CAJ | 학술논문

　　目的：在临床路径管理方面，传统纸媒介的临床路径管理模式面临诸多实际困难，在推行临床路径过程中瓶颈难以破解，如何实现临床路径的信息化已成为当前临床路径推进过程中亟须解决的重要问题。方法：在对临床路径研究的基础上，提出面向电子病历集成的临床路径设计理念。通过采用现代软件工程的理念和Cache、CSP、Extjs等先进技术，建立以患者诊疗计划为主线，具有循证医学证据并支持HL7标准的临床路径管理系统，实现了路径制定、路径执行、路径管理及统计分析等功能，将知识库信息贯穿整个医疗过程，在自动化、智能化的指导和监督下既严格遵循路径流程，又方便快捷完成诊疗过程。结果：临床路径信息管理系统实现了临床路径的信息化管理，病人平均住院日和手术等待时间取得明显改善，例均住院总费用和例均药品费用绝大部分下降或持平。结论：临床路径信息管理系统的应用最终达到了规范医疗行为、降低成本、减少变异、提高医疗质量的目的。
　　목적：재림상로경관리방면，전통지매개적림상로경관리모식면림제다실제곤난，재추행림상로경과정중병경난이파해，여하실현림상로경적신식화이성위당전림상로경추진과정중극수해결적중요문제。방법：재대림상로경연구적기출상，제출면향전자병력집성적림상로경설계이념。통과채용현대연건공정적이념화Cache、CSP、Extjs등선진기술，건립이환자진료계화위주선，구유순증의학증거병지지HL7표준적림상로경관리계통，실현료로경제정、로경집행、로경관리급통계분석등공능，장지식고신식관천정개의료과정，재자동화、지능화적지도화감독하기엄격준순로경류정，우방편쾌첩완성진료과정。결과：림상로경신식관리계통실현료림상로경적신식화관리，병인평균주원일화수술등대시간취득명현개선，례균주원총비용화례균약품비용절대부분하강혹지평。결론：림상로경신식관리계통적응용최종체도료규범의료행위、강저성본、감소변이、제고의료질량적목적。
Objective: In clinical pathway management, the traditional paper-based media of management mode existed many difficulties, it is difficult to break the bottleneck in the process of clinical pathway, and how to implement of clinical pathway informatization is a problem to be solved imperatively. Methods: Based on the study of the clinical pathway, this paper presents the design concept of electronic medical record oriented integration. By adopting the theory of software project, Cache、CSP 、Extjs and other advanced technology, it establishes the clinical pathway management system with evidence-based medicine and supporting the HL7 standard, patients plan as its storyline, the system realizes the path design, path execution path management and statistical analysis, which puts knowledge base through the course of medical care, that is both follow the path procedure strictly and convenient to complete the treatment process under the guidance and supervision of automatic and intelligent. Results: The information-based management of the clinical pathway is achieved by clinical pathway management system, both average days for inpatients and waiting times for operations are improved obviously, most of the average case expense and average case medicine expense are decreased or flatted. Conclusion: Standardize medical behavior, cost reduction, and variation reductions, and the improvement of medical quality are optimized finally by using the clinical pathway management system.