Zhan Songhua, a member of the Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, told reporters that since the implementation of the second phase of the construction of the Medical Image Storage and Transmission System (PACS), various functions of the hospital have gradually improved. Now patients go to the 24-hour self-service terminal in the hospital lobby to swipe the medical card or insert the medical insurance card. The service terminal can print out the film and examination report. The patient does not need to go to the window to ask, nor will he get the report by the same name.
According to the "2010 Medical Equipment Allocation Status and Development Trends in China", more than 85% of hospitals in China during the "Eleventh Five-Year Plan" period basically implemented information management, and the total investment in the medical information market has exceeded 9 billion yuan. The new medical reform plan regards medical informatization as one of 24 opinions, which clarifies the importance of medical informatization for medical reform. As an important part of the medical information system, PACS is of great significance for improving the service capabilities of medical institutions, especially primary medical institutions. With the deepening of the new medical reform, the current PACS construction is facing great challenges in the overall planning and seamless connection of information.
Challenge: Regionalized medicine
Xinjin County, Chengdu, Sichuan Province has 213 medical and health institutions at all levels and is a pilot county for medical reform in Chengdu. At the end of 2010, the county began to explore the regional PACS. The relevant person in charge of the Xinjin County Health Bureau told reporters that the purpose of building the regional PACS is to achieve the sharing and exchange of medical imaging data and related resources of medical institutions at all levels in the region, so that the people can conduct imaging examinations at the grass-roots medical and health institutions nearby, reducing duplication. Check and repeat charges, optimize the allocation of medical resources reasonably, and effectively alleviate the problem of "expensive and difficult to see a doctor".
"With the implementation of the new medical reform, the scale and scope of regional medical services will continue to expand, from the same region to the same province, and then to different provinces. How to establish a system that is suitable for long-distance collaboration, is operable, and has relatively high costs The low regional PACS has become a major issue in the current medical informatization. "Said Hu Chengdong, Beijing Tongren Hospital.
According to Hu Chengdong, in recent years, Tongren Medical Industry Group has built large-scale comprehensive tertiary hospitals such as Nanjing Tongren Hospital and Kunming Tongren Hospital based on Beijing Tongren Hospital, and opened ophthalmology chain hospitals in Nanchang and Zhengzhou. Each hospital is equipped with advanced imaging, ultrasound, pathology and other medical equipment. When there is a need for diagnosis of difficult image pictures between hospitals, experts from each hospital support each other and flow across regions. Except for Beijing, patients have little mobility in the hospitals of the Group.
Through the construction of PACS, they summed up the idea of ​​"large concentration in the same area, distributed in different areas", that is, large and medium-sized cities with good conditions or areas where hospitals are relatively concentrated, the large concentration mode can be considered; for wide spans and general network operating conditions In regions, a distributed model can be adopted to share the necessary image data to reduce the impact on the medical order of relevant hospitals and the investment in storage costs.
Tackling: seamless docking
The construction of PACS also faces a serious practical problem-the seamless connection of information systems.
"At present, most of the PACS systems used by primary-level medical institutions have not been tested by the Integrated Medical Environment (IHE) standard, and it is difficult to achieve information sharing and data interconnection in actual operation. This has become a bottleneck in the construction of medical and health information, which has affected The development of electronic medical records, health files and telemedicine. "Zhu Qingsheng, chairman of the China Medical Equipment Association, pointed out at the" 2011 China PACS Conference "not long ago.
IHE was originally initiated by the North American Radiological Society (RSNA) and the American Health Information Management System Association (HIMSS). It aims to improve and enhance the sharing of medical information. Based on the existing interconnection standards, a set of standardized workflow integration mode.
After three years of preparation, in August 2010, the China Medical Equipment Association Medical Equipment Information Interaction and Integration (IHE-C) branch was established. This shows that China has taken a big step forward in the integration of medical equipment information interaction.
Zhu Qing ’s Physiological Director told reporters that at present, the IHE-C branch has initially formed PACS testing standards, including 5 integration modes and 32 functional role tests. But this is only a small part of the IHE test work.
The reporter learned that in the "IHE China Radiological Basic Working System Special Test" held by the China Medical Equipment Association in March this year, 324 functional roles of 21 manufacturers participated in the test, and 293 functional roles passed the test. Lan Yun, General Electric, Sichuang Guanyu, Neusoft, Huahai, Daika, Leida, Medicon, Start, Weiye Future, EBM, Siemens, Best, Tianfeng, Anke, Tianjian, Agfa A total of 62 systems from 17 vendors passed system tests. The products or some systems of these manufacturers can meet the requirements of the interconnection and intercommunication of the image information of the primary medical institutions.
Relevant experts analyzed that although from the current situation, the IHE test is still a "manufacturer club", but the ultimate beneficiary of the IHE test is the hospital. In the past, when the hospital was constructing the information system, each newly added device had to be specially modified to be added to the information system, and it could not be plugged and used; while selecting equipment that had passed the IHE test, it could be plugged. Ready to use. If the hospital can join the IHE test in the future, a long-term "standard-product-user" communication mechanism will be formed.
PACS: the medical image storage and transmission system. It converts medical image data into computer digital form, completes the collection, storage, management, processing and transmission of image information through high-speed computing equipment and communication network, so that image data can be effectively managed and fully utilized.
IHE test standard: stipulates 5 integration modes of appointment workflow, report workflow, patient information integration, portable image processing and image consistency mark during the transmission of medical image information, covering from patient registration, appointment application, appointment execution, operation Step management, report creation, management and reading, image creation, management, collection and display, and the whole medical service information process. The PACS system that passed the standard test can basically realize the interconnection and intercommunication of the image information of the primary medical institutions.
Metal oxide semiconductor field effect (MOS) transistors can be divided into N-channel and P-channel. P-channel silicon MOS field-effect transistors have two P+ regions on the N-type silicon substrate, which are called source and The drain is not conductive between the two poles, and when a sufficient positive voltage (gate ground) is applied to the source, the surface of the N-type silicon under the gate exhibits a P-type inversion layer, which becomes a channel connecting the source and the drain. . Changing the gate voltage changes the density of the holes in the channel, thereby changing the resistance of the channel. Such a MOS Field Effect Transistor is called a P-channel enhancement type field effect transistor. If the surface of the N-type silicon substrate is free of gate voltage, the P-type inversion layer channel already exists, and the appropriate bias voltage can increase or decrease the resistance of the channel. Such a MOS field effect transistor is referred to as a P-channel depletion field effect transistor. They are collectively referred to as PMOS transistors.
P Channel Mosfet,P Channel Power Mosfet,Field Effect Transistor,Field Effect Transistor Symbol
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