1. Overall demand
1. Avoid complicated installation. The system installation and operating environment recovery time from bare metal to system availability should not exceed 1 hour, and it is best to control it within 40 minutes;
2. Avoid complex logical judgments and intelligence, all for the purpose of recording business and business continuity in emergency situations;
3. Adopt the client server model. Under normal circumstances, outpatient and inpatient hospitals share an emergency server system. If the network does not allow it, inpatient and outpatient departments can each deploy an emergency service system;
4. Support outpatient registration, outpatient prescription (doctor station), outpatient charging and basic business functions of outpatient pharmacy; support admission, medical order processing, medical record writing and printing, and basic inpatient pharmacy business;
5. The database system and client system do not require installation, and support quick recovery of server system and client system through hard disk cloning.
2. Overall design
1. Emergency system database
(1) Basic data
Department service items and prices, department pricing strategies, terminology dictionary, drug and sanitary material inventory and prices, employee directory, user and position information, basic patient information, etc.
(2) Business data
Registration, admission, prescription (application form), doctor's orders, charges, medical records, drug incoming and outgoing
2. Emergency business backup, recovery and monitoring system
(1) Backup system
The emergency business backup system initializes the emergency database snapshot based on the production system at 4 a.m. every day, and automatically saves the daily snapshot database for the last 7 days. At the same time, based on the snapshot database of the day, dynamic changes in hospital patients, prescriptions, medical orders, medical records and inventory of the production database are dynamically monitored, and updated to the emergency system database in real time. The updated data received from the production system may be emergency The business recovery system updates the business data of the production system. At this time, the emergency backup system should be abandoned.
(2)Restore system
The business data generated by the emergency business system in the emergency state, including registration, admission, prescription (application form), doctor's orders, charges, medical records, drug incoming and outgoing, etc., need to be collected into the production system and redone according to the business logic of the production system. These businesses generate corresponding data in the production system. When the production system redoes emergency business, it should record the source of the business, that is, which emergency system the business came from, so that the emergency business backup system can correctly distinguish which data needs to be discarded.
(3) Monitoring system
Set the operating status and initial conditions of the emergency system, such as outpatient queues, system status, etc., and monitor the operation of the system.
3. Emergency business processing system
The emergency business processing system is activated when the production system is expected to be unable to restore access within a short period of time. Before enabling the emergency business processing system, the emergency business backup system needs to be stopped. Data backup from the production system is prohibited until the emergency business processing system is closed and business recovery is carried out. , the emergency business backup system can be restarted.
The emergency business processing system includes several modules that can run independently:
(1) Emergency registration system
When there is a queuing and calling system, the registration queue is selected for registered patients based on the queuing situation of the outpatient queue. When there is no queuing system, an outpatient doctor will be selected for the patient to register based on the outpatient doctor's attendance. Ability to create patient files (patient master index), and recharge or refund prepayments to the diagnosis and treatment card account.
(2) Emergency outpatient doctor station
When there is a queuing system, call the patient for medical treatment from the queuing system. When there is no queuing system, patients are called manually based on registration records, or patients are assigned to the clinic after the triage nurse calls the number. When the patient arrives at the clinic, confirm the patient's identity based on the patient's registration receipt or medical record, match the registration record, retrieve patient information, issue an application form and write outpatient medical records (or scan and take photos for archiving), correct outpatient diagnosis, and issue drug prescriptions . The outpatient doctor's workstation can issue an electronic hospitalization certificate, and the admission registration system can handle hospitalization procedures based on the electronic hospitalization certificate. When the electronic hospitalization certificate cannot be shared due to network reasons, the doctor will issue a handwritten hospitalization certificate at the same time. It is best to integrate the electronic medical record system so that outpatient medical records can be written at the doctor's workstation at the same time.
(3) Emergency charging system
It is possible to set bill parameters (bill type, number segment, printer, etc.), to generate billing orders based on manual marking of paper prescriptions (application forms), and to collect and settle billing bills. It is best to support medical insurance settlement and Internet payment, and at least support cash, bank card swiping and medical card prepayment settlement. Supports recharge and refund of medical card prepaid account.
(4) Emergency outpatient nurse station
The emergency outpatient nurse station is used to process the billing of outpatient treatment in our hospital or the account settlement of prepayment of medical card. It can also handle the billing of out-of-hospital drug collection, treatment (injection) billing and prepayment of medical card. Account settlement. Reviews related to safe drug use need to be completed, and it is best to conduct skin test management.
(5) Emergency outpatient pharmacy system
The emergency outpatient pharmacy system can handle basic pharmacy services such as drug storage (application or allocation), prescription inventory reservation and pricing, and prescription issuance. It would be best to review prescriptions for safe and rational drug use.
(6) Emergency admission registration system
The emergency admission registration system can share the electronic hospitalization certificate issued by the outpatient doctor station for patient admission, or it can enter the handwritten admission certificate for patient admission. The emergency admission registration system does not handle hospitalization prepayments and discharge settlements. Patients who are discharged during the emergency period need to wait until the production system is restored before handling discharge settlement through the production system.
(7) Emergency resident doctor station
The emergency hospital doctor station can handle the diagnosis and medical orders (including discharge orders) of patients in the hospital. It is best to integrate the electronic medical record system to write the medical records of inpatients (excluding the home page of the medical record).
(8) Emergency inpatient nurse station
The emergency inpatient nurse station can handle the entry and exit of inpatients, as well as the medical orders (including discharge orders) and nursing records of inpatients. It is best to integrate the electronic medical record system to realize the writing of nursing documents.
(9) Emergency inpatient pharmacy
Emergency inpatient pharmacies can handle inpatient pharmacy services such as drug warehousing, doctor's order collection, doctor's order dispensing, discharge medication application, discharge medication adjustment, and medication issuance review.
(10) Emergency medical technology fee confirmation system
Able to receive the medical technology price billing form from the outpatient charging system, and use the balance of the prepaid account of the medical card to settle the bill. Mark the execution status (execution, executed, canceled execution, etc.) of the billing orders that have been settled to prevent incorrect refunds from the charging system.
(11) Emergency electronic medical record system
The emergency electronic medical record system can create or modify electronic medical record files for patients in the hospital, and can also seal and print electronic medical records.
3. Technical route
The emergency system uses MySQL database and uses visual development tools such as Powerbuilder/Delphi/VS for rapid development. Data exchange and communication between subsystems are carried out through shared databases.