In recent years, the rapid development and wide application of cloud computing, big data and other information technologies have put forward higher and higher requirements for the construction of regional health information platforms, so much so that regional health information platforms under construction without the introduction of the above technologies have become outdated, not to mention their real practical value. However, the application of new information technology is definitely not a simple technical issue, but involves management concepts, organizational structure, business processes, values, and many other aspects that must be seriously addressed.
Application of the urgent need
This is not part of the scope of technological progress, but is the fundamental driving force to promote regional health information technology. Regional platform construction must be closely for health care reform and improve the quality of service to provide information services to the theme of the platform should be built at the beginning of the overall consideration of the application of information.
1. New technology brings new challenges
The contradiction between public and private clouds is highlighted. In the regional healthcare cloud, hospitals always occupy an important position. The private cloud construction of hospitals is essentially in competition with the public cloud of the regional health cloud platform for a variety of resources, including financial materials and information. Along with the birth of the regional health public cloud platform, the scale or necessity of the hospital private cloud is increasingly being questioned. Whether this pair of contradictions can be properly handled directly affects the development of regional health cloud platform.
Remote medical monitoring and wearable devices. The adoption of these technologies also faces the contradiction between individual and group, short-term and long-term in the process of data collection and processing. The application of IoT technology in medical activities and health maintenance practices is mainly reflected in the remote medical monitoring and wearable health maintenance devices. At present, it is mainly embodied in the measurement and analysis of a certain time period or point in time of an individual, and lacks comprehensive, continuous and long-term statistical analysis, and even more rarely seen macro-analysis and processing of group data.
The contradiction between data collection, storage and mining utilization. In papers or presentations about the construction and development of regional health information platforms, it is commonplace to see articles about how many millions (millions, tens of millions, billions...) of articles are collected by regional health information centers every day, and how many terabytes, petabytes, or even ebabytes have been stored. But how this information is utilized and what effects and results are produced are rarely reported. The application of big data in the health sector is more limited to a few cases such as Google flu prediction, which is very "high-end" (hanging high in the cloud). There are many reasons for this situation, such as little knowledge (information professionals collect and manage data but do not know its value for clinical research and processing methods, while clinical researchers are not aware of the existence, connotation and application value of the data on the regional health information platform), the high cost of data processing, and the lack of uniformity in the quality standards of data collection. The latter is one of the main obstacles to the full utilization of data.
2. Standardization Issues
In fact, there are many standard systems involving regional health information platforms, mainly information engineering, communication engineering, construction standards, data exchange standards, storage standards, standard coding and terminology for healthcare operations and management. The construction of the vast majority of regional health information platforms basically follows the various standards of information engineering and communication engineering construction, and thus many interconnected regional health information infrastructure network facilities throughout urban and rural areas have been born one after another. The implementation of data exchange and storage standards is also basically satisfactory, because the vast majority of regional health information platforms have also built a combination of centralized and distributed storage models, realizing the basic requirements of information **** enjoyment in the region.
However, due to the disconnection between information engineering and healthcare business management, the application of medical business and management coding and terminology has been neglected. The purpose of building a regional health information platform is application, not to accomplish performance engineering. Information engineering construction is essentially a revolution in business processes, management concepts and practices. This disconnect essentially reflects the fact that the current health care industry is not fully prepared for the advent of the information age. And it is even more prominent in the hospital industry. As a result, the regional health information platform that insists on the construction of various standards is still faced with different standards of collected data and information, making it difficult to carry out effective data mining and utilization.
3. Integration of hospitals into the regional health information network
Hospitals are the giants of the entire health industry, accounting for more than 70% of the health industry's personnel and assets, and at the same time are the most important source of generating healthcare big data, the quality of which has a direct impact on the availability of data. The main focus of hospitals is on saving lives and relieving illnesses. The support systems that serve them, such as the construction of information systems, coding, and adoption of terminology are also mostly centered around this goal. This is natural, unjustifiable, and the most cost-effective within a single hospital. However, there is a potential conflict between the self-centered way hospitals operate and the building of regional health information platforms:
Private versus public cloud. It has been discussed in the previous article, and it needs to be stated again because regional health information construction in the cloud era should raise the level of planning and technology application, so that the cloud technology really and as soon as possible to play a role. Otherwise, countless resources are consumed in our discussion and more information chimneys are created at the same time.
Coding terminology adoption. In the case of a single hospital information system system, the adoption of coding terminology is not an issue, and at best is a problem that can be solved with a little coordination. However, for the construction of regional health information platforms, it is a very tricky issue. Different coding terms make it impossible to count and analyze information from different medical institutions, and even simple statistics can easily produce erroneous results. For a large city that houses all types of medical institutions at all levels, including national, provincial, municipal, district and military, the difficulty of coordination can be imagined.
Maintenance of coding terminology. Even if there is agreement on the adoption of coding terminology, the maintenance of coding terminology is also problematic, especially in the region as a whole maintenance work under the jurisdiction of whom there is still no clear answer. However, if this problem is not solved, information communication and **** enjoyment, statistics and analysis, and the mining and utilization of big data will be difficult to realize. At present, the regional platform for hardware and software maintenance have been included in the budget management, but only for business management coding terminology maintenance no one asked.
Who is the owner of the information? From the legal point of view, personal health information belongs to the individual, the medical institutions that produce it are only in accordance with the law on behalf of the custodian. The reality is that most healthcare organizations believe they are the masters of this information and are fully responsible for its use and safety. As a result, they are unwilling to "hand over" or share the information under their control with outsiders, thus seriously affecting the collection and ****sharing of information on the regional health information platform.
Important Opportunities
The above challenges do not mean that the construction of regional health informationization is at a standstill or in trouble. On the contrary, the existence of challenges indicates that all parties to the construction of regional health information platform has higher requirements and greater hopes. Challenges and opportunities coexist, difficulties and hopes. To make the regional health information construction out of the dilemma, but also in the challenge to find answers. 1. Litmus test
Satisfying the demand is the litmus test to measure the effectiveness of platform construction. The application of big data to the regional health information platform is a requirement for the reform of the medical and health system, a requirement to improve the level of medical and health services, a requirement to improve the level of medical and health management, and a requirement for the people to seek medical treatment and self-care. The degree of application is a litmus test of the effectiveness of regional health informationization. If the regional platform has been built for many years, but is still unable to provide the main health and disease diagnosis and treatment data of the residents in the region and relevant statistical analysis, its role and the value of its existence will lead to many questions.
2. New technology brings new opportunities
Cloud computing brings new hope for improving efficiency and reducing duplication of investment. Cloud computing forces us to re-examine the technical program of planning and construction of regional health information platforms and ensure that they must be built on a higher level of technology. Today, if one sees that primary healthcare institutions still establish separate information centers in regional platforms, one must feel that there is room for improvement in system design. The correct application of cloud computing technology has, to a certain extent, provided credible theoretical and technical support for the construction of regional health information platforms to reduce duplication of inputs and realize a high degree of integration. To a certain extent, it can be said that the degree of utilization of cloud computing reflects the planning level, integration level and system efficiency of regional health platform construction.
Data mining utilization puts forward clear requirements for the seamless connection between regional platform construction and healthcare business management. In the past, the platform construction paid more attention to the realization of information engineering and communication network technology, and neglected the supporting improvement of medical and health care business management. The data mining utilization of the regional health information platform had a difficult start amidst the cheers, which in turn required the health administration to improve the standardization and normative management level and take the initiative to interface with the information technology application while establishing the regional information platform. In short, big data can be mined, can be utilized to measure the effectiveness of the litmus test of the platform construction. Xiamen Citizen Health Information System has made some attempts in this regard, produced application results, will be briefly introduced in the next section.
3. Application of standards from information engineering to expand into the field of health care business and management
Due to the increasing demand and practice of data analysis and utilization, the understanding of the importance of health care business and management standards has become clearer. As expectations for the application of regional health information platforms have risen, and as applications have become broader and deeper, it has become ****cognizant of the need to expand standards from the purely information engineering domain to the healthcare business and management domain.
4. More and more deans advocate active integration of hospital information systems into regional health information networks
In recent years, many visionary and famous deans have taken the initiative to advocate the active integration of hospital informatization into regional health information networks on different occasions in order to realize the true meaning of big data and information ****sharing. This foresight is actually through years of practical experience and painful groping refined, is in the deep medical management and information technology construction on the accumulation of sublimation, heralding the hospital initiative to deep integration into the regional health information network is gradually becoming **** knowledge. Hospital managers have such a profound understanding, so that we see the regional health information platform data sources and quality improvement of new hope.
Xiamen practice experience revelation
As China's earliest built regional health information platform covering the entire jurisdiction, Xiamen Citizen's Health Information System in recent years has carried out the practice of mining and analyzing the utilization of regional health information data. On this basis, the 2013 Xiamen Health Report has for the first time fully utilized data from the regional health information platform - Xiamen Citizen Health Information System.
Data from Xiamen's regional health information platform is provided by healthcare organizations that account for more than 90% of the jurisdiction's resources. In comparison with the traditional caliber of health statistics, in 2012, the workload statistics included in the system accounted for more than 95% of the city's total. Therefore, it is basically the full sample data of Xiamen residents' consultation. Statistical analyses made with this data can basically reflect the health level of Xiamen residents, major health problems, reasons for consultation, frequency of consultation, and cost of consultation.
The construction of the regional health information platform in Xiamen City is also from the top-level design, step-by-step implementation to the whole region coverage, and gradually towards the cloud. And from building a regional health information network platform to the application of health big data has gone through a groping gradual standardization process, the most important part is not only the application of information engineering standards, but also includes health care business and management coding and terminology of the "three unity", that is: version of the unity, unity of standards, uniformity of maintenance. To achieve these three unity, without the health administrative departments of the forward-looking planning and strong push is not completed.