According to the Guiding Opinions, in accordance with the principles of "system first, overall design, enhanced application, interconnection and business collaboration", and on the basis of ensuring the continuity of the original health informatization and population and family planning informatization, we will comprehensively coordinate the construction of population information, electronic health records and electronic medical records, and integrate public health, family planning, medical services, medical security and drug management. National, provincial, prefectural and county-level population health information platforms are hubs, residents' health cards are carriers, information standards and security systems are guarantees, and interconnection and business collaboration are key population health information projects.
The Guiding Opinions identified several key projects in the near future, namely, taking the national medical insurance informatization project and the "Golden Man Project" as the guide, expanding the coverage of regional platforms with regional informatization demonstration projects, and taking the construction of four-level platforms as a whole to realize six major business applications and three major database information. Widely use resident health cards, promote health and family planning services to benefit the people, strengthen telemedicine, promote the enjoyment of high-quality medical resources, and improve service accessibility.
The Guiding Opinions clarified the phased construction objectives of population health informatization during the Twelfth Five-Year Plan and the Thirteenth Five-Year Plan, and finally built a practical, accessible and safe population health information network for the whole industry, so as to facilitate the people to obtain high-quality and efficient medical and health services and improve the scientific management level of health and family planning. After years of efforts, China's population health information construction has entered a period of comprehensive and rapid development. At present, some areas have initially realized population health information sharing and cross-regional business collaboration through the population health information platform. The national network for reporting infectious diseases and public health emergencies has been fully established, which has improved public health service and management capabilities. Hospital informatization construction with electronic medical records as the core has played an increasingly important role in improving the efficiency and quality of medical services. The telemedicine system has begun to take shape, which has promoted the extension of high-quality medical resources to the grassroots. The application of resident health card has been steadily promoted, and it has become an important carrier of health management and service for the whole population and the whole life cycle. The database of total population information resources covering 654.38+0.3 billion people provides strong information support for population and family planning services. The construction of information standards and safety system is becoming more and more perfect. 150 standards and safety specifications initially meet the current needs of population health informatization construction. Informatization plays an increasingly prominent role in improving the service and management level of health and family planning and improving the people's feelings of seeking medical treatment. But there are also weak links, especially in interconnection, information sharing, business collaboration and so on. It is urgent to strengthen the top-level design, coordinate implementation and speed up the progress.
The Third Plenary Session of the 18th CPC Central Committee made overall arrangements for deepening the reform of the medical and health system and improving the birth policy, and put forward clear requirements for making full use of information technology to promote the vertical flow of high-quality medical resources. Central leading comrades have repeatedly made important instructions on population health informatization. Through a series of important livelihood policies involving information consumption, health service industry, old-age service industry and broadband China, the State Council has planned and deployed population health informatization and pointed out the direction.
According to the deployment of the CPC Central Committee and the State Council, the National Health and Family Planning Commission conducted in-depth research on the original informatization work, visited more than ten provinces successively, and organized experts in related fields to discuss it many times. On the basis of ensuring the continuity of the original health informatization and population and family planning informatization, the idea of top-level design of population health informatization was formed, and the Guiding Opinions on Accelerating the Construction of Population Health Informatization was formulated. The principles, overall framework, key tasks and key projects of population health informatization construction have been clarified, and the national population health informatization construction has been accelerated, which will more effectively support the deepening of medical and health system reform, the improvement of birth policy and the scientific development of health and family planning. The total population information includes basic population information, family planning service management related information and floating population family planning service management information. At present, national and provincial population information databases have been basically established, covering 654.38+0.3 billion population information of the whole country, and supporting the application of family planning services at the national, provincial, prefectural, county, township and village levels.
Electronic health records are standardized and scientific records of residents' health management (disease prevention and control, health protection, health promotion, etc.). ). It is an information resource that takes residents' personal health as the core, runs through the whole life process, covers various health-related factors, realizes multi-channel information dynamic collection, and meets the needs of residents' self-care, health management and health decision-making. At present, provincial electronic health record databases have been established in Beijing, Shanghai, Jiangsu, Zhejiang and other 19 provinces.
Electronic medical record refers to digital information such as words, symbols, charts, graphs, data and images that can be stored, managed, transmitted and copied by medical staff in the process of medical activities. This is a medical record. At present, more than 3,700 medical institutions across the country have carried out hospital informatization construction with electronic medical records as the core, and realized information sharing within medical institutions. Six provinces including Jiangsu, Zhejiang, Henan and Chongqing have established provincial electronic medical record databases.
Population information database, electronic health record database and electronic medical record database are relatively independent and interrelated. The basic information of electronic health record database and electronic medical record database is provided through the whole population information database. Electronic health records record the health information of individuals throughout their life cycle, and electronic medical records are an important information source of electronic health records. The three databases share information through the population health information platform and update dynamically in real time to ensure the consistency, accuracy and integrity of the basic information of the three databases and support business collaboration. Population health informatization should build a national, provincial, prefecture-level and county-level population health information platform with unified standards, open integration, organic docking, hierarchical management, safety and reliability, promote the linkage of health and family planning institutions, realize the real-time dynamic update and integration of all population information, electronic health records and electronic medical records, and ensure cross-regional and cross-business cooperation.
County-level platforms carry a variety of health and family planning business applications in the region, which is the foundation and hub for the interconnection, information sharing and business collaboration of various information systems in the region, and provides regional population health information for provincial platforms. The provincial platform forms an index database of electronic health records of residents in the whole province, which is an important support of national population health information resources and a data source for information summary, statistical analysis and comprehensive decision-making of national platforms. Dispatch all levels of platforms in the province and connect business systems to meet the needs of cross-regional business collaboration. The national platform coordinates the functions of disease prevention and control, maternal and child health, comprehensive supervision, family planning, Chinese medicine management, new rural cooperative medical system, emergency command, etc., forms a multi-theme database, highlights information integration and big data application, and supports national population health management and decision-making.
At present, Tianjin, Shanghai, Jiangsu, Zhejiang, Anhui, Fujian, Shandong, Henan, Hunan, Chongqing and other provinces 10. A provincial information platform has been built to realize real-time collection and exchange of health information of some people, support cross-regional business collaboration, and serve comprehensive management and scientific decision-making. Some cities and counties have established regional information platforms to realize the coordination of medical and health services in the region. Six business applications are important means to meet the business needs of public health, family planning, medical services, medical security, drug management, comprehensive management and so on. , improve the service and management level. Relying on population health information platforms at all levels to realize information sharing and business collaboration.
The focus of public health service application construction is to build and improve information systems such as disease prevention and control, maternal and child health care, comprehensive supervision, food safety, blood management and health education. , realize hierarchical management, improve business ability, and promote the equalization of basic public health services.
The application and construction of family planning business will focus on the construction of national and provincial population management information systems, support the application at the national, provincial, prefectural, county, township and village levels, and realize the family planning service and management within the jurisdiction.
The application construction of medical service business focuses on strengthening the hospital information construction with electronic medical records (Chinese and Western medicine) as the core, optimizing the medical service process, and docking with the population health information platform to realize information sharing within and between hospitals, and promoting the up-and-down linkage between large hospitals and primary medical institutions through telemedicine to promote the sharing of high-quality medical resources.
The focus of medical insurance business application construction is to speed up the improvement of the new rural cooperative medical information system, realize the docking of provincial and national new rural cooperative medical systems, realize cross-regional instant reporting, promote the enjoyment of medical insurance information, and improve the supervision level and efficiency of new rural cooperative medical fund. At present, the provincial information systems of the new rural cooperative medical system in nine provinces, such as Beijing, Shanghai, Anhui, Jiangsu, Henan, Zhejiang, Inner Mongolia, Jilin and Hainan, are networked with the national new rural cooperative medical system and share information. Shanghai, Anhui, Jiangsu and Henan provinces realize real-time reporting across provinces and regions.
The focus of the application and construction of drug management business is to improve the drug supply guarantee information system of medical and health institutions, support the monitoring and management of essential drugs, support the bidding, procurement, distribution and use management of drugs and medical devices, and strengthen the application of drug electronic supervision system in medical and health institutions.
The application construction of comprehensive management business focuses on improving the comprehensive analysis and utilization ability of population health information, realizing the fine management of internal management and external supervision of various business work, and effectively supporting scientific decision-making and policy planning. The resident health card has the functions of resident identification, basic health information storage, cross-regional and cross-institutional medical treatment and financial services. The purpose is to gradually unify the medical cards, immunization certificates and new rural cooperative medical system certificates of different medical institutions, so as to facilitate residents' appointment registration, vaccination and examination results, facilitate residents' access to sustained and convenient medical and health services and serve the whole life process of the whole people.
As the carrier for people to enjoy all kinds of health and family planning services, residents' health card can change the people's medical treatment mode, optimize the service mode of medical and health institutions, build a convenient, continuous, verifiable, mutual trust and * * * enjoyment medical service process, improve the refined service level, improve the timeliness and quality of cross-institutional and cross-regional diagnosis and treatment, improve the people's medical experience, promote the coordination of medical and health services and extend to the health service industry, gradually solve the people's medical treatment problems, and meet the people's health needs.
In order to give full play to the health management of residents' health cards and their functions of facilitating the people and benefiting the people, the National Health and Family Planning Commission has studied and promulgated the Measures for the Administration of Residents' Health Cards and formulated relevant technical specifications. At present, Henan, Inner Mongolia, Liaoning, Guangdong, Jiangsu and other 15 provinces, as well as Peking Union Medical College Hospital, China-Japan Friendship Hospital, Huazhong University of Science and Technology tongji hospital and other large hospitals carry out the issuance and application of residents' health cards. It realizes the integration of multiple cards, one card for medical treatment across institutions and regions, real-time settlement of expenses, dynamic recording and * * * sharing of medical and health service information, and meets the needs of emergency medical treatment, information sharing in different places and residents' health management. In accordance with the requirements of the national information security level protection system, the National Health and Family Planning Commission actively promoted the information security level protection work, effectively improved the information security protection ability, hidden danger investigation ability and emergency response ability, and realized the synchronous planning, synchronous design and synchronous implementation of information security guarantee and informatization construction. The important information system of the National Health and Family Planning Commission has completed grading filing, safety construction rectification and grade evaluation in accordance with the requirements of the information security grade protection system and relevant standards and specifications, and carried out grade evaluation and related safety rectification work every year to achieve dynamic safety. The national health information system for important people has basically completed the classification and filing work, and the local regional information platform and the national third-class first-class hospitals have actively carried out the construction of grade protection.
In accordance with the national electronic signature law and the relevant provisions of national password management, the National Health and Family Planning Commission actively promotes the construction of a network trust system based on CA electronic authentication technology, and establishes a network trust system with true and reliable identity, complete and credible business data, controllable user behavior norms and clear responsibilities to ensure the safe and effective operation of business. At present, 22 third-party electronic certification institutions have passed the compliance test of the electronic certification supervision platform of the National Health and Family Planning Commission, followed the unified certificate format standards and interface standards, and realized the universality, mutual recognition and mutual trust of cross-regional and industry-wide information systems.
In the population health informatization, it is clear that the administrative departments of health and family planning at all levels are the competent departments of population health informatization, and all kinds of health and family planning institutions at all levels (public health institutions, medical institutions, Chinese medicine institutions, etc.). ) is the responsible unit of population health information. Clearly do not provide information involving state secrets and personal privacy. It is clear that the health information of people in charge of the competent departments and responsible units shall not be stored abroad. Pay attention to the implementation of management measures and technical means, properly protect privacy and realize information *. To speed up the overall framework construction of population health informatization, we should do a good job in several key projects at present and promote them comprehensively, systematically and rapidly from different levels and angles.
1. About the National Health Insurance Informatization Project and the Golden Man Project.
According to the "Twelfth Five-Year Plan for the Construction of National Government Information Project", the National Health and Family Planning Commission will take the lead in building the national health insurance information project, focusing on coordinating Chinese medicine management, disease control, health supervision, new rural cooperative medical system and other businesses, building a national information platform, connecting provincial platforms, promoting the construction of regional platforms, coordinating six business applications, * * * enjoying the information of the three major databases, realizing information integration and big data application, and forming a practical * * for the whole industry.
According to the Twelfth Five-Year Plan of the National Population Development, the overall population management information system ("Golden Man Project") will be built, with birth registration information and overall population information as the main line, mainly serving the family planning work, building national and provincial population management information systems, and supporting the application of national, provincial, prefectural, county, township and village levels.
Generally speaking, taking the overall promotion of the two projects as an opportunity, we will coordinate business needs, accelerate the construction of national and regional information platforms, and promote software and hardware support, information integration and big data applications.
2. Residents' health card information benefiting the people project.
According to the State Council's Opinions on Promoting Information Consumption and Expanding Domestic Demand, the National Health and Family Planning Commission will further accelerate the construction of residents' health cards. Strengthen organizational leadership, establish and improve the working mechanism, and improve the basic environment construction of residents' health cards. We will continue to focus on farmers, newborns, high-risk groups of occupational diseases and unpaid blood donors who participate in large hospitals and the new rural cooperative medical system, give full play to the role of population information database, and issue cards for the masses free of charge. Promote large hospitals to take residents' health cards as the entry point of refined management and convenience for the people, and connect with primary medical and health institutions, so that the masses can truly feel the convenience, speed and benefits of holding cards for medical treatment. Taking the opportunity of promoting the application of financial IC cards in the medical and health field, we will promote the financial IC cards to be loaded with health applications (residents' health cards). Continue to adhere to the premise of maintaining the main functions, standards and norms, key systems and management subjects unchanged, and "combine cards with other public service cards such as citizen cards" to facilitate the masses to "use one card for multiple purposes".
3. About telemedicine information benefiting the people project.
According to "Several Opinions of the State Council on Promoting Information Consumption and Expanding Domestic Demand", the project of telemedicine information benefiting the people was implemented. From 20 10, the central government transferred funds to support the construction of telemedicine system in the central and western regions. At present, more than 800 hospitals have carried out telemedicine services, which have played an important role in promoting the extension of high-quality medical resources to the grassroots, improving service accessibility and solving the problem of people seeking medical treatment. In the next step, through the construction of national telemedicine service supervision system and provincial telemedicine service information system, we will build a national unified standard, interconnection, resource sharing, safe and practical telemedicine service system, make full use of new technologies such as cloud services and video networking, constantly explore and innovate telemedicine service models, and establish and improve the telemedicine operation supervision mechanism.
4. Demonstration of regional population health informatization.
Select some cities, demonstrate and popularize the experience of regional health informatization in Shanghai, establish a resource-intensive, process-scientific and standardized medical and health service model based on residents' health cards and medical staff performance appraisal cards, with the guidance of health and family planning collaborative services and the support of information technology, promote the linkage between medical institutions and establish a new mechanism of division of labor and cooperation between public hospitals and primary medical and health institutions; Promote information sharing and medical and public health cooperation in the region, and establish a new health management model combining prevention and treatment; Build a comprehensive regional health supervision system with internal management, external supervision, performance appraisal and government compensation, further improve the service ability and level of medical and health institutions, and enhance the government's supervision, evaluation and assessment ability and level of medical and health institutions.
5. Information about public emergencies.
Since 2003, China's health emergency information construction has made great progress, and a health emergency command system covering national, provincial and municipal levels has been built, which has played an important role in various health emergencies. According to the requirements of the Twelfth Five-Year Plan for the Construction of National Emergency System, on the basis of the existing health emergency command system, expand the coverage of health emergency command system to the county level, improve the level of health emergency information equipment at all levels, improve the ability of health emergency information monitoring, analysis and judgment, realize early warning evaluation, auxiliary decision-making, on-site command, effective management and scheduling of teams and materials, and strengthen the construction of mobile emergency command platform. Use a variety of communication means to build a health emergency communication security system, improve the emergency command and management process, and constantly build and improve the interconnected, information-sharing and responsive health emergency command system among countries, provinces, cities and counties.
6. About the informationization of traditional Chinese medicine.
Informatization of traditional Chinese medicine is an important part of population health informatization. Through years of construction, the informatization of traditional Chinese medicine has made some progress. The establishment of TCM medical quality monitoring center has initially realized the networking of TCM medical quality monitoring database reporting; Constantly improve and update all kinds of traditional Chinese medicine information databases, and initially build a sharing platform for traditional Chinese medicine databases; Basically establish a platform for sharing electronic resources of traditional Chinese medicine, and give full play to the role of online publicity and education of traditional Chinese medicine. Construction of regional and inter-hospital information sharing network, to carry out telephone network appointment registration, telemedicine consultation and other network services. Some Chinese medicine hospitals have established information systems with Chinese medicine characteristics, focusing on information sharing and communication. Actively formulate information standards related to traditional Chinese medicine, and develop a number of traditional Chinese medicine databases such as clinical terminology database, disease diagnosis and treatment database, basic information database of traditional Chinese medicine, and national medicine database.
In the next step, we will strengthen the construction of electronic medical records of traditional Chinese medicine and medical information systems of integrated traditional Chinese and western medicine in hospitals and primary medical institutions, popularize and apply standards and norms of traditional Chinese medicine, give full play to the characteristics and advantages of traditional Chinese medicine, and improve the level of syndrome differentiation and treatment of traditional Chinese medicine. Relying on the four-level population health information platform, the cooperation and information sharing between Chinese medicine and health and family planning can be realized, and the quality and level of Chinese medicine medical service can be improved. Establish the basic data service and dynamic monitoring information system of Chinese medicine resources to realize the information monitoring and management of Chinese medicine medical quality. Build a resource database of ethnic medical institutions, promote the informatization construction of ethnic medical services, and promote the development of ethnic medicine. In order to ensure the realization of population health informatization project on schedule, it is necessary to make overall planning, strengthen organizational leadership and improve working mechanism. The National Health and Family Planning Commission set up an information work leading group to guide the national population health information work. The office is located in the Planning Information Office and undertakes the daily work responsibilities of the leading group. The National Health and Family Planning Commission has set up an expert advisory committee on population health informatization, which will work under the leadership of the informatization leading group, give full play to the role of experts in the development strategy, policy planning and major projects of population health informatization, and provide professional consultation and decision-making reference. All localities can refer to the organizational model of the National Health and Family Planning Commission, strengthen leadership, improve the organization, clarify responsibilities, and strive to build a population health information work pattern with unified powers and responsibilities, reasonable division of labor, linkage from top to bottom, and strong guarantee.
Strengthen the construction of talent team, give full play to the role of social resources, encourage and guide enterprises and scientific research institutions to carry out targeted personnel training in technology and management, increase personnel training, and gradually form a stable and sustainable compound talent team training, management and security system.
Improve the fund guarantee mechanism and increase investment. Health and family planning administrative departments at all levels shall, in conjunction with local development and reform, finance, information management and other relevant departments, ensure the investment in population health information construction, focus on ensuring the investment in major projects and system operation and maintenance, and ensure the sustainable development of population health information construction.