84项指标的自动汇总分析、提取信息的规则引擎校验及展示。结论医院数据对接程序上报的病案首页信息符合卫生计生委的相关要求，并能有效的提高医院病案质量管理水平。
목적：실현의원병안수혈신식적자동준학상보。방법분석병안수혈수거상보수구，설치수거규칙교험인경，개발병안수혈상보수거대접정서。결과기우의원수거평태개발적수거대접정서실현료병안수혈신식적자동준학상보，병실현료상보수거대응84항지표적자동회총분석、제취신식적규칙인경교험급전시。결론의원수거대접정서상보적병안수혈신식부합위생계생위적상관요구，병능유효적제고의원병안질량관리수평。
Objective to achieve reporting hospital medical records information automatically and accurately. Methods analysis the requirements of reporting medical records quality information, set the data rules engine and develop data docking system of medical records quality monitoring. Results Based on the data platform of hospital, the medical records information is reported automatically and accurately by Data Docking System. And the 84 indexes are collected and analyzed automatically;the results of the checking are shown. Conclusion The Data Docking System has met the requirements of national Health and Family Planning Commission;and it is useful to improve the level of medical records quality management.