Masic Fedja
Faculty of Dental medicine, Medical university of Vienna, Austria.
Acta Inform Med. 2012 Mar;20(1):47-55. doi: 10.5455/aim.2012.20.47-55.
Almost the entire human creativity today, from the standpoint of its efficiency and expediency, is conditioned with the existence of information systems. Most information systems are oriented to the management and decision-making, including health information system. System of health and health insurance together form one of the most important segments of society and its functioning as a compact unit. Increasing requirements for reducing health care costs while preserving or improving the quality of services provided represent a difficult task for the health system.
Using descriptive metods by retreiiving literature we analyzed the latest solutions in information and telecommunications technology is the basis for building an effective and efficient health system. Computerization does not have the primary objective of saving, but the rationalization of spending in health care. It is estimated that at least 20-30% of money spent in health care can be rationally utilized. Computerization should give the necessary data and indicators for this rationalization. Very important are the goals of this project and the achievement of other uses and benefits, improving overall care for patients and policyholders, increasing the speed and accuracy of diagnosis in determining treatment using electronic diagnostic and therapeutic guidelines.
Computerization in dentistry began similarly as in other human activities-recording large amounts of data on digital media, and by replacing manual data processing to machine one. But specifics of the dental profession have led to the specifics of the application of information technology (IT), and continue to require special development of dental oriented and applied IT. Harmonization of dental software with global standards will enable doctors and dentists to with a few mouse clicks via the internet reach the general medical information about their patients from the central national health database. Standardization will also allow access to general medical and dental history data on citizens of foreign countries who seek help of doctors or dentists during their vacation. Such a method of using IT will provide a higher level of health services and better health care. Also, the identification procedures in mass disasters availability of data can contribute to accelerate the identification of victims.Dental information systems lately are based on Web applications to facilitate data exchange. Electronic patient record contains basic information and entering of this data is automatically created the protocol of patients that can be printed.Besides these general data Electronic patient record also contains history data related to allergies and other diseases which existence can significantly affect the treatment, data on current diagnosis, location of a pathological process in the tooth refers to the following location (mesial, distal, vestibular, oral, occlusal), teething, therapy of the tooth , type of material used with location on the tooth. The system may defined also the surgical procedures that were performed on the teeth such as tooth extraction or tooth root resection with the ability to accurately indicate that the root is resected. Implants, upgrades, grinding teeth, and independent crown can be defined for each tooth and its rightful place if a tooth is missing. Specially designed graphical representation of teeth enables to enter data by first clicking on the tooth or place where it is and also on that occasion to open a menu with options. Control of data entry prevents entry of illogical data.
The system according to the HL7 standard represents electronic documents which eliminate the need for paper documents and a variety of daily and monthly reports of doctors who are still in use today, and the doctor and nurse are almost completely freed of administrative tasks.
从效率和便利性的角度来看,如今几乎整个人类创造力都依赖于信息系统的存在。大多数信息系统都面向管理和决策,包括健康信息系统。健康系统和健康保险共同构成社会最重要的组成部分之一,并作为一个紧密的整体发挥作用。在保持或提高所提供服务质量的同时,降低医疗保健成本的要求日益增加,这对卫生系统来说是一项艰巨的任务。
通过检索文献使用描述性方法,我们分析了信息和通信技术中的最新解决方案,这些技术是构建有效且高效的卫生系统的基础。计算机化的主要目标不是节省开支,而是实现医疗保健支出的合理化。据估计,至少20% - 30%的医疗保健支出可以得到合理利用。计算机化应为此合理化提供必要的数据和指标。该项目的目标以及实现其他用途和益处非常重要,包括改善对患者和投保人的整体护理,提高使用电子诊断和治疗指南确定治疗方案时诊断的速度和准确性。
牙科领域的计算机化与其他人类活动类似地开始——在数字媒体上记录大量数据,并将手动数据处理替换为机器处理。但牙科专业的特殊性导致了信息技术(IT)应用的特殊性,并继续要求专门开发面向牙科的应用IT。使牙科软件与全球标准相协调,将使医生和牙医能够通过互联网点击几下,从国家中央健康数据库获取有关其患者的一般医疗信息。标准化还将允许访问在国外度假期间寻求医生或牙医帮助的外国公民的一般医疗和牙科病史数据。这种使用IT的方法将提供更高水平的健康服务和更好的医疗保健。此外,在大规模灾难中的身份识别程序以及数据的可用性有助于加快受害者的身份识别。牙科信息系统最近基于Web应用程序以促进数据交换。电子病历包含基本信息,输入这些数据会自动创建可打印的患者病历。除了这些一般数据外,电子病历还包含与过敏和其他疾病相关的病史数据,这些疾病的存在可能会对治疗产生重大影响,当前诊断数据,牙齿病理过程的位置(指近中、远中、前庭、口腔、咬合面),出牙情况,牙齿治疗,所用材料的类型及其在牙齿上的位置。该系统还可以定义对牙齿进行的外科手术,如拔牙或牙根切除术,并能够准确指示牙根已被切除。如果牙齿缺失,可以为每颗牙齿定义种植体、修复、磨牙和独立牙冠及其正确位置。专门设计的牙齿图形表示允许通过首先点击牙齿或其所在位置,同时打开带有选项的菜单来输入数据。数据输入控制可防止输入不合逻辑的数据。
符合HL7标准的系统代表电子文档,消除了对纸质文档以及如今仍在使用的医生各种每日和每月报告的需求,医生和护士几乎完全从行政任务中解脱出来。