CN111863213A - Bidirectional referral system based on primary-level first-aid screening, bidirectional referral service platform and primary-level first-aid workstation - Google Patents
Bidirectional referral system based on primary-level first-aid screening, bidirectional referral service platform and primary-level first-aid workstation Download PDFInfo
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Abstract
The invention discloses a two-way referral system based on primary-level emergency screening, which is characterized in that a primary-level emergency screening workstation is constructed in a primary-level organization to screen/triage high-risk patients/critical patients, and when the high-risk patients/critical patients are found, a rapid channel referral request is initiated, the rapid channel referral request is forwarded to a pre-stored default referral receiver by a two-way referral service platform, a request result fed back by the default receiver is obtained, and if the request result indicates that the referral is accepted, the primary-level emergency screening workstation is informed that the request is successful; on the other hand, the referral requester, the referral object, the referral receiver and the patient receiving the referral are connected by combining the Internet of things, so that the message can reach the corresponding object in time and can interact. Correspondingly, the invention also provides a corresponding primary emergency screening workstation and a bidirectional referral service platform.
Description
Technical Field
The invention relates to the technical field of medical information processing, in particular to a bidirectional referral system, a bidirectional referral service platform and a primary emergency workstation based on primary emergency screening.
Background
China issued 'guidance opinions about promoting the construction of a hierarchical diagnosis and treatment system' in 2015 and 9 months, the opinions are provided, and by 2020, a hierarchical diagnosis and treatment mode of basic level first diagnosis, bidirectional referral, acute and slow treatment and up-down linkage is gradually formed, so that the hierarchical diagnosis and treatment system conforming to the national conditions is basically established. The classified diagnosis and treatment actually refers to the classification according to the degree of urgency and urgency of diseases and the difficulty of treatment, and medical institutions of different grades undertake diagnosis and treatment of different diseases, so that the medical process from the general department to the specialization is gradually realized. In recent years, a hierarchical diagnosis and treatment system is also vigorously pursued in various parts of China to realize mutual referral in primary hospitals and central hospitals, but the effect is very little, mainly because: on one hand, most of the dominant medical resources are mainly distributed in provincial and urban hospitals, basic equipment is simple and crude, and the medical service capability is low, so that the basic level cannot be fully utilized, and thus the three hospitals are full of patients, the basic level hospitals are peacocky, and a series of problems of difficult and expensive medical care, medical care contradiction and the like occur; on the other hand, the basic information management mechanism is lagged behind, an effective information platform for hierarchical diagnosis and treatment management cannot be formed, and a relatively uniform management module and an information intercommunication platform are not built between a large provincial and municipal hospital and the basic level, so that resource sharing cannot be realized, and quick bidirectional referral cannot be realized.
In view of the above, a bidirectional referral mechanism of a primary hospital and a comprehensive hospital becomes a current research hotspot direction, and a corresponding bidirectional referral method and system are also proposed, for example, chinese patent application 201410559964 discloses a bidirectional referral system, method and platform for a hospital, which stores a health file uploaded by a referral request client by constructing a health file data center, wherein after a bidirectional referral processing module receives a referral request sent by the referral request client, a corresponding referral receiving hospital is automatically matched according to a preset referral principle, and a referral receiver receives the referral request forwarded by a bidirectional referral processing module through the referral receiving client, and calls a health file of a patient from the health file data center to know the illness state of the patient in time after receiving the referral request; chinese patent application 201610046075 discloses a bidirectional referral system and method supporting hierarchical diagnosis and treatment, which realizes the informatization management of hierarchical diagnosis and treatment by forwarding a doctor diagnosis workstation of a hospital, forwarding a PACS system server of a hospital, receiving a PACS system server of a hospital and receiving the forwarded referral message and confirmed referral message of the doctor diagnosis workstation of the hospital. However, all of these two-way referral methods or systems only implement sharing and intercommunication of hospital information to implement two-way referral, but do not mention the construction of the basic emergency medical science and do not mention the screening and grading diagnosis and treatment for patients with chronic diseases.
As mentioned above, the first step of the classified diagnosis and treatment is the primary first visit, which means that urban and rural old people and residents in the working age practice the primary first visit system, and the ordinary outpatient service needs to go to the primary hospital first, and if needs to go to other secondary and tertiary hospitals, needs to go through the primary fixed-point medical institution and then go to the transfer. However, at present, no complete emergency medical science is constructed at the basic level of China, and a corresponding slow disease screening mechanism is not constructed at the basic level.
However, due to the traditional 'home-based care' habit of the people, the living communities and the care institutions such as the senior homes and the dry rest homes gather a large number of elderly people who have a large number of high risk groups and patients of chronic diseases such as cardiovascular and cerebrovascular diseases. According to reports of nutrition and chronic disease conditions of residents in China (2015), it is shown that currently, clearly diagnosed chronic patients exceed 2.6 hundred million people, the mortality rate of chronic diseases of residents in China in 2012 reaches 533/10 ten thousand, the death caused by the chronic diseases accounts for 86.6% of the total death number, and major chronic diseases such as cardiovascular and cerebrovascular diseases, malignant tumors, chronic obstructive pulmonary diseases, diabetes, neuropsychiatric diseases and the like are main causes of death. Particularly, the life style change and the aging of population are predicted to be in a rapid growth state in China for 10-15 years in the future. The patients mainly belong to community hospitals and other base layers for medical service, but the medical equipment of the base layer falls behind and the medical resources are weak, so that the medical requirements of high risk groups of cardiovascular and cerebrovascular diseases and the patients cannot be met, namely the patients cannot be cured by the base layer; also, the acute phase of chronic disease is usually treated in emergency departments. It is predicted that the outpatient volume of medical centers, especially the general outpatient department, will be reduced by 90% in the next 10 years, and in such a background, the emergency treatment system will take important tasks. The pre-examination and triage of the emergency treatment are the first links of the emergency treatment, and the safe and effective pre-examination and triage of the emergency treatment can accurately identify the patients with critical illness, ensure the safety of the patients and improve the operation efficiency of the emergency treatment. Although China is currently advocating the construction and development of the primary emergency medical science, the pre-inspection triage of China is not preposed in the primary medical service institution, so the emergency efficiency is low and the emergency effect is influenced.
Therefore, a hierarchical management mode suitable for emergency patient triage and suitable for the national conditions of China, which is based on the principle that critical care is prioritized and patient-centered service concept and leads emergency triage to the basic medical service organization, is urgently needed.
Disclosure of Invention
Aiming at the technical problems, the invention provides a bidirectional referral server platform based on primary-level first-aid screening.
In order to solve the technical problems, the invention adopts the technical scheme that:
a bidirectional referral service platform based on primary aid screening, comprising:
the acquisition module is used for acquiring a rapid channel referral request sent by the primary emergency screening workstation and acquiring a request result fed back by a default referral receiver;
the referral module is used for forwarding the quick channel referral request to a prestored default referral receiver, and feeding back a notification that the request is successful to the primary emergency screening workstation when the request result is that the default referral receiver indicates that the quick channel referral request is accepted;
the quick channel referral request is initiated through the primary first-aid screening workstation when a screened object/an emergency patient is a high-risk chronic patient/a critical patient according to the acquired screening data/vital sign data by a chronic screening expert/an emergency pre-examination triage staff.
Further, the bidirectional referral service platform further comprises:
the patient management module is used for informing the referral module to forward the quick channel referral request when an instruction that the referral object indicates to approve the referral is acquired from the quick channel referral request;
wherein the instructions indicating approval to referral are added to the quick channel referral request when the primary emergency screening workstation obtains the instructions indicating approval to referral by the referral subject.
Still further, the two-way referral service platform further comprises:
the referral database is used for storing basic information and event states of referral events;
the referral module is further configured to update the event status of each referral event in the referral database in real time, and notify the primary emergency screening workstation, the referral subject, and/or the default referral recipient of the latest event status of the referral event.
The acquisition module is further used for acquiring a rehabilitation referral request initiated by the non-primary institution and a request result fed back by a default primary emergency screening workstation; the patient management module is further used for acquiring a rehabilitation referral list filled by the non-primary institution, forwarding the rehabilitation referral list to a referral object to inform the referral object to confirm whether the referral object agrees to referral, and adding the rehabilitation referral list to the rehabilitation referral request when an instruction that the referral object indicates agreement of referral is acquired;
The referral module is further configured to send the rehabilitation referral request to the default primary emergency screening workstation, and when a request result fed back by the default primary emergency screening workstation indicates that the rehabilitation referral request is accepted, respectively feed back a notification that the request is successful to the referral object and the default primary emergency screening workstation.
Furthermore, the bidirectional referral service platform further comprises:
the system comprises a medical treatment database, a database management system and a database management system, wherein the medical treatment database is used for storing pre-planned medical treatment activity schemes;
and the pushing module is used for pushing the medical examination activity scheme stored in the medical examination database to the referral object and/or the primary emergency screening workstation.
In another aspect of the present invention, there is also provided a primary emergency screening workstation, including:
the data acquisition equipment is used for periodically acquiring screening data of a screened object for a chronic disease screening specialist to screen diseases or acquiring real-time vital sign data of an emergency patient for emergency pre-examination triage personnel to triage;
at least one memory for storing the real-time vital sign data and screening data;
and the primary referral terminal is used for acquiring the screening result/triage result, and when the screening result indicates that the screening object is a high-risk slow patient or the triage result indicates that the emergency patient is a critical patient, initiating a rapid channel referral request to the bidirectional referral service platform and receiving a request result fed back by the bidirectional referral service platform.
Further, the primary emergency screening workstation further comprises:
and the basic-level rehabilitation terminal is used for receiving the referral request initiated by the non-basic-level mechanism and forwarded by the bidirectional referral service platform, acquiring the request result of the basic-level referral receiver and feeding back the request result to the non-basic-level mechanism through the bidirectional referral service platform.
Based on the primary emergency screening workstation and the bidirectional referral service platform, the invention also provides a bidirectional referral system based on the primary emergency screening, which comprises:
the primary emergency screening workstation is used for periodically acquiring screening data of a screened object for screening by a disease screening expert, or acquiring real-time vital sign data of an emergency patient for triage by emergency pre-examination triage personnel, and initiating a rapid channel referral request when the triage result indicates that the emergency patient is a critical patient or the screening result indicates that the screened object is a high-risk slow patient;
the bidirectional referral service platform is used for acquiring the quick channel referral request and forwarding the quick channel referral request to a prestored default referral receiver; and obtaining a request result fed back by the default referral receiving party, and when the request result shows that the quick channel referral request is accepted, informing the primary triage terminal and/or the emergency patient that the referral request is successful;
And the non-primary referral terminal is used for receiving the rapid channel referral request forwarded by the referral service platform, notifying a default referral receiver to confirm whether the request is accepted or not, acquiring a request result fed back by the default referral receiver and forwarding the request result to the referral service platform.
Further, the bidirectional referral system further comprises:
the system comprises at least one referral object terminal, a referral service platform and a primary emergency screening workstation, wherein the referral object terminal is used for receiving a referral order sent by the primary emergency screening workstation, acquiring an instruction of referring to the referral object to approve the referral and sending the instruction to the referral service platform; then the process is repeated accordingly,
the referral service platform is further used for acquiring a referral form filled by pre-examination triage personnel/disease screening experts, forwarding the referral form to a referral object terminal carried by the referral object for the referral object to confirm whether to approve the referral, and adding the referral form to the rapid channel referral request when an instruction that the referral object indicates approval of the referral is acquired.
Still further, the two-way referral service system further comprises:
at least one receiver terminal, configured to receive a referral notification sent by the non-primary referral terminal, obtain an instruction indicating that the receiver agrees to receive a referral, and send the instruction to the non-primary referral terminal; accordingly, the number of the first and second electrodes,
The non-primary referral terminal is also used for generating a corresponding referral notice according to the rapid channel referral request and sending the referral notice to the receiver terminal to inform the receiver of receiving the referral; and when receiving the instruction which is sent by the receiver terminal and indicates that the receiver agrees to receive the doctor, feeding back the instruction to the referral service platform.
Still further, the two-way referral service system further comprises:
the non-primary rehabilitation equipment is used for initiating a rehabilitation referral request to the bidirectional referral service platform;
the basic-level rehabilitation equipment is used for receiving a rehabilitation referral request sent by the bidirectional referral service platform; accordingly, the number of the first and second electrodes,
the patient receiver terminal is further used for acquiring the rehabilitation referral list filled by the patient receiver and forwarding the rehabilitation referral list to the non-primary-level rehabilitation equipment so as to trigger the non-primary-level rehabilitation equipment to initiate a rehabilitation referral request to the bidirectional referral service platform;
the bidirectional referral service platform is further used for acquiring a rehabilitation referral request initiated by the non-primary-level rehabilitation equipment, forwarding the rehabilitation referral request to the default primary-level rehabilitation equipment, and feeding back a notification of successful request to the non-primary-level rehabilitation terminal when the acquired representation fed back by the primary-level rehabilitation equipment accepts the rehabilitation referral request.
The invention has the advantages that:
the invention screens/divides the high-risk slow disease patient/critical patient by constructing a basic-level first-aid screening workstation in a basic-level organization, and when the high-risk slow disease patient/critical patient is found, a rapid channel referral request is initiated, the rapid channel referral request is forwarded to a prestored default referral receiver by a bidirectional referral service platform, and a request result fed back by the default receiver is obtained, if the request result indicates that the referral is accepted, the basic-level first-aid screening workstation is informed that the request is successful; on the other hand, the referral requester, the referral object, the referral receiver and the patient receiving the referral are connected by combining the Internet of things, so that the message can reach the corresponding object in time.
Drawings
FIG. 1 is a functional block diagram of an embodiment of a primary emergency screening workstation of the present invention;
fig. 2 is a functional block diagram of an embodiment of a bidirectional referral service platform based on primary emergency screening according to the invention;
FIG. 3 is a block diagram of an embodiment of a two-way referral system based on primary aid screening according to the invention;
FIG. 4 is a timing diagram illustrating an embodiment of the two-way referral system of FIG. 3 implementing an referral-up;
FIG. 5 is a timing diagram illustrating an embodiment of the bi-directional referral system of FIG. 3 implementing an up-referral and a down-referral;
fig. 6 is a timing diagram of another embodiment of the bidirectional referral system of fig. 3 implementing bidirectional referral and referral downward.
Detailed Description
The present invention will be described in detail below with reference to the accompanying drawings.
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is described in further detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
The term is defined as:
the referral requesting party: the referral requester in the present text refers to the party who initiates referral, and if the primary level initiates a referral request for referral to a superior medical institution, the primary level is the referral requester; if a higher medical institution initiates a referral request to a lower medical institution, the higher medical institution is the referral requester. For example, when the basic level initiates a referral request for referral to the city level central hospital, the basic level is the referral requester; or, when the city level central hospital initiates a referral request for referral to the base level, the city level central hospital is a referral requester.
The receiver of referral: the referral receiving party in the text is the party only receiving the referral, and if the primary level initiates a referral request for referral to a superior/subordinate medical institution, the superior medical institution receiving the referral request is the referral receiving party; if a higher medical institution initiates a referral request to a lower/lower medical institution, the higher medical institution is the referral requester. For example, when the base level issues a referral request for an upward referral to the central hospital in the city level, the central hospital in the city level is a referral receiver; or, when the city level central hospital sends a referral request for referral to the base level, the base level is the referral receiver. As described above, the chronic patient is generally provided with medical services by the basic level, but if the chronic patient is ill once, the basic level cannot be cured, and at this time, the patient needs to be transferred to the comprehensive hospital, so in order to save time, the invention provides a green channel for transferring the patient from the basic level to the city level central hospital, that is, once the chronic patient is found in the basic level, that is, once the substrate finds that the emergency patient needing transferring is marked as a chronic patient, the rapid channel transfer request is directly sent to the preset city level central hospital, and the city level central hospital is the default transfer recipient preset in the transfer service platform.
The patient receiving the treatment: the referrer in this context means a doctor who receives the referral subject and performs treatment for the referral subject after the referral subject reaches the referral recipient.
The data acquisition equipment: the data acquisition device herein refers to various devices for acquiring vital sign data of a patient, and the vital sign data includes various screening data for chronic disease screening, such as vital sign data of blood lipid, blood pressure, etc.
First-aid screening experts: the first aid screening experts herein include chronic disease screening experts, abbreviated as screening experts, and emergency pre-inspection triage personnel, abbreviated as triage personnel, which refer to emergency triage obligators of the infrastructure based on data collected by each screening device. Of course, the screening specialist may also be a triage, and similarly, the triage may also be a screening specialist, such as a doctor who is also a triage of an emergency department at the same time as the screening specialist.
Emergency events: the emergency event in this context refers to the whole event that when the primary emergency screening workstation finds that the emergency patient is a critically ill patient or finds that the screened object is a high-risk slow patient, it determines that the patient needs emergency treatment and initiates a fast channel referral request to the referral object to be treated, and each stage of the emergency event occurs will be in response to the corresponding event status, such as referral request, pending receipt, pending audit, and accepted treatment, wherein the referral request indicates that the referral requester initiates the referral request, but the referral request is not accepted by the referral receiver; the receiving end is ready to receive the information that the referral receiving end has received the referral request but the emergency patient does not arrive yet, so the receiving end is in a state of waiting for the arrival of the emergency patient; the receiving part is received, which indicates that the patient reaches the referral receiving part, and the referral receiving part arranges a corresponding referral personnel for the referral object; the examination and verification result shows that the examination receiving personnel receives the examination receiving notice but does not confirm whether the examination receiving object is received; the patient to be treated shows that the patient receiving personnel already shows that the patient receiving personnel receives the referral object and is about to carry out diagnosis and treatment on the referral object; invalid, indicating that the referrer refuses to receive the referral, or that the emergency event is pending for more than 24 hours.
The core idea of the invention is that a basic-level first-aid screening workstation is constructed in a basic-level organization to screen/triage high-risk patients/critical patients, when the high-risk patients/critical patients are found, a rapid channel referral request is initiated, the rapid channel referral request is forwarded to a pre-stored default referral receiving party by a bidirectional referral service platform, a request result fed back by the default receiving party is obtained, and if the request result indicates that the referral is accepted, the basic-level first-aid screening workstation is informed that the request is successful; on the other hand, the referral requester, the referral object, the referral receiver and the patient receiving the referral are connected by combining the Internet of things, so that the message can reach the corresponding object in time.
Example one
Referring to fig. 1, which is a schematic diagram of a framework of an embodiment of a primary emergency screening workstation of the present invention, specifically, the primary emergency screening workstation of the present embodiment includes:
the data acquisition equipment is used for periodically acquiring screening data of a screened object for a chronic disease screening specialist to screen diseases or acquiring real-time vital sign data of an emergency patient for emergency pre-examination triage personnel to triage;
At least one memory connected with the data acquisition equipment and used for the patient data acquired by the data acquisition equipment and constructing a corresponding patient information base and an emergency screening expert base; the first-aid screening expert database comprises basic information (such as names, departments to which the patients belong, contact information and the like) and medical data (such as registration date and time, registration departments and doctors, vital sign data acquired during emergency treatment, screening data acquired periodically, whether the patients are slow patients or not and the like) of the patients, and the first-aid screening expert database comprises basic information (such as names, departments to which the patients belong, contact information and the like) of each basic level slow disease screening expert and each emergency pre-inspection triage personnel;
and the primary referral terminal is connected with the storage and the data acquisition equipment and is used for acquiring the screening result/triage result, initiating a rapid channel referral request to the bidirectional referral service platform and receiving a request result fed back by the bidirectional referral service platform when the screening result indicates that the screening target is a high-risk slow patient or the triage result indicates that the emergency patient is a critical patient.
Generally, before a primary emergency screening workstation initiates a quick channel referral request, the consent of a referral subject or a family thereof needs to be obtained (for simplicity, the consent of the referral subject or the family thereof is collectively referred to as the consent of the referral subject), specifically, a referral sheet with the referral information written therein can be printed out in a printing mode and confirmed by the referral subject (or the family), and the referral sheet is scanned and uploaded to the primary referral terminal after the consent is signed, so that when the primary referral terminal acquires the referral sheet, the confirmation result of the referral subject can be known, and if the consent is obtained, the quick channel referral request is initiated, as shown in fig. 4; or, the primary referral terminal directly sends the referral list to the referral object terminal carried by the referral object through the internet of things, receives the referral list which is fed back by the referral object terminal and is confirmed by the referral object or family members, obtains the confirmation result of the referral object from the referral list, and initiates a quick channel referral request if the referral object is approved, as shown in fig. 5.
In a specific embodiment, the data acquisition device specifically includes: the identity scanner is used for scanning identity information (such as certificate numbers, names and addresses) and head portrait in the certificate of the screened object/emergency patient, identifying and extracting the identity information and the head portrait, and generating certificate text information and head portrait pictures, so that the problem of fast, accurate and efficient recording of the certificate into a computer information system is solved, the processes of certificate copying and manual recording are replaced, and the working efficiency is improved; various mobile medical devices such as mobile electrocardiographs and portable monitors which are commonly used in various medical institutions are used for realizing real-time acquisition and remote transmission of vital sign data through an Internet of things system; and various intelligent auxiliary equipment, such as intelligent bracelet, time mother clock, first aid time tracker etc. for gather first aid time state data.
Further, in another embodiment, the primary first aid screening workstation further comprises:
the clinical assistant decision system is a robot assistant diagnosis system which is used for combining stroke big data and an artificial intelligence technology and aims at strengthening medical relevant decision and prescription accuracy and improving medical service efficiency and quality. Specifically, the clinical assistant decision system can be integrated on the basic level referral terminal, and the principle is as follows:
Firstly, collecting sample data, and dividing the preprocessed sample data into training data and test data; in a specific embodiment, 200 pieces of information of a front line/a back line of a stroke patient before/after the stroke and prognosis conditions are collected, all data are standardized and normalized, and a vector for discriminant training is formed;
secondly, a chronic disease identification model is constructed by combining a linear machine learning method and a nonlinear deep learning method; in a specific embodiment, a Support Vector Machine (SVM) and a Convolutional Neural Network (CNN) are used to train training data to form a preliminary recognition model;
then, carrying out transfer learning and reinforcement learning by utilizing the formed preliminary identification module, and correcting; in a specific embodiment, test data is used as input of a recognition model, experienced medical staff judges the recognition result of the recognition model, if the recognition result is correct, agreement information is input, if the recognition result is wrong, disagreement information is input, and after a large number of tests, a final chronic disease recognition model is obtained, namely cross validation (cross validation) is carried out by including a new variable in the transfer learning of the SVM, and training can be carried out through the change of a reward-penalty coefficient in an artificial neural network, so that the final chronic disease recognition model is obtained.
Further, in this embodiment, referring to fig. 5 and fig. 6, the primary emergency screening workstation further includes a primary rehabilitation terminal, connected to the storage, and configured to receive a rehabilitation referral request initiated by a non-primary institution and sent by the bidirectional referral service platform, acquire a request result of a rehabilitation referral recipient, and then feed back the request result to the non-primary institution (the default referral recipient as described above) through the bidirectional referral server platform.
Example two
Referring to fig. 2, a schematic diagram of a framework of an embodiment of a bidirectional referral service platform based on primary-level first-aid screening according to the invention is shown, specifically, the bidirectional referral service platform in this embodiment includes:
the acquisition module is used for acquiring a rapid channel referral request sent by the primary emergency screening workstation and acquiring a request result fed back by a default referral receiver;
and the referral module is used for forwarding the quick channel referral request acquired by the acquisition module to a prestored default referral receiver, and feeding back a notification that the request is successful to the primary emergency screening workstation when the request result fed back by the default referral receiver indicates that the quick channel referral request is accepted.
In this embodiment, the fast channel referral request is sent by the primary emergency screening workstation when the slow disease screening specialist/emergency pre-examination triage in the primary emergency screening workstation obtains that the screened object/emergency patient is a high-risk slow disease patient/critical patient according to the collected screening data/vital sign data, and the slow disease screening specialist/emergency pre-examination triage initiates the request through the primary emergency screening workstation and sends the request to the bidirectional referral server platform through the internet of things.
Generally, before the primary emergency screening workstation initiates a quick channel referral request, the consent of the referral subject or family thereof needs to be obtained (see fig. 4 and 5, for simplicity, the consent of the referral subject or family thereof is collectively referred to as the consent of the referral subject), and therefore, the bidirectional referral service platform of the embodiment further comprises:
and the patient management module is used for informing the referral module to forward the quick channel referral request initiated by the primary-level first-aid screening workstation to a pre-stored default referral receiver when the referral object indicates the instruction of agreeing to referral is acquired from the quick channel referral request.
In this embodiment, the bidirectional referral service platform further includes a storage device, which stores basic information of all the primary institutions and non-primary institutions in the area (corresponding primary institution databases and non-primary institution databases may be constructed), and a default referral receiver when each primary emergency screening workstation initiates a quick channel referral request (corresponding database corresponding to a default referral relationship may be constructed, and usually, a plurality of primary emergency screening workstations in close proximity correspond to the same default referral receiver at the same time), so that when the bidirectional referral service platform receives the quick channel referral request sent by the primary emergency screening workstation, the bidirectional referral service platform can automatically query the corresponding default referral receiver according to the basic information of the primary emergency screening workstation and forward the quick channel referral request to the default referral receiver, thereby performing temporary scheduling without a special scheduler, the efficiency of first aid is improved, especially for the high-risk diseases such as cerebral apoplexy which must compete for seconds, the efficiency of first aid is greatly improved.
In this embodiment, the referral object indicates that the granted instruction is pre-carried in the quick channel request. Generally, before the slow disease screening specialist/emergency pre-screening triage will initiate the fast channel referral request through the primary emergency screening workstation, it may have previously obtained the consent of the referral subject (i.e., screening subject/emergency patient), for example, the referral is printed out for confirmation and signature by the referral subject, then scanned for documentation, and added as an attachment to the fast channel referral request; or, a referral order of an electronic file is generated in advance directly through the primary emergency screening workstation, and is filled by a corresponding screening expert/emergency pre-examination triage, and then is sent to a referral object terminal carried by the referral object, then the primary emergency screening workstation obtains a confirmation result (including referral approval or referral rejection) fed back by the referral object terminal through the internet of things, and when the confirmation result indicates referral approval, the primary emergency screening workstation initiates a rapid channel referral request to the bidirectional referral service platform and carries the instruction indicating referral approval.
Further, the memory of the bidirectional referral service platform of the embodiment is also used for storing basic information (such as the address of the first aid, the time of the first aid, the contact person and other basic information) and the event status of the referral event; and the event status of each referral event in the referral database is updated in real time by the referral module, specifically, different event statuses can be respectively marked for the referral requester and the referral receiver, such that when the default referral receiver receives the rapid channel referral request (including referral information) forwarded by the two-way referral service platform, the event status of the referral event is marked as 'to be accepted', when the referral object reaches the default referral relay receiver and the default referral receiver notifies the pre-assigned receiver to accept, the event status of the referral requester is updated as 'to be checked', the event status of the referral receiver is updated as 'accepted', when the receiver checks the corresponding notification and agrees to indicate the accepting, the event status of the referral requester is updated as 'to be accepted', if the receiver indicates to refuse the accepting, updating the status of the event at the referral request side to be invalid (further, the referral event in the "to be referred to" status for more than 24 hours can be automatically marked as invalid); of course, corresponding data can also be constructed according to corresponding event states, such as:
The database for receiving a doctor is used for storing various emergency events in a state of waiting for a doctor;
the accepted diagnosis database is used for storing various emergency events in a 'accepted diagnosis' state;
the database to be audited is used for storing various emergency events in the state of 'to be audited';
and the invalid referral database is used for storing various emergency events in an invalid state.
Furthermore, the referral service platform can also create different databases to be referred to, a database to be audited and an invalid referral database for different referral requesters, namely, each referral requester corresponds to one database to be referred to, one database to be audited and one invalid referral database; of course, a corresponding database can be constructed for different referral recipients.
Of course, when the event status is updated, the referral module also informs the primary emergency screening workstation, the referral subject, the default referral recipient, and/or the referrer of the latest event status of the referral event.
Further, when the patient can perform rehabilitation treatment in the basic institution after the non-basic institution (such as the default referral receiving party) is treated, then the referral needs to be performed downwards, specifically, the non-basic institution can initiate a rehabilitation referral request to the bidirectional referral service platform through its corresponding rehabilitation system/device, and accordingly,
The acquisition module is also used for acquiring a rehabilitation referral request initiated by a non-primary institution and a request result fed back by a default primary emergency screening workstation; specifically, when a referral is made downwards, the referral is returned according to the original path when the referral is made upwards, namely, if a certain primary-level first-aid screening workstation serves as a referral requesting party when the referral is made upwards, a rapid channel referral request is initiated upwards, a non-primary-level mechanism serving as a default referral receiving party of the primary-level first-aid screening workstation is stored in the bidirectional referral service platform, and after a referral object is treated by the default receiving party, the referral is required to be made downwards, and when a rehabilitation referral request is initiated to the bidirectional referral service platform through a rehabilitation system/equipment, the bidirectional referral service platform defaults to take the primary-level first-aid screening workstation as a rehabilitation referral receiving party and forwards the rehabilitation referral request to the primary-level first-aid screening workstation;
the patient management module is also used for acquiring a rehabilitation referral list filled by the non-basic-level institution and forwarding the rehabilitation referral list to the referral object to inform the referral object to confirm whether to approve the referral, and when an instruction that the referral object indicates to approve the referral is acquired, the rehabilitation referral list is added to the rehabilitation referral request;
The referral module is further used for sending the rehabilitation referral request added with the rehabilitation referral list to a default primary emergency screening workstation, and when the request result fed back by the default primary emergency screening workstation indicates that the rehabilitation referral request is received, the referral module respectively feeds back a notification that the request is successful to the referral object and the default primary emergency screening workstation.
Furthermore, in this embodiment, the bidirectional referral service platform further includes:
the system comprises a doctor database, a database and a database server, wherein the doctor database is used for storing doctor activity schemes planned in advance by non-basic institutions;
and the pushing module is used for pushing the medical examination activity scheme stored in the medical examination database to the referral object and/or the primary emergency screening workstation.
Furthermore, in this embodiment, the bidirectional referral service platform further includes:
the comprehensive management module is used for defining different operators and configuring different operation rights for the different operators; specifically, the operator includes an operator at a primary referral terminal, an operator at a non-primary referral terminal, a referral subject, a referral receiving person, a system administrator, and the like.
EXAMPLE III
Referring to fig. 3, a schematic diagram of a framework of an embodiment of a bidirectional referral system based on primary-level first-aid screening according to the invention is shown, and in particular, in this embodiment, the bidirectional referral system includes:
The basic-level first-aid screening workstation is used for acquiring real-time vital sign data of an emergency patient for basic-level pre-examination triage personnel to conduct triage, periodically acquiring screening data of a screened object for a slow disease screening expert to screen, and initiating a rapid channel referral request to the referral service platform when the triage result indicates that the emergency patient is an acute and critical patient or the screening result indicates that the screened object is a slow disease high-risk patient; specifically, the primary first-aid screening workstation of this embodiment adopts the primary first-aid screening workstation of the first embodiment, and the working principles thereof are the same and will not be described herein again;
the bidirectional referral service platform is used for acquiring a rapid channel referral request sent by the primary first-aid screening workstation and forwarding the rapid channel referral request to a preset default referral receiver; and obtaining a request result fed back by the default referral receiving party, and when the request result indicates that the quick channel request is accepted, informing the primary first-aid screening workstation and/or the referral object of successful referral; specifically, the two-way referral service platform of the present embodiment adopts the two-way referral service platform of the second embodiment, and the working principles thereof are the same and are not described herein again;
At least one non-primary referral terminal, which is used for receiving the rapid channel referral request forwarded by the bidirectional referral service platform and informing a pre-allocated receiver to confirm whether to accept the request; and acquiring a request result fed back by the default receiver and forwarding the request result to the bidirectional referral service platform.
Further, the bidirectional referral system of the embodiment further comprises:
at least one referral object terminal, which is used for receiving the referral order sent by the primary-level first-aid screening workstation/non-primary-level institution, acquiring an instruction of the referral object indicating approval of referral and sending the instruction to the primary-level first-aid screening workstation/non-primary-level institution; then the process is repeated accordingly,
the primary emergency screening workstation/non-primary institution is further used for acquiring the referral note filled by the emergency screening expert/the referrer, forwarding the referral note to a referral object terminal carried by the referral object for the referral object to confirm whether the referral object agrees, and adding the referral note to the corresponding rapid channel referral request/rehabilitation referral request when an instruction indicating the referral object agrees is acquired.
Furthermore, the bidirectional referral system of the embodiment further comprises:
the system comprises at least one receiver terminal, a non-primary-level referral terminal and a non-primary-level referral terminal, wherein the receiver terminal is used for receiving a referral notification sent by the non-primary-level referral terminal to prompt a receiver to confirm whether the receiver agrees to receive a referral or not, and sending the instruction to the non-primary-level referral terminal when the receiver indicates that the receiver agrees to receive the referral is obtained; accordingly, the number of the first and second electrodes,
The non-primary layer referral terminal is also used for generating a corresponding referral notice according to the received rapid channel referral request, generating a corresponding referral notice and sending the corresponding referral notice to a pre-distributed receiver terminal carried by a receiver; and when an instruction which is sent by the receiver terminal and indicates that the receiver agrees to receive the doctor is obtained, the instruction is fed back to the bidirectional referral service platform.
Generally, when a patient needs to return to the basic institution for rehabilitation after being treated, a non-basic institution is required to initiate a rehabilitation referral request for referral downwards, so that in another embodiment, the bidirectional referral system further comprises:
the non-primary rehabilitation equipment is used for initiating a rehabilitation referral request to the bidirectional referral service platform;
the basic-level rehabilitation equipment is used for receiving a rehabilitation referral request sent by the bidirectional referral service platform; accordingly, the number of the first and second electrodes,
the receiver terminal is also used for acquiring the rehabilitation referral order filled by the receiver and forwarding the rehabilitation referral order to the non-primary rehabilitation equipment so as to trigger the non-primary rehabilitation equipment to initiate a rehabilitation referral request to the bidirectional referral service platform; specifically, before initiating a rehabilitation referral request, the non-primary referral terminal forwards (can be printed or directly sends an electronic version) the received rehabilitation referral list to the referral object to inform the referral object to confirm whether to approve the referral, and when an instruction that the referral object indicates to approve the referral is obtained, the rehabilitation referral list is added to the rehabilitation referral request and the rehabilitation referral request is sent to the bidirectional referral service platform;
The bidirectional referral service platform is also used for acquiring a rehabilitation referral request initiated by the non-primary-level rehabilitation equipment, forwarding the rehabilitation referral request to default primary-level rehabilitation equipment, and feeding back a notification of successful request to the bidirectional referral service platform when the acquired primary-level rehabilitation equipment feedback indicates that the rehabilitation referral request is received.
Example four
The invention also provides another bidirectional referral system based on primary-level first-aid screening, which comprises the modules in the third embodiment, and the working principles are the same, except that the bidirectional referral service platform in the bidirectional referral system in the embodiment further comprises:
and the statistical analysis module is used for periodically performing statistical analysis on the emergency events and generating a corresponding visual chart. In an embodiment, the period of the statistical analysis may be set to be daily or monthly or time-sharing (e.g. 1, 2, 4, 6, 8h), and the statistical analysis items may be the number of emergency patients, the number of emergency patients in each department, the number of people going in and out of the rescue room (observation), etc., and generate corresponding visual charts, such as statistical charts of the number of emergency patients according to the division pattern analysis of departments, the number of emergency patients according to the time-division pattern analysis of time-division, the number of emergency patients according to the departments, the trend pattern analysis of each department, etc.
Further, in an embodiment, the referral service platform further comprises:
and the printing module is used for acquiring the printing operation instruction and sending the printing control instruction to the external printing equipment to print the selected chart in the printing operation instruction.
EXAMPLE five
The invention also provides another bidirectional referral system based on primary-level first-aid screening, which comprises the modules in the third embodiment, and the working principles are the same, except that the bidirectional referral system in the embodiment further comprises:
the expert database is used for storing the expert information and the corresponding expert terminal information;
the emergency site terminal is used for initiating a site guidance request by emergency personnel on an emergency site; correspondingly, in this embodiment, the referral service platform further includes:
the field guidance expert database is used for storing basic information of the field guidance expert;
and the field guidance module is used for acquiring a field guidance request initiated by the first-aid field terminal and forwarding the field guidance request to the user terminal of the field guidance expert.
The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents and improvements made within the spirit and principle of the present invention are intended to be included within the scope of the present invention.
Claims (11)
1. A two-way referral service platform, comprising:
the acquisition module is used for acquiring a rapid channel referral request sent by the primary emergency screening workstation and acquiring a request result fed back by a default referral receiver;
the referral module is used for forwarding the quick channel referral request to a prestored default referral receiver, and feeding back a notification that the request is successful to the primary emergency screening workstation when the request result is that the default referral receiver indicates that the quick channel referral request is accepted;
the quick channel referral request is initiated through the primary first-aid screening workstation when a screened object/an emergency patient is a high-risk chronic patient/a critical patient according to the acquired screening data/vital sign data by a chronic screening expert/an emergency pre-examination triage staff.
2. The two-way referral service platform of claim 1 further comprising:
the patient management module is used for informing the referral module to forward the quick channel referral request when an instruction that the referral object indicates to approve the referral is acquired from the quick channel referral request;
wherein the instructions indicating approval to referral are added to the quick channel referral request when the primary emergency screening workstation obtains the instructions indicating approval to referral by the referral subject.
3. The two-way referral service platform of claim 1 further comprising:
the referral database is used for storing basic information and event states of referral events;
the referral module is further configured to update the event status of each referral event in the referral database in real time, and notify the primary emergency screening workstation, the referral subject, and/or the default referral recipient of the latest event status of the referral event.
4. The two-way referral service platform of claim 2,
the acquisition module is also used for acquiring a rehabilitation referral request initiated by the non-primary institution and a request result fed back by a default primary emergency screening workstation;
the patient management module is further used for acquiring a rehabilitation referral list filled by the non-primary institution, forwarding the rehabilitation referral list to a referral object to inform the referral object to confirm whether the referral object agrees to referral, and adding the rehabilitation referral list to the rehabilitation referral request when an instruction that the referral object indicates agreement of referral is acquired;
the referral module is further configured to send the rehabilitation referral request to the default primary emergency screening workstation, and when a request result fed back by the default primary emergency screening workstation indicates that the rehabilitation referral request is accepted, respectively feed back a notification that the request is successful to the referral object and the default primary emergency screening workstation.
5. The bi-directional referral service platform of any one of claims 1-4, further comprising:
the system comprises a medical treatment database, a database management system and a database management system, wherein the medical treatment database is used for storing pre-planned medical treatment activity schemes;
and the pushing module is used for pushing the medical examination activity scheme stored in the medical examination database to the referral object and/or the primary emergency screening workstation.
6. A two-way referral system based on primary aid screening, comprising:
at least one primary emergency screening workstation according to any one of claims 1 to 5, for periodically acquiring screening data of a screened object for screening by a disease screening specialist, or acquiring real-time vital sign data of an emergency patient for triage by emergency pre-screening triage personnel, and initiating a fast channel referral request when the triage result is that the emergency patient is a critical patient or the screening result is that the screened object is a high-risk and slow-rate patient;
the bidirectional referral service platform is used for acquiring the quick channel referral request and forwarding the quick channel referral request to a prestored default referral receiver; and obtaining a request result fed back by the default referral receiving party, and when the request result shows that the quick channel referral request is accepted, informing the primary triage terminal and/or the emergency patient that the referral request is successful;
And the non-primary referral terminal is used for receiving the rapid channel referral request forwarded by the referral service platform, notifying a default referral receiver to confirm whether the request is accepted or not, acquiring a request result fed back by the default referral receiver and forwarding the request result to the referral service platform.
7. The two-way referral system of claim 1 further comprising:
the system comprises at least one referral object terminal, a referral service platform and a primary emergency screening workstation, wherein the referral object terminal is used for receiving a referral order sent by the primary emergency screening workstation, acquiring an instruction of referring to the referral object to approve the referral and sending the instruction to the referral service platform; then the process is repeated accordingly,
the referral service platform is further used for acquiring a referral form filled by pre-examination triage personnel/disease screening experts, forwarding the referral form to a referral object terminal carried by the referral object for the referral object to confirm whether to approve the referral, and adding the referral form to the rapid channel referral request when an instruction that the referral object indicates approval of the referral is acquired.
8. The two-way referral system of claim 7 further comprising:
at least one receiver terminal, configured to receive a referral notification sent by the non-primary referral terminal, obtain an instruction indicating that the receiver agrees to receive a referral, and send the instruction to the non-primary referral terminal; accordingly, the number of the first and second electrodes,
The non-primary referral terminal is also used for generating a corresponding referral notice according to the rapid channel referral request and sending the referral notice to the receiver terminal to inform the receiver of receiving the referral; and when receiving the instruction which is sent by the receiver terminal and indicates that the receiver agrees to receive the doctor, feeding back the instruction to the referral service platform.
9. The bidirectional referral system of claim 6 or 7 or 8 further comprising:
the non-primary rehabilitation equipment is used for initiating a rehabilitation referral request to the bidirectional referral service platform;
the basic-level rehabilitation equipment is used for receiving a rehabilitation referral request sent by the bidirectional referral service platform; accordingly, the number of the first and second electrodes,
the patient receiver terminal is further used for acquiring the rehabilitation referral list filled by the patient receiver and forwarding the rehabilitation referral list to the non-primary-level rehabilitation equipment so as to trigger the non-primary-level rehabilitation equipment to initiate a rehabilitation referral request to the bidirectional referral service platform;
the bidirectional referral service platform is further used for acquiring a rehabilitation referral request initiated by the non-primary-level rehabilitation equipment, forwarding the rehabilitation referral request to the default primary-level rehabilitation equipment, and feeding back a notification of successful request to the non-primary-level rehabilitation terminal when the acquired representation fed back by the primary-level rehabilitation equipment accepts the rehabilitation referral request.
10. A primary aid screening workstation, comprising:
the data acquisition equipment is used for periodically acquiring screening data of a screened object for a chronic disease screening specialist to screen diseases or acquiring real-time vital sign data of an emergency patient for emergency pre-examination triage personnel to triage;
at least one memory for storing the real-time vital sign data and screening data;
and the primary referral terminal is used for acquiring the screening result/triage result, and when the screening result indicates that the screening object is a high-risk slow patient or the triage result indicates that the emergency patient is a critical patient, initiating a rapid channel referral request to the bidirectional referral service platform and receiving a request result fed back by the bidirectional referral service platform.
11. The first aid screening workstation of claim 11, further comprising:
and the basic-level rehabilitation terminal is used for receiving the referral request initiated by the non-basic-level mechanism and forwarded by the bidirectional referral service platform, acquiring the request result of the basic-level referral receiver and feeding back the request result to the non-basic-level mechanism through the bidirectional referral service platform.
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