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山陽縣:構建數字健康一張網,打造智慧醫共體新模式

2025-05-23
408

山(shan)陽縣(xian)以(yi)破解緊密型(xing)縣(xian)域醫(yi)共體(ti)建設中縣(xian)鎮村醫(yi)療(liao)機構(gou)(gou)(gou)、醫(yi)療(liao)與(yu)公(gong)衛服務(wu)、機構(gou)(gou)(gou)與(yu)個人間的(de)信(xin)息(xi)壁壘為(wei)目標,創新運用云原(yuan)生(sheng)(sheng)、微(wei)服務(wu)等數(shu)(shu)字(zi)(zi)化技(ji)術,構(gou)(gou)(gou)建起“高效互聯(lian)、集成共享、安全(quan)(quan)可靠、融合開放”的(de)全(quan)(quan)民(min)“數(shu)(shu)字(zi)(zi)健(jian)康(kang)(kang)(kang)一張網” ,作為(wei)緊密型(xing)醫(yi)共體(ti)建設的(de)核(he)心支撐,“數(shu)(shu)字(zi)(zi)健(jian)康(kang)(kang)(kang)一張網”全(quan)(quan)面實現“縣(xian)鎮村醫(yi)療(liao)機構(gou)(gou)(gou)信(xin)息(xi)互通共享、醫(yi)療(liao)與(yu)公(gong)衛數(shu)(shu)據(ju)實時互聯(lian)、群眾(zhong)健(jian)康(kang)(kang)(kang)信(xin)息(xi)手機一鍵(jian)可查”,有效推動(dong)醫(yi)療(liao)衛生(sheng)(sheng)服務(wu)從“以(yi)治病為(wei)中心”向“以(yi)人民(min)健(jian)康(kang)(kang)(kang)為(wei)中心”深度(du)轉型(xing),為(wei)城(cheng)鄉(xiang)居民(min)提供全(quan)(quan)方位(wei)全(quan)(quan)生(sheng)(sheng)命周期健(jian)康(kang)(kang)(kang)服務(wu),轄區居民(min)健(jian)康(kang)(kang)(kang)需(xu)求(qiu)滿意(yi)度(du)與(yu)體(ti)驗感顯(xian)著提升。

自建成“數字(zi)(zi)健(jian)康(kang)一張網(wang)”以來(lai),全縣共上(shang)傳就診(zhen)信息(xi)142.43萬(wan)條,鎮(zhen)村遠程(cheng)上(shang)傳心電檢(jian)(jian)(jian)查(cha)44563例、遠程(cheng)影(ying)像檢(jian)(jian)(jian)查(cha)9620例,診(zhen)斷報告回傳率(lv)(lv)100%,平(ping)均用時(shi)9分鐘。截至(zhi)目前(qian),通(tong)過“數字(zi)(zi)健(jian)康(kang)一張網(wang)”完成家醫簽約30.61萬(wan)人(ren),簽約率(lv)(lv)84.91%,向公衛(wei)系(xi)統(tong)推送慢病患者提醒信息(xi)72766條,經核(he)實后納入慢病管理(li)43813人(ren)。截至(zhi)目前(qian),云(yun)健(jian)康(kang)信息(xi)系(xi)統(tong)已上(shang)傳檢(jian)(jian)(jian)查(cha)檢(jian)(jian)(jian)驗結果113.62條,累計更新完善(shan)居民(min)健(jian)康(kang)檔案36.05萬(wan)人(ren),開(kai)放居民(min)健(jian)康(kang)檔案35.36萬(wan)人(ren),檔案開(kai)放率(lv)(lv)98.08%。

打造智慧醫療,衛生健康信息互聯互通

統(tong)(tong)(tong)籌平臺建設,系(xi)(xi)統(tong)(tong)(tong)性(xing)能(neng)優(you)化升級。整(zheng)合縣(xian)鎮(zhen)(zhen)(zhen)(zhen)村(cun)389個醫(yi)(yi)療(liao)機構(gou)的HIS、LIS、PACS、電(dian)(dian)(dian)(dian)子病歷(li)、心(xin)(xin)電(dian)(dian)(dian)(dian)等信息(xi)(xi)系(xi)(xi)統(tong)(tong)(tong),實(shi)現(xian)(xian)縣(xian)域(yu)衛(wei)生(sheng)健康“一朵云(yun)存儲、一套庫共(gong)享、一平臺管理、一張網運行”,縣(xian)鎮(zhen)(zhen)(zhen)(zhen)村(cun)醫(yi)(yi)療(liao)數據(ju)縱向互(hu)通,系(xi)(xi)統(tong)(tong)(tong)功能(neng)更加優(you)化。統(tong)(tong)(tong)一硬件(jian)配(pei)備,遠(yuan)程診斷(duan)快速高效(xiao)。統(tong)(tong)(tong)一為(wei)18個醫(yi)(yi)共(gong)體分(fen)院(yuan)(yuan)和(he)(he)244個公(gong)有制村(cun)衛(wei)生(sheng)室(shi)配(pei)置帶遠(yuan)程上傳(chuan)功能(neng)的心(xin)(xin)電(dian)(dian)(dian)(dian)圖(tu)機等硬件(jian)設備,分(fen)院(yuan)(yuan)的DR、彩超等影像(xiang)(xiang)設備全(quan)部接入信息(xi)(xi)系(xi)(xi)統(tong)(tong)(tong),鎮(zhen)(zhen)(zhen)(zhen)、村(cun)醫(yi)(yi)療(liao)機構(gou)影像(xiang)(xiang)和(he)(he)心(xin)(xin)電(dian)(dian)(dian)(dian)檢查實(shi)時上傳(chuan)總院(yuan)(yuan)遠(yuan)程影像(xiang)(xiang)和(he)(he)心(xin)(xin)電(dian)(dian)(dian)(dian)診斷(duan)中心(xin)(xin)進行診斷(duan),10分(fen)鐘內回傳(chuan)診斷(duan)報告(gao)。打破信息(xi)(xi)孤島,健康數據(ju)互(hu)聯(lian)互(hu)通。信息(xi)(xi)系(xi)(xi)統(tong)(tong)(tong)可以查看患者在(zai)縣(xian)、鎮(zhen)(zhen)(zhen)(zhen)、村(cun)三級醫(yi)(yi)療(liao)機構(gou)的診斷(duan)結果、檢驗(yan)檢查結果、用(yong)藥處(chu)方等詳細診療(liao)記錄(lu),做(zuo)到檢驗(yan)檢查結果互(hu)認,實(shi)現(xian)(xian)縣(xian)域(yu)內醫(yi)(yi)療(liao)機構(gou)診療(liao)信息(xi)(xi)共(gong)享。

實施智慧公衛,家醫簽約服務提質增效

及時提醒(xing),公衛(wei)服(fu)(fu)(fu)(fu)務更(geng)精準精細(xi)。新(xin)診斷(duan)的慢(man)病患者信(xin)(xin)息(xi)從醫(yi)(yi)院信(xin)(xin)息(xi)系統(tong)同步自動推(tui)送至公衛(wei)系統(tong)并反饋給各村(cun)衛(wei)生室,慢(man)病漏簽(qian)和(he)服(fu)(fu)(fu)(fu)務盲點問題(ti)得到改(gai)善,公衛(wei)服(fu)(fu)(fu)(fu)務更(geng)加(jia)精準。掌上簽(qian)約(yue)(yue)(yue)(yue),公衛(wei)服(fu)(fu)(fu)(fu)務更(geng)簡便快捷。全面(mian)實行電(dian)子化(hua)簽(qian)約(yue)(yue)(yue)(yue)服(fu)(fu)(fu)(fu)務,家(jia)庭(ting)(ting)醫(yi)(yi)生通過手(shou)機(ji)端可(ke)以(yi)直(zhi)接開展(zhan)家(jia)庭(ting)(ting)醫(yi)(yi)生簽(qian)約(yue)(yue)(yue)(yue)、慢(man)病隨訪等公衛(wei)服(fu)(fu)(fu)(fu)務,高效(xiao)(xiao)為簽(qian)約(yue)(yue)(yue)(yue)居民提供優質的醫(yi)(yi)療衛(wei)生服(fu)(fu)(fu)(fu)務,有(you)力減輕基層醫(yi)(yi)務人(ren)員負擔(dan)。智(zhi)能(neng)分析,公衛(wei)服(fu)(fu)(fu)(fu)務更(geng)科學高效(xiao)(xiao)。醫(yi)(yi)療機(ji)構(gou)通過信(xin)(xin)息(xi)系統(tong)可(ke)以(yi)看到轄區(qu)范圍(wei)各類慢(man)病人(ren)群(qun)的分類數(shu)據以(yi)及詳細(xi)信(xin)(xin)息(xi),各醫(yi)(yi)療衛(wei)生機(ji)構(gou)簽(qian)約(yue)(yue)(yue)(yue)(履(lv)約(yue)(yue)(yue)(yue))率、各重(zhong)點人(ren)群(qun)簽(qian)約(yue)(yue)(yue)(yue)(履(lv)約(yue)(yue)(yue)(yue))率、家(jia)庭(ting)(ting)醫(yi)(yi)生簽(qian)約(yue)(yue)(yue)(yue)服(fu)(fu)(fu)(fu)務記錄和(he)服(fu)(fu)(fu)(fu)務現場照片可(ke)一鍵查詢。

拓寬智慧服務,便民惠民措施成效明顯

一(yi)卡(ka)(ka)通辦(ban),群(qun)眾(zhong)就診(zhen)(zhen)省時便捷。群(qun)眾(zhong)辦(ban)理電(dian)子(zi)健康卡(ka)(ka)后,可(ke)享受全(quan)(quan)程(cheng)(cheng)導診(zhen)(zhen)、線上繳(jiao)費等全(quan)(quan)流程(cheng)(cheng)就醫(yi)(yi)服(fu)務和檢(jian)查(cha)檢(jian)驗報告、繳(jiao)費信(xin)息(xi)實(shi)時手(shou)機(ji)(ji)查(cha)詢服(fu)務,群(qun)眾(zhong)人(ren)均(jun)就診(zhen)(zhen)時間從一(yi)個小(xiao)時縮短至(zhi)二(er)十分(fen)鐘(zhong),就診(zhen)(zhen)效率大大提(ti)高,群(qun)眾(zhong)就醫(yi)(yi)體驗感持(chi)續(xu)提(ti)升。一(yi)鍵(jian)查(cha)詢,報告讀取精準智能。縣(xian)域醫(yi)(yi)療機(ji)(ji)構開(kai)展的各類檢(jian)查(cha)檢(jian)驗結果(guo)、影像照片(pian)及診(zhen)(zhen)斷結論全(quan)(quan)部實(shi)時上傳信(xin)息(xi)系統,患者(zhe)通過(guo)手(shou)機(ji)(ji)端(duan)的電(dian)子(zi)健康卡(ka)(ka)可(ke)以一(yi)鍵(jian)查(cha)詢,隨(sui)(sui)時隨(sui)(sui)地(di)讀取,醫(yi)(yi)共(gong)體內醫(yi)(yi)療、公衛服(fu)務質(zhi)效明顯(xian)提(ti)升。動態更(geng)新,居民(min)檔(dang)(dang)案(an)信(xin)息(xi)實(shi)時共(gong)享。群(qun)眾(zhong)利用(yong)手(shou)機(ji)(ji)端(duan)可(ke)以查(cha)看自己的家(jia)庭(ting)醫(yi)(yi)生簽約(yue)信(xin)息(xi)、公共(gong)衛生服(fu)務記錄(lu)和健康檔(dang)(dang)案(an),數據實(shi)時更(geng)新,檔(dang)(dang)案(an)柜中的紙質(zhi)“死檔(dang)(dang)案(an)”變為可(ke)隨(sui)(sui)身(shen)攜帶(dai)隨(sui)(sui)時更(geng)新的數字“活檔(dang)(dang)案(an)”,人(ren)民(min)群(qun)眾(zhong)健康獲得感顯(xian)著(zhu)增(zeng)強。

強化智慧管理,縣域醫共體運行高效有序

統(tong)(tong)(tong)一數(shu)據監(jian)測(ce),實(shi)(shi)現精準(zhun)化管(guan)(guan)(guan)理(li)。醫(yi)共體總(zong)院(yuan)通(tong)過(guo)數(shu)字健(jian)康(kang)一張網對(dui)總(zong)院(yuan)和(he)各(ge)分院(yuan)的(de)門診、住院(yuan)人(ren)數(shu)、床位(wei)使用率、藥物使用情(qing)況、檢驗陽性率、住院(yuan)次均費用等醫(yi)療(liao)(liao)質(zhi)量(liang)、運行(xing)效(xiao)率、公衛質(zhi)控等數(shu)據實(shi)(shi)時動態監(jian)測(ce),每日統(tong)(tong)(tong)計(ji)分析,為(wei)總(zong)院(yuan)的(de)各(ge)項決策提供更(geng)加真實(shi)(shi)準(zhun)確(que)的(de)數(shu)據支撐(cheng)。統(tong)(tong)(tong)一管(guan)(guan)(guan)理(li)模(mo)式,實(shi)(shi)現規范化管(guan)(guan)(guan)理(li)。通(tong)過(guo)數(shu)字健(jian)康(kang)一張網,對(dui)縣(xian)(xian)域醫(yi)共體實(shi)(shi)行(xing)統(tong)(tong)(tong)一管(guan)(guan)(guan)理(li),強(qiang)化對(dui)基層(ceng)醫(yi)療(liao)(liao)行(xing)為(wei)、醫(yi)療(liao)(liao)質(zhi)量(liang)的(de)管(guan)(guan)(guan)理(li)和(he)指導,確(que)保縣(xian)(xian)鎮醫(yi)療(liao)(liao)服務規范化、同(tong)質(zhi)化。統(tong)(tong)(tong)一質(zhi)效(xiao)考核(he),實(shi)(shi)現科學化管(guan)(guan)(guan)理(li)。縣(xian)(xian)醫(yi)管(guan)(guan)(guan)辦通(tong)過(guo)數(shu)字健(jian)康(kang)一張網,每雙(shuang)月對(dui)各(ge)醫(yi)共體單位(wei)進行(xing)統(tong)(tong)(tong)一績效(xiao)評價,評價結果與職(zhi)工績效(xiao)總(zong)量(liang)掛鉤(gou),確(que)保緊密(mi)型縣(xian)(xian)域醫(yi)共體運行(xing)更(geng)加高效(xiao)。

主要成效

(一)率先實現縣鎮村醫療信息互通通(tong)過對(dui)縣(xian)、鎮、村(cun)(cun)(cun)醫療機(ji)構(gou)(含公(gong)立醫院(yuan)、民營醫院(yuan)、衛生院(yuan)、衛生室、診(zhen)所)信(xin)息系統升(sheng)級(ji)更新,打破醫療機(ji)構(gou)間信(xin)息壁壘,縣(xian)鎮村(cun)(cun)(cun)醫療數(shu)(shu)據縱向互通(tong),全(quan)面(mian)實現“醫學影像(xiang)聯到鎮、遠(yuan)程心電(dian)通(tong)百村(cun)(cun)(cun)、消毒物資統一供,檢(jian)查結果相互認,診(zhen)療信(xin)息全(quan)共(gong)享”。自建成“數(shu)(shu)字健康一張網”以來,全(quan)縣(xian)共(gong)上傳(chuan)就診(zhen)信(xin)息142.43萬(wan)條,鎮村(cun)(cun)(cun)遠(yuan)程上傳(chuan)心電(dian)檢(jian)查44563例(li)、遠(yuan)程影像(xiang)檢(jian)查9620例(li),診(zhen)斷報告(gao)回傳(chuan)率100%,平均用時9分鐘。

(二)領先實現醫療公衛信息互通在全(quan)省率先打(da)破醫療、公衛(wei)(wei)(wei)信(xin)息(xi)(xi)壁壘,醫療系(xi)統既(ji)可(ke)以通過信(xin)息(xi)(xi)平臺自動將(jiang)患(huan)者(zhe)信(xin)息(xi)(xi)推(tui)(tui)送(song)到(dao)公衛(wei)(wei)(wei)系(xi)統,也可(ke)以從(cong)信(xin)息(xi)(xi)平臺調取患(huan)者(zhe)的公共衛(wei)(wei)(wei)生(sheng)服務檔案,了解(jie)患(huan)者(zhe)的既(ji)往健(jian)康狀況,實現醫療與公衛(wei)(wei)(wei)數據的橫(heng)向互通,真正做到(dao)衛(wei)(wei)(wei)生(sheng)健(jian)康信(xin)息(xi)(xi)全(quan)面(mian)共享。截至目前,通過“數字(zi)健(jian)康一張網”完成家醫簽約30.61萬人,簽約率84.91%,向公衛(wei)(wei)(wei)系(xi)統推(tui)(tui)送(song)慢病(bing)(bing)患(huan)者(zhe)提醒信(xin)息(xi)(xi)72766條(tiao),經核(he)實后納(na)入慢病(bing)(bing)管理43813人。

(三)優先實現衛生健康信息與患者互通打通(tong)(tong)醫療機(ji)構與群眾信(xin)息渠(qu)道,群眾辦理(li)電(dian)子健(jian)(jian)康(kang)卡(ka)后,全縣一(yi)張卡(ka)就診(zhen),通(tong)(tong)過(guo)手機(ji)端可以(yi)一(yi)鍵預約就診(zhen)、查詢家醫簽約信(xin)息、健(jian)(jian)康(kang)檔案、公(gong)衛服務記錄和就醫服務信(xin)息,讓“數據(ju)多跑路,患者少跑腿”成為現實,就醫服務更(geng)(geng)加(jia)優(you)質、高(gao)效、便捷,群眾健(jian)(jian)康(kang)獲得感(gan)大(da)大(da)增強。截至目前,云健(jian)(jian)康(kang)信(xin)息系統已上傳檢(jian)查檢(jian)驗結(jie)果113.62條(tiao),累計(ji)更(geng)(geng)新完善居民(min)健(jian)(jian)康(kang)檔案36.05萬人,開放居民(min)健(jian)(jian)康(kang)檔案35.36萬人,檔案開放率98.08%。

(四)創新做法在省內外全面推廣。山陽(yang)縣(xian)“數字健康(kang)(kang)一張網(wang)”在全(quan)國基(ji)層衛生健康(kang)(kang)發展與(yu)傳播大會暨基(ji)層重點衛生工作會上做經驗(yan)交流,陜(shan)西(xi)(xi)新聞聯播頭(tou)條播出,并先(xian)(xian)后(hou)在《陜(shan)西(xi)(xi)衛生健康(kang)(kang)信(xin)(xin)息》《陜(shan)西(xi)(xi)大衛生》《學習強國陜(shan)西(xi)(xi)平(ping)臺》《商(shang)洛(luo)信(xin)(xin)息》《商(shang)洛(luo)改革動態》《商(shang)洛(luo)日報》《陽(yang)光網(wang)》《環球網(wang)》《西(xi)(xi)北信(xin)(xin)息報社》等刊載推(tui)廣(guang),成(cheng)功入(ru)圍2024年“數據要素X”大賽陜(shan)西(xi)(xi)決(jue)賽,甘(gan)肅(su)、漢中、寶雞(ji)、安康(kang)(kang)等兄弟省市縣(xian)先(xian)(xian)后(hou)前(qian)來學習交流。

經驗啟示

(一)行政推動是關鍵。要始終(zhong)堅(jian)持以人(ren)民為(wei)中(zhong)心的發展思(si)想(xiang),在(zai)信息(xi)化系(xi)統(tong)部署過(guo)程中(zhong)要隨時(shi)跟進調度,協調解決建設過(guo)程中(zhong)的問題和困(kun)難;及時(shi)通報指(zhi)導,提(ti)高各機構系(xi)統(tong)規范應用率;廣泛宣傳動員,增加(jia)群眾注冊使用電子健康卡的普及率。

(二)運行保障是前提。在信(xin)息化(hua)建(jian)設的(de)過程中要確(que)保信(xin)息網絡的(de)高度(du)整(zheng)合統(tong)一,提前(qian)完(wan)成(cheng)(cheng)網絡資源(yuan)整(zheng)合與網絡端口預(yu)留(liu),通(tong)過標準化(hua)價格談(tan)判機制鎖定整(zheng)體(ti)建(jian)設成(cheng)(cheng)本,確(que)保后(hou)期能夠免費進行(xing)業(ye)務功能擴(kuo)展、系統(tong)迭(die)代升(sheng)級及接口調(diao)用,保障整(zheng)體(ti)信(xin)息化(hua)系統(tong)平(ping)穩運行(xing)。

(三)統籌建設是基礎在醫(yi)(yi)共(gong)體(ti)信息(xi)化(hua)建設(she)過(guo)程(cheng)中(zhong),要(yao)把綜合醫(yi)(yi)院(yuan)(yuan)(yuan)、專科醫(yi)(yi)院(yuan)(yuan)(yuan)、民(min)營醫(yi)(yi)院(yuan)(yuan)(yuan)、衛生院(yuan)(yuan)(yuan)、公衛機(ji)構、衛生室、診所等(deng)各類醫(yi)(yi)療(liao)機(ji)構納入建設(she)規劃(hua)一體(ti)推進(jin)。針對醫(yi)(yi)共(gong)體(ti)內機(ji)構數(shu)量較多、類型各異且(qie)需求不(bu)同的現(xian)狀,要(yao)為各個機(ji)構統一配置數(shu)據接(jie)口高度統一、內部應用(yong)模塊緊(jin)密銜接(jie)的硬件設(she)備,確保(bao)信息(xi)化(hua)建設(she)整體(ti)推進(jin)。

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