基于数据约束的病案首页数据管理模式的探索  

Exploration of Data Management Model for Medical Record Homepage Based on Data Constraints

作　　者：李建[1] 杜静[1] 高健[1] 王国乙 LI Jian;DU Jing;GAO Jian;WANG Guoyi(Department of Medical Affairs,the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University,Huai’an Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院医务处,江苏淮安223300

出　　处：《中国卫生标准管理》2023年第19期13-16,共4页China Health Standard Management

基　　金：江苏省医院协会医院管理创新研究课题(JSYGY-1-2021-655)。

摘　　要：通过数据流程图与数据质控规则库的建立形成病案首页数据质量预警机制,构建数据精细化管理模式。文章对目前病案首页数据问题现状进行分析,提出构建三级质控体系、梳理数据流程图、采集首页数据质量评价指标等工作方案,实现异常数据的可追溯性管理。根据编码规则、数据质量管理经验总结整理病案首页数据质控规则,转化计算机语言,嵌入信息系统,在数据录入、保存等环节进行预警。精细化的病案首页数据管理模式有助于提升数据的可追溯性管理,需要引入长效管理机制进行保障,从各环节有效控制改善数据质量,为管理的科学应用提供数据保障。Through the establishment of data flow chart and data quality control rule base,the early warning mechanism of data quality on the first page of medical records was formed,and the data fine management model was constructed.Based on the analysis of the current situation of data problems on the first page of medical records,the paper proposes work plans such as building a quality control system,sorting out data flow charts,and collecting data quality evaluation indicators on the first page to achieve traceability management of abnormal data.Summarize the data quality control rules of the first page of medical records according to the coding rules and data quality management experience,transform the computer language,embed the information system,and give early warning in the data entry,storage and other links.The refined data management mode of the first page of medical records is helpful to improve the traceability management of data,and it is necessary to introduce a long-term management mechanism for protection,effectively control and improve the quality of data from all links,and provide data protection for the scientific application of management.

关 键 词：数据流程图 质控规则库 病案首页 质量控制 数据管理模式 管理科学 

分 类 号：R197[医药卫生—卫生事业管理]