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本報(bào)告根據(jù)衛(wèi)生部公立醫(yī)院改革試點(diǎn)關(guān)于醫(yī)院管理信息系統(tǒng)建設(shè)的目標(biāo)和要求，在充分調(diào)研、考察和論證了各專業(yè)IT企業(yè)的解決方案、汲取國(guó)內(nèi)同行相關(guān)實(shí)踐經(jīng)驗(yàn)的基礎(chǔ)上，結(jié)合集團(tuán)化醫(yī)院的業(yè)務(wù)特點(diǎn)，對(duì)不同的技術(shù)路線就其可行性、先進(jìn)性以及與建設(shè)目標(biāo)的契合度等多個(gè)方面進(jìn)行了較為深入的比較分析，并在此基礎(chǔ)上規(guī)劃和設(shè)計(jì)了集團(tuán)化醫(yī)院IT建設(shè)的整體方案。在保證IT架構(gòu)的先進(jìn)性和可持續(xù)性前提下，突出了應(yīng)用整合層面建設(shè)如何實(shí)現(xiàn)集團(tuán)化醫(yī)院在統(tǒng)一管理、有效資源整合和調(diào)配、便民服務(wù)、降低醫(yī)療成本等建設(shè)目標(biāo)和任務(wù)。建設(shè)項(xiàng)目的啟動(dòng)以市一院為龍頭，主體項(xiàng)目計(jì)劃一年內(nèi)完成，集團(tuán)內(nèi)推廣建設(shè)計(jì)劃在三年內(nèi)全部結(jié)束。
目 錄
1. 建設(shè)目標(biāo) ................................................................................................................................................ 5
1.1 前言 .................................................................................................................................................................. 5
1.2 建設(shè)目標(biāo) ......................................................................................................................................................... 5
1.2.1 總體目標(biāo) ......................................................................................................................... 5
1.2.2 短期建設(shè)目標(biāo)................................................................................................................. 6
1.2.3 長(zhǎng)期建設(shè)目標(biāo)................................................................................................................. 6
2. 建設(shè)方法 ................................................................................................................................................ 8
2.1 集團(tuán)業(yè)務(wù)模式 ................................................................................................................................................ 8
2.2 IT建設(shè)技術(shù)路線........................................................................................................................................... 9
2.3 總體架構(gòu)規(guī)劃 .............................................................................................................................................. 10
2.3.1 信息化規(guī)劃過(guò)程 .......................................................................................................... 10
2.3.2 BDN分析 ...................................................................................................................... 12
3. 建設(shè)內(nèi)容 .............................................................................................................................................. 20
3.1 構(gòu)成技術(shù)方案的幾個(gè)核心問(wèn)題 ............................................................................................................. 20
3.1.1 平臺(tái)建設(shè)是否必要 ...................................................................................................... 20
3.1.2 現(xiàn)有的應(yīng)用系統(tǒng)如何處置 ......................................................................................... 21
3.1.3 機(jī)房建設(shè)如何規(guī)劃 ...................................................................................................... 22
3.2 整體高端業(yè)務(wù)架構(gòu)設(shè)計(jì)說(shuō)明 .................................................................................................................. 22
3.3 基于“云－端”計(jì)算的整體架構(gòu)設(shè)計(jì) ............................................................................................... 23
3.4 集團(tuán)IT系統(tǒng)建設(shè)架構(gòu)設(shè)計(jì) ..................................................................................................................... 25
3.4.1 集團(tuán)平臺(tái)IT架構(gòu)設(shè)計(jì) ................................................................................................ 25
3.4.2 集團(tuán)技術(shù)架構(gòu)設(shè)計(jì) ...................................................................................................... 30
3.5 下屬醫(yī)療機(jī)構(gòu)IT系統(tǒng)建設(shè)架構(gòu)設(shè)計(jì) .................................................................................................. 32
3.5.1 基礎(chǔ)業(yè)務(wù)層 ................................................................................................................... 33
3.5.2 整合層 ............................................................................................................................ 35
3.5.3 整合業(yè)務(wù)層 ................................................................................................................... 36
3.5.4 IT支撐層 ....................................................................................................................... 37
3.5.5 標(biāo)準(zhǔn)支撐層 ................................................................................................................... 38
3.6 數(shù)字化醫(yī)院IT總體架構(gòu)設(shè)計(jì) ................................................................................................................ 38
3.6.1 基礎(chǔ)業(yè)務(wù)應(yīng)用服務(wù) ...................................................................................................... 41
3.6.2 公共整合服務(wù)............................................................................................................... 41
3.6.3 整合業(yè)務(wù)應(yīng)用服務(wù) ...................................................................................................... 42
3.6.4 IT系統(tǒng)安全和管理服務(wù)............................................................................................. 42
3.6.4.1 IT系統(tǒng)安全現(xiàn)狀分析 ................................................................................................. 42
3.6.4.2 對(duì)IT安全管理的構(gòu)想 ................................................................................................ 42
3.6.4.3 建議采用或增強(qiáng)的解決方案 .................................................................................... 43
3.6.4.4 依托專業(yè)廠商的信息化技術(shù)體系架構(gòu)服務(wù) .......................................................... 46
3.6.5 IT基礎(chǔ)支撐服務(wù) .......................................................................................................... 47
3.6.6 標(biāo)準(zhǔn)支撐服務(wù)............................................................................................................... 47
3.7 集團(tuán)平臺(tái)與集團(tuán)下屬醫(yī)院之間的關(guān)聯(lián)性設(shè)計(jì) ................................................................................. 47
3.8 集團(tuán)平臺(tái)與市區(qū)域公共衛(wèi)生平臺(tái)之間的關(guān)聯(lián)性設(shè)計(jì).................................................................... 48
3.9 核心應(yīng)用系統(tǒng) .............................................................................................................................................. 49
3.9.1 集團(tuán)預(yù)約系統(tǒng)............................................................................................................... 51
3.9.2 集團(tuán)電子病歷系統(tǒng) ...................................................................................................... 53
3.9.3 臨床信息共享............................................................................................................... 56
3.9.4 醫(yī)院運(yùn)營(yíng)關(guān)鍵指標(biāo)監(jiān)測(cè) ............................................................................................. 56
3.9.5 醫(yī)療質(zhì)量監(jiān)控系統(tǒng) ...................................................................................................... 57
3.9.6 集團(tuán)協(xié)同醫(yī)療系統(tǒng) ...................................................................................................... 59
3.9.7 集團(tuán)協(xié)同辦公門戶 ...................................................................................................... 60
3.9.8 集團(tuán)HRP系統(tǒng) ............................................................................................................ 61
3.10 關(guān)鍵平臺(tái)服務(wù) .............................................................................................................................................. 64
3.10.1 集團(tuán)數(shù)據(jù)中心平臺(tái) ...................................................................................................... 65
3.10.2 患者主索引服務(wù) .......................................................................................................... 66
3.10.3 統(tǒng)一用戶管理服務(wù) ...................................................................................................... 67
3.10.4 統(tǒng)一通訊服務(wù)............................................................................................................... 68
3.10.5 企業(yè)服務(wù)總線服務(wù) ...................................................................................................... 69
3.11 架構(gòu)驗(yàn)證 ....................................................................................................................................................... 70
4. 實(shí)施計(jì)劃 .............................................................................................................................................. 72
4.1 項(xiàng)目關(guān)鍵成功因素及實(shí)施策略 ............................................................................................................. 72
4.2 第一階段建設(shè)內(nèi)容 .................................................................................................................................... 73
4.3 第二階段建設(shè)內(nèi)容 .................................................................................................................................... 76
4.4 第三階段建設(shè)內(nèi)容 .................................................................................................................................... 79
4.5 分階段交付的成果 .................................................................................................................................... 79
5. 實(shí)施方法 .............................................................................................................................................. 85
5.1 項(xiàng)目實(shí)施管理 .............................................................................................................................................. 85
5.1.1 范圍管理 ....................................................................................................................... 86
5.1.2 風(fēng)險(xiǎn)管理 ....................................................................................................................... 88
5.1.3 質(zhì)量管理 ....................................................................................................................... 91
5.1.4 時(shí)間及進(jìn)度管理 .......................................................................................................... 92
5.1.5 溝通及團(tuán)隊(duì)管理 .......................................................................................................... 93
5.2 項(xiàng)目組織架構(gòu) ........................................................................................................................................... 104
5.3 項(xiàng)目實(shí)施計(jì)劃 ........................................................................................................................................... 105
5.4 系統(tǒng)上線與交付 ...................................................................................................................................... 106
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