探讨医生集成化桌面系统的可行性

edward

随着医院信息化建设的深入，对于医生来说所应用的信息系统产品也越来越多，这样医生工作可能会比较繁琐，比如需要登录不同的系统，操作独立的软件，如果有比较方便而又功能强大的医生集成化桌面系统，将不同的系统功能集成到一个界面上来，也就是说医院可以独立运行着许多不同的系统，但对于医生来说，所有的工作都在自己集成化的桌面系统上来完成，这样就会非常方便医生的工作，我了解到国外有类似的系统建设，不知道大家怎么看待这个问题呢

jdli

The request you asked is called CCOW compliance. It is one of the HL7 standards at mature status. The key is integrating applications'interfaces into an unified manner based on Patient Context or User Context, or Both. The data storage for each application is not integrated and still in different disignated databases. Following is a brief description about CCOW copied from HL7 site:

Overview of HL7抯 CCOW Standard
Robert Seliger, Co-Chair, CCOW Technical Committee
       
Introduction
Aimed at facilitating the integration of applications at the point of use, CCOW is an end-user-focused standard that complements HL7抯 traditional emphasis on data interchange and enterprise workflow. Using a technique known as context management, the clinical user抯 experience is one of interacting with a single system, when in fact he or she may be using multiple, independent applications from many different systems, each via its native user interface.
By synchronizing and coordinating applications so that they automatically follow the user抯 context, the CCOW Standard serves as the basis for ensuring secure and consistent access to patient information from heterogeneous sources. The benefits include applications that are easier to use, increased utilization of electronically available information, and an increase in patient safety. Further, CCOW support for secure context management provides a healthcare standards basis for addressing HIPAA requirements. For example, CCOW enables the deployment of highly secure single sign-on solutions.

Impact
CCOW抯 impact on the healthcare industry is apparent. Leslie Kelly Hall, CIO of St. Alphonsus Regional Medical Center described what CCOW has meant for her organization. 揑t's difficult to overstate the significance of this breakthrough because it means physicians finally have intuitive access to the entire breadth and depth of clinical information.?  
All of the major HIS vendors are now shipping or planning on shipping both Windows- and Web-based CCOW-compliant applications, while vendors in virtually every segment of the clinical healthcare market have adopted the standard as well. VHA Inc.梐 nationwide network of 1,900 leading community-owned healthcare organizations and their affiliated institutions梟ow requires all of its new business partners to be CCOW-compliant. A growing number of healthcare organizations are also implementing context management solutions to link together diverse multi-vendor, multi-technology IT systems on an enterprise-wide basis.

How It Works
The CCOW Technical Committee became a part of HL7 two years ago after starting out as an independent healthcare industry consortium. In that short time, the committee has developed and ratified four versions of the CCOW Standard. This unprecedented pace has been, in part, due to the modular component-based nature of the architecture upon which the standard is based, enabling new specifications to be developed in a complementary and add-on manner.


CCOW抯 Context Management Architecture (CMA) was founded on the principle that common context can be estab琹ished across applications by identifying things梥uch as a patient梠r concepts梥uch as a clinical encounter梚n a manner that different applications can never瑃heless recognize.
The core architecture is comprised of three main types of components: applications; a context manager that coordinates and synchronizes applications; and mapping agents that can represent the various synonymous real-world identifiers used to identify clinical patients, users, etc. The architecture defines the roles and responsibilities for each of these components and precisely prescribes the interfaces that enable them to communicate. The architecture does not define or dictate the implementation of any of the components.
The user sets the context using any CCOW-compliant application, for example, to select a patient of interest. The application then tells the context manager that it wants to set the patient context and provides the context manager with an identifier that indicates the context subject, which, in this case, might be the medical record number for the patient of interest.
The context manager then tells the other applications that the context has been changed, and each application obtains the patient抯 identifier from the context manager. Each application then adjusts its internal state and data display accordingly. This all happens in real-time.

discoverer

对啊，这两天我也正在想这个问题，打算做个程序，把我们医院所用的系统程序做在一个程序界面中以方便调用，只是不知如何入手。 _:-(

edward

听楼上的介绍后，看来确有所谓医生集成桌面的实际应用的需求，只是我们在这方面的了解还比较少，需要进一步做深入的研究，感谢二楼的介绍，还有三楼的，有没有兴趣交个朋友探讨一下

he3kulai

做一个外挂程序，代替WINDOWS开机用的EXPORT.EXE就行了，，

edward

楼上有更多一点的介绍吗

he3kulai

http://www.bjdwwb.net/soft/602.htm

GOOGLE约有1,900,000项符合网吧管理软件的查询结果，

·万象 2003网吧管理软件 15.324破解版
·方竹网吧集中管理器 V5.33 标准版
·金牛网吧管理 V5.2
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·逍遥游网络大管家 V8.85

http://download.pchome.net/industry/netbar/10507.html
Pubwin4旨在为公众电脑屋自身管理和主管部门行使职能提供完整的解决方案。Pubwin4在设计上采用了全新的思路，整个系统有如下改进：
更安全：客户机安全控制采用了磁盘写保护等新的手段，用户可以灵活的定制安全方案；提供Windows桌面和 :B-D: 虚拟桌面 :B-D: 两种模式供选择。 网络成员能自动搜索，客户版通过 :B-D: 网络分发 :B-D: ，远程唤醒等增强的网络功能使操作更方便。 更灵活：多种操作方法，多种解决方案可以按需要组合使用。

jdli

真正的医生集成化桌面系统可以实现以下功能:
1. 用户只需LOGIN一次, 就可以使用多个APPLICATIONS.例如: 用户LOGGED IN 电子病历系统后,同时再打开牙科管理系统, 药物条形码管理系统, 妇女保健系统,后三者均不需要用户LOGIN, 而是由集成系统(CCOW)自动检测到电子病历系统的LOGIN信息,自动完成其他程序的LOGIN.(CCOW USER CONTEXT)

2. 在电子病历中,如果用户正在浏览病人A的临床资料, 当同时打开牙科管理系统, 药物条形码管理系统, 妇女保健系统时,后三系统会自动同步显示病人A的资料,当然,前提是病人A在后三系统中存在.(CCOW PATIENT CONTEXT)

以上仅仅是CCOW的基本描述,还有许多其它功能在此不予详述,可参考HL7 CCOW文件.(如需要,请EMAIL: HIMSOFJD@YAHOO.COM).

美国主要CCOW厂商之一Sentillion有DEMO, 或许会有一些启示.
http://www.sentillion.com/demos/demos.asp

he3kulai

Brio Performance Suite 8整合商业智能  http://www.cpw.com.cn/cpwnew/news_v.asp?id=20030912061 谢涛　日期：20030912　　阅读76次

　　近日，Brio公司推出了最新产品Brio Performance Suite 8的简体中文版商业智能软件。Brio Performance Suite 8是一款整合商业智能和企业报表技术的产品。通过整合Brio知识挖掘、商业智能交互技术和Brio SQR报表工具卓越的发布能力，Brio已经能够为用户提供覆盖面极广的包括企业信息生产、管理和发布等方面的一整套工具。在商业智能市场，Brio产品的易用性获得了业内人士的广泛认可，而新产品Brio Performance Suite 8增加了一个功能强大的企业级基础架构作为整合平台，并且改进了产品的直观界面。目前Brio不仅能够提供简单到无论多小的部门都可以安装、实施和维护的套件，而且也能够为任何规模的企业或组织提供高性能的、伸缩性强的基础架构。Brio Performance Suite 8已在全球范围内实现软件本地化，包含了Brio原有的Brio Intelligence、Brio Portal、Brio Report 三大产品，是更加广泛意义上的企业级信息统一服务平台。

　　Brio Performance Suite 8 具有如下特点：完整的HTML分析、广泛的数据源支持、能以HTML、PDF、 Excel、XML和analysis-ready格式输出分析文件、兼容现有安全结构、先进的安排日程和工作流程功能、快捷方便的指标板设计以及熟悉易用的界面等。

熟透番薯

是个很好的话题，不过讨论的人似乎不多。CCOW有好处，也有不足，不知道大家怎么看？是否有更好的办法？

bb88qq

最初由 jdli 发表
[B]真正的医生集成化桌面系统可以实现以下功能:
1. 用户只需LOGIN一次, 就可以使用多个APPLICATIONS.例如: 用户LOGGED IN 电子病历系统后,同时再打开牙科管理系统, 药物条形码管理系统, 妇?后三者均不需要用... [/B]

龙康门诊/分诊排队系统,基于自己的LKQQ平台,实现了CCOW的USER CONTEXT功能,以及CCOW的PATIENT CONTEXT. 医生桌面应用有KQQ客户端(LKQQ.EXE), 不同门诊科室的接诊软件LK_XX_CIS.EXE(XX为接诊科室拼音代码, 不好意思, 实在写不出一个公用的EXE解决所有门诊科室的望/闻/问/切, 只好各门诊科室各个击破), 注册台登记软件(LKREG.EXE), LKRIS.EXE,LKPACS.EXE, 特定科室进销存(如眼科的镜片/镜架LKGLASS.EXE), 周边电器万能学习型红外线遥控软件LKRemote.EXE(用于叫号时自动静音候诊室的电视,或者办公室下班自动关空调等设备)等. 任何一个EXE中登陆系统后, 其它EXE无需登陆; 所有EXE针对同一个病人的资料处理, 任何一个EXE切换了病人,其它EXE皆自动同步.整个系统完全基于自己的LKQQ协议工作流流转平台, 大多数EXE有类似于DICOM标准的任务清单Worklist.工作流可以可视化编辑节点条件分流.全部代码C++, 仅万能红外遥控用到部分少量内嵌汇编语言, 数据库接口采用ADO, 如果客户需要降低成本, 龙康系列软件支持用单机版的ACCESS数据库, 实现通常只有大型分布式数据库(SQLSERVER, CACHE,ORACLE, SYBASE)才能实现的分布式应用. 龙康特有的单机版数据库仿真分布式数据库, 性能可以接近分布式数据库90%.部分指标甚至远高于分布式数据库. 从仿真状态切换到一般分布式数据库, 仅需3分钟的配置时间.

详细内容,参阅www.lkkj.net.
欢迎医院索取演示CD盘(260MB), 演示光盘隐含使用单机版数据库仿真分布式数据库, 无并发用户数的限制,可以无需专业人士指导,自行轻松安装N台工作站.各装好的工作站自动遥相呼应.

内网的全部龙康EXE在LKQQ中以拟人的方式自动各自加为好友,与自然人在QQ中的逻辑地位等价.从此各EXE在网络环境下不再寂寞,而是在网络大环境下构成一个个互动的神经元. C++的贡献之一是友类的定义(friend class),即时通(QQ/ICQ...)的贡献是人以类聚,龙康以"友模块"扩展了友类的概念之后,集前两者之总成.

正式版CD隐含使用分布式数据库, 但DBMS需要客户自备或龙康代购, 需专业人士现场建立数据库名字空间,并指导安装布署.

客户如果不满意龙康自带的隐含报表格式, 可在ACCESS中可视化设计/修改同名报表格式, 以趋报表图文并茂更中国化, 并存储在MDB文件中, 完全不用更改C++程序.