(A) foreign developments
Electronic computers in the application of hospitals has a history of more than thirty years, the early 1960s, the United States began the study of HIS. The famous Massachusetts General Hospital & lt; MGH & gt; development of the COSTAR system is the beginning of the 60's and developed into today's large-scale clinical patient information system. With the development of computer technology, the 70s, HIS into a period of great development, the United States, Japan and Europe, hospitals, especially university hospitals and medical centers have developed HIS, and become the basis for the formation and development of medical informatics. 70-80 years, the U.S. HIS industry has been a great development.
The 1985 U.S. National Hospital Data Processing Survey showed that more than 100 beds in the hospital, 80% of the realization of the computerized financial charge management, 70% of the hospital can support the patient registration and administrative affairs management. 25% of the hospital has a more complete HIS, that is, the realization of the ward medical staff directly with the computer to deal with the doctor's orders and query the test results of the laboratory. 10% of hospitals (2530) have a fully computerized HIS.
HIS development and application in Japan began in the early 1970s. Most Japanese hospitals started their HIS efforts after the 1980s, but the development was very rapid and quite large, with a mainframe-centered hospital computer system. For example, Kitasato University Hospital's IBM/3090 dual-computer system. The current general trend of HIS in Japan is systematic, networked, comprehensive, began to take the top-down development route, generally have a mainframe as the center, support the work of the entire system, and try to use microcomputer and network technology, the scale of the investment is large, is the realization of ORDERING the way of work, that is, the data from the source of the occurrence of direct input into the computer. By 1991, there were nearly 10 such systems in operation or basically in operation. Functions to support diagnosis and treatment are being strengthened, and the system operates 24 hours a day. A lot of software is jointly developed by hospitals and computer companies, and some large companies have also developed some general hospital information management software packages, and some hospitals have developed their own. Kitasato University, for example, developed a comprehensive HIS at a development cost (excluding machinery and equipment) of 340 million yen (about 13 million yuan). Daily running cost expenditure is 510 million yen a year (about 20 million yuan).
European HIS development is slightly later than the United States, most of the mid-70s and 80s began. European HIS is characterized by the realization of a number of regional information systems. RedSystem in Denmark, for example, manages 76 hospitals and clinics. France's Eighth Healthcare Center has realized an integrated information system - GrenobleIntegratedHIS - capable of managing three major hospitals and three medical colleges.With the development of primary health care, regional hospital computer networks will be realized in various European countries. At present the European **** body of SHINE project & lt; StrategicHealthInformaticsNetworkforEurope> has begun, Britain, France, Italy and Germany many companies are involved in this project. A great deal of work has been done on distributed database systems and open net engineering.
(II) the domestic situation
Computers entered China's medical industry in the late 70's, when IBM's M340 minicomputer-based, only a few large-scale ministry of general hospitals and teaching hospitals, such as the Peking Union Medical College Hospital, the Beijing Tumor Hospital, 301 hospitals and so on, mainly used in scientific research and teaching, has not been applied to the management of HIS. 80's. In the early 80's, with the appearance of Apple PC and the popularization of BASIC language, some hospitals started to develop some small management software, such as payroll software, etc. In the mid-80's, with the appearance of XT286 and localization, as well as the appearance of DBASEIII and UNIX network operating system, some hospitals started to set up a small local area network, and developed small network based on the departmental management. management system, such as hospitalization management, pharmacy management and so on. Into the 90's, NOVELL network and FOXBASE, FOXFRO database is increasingly prevalent, the realization of a complete hospital network management system has become possible, so some of the computer technology strength of the hospital began to develop hospital management system suitable for their hospitals. Some computer companies are not the right time to develop HIS, such as Dalian Huiyuan Electronic Systems Engineering Company Limited (in cooperation with 301 Hospital), IBM, Microsoft, PUTIEN RuiTuo Software Company Limited, Wave and so on.