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日本的电子病历与医学信息技术:数据的扩展、整合与再利用

Japanese EMRs and IT in Medicine: Expansion, Integration, and Reuse of Data.

作者信息

Takabayashi Katsuhiko, Doi Shunsuke, Suzuki Takahiro

机构信息

Chiba University Hospital, Chiba, Japan.

出版信息

Healthc Inform Res. 2011 Sep;17(3):178-83. doi: 10.4258/hir.2011.17.3.178. Epub 2011 Sep 30.

Abstract

OBJECTIVES

The prevalence of electronic medical record in Japan varies according to the size of the hospital which is 62.5% in major hospitals, 21.7% in medium, 9.1% in small size hospitals, and 16.5% in clinics. The complete paperless system is very limited, though some major hospitals are aiming at this system. Several regional network systems which connect different platforms of EMRs, have been developing in many districts, while the final picture of a regional network has not been clearly proposed. To develop a whole electronic health record or personal health records system from the regional network data, we have several obstacles to overcome such as standardization, a privacy act, unique national health number.

METHODS

Some experimental trials have just been started. The reuse of the accumulated data has also just been initiated. We exploited text mining systems (term frequency-inverse document frequency method) to find similar cases and auto-audit Japanese diagnosis related group (DRG) coding by using discharge summaries.

RESULTS

The same or even a more extreme phenomenon of huge data accumulation is occurring in genetic research and confluence of multi-disciplines of informatics is the next step, which has an enormous accumulation of data and discoveries of the relations beyond the dimension of each informatics.

CONCLUSIONS

We need another approach to science apart from the conventional method, and data-driven approach with data mining techniques must be brought in for each field. Informaticians have new important roles as coordinators to link up numerous phenomena over dimensions.

摘要

目的

日本电子病历的普及率因医院规模而异,大型医院为62.5%,中型医院为21.7%,小型医院为9.1%,诊所为16.5%。尽管一些大型医院的目标是实现完全无纸化系统,但该系统的应用非常有限。许多地区正在开发连接不同电子病历平台的区域网络系统,然而区域网络的最终模式尚未明确提出。要从区域网络数据中开发整个电子健康记录或个人健康记录系统,我们有几个障碍需要克服,如标准化、隐私法、全国唯一健康编号。

方法

一些试验刚刚开始。对积累数据的再利用也刚刚起步。我们利用文本挖掘系统(词频-逆文档频率法)查找相似病例,并通过出院小结自动审核日本诊断相关组(DRG)编码。

结果

基因研究中也出现了同样甚至更极端的海量数据积累现象,下一步是多学科信息学的融合,这将产生海量数据,并发现超越各信息学维度的关系。

结论

除了传统方法,我们需要另一种科学方法,每个领域都必须引入数据挖掘技术的数据驱动方法。信息学家作为协调员,在连接不同维度的众多现象方面发挥着新的重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd29/3212745/2ddc0984c996/hir-17-178-g001.jpg

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