Study On The Informationization Of Referral Supervision System Between Hospitals And Community Health Services Institutions

Research background and purpose:In recent years, our country has issued series of documents encouraging the development of community health service institutions and the establishment of two-way referral system, hopes to solve series of problems such as unreasonable allocation of health resources, rapidly increase health expenditure, difficult medical services and expensive medical cost, and so on. On the basis of such environment, two-way referral has become hot research field in recent ten years. Combining with literature research, although domestic two-way referral research has become rich and deep increasingly, we lack effective referral supervision systems at present, and existing supervision and evaluation still stay a low level of routinization. Given this, based on the regional health platform of the project implementation unit, the paper discusses how to realize a referral supervision system by information means, thus standardizes and encourages two-way referral, helps patients enjoying more convenient and high quality medical services, and finally achieves the goal of promoting two-way referral service routinization and standardization.Methods:The paper mainly adopts the methods of information analysis, empirical research and software engineering. The empirical research in Guangzhou first municipal people's hospital and its community health services institutions aims to find the difficulty of implementing two-way referral and the needs of doctor and patient, and define the service process and supervision contents of two-way referral.Contents:Based on literature research and empirical investigation, according to the theory, principles and forms of building referral supervision systems, the paper explicates supervision contents, constructs the basic model and discusses part of implementation.Conclusions:(1) On the basis of two-way referral service process, the framework and five subjects of referral supervision system are proposed. The five subjects are government departments, the medical insurance department, hospitals, community health services institutions and patients. According to straighten out the relationship among them, the paper explicates main supervision contents of these subjects.(2) The paper also discusses information flow of referral supervision system from structure level and data level, and explains newly added function module of HIS and CHIS from formation, confirmation, acceptance and treatment of referral requests.(3) Before realizing referral supervision system, there are some problems must be solved such as developing clinical pathway of different disease entities in referral, establishing the incentive mechanism and restriction mechanism, using Non—government Organization to supervise referral. Developing clinical pathway of different disease entities in referral is the premise, establishing the incentive mechanism and restriction mechanism is the impetus, using NGO is the guarantee. They are inevitable courses of realizing referral supervision system.