Development And Meaningful Use Of The EMR System Supporting Medical Process Management

With the development of economy and society, the demand of more and higher-quality healthcare services is becoming exigent. The effective application of IT technology in medical industry is a fundamental way to improve efficiency and quality of healthcare services, ensure patients’safety, and control the medical cost. In2009, China launched a new medical reform program, in which made the construction of healthcare informationizaion as one of the eight supports for the healthcare system reform. Healthcare informationizaion is becoming an inevitable trend of the development of modern medicine.The new medical reform program brought new opportunities as well as new requests to the construction of healthcare informationization. As a core content of healthcare informaionization, the development and application of Electronic Medical Records (EMR) should play an important role in improving healthcare quality and ensuring patients’safety, which means "meaningful use". To promote the development and application of EMR, this thesis presents a design, development, and application project of EMR supporting medical process management. In addition to the electronization and structurizaion of medical records, we also improve and optimize the medical operation flow by introducing process management theory, combined with clinical decision support and knowledge base to achieve monitoring and management of the whole medical process. The main work is as follows:●Process management is an important way to realize total healthcare quality management. The traditional manual operation mode is difficult to meet the betimes requirements of information feedback. To ensure the medical staff and hospital managers can obtain information in time, this thesis introduces the PDCA Cycle into the process design. The specific operation is corresponding with the step of PDCA Cycle. The EMR System can obtain information automatically and feedback in time.●Besides the functions of the EMR System, application of it is also a direct impact on its role in the play. In this thesis, clinical decision support and knowledge base are embedded into the system to supervise the prescriptions of antibiotics, which is an important content of "meaningful use" of EMR. We evaluate the effect of the system on curbing antibiotic abuse quantificationally through analyzing clinical data in hospital and analyze factors which influence antibiotic use.●The effect of EMR on curbing antibiotic abuse is reflected by changes in antibiotic consumption through mining clinical data generated in hospitals. Moreover, we analyzed factors which affect anbitiotic use by variable importance analysis and artificial neural network algorithm. The analysis results are used to evaluate the effect on promoting rational anbiotic use in different treatment.EMR supporting medical process management is the advanced stage of EMR development. It can integrate all equipments and systems used in hospitals and cover all the information generated in medical process. Proved by the study results, the system can reduce antibiotic use significantly. The antibiotic consumption was decreased from727.42DDDs/1000patient-days to477.03DDDs/1000patient-days. The antibiotic selection, period of treatment, and administration route were more rational. Besides, the outcome of recover and improvement were raised from84.88%to90.47%. The motality was decreased from3.17%to1.57%. The average patients’ days in hospital were shortened from13.03days to10.40dyas. The average cost of inpatients was reduced from10232.02yuan to8871.37yuan. EMR oriented to medical process can provide more high-quality healthcare services with lower cost.