【作者】 王娜；

【导师】 蒋志方；

【作者基本信息】 山东大学 ， 计算机技术（专业学位）， 2014， 硕士

【摘要】 随着数字化信息时代的来临,数字化医院已经成为数字医学的重要内容和载体。目前,国内医院常见的信息系统有医院信息系统(HIS)、临床检验系统(LIS)、医学影像存储与传输系统(PACS)、放射科信息系统(RIS),电子病历系统(EMR)。PACS系统是Picture Archiving and Communication Systems的缩写,即影像归档和通信系统,它随着数字成像技术、计算机技术和网络技术的进步而迅速发展起来,目的是将影像采集设备(如CT、磁共振)、存储设备和影像工作站通过网络连接在一起,实现数字化采集、集中化存储、组合化检索和网路化调用。RIS系统是Radiology Information System的缩写,主要实现预约登记、检查、报告的计算机化,它与PACS系统共同构成医学影像学的信息化环境,简称为PACS/RIS系统。PACS/RIS系统不仅为医院实现无胶片化管理和影像信息集成提供解决方案,而且为实现远程医疗、计算机辅助医学影像诊断,数字化手术计划和导航等提供了支持平台,PACS/RIS系统建设已经成为数字化医院的重要组成部分。本文在医院现有信息系统基础上,经过分析实施医院影像科室的业务需求和业务流程,并结合其它医院信息化建设的经验,成功为某三甲综合医院实施了医学影像信息管理系统—PACS/RIS。实践证明,系统的使用与推进改变了传统的工作方式,它所带来的一系列变革已在影像医学、临床诊断、医学教育和远程医疗方面发挥着重要作用。首先,本文在研究医院PACS/RIS系统项目背景和实施所面临问题的基础上,调研分析医院影像设备、检查工作量和网络建设情况,全面讨论了每个部门对系统的功能需求,对PACS/RIS系统解决的主要问题做了详细论述。在需求分析基础上,提出PACS/RIS系统的解决方案。首先根据系统需求提出系统设计目标和原则,然后分别对系统的影像处理、影像存储和网络建设进行方案设计,其中着重对影像存储方案进行详细说明,存储规划分为离线存储规划和在线存储规划两部分,为了更好地理解存储规划,首先对存储设计原则和存储架构进行了介绍,存储架构的设计遵循高效性、系统性、安全性。其次,进行RIS与HIS系统集成的详细设计。首先介绍了PACSRIS与HIS的关系,HIS与RIS之间相互依存,HIS为RIS提供数据支持,RIS和HIS的融合过程,实际上是合理重建影像科室工作流程,对HIS和RIS进行再设计的过程。本文简单介绍了HIS的数据结构和提供的接口视图。集成接口的设计分为登记模块、检查模块、报告模块三部分,每一部分都以流程图和代码分析的形式进行了详细说明。再次,对PACS/RIS系统进行了容灾测试和速率测试,简单介绍PACS/RIS系统上线前的准备工作,对PACS/RIS上线后的应用价值以公式计算和表格形式做了系统比较,可以看出PACS/RIS建成后对医院的产出和医疗效率都会产生重大的正面影响。最后,通过问卷调查形式,搜集试运行阶段出现的问题,查找系统漏洞集中整改,总结PACS/RIS系统在医院影像科室的应用情况,对系统建设存在亟待解决的问题,提出了自己的改进意见。综上所述,充分发挥PACS/RIS的商业价值,必须在建设面向全院信息规划的全新PACS/RIS系统架构基础之上。我们在分析影像检查流程和临床诊断需求的基础上,针对实施医院的具体情况,提出了可行的实施解决方案,设计并实现了针对医院规模,适合影像科室工作的PACS/RIS影像信息管理系统,PACS/RIS系统的成功应用加快了医院信息化建设步伐。更多还原

【Abstract】 Along with the coming of the digital and information age, the digital hospital has become the important content and the carrier of digital medicine. At present, hospital information system (HIS), clinical laboratory information system (LIS) picture archiving and communication system (PACS), Radiology Information System (RIS), electronic medical record system (ERM) are the common information system in domestic hospital, PACS is the abbreviation of Picture Archiving and Communication Systems, that is, the picture archiving and communication system. The aim at connecting image acquisition device (such as CT, magnetic resonance), storage devices and image workstation together through the computer network, to realize digital collection, centralized storage, retrieval and web based call combination. RIS is the abbreviation of radiology information system, It mainly realize electronic booking registration, examination, report, It with the PACS system constitute the information environment of medical imaging, short for PACS/RIS system.PACS/RIS not only realize non-film medical examination for hospital and provide integrated solutions, but also provides a platform of digital operation planning and computer aided diagnosis of medical image, PACS/RIS system has become an important part of digital hospital.In this paper, the writer after analysis of the implementation of hospital radiology department’s requirements and processes, based on the current hospital information system, and in combination with experience of other hospital information construction, successfully realizing the medical image system-PACS /RIS in a tertiary comprehensive hospital。The practice proved that the use of the system has changed the traditional way of working, It plays an important role in medical imaging, clinical diagnosis, medical education and telemedicine.First of all, this paper analysis the implementation of PACS/RIS based on the background and the problems faced, Analysis of imaging equipment, workload and network construction, a comprehensive discussion of each department needs for the system, the main problems what the PACS/RIS system solved are discussed in detail.On the basis of the needs analysis, put forward the solution of PACS/RIS system. Firstly, Put forward design objectives and principles according to the demand of the system, and then design separately on the system of image processing, image storage and network construction programme.Second,the detailed design of system integration of PACS/RIS and HIS. Firstly introduces the relationship between PACS/RIS and HIS, interdependence between HIS and PACS/RIS,HIS provides data support for PACS/RIS, PACS/RIS and HIS fusion process, which is actually a reasonable reconstruction imaging department work process, to redesign the process of HIS and PACS/RIS.This article simply introduces the HIS data structure and interface view.Integration of the interface design is divided into registration module, check module and report module three parts, each part in the form of flow chart and code analysis has carried on the detailed instructions.Then, testing the disaster of PACS/RIS system, and the rate of simple introduces the preparing work before PACS system online again,the application of PACS /RISonline after the value in the form of formula and forms made system comparison, it can be seen after the completion of PACS/RIS and to the output of the hospital medical efficiency will have a significant positive impact.Finally, through the questionnaire survey form, to collect problems in commissioning phase, find system vulnerabilities concentration alteration, summed up in the hospital PACS/RIS system image department, the application of existing problems to be solved for the system construction and put forward its own improvements.Above all, give full play to the commercial value of PACS/RIS, must in the construction planning and partial information oriented new PACS/RIS system architecture based on the analysis of the imaging process and on the basis of the clinical diagnosis demand, according to the specific situation of the implementation of the hospital, put forward the implementation of feasible solution, designed and implemented for the hospital size, suitable for image workstation of PACS/RIS image archiving and communication system, the successful application of PACS/RIS system to speed up the pace of the hospital information construction.更多还原