Due to the complexity of intelligent hospital functions, high technology content, its design involves architecture, nursing, hygiene, biology, engineering and other scientific fields, coupled with the rapid development of medicine, and a variety of modern high-tech interpenetration and combination of all impact on the design of the functional layout of the hospital. How to carry out the design of the hospital has become a medical and health departments, architectural design departments **** with the urgent solution to the problem. The author combined with their own practical experience in hospital engineering, the design of intelligent hospitals and their difficulties to elaborate and discuss.
How to carry out intelligent hospital design, first of all, from the understanding of the use of hospital functions and characteristics.
Hospitals are different from hotels, office buildings, commercial and residential buildings. It is "patient-centered" implementation of hospital services in a special place. The main features of the hospital are as follows:
First of all, dense, large flow. The second equipment-intensive, large flow of material hospital medical equipment and other equipment, the variety and quantity of ordinary buildings can not be compared, according to the function of the equipment can be divided into four categories:
* Ordinary building equipment: such as water supply and drainage, power supply and distribution, ventilation and air conditioning, fire alarms and fire fighting, elevators and other equipment.
* Building medical equipment: this is the same ward building synchronized design, installation, commissioning of medical equipment. Such as central oxygen, central attraction, compressed air, anesthesia gas supply and recovery, central intercom, central monitoring, laminar flow wards, clean surgical department. These devices are unique to hospitals.
* Medical equipment in the ward: such as monitoring equipment, first aid equipment, small therapeutic equipment, inspection equipment.
* Office and conference equipment: medical staff to use a variety of office equipment and various types of teaching equipment in the hospital also has a larger number.
Third information-intensive, complex circulation. Hospital operation and management is complex, both human management, but also the management of things. Human management includes both the management of patients, including the management of medical staff. The management of things is more diversified. Hospital management information circulation is multi-channel, there are administrative management information circulation channels, there are also medical management information circulation channels.
Intelligent hospital is in the usual hospital building design to increase some or all of the intelligent hospital "intelligent" function, is a special category of intelligent hospital.
Intelligent hospitals are usually composed of three major systems, namely, communications automation (CA), office automation (OA), building automation (BA), and combining these three functions to achieve system integration.
In the specific design, intelligent hospitals usually contain the following a number of weak power systems, information communication; broadcasting equipment monitoring; public **** security management; integrated wiring; office automation; system integration.
Intelligent hospitals are based on ordinary hospitals to enhance the building's "intelligent" function, although the same object and service, but in the medical environment is not comparable to ordinary hospitals, ordinary hospitals basically no centralized air conditioning system, hot water supply system, the weak power system is just a basic call system, telephone system, and radio, television system, and intelligent hospitals. and radio, television system, while the intelligent hospital is after the architect of the building appearance, color, internal functional layout and space environment carefully designed to meet people's psychological and physiological needs, while the building uses air conditioning, ventilation system, centralized heating system and wards with small openings hotel design, wards with shower facilities, independent health and telephone, radio, television equipment. The design of the weak electricity system adopts most of the "intelligent" systems in the intelligent building, realizing the computer management of building equipment, medical services network and management automation.
Intelligent hospital building is a special building with intelligent building functions, although the two in the form of intelligent systems have many similarities, but because of the different objects of service, different purposes of the service object, the system design to show the focus of the natural differences in design, the former more emphasis around the idea of serving patients, such as: ward design how to consider a part of the patient to provide radio and television services, but also consider meeting the fire safety and health services, the design of the hospital building is not the same as the design of the hospital. The former emphasizes more on the idea of serving patients, such as: how to consider the ward design to provide some patients with broadcasting and TV services, and also consider meeting the requirements of the fire code; how to combine the characteristics of the hospital to increase the monitoring of the hot water pipeline, monitoring of oxygen supply and attraction equipment; how to solve the security system for the ward area of the management and control of the off-duty entrance, and also to meet the fire code of the requirements of the channel evacuation. In addition, intelligent hospitals have a number of intelligent buildings are usually not dedicated to the hospital patient service system.
Intelligent hospital building due to the hospital itself is the only user, the object of service is the patient, the implementation of the computer local area network function of the building, the implementation of the weak power system have practical, clear requirements, compared to those who only seek the name of the "intelligent building", easier to carry out the system integration, will be more embodied in the "intelligent hospital". Intelligent hospital "gold".
In the preliminary design of a hospital intelligent project, the weak electricity system project includes 12 subsystems:
* Comprehensive wiring system
* Computer network system
* Digital hospital
* Hospital video system
* Remote diagnosis system
* Call system
* Screen display system
* The hospital is a very important part of the project. Screen Display System
* Cable and Satellite TV Reception System
* Public **** Broadcasting System
* Closed Circuit Surveillance and Anti-theft System
* Parking Management System
* Building Automation System
The author believes that among them, the digital hospitals, hospitals, hospitals and telemedicine systems are the technically difficult and high-tech sub-systems. Higher subsystems, the following focus on the elaboration and discussion.
First, the digital hospital
Information is the most important strategic resource in the information revolution and social informatization process. The degree of information technology is directly related to the level of survival and competitiveness of modern hospitals. The direct benefit of the application of information technology is to greatly improve the efficiency of hospital operations.
Benefit-centered hospital management system is the new economic era (i.e., the knowledge-based economy, also known as the benefit economy) resulting in a new management system. The benefit-centered hospital management system includes quality-centered and patient-centered management systems.
The effective operation of the benefit-centered management system requires the technical support of the hospital information system. The full implementation of the benefit-centered management system depends on the full establishment and use of hospital information systems.
Digital thinking and digital management mode is a quantitative assessment of the results of thinking and management mode. It is an important foundation for the effective understanding and use of a benefit-centered management system.
Information technology and information systems are not a tool or a piece of equipment, they are the infrastructure and infrastructure of an efficiently operated healthcare structure
Clinical Information System (CIS) and Hospital Management System (HMS) together constitute the hospital information system.
HMS is the hospital as an economic entity to manage and operate the system. The system consists of a number of functional subsystems. These subsystems include financial management systems, administrative office systems, personnel systems and other non-clinical functional subsystems. Some hospital management systems also include basic and simple clinical subsystems such as patient registration systems.
CIS consists of functional subsystems that process clinical information. These functional subsystems include outpatient management systems, patient care and electronic medical record systems, medical imaging systems, pharmacy management systems, laboratory (laboratory) management systems, remote management systems, medical data repositories, and information integration and wide-area dissemination systems.
Clinical information technology at the departmental level has evolved over 20 years and is more widely used in developed countries. Technology development for hospital-wide/inter-hospital clinical information has entered the application phase in the last few years and is expected to enter the widespread application phase in the next decade or so.
The emergence of CIS is in line with the current trend of hospital management and the integration of the entire healthcare industry; CIS is centered on the doctor's workstation, and patient information is the main content to deal with the entire hospital's information process. This is a match for the connection with the health insurance system and the exchange of doctor-patient information required by the example of community healthcare. At the same time, this idea and the current international widely used HL7 standard design ideas (medical event-driven Trigger Event) is also consistent.
At present, the development and production of hospital information systems manufacturers to do their own thing, but also seldom take into account the need for user integration, so their products or can not be integrated with other systems, or can be integrated with other systems, but the interface for the exchange of data is the vendor's own definition of the interface. In this way, the formation of various vendors, "the king of the mountain" situation, to establish a complete, unified hospital information system has brought great difficulties. Difficulties are reflected in these points: either the subsystems can not be integrated, and can not form a complete, unified hospital information system; or subsystems and other subsystems with each other to define the interface standard exchange of data, so that although the formation of a complete, unified hospital information system, but the integration of the complexity of the high, the overhead is also very large, and the later is not easy to maintain.
The two subsystems must support a unified standard between the integration, and thus exchange patient information.
The subsystems must support harmonized standards to reduce the complexity of integration. The chosen standard must be open to reduce the cost of acquiring the standard; the chosen standard must be simple and not technically difficult to implement to reduce the cost of implementation of the integration; and the chosen standard must be reliable to reduce the cost of maintenance of the integration.
Integration will have three following modes:
* Single-vendor model: the advantages of the traditional model, no need for integration, simple project management, low technical complexity, saving money; the disadvantage is the limited scope of application, functionality, single point of failure, single-vendor risk, poor maintenance, maintenance costs are greater, and can not be realized as a complete solution;
* Multi-vendor model: Advantages are suitable for the application, high level of system, easy to modify, decentralized costs; disadvantages are too many vendors, difficult to choose, difficult to manage, technically complex;
* Hybrid model: respectively, choose a single manufacturer to build the cost/financial management system, the electronic medical records system, and multi-vendor construction of other systems; limited division of the entire system, which maintains the flexibility of the system, but also limits the complexity of the system
The author of the book is the author of the book.
The author believes that the third model is more reasonable and suitable for the actual situation in the country.
In the past, the international CIS market was very chaotic, with many small products from small and medium-sized companies flooding the market. The lack of good overall planning led to complex system interconnections, data redundancy, and maintenance difficulties.
When choosing interface standards for subsystems, HL7 is recommended, and is now commonly used internationally as the data exchange standard for hospital information systems.
Not that the use of HL7 as the interface standard for clinical information systems can solve all the problems, a good standard has to be well used to really solve practical problems. In the process of applying HL7 will also face a number of challenges, the most common of which are:
Hospitals, especially hospital decision makers should have a full understanding of the importance of HL7. First of all, the importance and necessity of applying HL7 should be recognized. Then, build the hospital information system to harmonize the system application standards and interface specifications to HL7.
Clinical information system vendor support for HL7. If the vendor does not support HL7, then we talk about HL7 is just a "moon in the water". From the current stage, the vast majority of vendors' products do not support HL7, but we also see that many vendors are gradually realizing the importance of supporting HL7, and are gradually improving their products to support HL7. In this process, hospitals play a big role in promoting.
During the fifteenth period, the focus of China's hospital informatization will shift to the construction of clinical information systems (CIS), a large number of clinical systems need to be integrated with the HIS (Hospital Information System), interconnections into the standardization of the centralized problem has become the focus of attention of all parties, which can save a large amount of money to improve the quality and reliability, to simplify the complexity of the interconnection of the systems of different manufacturers, to provide large-scale HIS integration. Possibility of large-scale HIS integration. The two most important standards for integration are DICOM3 and HL (Health Level7, Hospital Information System Interconnection Standard). HL7 is the interface standard for HIS (Hospital Information System) integration, a standard that involves a wide range of content and will have a significant impact on the entire HIS construction, which has become an international hotspot in recent years.
HIS system products at home and abroad, a wide variety of GE and other internationally renowned brands have to beach China's market, high quality and price, only a few domestic famous tertiary hospitals used. Domestic products to (Beijing) Zongbang Huizhi company products leading technology. The HIS developed by Zhongbang Huizhi Company includes thirteen modules such as outpatient charges, hospitalization, etc. The system adopts the Client/Server architecture. The system adopts Client/Server structure, using Windows NT operating system and SQL7.0 database, and its functions cover the main departments of outpatient and inpatient consultation. It is the first attempt to use HL7 to connect PACS and HIS in China. It serves as the first large-scale hospital information system (HIS) in China, and in recent years, on the basis of continuous improvement of the existing system, it is constructing the medical image storage, transmission and processing system (PACS), the Laboratory Science Information Management System (LIS), the Operating Room Information Management System (ORIS), the Clinical Supervision Information Management System and so on.
II.
Second, the hospital video system
The hospital demonstration system is used for the hospital operating room surgery process live broadcast and record, is to improve the hospital medical technology is an important means. Television teaching system is divided into two areas, the operating room, medical camera area and classroom demonstration area. By the operating room using live shadowless color camera from the top of the surgical part of the surveillance, and in the monitoring room on the remote control of the camera operation, the camera's control line, the video line, the power line are supplied by the monitoring room, the picture is transmitted by the coaxial cable to the demonstration of the classroom projection equipment, the system is usually accompanied by a bidirectional intercom call function. The camera and the display device is usually used in the form of multi-head and single-tailed.
The number of teaching signal source settings, according to a hospital side of the operating room 2, 3 medical area.
Two-way video call consolation system: according to a hospital side of the completion of 8 delivery rooms have 8 ICU wards consolation.
Third, remote consultation system
Remote consultation system is to enhance academic exchanges between hospitals, looking for social forces on difficult cases of remote distance consultation, or use their expertise to help others, is a new type of hospital means. Telemedicine needs to be set up in the hospital a consultation room (the main meeting place), inside a set of telemedicine visual diagnostic system, can be the actual consultation through the camera system will be the image transmitted to the consultation room projection equipment, and has the language communication function. Remote hospital system can use ISDN digital program-controlled exchange network or Internet network for two-way communication.
Fourth, the hospital video system, remote consultation system and CCTV monitoring and alarm system
A hospital design program will show teaching, comfort vision, remote consultation, monitoring system into one. The system consists of front-end cameras, monitoring room monitoring and control equipment, alarm probes, power supplies and other accessories.
The system has a monitoring and control center, while reserving three sub-control center interface, in order to facilitate the expansion of the dean and other sub-control.
The central control room can control and monitor the situation in the medical center in a timely manner, the operator can be in the central control room of the medical center inside and outside the monitoring point of all the images to call, monitoring, control, storage, retrieval of all image data.
The reserved sub-control center can also control and monitor the entire medical center, the reserved sub-control keypad and the monitoring center of the main control keypad function is equivalent, to facilitate multi-level control and management.
Define and limit the priority of the main control keypad and sub-control keypad to ensure that important people have priority in commanding the monitoring system.
Instruction system by the front-end high-speed ball and cart in the high-speed ball will be the entire surgical process filmed down.
A hospital teaching, comfort vision, remote consultation and monitoring alarm system by the fixed camera and PTZ camera, matrix control host, operating keyboard, digital hard disk recorders, high-definition monitors, infrared alarm probes, codecs, power supply and other major equipment and signal transmission media.
The front end of the system needs to be equipped with indoor cameras, hall entrances and exits PTZ cameras, the requirements of a reasonable distribution of cameras, indoor cameras to observe the key areas, hall entrances and exits PTZ cameras require a full range of fast tracking targets.
The control room monitoring screen to the front-end camera to implement a full range of monitoring, the matrix control for the timing of switching or manual switching alternating display. Surveillance priority: fire → theft → disciplinary: through the operation of the keyboard to switch any desired screen.
The system supports network interconnection and weak power system related interfaces, protocols, databases and other aspects of integration services. The system matrix control host can be networked with the computer multimedia system, and fire alarm system, burglar alarm system linkage (with 110 alarm system linkage interface), by the computer issued a command to start the CCTV system matrix control host will be corresponding to the camera ingested images switched to the details of the monitor and can be recorded on video.
The key parts of the system such as charge window, financial room and other key prevention.
The system **** 57-channel video signal: the main building **** 27-channel camera video signal; medical technology area 5-channel video signal.
The main building 27-way and emergency building 7-way camera video signal transmitted through the video cable to the main building on the ground floor of the duty control room of the two MD200 intelligent character overlay, from the character overlay sent out by one of the way the video signal access to the two sixteen-screen hard disk recorder for video recording, the other way the video signal input to the switching matrix, and then by the switching matrix output to the monitor on the display.
Consolation system **** 16-way, point-to-point signal transmission to the monitoring room of the small audio and video matrix, and then the matrix output to the monitor.
The remote consultation system compresses and packages the data stream through the codec and transmits it remotely through the network to the conference hall. The main meeting place video signal through the encoder compressed data through the network transmission to the meeting place by the decoder will decompress the data on the Internet to browse.
Demonstration system 6-channel video signal, which is mobile on the 1-channel signal directly into the long-delay video recorder. And then by the VCR output to the monitor. The remaining five signals through the 8-way DVR network serial port output to the LAN, the classroom through the IP address search query recorded process.
This is a network as the core of the system, all the subsystems or devices can be connected to the Internet to run, and through the network to complete the transmission of information and interaction within the hospital through the LAN operation; remote consultation system through the wide area network operation; at this point in time, the monitoring device to complete the basic monitoring and alarm functions, network communications to achieve the command transfer and exchange of information, the computer system is to unify the entire comprehensive digital network Management system operation. It is characterized by the realization of a comprehensive hospital management functions, so that it is possible to image compression, multiplexing and other digital processes on the basis of the realization of television monitoring, teaching, comfort vision, remote consultation of the four elements of the real organic combination of integrated digital network, especially its establishment in the social public **** information network.
Fifth, the hospital video system and remote consultation system other programs
Hospital video system and remote consultation system is the most distinctive highlights of intelligent hospitals, but also "gold" high technical difficulties, has been the domestic and foreign related technologies and products in-depth investigation and research. Foreign related technologies and products of the United States, Europe, Japan and other countries have, but the price is expensive, unacceptable; and domestic related technologies and products are rare, the design program has been selected above advanced, reasonable, saving design solutions; but a different way of thinking, another way to go, we are concerned about the other side of the related technologies and products, that is, the new technology in the field of security --- video network monitoring system, also recommended. -video network monitoring system, also recommended to the hospital to consider, as the second set of design programs, advanced technology, but the price is more expensive than the above design programs (also lower than the price of foreign related technologies and products), there is no hospital type of application examples, is introduced as follows:
Gray remote video system is a domestic video network monitoring system products, using a completely Gray remote video system is a domestic video network monitoring system product, using completely independent coding technology, audio and video conversion, transmission is currently the first domestic, with independent intellectual property rights. The system has reached the international synchronization level. After testing, the system's synchronized transmission of audio and video signals is clear, the system is simple to operate, has a high degree of security and confidentiality features, and easy maintenance.
Performance indicators are as follows:
* Image clarity:
As a result of the use of unique image algorithms, so that in the 4-screen when each small picture image is clear and detailed, with a resolution of up to 512 × 384 true color;
* Security and confidentiality:
With independent intellectual property rights of the world's leading special coding technology, the images transmitted and information are highly secure and confidential.
* Video parameters:
Single maximum resolution of 768 × 576, 25 frames / second, true color.
* Image storage:
Cyclic video hard disk capacity of 120Mb/hour or so.
* Compression Ratio:
Software compression ratio adaptive, according to the movement of moving objects to determine their own compression ratio from 200:1-2000:1.
* Software Platform:
Windows 2000\ Windows XP.
* Support Protocols: TCP/IP, TCP/IP, TCP/IP, TCP/IP, TCP/IP, TCP/IP, TCP/IP, TCP/IP, TCP/IP. p> * Support protocol: TCP/IP protocol.
1. Hospital teaching system:
The system uses a special video capture card, can collect 480,000 pixels of video capture equipment, with the computer host equipment in the LAN to provide similar to the quality of the DVD quality of the picture, the quality of the image display 768 * 576.
Each set of these include: a professional server, 1 set of teaching software server, video capture card, a video distributor, a video distributor, a video distributor, a video distributor, a video distributor, a video distributor, a video distributor, a video distributor, a video distributor, a video distributor, a video distributor, a video distributor. A video capture card, a video distributor, 4 high-resolution focal length controllable cameras.
2. Two-way video consolation system
The system uses or USB interface camera can collect 300,000 pixels of video capture device, with the computer host equipment in the LAN to provide similar to the quality of the DVD quality of the picture, the quality of the image display 384 * 288
Each set of these two sets of computers, visual system software 2 sets of USB cameras, 2 sets of microphones, 2 sets of USB cameras, 2 sets of microphones, 4 high-resolution focus controllable cameras, 2 sets of video capture card. 2 sets, 2 microphones, 2 sets of headphones or audio/video of your choice.
3. Remote consultation system
The system uses the BT848 chipset FLYVIDEO EZII video capture card, which can collect 480,000 pixels of video capture equipment, with the computer host equipment in the more than 512Kb/s ADSL connection rate to provide similar to the quality of the DVD quality of the picture, the quality of the image display 768 * 576.
Each set includes: 2 sets of computer visual system software, 2 sets of USB camera, 2 sets of microphone, 2 sets of headphones or audio-visual optional. p>
Each set includes: 1 professional server, 1 set of remote consultation software server, 1 video capture card, 1 video splitter, 4 high-resolution focal length controllable cameras, and 1 microphone.