Application And Development Of A Clinical Audiology Diagnostic System Based On Hospital Information System

At present, the network based on HIS among departments of domestic largecomprehensive hospitals and the management framework of various kinds of informationdiagnosis subsystems are becoming more and more mature, and the information sharingplatform between clinical departments and medico-technical departments has been basicallyestablished. However, between hearing diagnosis equipments, which have significantinfluence and diagnostic effects, and HIS network, the information sharing of examination,diagnosis, and clinical data and results in the diagnosis of otological diseases has not beenrealized. The front-line clinical hearing testers deal with a great part of their work still byhand. With high labor intensity and low work efficiency, doctors and technicians spend a lotof time on clerical work, and this causes “cannot give people’s talent into fullest play” andthat the precious data accumulated daily can not adequately and timely serve for clinicalresearch. Under this urgent demand, considering the reality of hospital and the developmenttrend of otology, we designed and developed the HIS-based clinical hearing medical centerinformation system according to the demand analysis carried out in earlier stage. This systemhas three running modes: HIS, one machine, LAN, and uses a same interface to managevarious kinds of equipments of various brands. It is a set of information platform, which canconduct comprehensive management for hearing tests and data, currently provide9comprehensive audiology report templates, and can realize the information sharing andstorage of the related data of patients going through hearing tests. It will largely facilitate theroutine work of hearing testers, improve the medical service quality and efficiency of otology,and create favorable conditions for further scientific management and audiology data miningand research in later stage. To implement the above research, the task is divided into threeparts: Part one：Requirements Analysis for Research and Development of aClinical Audiology diagnostic System Based on Hospital InformationSystemObjective To analyze the requirements of medical center of clinical audiologyinformation system(MCCAIS) based on the hospital information system(HIS), establish theprotocols in order to understand the problems and targets for which the MCCAIS is to solve.Methods The requirements analysis involve clinical audiology technicians frequentcommunicated with otolaryngology specialists, the project managers and hospital softwareengineers to familiar the facilities and to determine specific feature expectations. Thesefeatures and details should be directed towards ensuring that the MCCAIS conforms toexpectative needs. Results The main problems and requirements include that patients’information could not be shared with HIS, existing manual processes urgent to record andanalyze automatically, total10different equipment pursue to connect with HIS. Managementsof hardware and software, system security, test report style, data input and output format, datamanage and analysis, all of these aspects need to be improved and standardized. ConclusionRequirements analysis is the process of determining what are clinical audiology center’sexpectations for existing net service. These requirements must be quantifiable, relevant andrealizable. Requirements analysis is an important aspect of informationization of clinicalaudiology center and hospital.Part two：The Significance and Structure Analysis on Function of anInformation System for Medical Center of Clinical Audiology (MCCAIS）Based on Hospital Information SystemObjective To design and develop a Information System for Medical Center ofClinical Audiology,(MCCAIS301).Methods The system framework was established bydeveloping software, constructing user platform and creating database. An implicationprocedure was also established for clinical use for the MCCAIS301. The MCCAIS301wasconnected with the Hospital Information System (HIS) in order to connect the equipment inthe auditory clinical center and other clinical database system. Results The MCCAIS301is anew database system for hospital information management specifically designed foraudiological tests. It provides an extra functions of the existing HIS system. TheMCCAIS301can store the testing results from more than ten different hearing instrumentsmade from five different companies. The data from the MCCAIS301can be transferred tothe HIS system. The results of the MCCAIS301can be retrieved and analyzed using the HIS system. MCCAIS301system has nine sets of standardized hearing testing results, fiveoutput formats and three statistical analyzing functions. Conclusion The MCCAIS301is aneffective information management system which has a strong practical use to improve theefficiency of daily audiology data analysis. The MCCAIS301using digital technologymoves the audiology data analysis from a manual low efficient stage to an effective andintelligent level.Part three：Research on auditory information systems of military noise andmodel-based hearing impairment monitoring of dynamic systemsObjective To establish information systems of military noise and model-basedhearing impairment monitoring of dynamic systems. Methods Total496recruits acceptedphysical examination and hearing test. Based on these informations and network facilities, weestablished a military noise dynamic monitoring system. We collected all auditory datafollowed a standard hearing examination protocol. We counted and analyzed data withsoftware PASW statistics18. Results We established the dynamic monitoring systemsuccessfully and tested all496soldiers based on this system in three days. These soldiers agedfrom17-25and average age of19-year-old. Among496soldiers,5were tested with abnormaltympanogram and17with different degrees of hearing loss based GJB2121-94grade. If weanalyzed them according average absolute auditory thresholds, total73ears with hearingimpairment (68mild and5moderate). The comparison results of mean hearing levels indifferent frequencies shown there had significant discrepancy between different frequencies in496soldiers, P<0.05. The frequency of3kHz and6kHz had significant statistic differencewith other frequencies, P<0.01. Conclusions This study indicated that the hearing dynamicmonitoring system could collect and analyze hearing situation of people with military noiseexposure conveniently and expeditiously. The baseline data analysis showed us that manyrecruits accompany different levels hearing loss before they were exposed in military noise.